The Commission to Eliminate Child Abuse and Neglect Fatalities continued their deliberations last week with a two day discussion in Virginia just outside of Washington DC. Based on the public discussions, members continued to disagree and debate what should be included in a final package of proposals that will go to the Administration, the Congress and ultimately the general public. The final report is due sometime early next year. The task is not easy since there are challenges on how to best prevent child deaths that officially total approximately 1600 each year. Those numbers, which many believe are a severe undercount, includes just those fatalities to children known to child protection and do not include some other systems such as hospital reports unconnected to child protection.
The Commission has issued a white paper, A Path Forward: Policy Options For Protecting Children From Child Abuse And Neglect Fatalities which will help shape final recommendations. Within the whitepaper which is still being debated, discussed and generating feedback are broad sweeping recommendations including:
- Transfer Congressional jurisdiction of the Child Abuse Prevention and Treatment Act (CAPTA) and integrating it into Title IVE of the Social Security Act. (Editor’s note: CAPTA is authorized by the Senate HELP and House Education and Workforce committees while Title IV-E and IV-B foster care, adoption assistance and flexible B programs are under the jurisdiction of Senate Finance and House Ways and Means)
- Create a coordinating interagency council to focus federal efforts to reduce child abuse and neglect fatalities co-led by the HHS, Department of Justice with membership agencies sharing responsibility of protecting children from harm and serving families in need.
- Hospital licensing requirements through Medicaid and Medicare should include compliance measures on child safety, specifically Plans of Safe Care and Birth Match.
- Congress should direct the administration to establish a national research agenda focused on eliminating child abuse and neglect fatalities. A centerpiece of this research agenda should be support for a Federally Funded Research and Development Center (FFRDC) on child abuse and neglect fatalities.
- The administration should spearhead a special initiative to support state entities engaged in protecting children, such as law enforcement and CPS, to support them in sharing real-time electronic information on children and families with each other via the use of data standards and electronic exchanges.
More specifically the paper outlines a series of narrower recommendations which the Commission is currently discussing for final inclusion. During Monday and Tuesday’s public hearing there was a great deal of debate on specific ideas and recommendations including a discussion of what funding request should be submitted to Congress if at all. The commission is also continuing to receive feedback but time is running short on what has been a two year process that has included numerous public hearing across the United States.
As the commission paper notes,
“Analyses of child death review reports showed that family configuration, social isolation, lack of support, maternal youth, marital status, domestic violence, substance abuse, poverty and parenting practices are associated with increased risk of child fatality from abuse or neglect. Children residing in households with unrelated adults were more likely to die from inflicted injuries than were children residing with two biological parents. Witnessing domestic violence and poverty may also be risk factors for child fatalities.”
There is agreement on these factors, the real challenge for Commission members is how to determine which families impacted by some combination of these factors are most and risk and how to get society and government at all levels to act effectively for the lives of children.