<%BANNER%>
HIDE
 Front Cover
 Title Page
 Acknowledgement
 Table of Contents
 Introduction
 Overview of child abuse and neglect...
 Understanding the problem of child...
 Critical problems in Florida
 Mission
 1994-1996 State level goals
 Service delivery plan
 Goals and objectives for service...
 Cooperative agreements with DOE...
 Plan for coordination and...
 Barriers
 Recommendations for change
 Conclusion
 Appendix A: Section 415.501, Florida...
 Appendix B: Interprogram task...
 Appendix C: Child abuse and neglect...
 Appendix D: Child abuse and neglect...
 Appendix E: Summary of district...
 Appendix F: District goals and...
 Appendix G: Summary of district...
 Appendix H: Summary of district...
 Appendix I: References
 Back Cover














Child abuse and neglect prevention
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Permanent Link: http://ufdc.ufl.edu/UF00075022/00002
 Material Information
Title: Child abuse and neglect prevention
Alternate title: Child abuse and neglect prevention state plan
Physical Description: v. : ill. ; 28 cm.
Language: English
Creator: Florida -- Dept. of Health and Rehabilitative Services
Florida -- Children, Youth, and Families Program Office
Evaluation Systems Design, Inc
Publisher: Dept. of Health and Rehabilitative Services
Place of Publication: Miami Fla.?
Creation Date: 1994
Frequency: triennial[<1991/1993>-]
biennial[ former <1987/1988>-]
three times a year
regular
 Subjects
Subjects / Keywords: Child abuse -- Prevention -- Government policy -- Periodicals -- Florida   ( lcsh )
Abused children -- Services for -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
serial   ( sobekcm )
 Notes
Issuing Body: Issued by: Dept. of Health and Rehabilitative Services, <1987/1988>- ; Dept. of Health and Rehabilitative Services, The Children, Youth and Families Program Office and Evaluation Systems Design, Inc, <1991/1993>- .
General Note: Description based on: 1987-1988; title from cover.
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Resource Identifier: aleph - 001860453
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System ID: UF00075022:00002

Table of Contents
    Front Cover
        Front Cover 1
        Front Cover 2
    Title Page
        Title Page 1
        Title Page 2
    Acknowledgement
        Acknowledgement
    Table of Contents
        Table of Contents
    Introduction
        Page 1
        Page 2
        Page 3
    Overview of child abuse and neglect prevention system
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
    Understanding the problem of child abuse and neglect
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
    Critical problems in Florida
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
    Mission
        Page 24
    1994-1996 State level goals
        Page 25
        Page 26
    Service delivery plan
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
    Goals and objectives for service delivery
        Page 42
        Page 43
        Page 44
        Page 45
    Cooperative agreements with DOE and FDLE
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
    Plan for coordination and integration
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
    Barriers
        Page 57
        Page 58
        Page 59
    Recommendations for change
        Page 60
        Page 61
        Page 62
    Conclusion
        Page 63
        Page 64
    Appendix A: Section 415.501, Florida Statues, prevention of abuse and neglect of children; state plan
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
        Page 73
        Page 74
    Appendix B: Interprogram task force
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
    Appendix C: Child abuse and neglect prevention plan district top needs or problems
        Page 81
        Page 82
        Page 83
        Page 84
    Appendix D: Child abuse and neglect prevention programs implementation of continuum components by district
        Page 85
        Page 86
        Page 87
        Page 88
    Appendix E: Summary of district child abuse and neglect prevention services
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
        Page 94
        Page 95
        Page 96
        Page 97
        Page 98
    Appendix F: District goals and objectives
        Page 99
        Page 100
        Page 101
        Page 102
        Page 103
        Page 104
        Page 105
        Page 106
        Page 107
        Page 108
        Page 109
        Page 110
        Page 111
        Page 112
        Page 113
        Page 114
        Page 115
        Page 116
        Page 117
        Page 118
        Page 119
        Page 120
        Page 121
        Page 122
        Page 123
        Page 124
        Page 125
        Page 126
        Page 127
        Page 128
        Page 129
        Page 130
        Page 131
        Page 132
    Appendix G: Summary of district barriers
        Page 133
        Page 134
        Page 135
        Page 136
        Page 137
        Page 138
        Page 139
        Page 140
        Page 141
        Page 142
        Page 143
        Page 144
        Page 145
        Page 146
    Appendix H: Summary of district recommendations
        Page 147
        Page 148
        Page 149
        Page 150
        Page 151
        Page 152
        Page 153
        Page 154
        Page 155
        Page 156
        Page 157
        Page 158
        Page 159
        Page 160
        Page 161
        Page 162
        Page 163
        Page 164
    Appendix I: References
        Page 165
        Page 166
        Page 167
        Page 168
        Page 169
        Page 170
    Back Cover
        Page 171
Full Text

































Lawton Chls Goero
















HV
742
.F6
F661
S1994/96,






CHILD ABUSE AND

NEGLECT PREVENTION


STATE PLAN:


1994-1


Department of Health and Rehabilitative Services
The Children and Family Services Program Office
Child Abuse and Neglect Prevention
2811-A Industrial Plaza Drive
Tallahassee, Florida 32301
(904) 488-4900

Evaluation Systems Design, Inc.
700 North Calhoun Street, Suite A-2
Tallahassee, Florida 32303
(904) 681-6553
(904) 681-6261 FAX


December 31, 1993


996


I






Child Abuse and Neglect Prevention Plan: 1994-1996 i -





Acknowledgements



This publication was a collaborative effort involving members of the Child
Abuse and Neglect Prevention Interprogram Task Force and the 15 district
task forces, the Florida Department of Health and Rehabilitative Services
(HRS) Office of Children and Family Services (C&F) staff, the HRS/C&F
district contract managers, other district program office staff, and Evaluation
Systems Design, Inc. (ESDI). The success of the planning process can be
attributed to the dedication and commitment of all participants.

The Interprogram Task Force and district task force members contributed
many hours to fulfilling their responsibilities and made the district and state
plans a cooperative venture among various prevention and social service
providers. The state and district plans reflect their commitment to coopera-
tion and to integration of child abuse and neglect prevention services within
the state and local service networks.

C&F prevention staff members, A. Leon Polhill, Program Manager for
Prevention, and Admiral Hendersen, Human Services Program Specialist,
provided guidance and were actively involved throughout the planning
process. The district contract managers and prevention providers contrib-
uted much time and effort to the production of the district plans.

Thanks are offered to Dick Sinclair, HRS Public Information Specialist, for
the excellent photographs provided for the plan.

EDSI staff, Dr. Constance Bergquist, Dr. Cornelia Orr, Dr. Pam Taylor,
and Gayle Day provided technical assistance to the Interprogram Task Force
and district task forces during the planning process and compiled informa-
tion for the Child Abuse and Neglect Prevention State Plan. Special thanks
is given for ESDI support staff, Heide Martin and Angie Tyre.









Florida Department of Health and Rehabilitative Services






ii Child Abuse and Neglect Prevention Plan: 1994-1996






Table of Contents


Introduction.................................................................................. 1

Overview of Child Abuse and Neglect Prevention System ....................... 4

Understanding the Problem of Child Abuse and Neglect ......................... 9

Child Maltreatment ................................................................ 10
Predictive Factors.................................................................. 14
Demographics of Perpetrators in Florida ..................................... 16
Critical Problems in Florida ..................................................... 17

Mission of the Child Abuse and Neglect Prevention Program .................. 24

1994-1996 State Level Goals ............................................................. 25

Service Delivery Plan for Child Abuse and Neglect Prevention................. 27

Current Status of Child Abuse and Neglect Prevention Services ......... 27
Other Prevention/Early Intervention Services ................................ 34
Goals and Objectives for Service Delivery ................................... 42

Cooperative Agreements with Department of Education and Florida
Department of Law Enforcement ....................................................... 46

Current Status ...................................................................... 47

Plan for Coordination and Integration................................................ 52

Current Status ...................................................................... 53
Goal and Objectives for Coordination and Integration ..................... 54

Barriers to a Comprehensive Approach to Prevention Services ................ 57

Recommendations for Change........................................................... 60

Conclusion.................................................................................... 63

Appendices ................................................................................... 65




- Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 1 -



Introduction


Children are our nation's most precious resource. They are the leaders and
the thinkers and the dreamers of tomorrow. All children deserve to be raised
in a loving, nurturing family. Too frequently, however, the childhood experi-
ences that should strengthen and enrich lives are overshadowed by the fear
and physical trauma of child abuse and neglect.

Across the nation, reports of child abuse have increased from 60,000 in 1974
to over 2.6 million in 1990. Sadly, about 1 million of the cases reported in
1990 were substantiated by knowledgeable professionals. These reports
included 1,200 fatalities and 160,000 serious injuries.

Florida has not escaped this terrible
scourge that decimates families and
marks children with lasting emotional and
palpable scars. For Calendar Year (CY)
1992, the Florida Abuse Hotline (for-
merly Florida Protective Services Sys-
tem) counted 365,999 maltreatments in
116,404 initial and additional reports
received by the Florida Abuse Hotline
Information System. In almost one-half
of these reports, investigations identified
some indications of abuse, neglect, or
exploitation, and in more than 8,000
reports, the preponderance of the evi- -
dence confirmed the maltreatment.

An increasing body of literature docu-
ments that prevention programs can be
effective in reducing and eliminating child abuse and neglect. A recent United
States General Accounting Office report states that "The evidence accumu-
lated to date indicates that prevention programs can have a variety of positive
measurable effects. Such programs help parents develop the skills they need
to raise their children. They provide support systems to turn to when difficult
situations occur, and they link families with needed health and social support
agencies, such as those that provide counseling, day care, and employment
services." This report also recommends strong state-level planning to ensure
consistent funding and coordination for prevention programs.



Florida Department of Health and Rehabilitative Services






2 Child Abuse and Neglect Prevention Plan: 1994-1996










In Florida, an integrated system for planning and funding child abuse and
neglect prevention services was initiated in 1982 by the Legislature. The
statute provides the framework for a planned, comprehensive approach to
prevention and requires HRS to submit a biennial plan to the House of Repre-
sentatives and the Senate by January 1 of alternate years. This document
meets the requirements of section 415.501, F.S., by providing a two-year plan
for child abuse and neglect prevention services and related activities. The
document also addresses the requirements of section 415.5015, F.S., to pro-
vide training to public school staff and children on prevention of child abuse
and neglect.






























- Florida Department of Health and Rehabilitative Services





Child Abuse and Neglect Prevention Plan: 1994-1996
























Florida map showing
the 15 HRS Service
Districts











Florida Department of Health and Rehabilitative Services


3 -


JIFLy]






- 4 Child Abuse and Neglect Prevention Plan: 1994-1996




Overview of Child Abuse and

Neglect Prevention System

In 1982, the Florida Legislature enacted section 415. 501, F.S., that created a
service system specifically focused on child abuse and neglect prevention
services. The statute designed a decentralized system for planning, imple-
menting, monitoring, and evaluating. The funds come to the Children and
Family Services Program Office (C&F), then are dispersed to the 15 HRS
districts. A task force operates within each district, comprised of local citizens
including private providers and state agency staff. The individual task forces
conduct a needs assessment biennially, then make recommendations to the
HRS district administrator as to the services that should be provided and the
providers with whom to contract. A state-level task force was created to
provide overall guidance to the system.

The statue contains three sections. Section 1 of the statute presents the legis-
lative intent. The section identifies child abuse and neglect prevention as one
of the priorities for the state. Specifically, the legislative intent is that "a
comprehensive approach for the prevention of child abuse and neglect be
developed for the state and that this planned, comprehensive approach be used
as a basis for funding." Section 2 of the statute specifies the responsibilities
for developing a comprehensive approach to the
prevention of child abuse and neglect. The
legislation calls for HRS to develop a compre-
In Calendar Year 1992, hensive state plan in cooperation with an
116,404 initial and interprogram task force. Section 3 of the statue
addresses the funding of child abuse and neglect
additional reports of prevention programs and maintains that budget
child abuse and requests are to be based on the state prevention
plan. A copy of the statute is provided in Ap-
neglect were received pendixA.
by the Florida Abuse
Hotline.





--Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 5









Allowable services. Section 415.501, F.S., allows for a broad range of ser-
vices and leaves open the definition of prevention. The definition adopted by
C&F includes primary, secondary and tertiary prevention, defined as:

* Primary services to the general public.
* Secondary services to at-risk populations.
* Tertiary services to children and their families where there have already
been confirmed incidents of abuse or neglect.

Interprogram and District Task Forces. The
statute requires that an Interprogram Task Force "The prevention of
for Abuse and Neglect Prevention be established, child abuse and
comprised of representatives from the HRS pro-
grams of Children and Family Services; neglect shall be a
Children's Medical Services; Alcohol, Drug priority of this state."
Abuse and Mental Health; Developmental Ser-
vices; the Office of Evaluation; and representa- (section 415.501, F.S.)
tives from the Department of Law Enforcement
and the Department of Education. In addition to
these statutorily required members, the present
task force also includes representatives of Economic Services and the Depart-
ment of Labor and Employment Security (Project Independence). A list of
Interprogram Task Force members is included in Appendix B. Responsibili-
ties of the Interprogram Task Force include developing action plans for better
coordination and integration of the goals, activities and funding pertaining to
child abuse and neglect prevention; providing a basic format for district task
forces to use in preparing local action plans; compiling information for the
state plan; providing technical assistance to district task forces; examining the
local plans for completeness and deficiencies; preparing the biennial state
plan; and working with the Departments of Education and Law Enforcement
to inform and instruct school children, parents, school and law enforcement
personnel, and the general public in the detection of child abuse and neglect
and proper reporting procedures.





Florida Department of Health and Rehabilitative Services






6 Child Abuse and Neglect Prevention Plan: 1994-1996










oDistrict Child Abuse and Neglect Preven-
tion Task Forces operate at the local level
to plan prevention services, coordinate
service provision, and advocate for
needed services. The members of the
district task forces are appointed by the
district administrator, with membership
S. representing local public and private
agencies and child advocates as specified
by section 415.501, F.S. (see Appendix
A). In addition, local prevention provid-
ers and other interested parties may be
members of the district task force. Dis-
Strict task force responsibilities include
documenting needed services and devel-
oping a district plan of action.

Planning process. One of the central features of section 415.501, F.S., is the
community-level planning for needed services. The state and district plans
have served as a mechanism for achieving this objective. These plans provide
needs assessment data, recommendations for service delivery in specific
geographic areas, and general information about the problem of abuse and
neglect in each locality. Districts prepare individual plans in response to
guidelines from the Interprogram Task Force. The latter group then summa-
rizes and compiles the district plans and presents the overall plan for the state.

