PRESENTED BY: Scott Advocacy and Consulting, LLC Where We Are and Where We Should Go So Our Children Are Safe from Abuse This presentation will begin with a look of child welfare data from the Iowa Department of Human Services for Iowa and this county. We hope this information will provide some answers you may have and offer a perspective. Don’t be surprised if you end up with more questions than answers. Feel free to raise them. We will provide an overview of abuse, share a picture of where we are now and have been previously, examine different types of abuse, and compare our county’s figures with other counties and the state. In the later part of the presentation, we will discuss how we are responding to child abuse here and what more we can do. PRESENTED BY: Scott Advocacy and Consulting, LLC www.scottadvconsult.com © Stephen Scott, 2017

Definitions, Process, and Statewide Data Overview of Child Abuse: Definitions, Process, and Statewide Data We will start by trying to get a basic understanding of what constitutes child abuse in Iowa, how DHS responds to abuse, and the what information we have available to get a sense of the scope of abuse.

The Core Requirements for an Abuse Report The child protection process starts with a report being received by a centralized intake system of the Iowa Department of Human Services. For the unit to accept a report as a possible case of child abuse, the allegations must involve: A victim who is less than 18 at the time of the alleged harm A possible perpetrator who is a “caretaker” An allegation that one or more of certain specified harms had occurred Does anyone who has been a reporter want to discuss the process? These are the three core requirements for DHS to accept and respond to a report of suspected child abuse. Anyone can make a report of suspected child abuse. Some professionals are listed as mandatory reporters under Iowa law and are required to report suspected abuse if perceived during the course of their professional conduct. More than half of all reports to DHS come from mandatory reporters. A list of mandatory reporters is available at Iowa Code 232.69: https://www.legis.iowa.gov/docs/code/232.69.pdf. The victim must have been less than 18 at the time of the event. A caretaker is defined as “someone responsible for the care of a child.” The only exception regarding the caretaker requirement involves cases of alleged sexual abuse, where any household member – not just a caretaker – can be a perpetrator. Data source: Iowa Department of Human Services

How DHS Responds to Accepted Reports Accepted reports are assigned to one of two pathways for assessment. All types of abuse, except those alleging denial of critical care, are assigned to the traditional Child Abuse Assessment pathway This pathway leads to a determination whether or not abuse occurred Beginning in 2014, denial of critical care cases seen as involving low risk are assigned to a new pathway called Family Assessment These reports do not result in a determination of child abuse Higher-risk denial of critical care cases go the Child Abuse Assessment pathway. Iowa’s process for responding to accepted cases of child abuse is called “Differential Response.” Over half the states have some form of a differential response process. Iowa changed to Differential Response in January 2014 following legislation enacted in 2013. Only denial of critical care cases are handled differently because of this change. A denial critical care report that does not allege imminent danger, death, or injury to a child results in the case going a family assessment pathway. That decision is made on the basis of the report made, without any preliminary follow-up or investigation. Family Assessments do not result in a determination of abuse. Data source: Iowa Department of Human Services

Categories of Abuse Iowa’s child abuse law contains four categories of abuse common to every state: Neglect (denial of critical care) Intentional physical injury Sexual abuse Mental injury Iowa law has several other distinctive categories related to drug- related activities, sex offenders, child prostitution, pornography, and sex trafficking. State, and not federal law, defines what constitutes child abuse. Iowa’s child abuse law was first passed almost four decades ago and has undergone multiple changes in the categories of abuse. Here is the section of Iowa law that defines the categories of abuse: https://www.legis.iowa.gov/docs/code/232.68.pdf. We will look more closely at these categories a few slides later. We will now look at state figures and later set forth our local ones. Data source: Iowa Department of Human Services

DHS Response to Accepted Reports in 2016 Reports accepted: 25,707 Assigned to Family Assessment pathway: 7,457 (29.0 % of all reports) Assigned to Child Abuse Assessment pathway: 18,250 (71.0 % of all reports) Cases of confirmed or founded child abuse: 6,484 (35.5 % of Child Abuse Assessments) Total children found to be abused: 8,892 Number of children found abused per 1,000 children: 12.25 Of the 25,707 reports accepted in 2016, less than 30 percent went the Family Assessment pathway – where DHS did not determine whether there was abuse. The remaining 71 percent received a determination whether there was abuse; the 35.5 percent of child abuse assessment cases that were confirmed is in the usual range More children are found to be abused than cases confirmed or founded because a case may involve more than one child The rate of abuse equals the number of Iowa children abused divided by the number of children in Iowa times 1,000. Please note that the percentage of children found to be abused was 1.25 % , not 12.25 %. Data source: Iowa Department of Human Services

