Effect of Connecticut CAPTA Implementation on Racial Disparities in Infants Reported to DCF

Background/Purpose: The issue of racial disparities in hospital reports to child protective services (CPS) of infants with prenatal substance exposure (IPSE) lacks consensus in existing studies. While some research suggests higher reporting rates for Black and Native American infants at birth, other data indicates that, when accounting for other risk factors, White infants are reported more frequently. Standardization in hospital practices regarding the identification and referral of IPSE has been proposed as a solution to ameliorating racial disparities. In 2019, Connecticut implemented a statewide policy to achieve this standardization, offering an opportunity to assess its impact on racial disparities in newborn maltreatment reports involving IPSE.

Research Questions:

• What is the rate per 1,000 births of DCF reports due to IPSE before and after Connecticut CAPTA implementation for infants of Black and non-Black mothers?
• What is the rate per 1,000 births of foster care placements before and after Connecticut CAPTA implementation for infants of Black and non-Black mothers?

Methods: This study employs a difference-in-differences identification strategy, with the Connecticut CAPTA policy as the treatment and rates of DCF reports due to IPSE and foster care placements as outcomes. Data from April 1, 2017 to July 30, 2022 on all infants born in Connecticut hospital to low-income mothers were analyzed. The final sample included 69,019 infants. Data for this study were abstracted from the Connecticut DCF child welfare and Department of Public Health (DPH) birth records. DCF data contained the outcome variables and DPH data contained control variables and the total number of births during the study time frame. Difference-in-difference regressions for each outcome were performed, controlling for alcohol and tobacco use during pregnancy, prenatal care, Neonatal Abstinence Syndrome (NAS), and child birth year.

Results: After Connecticut CAPTA implementation, the rate of DCF reports due to IPSE decreased for Black infants by 0.07 percentage points compared to their non-Black counterparts (p<.10). Being Black was associated with an increased likelihood of a DCF report due to IPSE. However, the policy did not significantly affect the rate of foster care placement for Black infants, resulting in only a 0.01 percentage point increase.

Conclusions and Implications: The policy’s impact on reducing racial disparities in reporting rates was minimal and possibly influenced by data limitations or unmeasured causal mechanisms. Furthermore, the policy did not alter foster care placement rates for Black infants. These findings underscore the complexity of addressing racial disparities in CPS reporting and the need for continued efforts to develop effective interventions.