Service delivery. The service delivery system is comprised of local providers
under annual contract to the district C&F Program Offices. Decisions about
specific services to be provided, e.g., parent education, crisis intervention, etc.,
are made within each district. The district task force makes recommendations
related to funding programs to the Health and Human Services Board (HHSB)
and district administrator. Final decisions for funding rest with the HHSB and
district administrator and are implemented by the district C&F Program
Office.




Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 7










In addition to direct client services, the legislation requires cooperation be-
tween HRS and the Departments of Education, Law Enforcement and other
agencies at the state and local level to instruct agency personnel in the detec-
tion of child abuse and neglect and in the proper action that should be taken in
a suspected case of child abuse or neglect.

Funding. Child abuse and neglect prevention services in Florida are funded
by both state General Revenue funds and federal Social Service Block Grant
funds. In addition, some programs have been funded through the National
Center for Child Abuse and Neglect (NCCAN), United Way, and various local
funding sources. No perpetuating fund, i.e., trust fund, for prevention services
was established by the Legislature. Instead, specific appropriations are made
each year. This funding arrangement differs from the funding mechanism of
most states. According to a recent survey (Evaluation Systems Design, Inc.
[ESDI], 1989), 78% of the states responding (21 of 27 states) use a trust fund
arrangement for child abuse and neglect prevention services.

HRS Reorganization. In 1992, the Florida Legislature passed HB 2379 that
enacted two major changes affecting the child abuse and neglect prevention
service system. These legislative requirements, effective July 1, 1993, were:

1. Creation of District HHSBs responsible for the service planning of the
district and advising the Secretary on health and human services policies
and procedures.

2. Creation of four new service districts, increasing the total to 15 service
districts.











Florida Department of Health and Rehabilitative Services






-8 Child Abuse and Neglect Prevention Plan: 1994-1996










The planning process for the 1994-96 State Prevention Plan began before the
four new service districts were established; thus, some of the new districts
opted to conduct their planning processes within the old district configuration
and submit joint plans. The relationships to the newly formed HHSBs to the
prevention planning process mandated in section 415.501, F.S., was being
developed in each district as the planning process drew to conclusion. Some
district task forces submitted their plans to the district HHSBs, others submit-
ted them to the district administrators.

Relationship to other prevention services. Section 415.501, F.S., estab-
lishes a prevention system specifically for child abuse and neglect. Many
other efforts within HRS and other organizations are funded to prevent prob-
lems that increase child abuse and neglect. Examples are teen pregnancy
programs, health programs, and programs targeted toward preventing family
violence and drug abuse. The district and state task forces are charged, within
the law, with coordinating all of these efforts as they relate to and can prevent
child abuse and neglect. Funds appropriated for implementing section
415.501, F.S., however, are a funding source directed specifically at prevent-
ing child abuse and neglect.



















-Florida Department of Health and Rehabilitative Services







SChild Abuse and Neglect Prevention Plan: 1994-1996


Understanding the Problem


of Child Abuse and Neglect



Child abuse and neglect is one of the largest F
health and safety risks for our nation's children. Number of Child Abusi
According to the most recent national incidence FY 19
study (NCCAN, 1991, page 25), an estimated
Number of Reports
2.7 million children in America were alleged 14-
victims of child abuse and neglect in 1991. This 14 ----
involves children of all ages, from all types of "20o- _
families with varying ethnic backgrounds and 00oo J
economic status. In addition, 1,081 children s0- 6.s.
died as a result of abuse or neglect in 1991, 6o -.8
however, the number is probably underreported 40-
83-84 84-85 85-86 86-1
(NCCAN, 1991, page 34).3-4 95 56 -
Source: Florida Abuse Hotline Inform
In Florida, the number of reports of child abuse 1991 and 1992 data are for the calen
and neglect has increased significantly since
1984. In Fiscal Year (FY) 1983-84, fewer than


47,000 reports of abuse and neglect
were received. In FY 1990, 119,374
initial and additional reports of child
abuse and neglect were received by the
Florida Abuse Hotline. Since 1990,
the reports of child abuse and neglect
have declined slightly to 116,404
initial and additional in 1992. As
depicted by Figure 1, the trend can be
expected to remain at this same level in
the near future. Figure 2 further
defines the problem of abuse and
neglect in Florida by displaying the
rate of reports received during CY
1992 by district. The rate of reports
taken in Districts 2, 3, 5, 12 and 14,
ranging from 49.15 to 55.12 per 1,000,


Florida Department of Health and Rehabilitative Services


9 -


figure 1
e and Neglect Reports Received
84 to CY 1992

(in thousands)

I I 106.971
.o4
_i___ _{_."_-4- J....t ....
- __4-------------------
-C- C-I I~----


87 87-88 88-89 89-90 1991* 1992*
Fiscal Year
nation System (formerly FPSS) Annual Reports
dar year.


Figure 2
Rate of 1992 Abuse and Neglect Maltreatment Reports
(Rate per 1,000 children ages 0-17)

60 U District Rate S3 State Rate
50
40
30
20

0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
URS Districts
Reports as per the Florida Abuse Hotline Information System (formerly FPSS)
Monthly Statistical Report, December 1992 (Table 1.5)


FIB






- 10 Child Abuse and Neglect Prevention Plan: 1994-1996










were substantially higher than the state rate of 39.67 per 1,000. The overall
increase in reporting during the past decade could be attributed to increased
publicity and awareness of the citizens in Florida and across the United States.
It is important, however, to recognize that the number of abused and neglected
children is much too high and represents a serious social problem that de-
mands a major societal response (U.S. Advisory Board on Child Abuse and
Neglect, 1990).

Figure 3 The most severe child maltreatment, abuse
Number of Child Abuse Death Cases
By District, 1986-1991 resulting in the death of a child, has recently
been studied in Florida. At least 290 children
Number of Child Abuse Deaths 1986-1991
Nubr or Child Abue Olh 19.1991 died due to abuse during the six-year study
which lasted from 1986 through 1991. The
study found that boys were more likely than
30 .-. 2 ----- girls to be victims, with 89 percent of the
1 --- ------ child victims being age 5 or younger. Three-
_,_ ," fourths (75 %) were age two or younger, and
about one-third (39 %) were less than one year
Sold. These child deaths were a result of such
1 6 + 4 7 6 ? 8 9 10 11 12 L3 14 Ib
HRS nlsiricis severe maltreatments as beatings (56%),
Source: Florida Abuse Hotline Information System (formerly FPSS) Annual Reporlt, 191 shaken baby syndrome (13 %), gunshot
wounds (12%), suffocation (6%), drowning
(4%), stabbing (3 %), and fire (2%) (Florida
Protective Services System Annual Report, 1991, pages 31-48). Figure 3
presents the breakdown of child deaths by district over the 3 1/2 year period.
It is important to note that in counties with more families below the poverty
level, a higher abuse death rate existed.


Child Maltreatment
Child maltreatment, in a general sense, refers to the combined problems of
child abuse and neglect, defined as "any interaction or lack of interaction
between a child and his or her caregiver which results in non-accidental harm
to the child's physical and/or developmental state" (Helfer, 1982, p. 252).



-- Florida Department of Health and Rehabilitative Services







11 -


Child maltreatment, however, is a multifaceted problem. The American
Association for Protecting Children (AAPC), a division of the American
Humane Association, maintains that child maltreatment consists of several
major categories of behavior. These categories include neglect, physical
injury, sexual abuse, emotional
injury and other maltreatment.
Each of these categories must be Figure 4
viewed separately to come to an Florida Maltreatments in Reports Closed by Verified
accurate under g the and Some Indication for Neglect Categories in CY 1992
accurate understanding of the
magnitude of the problem of child
abuse and neglect.


Neglect


Abuse
33%


Neglect is characterized by acts of
omission. Generally, the caretaker
Threatened Hart
that is responsible for the child 23%
either deliberately, or by negligent
inattentiveness, permits the child to
experience suffering or fails to
provide one or more of the ingredi-
ents generally deemed essential for Source: Florida A
developing a person's physical,
intellectual and emotional capacities
(Polanski, N.A., DeSaix, C., & Sharlin, S.A., 1972).


Environ. Neglect
38%
Lack of Health Care
6%
Inadequate Super.
42%
Other Neglect
14%


Types of
Neglect


,buse Hotline Information System (formerly FPSS) Annual Report CY 1992


Categories


a


Neglect
44%


Neglect is the most frequently reported form of child maltreatment nation-
wide. The 1991 NCCAN Data System (NCANDS) data indicate that neglect
was estimated to have occurred with 384,499 children in 1991. Physical
neglect was the most prevalent form of neglect. Educational neglect followed
with emotional neglect being slightly lower. Figure 4 presents the 1992
Florida data for neglect maltreatments in reports closed with verified and
some indication findings in Calendar Year 1992.


-- Florida Department of Health and Rehabilitative Services


-I







- 12 Child Abuse and Neglect Prevention Plan: 1994-1996











As shown in Figure 4, there were 81,939 maltreatments with some indication
and verified findings in the neglect categories in 1992. Of this total, 34,507
(42%) involved inadequate supervision; 31,312 (38%) involved environmental
neglect; 4,989 (6%) involved lack of health care; and 11,131 (14%) involved
other neglect (including failure to protect from physical injury).

Abuse

Physical abuse. Physical abuse is defined as physical injury, including death,
permanent or temporary disfigurement or impairment of any bodily part. It is
the result of action by a caretaker, or other person responsible for a child's
welfare that results in injury or threatened harm to the child (section 415.503,
F.S.).

Based on national estimates
Figure 5 in the 1991 NCANDS
Florida Maltreatments in Reports Closed by Verified report, physical abuse
and Some Indication for Abuse Categories in CY 1992 occurred with 453,766
children. Physical abuse
accounted for 45 % of the
maltreatments, sexual abuse
Mental Injury I1%
Threatened Harm aln 29% and emotional injury
23% Sexual Maltrtmnt 22%
rug-Expsd Nwbrn 8% for 11%.
33% Physical Injury 59%
Neglect
44% Other Abuse 0%

Types of
Categories Abuse


Source: Florida Abuse Hotline Information System (formerly FPSS) Annual Report CY 1992







-- Florida Department of Health and Rehabilitative Services






SChild Abuse and Neglect Prevention Plan: 1994-1996 13 -









In Florida, 33% of all reports closed with "verified" and "some indication"
findings in 1992 were reports of abuse. Figure 5 depicts the percentage of
abuse by category for CY 1992. The Florida Protective Services System Data
Tables for Calendar Year 1992 revealed that of the 61,446 instances of abuse
maltreatment cited within the reports closed, 38,857 (59%) were physical
abuse, much higher than the national percentage.

Sexual abuse. Downer (1985) defines sexual abuse as contacts or interactions
between a child and an adult in which the child is used
for the sexual stimulation of the perpetrator or another "Sexual abuse is
person. Sexual abuse may also be committed by a
person under 18 when the person is either significantly believed to be the
older than the victim or is in a position of power and m unreported rm
control over another child. "Sexual abuse is believed most nrep form
to be the most unreported form of child maltreatment of child maltreatment
because of the secrecy or conspiracy of silence which c f th
so often characterizes these cases" (U.S. Department of be of
Health and Human Services, March 1990). secrecy or conspiracy

It should also be noted that even with the suspicion of of silence which so
unreported instances of sexual abuse, known sexual often characterizes
abuse has tripled nationally since 1980. Sexual abuse these cases" (U.S.
occurred in 129,697 children nationally in 1991 te c (..
(NCCAN, 1991). Department of Health and Human
Services, March 1990).
In Florida, 22% of all "verified" and "some indication"
abuse reports received in 1992 involved sexual mal-
treatment. More than 70% of sexual abuse victims were
females, compared to a national rate of 61 %. Black children accounted for
16% of sexual abuse reports.







Florida Department of Health and Rehabilitative Services






- 14 Child Abuse and Neglect Prevention Plan: 1994-1996










Emotional abuse. Emotional abuse is defined as close confinement, verbal or
emotional assault or other abuse. These emotional abuses can further be
described as some tortuous restriction or movement, a habitual pattern of
belittling, denigrating, scapegoating, or other nonphysical forms of overtly
hostile behavior, as well as threats of other forms of maltreatment. Emotional
abuse generally occurs in combination with some other form of child maltreat-
ment.

In 1991, national data reflected that emotional maltreatment occurred with
49,124 children. In Florida, 6,633, or 11% of the abuse report incidents
reported to the Florida Abuse Hotline, involved emotional abuse.

Predictive Factors

Knowledge of incidence rates among various sections of the population
should facilitate the identification of likely perpetrators or victims and the
development of effective service delivery; however, this is not necessarily the
case. The problem lies in deciding which factors are more prevalent, where to
target services and which approaches work best. Even so, knowledge of
characteristics of victims is helpful in under-
standing the problem and in planning for
needed services (Evaluation Systems Design,
Inc. [ESDI], 1989). To add to our understand-
ing of the victim characteristics, information
from the 1991 NCCAN study is provided in
the following sections.











Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996


Gender. Due to greater vulnerability, sexual abuse occurred more often with
females 61 %, compared to 39 % for males. Males were more likely to be
emotionally abused rather than sexually abused. It is difficult to determine
whether these differences, particularly in sexual abuse, are a function of
reporting rather than actual incidence. The similarity in pattern and distribu-
tion of child maltreatment among males and females leads to the conclusion
that gender cannot be used successfully as a predictor, except perhaps with
sexual abuse.

Age. Child abuse and neglect occurs to children of all ages. Generally, the
percentages of victims are fairly evenly distributed across most age groups.


Physical abuse, educational neglect and emotional
neglect appeared to be positively correlated with age.
Although children appeared to be at greater risk with
increasing age, fatalities were more numerous among
younger children. These data point to the increasing
concern that abuse of younger children remains undetec-
ted until those children enter school.

Race/Ethnicity. According to the NCCAN study, more
than half of victims (55%) are reported as white and 26%
as African American. Nine percent are reported as
Hispanic, but some states with major Hispanic popula-
tions (Florida) were unable to report separately on His-
panic victims; therefore, it is probable that the percentage
of Hispanic victims is higher.


Family Income. Family income is a highly significant factor in the prediction
of child abuse and neglect. According to the NCCAN study (1988), families
with annual incomes of less than $15,000 abused or neglected their children at
a higher rate than families with more income. Abuse was 4.5 times more
frequent and neglect was nine times more frequent. These incidence rates
confirm the literature connecting poverty with child abuse and neglect.





