On July 10, 2020 Governor Kay Ivey announced a $375,000 grant to Children’s of Alabama and the UAB Department of Pediatrics to establish a statewide medical network to ensure that victims of child abuse receive immediate and professional care. The network, the Alabama Child Abuse Medical System (ALCAMS), is a joint effort between UAB and the Alabama Network of Child Advocacy Centers.
Child maltreatment is a serious public health problem in Alabama. In 2018, reports involving 42,379 children were made to the Alabama Department of Human Resources1. After investigation, 12,506 of these children were determined to be victims. This amounted to 4% of Alabama’s children being involved in investigations and 1% being identified as victims that year. The health consequences for abused children are substantial, including short term consequences such as physical injuries, sexually transmitted infections, pregnancy, mental health problems, and death. In 2018, 43 children died from child abuse. The financial cost to society is substantial, estimated at $2.3 billion annually in Alabama alone2. The primary roles for the medical profession in the investigation are: determining the overall health of the child; identifying medical problems including injuries, illnesses, or mental health problems; initiating treatment; and preventing any additional harm. The latter is accomplished through communication with the investigative agencies with a goal of protecting the child.
The ability of a medical provider (MP) to assist in the investigation of child maltreatment is dependent on the training and experience of the examiner. The MP needs specific training in child abuse pediatrics. There is considerable variability in residency training in child abuse pediatrics and even if the MP has been adequately trained, maintaining those skills through experience and ongoing education is difficult in the typical healthcare setting.
In recognition of this need, some states have developed medical networks in order to increase the quality and quantity of resources available to perform evaluations of abused children. Other states in the southeast with child abuse networks include Florida, Mississippi, North Carolina, and South Carolina. Thanks to the generous grant from the Alabama Department of Economic & Community Affairs, Alabama will establish the ALCAMSnetwork by early 2021. The immediate goals of the system will be to:
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Recruit & train an adequate number of MPs across the state who are proficient in the recognition & management of child maltreatment.
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Increase the quality of the medical evaluations by standardizing the approach to the assessment based on current recommendations.
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Maintain a central database of the assessment results for ongoing reporting and quality improvement.
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Provide support to the MPs by providing training in child abuse and ongoing peer review for cases seen.
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Provide ongoing communication with the members of the investigative team (DHR, law enforcement) regarding indications for when to obtain a medical assessment.
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Collaborate with involved agencies to remove barriers and improve delivery of medical services to child maltreatment victims.
References:
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US Department of Health and Human Services, Children’s Bureau. Child Maltreatment 2018. Washington, DC: US Government Printing Office; 2020. (available at http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatment)
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Boschung M, Kendrick A, Addy S, Bell G, Ijaz A, Riiman V. The cost of child maltreatment to the Alabama economy in 2013. From the Department of Child Abuse and Neglect Prevention, The Children’s Trust Fund. Available at http://ctf.alabama.gov/2015-2016/Cost%20of%20Child%20Maltreatment_Alabama%202013.pdf