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Administration for Children and Families

Administration on Children, Youth and Families

Children’s Bureau

Child Welfare Information Gateway

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Email: info@childwelfare.gov

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Reducing Re-referral in 

Unsubstantiated Child 

Protective Services Cases

Research to practice

June 2003
This document was made possible by the Children’s Bureau, Administration on Children, 

Youth and Families, Administration for Children and Families, U.S. Department of Health and 

Human Services. The conclusions discussed here are solely the responsibility of the authors and 

do not necessarily represent the views of the researchers. Suggested citation: Child Welfare 

Information Gateway (2003). Reducing Re-referral in Unsubstantiated Child Protective Services 

Cases: Research to Practice. Washington, DC: U.S. Department of Health and Human Services.
Reducing Re-referral in Unsubstantiated Child Protective Services Cases

 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at www.childwelfare.gov/pubs/focus/researchtopractice/.

www.childwelfare.gov

The decision not to substantiate a child protective services (CPS) referral does not necessarily guarantee a child’s safety from future 

harm. Many of the children in unsubstantiated 

cases are eventually the subjects of subsequent CPS referrals. In seeking to improve 

safety outcomes for these children, however, 

child welfare leaders face a daunting list of 

challenges that may compromise decisionmaking and the ability to ensure child safety. 

This paper identifies strategies to reduce rereferral in unsubstantiated cases. 

These suggestions for practice are based on 

the findings of three research grants funded 

by Children’s Bureau to explore decisionmaking and outcomes in unsubstantiated 

CPS cases. (See Appendix A.) The findings 

are synthesized in more detail in the Child 

Welfare Information Gateway publication, 

Decision-Making in Unsubstantiated Child 

Protective Services Cases: Synthesis of Recent 

Research, available from Information Gateway 

at 800.394.3366 or info@childwelfare.gov. 

While the studies do not represent a national 

sample, they do provide some thought-provoking findings practitioners and administrators may want to consider as they build and 

refine child welfare programs for this population. The suggestions for practice discussed 

	 The meaning and use of the terms “substantiated” and

“unsubstantiated” vary by State. For the purposes of this

document, “substantiated” means there is reasonable

cause to believe the child has been abused or neglected.

“Unsubstantiated” means no maltreatment occurred or there

was insufficient evidence under State law or agency policy to

conclude that the child was maltreated. Some States require the

caseworker to determine not only whether a specific incident of

abuse or neglect occurred, but also whether the child is at risk 

of future maltreatment, in making the decision to substantiate or

unsubstantiate a referral.

	 For the purposes of this document, the term “re-referral”

is used to indicate any situation in which a CPS case (whether

initially substantiated or not) returns to the system for a second

or subsequent referral.

here are those of Information Gateway and are 

not necessarily endorsed by the researchers. 

Summary of Key Research

Findings

Factors That Influence CPS DecisionMaking About Case Disposition

The researchers generally agreed that factors 

related to the case, child, and family circumstances all are significant to decision-making 

in CPS cases. However, the context for CPS 

decision-making is complex, and other factors 

(such as those related to caseworker characteristics, the organizational environment, and 

State laws and policies) were also found to 

influence these decisions.

Some of the research findings regarding 

factors influencing CPS decision-making 

include:

Multiple risk factors. In one study, when 

risk factors were found in more than five 

different categories (such as child characteristics, caretaker characteristics, social and 

economic factors), the likelihood of a substantiated finding for that case increased 

significantly.

Prior referrals. In general, cases with 

prior referrals were more likely to be 

substantiated.

Neglect. In one study, caseworkers indicated they were least likely to substantiate 

referrals for neglect.

	 English I, p. 115.

	 Fluke, p. 109, 115.

English II, p. 98.

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State policies. States with options for 

decision-making that acknowledged uncertainty about the occurrence of maltreatment, such as “unable to determine” or 

“insufficient evidence,” were found to have 

lower proportions of unsubstantiated cases. 