Florida Department of Health and Rehabilitative Services


Abuse is 4.5 times
more likely in
families with income
of less than $15,000.
Neglect is nine times
more likely.


.


15 -







- 16


Figure 6
Age of Perpetrators in Florida Family size. Children of families that con-
sisted of more than four children were more
Number of Perpetrators (Thousands) likely to be abused or neglected. According
34 -1/ 3 3.512 to an NCCAN study (1988), the rates varied
1 --------- from 21 per 1,000 for families with 2-3
Children, to 35.6 per 1,000 for families with
2 1.555 four or more children. The trend was only
slightly higher for neglect.
0.21
o Demographics of
Under 18 18-24 25-29 30-34 35.44 Over 44Unknown
Age Perpetrators in Florida
Source: Florida Abuse Hotline Information System, 1992-93 data formerlyy FPSS)

Figures 6 and 7 represent the age and race of
proposed confirmed and confirmed perpetra-
tors in Florida (Florida Abuse Hotline Information System, 1992-93). Almost
50% of the perpetrators in Florida were between the ages of 30 and 44. Sixty-
three percent (63%) of the perpetra-
Figure 7 tors were Caucasian and 36% were
Race of Perpetrators in Florida African-American.


Caucasian
9,174 63%






Other
94 1% African-American
5,219 36%

Source: Florida Abuse Hotline Information System, 1992-93 data (formerly FPSS)







Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 17 -










Critical Problems in Florida

Methodology

District task forces from each of Florida's 15 HRS districts rated the critical
needs/problems that were most prevalent to their district by using a systematic
method of needs assessment documented in the Needs Assessment Guidelines
(ESDI, 1993). The task force members rated 30 needs or problems and identi-
fied the ten most critical issues. The rating decisions were based on a critical
review of incidence data and input from key respondents. Then members
ranked the ten most critical needs/problems.

Results of Needs Assessment

Most of the 15 districts conducted formal needs assessment processes to
determine the prevalence and criticality of needs related to child abuse and
neglect prevention. Thirteen of the 15 districts submitted a priority ranking of
the ten most critical needs identified in these processes. Appendix C contains
the ranking of the district needs and problems with one being the most critical
and ten being the least critical to address with abuse and neglect prevention
services.















Florida Department of Health and Rehabilitative Services






18 Child Abuse and Neglect Prevention Plan: 1994-1996






Figure 8
Most Critical Needs/Problems
as Ranked by All Districts
Critical Need/Problem
Lack kndge p.ar ski-l Districts identified more than 30 different
Substc abusing paiunt--s needs. Figure 8 graphically depicts the most
Economic stresses critical needs/problems ranking by districts.
Aordble reg day can 1 ---- The lack of knowledge of effective parenting
Sexually abused chidr- I
MedIpsyc problems --J. Ranked 3 skills and child development or infant care
Single pare nts I ORankeld 2 was the most critical need (ranked one or two
Teen/first time parts ---- ----- Ranked I
par-- Eank-d by eight of the districts). The second most
0 2 4 6 8 10 critical need is substance abusing parents and
Frequency
Source: District Chid Abue andeq the impact on drug-exposed children. Eco-
Neglect Prevention Task Force. nomic stresses and the need for affordable
regular day care were ranked very high by
districts, as well as the needs of sexually
abused children and problems with medical or psychological problems requir-
ing early intervention. Single parents and teen or first-time parents were also
ranked as very critical by districts. The Interprogram Task Force used these
results as they were generating the statewide goals and objectives.

Substance-abusing parents. Use of
Figure 9 drugs and alcohol continue to be a
Percentage of Admissions to Drug Treatment critical problem in the state of Florida
for Cocaine Use in FL., 1980-1991
and nationally. Use of cocaine is a
Percentage particularly significant issue. As
so8 -__-------------------------_----_ documented in the HRS ADM report
70% ------ Patterns and Trends of Alcohol and
so%5 ---- ----_- -_ _______--- Drug Abuse in Florida (1992), "The
40% -- -- -- -- ---- majority of this increase (in drug
_0%---- --------- -.. -- -- -- -- _-_-- -- -----
20% -/ treatment admissions) over the last six
10% L / / / / / / / / / years is due to crack/cocaine admis-
80 81 82 83 84 85 6 87 88 89 90 91 sions. From 1986 to 1991 the number
Year of public admissions indicating crack/
So..rce: Florida lRS ADM Program Admissions ainas the primary substance of
Public Treatment Programs (CODAP 0-9, SISAR 91) Caine as the primary substance of
abuse increased 291%." (p. HRS-
ADM 6). As represented by Figure 9,
admissions to drug treatment centers for cocaine use increased from 1980 until
1989 and has declined slightly in the last two years.



- Florida Department of Health and Rehabilitative Services







Child Abuse and Neglect Prevention Plan: 1994-1996


Cocaine use presents a major concern, espe-
cially among women of child-bearing age.
Sixty-seven percent of the women who en-
tered drug treatment in 1989 abused cocaine
as their primary drug. These women put not
only themselves at risk, but also the children
they may already have or any children they
may conceive while using cocaine.

Drug-dependent newborns. Drug-dependent
newborns have become the most critical child
maltreatment problem in Florida. There is an


alarming upward trend in the number of reported cases by (FAHIS) and by
HRS County Public Health Units. In
1992, 3,916physically drug-depen- Figure 11
dent infants were reported to FAHIS. Rate of Drug-Dependent Ne
Fifty-five percent (2,148) of the All Findings in Reports Clos
reports were substantiated as either
verified or having some indication of 40 District Rate
drug dependency. Figure 10 presents StteRate ....
the number of physically drug-depen- 30
dent newborns for the last three years --------- i
and shows a slight downward trend, 20
but the incidence is still very high. 1o

The heavily urban areas of the state 0
have especially serious problems with i 2 3 4 5 7 s 9 10
the rate of drue-dependent newborns. Sour.c: Florid Abue Hline Ins.llo.tin System ,ferly FP


Figure 11 targets those HRS districts
having rates of physically drug-depen-
dent newborns that are higher than the state rate. Rates were calculated using
the number of physically drug-dependent newborns and the total number of
live births in 1992 (Bureau of Vital Statistics). As noted in Figure 11, Dis-
tricts 8, 9 and 15 have rates of physically drug-dependent newborns ranging


SFlorida Department of Health and Rehabilitative Services


Figure 10
Number of Drug-Dependent Newborns
in Florida


)00-
2y -____-------

500 -
500-

500-
2
0 '
CY 1991 CY 1992 FY 1993


Source: Florida Abuse Hotline Information System (formerly FPSS)


wborn Victims
ed in CY 1992









]--I---i


11 12 13 14 IS
SS) A.,..I Repot CY 1992


I






- 20 Child Abuse and Neglect Prevention Plan: 1994-1996










from 33 to 36 per 1,000 children which is higher than the state rate of 20.54
per 1,000 live births. The state rate is considerable higher in 1992 than in
1989 when the state rate was 18.18 per 1,000 live births.

Drug-dependent newborns present a number of costly demands, both mon-
etary and physical. If the drug-exposed infant lives, he/she will have a range
of health and social problems which will undoubtedly require later interven-
tion by HRS in the form of health and social services. Children who are born
as drug-exposed are more likely to be premature, have lower birth weight, and
some will suffer from developmental disabilities, which may hinder school
and later work performance. Behavioral problems in school will present extra
demands on the classroom teacher and school system. Many infants who are
born as drug-exposed do not go home with their parents, but are placed in
foster care. Of those who do go home with their parents, many eventually
enter the Florida Protective Services System because of the chaotic and often
dangerous home environment that is associated with parental drug abuse.

Cocaine and other Schedule I and II drugs are not the only danger to new-
borns. Another substance abuse problem is use of alcohol by women during
pregnancy. Between one and three of every 1,000 infants are born with Fetal
Alcohol Syndrome (FAS), which can have debilitating effects on the child.
Prenatal exposure to alcohol is one of the leading causes of mental retardation
(Abel & Sokol, 1986). In utero alcohol exposure produces a wide range of
effects. Infants who are exposed in utero to heavy amounts of alcohol can
show the full effects of FAS or just some fetal alcohol effects. Many of the
babies exposed to alcohol in utero go undetected due to the inadequate mecha-
nism for reporting and the difficulty of detecting symptoms in newborns.
Fetal alcohol babies are not considered "abused" by FPSS standards, which
are based on section 415.503, F.S. It is, however, an indicator of the larger
problem of substance-abusing parents. The parent's continuing substance
abuse places the infant at high risk for abuse and neglect.







-Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 21










Adequate prenatal care would help prevent or at least alleviate the problems
that are associated with drug-exposed infants. Adequate prenatal care could
significantly improve the health of those infants that were born to drug-using
women and could reduce the risks of other long-term problems. According to
the Government Accounting Office (GAO) report on drug-exposed infants
(1990), three basic components of prenatal care are recommended: (1) early
and continued risk assessment, (2) health promotion, and (3) medical and
psychosocial interventions and follow-up.

Lack of affordable child care. Lack of affordable child care presents a
problem for parents of young children who must work and those who need
occasional respite from the demands of child care. The increase of emotional
stress in the family has been linked to increased incidence of child abuse and
neglect. Whether occasional or regular, child care allows the parent to work
and provides a break for the parent from the responsibilities of child care,
which should reduce parental stress. Successful child care programs will also
enhance the child's opportunities to be with other children and facilitate child
development.

In Florida, the Subsidized Child Care Program provides child care for families
who cannot otherwise afford it. Priority for services is given to families where
abuse or neglect has occurred and families at risk of abuse or neglect. Other
groups are eligible, such as those whose parents participate in the employment
and training programs of Project Independence and those entitled under Title
IV-A; those whose families receive Aid the Families with Dependent Children
(AFDC) or Supplemental Security Income (SSI); children of migrant, teen, or
Native American parents; or those whose families earn less than 150% of the
federal poverty level (the working poor). Unfortunately, many families in
need are not able to participate in subsidized child care programs, as indicated


SFlorida Department of Health and Rehabilitative Services







Child Abuse and Neglect Prevention Plan: 1994-1996


Figure 12
Rate of Children on Waiting Lists
for Subsidized Day Care FY 1992

70 District Rate
60 a State Rate

so
40o --
30 o
20


1 2 3 4 5 6 7 8 9 10 11 12 13 14 IS
HRS Districts
Source: Children ad Families Program Office Subsidizd Child Care Program Management Report.
Data were available only for FY 1991.92 and districts 112.


I Births to teen mothers. Teen pregnancy
and parenthood are serious problems in
Florida, with one of every six infants being
born to teen mothers. Research has documented higher incidence rates of
child abuse and neglect among children born to teen mothers. This problem is
magnified by the fact that 96 percent of all teen mothers keep their babies.
Figure 13 represents the rate of births to teen mothers in Florida by age group
for 1992.


Statewide, births to teen moth-
ers in 1992 occurred at a rate of
88.88 per 1,000, lower than the
95.05 rate in 1988. As noted in
Figure 13, Districts 2, 3, 14 and
15 have the highest incidence in
the state with rates of over 100
per 1,000. Data provided by the
Bureau of Vital Statistics were
used to calculate the rate. The
rate was calculated by using the
number of live births to mothers
under age 19 for 1992 and the
total number of live births to all
mothers in 1992.


Florida Department of Health and Rehabilitative Services.


by the number or children on a waiting list
to enroll in these programs. Figure 12
indicates that the rate of children on waiting
lists is above the state rate of 26.79 per
1,000 in Districts 3, 4, 5 and 9. These rates
were calculated by using C&F Subsidized
Child Care Waiting Lists for Services (May
1992) and the total population ages 0-4.


Figure 13
Rate of Births to Teen Mothers in 1992


I 2 3 4 5 6 7 8 9 10 II 12 13 14 15
HRS Districts
Source: HRS Public Health Statistic (calculated using births to females under 19 and
births to all females In 1992, provisional data)


- 22

















Figure 14
Rate of Florida Children
Economic stress. Economic stress is a Living Below the Poverty Level in
significant indicator of abuse and neglect.
Families earning under $15,000 per year are 300- ---- -- DistrictRate
five times more likely to abuse or neglect 2so
their children. In Florida, the state rate for 200
children in poverty is 166.64 per 1,000, much 150
lower than 213.57 in 1988. Figure 14 depicts 1oo
the number of children, by district, that are so-
below the poverty level. In 1992, more than 1 2 3 4 6 7 9 0 13
one-sixth of all of Florida's children were HRS Districts
living below the poverty level. The highest Source: 199 U.S.Burea of Cenus (ae calculated by usignumbe
rates occur in the northern part of the state in fte cen nd the number of children 0. yeas of ase).
Districts 1, 2 and 3. District 11 also had a
high rate. The rates were calculated by using
the number of children living below the poverty level according to projections
from the 1990 Census data and the total population 0-17.

Unemployment also provides an
economic stress on families that Figure 15
can increase child abuse and Rate of Unemployment in 1992
neglect. Figure 15 shows the
rates of unemployment for the 15 ,4 District Rate State Rate
HRS districts in Florida. The :2
highest rates of unemployment 0-
are found in Districts 8, 9, 14, and 8-
15. 6-
4-
2-
0 V
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
HRS Districts
Source: Florida Department of Labor and Employment Security.
Rates are rate per 100 persons.


Florida Department of Health and Rehabilitative Services


23 -


1992


14 15

below poverty level






-24 Child Abuse and Neglect Prevention Plan: 1994-1996





Mission



Sn section 415.501, F.S., the Legislature responded to the rapidly increasing
rate of child abuse and neglect in Florida. The Legislature recognized the
high cost of such maltreatment in human terms and in terms of immediate
costs to the state for protective investigation, treatment services, and out-of-
home placements for abused and neglected children. The Legislature also
acknowledged future costs relating to the need for alcohol, drug abuse and
mental health services, delinquency and correctional services, and health
services.

Previous state plans have operationalized the legislative intent into a mission
statement for the Abuse and Neglect Prevention Program. As part of the
planning effort for the 1994-96 Child Abuse and Neglect Prevention Plan, the
Interprogram Task Force reviewed and revised the mission statement for the
Child Abuse and Neglect Prevention Program. The mission of the program is
as follows:



The mission of Florida's Child Abuse
and Neglect Prevention Program is to
promote and provide comprehensive,
planned programs designed to
encourage factors that lead to healthy,
permanent, stable families, free from
abuse and neglect. The programs
should be locally planned, community-
based, family-centered, and culturally
sensitive.






Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 25





1994-1996 State Level Goals



The Interprogram Task Force for Child Abuse and Neglect met on eight
occasions between July and December, 1993 to review all district plans and
generate the goals to be pursued by the prevention program for the next two
years. These goals reflect the plans submitted from 15 district task forces that
followed a systematic needs assessment and goal development process. The
state goals represent a compilation and synthesis of the goals for all preven-
tion programs in Florida.

Goal 1

Support and encourage efforts to inform and educate the public, profes-
sionals, and decision-makers about child abuse and neglect and about the
needs, services, and programs for preventing child abuse and neglect.

The key to success in preventing child abuse and neglect is an informed and
alert public. Greater efforts are needed to help all Floridians understand the
severe and lasting consequences of harming children and the many positive
ways to avoid abuse and neglect. All people need to believe in and support
the long-term benefit of prevention programs.

Goal 2

Encourage the sensitivity and responsiveness of child abuse and neglect
prevention services and programs to the populations in need of services.

Research has identified risk factors that increase the probability of child abuse
and neglect. Programs targeted on families with high risk factors must be
developed and implemented with an understanding and appreciation of the
cultural background of the families.


SFlorida Department of Health and Rehabilitative Services






SChild Abuse and Neglect Prevention Plan: 1994-1996


Goal 3

Enhance the development and implementation of family-centered child
abuse and neglect prevention programs and services.
Children live within families. Effective prevention programs incorporate the
entire family in developing and implementing long-term solutions.

Goal 4

Enhance coordination among all agencies and organizations responsible
for prevention of child abuse and neglect.
Many public and private agencies and organizations comprise the child abuse
and neglect prevention system in Florida. This goal reflects the need for
integrating prevention and early intervention initiatives of the state. Coordina-
tion will reduce the fragmentation of funding
and increase the efficiency of programs so
that more families and children can receive
-rrvm T-cI/ I the quality prevention services they need.


Florida Department of Health and Rehabilitative Services


C I I t1 1 t1 il vI %4 I. r1 1
Force established four
statewide prevention
goals.


I


+-


Tk Itrri


- 26






27 -


Service Delivery Plan



Current Status of Child
Abuse and Neglect Prevention Services

Continuum of Prevention Services

Clearly there is no single approach to preventing child abuse and neglect. As
a framework for defining services, C&F adopted the continuum of services
defined by the National Committee for the Prevention of Child Abuse. This
continuum is used in Florida at the state and local levels to coordinate services
and to identify any gaps where services may not exist.

The continuum is composed of 13 general service areas. Two of the areas
address a specific target group of clients, expectant or new parents, while the
remaining categories address specific service delivery strategies.

Although some of the continuum categories may reflect programs that provide
mostly primary, secondary, or tertiary services, programs in any of the con-
tinuum categories may reflect any of the three levels of services. For ex-
ample, an in-home education and support program may be targeted at an at-
risk population of young or single parents and therefore provide secondary
prevention services. Some counties, however, provide in-home education and
support to all families of newborns, regardless of risk factors. These programs
would be primary prevention programs.


-- Florida Department of Health and Rehabilitative Services


II:







- 28 Child Abuse and Neglect Prevention Plan: 1994-1996










Prenatal Support for Expectant Parents.
r Services include support, maternity medical
care, information about community resources,
and education for expectant parents during the
prenatal period. Low birth weights and medical
problems resulting from poor prenatal care
increase the risk of abuse or neglect among
n babies. Improving prenatal care and education
for expectant parents can, therefore, reduce the
risk of abuse and neglect for infants.

Postnatal Education and Support. New parents are prepared for responsi-
bilities relating to infant and child care through postnatal medical care, infor-
mation on available community resources, individual and group education and
postnatal support groups. Postnatal education and support works similarly to
prenatal programs and can be a continuation of prenatal services. Through
education and support programs the parent-child relationship can be strength-
ened and bonding enhanced. Studies suggest that the risk of child abuse and
neglect is reduced significantly when bonding between parent and child is
strong. Additionally, preparing and educating new parents and providing
support can lessen the stress of child rearing responsibilities, thus reducing the
risk of child abuse and neglect.

In-Home Education and Support. Information and advice are provided on
child care, routine health needs, nutrition and home management to isolated
families in need of ongoing support. Again, the demands of a young child and
the additional stress that a child presents to a family can easily result in abuse
and neglect. This is particularly true of young, inexperienced or single par-
ents, or low-income families. Home visitor programs offer in-home support to
these families, provide education, and act as a first alert to problems develop-
ing within the family which may result in child abuse and neglect.







-Florida Department of Health and Rehabilitative Services








29 -


Early and Regular Educational, Medical and Psychological Screening.
Screening provides early detection of health, developmental and psychological
problems to children through home visitor, health-related or school-based
programs. The risk of child abuse and neglect is greater among children with
developmental delays, health and psychological problems. With early detec-
tion of these problems, the risk can be reduced by helping families to cope
more effectively and securing services for the child.

Medical and Psychological Services. Comprehensive services are provided
for children at risk of abuse/neglect and their families based on individual
needs. These services function in the treatment of problems that may increase
the risk of abuse and neglect.

Child Care. Regular or occasional child care is provided for children at risk
of abuse/neglect. Child care is typically needed to allow parents to work. In
the prevention continuum, however, child care may be used as a respite for
parents who are overwhelmed by child caring responsibilities or as a therapeu-
tic intervention for children. Giving the parents a break from child caring
responsibilities can reduce parental stress and serve the added purpose of
ensuring that the basic needs of children are provided and the child's develop-
ment is enhanced. When family members interact with professionals, natural
opportunities occur for modelling appropriate parenting skills.

Self-help Groups. Self-help groups provide an avenue to reduce the isolation
of parents with a high probability of abuse/neglect by developing a peer
support network. In addition to providing group social activities, the self-help
group can function as a network of concerned individuals for parents to
contact when stressful situations threaten the safety and well-being of their
children. These groups often expand to provide education and training to
members that improve their understanding of appropriate parenting tech-
niques.







Florida Department of Health and Rehabilitative Services -








- 30 Child Abuse and Neglect Prevention Plan: 1994-1996






None of the 15 HRS districts
are funded to implement Parent Education and Training. With
prevention programs in all greater understanding of children's
behavior, care, and alternative methods
areas of the child abuse of discipline, parents are less likely to be
and neglect continuum of abusive and neglectful. Parent education
classes are designed to teach necessary
services, child-rearing skills. Areas of focus
include child development, parent/child
relationships, child discipline and child
health care.

Child Safety Training. Training in child safety and life skills helps children,
adolescents and young adults not to follow the abusive and neglectful patterns
of their parents, to recognize abuse and neglect, and to protect themselves. It
also helps young people cope with the demands of adult living, e.g., work,
relationships, parenting. Education for adolescents, particularly in the areas
of sexuality and pregnancy prevention, can impact significantly on teenage
pregnancy and the high risk of abuse and neglect for children of young par-
ents.

Family Crisis and Intervention Support. Immediate assistance is offered to
parents in crisis or under undue stress, intervening before a potentially abusive
incident can occur or after an incident to prevent its reoccurrence. Services
may include: telephone hot lines, crisis caretakers, crisis nurseries or child
care, and crisis counseling.

Treatment and Intervention Services. Programs provide individual and
group treatment or therapeutic child care to minimize the long-term effects of
abuse and neglect on children and their families. Treatment services in the
prevention effort address the cyclical nature of the child abuse and neglect
phenomenon. In treating the victims of child abuse and neglect, prevention
service providers hope to change abusive/neglectful patterns. Children who
have been abused and neglected will then be less likely to become abusive and
neglectful parents.





-Florida Department of Health and Rehabilitative Services








Child Abuse and Neglect Prevention Plan: 1994-1996 31 -










Community Organization. These programs function to increase the avail-
ability and enhance the coordination of social service, health and education or
other support services to families in an effort to reduce family and environ-
mental stress. Their target audience is the community at large and the social
service delivery system existing in the community.

Public Information. Services are based on the philosophy that being aware
of the problem is a first step toward doing something about it. Media cam-
paigns and public speaking engagements which emphasize the difficulties of
parenting and provide information on where parents can go if they need help
are part of public information efforts. These efforts increase community and
professional awareness of the dynamics of child abuse and neglect.

Implementation of the Child Abuse and Neglect
Prevention Service Continuum

The HRS districts have implemented many of the prevention services delin-
eated in the continuum, although no district has been able to fund the full
continuum of child abuse and neglect prevention services. Appendix D
provides a matrix that indicates, for each part of the continuum, the districts
that fund each type of service through section 415.501, F.S., resources. As
Appendix D illustrates, the prevention funds are used differently in each
district.

During the past biennium, the districts have concentrated their efforts on two
or three areas of the continuum. Some provided only two or three types of
services, while others distributed funding to programs that concentrated
services in a few areas but provided a wider range of services. Home visitor
services, parent education, and perinatal education and support were among
the most commonly provided services. An increasing number of districts have
been providing treatment services through the prevention funds. Community
organization or public information services were not widely available.





Florida Department of Health and Rehabilitative Services -








- 32 Child Abuse and Neglect Prevention Plan: 1994-1996










A new development that will help Florida's communities is the Pew Charitable
Trusts' Children's Initiative: Making Systems Work. Florida has received a
planning grant and may receive funds to implement this exciting new ap-
proach. The purpose of the Children's Initiative is to improve the well-being
of children and their families through broad institutional reform of existing
systems that serve children and their families. The core components of the
Initiative include:

Effective outreach and engagement in prenatal care and related services to
the broadest possible number of pregnant women.

Contact with the families of all newborns at birth, with appropriate fol-
low-up services.

A network of referrals between agencies (including schools) and family
centers, as well as a wide array of other formal and informal programs and
institutions that serve children and families.

Also included in the Initiative are establish-
ing neighborhood family centers as the hub
of service delivery, incorporating family-
.centered practice, and establishing neigh-
borhood and community governance struc-
tures. Many of the approaches being
planned through the Initiative reflect or
incorporate prevention strategies imple-
mented in some districts' section 415.501,
F.S. programs.










Florida Department of Health and Rehabilitative Services








Child Abuse and Neglect Prevention Plan: 1994-1996 33 -










Funding of Services

Specific appropriations for child abuse and neglect prevention services are
made each year. Prevention services funded under section 415.501, F.S.,
represent one of the appropriation categories for C&F services. Since the
initial appropriation of $1.1 million in 1983, amounts (combining General
revenue and Social Service Block grant funds) increased annually for five years
to a maximum of $4.9 million appropriated in 1988-89. Funds decreased in
1989-90 and 1990-91 to $3.8 million and $3.2 million respectively. In 1992-93
and in 1993-94, $3,061,835 was appropriated.

District Child Abuse and Neglect Prevention Services

Districts distributed prevention funding in a variety of ways: across types of
services, among service providers, and across target populations. Some dis-
tricts funded only one service provider while others contracted with multiple
providers. In 1993-94, 26 providers received funding under section 415.501,
F.S. Prevention efforts sometimes were concentrated on one type of service,
such as prenatal education and support or treatment and intervention. In some
districts, certain client groups, such as teen parents, were targeted. The specif-
ics of district funding, providers, and services are included in the district plans.
A summary of the district information is located in Appendix E.


- Florida Department of Health and Rehabilitative Services


I|








34 Child Abuse and Neglect Prevention Plan: 1994-1996










Other Prevention/Early Intervention
Services

Project Safety Net. In accordance with sections 402.3125 and 402.3135,
F.S., case management and transportation services are provided for children in
subsidized child care who are at risk of child abuse and neglect. In-home
services are available to the families of these children. Safety Net services are
available in all 15 HRS districts.

Home Visitor to High-Risk Newborn
Project. Contracted services through the
HRS/C&F Program Office are available to
multi-problem, high-risk families expecting
newborns or parenting infants in all HRS
districts. In-home services address prenatal
care, parent-child bonding and infant stimula-
tion, screening, assessment and follow-up,
d parent training, parental stress, and healthy
.k family functioning.

.i-i Parents Anonymous. Self-help groups are
established which provide an opportunity for
parents to interact and form a network of
supportive individuals who may be contacted
in times of crisis or stress to prevent child abuse or neglect. A statewide
parent help-line is also provided.

Subsidized Child Care. Comprehensive care of preschool and school-age
children in licensed child care facilities or family child care homes is provided
through purchase of service contracts with local child care providers. A
limited number of child care slots are available for low income families,
children of Project Independence clients, or children at risk of abuse or neglect
under the protective supervision of HRS/C&F.



- Florida Department of Health and Rehabilitative Services








Child Abuse and Neglect Prevention Plan: 1994-1996 35 -










Prekindergarten Early Intervention Programs. Early educational and
developmental experiences are provided to economically disadvantaged and
other high-risk four year olds. Services may include classroom instruction
and health/education screening and referral. The parent involvement compo-
nent of some programs is designed to enhance parental involvement in their
child's educational, social and physical development.

Chapter 1. Developmental early learning services are provided for three- and
four-year-old children from low-income families. The program seeks to
promote cognitive, social, emotional and physical development of disadvan-
taged children. Eligibility is based on two factors: 1) availability of the
program in the child's school, as programs are located only in schools where a
significant proportion of students are economically disadvantaged; and 2)
scoring on a needs assessment survey which denotes the child as educationally
disadvantaged.

Head Start Programs. Language, cognitive, social, emotional and physical
development is emphasized in the Head Start program. Some medical and
dental services are provided. Parental involvement is also a component.
Services are provided to disadvantaged children, ages three and four, with
special consideration to handicapped children. Estimates are that less than one
fourth of the target population is being served. Wrap-around services are
needed to provide before- and after-school care for children of working par-
ents.

First Start. Services are provided to promote parents as their children's first
teachers and enhance children's early intellectual, language, physical and
social development. A variety of services are available through Parent Re-
source Centers to families with children birth to age three. These include:
home visits, group meetings, lending libraries of toys and books, parent
education, advocacy, and educational, medical and developmental screening
and referral. In 1993-94, 24 local school districts were operating First Start
programs.


SFlorida Department of Health and Rehabilitative Services








- 36 Child Abuse and Neglect Prevention Plan: 1994-1996










Child Care Resource and Referral Network. The network provides a child
care resource and referral service to parents who need child care services. The
statewide Network Office contracts with child care central agencies to refer
parents to child care centers available in the community and refer eligible
parents to subsidy programs and other family support services, family child
care homes, public prekindergarten/early intervention programs, Head Start
and other programs. In addition, the central agencies provide resource infor-
mation, recruit child care providers, establish lending libraries for parents, and
provide technical assistance to child care providers.

