Better Child Abuse Fatality Reviews Are Key to Overhauling Child Welfare

Photo: American Academy of Family Physicians

The Family First and Prevention Services Act (FFPSA), which passed into law as part of the 2018 budget resolution, is one of the largest overhauls of our nation’s child welfare system in the last decade. The law aims to realign resources toward prevention and intervention before a child reaches the critical point of being placed into the foster care system.

Most of the attention on the new law is focused on new ways to use Title IV-E funding, which previously could only be used for a child already in foster care or who had been placed into an adoption or guardianship. The Family First Act now allows funding to states for approved evidence-based and trauma-informed prevention services for families of children at risk of entering foster care. Mental health and substance abuse services and in-home parenting support for these families will now be reimbursable.

Receiving lesser attention are the provisions in the law addressing child abuse and neglect fatalities (Section 50732 of the law). These require states to document how they quantify complete and accurate information on child maltreatment deaths and how they plan to develop and implement a comprehensive statewide plan to prevent them.

Teri Covington

Teri Covington, director of the Within Our Reach office at the Alliance for Strong Families and Communities. Photo courtesy of the Alliance

These new provisions are part of a road map developed two years ago by the Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF), which was mandated by Congress and the White House to develop a national strategy and recommendations for reducing child fatalities resulting from abuse and neglect. In their final report, the commission outlined a strategy for how to realign organizations, communities, state and federal policy to protect children at highest risk of fatality from abuse or neglect.

The commission put forth several key recommendations in its final report to address the estimated five to eight children who die every day at the hands of their caretakers. Foremost among these recommendations was a call to develop and use data to better identify, count and understand maltreatment deaths, and based on that data, the development of state fatality prevention plans that address the children most at risk.

The Family First legislation has quickly moved these recommendations forward in law through the new fatality provisions. The law set a deadline of October 1, 2018, for states to begin documenting in their Title IV-E state plans the steps they are taking to track and prevent fatalities.

Only a few states are known to be implementing this provision. Texas and Colorado had already begun their fatality prevention planning prior to passage of the Family First Act. Texas’ Department of Family and Protective Services developed a comprehensive and ambitious five-year plan back in 2016 as the state was experiencing a heightened focus on child abuse and fatalities. State legislation required the department to develop a five-year plan focused on early intervention and prevention. In 2018, an accompanying business plan was completed to drive implementation of the many strategies identified in the plan.

Ilana Levinson, senior director of government relations for the Alliance for Strong Families and Communities. Photo courtesy of the Alliance.

Colorado’s Department of Human Services developed the Colorado Child Maltreatment Prevention Framework for Action in 2017, through a partnership with more than 200 organizations. Colorado’s 48 Child Fatality Prevention System local child fatality teams is using the framework as a guide to inform prevention efforts in their communities. The state is also funding communities to deploy the plan locally.

As soon as FFPSA became law, New Hampshire began efforts to develop its plan by convening a broad group of state and community partners. Their final plan is near completion.

Despite these early examples, most states have yet to implement the Family First Act provisions and no guidance has been released from the Trump administration to inform the process. It is important to look at what the commission recommended to be the critical element of successful fatality prevention plans. Recommended elements include:

  • Plans should take a comprehensive, early intervention approach, with child protective services (CPS) being one of multiple key partners.
  • States should engage broadly with multiple stakeholders, including CPS and other state public health agencies, community-based organizations, educators, health care organizations, state courts, faith-based communities, public-private partners and especially families.
  • The plans’ strategies must be driven by data from state needs assessments, cross-system data sharing, and fatality and life-threatening injury reviews.
  • Plans should use three or more data sources in tracking fatalities and life-threatening injuries, and identify and focus on areas with high rates of child abuse and neglect fatalities and life-threatening injuries.
  • The plans should include requests for flexibility in relevant funding streams to better address needs.

How can these measures prevent fatalities? They help on two key fronts: utilizing accurate data and cross system coordination to prevent children from falling through the cracks, and identifying the points where investments in upstream prevention are needed.

For example, let’s say a state’s data shows that parental substance use is a significant risk factor for fatalities. The plan should reflect improved coordination, flexible funding and shared accountability not just with CPS but also among the state’s substance abuse services, such as local hospitals and treatment centers.

Although the services provisions of the Family First Act are the focus now in most states, we hope that the fatality prevention provisions will not get lost in the shuffle as states work to implement the law’s many provisions.

Family First is an important catalyst to building an effective, accountable child welfare system for the 21 Century – one that can harness earlier intervention and cross-system coordination to prevent child abuse and neglect fatalities in communities nationwide.


Theresa Covington is director of the Within Our Reach office at the Alliance for Strong Families and Communities, the National Center for Fatality Review and Prevention, and previously served as a commissioner on the Commission to Eliminate Child Abuse and Neglect Fatalities. Ilana Levinson is the senior director of government relations for the Alliance for Strong Families and Communities.

Your support allows The Imprint to provide independent, nonpartisan daily news covering the issues faced by vulnerable children and families.

Subscribe or Donate

The pick is in and it's @KamalaHarris. Last year we covered her plan to create a federal Bureau of Children and Family Justice...

House bill would send $2 billion to states for emergency help on family, youth #homelessness