Organization and Funding of Medically-Oriented Child Abuse and Neglect Teams in the USA: Key Issues to Consider
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Abstract
Ideally, children reported for potential abuse and/or neglect would receive an evaluation by a medically-oriented child maltreatment team composed of an interdisciplinary team of health care professionals who collaborate with the community’s child protection and law enforcement professionals who then conduct an investigation to potentially substantiate the abuse and/or neglect. Each year, approximately 3 million reports for potential child abuse and neglect are received by authorities in the USA, and after investigation in 2022, over 558,000 children under 18 years of age were determined to be victims of some form of child maltreatment. This topical review explores the literature that has emerged over the past 25 years describing the systematic study of the organization and funding of medically-oriented child abuse and neglect teams in the USA. Several national surveys are summarized and compared regarding the organization and funding of such teams and programs. The majority of these teams are housed in the nation’s children’s hospitals, and child maltreatment programs vary widely in terms of 1) the professionals who staff the team, 2) the range of services each team provides, and 3) the manner in which they are funded and financially managed. Local factors are key to how teams are staffed and sustained, and, while the services provided are essential to the care of the children involved, the institutions housing the child abuse and neglect teams uniformly shoulder a significant portion of the financial responsibility to operate the programs on an annual basis.
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References
2. Klika, J.B., Rosenzweig, J. & Merrick, M. Economic Burden of Known Cases of Child Maltreatment from 2018 in Each State. Child Adolesc Soc Work J 37, 227–234 (2020). https://doi.org/10.1007/s10560-020-00665-5
3. Peterson C, Florence C, Klevens J. The economic burden of child maltreatment in the United States, 2015. Child Abuse Negl. 2018;86:178-83. doi: 10.1016/j.chiabu.2018.09.018
4. McColgan MD, Siconolfi DA, DeJong A. Multidisciplinary Teams. In: Giardino A, Lyn M, Giardino E, eds. A Practical Guide to the Evaluation of Child Physical Abuse and Neglect. Cham: Springer; 2019:447-467. doi:10.1007/978-3-030-00635-8_15
5. Scribano PV, Giardino AP. Interdisciplinary approaches to child maltreatment: Accessing community resources. In: Giardino AP, ed. Medical Evaluation of Child Sexual Abuse: A Practical Guide. 2019:331-354. Elk Grove Village, IL: American Academy of Pediatrics. doi:10.1542/9781610022965-ch13.
6. Ells, M. Forming a Multidisciplinary Team to Investigate Child Abuse. Rockville, MD: Office of Juvenile Justice and Delinquency Prevention; 2000. https://www.ojp.gov/pdffiles1/ojjdp/170020.pdf, Accessed 01-07-2025
7. Wallace GH, Makoroff KL, Malott HA, Shapiro RA. Hospital-based multidisciplinary teams can prevent unnecessary child abuse reports and out-of-home placements. Child Abuse Negl. 2007 Jun;31(6):623-9. doi: 10.1016/j.chiabu.2006.12.010. Epub 2007 Jun 27. PMID: 17590436.
8. Kupfer GM, Giardino AP. Reimbursement and insurance coverage in cases of suspected sexual abuse in the emergency department. Child Abuse Negl. 1995;19(3):291-5. doi.org/10.1016/S0145-2134(94)00128-6
9. Giardino AP, Montoya LA, Richardson AC, Leventhal JM. Funding realities: child abuse diagnostic evaluations in the health care setting. Child Abuse Negl. 1999;23(6):531-8. doi.org/10.1016/S0145-2134(99)00034-4
10. Tien I, Bauchner H, Reece RM. What is the system of care for abused and neglected children in children’s institutions? Pediatrics. 2002; 110(6):1226-31. doi: 10.1542/peds.110.6.1226
11. Giardino AP, Montoya LA, Leventhal JM. Financing medically-oriented child protection teams in the age of managed health care: a national survey. Child Abuse Negl. 2004;28(1):25-44. doi.org/10.1016/j.chiabu.2003.05.003
12. Socolar RR, Fredrickson DD, Block R, Moore JK, Tropez-Sims S, Whitworth JM. State programs for medical diagnosis of child abuse and neglect: case studies of five established or fledgling programs. Child Abuse Negl. 2001;25(4):441-55. doi:org/10.1016/S0145-2134(01)00219-8
13. Kairys S, Ricci L, Finkel MA. Funding of child abuse evaluations: survey of child abuse evaluation programs. Child Maltreat. 2006 May;11(2):182-8. doi: 10.1177/1077559505285778. PMID: 16595851.
14. National Association of Children’s Hospitals and Related Institutions. Responding to Child Maltreatment: Children’s Hospitals Child Abuse Services 2005 survey results. 2005
15. National Association of Children’s Hospitals and Related Institutions. Responding to Child Maltreatment: Children’s Hospitals Child Abuse Services 2008 survey results. 2008
16. Children’s Hospital Association. (2012). Survey findings of children’s hospitals’ child abuse services Accessed at https://www.childrenshospitals.org/issues-and-advocacy/population-health/child-abuse/reports/2012/2012-survey-findings-childrens-hospitals-child-abuse-services
17. Bachim, A., Culotta, P., Thompson, R., Giardino, A., & Greeley, C. (2023). National Children’s Hospital Child Abuse services survey: 2015 executive summary. Available from https://www.medicpresents.com/download-free-medical-notes/national-childrens-hospital-child-abuse/1293.html
18. Peeler E, Dakil S, Culotta P, Giardino A, Greeley C, Bachim A. Financing pediatric hospital child abuse teams in 2015: national survey results. Child Abuse Negl. 2023;139:106114. doi: https://doi.org/10.1016/j.chiabu.2023.106114
19. Children’s Hospital Association. Defining the Children’s Hospital Role in Child Maltreatment (2nd Ed). https://xdocs.net/preview/defining-the-childrens-hospital-role-in-child-maltreatment-5e0a57af5c257 2011
20. Sister Irene Kravis quote no margin no mission. https://www.forbes.com/sites/sachinjain/2022/04/29/when-margin-becomes-the-mission-healthcares-sometimes-unholy-pursuit-of-profit/