Prekindergarten Handicapped Programs. Services are provided to children
ages birth to five. Home instruction, including training to the parent or guard-
ian, is provided to handicapped children ages birth to three. Other services
including physical, occupational and speech therapy are available. Eligibility
criteria are specified in State Board of Education Rule 6A-6.03026 (2)(a)(b),
FAC.

Florida Diagnostic Learning Resource System (FDLRS). FDLRS provides
in-service training, media and materials, information and consultation, and
instruction to parents and others who work with handicapped children. Two
priorities were established: parent services and prekindergarten programs.

Foster Grandparent/Retired Senior Volunteer Program. Senior citizens
over age 60 provide support services to high-risk and handicapped children in
child care centers, prekindergarten programs and intensive care units.

Community Resource Mothers and Fathers. Programs in the Hillsborough
and Leon County Public Health Units serve low-income pregnant women and
their families. A variety of health-related and social services are provided, as
well as case management. An Individual Family Service Plan (IFSP) guides
service delivery.







Florida Department of Health and Rehabilitative Services








37 -


Children's Early Investment Program (CEIP). CEIP provides intensive
early intervention to at-risk expectant mothers and young children, birth to age
one. Services may include maternal and child health care, parenting education
and support, information and referral, child care, and home visiting. Programs
are operating in Boynton Beach, Clewiston, the Harlem area of Hendry
County, and Liberty City in Miami.

Teen Parent/Pregnancy Programs. A
variety of health, education and support, and
child care services are available to teens
through HRS and DOE programs. Project
Independence provides educational opportu- I
cities for teen parents on public assistance
and a variety of health and parent education .
training and child care. Many health-related
services are focused on teen parents and
preventing teen pregnancy. School district
Teenage Parent (TAP) programs must
provide entitled child care transportation and
access to health and social services to stu-
dent teen parent participants.

Health-Related Programs. Florida's
Healthy Start initiative and Children's
Medical Services provide important health-
related services that are described under separate headings in this section. A
variety of other health-related programs operate under the auspices of the HRS
Health Services and County Public Health Units. These include health educa-
tion, family planning, teen pregnancy prevention clinics, prenatal care, parent
education, nutrition services for low-income pregnant women (WIC), home
health care assessment, Early and Periodic Screening, Diagnosis and Treat-
ment (EPSDT), and immunizations.






Florida Department of Health and Rehabilitative Services








- 38


In 1993-94, 26
providers received Children's Medical Services (CMS). CMS
funding under provides a statewide network of 22 medically
section 41 5.50 F S. directed, multidisciplinary Child Protection Teams
that act as a resource to the Children and Families
staff in the detection, evaluation, and treatment
planning for preventing further abuse. The teams
also conduct educational and community awareness
activities to enable professionals and the general public to prevent child abuse
and neglect in their communities. CMS also funds 12 providers around the
state for the provision of intrafamilial sexual abuse treatment through a combi-
nation of group, family, and individual counseling to child victims, the non-
offending parent, and the offender. By providing total family treatment, the
program aims to reduce the trauma caused by the child sexual victimization,
assist the family to recover, and prevent further abuse from occurring.

The CMS Perinatal program provides medical services to high-risk pregnant
women, neonatal intensive care services to medically-involved high risk
newborns, and planning for medical and family support plans upon discharge
from the hospital. The Developmental and Early Intervention Program (DEI)
serves children 0 to 3 years who are at risk for developmental delay and
provides multidisciplinary evaluation and family support services. The
Primary Care program provides a network of pediatric health services for low-
income children. The CMS clinic program provides or arranges for medical
supplies and equipment, parent education and training, case management and
social services to support parents in providing care to a medically-involved
child.

Migrant Services. Migrant health services for school-age children are avail-
able through DOE, Division of Public Schools in 22 counties and, for
preschoolers, through two Redlands Christian Migrant Associations. In
addition, an early Childhood Learning Program is available to less than half
the migrant population from ages three to four.

The difficulties in distinguishing one prevention program from another with
similar service delivery methods and target populations are obvious. Yet gaps



-- Florida Department of Health and Rehabilitative Services







Child Abuse and Neglect Prevention Plan: 1994-1996 39









in services exist and specific target populations continue to be underserved.
To target child abuse and neglect prevention services and to promote the
coordination of these services with other prevention/early intervention ser-
vices offered statewide and in local communities, specific goals and objectives
were established.

Healthy Start. In 1991, Gover- New state and federally funded
nor Lawton Chiles signed the initiatives such as Healhy Sar,
Healthy Start bill into law.uch as Healthy Start
Florida's Healthy Start initiative Family Builders, and Even Start are
was designed to reduce infant helping to fill some gaps in the
mortality, improve birth out-
comes, and improve infant continuum of services delivered in
health and development. each county in Florida
Healthy Start ensures access to entry Florida.
prenatal care for all pregnant
women and health care for their
babies, educates pregnant
women of child-bearing age about health and nutrition during pregnancy, and
identifies and addresses potential health and environmental problems early.

The initiative establishes and empowers community-based prenatal and infant
health care coalitions to identify and unify resources at the local level. The
coalitions assess community needs, and develop community-based service
delivery plans, coordinate local health and social services, link programs,
assist programs in working together to reduce duplication of services, and fill
in the gaps in needed services. Child abuse prevention programs need to
communicate with the coalitions, to coordinate services that will reduce
families' risk for child abuse.

Healthy Start provides prenatal and postnatal screening by private and public
health care providers to identify health, growth, developmental, or child abuse
risks. Care coordination is provided for women and infants whose prenatal
and postnatal screenings suggest a need for specialized services. Enhanced
services such as counseling, home visits, childbirth and parent education
classes are offered to these families.


Florida Department of Health and Rehabilitative Services


II.. -1 11







Child Abuse and Neglect Prevention Plan: 1994-1996


indicates tha
programs ca
variety of pos
measurable
(U.S. General Accou


r prevention Even Start. This federally-funded program is
n have a designed to provide assistance to local educa-
tion agencies or community-based organiza-
Sitive tions to improve the education of children and
effects." adults by integrating early childhood educa-
tion, adult education, and parent education in a
rating Office, 1992) unified program. The three components of
Even Start include adult education, early
Education and care, and home visitation/parent
education. Scheduling and location of services
must allow for joint participation of children
and parents. Services should include home-service activities, although center-
based activities are permissible. Even Start funds are intended to build on
existing resources in order to create a complete program. Families must
participate in all three components of the program in order to be served in any
component. There are 24 Even Start programs operating in Florida local
school districts.

Family Builders. This is a contracted service which allows the immediate
mobilizing of intensive family preservation resources for families with chil-
dren who would normally be removed from their homes due to abuse and
neglect. The family builders model provides up to four months of comprehen-
sive services, using a professional treatment team approach, and including
such services as parent aides, child care, crisis counseling, homemaker/house-
keeper and includes the availability of flexible funds to meet the unique needs
of the family.

Working in teams of a professional and paraprofessional which serve no more
than six families at any time, the goal of the program is to keep families safely
together and when possible return children safely home from out-of-home
placements. The program is able to receive referrals and work with families in
their own homes 24 hours a day seven days a week. An average of $500 per
family is available for meeting some of the basic needs of the family. Psycho-
logical and psychiatric services are also readily available for evaluation,
testing and counseling.


Florida Department of Health and Rehabilitative Services


"The evidence
accumulated to date
.m.. .i tl


- I:I = "A.l








Child Abuse and Neglect Prevention Plan: 1994-1996 41










Intensive Crisis Counseling Program (ICCP). The purpose of the Intensive
Crisis Counseling Program is to prevent removal of children from their homes
during crisis situations which are precipitated by abuse, neglect, or status
offense behavior. The program provides immediate services to families in
their own homes. The counselors in the program have small caseloads which
allow them to work intensively with up to four families at a time in resolving
crises. The program is designed to prevent placing children in out-of-home
placements.

ICCP counselors are on call 24 hours a day to enter the homes of families in
crisis. They remain in the home for as long as necessary to facilitate resolu-
tion of the immediate crisis. After the counselors have assisted the family
through the immediate crisis, they meet with them on a regular basis for up to
six weeks to teach family members new skills to help prevent the recurrence
of crises. The timeliness, intensity, and accessibility of the services are the
key factors in the success of the program. While the counseling services are
designed for families where intensive therapeutic intervention is needed, the
therapists assess the families' needs for other services and provide informa-
tion, referral or liaison assistance toward getting the family involved with
other appropriate community agencies. With small caseloads, counselors
spend as much time as needed to work with each family in resolving the
existing crisis and assess other needs.

















Florida Department of Health and Rehabilitative Services







-42 1 Child Abuse and Neglect Prevention Plan: 1994-1996










Goals and Objectives for Service Delivery

To achieve focused service delivery, the Interprogram Task Force established
three statewide prevention goals related to service delivery and program
planning. These goals promote the delivery of family-centered, culturally
sensitive services and encourage greater emphasis on public awareness of
child abuse and neglect prevention.

Goal 1

Support and encourage efforts to inform and educate the public, profes-
sionals, and decision-makers about child abuse and neglect and about the
needs, services, and programs for preventing child abuse and neglect.

State Objectives for Goal 1

The state objectives refocus prevention efforts at the state and local levels on
informing all citizens of Florida about prevention of child abuse and neglect.
Local communities are challenged to heighten public awareness and support in
ridding our state of the harmful effects of child abuse and neglect.

1.1 C&F will encourage local service providers to assume leadership roles
in organizing communities to advocate for and promote prevention
efforts.

1.2 C&F will require all providers to perform some community awareness
and advocacy activities.

1.3 C&F will increase the tools and resources available to districts and
programs for promoting and developing community awareness of child
abuse and neglect.





SFlorida Department of Health and Rehabilitative Services








Child Abuse and Neglect Prevention Plan: 1994-1996 43 -










1.4 C&F will identify and distribute camera-ready promotions and bro-
chures for a planned campaign for the prevention of child abuse and
neglect.

1.5 C&F will encourage districts and local service providers to identify
and obtain alternative funding sources (private and foundation) for
promoting prevention services.

1.6 C&F and the Interprogram Task Force will support the ongoing com-
munication and networking among prevention professionals and
decision-makers.

1.7 C&F will conduct biennial child abuse and neglect prevention confer-
ences to increase awareness of the need for and ways to implement
prevention programs and to address the transition to the family re-
sponse model.

Goal 2

Encourage the sensitivity and responsiveness of child abuse and neglect
prevention services and programs to the populations in need of services.

State Objectives for Goal 2

The residents of Florida live in many different cultures. Prevention efforts
should be implemented that consider this diversity and is respectful of the
cultures and values of participants.

2.1 C&F and the Interprogram Task Force will encourage districts to
implement community-based programs and services that are delivered
as closely as possible to where those who need the services live and at
convenient times for participating families.





Florida Department of Health and Rehabilitative Services


















2.2 C&F and the Interprogram Task Force will encourage districts to
implement programs that coordinate and use community resources in
neighborhoods including local and community law enforcement and
social service agencies.

2.3 C&F and the Interprogram Task Force will encourage districts to
implement culturally sensitive programs and services that are compat-
ible with the communities being served.

2.4 C&F will provide training for providers and district and state staff on
cultural differences and customs.

2.5 C&F will provide technical assistance to help districts develop pro-
vider services that are culturally sensitive to the language, customs,
and background of the families served.

2.6 C&F and the Interprogram Task Force will encourage districts to
involve participants and local communities in planning for programs
and services.

Goal 3

Enhance the development and implementation of family-centered child
abuse and neglect prevention programs and services.

State Objectives for Goal 3

Family-centered programs involve families in the development and implemen-
tation of programs and value the contributions that all members of the family
provide.

3.1 All planning and delivery of prevention programs and services will
include involvement and participation of the families served, including
the Interprogram Task Force and local task forces.



-- Florida Department of Health and Rehabilitative Services







Child Abuse and Neglect Prevention Plan: 1994-1996 45










3.2 C&F will provide training to providers, administrators, and other
interested parties on the family-centered approach to programs and
services.

3.3 C&F and the Interprogram Task Force will create a "Best Practices"
exchange program of family-centered activities and ideas.

3.4 C&F will promote family-centered activities such as family days in
schools and communities, parks, cooperative extension agencies, and
offices.

3.5 C&F and the Interprogram Task Force will encourage planning efforts
that address the needs of individuals/groups with high-risk factors such
as children with disabilities, substance abusing families, teen parents,
homeless families, and those with other high-risk factors.

3.6 C&F will encourage districts to use the Family Support Planning
process in delivering prevention services.

3.7 C&F will encourage districts to develop and implement programs and
services that participants/families use on a voluntary basis.

Other Service Delivery Goals and Objectives

District goals addressed many aspects of service delivery. Some goals tar-
geted specific populations such as drug-involved families. Other goals re-
ferred to major service gaps such as day care and transportation. Several
districts were concerned about the use of corporal punishment in the schools.
Refer to the District Goals and Objectives listed in Appendix G for a complete
display of the areas targeted by districts.


Florida Department of Health and Rehabilitative Services


I1






- 46 Child Abuse and Neglect Prevention Plan: 1994-1996





Cooperative Agreements

with DOE and FDLE

Section 415.501, F.S., requires the Department of Health and Rehabilitative
Services to work cooperatively with:

1. The Department of Education (DOE) "to inform and instruct parents of
school children and appropriate district school personnel in all school
districts in the detection of child abuse and neglect and in the proper
action that should be taken in a suspected case of child abuse or neglect,
and in caring for a child's needs after a report is made" (s. 415.501
(2)(b)2., F.S.).

2. The Florida Department of Law Enforcement (FDLE) to instruct their
personnel "in the detection of child abuse and neglect and in the proper
action that should be taken in a suspected case of child abuse or neglect"
(s. 415.501 (2)(b)3., F.S.).

3. Other appropriate public and private agencies "to emphasize efforts to
educate the general public about the problem of and ways to detect child
abuse and neglect and the proper action that should be taken in suspected
cases of abuse and neglect" (s. 415.501 (2)(b)4., F.S.).

4. The Department of Education on the "enhancement or adaptation of
curriculum materials to assist instructional personnel in providing instruc-
tion through a multidisciplinary approach on identification, intervention,
and prevention of child abuse and neglect" for grades K-3, 4-6, 7-9, and
10-12(s. 415.501 (2)(b)5., F.S.).

