Keystone State Child Abuse Medical Forum Strategic Plan

Each year, 150-200 Pennsylvania children experience fatal and near-fatal child abuse or neglect.  Evidence suggests that prior to these lethal and near-lethal events children often do not receive care from specialty trained healthcare professionals and the same evidence also reveals that many children reported for sexual abuse also do not receive specialized health care during child abuse investigations.  Pennsylvania has under-developed policies about when a child should receive specialized health care evaluations and insufficient resources for such health care services.

In October, an interdisciplinary state-level leadership team convened by the Pennsylvania Chapter of the American Academy of Pediatrics (PA AAP) supported by the federal Children’s Justice Act, released a comprehensive report and series of recommendations to Governor Shapiro and the Pennsylvania General Assembly.  Central to the team’s recommendations were establishment of standardized policies along with coordinated and enhanced resources to better connect children to specialized health care services as part of a high-quality child abuse investigation.

The goal of the Keystone State Child Abuse Medical Forum is to “reduce child morbidity and mortality from all forms of child maltreatment by ensuring children have timely access to high-quality medical evaluations.” (PA AAP, 2023).

The interdisciplinary leadership team convened by PA AAP reflected expertise from health care, child welfare, law enforcement, children’s advocacy centers (CACs), district attorney offices, and state agencies like the Center for Rural Pennsylvania, the Department of Health and the Department of Human Services.  The team offered six recommendations and then outlined specific actionable steps needed by the Governor and legislators (PA AAP, 2023):

1. Ensure Pennsylvania’s children have access to equitable, timely, and high-quality medical evaluations informed by standardized criteria and in consultation with specialty trained healthcare professionals for all types of child maltreatment.
2. Ensure the Pennsylvania Department of Human Services’ Office of Children, Youth and Families (OCYF) is equipped to make evidence-based child safety and protection decisions, informed by real-time consultation with specialty trained healthcare professionals.
3. Make prevention of child morbidity and mortality from maltreatment a Commonwealth priority with emphasis on children less than 3 years of age.
4. Clarify the role and enhance the capabilities of CACs, including the availability of expanded high-quality healthcare services, as part of the Commonwealth’s commitment to multidisciplinary interventions with children.
5. Equip mandated reporters with the knowledge and skills necessary to file high-quality reports and ensure training aims to reduce bias and disproportionality.
6. Identify and address unintended consequences arising from Pennsylvania’s child abuse and neglect registry.