Researchers suggest that this may indicate 

that ambiguous cases are recorded in these 

categories when States have them available, while in States with only two options 

those ambiguous cases may be more likely 

to be recorded as unsubstantiated. Also, 

the proportion of unsubstantiated cases 

tended to be higher in States where the 

evidence threshold to substantiate a case 

was higher.

Case Factors That Influence

Re-referral

In general, substantiated or inconclusive 

cases were found to be more likely to re-refer 

than unsubstantiated cases. However, initially 

unsubstantiated cases accounted for the 

greatest number of children returning as a rereferral. One study also found that one-third of 

cases classified as inconclusive or unsubstantiated re-referred within 12 months of the last 

investigation. Some of the factors found to 

influence re-referral include:

Neglect. Initially substantiated neglect 

cases were found to be highly likely to 

re-refer.

Younger children. In both initially substantiated and unsubstantiated cases, younger 

children were more likely to be re-referred 

	 Fluke, p. 32, 45.

	 Fluke, pp. 33-34.

English, p. 119.

Drake, p. 134.

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to the system for all types of maltreatment 

except sexual abuse.10

Perpetrator factors. In both initially substantiated and unsubstantiated cases, 

younger perpetrators, parent perpetrators 

(for most maltreatment types), and families 

with fewer financial resources were found to 

re-refer at higher rates.11

Impact of Services on Re-referral

The research found that families whose cases 

were substantiated were more likely to participate in services actively and use them 

effectively.12 Services were found to reduce 

re-referral. Some examples:

Neglect cases. Although neglect cases 

were found to be highly likely to re-refer, 

any form of services was found to reduce 

the likelihood of re-referral.13

Child fatalities. In at least one small 

sample, all cases that later returned as child 

fatalities were found to have received no 

services after the initial finding (whether 

substantiated or unsubstantiated).14

Type of service. One study compared the 

outcomes of family preservation services 

(brief, intensive, in-home services provided to families at greatest perceived risk 

for foster care placement) with what the 

researchers referred to as “family-centered 

services” (less intensive, in-home services 

provided, over several months, to families 

at lower risk for out-of-home placement) 

and foster care (out-of-home services). In 

that study, family-centered services and 

10 Drake, p. 142.

11 Drake, p. 143; English III, p. 63.

12 English, p. 42.

13 Drake, p. 134.

14 Drake, p. 168.

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Reducing Re-referral in Unsubstantiated Child Protective Services Cases

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Information Gateway. Available online at www.childwelfare.gov/pubs/focus/researchtopractice/.

www.childwelfare.gov

foster care were found to reduce the risk of 

re-referral significantly. Family preservation 

services were found to be associated with 

a greater likelihood of re-referral involving eventual out-of-home placement.15 It 

is important to note, however, that family 

preservation services were designed to 

provide intensive short-term services to 

families at imminent risk of having a child 

removed. Caseworkers providing family 

preservation services, who are with a family 

so frequently, may be more likely to identify 

risk factors too great to permit the child to 

remain safely in the home. In this case, rereferral may actually indicate a higher, not 

lower, level of protection for the children.

Length of service provision. Among families who received any type of services, the 

longer it had been since the service ended, 

the more likely a family was to experience 

re-referral. One study found that increasing 

the duration of foster care (up to a total of 7 

to 11 months) was associated with lower rereferral rates following reunification.16 This 

may suggest that the longer services are 

provided, the more effective they will be.

Kinship care. Among children who entered 

foster care, those who exited to a relative’s care experienced a reduced risk of 

re-referral.17

Implications for Practice

Research suggests that a case finding of 

unsubstantiated does not necessarily mean no 

child maltreatment occurred—other factors, 

15 Drake, pp. 141-142.

16 Drake, p. 151.

17 Drake, p. 152.

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including State policy regarding required 

levels of evidence, play a role. Some at-risk 

children and families who come to the attention of the child welfare system and who are 

in need of services are not receiving services 

because of a finding of unsubstantiation. 

