Child abuse is not inevitable, but preventable — local policy changes prove that

When the federal Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) began its effort to develop a national strategy to eliminate child maltreatment fatalities, we knew the challenging task we were facing. Few, if any, evidence-based interventions existed that were shown to prevent fatalities and neglect.

However, despite these challenges, at the conclusion of our two years of research, study, review and deliberations, we were able to identify a framework for reform and a new vision for a 21st century child welfare system.

{mosads}Our report, which was issued in March 2016, identified 114 recommendations encompassing three interrelated core components: improving leadership and accountability, grounding child protection decisions in better data and research, and enhancing multidisciplinary support for families.

The question we ask ourselves today is: What, if anything, has changed since the commission issued its findings and recommendations?

Surprisingly, the answer is that there have been a tremendous amount of progress and change, and the majority of those reforms are being driven at the local level by the actions of nonprofits, local, county and state agencies and collaborations between previously siloed organizations.

Perhaps most significantly is the shifting view that child abuse and neglect fatalities are not inevitable, but are in fact preventable, and that steps can be taken today to save children’s lives.

Just this month, the Within Our Reach office and the Children’s Advocacy Institute at the University of San Diego’s School of Law released a follow-up report Steps Forward, that finds significant policy and practice changes taking place across the U.S., in all 50 states, that are consistent with strategies the commission put forth.

The Steps Forward report identified 180 different child maltreatment fatality prevention efforts at the state and county levels. Some examples of activities targeting prevention include:

• Eight states (Alabama, Oregon, Wisconsin, Tennessee, West Virginia, Virginia, Maryland, and Kentucky) are developing state fatality prevention plans with the support of technical assistance from the Three Branch Institute on Improving Child Safety and Preventing Child Fatalities.
• Seven states (Alaska, Connecticut, Florida, Illinois, Indiana, Maine and Oklahoma) are working to implement Eckerd Rapid Safety Feedback, a unique process highlighted in the Commission report that relies on real-time data analytics to flag high-risk child protection cases for intensive monitoring and caseworker coaching.

Some jurisdictions have pioneered new approaches. In Monterey County, California, the Monterey County Department of Social Services (DSS) became the first in the nation to use the Commission’s recommendations as a basis for local strategic planning and action.

In partnership with the American Public Human Services Association (APHSA) and guided by the Commission’s recommendations, they developed a roadmap to child well-being with a goal of identifying resources and services geared toward prevention, and strengthening knowledge of child abuse and neglect reporting.

In Ohio, through a $1 million grant from the Ohio Attorney General’s office, they developed a Timely Recognition of Abusive Injuries (TRAIN) Collaborative, which works with physicians and hospitals to pay special attention to a list of more than 50 “sentinel injuries” (minor injuries that could be potential warning signs of abuse) when children are brought into emergency departments.

Minnesota launched a Native American Equity Project seeking to research the causes that result in a disproportionate number of Native American children in the state’s foster care system.

Minnesota has one of the highest rates of out-of-home care for Native American children in the country. On its own initiative, the Minnesota Department of Human Services (DHS) entered into a contract with the University of Minnesota, Duluth for a three-year pilot.

These are just a few examples of the many innovative, evidence-based activities being undertaken at the local, county and state level. It is hoped that these policy and practice changes can help inform efforts among federal policymakers to shift legislation focus and funding to prevention and multidisciplinary coordination.

We have seen some early signs that are promising. Congress has passed two pieces of legislation that relate to the Commission recommendations and fatality prevention: The Comprehensive Addiction and Recovery Act of 2016 (CARA), which includes a provision for infant plans of safe care and Talia’s Law which requires mandated reporters within the Department of Defense to report known or suspected child maltreatment to state CPS agencies.

In addition, the bipartisan Child Welfare Oversight and Accountability Act was introduced in 2017, proposing enhanced enforcement of child welfare law, strengthening reporting requirements for child maltreatment fatalities, requiring multidisciplinary public annual reports on fatalities, and encouraging states to adopt guidelines for caseworker training and caseload limits.

The Child Abuse and Prevention Treatment Act (CAPTA), which is up for reauthorization, is central to a considerable number of the commission’s findings and could be a conduit for many of the policy and practice changes now occurring at the local and state level.

Collectively, these actions represent an essential shift to adopt a public health approach to child safety predicated on prevention and community-level support that aligns and leverages existing resources to prevent crises before they occur.

We hope these steps forward will continue to build a groundswell of change and provide the momentum toward realizing our nation’s goal of protecting vulnerable children from abuse and neglect.

Teri Covington is executive director of the Within Our Reach office at the Alliance for Strong Families and Communities. She previously served on the federal Commission to Eliminate Child Abuse and Neglect Fatalities and as Director of the National Center for Fatality Review and Prevention and the Michigan Public Health child death review panel.