In addition, section 415.5015, F.S., requires the Florida Department of Educa-
tion, through the Child Abuse Prevention Training Act of 1985, to encourage
primary prevention training for all children in kindergarten through grade 12
through the training of school teachers, guidance counselors, parents, and
children. School districts are to implement "a training and educational pro-
gram for children, parents, and teachers which is directed toward preventing
the occurrence of child abuse, including sexual abuse, physical abuse, child
neglect, and drug and alcohol abuse, and toward reducing the vulnerability of
children...." The law also mandates establishment of three private, nonprofit
prevention training centers. (section 415.5015, F.S.)

Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 47










Current Status

Department of Education

The Department of Education has worked cooperatively with HRS on the
development and enhancement of curriculum materials to be implemented by
the local school districts. The Curriculum Development Model is based on the
following assumptions, as stated in the 1991-93 Prevention State Plan:

* "Child abuse and neglect is a family, social and legal problem requiring
solutions which are cooperatively developed by local family, social and
legal agencies."

* "The prevention of child abuse and neglect, as a content area for inclusion
in the public school curriculum, must be defined and implemented at the
local level by each of Florida's 67 school districts."

* "Interagency sharing of training, information, resources and responsibili-
ties requires state and local coordination;
however, this sharing will vary among
communities. The HRS district plans should
also incorporate interagency sharing."

" "Related curriculum materials and learning
activities are already used in some communi-
ties. This information, however, is usually
geared to adults, while material specifically
intended for children is not always available.
The implementation of instruction about the
prevention of child abuse and neglect should
be a coordinated effort which uses existing
resources in health and safety education,
home economics, social studies and other
curricular programs with compatible objec-
tives."


Florida Department of Health and Rehabilitative Services







48 Child Abuse and Neglect Prevention Plan: 1994-1996











"The prevention of child abuse and neglect, as a new content area for
inclusion in the public school curriculum, must be understood and sanc-
tioned by local school boards." (p. 41)

Recommended The Department of Education led in
Child Abuse and Neglect Curriculum Outline the development of a curriculum
model. The model assists local
Grades Curriculum Content interagency curriculum development
K-3 Relationships committees to enhance, adapt and
K-3 / Relationships -
/ Safety implement appropriate curriculum
/ Feelings concepts, goals, objectives, instruc-
SGood Touch Bad Touch tional strategies, and resources. The
/ StrangerDanger
model includes a scope and sequence
4-6 / Safety for identifying, intervening and
/ Growth and development preventing child abuse and neglect at
/ Decision making
/ Family life each of the progressional levels, K-3,
/ Good Touch Bad Touch 4-6, 7-9, 10-12. Instructional objec-
/ Stranger Danger tives should be established at the

7-9 / Mental and emotional health local school districts to address
Interpersonal problems physical, emotional and sexual
Coping skills abuse, and neglect. In addition,
Mental and emotional health as related to community health
/ Family health public school districts should de-
Child abuse and neglect differences velop additional objectives, incorpo-
Child abuse and neglect identification rate resources of local child protec-
/ Community organizations available to help abused and abusing
individuals tion agencies, and obtain approval of
local child abuse and neglect cur-
10-12 / Rape, abuse and neglect riculum committees, superintendents
Social effects supe
Physical effects and school boards.
Psychological effects
/ Family living, sex education, and mental health A curriculum outline was proposed
/ Child care, guidance and development ue a Nelc
/ Problem solving and decision making in 1991-93 Child Abuse and Neglect
/ Crisis management Prevention Plan and is recommended
/ Coping skills for continued use.
/ Family member roles and responsibilities




hI=E^'I i-i__ rt__-l'_pur i v nUiiii UIIU I^4LJIIIrUI::J.i; Ct h S___iVk


I I ='V'"Oi


dirolF a Department s






Child Abuse and Neglect Prevention Plan: 1994-1996 49 -










Florida schools continue activities related to child abuse and neglect preven-
tion instruction in the school curriculum. Information exchange between state
and local agencies has enhanced working relationships and promoted shared
responsibility for services related to the identification, intervention and pre-
vention of child abuse and neglect. Both state and local agencies have desig-
nated an individual to work toward planned, coordinated activities including
curriculum development and interagency coordination. Additional coordina-
tion and integration activities promoted by DOE include:

* Information on child abuse conferences and workshops are shared with
public school districts. DOE staff members participate in these meetings
and encourage school districts to send representatives.

* Materials relevant to child abuse and neglect prevention are collected or
developed and disseminated to public school personnel, children, and
parents.

* An interagency agreement between Head Start, HRS, and DOE exists to
establish methods of cooperation.

* DOE continues to have a working relationship with the North East Florida
Consortium and the Panhandle Area Education Consortium. Child abuse
and neglect prevention training sessions for teachers and administrators
can be planned and conducted at meetings of these groups.

* Teachers and administrators continue to request and receive articles and
materials on child abuse and neglect prevention from DOE.

* DOE staff work with civic, social and educational groups including
various sorority and fraternal groups, honor societies, and Chambers of
Commerce to inform people about prevention of child abuse and neglect.

* DOE has a Course Code Directory, Student Performance Standards
(grades 6-12), and Curriculum Frameworks (grades 6-12) which include
child abuse and neglect prevention topics to assist teachers in providing
instruction.


Florida Department of Health and Rehabilitative Services






50 Child Abuse and Neglect Prevention Plan: 1994-1996








DOE has not standardized instructions to school personnel and parents but
local school districts have used some of the following techniques to imple-
ment the requirements of section 415.501, F.S.

Contract with prevention projects to provide instruction.

Use a videotape and viewers guide to instruct school personnel.

Provide intensive training to school social workers who then instruct other
school personnel.

Present instruction during a one-day conference.

Ask the Child Protection Team to provide the required instruction.

Presently, DOE and HRS are working cooperatively to develop and make
available an appropriate primary prevention training program for school staff,
students, and parents.


The prevention of child abuse
and neglect, as a content
area for inclusion in the public
school curriculum, must be
defined and implemented at
the local level by each of
Florida's 67 school districts.






-Florida Department of Health and Rehabilitative Services






51 -


The FDLE, through the
Criminal Justice
Florida Department of Law Standards and Training
Enforcement Commission, provides

FDLE has addressed the statutory require- child abuse and
ments by incorporating instruction on child neglect training for all
abuse and neglect in its basic curriculum
used at the law enforcement academies to new police officers.
train all new law enforcement recruits.
During 1992, a total of 2,730 (100%) new
police officers received FDLE curriculum
training in the 40 certified recruit training centers around the state. The same
curriculum and plan for training new police officers is used presently.

In 1985-86, FDLE, through the Criminal Justice Standards and Training
Commission, received special legislative funding to develop training programs
on child abuse investigation. The curriculum includes approximately 16-20
hours of instruction on the dynamics of child abuse and neglect and empha-
sizes detection and correct reporting procedures. The training programs were
designed to educate law enforcement officers, thejudiciary, state attorneys,
and HRS personnel who are involved in investigating and taking legal action
in child abuse cases. The training program includes:

/ a Directory of Child Abuse and Neglect Intervention Training;
/ a catalog of Child Abuse and Neglect Intervention Training Materials;
/ a Participant's Guide to Child Abuse and Neglect Intervention Training;
/ a Trainer's Guide to Child Abuse and Neglect Intervention Training; and
/ a variety of videotapes relating to child physical and sexual abuse and
neglect.

These training materials were distributed to a variety of individuals and
groups including law enforcement personnel, and are available upon request.





Florida Department of Health and Rehabilitative Services






- 52 Child Abuse and Neglect Prevention Plan: 1994-1996





Plan for Coordination and

Integration

As required by section 415.501, F.S., HRS established an Interprogram Task
Force comprised of representatives from the following program offices or
agencies:

Children and Family Services
Children's Medical Services
Alcohol, Drug Abuse and Mental Health
Health
Developmental Services
Office of Evaluation (defunct)
Office of Program Policy Development (defunct)
Operations Office
Florida Department of Law Enforcement
Department of Education

As one of its required activities, the Interprogram Task Force is responsible
for "developing a plan of action for better coordination and integration of the
goals, activities, and funding pertaining to the prevention of child abuse and
neglect conducted by the department in order to maximize staff and resources
at the state level."













Florida Department of Health and Rehabilitative Services






53 -


"Children have a right to
grow up in a family
Current Status environment, in an
In 1983, the Interprogram Task atmosphere of happiness,
Force fulfilled the initial responsi- love and understanding. "
abilities mandated by the law
through development of a policy (Second Report of the U.S. Advisory Board
guide on district task force mem- on Child Abuse and Neglect, p. 43)
bership and responsibilities, a
prevention continuum, an opera-
tional plan and a format for local
plans. During each of the past five biennial planning cycles, technical assis-
tance was provided to the districts through feedback on district plans.

Efforts to coordinate and integrate child abuse and neglect prevention services
have been primarily the responsibility of the Children and Family Services
Program Office prevention staff. C&F has oversight responsibility for a
variety of child abuse and neglect prevention programs and for coordination
with other prevention/early intervention initiatives (for example, the Ounce of
Prevention and the DOE Prevention/Early Intervention program). As indi-
cated in An Evaluation Study of the Florida Child Abuse and Neglect Preven-
tion Service System, Volume 3, state prevention plans from 1983-1991 did not
include a plan to coordinate and integrate prevention activities across agencies
or within HRS. Statewide planning by the Interprogram Task Force had been
limited to reviewing the district plans (ESDI, 1989).

In the 1991-93 and 1994-96 planning periods, however, the Interprogram Task
Force members were particularly active in the planning process. They
proactively identified a statewide mission statement for use by districts,
established state goals, reviewed and critiqued district plans, and established
state objectives. The state goals and objectives established by the
Interprogram Task Force confirm their commitment to statewide planning and
coordination of prevention services, consistent with the legislative intent of
section415.501, F.S.




Florida Department of Health and Rehabilitative Services






- 54 Child Abuse and Neglect Prevention Plan: 1994-1996











Goal and Objectives for Coordination and
Integration

Goal 4

Enhance coordination among all agencies and organizations responsible
for prevention of child abuse and neglect.

State Objectives for Goal 4

Goal 4 recognizes the importance of coordination and communication among
all groups engaged in preventing child abuse and neglect. These groups
include HRS, DOE, FDLE, local communities, private and non-profit service
providers, and participants in the programs. All groups must work together to
inform the public and at-risk families of the consequences of child abuse and
neglect and available prevention programs and services. Education programs
in our schools on identification, intervention, and prevention of child abuse
and neglect can alert children to family behavior patterns and personal safety
practices that may cause physical or psychological harm. By encouraging
children to report these problems to a responsible adult, abuse and neglect
may be prevented. Instruction also may help children learn coping skills and
child rearing practices that break the cycle of abuse and neglect which repeats
from generation to generation.

The state objectives encourage HRS/C&F prevention staff, FDLE training
personnel, and DOE student services to work cooperatively to achieve this
goal. Additionally, each school district and C&F district prevention staff are
to ensure that each school has in place a curriculum designed to provide
instruction on the identification, intervention and prevention of child abuse
and neglect which includes instruction to teachers, other school personnel,
parents and children.




Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 55-










Coordination and integration of child abuse and neglect prevention with other
prevention/early intervention initiatives is an issue due to the multiplicity of
programs targeting at-risk families. Similar prevention/early intervention
programs operate under the auspices of various program offices within the
Department of Health and Rehabilitative Services, the Department of Educa-
tion, and a number of public and private agencies. The effort to coordinate
and integrate these services requires interagency, interprogram and commu-
nity cooperation and planning so that services are not duplicated and unneces-
sary expenditures are avoided. To address these issues, the Interprogram Task
Force proposed eight state objectives.

4.1 C&F and the Department of Education will collaborate on the imple-
mentation of section 415.5015, F.S. Representatives from C&F and
DOE will meet to discuss the possibility of DOE working cooperatively
with the three established C&F child abuse prevention training centers
(Professional Development Centres) in Florida to provide a primary
prevention training program for teachers working with children in grades
K-12.

4.2 C&F prevention staff will inform district contract managers and preven-
tion providers of the services offered by DOE in each local school
district which inform/instruct school personnel and parents in the detec-
tion, reporting, and prevention of child abuse/neglect.

4.3 C&F prevention staff will help district prevention contract managers
identify and remove any barriers related to access of prevention educa-
tion services through the local school districts.

4.4 FDLE will continue to support training academies in providing instruc-
tion to law enforcement officers in the identification, intervention, and
prevention of child abuse and neglect.

4.5 FDLE will report annually to the Interprogram Task Force on the status
of district implementation of the law enforcement abuse/neglect preven-
tion curriculum.


-- Florida Department of Health and Rehabilitative Services






- 56 Child Abuse and Neglect Prevention Plan: 1994-1996










4.6 C&F will continue to develop prevention guidelines for the prevention
planning efforts of districts.

4.7 C&F will provide technical assistance to districts on planning for
prevention services and programs.

4.8 C&F will support districts in establishing and maintaining accountabil-
ity for all prevention programs and services.

4.9 C&F and the Interprogram Task Force will promote the development
and implementation of the full continuum of services in all communi-
ties in the state.

4.10 C&F will ensure that districts coordinate their local prevention plan-
ning efforts with the district Health and Human Services Boards.

4.11 The Interprogram Task Force will meet quarterly to review and assess
the implementation status of the state plan and review the need for
assistance to the districts in implementing effective prevention pro-
grams and services.

4.12 The Interprogram Task Force and
C&F will encourage local task forces
to meet quarterly to review the status
of local prevention programs and
services and identify any technical
assistance needs.

4.13 C&F will increase representation on
the Interprogram Task Force to
Include district representation and
representation of families served.






Florida Department of Health and Rehabilitative Services






57 -


Barriers



A comprehensive approach to child abuse and neglect prevention services
can be enhanced if certain barriers are removed. As required by statute, the
district task forces identified a variety of barriers which impede the effective
delivery of prevention services. The most frequently mentioned barriers are
described below. In Appendix G, summary statements of the barriers identi-
fied in the district plans are listed.

Overview of District Barriers

Inadequate Funding. All of the 15 districts identified inadequate funding for
prevention as a barrier to providing a comprehensive approach. In addition,
the fluctuations in annual appropriations from the Florida Legislature for
prevention programs inhibit the development of consistent prevention ser-
vices. Districts also identified inadequate funding in critical treatment ser-
vices as a barrier. When funds for treatment programs are scarce, districts
tend to use prevention funds to treat children and families in which abuse has
already occurred rather than for primary or secondary prevention services.

Transportation. Almost all districts identified transportation as a barrier to
service delivery. The lack of public transportation in many areas limits the
access of participants to needed services, especially for those with low in-
comes. Because of the lack of transportation, participants fail to meet appoint-
ments, cannot participate in some programs, and cannot follow through on
referrals to needed services.

