Child abuse and neglect prevention

STATE OF FLORIDA

DEPARTMENT OF HEALTH AND
REHABILITATIVE SERVICES

E!4:89 !9

State Plan

For the

Prevention of

Child Abuse

& Neglect

*7PARil1E

BOB MARTINEZ, GOVERNOR

GREGORY L. COLER, SECRETARY

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1989191
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ACKNOWLEDGEMENTS

The HRS Children, Youth and Families Program Office acknowledges and thanks the
following groups and their representatives who participated in developing the information
contained in Part II of this plan. Their continued collaboration and participation in
planning and implementation is essential to the success of child abuse and neglect
prevention efforts in the State of Florida.

o The Interprogram Task Force for the Prevention of
Child Abuse and Neglect

o The 11 District Task Forces for the Prevention of
Child Abuse and Neglect

o District Program Office staff for Children, Youth and
Families

o The Florida Department of Education

o The Florida Department of Law Enforcement

o The Florida Committee for the Prevention of Child
Abuse

o The Ounce of Prevention Fund

----------------------------------------....................................................................................................
This publication was produced at a cost of $2132.50 or $8.52 per copy, to report to the Florida Legislature on
the status of child abuse and neglect prevention services and needs for the next two years. HRS complies with
the state and federal non-discrimination policies, relating to race, sex, age and handicapping conditions.
----------------------------------------....................................................................................................

For Further Information Contact:

o DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES

o Children, Youth and Families Program Office

o Child Abuse and Neglect Prevention Unit

1317 Winewood Boulevard, Building 8, Tallahassee, Florida 32301 904-488-8762

PREFACE

The State Plan for Prevention of Child Abuse and Neglect 1989-91: Part I and Part II
is Florida's fourth state plan for the prevention of child maltreatment. The Department
of Health and Rehabilitative Services (HRS), Children, Youth and Families Program
Office (CYF), Child Abuse and Neglect Prevention Unit, has prepared this plan in
compliance with Section 415.501, F.S.; Prevention of abuse and neglect of children; state
plan. The plan is due biennially and covers the period of January 1, 1989 to January 1,
1991. Through the submission of the plan, all requirements of the statute have been met.

Part I of the plan provides a statewide perspective, summarizing district information and
clarifying future goals and direction.

Part II of the plan is a reference document that provides detailed information on
legislation, each of the 11 district plans, and interagency efforts in place to address the
prevention of child abuse and neglect in Florida. This Document is Part II.

TABLE OF CONTENTS

EXECUTIVE SUMMARY iii

I. INTRODUCTION 3

SII. HISTORY OF LEGISLATION 7

" III. DISTRICT TASK FORCES/DISTRICT PLANS 11
Plan Guide
District Plans
District I 17 District VII 153
District II 43 District VIII 177
District III 61 District IX 199
District IV 87 District X 221
District V 113 District XI 241
District VI 133

)IV. CHILD ABUSE AND NEGLECT PREVENTION PROJECTS 259

V. INTERAGENCY COORDINATION
{ Interprogram Task Force 277
0 Department of Education Efforts 281
Instruction of Parents and School Personnel 289
Instruction of Law Enforcement Personnel 291
Prevention of Migrant Child Abuse 295

v VI. PUBLIC/PRIVATE PARTNERSHIPS
Florida Committee for the Prevention of Child Abuse 299
Ounce of Prevention Fund of Florida, Inc. 301

VII. APPENDICES
Section 827.075, F.S.-1982 305
Section 415.501, F.S.-Amended 1985-86 311

EXECUTIVE SUMMARY

Florida's Child Abuse and Neglect Prevention Program has generated strong national
interest for its solid funding base and innovative approaches to curb child maltreatment.
Florida is one of the few states to have a line item for child abuse and neglect
prevention. Since 1982, Florida has sponsored a statewide network of community-based
agencies offering a continuum of prevention services. The 1988-89 state appropriation
was $4.2 million which funds programs with sites in every county of the state. In
addition to programs funded under the current legislation, two other sources fund child
abuse and neglect prevention including program-specific legislative appropriations
totalling $299,934 and $861,036 in federal grant monies.

Child abuse is a complex problem. A variety of programs are necessary to address its
multiple causes and to coordinate these programs in a comprehensive community-based
prevention plan. The comprehensive approach to child abuse and neglect prevention is
funded under legislation commonly known as the "Mills Bill" (Section 415.501, F.S.). As
mandated by law, responsibility for planning is centered in the 11 HRS district task
forces, appointed by the district administrators. The task forces are comprised of
community leaders who develop a biennial plan that describes the services they provide,
identifies gaps and barriers, and priorities needed services within their communities.
Part II contains each of the 11 district plans in their entirety.

