April is National Child Abuse Prevention Month. This provides an opportunity to highlight multiple programs and strategies that focus on prevention: making sure children have access to health care, home visit programs for young children, and advocacy efforts that bring attention to the need for resources to support and strengthen families and to keep children safe. There are critical roles for social workers in all three domains.

Home visitation: Helping children and families has always been a major objective for the social work profession. The good news is that the Obama administration supports of child welfare initiatives and calls for funding a home visitation program for states in the 2010 fiscal year budget.

“The president’s focus on home visitation for very young children is a major step forward,” said Susan Stepleton, president and CEO of Parents as Teachers National Center based in St. Louis. Parents as Teachers is one of several evidence-based home visiting models that is being replicated around the country to prevent child abuse and neglect.

“A real positive has been the broadening of the parents’ role in ways that can not only help children very early in life, but also throughout the child’s life,” Stepleton said. “It is gratifying that a sizeable coalition of child advocacy organizations has supported this broadening approach and worked together to craft language making it possible.”

Stepleton said her organization has been pleased to discover a more inclusive attitude among administrators of child welfare/child abuse prevention programs.

“In Washington, D.C., Parents as Teachers is seeing demonstrated communication, mutual outreach and joint planning among” Head Start, Maternal and Child Health Bureau, the Administration of Children and Families, Title I and others at the highest levels of government, she said. “Even in difficult economic times, setting this tone is hugely important and bodes well for children in the future. The challenge will be fostering the same level of cooperation at state levels.”

Catherine Nolan, a social worker who directs the Office on Child Abuse and Neglect in the Department of Health and Human Services, said home visitation is more effective when linked with a range of services and supports for families with young children.

“While home visiting is not a panacea for solving complex societal issues and family problems, it can serve as a vehicle for connecting families to needed services and supports,” she told the NASW News. The OCAN program’s overarching goal is to generate knowledge about the use of evidence-based home visiting programs to prevent child maltreatment, Nolan explained.

Health insurance for children: Child abuse prevention is not only a child welfare issue, but also a public health issue; ensuring access to health care and health insurance are important aspects of prevention. There are an estimated 5 million children eligible for federal health assistance who, for various reasons, are not receiving the coverage, says Kathleen Sibelius, HHS secretary.

In honor of National Child Abuse Prevention Month, social workers are being encouraged to help connect families with aid that can help their children. Nolan said social workers are ideally trained to help get the message out to those who need it most.

“Social workers work in social service, family service and child welfare agencies,” she said. “They are in schools, hospitals and other health care facilities, as well as in mental health agencies, courts, law offices, law enforcement, the military and the business world. In all these venues, social workers have an opportunity to inform families about the availability of Medicaid and [Children’s Health Insurance Program, or CHIP] programs.”

Sebelius said she is encouraging states, local governments, community-based operations as well as faith-based organizations to help enroll the 5 million children who are eligible for help. A Web site, InsureKidsNow.gov, offers state-specific information about CHIP and Medicaid for families and professionals. It is written in English and Spanish.

This new campaign is happening during the one-year anniversary of the Children’s Health Insurance Program Reauthorization Act that offers states new financial resources and program options to provide health coverage for children in Medicaid and CHIP. That has brought an additional 2.6 million children into Medicaid and CHIP coverage in fiscal year 2009. The programs served nearly 40 million children last year, according to HHS.

We Can Do Better campaign: While there have been new strides in improving child welfare services, there is also the threat that the ongoing recession will damper any progress.

Among the most vocal social workers on the issue is Michael Petit, president and founder of Every Child Matters.

As part of a campaign to help stop deaths due to child abuse and neglect, the Every Child Matters Education Fund partnered with NASW, the National Children’s Alliance and the National District Attorneys Association to run ads in newspapers popular on Capitol Hill that urged Congress to address the fatalities that claim the lives of innocent children.