Iowa Child Abuse Reports and Assessments, 2014-16 Year Reports Accepted Family Assessments Child Abuse Assessments Percent Assigned to FA Confirmed or founded reports Percent Confirmed Abused Children Children abused/ 1,000 2014 23,562 7,769 15,793 33.0% 5,534 35.0% 7,429 10.28 2015 24,298 7,469 16,829 30.7% 6,042 35.9% 8,298 11.43 2016 25,707 7,457 18,250 29.0% 6,484 35.5% 8,892 12.25 This slide shows state changes in reports, confirmed cases, and abused children for 2014-16. We will look at local changes later. The number of abused children in 2016 (8,892) is almost 20 percent higher in 2014, when 7,429 children were found to be abused. The 2016 number is also 7 percent higher than the 2015 one (8,298 children). The rise in the number of abused children is associated with both an increase in the number of reports accepted (9 percent higher in 2016 than in 2014) and a decrease in the percentage of cases assigned to the Family Assessment pathway – from 33 percent in 2014 to 29 percent in 2016. Do you have any thoughts about what might be behind the changes? Data source: Iowa Department of Human Services

Number of Abused Iowa Children, 1998-2013 This shows how Iowa figures can bounce around from year to year. Whether the rise in abuse numbers is more the result of increased instances of harm to children or other causes, such as agency practice or more community vigilance, is uncertain. Child abuse numbers have risen (and fallen) in earlier years. Past increases have sometimes been associated with specific events or developments, such as the high-profile death of Shelby Duis (in 2000) and the rise in meth use and manufacturing in the early- to mid-2000s. Other increases have not had been associated with discernible events or factors. Do you know of any factors that might be impacting abuse now? Data source: Iowa Department of Human Services

Number of Types of Child Abuse, 2016 Types of Abuse Number Percent of All Abuse Denial of critical care 9,369 71.2% Presence of illegal drugs in a child’s body 1,522 11.6% Physical injury 1,300 9.9% Sexual abuse 773 5.9% Allowing Access to a Sex Offender 137 1.0% Manufacturing dangerous drug in child’s presence 33 0.3% Mental injury 24 0.2% This table lists the number and types of abuse that DHS confirmed in 2016. Over 7 in 10 child abuse cases in 2016 involved denial of critical care – where a parent or caretaker failed to provide adequate supervision, food, shelter, clothing, or other care necessary for a child’s well-being. Next most common were cases involving illegal drugs in a child’s body because of caretaker action or inaction (11.6 percent of all abuse), intentional physical injury (9.9 percent), and sexual abuse (5.9 percent). DHS found only 24 (0.2 percent) instances of mental injury.   In 2016, DHS found 137 cases (1.0 percent) of abuse involving a parent or caretaker knowingly allowing a sex offender access to a child and 33 (0.3 percent) instances where a child’s parent or other caretaker was involved in manufacturing a dangerous drug in a child’s presence. Data source: Iowa Department of Human Services