Research also points to identifiable factors that 

put families at greater risk (such as younger 

parents and those with fewer resources). Using 

knowledge gained from research to target 

services to these families may help agencies 

maximize the impact of limited resources. 

This approach also can be used to develop 

targeted preventive services (such as a home 

visiting program for very young parents who 

lack support systems) that may keep families 

from ever being referred to the child welfare 

system in the first place. 

The following are some examples of strategies 

that are suggested by the research findings 

and the work of experienced child welfare 

practitioners. These suggestions may help 

agencies more effectively target services to 

children and families who need them most. 

Some of these strategies have not yet been 

formally tested or validated; more research will 

be needed to determine if they lead to better 

outcomes for children and families, and under 

what circumstances. 

Assess Risk More Effectively

Better outcomes for families may result when 

an assessment of risk, rather than an investigation of a specific alleged maltreatment 

incident, drives service provision. Research 

findings about the impact of case factors on a 

child’s risk of harm can be used in a variety of 

ways to improve practice and achieve better 

outcomes for children. While the issue of 

safety was not addressed specifically in these 
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research studies, assessing safety and developing safety plans (along with risk assessment) 

will further enhance the protection of children. 

Some of the following suggestions about 

risk assessment might also apply to safety 

assessment:

Use a risk assessment instrument. In light 

of the number of risk factors and other 

concerns caseworkers must keep in mind, 

effective risk assessment instruments help 

caseworkers avoid overlooking critical 

items. A number of instruments are now 

available. Agencies are encouraged to 

consider those based upon research and 

continually evaluated and refined as new 

research emerges. 

Assess risk throughout the life of the 

case. Whatever tool is used, assessing children and families throughout the life of a 

case, not just during an initial investigation, 

will help caseworkers evaluate the success 

of interventions and ensure more positive 

outcomes for children. 

Provide ongoing risk training. 

Caseworkers will need training to understand what will be, for some, a significant 

philosophical shift from an incident-based 

system to a risk-based system. Ongoing 

training on issues such as how to engage 

clients in services or how to assess the interaction of individual risk factors in a specific 

family situation is recommended. 

Ensure independent internal review of 

high-risk cases. Certain high-risk cases 

identified in the research (e.g., multiple 

prior referrals, younger child) may benefit 

from an additional agency reviewer. 

Create an agency risk specialist. Some 

agencies dedicate a skilled staff member 

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to deal solely with risk issues. These staff 

members serve as consultants to caseworkers and others in the agency, review 

high-risk cases, and provide informal and 

ongoing training. 

Provide Services to At-risk Families

in Unsubstantiated Cases

Some families who need and are likely to benefit 

from services do not receive them because the 

system does not provide resources for offering 

services to families in unsubstantiated cases. 

Some States are finding creative ways to ensure 

that services are available to these families, 

including:

Create a third dispositional category. At 

least 14 States offer a third dispositional 

category (such as “inconclusive” or “unable 

to determine”) for cases that can be neither 

substantiated nor unsubstantiated.18

Families whose cases fall into this third 

category may be more likely to participate 

in supportive services, when offered, than 

families whose cases are unsubstantiated. 

Employ an alternative response model. 

In these models (sometimes called “dual 

track” or “flexible response” models), a 

decision is made at intake or screening to 

send cases with less risk to a more serviceoriented track and cases with more identifiable risk to a more traditional investigative 

process. As a result, agency staff is able to 

devote more attention to investigating critical cases, while low-risk cases are offered 

voluntary services. 

Use volunteers. Provision of formal therapy 

by a professional is critical in some cases, 

especially where significant mental health 

18 Fluke, p. 25.

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Reducing Re-referral in Unsubstantiated Child Protective Services Cases

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issues are involved. However, in many 

cases, services could be provided by welltrained volunteers who may be better 

received by families as “friendly visitors.” 