Inadequate Child Care. Over 75 % of the districts identified the lack of child
care services as a critical barrier to providing comprehensive prevention
services. The barriers included insufficient spaces available in subsidized
child care as well as the lack of accessible and affordable day care openings in
private and non-profit centers. For example, Medicaid may pay for a mother
to attend a drug treatment program, but will not pay for the child's care while
the mother attends the program. Without day care for young children, many
parents cannot attend parent education programs, obtain and keep jobs, or
access other prevention services.



Florida Department of Health and Rehabilitative Services ----







- 58 Child Abuse and Neglect Prevention Plan: 1994-1996










Overcoming participant resistance. All districts identified overcoming the
resistance or refusal of services by participants as a barrier. In many in-
stances, individuals do not admit their problems and will not participate
voluntarily in any of the variety of programs available, including parent
education classes or drug treatment programs. Programs targeted toward
high-risk individuals and families encounter particular difficulty in resistance
and refusal. Districts also identified cultural factors contributing to the resis-
tance of some high-risk groups to CAN prevention programs.

Geographic/size barriers. Six of the 15 districts identified geographic area
or size as a barrier to providing comprehensive prevention services for child
abuse and neglect. In rural areas with low population densities, it is difficult
to provide services close enough for targeted families to participate without
having to travel long distances. In districts with large populations, families
and children at risk may not receive the individual attention that is most
effective in preventing abuse and neglect.

Lack of public understanding and involvement. Five of the 15 districts
cited lack of public awareness and understanding of child abuse and neglect as
a barrier to providing comprehensive prevention services. Districts perceive a
growing trend of citizens to "cocoon," with a reduction in working with their
community leaders in seeking ways to resolve problems associated with child
abuse and neglect.

Lack of evaluation information. Four districts listed as a barrier the diffi-
culty in evaluating the success of existing programs due to the wide range of
characteristics of the program services and participants. Prevention results are
often difficult to measure. By their very nature, the programs keep harmful
effects from occurring which is difficult to prove through standard research
methods. In addition, few consistent outcome measures are available in this
area to show the successes programs cause. Without data-based results,
program managers find it difficult to allocate resources and to defend contin-
ued funding.





Florida Department of Health and Rehabilitative Services






59 -


Staffing. Four districts identified staffing issues as barriers. Trained, experi-
enced professional and volunteer staff are limited, and staff turnover is high.
Low salaries and emotionally stressing work contribute to these problems.
These limitations impact the quality of prevention programs and continuity of
service delivery. No district level HRS staff are assigned full-time to coordi-
nate prevention services.

































Florida Department of Health and Rehabilitative Services






-60 Child Abuse and Neglect Prevention Plan: 1994-1996





Recommendations for

Change

As required by section 415.501, F.S., the district task force members in-
cluded in the district plans recommendations for changes that can be accom-
plished only at the state program level or by legislative action. These district
recommendations are listed in Appendix H. The State Interprogram Task
Force reviewed the district recommendations for change and identified the
following recommendations'for state and legislative action.

Recommendations
for State Implementation

Prevention Funding Mechanisms. HRS should ana-
lyze the current funding mechanisms for prevention of
S child abuse and neglect and develop a plan for increasing
funding for prevention efforts and pursue additional
funding sources. The analysis should examine the
.'. effectiveness of existing prevention programs to ensure
appropriate use of existing funding. Alternative funding
methods to be explored should include establishing a fee
source to fund child abuse and neglect prevention,
Including sections 415.501 and 415.5015, F.S. Possible
fee sources are marriage licenses, birth certificates,
license plates, and drug confiscation programs.

Funding Additional Treatment Services. HRS should
S prepare Legislative Budget Requests for the develop-
ment and additional funding of treatment programs in
the following areas:

Juvenile sex offenders.
Treatment services for victims of physical, sexual and emotional abuse.
Drug/Alcohol/HIV-infected babies.
Child victims/witnesses of major trauma.


SFlorida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 61 -










DOE Prevention Specialist. The Department of Education should designate
an individual/position responsible for coordinating state and local efforts in
child abuse and neglect prevention.

Public Awareness Campaign. Sponsor a month-long campaign for preven-
tion of child abuse and neglect.

Recommendations for Legislative Action

Funding. Increase funding allocation for section 415.501, F.S., to provide for
full implementation of the continuum of child abuse and neglect prevention
serivces.

Section 415.501, F.S. Revise section 415.501, F.S., to define the relationship
between the current HRS structure and the newly created Health and Human
Services Boards and to include representation on the Interprogram Task Force
from districts, participants, and advocacy groups.

Child-on-Child Abuse. Change the definition of child abuse in the law to
include child-on-child abuse, thus increasing prevention and treatment ser-
vices that will break the cycle of abuse.

Corporal Punishment. Implement a statewide ban on corporal punishment
in the schools.

Fetal Alcohol Syndrome. Include fetal alcohol syndrome as "harm" in the
definition of child abuse and neglect in the Florida Statutes.

Children's Services Councils. Mandate Children's Services Councils for all
counties and provide funding for them.







Florida Department of Health and Rehabilitative Services






- 62 Child Abuse and Neglect Prevention Plan: 1994-1996






The Legislature should increase
funding allocation for section
415.501, F.S., to provide for full CAN ProgramSpecialist. Allocate
implementation of the funds to establish or contract for a
full-time child abuse and neglect
continuum of child abuse and prevention specialist in each district.
neglect prevention services.
Travel Reimbursement Rate.
Increase travel reimbursements from
20 cents per mile to the current rate
allowable by the federal Internal
Revenue Service. Prevention services often require extensive travel to pro-
vide services in the homes of participants. The low travel reimbursement
discourages districts from implementing the more effective in-home services,
in favor of less effective programs.

Adult Education Funds. Reinstate Adult Education funds to make parent
education programs available to all communities through the schools.

Outcome Evaluations. Provide specific funding for outcome evaluations of
child abuse and neglect prevention programs.

Healthy Start. Increase the funding for Healthy Start so that all pregnant
women and infants in need can be served through care coordination, case
management, and enhanced services.

Domestic Violence/Drug Abuse. Increase funding levels for programs
preventing domestic violence and drug abuse.

Subsidized Day Care. Increase funding levels for subsidized day care to
eliminate waiting lists.

Separate Funding. Maintain child abuse and neglect prevention funds as a
separate line item in the budget to ensure expenditure of funds for prevention
instead of treatment and to prevent loss of federal prevention funds.

Consolidate Prevention Funding. Consolidate the various child abuse and
neglect prevention funding sources into a single line item in the budget.


-- Florida Department of Health and Rehabilitative Services






63 -


Conclusion



As stated in the Second Report of the U.S. Advisory Board on Child Abuse
and Neglect (1991), "All Americans share an ethical duty to ensure the safety
of children." (p. 7) The long-term benefits of prevention are indisputable. No
one would question investing in a safe public water supply to prevent the
debilitating effects of typhoid fever. The toll of pain, sorrow, and death from
child abuse and neglect are just as thoroughly documented as are the effective-
ness of prevention efforts. Too often we invest more efforts in treatments
after abuse and neglect have occurred instead of funding and supporting the
prevention efforts that will result in
greater human and fiscal cost savings.

Prevention and early intervention services
are the critical components of a success-
ful program to reduce child abuse and
neglect and to strengthen and preserve the
family. Increasingly, Florida families are
diverse and represent many different
cultural and ethnic perspectives. Local
communities and participants must work
together in planning and coordinating
culturally sensitive prevention efforts for c b
families and children to reduce the risk of ..
abuse and neglect.

The goals and objectives addressed
within the 1994-96 State Child Abuse and Neglect Prevention Plan recognize
the need for family-centered programs and services. These goals and objec-
tives include:

0 Support and encourage efforts to inform and educate the public,
professionals, and decision-makers about child abuse and neglect and
about the needs, services, and programs for preventing child abuse
and neglect.

M Encourage the sensitivity and responsiveness of child abuse and
neglect prevention services and programs to the populations in need
of services.
Florida Department of Health and Rehabilitative Services -






SChild Abuse and Neglect Prevention Plan: 1994-1996


* Enhance the development and implementation of family-centered
child abuse and neglect prevention programs and services.

* Enhance coordination among all agencies and organizations respon-
sible for prevention of child abuse and neglect.

* Enhance access and availability to employment and training pro-
grams to increase employment opportunities and reduce economic
stress that contributes to child abuse and neglect.

As more Floridians recognize the need for and effectiveness of child abuse
and neglect prevention programs, we will witness a realization of the goal for
a safe, healthy, and happy childhood for all of our children.


Florida Department of Health and Rehabilitative Services


"All Americans share an
ethical duty to ensure the
safety of children."
(Second Report of the U.S. Advisory Board
on ChildAbuse and Neglect, 1991, p. 7)


- 64


-M





Appendix A 65 -

Section 415.501, Florida Statues, Prevention
of Abuse and Neglect of Children; State Plan


























Florida Department of Health and Rehabilitative Services j-






-66 Child Abuse and Neglect Prevention Plan: 1994-1996

















































Florida Department of Health and Rehabilitative Services






67 -


Appendix A



Section 415.501, Florida Statutes
Prevention of Abuse and Neglect of
Children; State Plan

1. LEGISLATIVE INTENT The incidence of known child abuse and child
neglect has increased rapidly over the past five years. The impact that
abuse or neglect has on the victimized child, siblings, family structure,
and inevitably on all citizens of the state has caused the Legislature to
determine that the prevention of child abuse and neglect shall be a priority
of this state. To further this end, it is the intent of the Legislature that a
comprehensive approach for the prevention of abuse and neglect of
children be developed for the state that this planned, comprehensive
approach be used as a basis for funding.

2. PLAN FOR COMPREHENSIVE APPROACH

(a) The Department of Health and Rehabilitative Services shall develop a
state plan for the prevention of abuse and neglect of children and shall
submit the plan to the Speaker of the House of Representatives, the
President of the Senate, and the Governor no later than January 1,
1983. The Department of Education shall participate and fully coop-
erate in the development of the state plan at both the state and local
levels. Furthermore, appropriate local agencies and organizations
shall be provided an opportunity to participate in the development of
the state plan at the local level. Appropriate local groups and organi-
zations shall include, but not be limited to, community mental health
centers; guardian ad litem programs for children under the circuit
court; the school boards of the programs for children under the circuit
court; the school boards of the local school districts; the district
human rights advocacy committees; private or public organizations or
programs with recognized expertise in working with children who are
sexually abused, physically abused, emotionally abused, or neglected
and with expertise in working with the families of such children;


Florida Department of Health and Rehabilitative Services -






- 68 Child Abuse and Neglect Prevention Plan: 1994-1996










private or public programs or organizations with expertise in maternal
and infant health care; multidisplinary child protection teams; child
day care centers; law enforcement agencies, and the circuit courts,
when guardian ad litem programs are not available in the local area.
The state plan to be provided to the Legislature and the Governor
shall include, as a minimum, the information required of the various
groups in paragraph (b).

(b) The development of the comprehensive state plan shall be accom-
plished in the following manner:

1. The Department of Health and Rehabilitative Services shall
establish an interprogram task force comprised of representatives
from the Children, Youth and Families Program Office; the
Children's Medical Services Program Office, the Alcohol, Drug
Abuse, and Mental Health Program Office; and the Office of
Evaluation. Representatives of the Department of Law Enforce-
ment and of the Department of Education shall serve as ex officio
members of the interprogram task force. The interprogram task
force shall be responsible for:

a. Developing a plan of action for better coordination and
integration of the goals, activities, and funding pertaining to
the prevention of child abuse and neglect conducted by the
department in order to maximize staff and resources at the
state level. The plan of action shall be included in the state
plan.

b. Providing a basic format to be utilized by the districts in the
preparation of local plans of action in order to provide for
uniformity in the district plans and to provide for greater
ease in compiling information for the state plan.

c. Providing the districts with technical assistance in the devel-
opment of local plans of action, if requested.



SFlorida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996 69 -










d. Examining the local plans to determine if all the require-
ments of the local plans have been met and, if they have not,
informing the districts of the deficiencies and requesting the
additional information needed.

e. Preparing the state plan for submission to the Legislature and
the Governor. Such preparation shall include the collapsing
of information obtained from the local plans, the cooperative
plans with the Department of Education, and the plan of
action for coordination and integration of departmental
activities into one comprehensive plan. The comprehensive
plan shall include a section reflecting general conditions and
needs, an analysis of variations based on populations of
geographic areas, identified problems, and recommendations
for change. In essence, the plan shall provide an analysis
and summary of each element of the local plans to provide a
statewide perspective. The plan shall also include each
separate local plan of action.

f. Working with the specified state agency in fulfilling the
requirements of subparagraphs 2, 3, 4, and 5.

2. The Department of Education and the Department of Health and
Rehabilitative Services shall work together in developing ways to
inform and instruct parents of school children and appropriate
district school personnel in all school districts in the detection of
child abuse and neglect and in the proper action that should be
taken in a suspected case of child abuse or neglect, and in caring
for a child's needs after a report is made. The plan for accom-
plishing this end shall be included in the state plan.

3. The Department of Law Enforcement and the Department of
Health and Rehabilitative Services shall work together in devel-
oping ways to inform and instruct appropriate local law enforce-




Florida Department of Health and Rehabilitative Services






- 70 Child Abuse and Neglect Prevention Plan: 1994-1996










ment personnel in the detection of child abuse and neglect and in
the proper action that should be taken in a suspected case of child
abuse or neglect.

4. Within existing appropriations, the Department of Health and
Rehabilitative Services shall work with other appropriate public
and private agencies to emphasize efforts to educate the general
public about the problem of and ways to detect child abuse and
neglect and in the proper action that should be taken in a sus-
pected case of child abuse or neglect. The plan for accomplishing
this end shall be included in the state plan.

5. The Department of Education and the Department of Health and
Rehabilitative Services shall work together on the enhancement
or adaptation of curriculum materials to assist instructional
personnel in providing instruction through a multidisplinary
approach on the identification, intervention, and prevention of
child abuse and neglect. The curriculum materials shall be geared
toward a sequential program of instruction at the four progressive
levels, K-3, 4-6, 7-9, and 10-12. Strategies for encouraging all
school districts to utilize the curriculum are to be included in the
comprehensive state plan for the prevention of child abuse and
neglect.