Trends in Types of Child Abuse in Iowa, 2010-16   Denial of Critical Care Physical Abuse Sexual Abuse Presence of Illegal Drugs in a Child’s Body Allowing Access to a Sex Offender Meth Manufacturing in Child's Presence Year Number % of all abuse 2010 15,470 81.1% 1,696 8.9% 637 3.3% 827 4.3% 258 1.4% 179 0.9% 2011 13,844 79.1% 1,689 9.7% 713 4.1% 861 4.9% 215 1.2% 162 2012 13,170 78.8% 1,570 9.4% 648 3.9% 1,002 6.0% 142 0.8% 169 1.0% 2013 14,279 78.6% 1,646 9.1% 716 1,174 6.5% 186 2014* 7,584 70.1% 1,339 12.4% 719 6.6% 921 8.5% 123 1.1% 2015* 8,852 71.7% 1,491 12.1% 600 1,164 158 1.3% 74 0.6% 2016* 9,369 71.2% 1,300 9.9% 773 5.9% 1,522 11.6% 137 33 0.3% Average 11,795 75.8% 1,533 10.2% 687 4.7% 1,067 7.3% 174 129 Change 2008-16 -6,101 -396 136 695 -121 -146 This table sets forth DHS data on trends in the types of child abuse from 2010-16. The table shows a major jump from 2014-16 in two categories: denial of critical care, which increased by 1,785 (23.5 %), and presence of an illegal drug in a child’s body, which rose by 601 (65.3 %). A coincident increase in these two types of abuse makes sense, since cases involving illegal drugs often also lead to a finding of denial of critical care. Whether these combined increases indicate more illegal drug activity or increased vigilance is a question. Cases of physical injury dropped slightly, continuing a decline in that category of abuse from 2010-16. Cases involving access to a sex offender dropped, as did those involving meth manufacturing, which fell to its lowest level (33) ever. Figures for sexual abuse rose from 600 instances to 773 – primarily because the 2016 Iowa Legislature broadened who may be a sexual abuse perpetrator to include all household members and not just those responsible for the care of a child. Data source: Iowa Department of Human Services

A look at our child abuse data Answers and Questions: A look at our child abuse data Now we will look at our local numbers, try to understand them, consider any questions, and identify where we would like to know more. We will also discuss how our community is responding to child abuse and what more we can do.

County-Specific Responses to Accepted Reports in 2016 Reports Accepted: [Local] Assigned to Family Assessment pathway: [Local] (state: 29.0%) Assigned to Child Abuse Assessment pathway: [Local](state: 71.0%) Cases of confirmed or founded child abuse: [Local] (35.5 % of Child Abuse Assessments) Total children found to be abused: [Local] Number of children found abused per 1,000 children: [Local](12.25 for state) Where do our community’s figures differ from the state’s? Why might these figures differ? The county-specific figures to fill in the blanks are available in “Child Abuse by County, 2016” at: http://www.scottadvconsult.com/wp-content/uploads/2017/06/Child-Abuse-2016.pdf. Decisions to accept reports are made at the state level; decisions to confirm are made locally Note that one year’s figures might be out of line in smaller communities because only a couple cases can make a large difference in abuse rates. Data source: Iowa Department of Human Services

Changes in Child Abuse in [Local], 2014-16 County 2014 Pop 0-17 2014 2015 2016 Change in no. 2014-16 Change in % 2014-16 Avg. no. abused 2014-16 Avg. abused/ 1,000 2014-16 Rank in abuse rate, 2014-16 The figures may be copied from the county’s row in “Abused Children in Iowa, 2014-16,” which can be found at: http://www.scottadvconsult.com/wp-content/uploads/2017/06/Iowa-abuse-2014-16.pdf Please note that the average rate of abuse is per 1,000 children and not a percent. Discuss any changes over the course of the three years. Do these changes make sense to you? Do we see any changes? Do any changes fit with what you have been seeing? Data source: Iowa Department of Human Services

Counties with Highest and Lowest Average Rates of Abuse, 2014-16 County 2014 Pop'n 0-17 Avg. No. abused ch'n, 2014-16 Avg. rate/ 1,000 ch'n 2014-16 Montgomery 2,360 53 22.46 Bremer 5,399 34 6.24 Lee 7,610 166 21.81 Ringgold 1,178 7 6.23 Clinton 10,893 233 21.42 Davis 2,535 16 6.18 Page 3,187 64 20.08 Plymouth 6,234 38 6.10 Appanoose 2,832 55 19.42 Kossuth 3,329 20 6.01 Greene 2,111 35 16.74 Mitchell 2,572 14 5.57 Decatur 1,801 30 16.66 Buchanan 5,604 31 5.47 Emmet 2,162 36 16.65 Dallas 22,100 117 5.29 Tama 4,210 69 16.47 Lyon 3,282 17 5.18 Hardin 3,643 57 15.74 Johnson 28,963 147 5.08 Cerro Gordo 8,865 139 15.64 Sioux 9,335 45 4.82 Woodbury 26,663 415 15.58 Winneshiek 3,930 18 4.50 We are looking at the rates of abuse in other counties, to see where our county compares with the highest and lowest. Note that rates of child abuse vary widely, with some counties having rates four to five times those of counties with the lowest rates. The table lists those counties with the highest and lowest rates of abuse per 1,000 children. Montgomery, Lee, Clinton, and Page counties all have rates of more than 20 children abused per 1,000, while the same rates for Mitchell, Buchanan, Dallas, Johnson, Sioux and Winneshiek counties are less than 6 per 1,000. Data source: Iowa Department of Human Services