Many faith- and community-based organizations have the resources to provide space 

and volunteers for such programs. Child 

welfare agencies could provide leadership 

and training. Despite start-up costs, these 

services often prove cost effective for agencies in the long term. Services provided by 

volunteers also mean more services available to more families, and families offered 

services in this way may be more likely to 

engage in them.

Provide the Appropriate Service

There is no “cookie cutter” model that works 

for all types of cases or all families. Models 

tailored to specific types of abuse or neglect, 

or models that acknowledge that cases of one 

type frequently re-refer as a different type, 

may prove more effective. (The type of maltreatment alleged in second or subsequent 

referrals is most often neglect, regardless of 

the type of maltreatment alleged in the initial 

referral.19) Families often have needs that are 

far beyond the specific incident for which 

they are referred to the CPS agency. Ideally 

all services would be designed to be familycentered, as this model has been found to be 

more effective. Strategies may include:

Re-think services for neglect. Research 

findings regarding the prevalence of rereferral in neglect cases suggest that more 

services may need to be developed specifically to address the multiple needs in 

neglect cases. For example, researchers in 

one study suggest concrete services (e.g., 

providing food, paying utility bills, providing 

19 Drake, p. 154.

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clothing) alone, without associated supportive services (e.g., counseling, parenting 

classes) and training to use concrete services appropriately, may not be productive 

with this population.20

Provide longer-term services. Research 

indicates that longer-term services may be 

more effective. To expect significant change 

in the very short period of a few weeks 

may be expecting too much too quickly. 

Breaking the cycle of child abuse and 

neglect may take more time.

Support kinship care. Children in kinship 

care retain family ties and, according to the 

research, are less likely to be re-referred to 

the child welfare system. More resources 

are needed to help relatives caring for 

children. Such resources might include 

financial grants, medical insurance, child 

care, and support services. Some agencies 

designate a small number of caseworkers as 

kinship specialists whose role is to develop 

resources, provide support groups, and 

link caregivers to existing resources. Other 

agencies have hired actual kinship caregivers to provide supportive services as relative 

advocates. 

Conclusion

In seeking to protect children, child welfare 

leaders must negotiate numerous challenges 

including high caseloads, frequent staff turnover, limited services, and ethical dilemmas. 

The findings of the research studies from 

which these practice implications were drawn 

suggest there are strategies that can improve 

child outcomes despite limited staff and 

20 Drake, p. 184.

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financial resources. Finding ways to assess risk 

more effectively, provide services to high-risk 

families whose cases are unsubstantiated, and 

provide the specific services needed by each 

individual family may help agencies maximize 

the impact of their resources and ensure that 

the right services are available to assist families and protect the safety of children. 

Appendix A: Research Studies on Unsubstantiated CPS Cases

Factors That Influence the Decision Not to Substantiate a CPS Referral; Phase I: Narrative and 

Empirical Analysis (English I); Phase II: Mail and Telephone Surveys of Child Protective Services 

Social Workers (English II); Phase III: Client Perceptions of Investigation (English III)

Grantee: State of Washington Department of Social and Health Services

Principal Contact: Diana J. English

Other Researchers: J. Christopher Graham, Sherry C. Brummel, Laura K. Coghlan, Tim Clark

The Dynamics of Unsubstantiated Reports: A Multi-State Study (Fluke)

Grantee: The American Humane Association

Principal Contact: John D. Fluke

Other Researchers: Cynthia F. Parry, Patricia Shapiro, Dana Hollinshead, Vicky Bollenbacher, 

Donald Baumann, Karen Davis-Brown

Recidivism in Child Protective Services Among Substantiated and Unsubstantiated Cases (Drake)

Grantee: Washington University, George Warren Brown School of Social Work

Principal Contact: Brett Drake

Other Researchers: Melissa Jonson-Reid, Ineke Way, Sulki Chung