The common feature of all prevention programs is the goal of preventing family
breakdowns and the occurrence or recurrence of maltreatment. Prevention services that
are provided in Florida include intensive case management services for high risk families,
in-home prenatal and perinatal support programs for teens and first-time parents,
respite/crisis nurseries and parent stress hot-lines, parent education, therapeutic programs
for children and families where abuse has occurred, and community awareness programs
that include training of professionals and child safety programs. Programs may be
located in medical, educational or social service settings and may address abuse in early
childhood through adolescence. Programs provide services to families considered high
risk for maltreatment or to families identified by protective services. Programs may
operate independently or as a mechanism for coordinating existing community services.

No one-dimensional approach, single program or service, or individual professional group
can prevent abuse. Prevention of child abuse and neglect requires multi-agency efforts.
It cannot be the job of social service agencies alone. Schools are the point of universal
contact with children and provide the setting for training children about abuse and self
protection. Health care professionals are in frequent contact with families who never
enter the social service system and can provide training, education, support and
monitoring services for these families. Workplaces are also important settings for
combatting parental stress and supporting the healthy functioning of families.
Community, religious, recreational and social groups have contact with and provide
critical support for many families.

The State Plan for Prevention of Child Abuse and Neglect-1989-91: Part -II describes the
status of prevention efforts in Florida and outlines concepts and strategies for the task
ahead.

The chapters within Part II serve as a reference document that addresses the mandates of
the legislation as follows:

iii

I. Introduction This section summarizes the human, social and fiscal costs of
child abuse and neglect and addresses the effectiveness of comprehensive,
intensive early intervention programs.

II. District Task Forces/District Plans This chapter presents a district plan
guide and contains each of the 11 district plans in their entirety.

IV. Child Abuse and Neglect Prevention Projects This chapter offers a listing
of all child abuse and neglect prevention programs funded under Section
415.501 (Mills Bill), and also includes program-specific legislative projects
as well as projects funded with federal dollars.

V. Interagency Coordination This chapter reviews the legislative
requirements of the Interprogram Task Force and the joint efforts of the
Florida Department of Health and Rehabilitative Services, the Department
of Education and the Department of Law Enforcement in addressing issues
of child maltreatment.

VI. Public/Private Partnerships This chapter provides information on the
Florida Committee for the Prevention of Child Abuse and the Ounce of
Prevention Fund.

VII. Appendices This chapter contains the original 1982 legislation and the
amended 1985 legislation.

I. INTRODUCTION

INTRODUCTION

The abuse, neglect and exploitation of Florida's children must be addressed effectively.
Abuse, neglect and exploitation of our children is the common denominator underlying the
state's most pressing social problems. Retrospective studies reveal that the most troubled,
disabled and dysfunctional members of society are often the survivors of childhood
maltreatment. For example, studies reveal that child abuse and neglect exist in the
background of:
o 22% of children handicapped by cerebral palsy,
o 30 to 40% of children hospitalized for psychiatric disturbances,
o 75% of adults diagnosed for multiple personality disorders,
o over 80% of juvenile delinquents,
o 71 to 92% of adolescent runaways,
o 45 to 57% of child molesters, and
o 45 to 65% of adolescent and adult prostitutes.

Prevention programs which are comprehensive, intensive and focus on early intervention
do work. Lisbeth Schorr's new book, Within Our Reach: Breaking the Cycle of
Disadvantage, confirms that certain intervention programs can alter the pernicious
conditions in which many poor, disadvantaged children grow up in America and thereby
reduce the odds of what Schorr calls "rotten outcomes". As Schorr states, "The more long-
standing the neglect, deprivation, and failure, the more difficult and costly the remedies."
Help early in the life cycle, she stresses, is "likely to be more economical and more
effective. Failure and despair don't have as firm a grip early as later. Life trajectories
are more easily altered." Prevention programs "do work" but there is no "quick fix".
Rigorous research over two decades has demonstrated the effectiveness of prevention in
many areas of child and family welfare.

The dollars invested in early prevention services are returned many times over in savings
on remedial health, education and social services. Quality day care and early childhood
education have proven that intervention in the critical, early years of children's lives
have lasting positive effects on children's educational, social and vocational success.
Long term research conducted through the High/Scope Educational Research Foundation
documents that for every $1 invested in quality pre-school education up to $7 is saved in
later public expenditures. The Children's Defense Fund (CDF) reports that every dollar
invested in prenatal care saves $7 in later medical and institutional costs by reducing
infant mortality and the rate of low birthweight.

