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December 2020Vol. 21, No. 9Stronger Communities, Safer Families, Zero Fatalities

Written by Amy Harfeld, National Coalition to End Child Abuse Deaths, Children's Advocacy Institute

In 2016, the Federal Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) concluded its tenure and issued a report setting forth a robust set of recommendations that resonates today more than ever. The report began with a vision:

Imagine a society where the safety and well-being of children are everyone's highest priority and federal, state, and local agencies work collaboratively with families and communities to protect children from harm. Imagine a society where all children are equally protected and their families equally supported, regardless of race, ethnicity, income, or where they live. Imagine child welfare in the 21st century...where children are safe and families are strong and where prevention of child abuse and neglect deaths is a reality.

This realignment is now underway. Greater emphasis on multidisciplinary primary prevention, implementation of new federal laws and policies aimed at keeping families together, and earnest efforts to dismantle deeply rooted racial inequity are beginning to shape a more just, kind, and effective child welfare system. Not only will this lead to fewer families facing unnecessary child protective services (CPS) interaction, it will allow child welfare workers to better focus their expertise on the children and families most in need and intervene more appropriately to address or prevent harm when necessary.

As we transition to a Biden-Harris administration and a new Congress, this work must continue while acknowledging the full continuum of child maltreatment. Close to two-thirds of the 678,000 confirmed CPS cases in 2018 involved neglect. With earlier support, many families on this end of the spectrum could and should have avoided CPS involvement. But the spectrum of maltreatment does not end with neglect. The other third of victims—225,096 children—comprised the 10.7 percent who were physically abused, the 7.0 percent who were sexually abused, and the 15.5 percent who suffered two or more types of maltreatment.

At the edge of the spectrum are the children who don't survive—the 1,770 infants and children who died as a result of abuse or neglect. That's one child killed every 5 hours...that we know about. Leading data experts believe the real number of fatalities to be three to four times higher. The racial disproportionality that pervades child welfare seeps through to this end of the spectrum as well, with Black children being 2.8 times more likely than White children to suffer fatal abuse.

Reviewing a daily national news digest of child abuse fatalities is a necessary but heartbreaking part of coordinating the National Coalition to End Child Abuse Deaths (NCECAD). It is very effective in fueling a continued sense of urgency to prevent the next senseless death and ensuring that ongoing efforts to transform our child protection system fully consider this end of the spectrum. It is this urgency, combined with an awareness of the total lack of political capital of children who suffer fatal and near-fatal abuse, that drives the committed and relentless work of the NCECAD. 

Yet a parallel newsfeed on child welfare innovations provides ongoing inspiration and an important reminder of the many promising efforts across the country to improve child protection and prevent the next death. In the first 2 years after CECANF's tenure, a report by the Children's Advocacy Institute and Within Our Reach at the Alliance for Strong Children and Communities found that every U.S. state had voluntarily adopted at least one of the CECANF's recommendations, reflecting more than 180 different efforts across federal, state, and community levels. Since that time, innumerable innovations have continued to advance across the spectrum.

Allegheny County (PA) launched Hello Baby, a voluntary parent-driven program to provide families with a wide range of supports, including postpartum mental health care, in-home visitation, and diapers and food. Los Angeles implemented the E-SCARS system, which enables thoughtful real-time data sharing between CPS and law enforcement. New geospatial predictive risk modeling by Predict-Align-Prevent identifies where child maltreatment and fatalities are most likely to occur—without profiling individuals—and strategically aligns resources where they are most needed. Thriving Families, Safer Children, a first-of-its-kind public-private partnership between the Children's Bureau, Casey Family Programs, the Annie E. Casey Foundation, and Prevent Child Abuse America is launching pilots with the ambitious goal of redesigning traditional, reactive child welfare systems into child and family well-being systems meant to prevent maltreatment.

At the federal level, the U.S. Department of Justice's demonstration initiative, Child Safety Forward, is developing multidisciplinary strategies and responses to address near-death injuries from neglect and reduce the number of child fatalities. The White House issued an Executive order this year calling for national standards on risk and safety assessments and encouraging prepetition legal representation for children and parents to protect rights and enhance safety. The U.S. Senate introduced bipartisan legislation, the Child Abuse Death Disclosure Act, which would require states to develop statewide fatality prevention plans, create a national standard definition of child abuse and neglect fatalities, and enhance training for child death review teams to address racial disparities. All of these developments reflect the strategy and recommendations of the CECANF.

As the nation pushes through unprecedented economic and public health crises with still-unknown consequence to children, continued pressure and further short- and long-term reforms are still urgently needed. The NCECAD remains determined to push fatality awareness and prevention as central to a smarter, more compassionate, and equitable child welfare system that strengthens families to keep children safe and thriving.

The strategic framework of the CECANF continues to provide a sound roadmap for the work ahead:

  • Enhance multidisciplinary primary and secondary prevention services for children and families such as mental health services, substance use disorder treatment, housing, child care, education, and home visiting.
  • Support the child welfare workforce by establishing reasonable caseload standards and improved management and supervision.
  • Ground child protection decisions in better data and research by enhancing equity-informed real-time data sharing and cross-notification between law enforcement, health-care providers, CPS, and others.
  • Improve the quality, consistency, and reliability of data on fatalities and near-fatalities.
  • Establish a national standard definition of child maltreatment fatalities and near fatalities.
  • Ensure the advancement of tailored and data-informed state fatality prevention plans required by the Family First Prevention Services Act.
  • Improve leadership and accountability by demanding significant increases in funding and appropriations for federal child welfare laws, such as the Child Abuse Prevention and Treatment Act, and safety net programs.
  • Press for more robust oversight and enforcement of federal law by the Administration for Children and Families and greater accountability by states.
  • Review and clarify the roles of mandatory reporters and invest in improved training.

A long-awaited and hard-fought transformation of child welfare is underway and moving in the right direction. Ensuring the continuation of this work to strengthen families and keep children safe at home will require nothing short of relentless advocacy across stakeholder communities and a shared belief that one child maltreatment fatality will always be one too many.