Specifically, the ad campaign asks policy makers to hold hearings and provide emergency funds to stop state cuts in child protective services. A corresponding report, “We Can Do Better,” is available at Every Child Matters.org. It outlines the issue and offers suggestions for improvement.

Obama and Congress have shown strong interest in child welfare in their early policy and budget decisions, he said. “Now they must beef up federal improvement in addressing what is a matter of homeland insecurity for thousands of the nation’s tiniest citizens,” Petit added.

An ongoing obstacle to child welfare is that each state conducts its own program and chooses its own funding level. The “We Can Do Better” report highlights the disparity in per capita spending for child welfare services. The latest figures put that range from $196.67 in Connecticut to $28.60 in Virginia.

“Child welfare varies widely and that’s not going to change unless there’s a federal standard,” Petit said. Because of this, child protection remains an “accident of geography,” he said.

A correlation has not been established between states’ spending on child protective services and their child abuse and neglect death rates, the report notes. But states that allocate more funds are more likely to investigate all reports, not just some, because social workers have more manageable workloads.

“Such huge variations in capability among states ... can translate directly into whether children live or die,” Petit said.

“States want to do (child welfare services) on their own,” he explained. “They want federal money, but they don’t want to be monitored. As long as this happens, you will have vast differences in outcomes among states.”

The We Can Do Better campaign calls for a federal approach for protecting children. Petit said even with broad public support for keeping children safe from harm, the nation’s present commitment of resources, laws and policies is too little.

“We can overcome inadequate funding for child protective services and wide variations in capacity among states only by enacting federal policy committed to protecting children no matter where they live,” he said.

The report says strengthening a formal child protective services system has the highest immediate promise for safeguarding children in dangerous situations. While child abuse occurs in all socioeconomic ranks, most fatality victims are very young and very poor, the report explains. It noted that in 2007, 75 percent of victims were age 4 or younger; almost half were under age 1.

Among the We Can Do Better Campaign’s goals is a federal strategy for stopping maltreatment deaths. This includes social service programs for home visiting, substance abuse and mental health treatment, teen pregnancy prevention, prenatal care and other proven policies, Petit said.

He said other ways to improve child welfare include:

• Require HSS to standardize definitions and methodologies used to collect data related to maltreatment deaths.
• Supply $3 billion to $5 billion in additional funding to reduce workloads for child protective workers and other frontline personnel.
• Require states to adopt national child welfare standards drawn from existing best practices and policies.
• Have HHS and state child protection agencies conduct public education campaigns to encourage reporting of child abuse.
• Have the Departments of Justice, HHS and states adopt a model protocol for assuring that civil and criminal legal proceedings are closely coordinated between child protection and law enforcement agencies.

Petit acknowledged these goals may appear ambitious, especially at a time when states are struggling to balance budgets with less revenue.

In the meantime, social workers can help make sure child welfare programs remain effective by lobbying and advocating for services in their home states.

“More social workers need to donate to (political action committee) funds that support social work initiatives,” he said. “I would also encourage more social workers to run for office.

“NASW chapters have an important role in educating the public,” Petit added. “They can’t afford to be silent. ... They deal with families that are vulnerable and they have to present a voice on behalf of the children.”

Joint efforts: Nolan said the Children’s Bureau and the Office on Child Abuse and Neglect have always held the philosophy that child abuse/neglect requires a multidisciplinary, community-involved solution.

“For that reason, we have been working with states to enhance the efficiency and effectiveness of child abuse and neglect programs by supporting and encouraging the development of community partnerships and collaborations,” she said. The agencies also offer state grants supporting evidence-based prevention programs.

Nolan acknowledges that it takes several approaches to keep children safe.

“There is not just one agency or one profession that can prevent child abuse and neglect in this country,” she said. “There needs to be a joint commitment on the part of social work, education, health care, law enforcement, the courts, communities, parents and families to ensure that our children grow up healthy, productive and safe.”