Specific child abuse prevention programs which have been rigorously evaluated have
reduced substantially the incidence of maltreatment among high-risk families. When
home health visitor services were provided to young, high risk mothers, on a randomized
basis, a University of Rochester study found that nearly five times as many of the "no
treatment" mothers later abused or neglected their children (Olds et al., 1986). None of the
children randomly assigned to receive lay home visitor services through a University of
Colorado program later received hospital care for abuse-related injuries, compared to 10%
of the children in similar families who received no visitation services (Gray et al., 1980).
Specially trained paraprofessionals in a home visiting program in South Carolina targeted
toward pregnant teens, showed that the control group had 55 percent more low
birthweight babies and four-and-one half times as many very low birthweight babies.
There is corresponding strong evidence that childhood health and developmental problems
significantly increase the risk that children will be abused. Parent education programs
for parents of children with special needs have demonstrated a reduction in the

occurrence of child maltreatment. Florida's child abuse and neglect prevention programs
provide all of these services.

II. HISTORY OF LEGISLATION

HISTORY OF LEGISLATION

During August, September and October of 1981, the Health and Rehabilitative
Services/Criminal Justice Appropriations Subcommittee of the Florida House of
Representatives conducted on-site visits to numerous major institutions operated by the
Department of Health and Rehabilitative Services and Department of Corrections. The
visits were designed to provide members with direct information about the day-to-day
operation of the facilities, problems and proposed solutions, both substantive and fiscal.

In the course of the visits and discussions regarding the clients/inmates served, a pattern
became apparent to the members and particularly to the Chairman of the committee
regarding one aspect of the client/inmate characteristics, i.e., a disproportionate frequency
of child abuse and neglect in many of the client/inmates case histories. This "discovery"
led many members to question what was currently being supported by the state to prevent
child abuse and neglect.

Subsequent to the site visits, House Bill 296 was drafted which required the Department
of HRS to develop a comprehensive state plan for the prevention of child abuse and
neglect to be submitted to the Governor, President of the Senate and Speaker of the House
on January 1, 1983.

The following is a brief history of child abuse and neglect prevention legislation in the
State of Florida.

1982

o The Florida Legislature enacted House Bill 296 (Section 827.075, F.S; subsequently
Section 415.501, F.S.), which required:

(1) the establishment of an Interprogram Task Force to oversee the development
of a comprehensive state plan which could be the basis for future budget
requests;

(2) representation on the Interprogram Task Force from the Children, Youth
and Families Program Office, Children's Medical Services Program Office,
Developmental Services Program Office, the Health Program Office, and the
Office of Evaluation (representatives of the Department of Education and
the Florida Department of Law Enforcement to serve as ex-officio
members);

(3) each district of the Department of Health and Rehabilitative Services to
establish a district task force and develop a district plan;

(4) the Department of Health and Rehabilitative Services and the Department
of Education to develop methods of instruction for public school personnel
in the detection of and intervention in suspected cases of child abuse and
neglect, and to develop curriculum on child abuse and neglect;

(5) the Florida Department of Law Enforcement and the Department of Health
and Rehabilitative Services to jointly develop ways of informing and
instructing appropriate law enforcement personnel in the detection of and
intervention in suspected cases of child abuse and neglect; and

(6) the Department of Health and Rehabilitative Services to work together with
public and private agencies in efforts to educate the general public
regarding the problem of child abuse and neglect and methods of detection.

o The Florida Legislature appropriated $1.1 million dollars for a six month period to
be distributed to each district based on the percentage of the child abuse and
neglect reports in the district, and the percentage of the state population at risk of
abuse and neglect in the district, with equal weight being given to each factor.
The districts developed requests for proposals for meeting identified priority needs.

1985:

o The legislation was amended to delete the reference to a distribution formula and
the requirement of request for proposals.

o Section 415.5015 was created which required the Department of Education to assure
primary prevention training for all children in grades K-12 through the training of
school teachers, guidance counselors, parents, and children. This section is cited as
the "Child Abuse Prevention Training Act of 1985."

1986:

o Section 415.5015 (cited above) was amended to expand the curriculum to include
information pertaining to child safety training children's rights, crisis counseling,
family stress, parenting, child development, and the relationship of child abuse to
handicaps in young children.

NOTE: Please refer to Appendices for 1982 legislation (Section 827.075, F.S.) and amended
1985 legislation (Section 415.501, F.S.)

III. DISTRICT TASK FORCES/DISTRICT PLANS

DISTRICT TASK FORCES/DISTRICT PLANS

"Each district of the Department of Health and
Rehabilitative Services shall develop a plan
for its specific geographic area."
Chapter 82-62, Laws of Florida.

The Children, Youth and Families Program Office appreciates the community leaders
who comprise the district Child Abuse and Prevention Task Force(s) and who have
devoted significant amounts of time and energy to writing the district plans. The
members of the district task forces are listed at the beginning of each plan. Additionally,
HRS prevention specialist, most of whom have many other responsibilities, are to be
commended for their considerable efforts.

DISTRICT PLAN GUIDE

This document will serve as a guide to persons reviewing the individual district plans.
This guide shows the format used by all districts in preparing each of the six sections
within the plan.

