Children who report child abuse are often victimized twice: once by their offenders, then by a fragmented reporting system that relies on a frustrating web of multiple
interviews and repeated investigations.
The Children's Medical Center (CMC) in Dayton, Ohio, devised a coordinated response to this dilemma by partnering with the local police department, the children services agency
and the sheriff's office to create a one-stop safe haven called CARE House. The facility, launched last year, is located across the street from the hospital and provides a central
location for child interviews, case consultations, coordination of medical evaluations and other treatment services for children and non-offending family members.
CARE House required significant staffing and financial commitments from partnering agencies to make it a success in its first year. Streamlining the reporting process was
particularly critical for the project because its mission was to care for the most extreme cases of child abuse, primarily involving physical and sexual abuse. For instance, by
the time a child abuse victim reached the hospital for evaluation, he may have been questioned by a school nurse, a prosecutor and/or a police officer. And after arriving at the
hospital, there is usually an additional battery of questions and a medical evaluation. Once each agency was given a full picture of how painful the reporting process was for
children in these situations, the CARE House concept was an easy sell, says Libby Nicholson, CARE House's director.
CARE House's partners helped raise the annual $200,000 operational budget necessary and provide ongoing staffing resources for a CARE Team that includes a case coordinator,
medical social worker, pediatrician, nurse, child psychologist, detectives, prosecutors and victim advocates.
Since opening its doors in January 1999, CARE House has worked with more than 542 child abuse victims and their family members. Last month, CARE House's partnership model was
recognized by the Society for Healthcare Strategy Market Development with a Circle of Distinction award.
Promoting the Positive Spin
CARE House has had a tough time promoting its services to the community because it specializes in an area that most want to block out. "Child abuse makes a lot of folks
uncomfortable, but it's important to raise awareness about what Dayton is doing about it," says Nicholson. Public speaking engagements are the best vehicles for community
education. CARE House representatives often speak on topics of child abuse at schools, rotary clubs, law enforcement meetings and various community events.
Children's hospitals, in particular, are well poised to take a leadership role in the community on child abuse prevention and treatment because they are respected pediatric
health providers, says Vicki Giambrone, CMC's VP of marketing and development.
CMC's marketing department handles most of CARE House's PR efforts.
In addition to scheduling speaking engagements, CARE House staff members are positioned as local media experts on child abuse trends and child protection advice. The hospital
PR staff also created a newsletter that goes to its partners and provides updates on operational needs, success stories and expansion goals.
While CARE House helps reinforce CMC's reputation as a child care advocate in the community, the project has been most successful at cementing its relationship with top-level
administrators in the law enforcement community, children's services agency and the education sector. "We are seen as a real coalition-builder in our community, capable of
leveraging community resources and efficiencies to become a stronger child advocate," says Giambrone.
(The Children's Medical Center, Vicki Giambrone, 937/226-8332; CARE House, Libby Nicholson, 937/512-1670)
Stealable Outreach Ideas
For children's hospitals that are looking to strengthen outreach on child abuse prevention and treatment, the CARE House partnership model offers fairly low-maintenance,
replicable strategies. CARE House relied on community resources that were already in place but needed to be better coordinated, says Giambrone. Immediate planning priorities
should focus on:
- identifying the areas of duplication among the various agencies involved with reporting or investigating child abuse;
- developing an advisory board comprised of members from law enforcement, education, children's services and area children's hospitals;
- drafting an integrated response to how child abuse is investigated and evaluated; and
- creating communication goals and guidelines internally and externally.
Given the number of government and social agencies involved with child abuse reporting, there are bound to be some protective turf issues that will have to be overcome. The
best way to resolve them is by making sure there is adequate representation at the advisory level and reinforcing messages that place children first and bureaucracy last.
"Although child abuse is a mandated reporting event for various community agencies, it is necessary that we come together and brainstorm ways to make the process easier for
children," says Nicholson.