April 2016Vol. 17, No. 2National Commission Delivers Final Report on Child Abuse and Neglect Fatalities

The 2012 Protect Our Kids Act established the national Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) to study and develop recommendations for ending child maltreatment fatalities in this country. The commission has just released its report, Within Our Reach: A National Strategy to Eliminate Child Abuse and Neglect Fatalities, which is the culmination of 2 years of public meetings, research, and input from a host of stakeholders.

The commission, made up of 12 commissioners (6 appointed each by the president and Congress), held 11 public meetings around the country to hear testimony from State and Tribal leaders, child welfare staff, law enforcement, medical professionals, advocates, and parents and families. They also heard from professionals in other safety-conscious industries, like the airline industry. They met with a number of stakeholders, including advocacy groups and government agencies, and they received written testimony from additional organizations and individuals. All of this information, combined with staff research, led to the development of the final report, which includes both findings and recommendations.

The commission learned that as many as eight children die each day from abuse or neglect, although the exact number is not known. The commission also learned that the great majority of these children are infants and toddlers. As many as half are not known to child protective services (CPS) when they die, but almost all have been seen by a medical professional or other adults who might have been in a position to report possible abuse or neglect. In addition, children who have been reported to CPS as possible victims of abuse or neglect (regardless of the disposition of the report) are at especially high risk.

In response to these findings, the report offers 10 major recommendations:

1. Every State should undertake a retrospective review of child abuse and neglect fatalities from the previous 5 years to identify family and systemic circumstances that led to fatalities.
2. Every State should review its policies on screening reports of abuse and neglect to ensure that the children most at risk for fatality—those under age 3—receive the appropriate response, with heightened urgency for those under the age of 1.  
3. The administration should lead an initiative to support the sharing of real-time information among key partners such as CPS and law enforcement.
4. State receipt of funding from the Child Abuse Prevention and Treatment Act (CAPTA) should be contingent on existing child death review teams also reviewing life-threatening injuries (also called "near fatalities") caused by child maltreatment.
5. All other programs—such as Medicaid and home-visiting programs—should be held accountable for ensuring their services are focused on reducing abuse and neglect fatalities.
6. Federal legislation should include a minimum standard designating which professionals should be mandatory reporters of abuse or neglect, and these professionals should receive quality training.
7. The Children's Bureau should be elevated to report directly to the Secretary of the U.S. Department of Health and Human Services, and it should have new responsibilities and authority.
8. Using information from their reviews of fatalities, all States should be required to develop and implement a comprehensive State plan to prevent child abuse and neglect fatalities.
9. Congress should conduct joint committee hearings on child safety, provide financial resources to support States, and encourage innovation to reduce fatalities. While all commissioners agreed that funding is needed to support these efforts, no consensus was achieved on the dollar amount of funding to be provided.
10. Congress should support flexible funding in existing entitlement programs.

The commission's recommendations reflect a public health approach to child safety that engages a broad spectrum of community agencies and systems to identify, test, and evaluate strategies to prevent harm to children. This approach is based on three interrelated core components: improved leadership and accountability, decisions grounded in better data and research, and multidisciplinary support for families.

Though the commission's work has concluded, it is hoped that the report and its recommendations, if implemented, lead to an end to child maltreatment fatalities in this country.

To read the commission's report, go to https://www.acf.hhs.gov/programs/cb/resource/cecanf-final-report.

For more information on CECANF, visit https://eliminatechildabusefatalities.sites.usa.gov.