Are In-Home and Foster Care Services Associated With Risk of Maltreatment-Related Fatality and Near Fatality Following a Child Protection Case? Evidence From Pennsylvania

Many children who experience child maltreatment fatalities (CMF) or near fatalities (CMNF) are previously known to the child welfare system (CWS). Although in-home services and foster care (FC) are tools for preventing CMF/CMNF, relatively little research has examined how each is associated with subsequent CMF/CMNF. Using a nested case-control design and linked administrative data from Pennsylvania, this study examined how in-home services and FC following an initial CWS case were associated with the odds of future CMF and CMNFs (n = 171 cases and 777 controls). Relative to receiving no services, in-home services were not associated with reduced odds of CMF/CMNF (OR = 1.27, p = 0.201), whereas FC was associated with lower odds (OR = 0.54, p = 0.061), though this association did not reach statistical significance at p < .05. Relative to in-home services, FC was significantly associated with 58% lower odds of CMF/CMNF (OR = 0.42, p = 0.010). Although replication with larger samples is needed, findings suggest that FC, but not in-home services, is associated with reductions in CMF/CMNFs in the years following CWS involvement.