Counties with Highest and Lowest Average Rates of Abuse, 2014-16 Here’s a map showing the 15 counties with the highest and the lowest rates of abuse. Note if your county is on the map or any nearby. Knowing what you do about Iowa does this map make sense? There is some geographic clustering, with 7 of the 15 counties in the lower two tiers of Iowa counties having high rates of abuse (though three counties with low rates of abuse are also in the same area). By comparison, the three most Northwestern counties and five Northeastern ones have low rates of abuse. Other than Woodbury County, those counties with Iowa’s 15 most populous cities are not among the highest or lowest. Data source: Iowa Department of Human Services

Number of Types of Child Abuse in [Local], 2016 Types of Abuse Number Percent Denial of critical care Presence of illegal drugs in a child’s body Physical injury Sexual abuse Allowing Access to a Sex Offender Manufacturing dangerous drug in child’s presence Mental injury The figures for each category of abuse are available from DHS at: http://www.scottadvconsult.com/wp-content/uploads/2017/06/Types-of-abuse-2016-DHS.pdf You can calculate the percent by dividing the number of cases of abuses for a particular type by the number in the far right column, which sums all types of abuse for each county. Data source: Iowa Department of Human Services

Number of Types of Child Abuse [Local], 2016 Physical Injury Sexual Abuse Presence of Illegal Drugs Denial of Critical Care County 2014 Pop 0-17 Avg. 2014-16 Avg. rate/ 1,000 ch'n. Rank in avg. rate STATE TOTALS 725,984 1,348 1.9 697 1.0 1,202 1.7 9,273 12.83 Data for this table is in “Average Number of Types of Abuse, by County, 2014-16” at http://www.scottadvconsult.com/wp-content/uploads/2017/06/Iowa-average-abuse-type-2014-16.pdf This number lists the average number of incidents for 2014-16 in our county for the last three years – along with the rate per 1,000 children and our ranking compared to other coounties. Data source: Iowa Department of Human Services

Our community’s response to abuse Now we move on to how we respond to all of this information as individuals and a community

Child Abuse Prevention Strategies Primary Prevention consists of activities that are targeted toward the community at large, before any allegations of abuse and neglect. They include public awareness and parent education classes open to everyone. Secondary Prevention consists of activities targeted to families with one or more risk factors such as substance abuse, early and single parenting, and poverty. It includes parent education and family support programs for high-risk parents. Tertiary Prevention consists of activities targeted to families that have been the subject of abuse reports. It may include DHS- supported services, drug treatment, and mental health services. There are three main types of prevention, depending on where on the continuum the effort takes place. Review examples. Note that these characterizations come from FRIENDS National Research Center, https://www.friendsnrc.org/prevention. Data source: FRIENDS National Resource Center

Protective Factors These are characteristics or conditions that reduce or buffer the effects of risk, stress or trauma – thereby reducing the risk of abuse. Those identified by FRIENDS are: Child Development / Knowledge of Parenting Concrete Supports Family Functioning / Resiliency Nurturing and Attachment Social Support Children’s Social and Emotional Competence Prevention efforts – particularly primary and secondary ones – seek to promote protective factors in and for families. These characteristics are all linked to FRIENDS if you want to go through them at more detail – or familiarize yourself before the presentation.

Questions About Our Community’s Effort What prevention efforts exist in our community? How well do we offer all three types of prevention? What individuals and organizations are helping lead these efforts? What is missing? What is the community doing as a whole to support prevention? What more can you and your organization do? Remember to look at more than agency responses and programs – at what happens at the community level to help families.

Local Resources Prepare this ahead of time, but give people the change to suggest resources.

The End PREPARED BY: Stephen Scott, Scott Advocacy and Consulting, LLC www.scottadvconsult.com steve@scottadvconsult.com || 515-274-3705