By Amy Templeman, director of the Alliance’s Within Our Reach Office 

When the federal Commission to Eliminate Child Abuse and Neglect Fatalities issued its groundbreaking report in March 2016, it envisioned a reimagined 21st century child welfare system, one predicated on strategies to address child abuse and neglect before it occurs. 

Commissioners called for a public health approach to transforming child welfare systems guided by greater leadership and accountability, decisions grounded in better data and research and a multidisciplinary approach to ensuring child safety.

Based on the Commission’s findings, the U.S. Department of Justice’s Office for Victims of Crime announced funding for a demonstration initiative known as Child Safety Forward to develop multidisciplinary strategies and responses to address serious or near-death injuries as a result of child abuse or neglect. Through a competitive grant process, they selected five sites that are receiving national technical assistance for a three-year period from a team of national experts. The sites were selected based on their ability to support a collaborative, community-based approach to reducing child maltreatment fatalities and serious injuries. 

This effort will provide what has been sorely lacking in previous attempts to reduce child fatalities – the identification and evaluation of evidence-based practices that draw upon a public health approach to addressing those at risk.

But what exactly does that mean?

In its report, Within Our Reach: A National Strategy to Eliminate Child Abuse and Neglect Fatalities, the Commission defined a public health approach for child safety in the following way:

“A Public Health Approach is one that promotes the healthy development and well-being of children. It builds off of a public health model used to tackle complex social problems, a model with a focus on prevention and support for community change. The Surgeon General connected this model with child maltreatment in 2005, calling prevention of child maltreatment a national priority. The Centers for Disease Control and Prevention also championed a public health approach around reduction of child abuse and neglect. They define four steps in a public health model: 

  1. Define and monitor the problem. 
  2. Identify risk and protective factors. 
  3. Develop and test prevention strategies. 
  4. Ensure widespread adoption.

A public health approach to child safety and prevention of fatalities looks for the maximum benefit for the largest number of people, which means it works not only at the family level, but also at the community and societal level. Public and private sectors work together to align, leverage, and coordinate existing resources to provide support to children and families and to address risks and promote resilience before there is a crisis. The entire system becomes more preventive and responsive. 

CPS remains a critical component of this approach in order to respond quickly when children are at risk of serious harm. But CPS is only one part of the picture. Other systems become key partners, including the courts, law enforcement, the medical community, mental health, public health, and education. Even neighbors who come into regular contact with young children and families are part of a public health approach. All have a role to play to ensure that help is available when families need it through services and supports such as prenatal care, mental health services, evidence-based home visiting programs, employment, education, parent partnerships, housing support, early childhood education, and parent skills training, as well as substance abuse, mental health, and domestic violence programs.

The CPS agency in the 21st century child welfare system will continue to respond to allegations of abuse or neglect and work to keep children safe. But the ultimate goal is that fewer families will need involvement with CPS. This will free up CPS agencies to respond with more in-depth support to every child who comes to their attention for abuse or neglect. As a result, CPS agencies will be stronger, and their case management teams will be more effective. They will have more multidisciplinary partners and better connections to professionals in the community to help families. Community- based partners will also be ready to step in with support for families when their CPS cases are closed.”

Rather than focusing exclusively on child protection, this new system places an emphasis on child well-being and provides the supports that help strengthen families that are at greatest risk. 

There are challenges, of course, particularly in the face of the current COVID-19 pandemic. In an August 3, 2020 article in the Journal of American Medical Association Pediatrics, “Child Maltreatment in the Era of Coronavirus 2019,” author Dr. Christopher Spencer Greeley notes: “As COVID-19 has forced a reevaluation of the social contract between what communities, cities, and states are obligated to provide for their citizenries, there should be an emphasis on eliminating the systemic and structural injustices that exist in our communities already. This is not the first pandemic or natural disaster, nor will it be the last. With the current disruption from COVID-19, financial budgets will tighten and hard choices will have to be made. Now is the time to be thoughtful about the kinds of policies, practices, and resources that we will wish we had put in place when the next catastrophe occurs.”

Child Safety Forward and the five demonstration sites are seeking to broaden our existing knowledge base to help inform policies and practices that support a public health approach to child welfare. All sites will establish learning exchange teams and communications strategies to share findings both regionally and nationally. 

In the words of the Commission’s final report: “In the Commission’s two years of hearings, deliberations, and meetings with stakeholder groups, we found little in the way of evidence-based programs to end child maltreatment deaths. We found no state that had developed a sufficiently comprehensive plan to address the problem. But we found hope and urgency for building the steps to a 21st century child welfare system that can prevent deaths of the 3,000 children who will die from abuse or neglect next year if the status quo remains in place.…We must build a more comprehensive child welfare system that goes beyond CPS agencies and uses a public health approach to develop community capacity to help families and prevent abuse and neglect before problems turn into tragedy.”

It is hoped that this innovative initiative will fulfill the mission of the Commission by taking the first step to inform an ongoing nationwide effort to reduce child abuse and neglect tragedies.