6. Each district of the Department of Health and Rehabilitative
Services shall develop a plan for its specific geographical area.
The plan developed at the district level shall be submitted to the
interprogram task force for utilization in preparing the state plan.
The district local plan of action shall be prepared with the in-
volvement and assistance of the local agencies and organizations
listed in paragraph (a) as well as representatives from those
departmental district offices participating in the treatment and
prevention of child abuse and neglect. In order to accomplish
this, the district administrator in each district shall establish a task




Florida Department of Health and Rehabilitative Services






71 -


force on the prevention of child abuse and neglect. The district
administrator shall appoint the members of the task force in
accordance with the membership requirements of this section. In
addition, the district administrator shall ensure that each
subdistrict is represented on the task force; and, if the district
does not have subdistricts, the district administrator shall ensure
that both urban and rural areas are represented on the task force.
The task force shall develop a written statement clearly identify-
ing its operating procedures, purpose, overall responsibilities, and
method of meeting responsibilities. The district plan of action to
be prepared by the task force shall include, but shall not be
limited to:

a. Documentation of the magnitude of the problems of child
abuse, including sexual abuse, physical abuse, and emotional
abuse, and child neglect in its geographical area.

b. A description of programs currently serving abused and
neglected children and their families and a description of
programs for the prevention of child abuse and neglect
including information on the impact, cost effectiveness, and
sources of funding of such programs.

c. A continuum of programs and services necessary for a
comprehensive approach to the prevention of all types of
child abuse and neglect as well as a brief description of such
programs and services.

d. A description, documentation, and priority ranking of local
needs related to child abuse and neglect prevention based
upon the continuum of programs and services.







Florida Department of Health and Rehabilitative Services






- 72 Child Abuse and Neglect Prevention Plan: 1994-1996










e. A plan for steps to be taken in meeting identified needs,
including the coordination and integration of services to
avoid unnecessary duplication and cost, and for alternative
funding strategies for meeting needs through the reallocation
of existing resources, utilization of volunteers, contracting
with local universities for services, and local government or
private agency funding.

f. A description of barriers to the accomplishment of a compre-
hensive approach to the prevention of child abuse and ne-
glect.

g. Recommendations for changes that can be accomplished
only at the state program level or by legislative action.

3. FUNDING AND SUBSEQUENT PLANS

(a) All budget requests submitted by the Department of Health and
Rehabilitative Services, the Department of Education, or any other
agency to the Legislature for funding of efforts for the prevention of
child abuse and neglect shall be based on the state plan developed
pursuant to this section.

(b) At lease biennially, the Department of Health and Rehabilitative
Services at the state and district levels and the other agencies listed in
paragraph (2)(a) shall readdress the plan and make necessary revi-
sions. Such revisions shall be submitted to the Speaker of the House
of Representatives and the President of the Senate no later than
January 1, 1985, and by January 1 or alternate years thereafter.

History- s. 1, ch. 82-62, s. 62, ch. 85-81, s. 10, ch. 85-248.

Note As amended by s. 10, ch. 85-248, s. 11, ch. 85-248 provides that





-Florida Department of Health and Rehabilitative Services






73 -


"This legislation is not intended to duplicate or supersede existing pro-
grams in child abuse and neglect prevention that are being utilized by the
local school districts to meet these needs, provided that all of the ele-
ments required by sections 1 through 10 of this act are being met."

Note- Former s. 409-70.


Interprogram Task Force

Committee Substitute for House Bill 296 mandated the development of an
Interprogram Task Force (IPTF); specifically it states:

The Department of Health and Rehabilitative Services shall establish an
interprogram task force comprised of representatives from the Children, Youth
and Families Program Office, the Children's Medical Services Program
Office, the Alcohol, Drug Abuse and Mental Health Program Office, the
Health Program Office, the Developmental Services Program Office, and the
Office of Evaluation.




















Florida Department of Health and Rehabilitative Services






-74 Child Abuse and Neglect Prevention Plan: 1994-1996

















































Florida Department of Health and Rehabilitative Services





75 -


- Florida Department of Health and Rehabilitative Services


Appendix B

Interprogram Task Force


, II IMM -






- 76 Child Abuse and Neglect Prevention Plan: 1994-1996













































--- Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996


Appendix B

State Interprogram Task Force


Appointee Staff Representative


Linda F. Radigan, Assistant Secretary
PDCF-Children & Family Services
Building 8, Room 316
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 488-8762

Dr. Michael Cupoli, Assistant Secretary
PDCM-Children's Medical Services
Building 5, Room 128
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 487-2690


Leon Polhill, SHSPS
PDCFP-Prevention & Early Intervention Services
2811-A Industrial Plaza Dr.
Tallahassee, FL 32301
(904) 488-4900


Nancy Fowler, ACSW
PDCMSD-Child Protection Team
Building 5, Room 118-A
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 488-5040


JayWhitworth, M.D.
Children's Crisis Center, Inc.
655 W. 8th Street
Jacksonville, FL 32209
(904) 549-4603


Jim Laney, Assistant Secretary
PDADM-Alcohol, Drug Abuse and Mental Health Programs
Building 7, Room 183
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 488-8304


Dr. Charles Mahan, Deputy Secretary
PDDH-State Health Office
Building 1, Room 115
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 487-2705


Trish Mann
Family Health Services (HSFHP)
Policy and Program Development
1317 Winewood Blvd.
Tallahassee, FL 32399-0700
(904) 488-2834


-- Florida Department of Health and Rehabilitative Services


I Child Abuse and Neglect Prevention Plan: 1994-1996


lI


W


77 -


IRA







- Child Abuse and Neglect Prevention Plan: 1994-1996


Richard Lepore, Assistant Secretary
PDDS-Developmental Services Program Office
Building 5, Room 215
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 488-4257

Pinky G. Hall, Office of the Inspector General
Building 1, Room 416
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 488-7722



Sue Ellen Adams
Bureau of Project Independence
Suite 202, Montgomery Building
2562 Executive Center Circle East
Tallahassee, FL 32399-2150
(904) 487-2380

Jean Battaglin
Family Health Services
Lafayette Building
Koger Center, Room 203H
Tallahassee, FL 32399
(904) 488-2834















-- FIc


Shirley Lanier
PDDS-Developmental Services
Building 5, Room 215
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 488-3673

Vicki Sims
Office of the Inspector General
Internal Audit
Building 6, Room 493
1317 Winewood Boulevard
Tallahassee, FL 32399
(904) 488-7722

Lonna Cichon
Bureau of Project Independence
Suite 202, Montgomery Building
2562 Executive Center Circle East
Tallahassee, FL 32399-2150'
PH 487-2380 FAX 922-9844


orida Department of Health and Rehabilitative Services


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Child Abuse and Neglect Prevention Plan: 1994-1996


The ex officio members of the IPTF are:

Michael O'Connell, Chief
Bureau of Academy
Florida Department of Law Enforcement
P.O. Box 1489
Tallahassee, FL 32302
(904) 488-1340

Penny Detscher, Coordinator
Comprehensive School Health Education Program
Department of Education
325 W. Gaines Street, Room 414
Tallahassee, FL 32399
(904) 488-7835


-- Florida Department of Health and Rehabilitative Ser


Merle Manzi
FDLE Academy
P.O. Box 1489
Tallahassee, FL 32302
(904) 488-4089


Kathleen Walton
Comprehensive School Health Education Program
Department of Education
325 W. Gaines Street, Room 414
Tallahassee, FL 32399
(904) 488-7835





























vices


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- 80 Child Abuse and Neglect Prevention Plan: 1994-1996








































Florida Department of Health and Rehabilitative Services





Appendix C 81

Child Abuse and Neglect Prevention Plan
District Top Needs or Problems


























Florida Department of Health and Rehabilitative Services






- 82 Child Abuse and Neglect Prevention Plan: 1994-1996
















































Florida Department of Health and Rehabilitative Services







83 -


Appendix C


CAN Prevention Plan District Top Needs or

Problems

Top Needs/Problem District Ranking
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Parent Charataeristics
Teen or first time parents 8 6 5 5* 4 5 8 3
Substance abusing parents 5 5 1* 3 2 1 3 3* 4* 4
Lack of knowledge of child development/infant care 2* 2 7 2* 9 2 5* 8 4*
Lack of knowledge ofeffective parenting skills 2* 1 1 2* 2 4 5* 1 1
Child Characterstics
Handicapped children 4*
Premature/low birthweight/failure to thrive 10* 7
Drug exposed newborn 4* 10* 1* 8 9* 6* 1 3* 8
Fetal alcohol syndrome children 4* 9* 6*
Infants and children with reported STD 8 7 6 5 5
Undetected medical/psychological problems 9 6 5 6
Medical/psychological problems requiring early intervention 5 6 10 1 9 3 5

Lack ofdevelopmentally appropriate learning experiences for 9*
children
Sexually abused children 1 4 2 3
Special needs children age 0-36 months 10
Household Characterstis
Single parents 9 8 7 3 9
Domestic violence 7 3 8 4 5* 8 3 10 10 7
Economic stresses 4* 2 4 10 2 1 4 2 5 1
Need for affordable regular day cae for at risk families 1 7 3 6 3* 7 2 4 9* 4 5 2
Need for affordable respite day care for at risk families 4 3* 8
Community Factors
Coordination ofabuse/neglect prevention services 6 7 10 7,8 10
Public awareness 4 9 9 5 9
Corporal punishment in schools 10
Reporting suspected abuse/neglect by teachers/ professionals 1,3 10 3 11 6,9,10 1,2,6,7 6


*Two needs/problems were ranked equally by the district


- Florida Department of Health and Rehabilitative Services


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Florida Department of Health and Rehabilitative Services






Appendix D

Child Abuse and Neglect Prevention
Programs Implementation of Continuum
Components by District


-- Florida Department of Health and Rehabilitative Services


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----- Florida Department of Health and Rehabilitative Services






87 -


Appendix D

CAN Prevention Programs Implementation of

Continuum Components by District


Continuum Area District
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Prenatal Support for X X X X X X X X X
Expectant Parents
Postnatal Education and X X X X X X X X X
Support
In-Home Education and X X X X X X X X X X X X
Support
Early and Regular
Educational, Medical and
Psychological Screening
Medical and Psychological
Services
Child Day Care
Self-Help Groups
Parent Education and X X X X X X X X X X X X
Training
Life Skills Training X
Family Crisis and X X
Intervention Support
Treatment and Intervention X X X
Services
Community Organization X X X X
Pubic Information X X X X X
Other X X


- Florida Department of Health and Rehabilitative Services


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Florida Department of Health and Rehabilitative Services





89 -


- Florida Department of Health and Rehabilitative Services


Appendix E

Summary of District Child Abuse and
Neglect Prevention Services







Child Abuse and Neglect Prevention Plan: 1994-1996


Florida Department of Health and Rehabilitative Services


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Child Abuse and Neglect Prevention Plan: 1994-1996 91




Appendix E

Summary of District CAN

Prevention Services


District 1

Funding: 1993-94 $168,611

Providers Amount

Northwest Florida Comprehensive $168,611
Services for Children, Inc.
Services: A range of prevention services, both primary and secondary in
nature, is offered within the district including: parent education
and training, pre and postnatal education and support, in-home
education and support services, a child enrichment group, public
information, and community organization.

District 2

Funding: 1993-94 $218,021
Providers Amount
Brehan Institute for Human $218,021
Services, Inc.

Services: Perinatal education and support services are concentrated on a
specific target population, pregnant teens, with services extending
to six weeks after birth. In-home visitor, child care educational
program, and family support services are concentrated on a specific
target population, children ages 0-1 who are considered at risk for
abuse/neglect and/or handicapping conditions (also serves 2-6 year
olds).


Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996


F-


$164,667


Providers

University of Florida
Department of Pediatrics
(CAPP)


Amount

$164,667


Services: Primary and secondary prevention services are provided through
parenting education classes and home visitor services.

District 4

Funding: 1993-94 $304,628


Providers


Children's Home Society
Visiting Nurse Association
Children's Crisis Center
Childbirth Parenting Education Association


Amount

$79,203
$91,388
$73,111
$60,926


Services: The district provides services that emphasize parent education as a
prevention strategy. A wide array of primary, secondary, and
tertiary services are provided. Children's Home Society provides
parent education classes and public information. Visiting Nurses
Society provides in-home education and support. Children's Crisis
Center provides prenatal support for expectant parents, postnatal
education and support, in-home education and support and public
information. Childbirth Parenting Education Association provides
prenatal support for expectant parents, postnatal education and
support, in-home education and support, and public information.


Florida Department of Health and Rehabilitative Services


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District 3

Funding: 1993-94





Chl Aue n Ngec reetinPln 19-19






93 -


District 5

Funding: 1993-94 $188,898

Providers Amount

Family Services Centers $128,000
Youth and Family Alternatives $60,898

Services: Family Services Center provides in-home parent education both
prenatally and postnatally for a period of up to six months. Youth
and Family Alternatives provides parenting education in-home
both prenatally and postnatally for a period of up to six months.

District 6

Funding: 1993-94 $318,027

Providers Amount

Northside Mental Health Hospital, Inc. $171,552
Hillsborough County Crisis Center $56,408
Manatee Children's Services $90,067

Services: The district provides home-based, long-term parent education for
teen parents, therapeutic intervention for children and adolescent
victims of sexual abuse and their families, and home-based parent
education and counseling services for clients with a high risk for
child abuse. Northside Mental Health Hospital provides intensive,
home-based, long-term counseling and educational services to
teenage parents identified as high risk for abusive or neglectful
treatment of their children. Hillsborough County Crisis Center
provides a sexual abuse treatment program for children, adoles-
cents and their families. Manatee Children's Services provides

Florida Department of Health and Rehabilitative Services






Child Abuse and Neglect Prevention Plan: 1994-1996


home based parent education, counseling, and crisis intervention to
teenage parents identified as high risk for abusive or neglectful
treatment of their children.


District 7

Funding: 1993-94 $312,894


Providers


Children's Home Society of Florida, Central Division
Child Care Association of Brevard, Inc.
Children's Home Society of Florida, Brevard Division
Orange County, Florida


Amount

$77,568
$33,943
$116,695
$84,688


Services: An array of primary, secondary and tertiary prevention services
exists within the district. District services emphasize: family
crisis and intervention support, perinatal education and support,
parent education, and in-home services including several home-
maker projects. CHS, Central Division and Child Care Associa-
tion of Brevard, Inc. provide support, education, and resources to
young, first time parents. CHS, Brevard Division provides educa-
tion, support, and resources to parents who are high risk. CHS,
Central Division, CHS, Brevard Division, and Orange County
provide Homemaker, in-home services to high risk families.


Florida Department of Health and Rehabilitative Services


-~s~----------


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