I. DOCUMENTATION OF THE PROBLEM

This section describes the magnitude of the problem of child maltreatment, including
sexual abuse, physical abuse, emotional abuse and neglect.

II. DESCRIPTION OF PROBLEMS

This section provides a comprehensive and detailed description of all programs funded in
whole, or in part, with 1987-88 prevention dollars allocated to the districts under Section
415.501, Mills Bill. (Note: the attached "Instructions" and the "Continuum-Type of
Services" are necessary references)

III. PRIORITIES

This section provides priority ranking of the 13 services on the continuum. Further, a
rationale is provided for designation of the top four services and an estimated dollar
amount for implementation.

IV. BARRIERS

This section lists barriers impacting the full implementation of the top four services.

V. ACTION PLAN

This section identifies the action steps to be taken in addressing the barriers identified in
section IV.

VI. RECOMMENDATIONS PERTAINING TO DEPARTMENTAL POLICY OR
LEGISLATIVE ACTION

This section offers recommendations for departmental policy (HRS) or Legislature
changes.

INSTRUCTIONS FOR COMPLETION OF

PROGRAM DESCRIPTION

Information requested for FY 87-88

AGENCY: Umbrella organization (or N/A if not applicable)

PROGRAM: Child Abuse and Neglect Prevention program funded with
state dollars

NUMBER OF SITES: A program may have more than one site

CONTACT PERSON: Director or head of program

COUNTY/COUNTIES SERVED: List

IMPACT: Brief description of type of clients served and service provided- e.g., single
parents, teen parents, parents of children with handicaps

TYPE OF PREVENTION: Designate letters)
P Primary Prevention: Measures taken to prevent child
abuse in the general population
S Secondary Prevention: Measures taken to prevent child
abuse in an identified high risk population
T Tertiary Prevention: Measures taken to prevent
reoccurrence of abuse through services targeted at
victims and their families

TYPE OF SERVICE: Designate numbers)

See attached page for program areas based on the National Committee for the
Prevention of Child Abuse (NCPCA) continuum.

ESTIMATED NUMBER OF FAMILIES COMPLETED PROGRAM: An unduplicated
count. Child and/or parent constitutes a 'family'. *May use N/A for community
awareness programs.

ESTIMATED STATUS OF FAMILIES SERVED: Estimated percent AFDC; low income
working (under 200% of federal poverty level); middle income.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: Direct service is defined as
direct client contact for most programs. Community awareness programs include
community presentations, training sessions for individuals and groups, distributing
information, etc.

COST OF PROGRAM: Total contract amount or total amount reimbursed (please specify
amount of ADM/PET funds, if any)

ESTIMATED COST PER UNIT OF SERVICE: Cost of program divided by number of
direct service hours.

PERCENT OF ADMINISTRATIVE OVERHEAD: Percent of administrative overhead
charged to this contract

REFERRAL SOURCE (s): Estimated percent e.g. 50% hospital, 30% HRS, 20% self
referral

TYPE OF SERVICE

PROGRAM AREAS ON THE CONTINUUM

1. Prenatal Support For Expectant Parents programs which provide support to
parents during the prenatal period for maternity medical care and education for
expectant parents, including information about community resources.

2. Postnatal Education and Support programs which provide support to new parents
pertaining to infant medical care, group and individual education, as well as
providing information on available community resources.

3. In-Home Education and Support programs designed to reach isolated families in
need of ongoing support, while providing information nd assistance in basic child
care, routine health needs, nutrition and home management.

4. Early and Regular Educational. Medical and Psychological Screening program
geared toward early and regular detection of health, developmental and
psychological problems.

5. Medical and Psychological Services programs which provide comprehensive
therapeutic services for all children at risk and their families based on individual
needs.

6. Child Day Care programs to furnish parents regular or occasional respite, out-of-
home care, for their children.

7. Self-Help Groups a variety of social networks and peer supports created to
reduce the isolation of parents at risk, as well as offer group activities and aid in
their establishment of social contacts.

8. Parent Education and Training programs to provide education for parents and
aid in the development of skills needed to rear children at any age.

9. Life Skills Training programs which provide training and education to children,
adolescents and young adults. These types of programs provide parents with
knowledge and interpersonal skills to aid in preventing abuse, to prepare them for
adulthood, as well as preparing parents for their roles.

10. Family Crisis and Intervention Support programs that provide immediate
assistance to parents in times of stress. These programs are available on a 24-hour
basis and provide referral to long-term services.

11. Treatment and Intervention Services programs designed to minimize the long-
term effects of abuse and neglect through a variety of age-appropriate and
situation-appropriate services, including individual and group treatment and
therapeutic child day care.

12. Community Organization community-based planning or coordinating bodies
which are representative of different community groups and agencies. The
primary goals are to increase the availability of social service, health and
education resources which address the reduction of family stress.

13. Public Information public awareness efforts, through the aid of media
campaigns, which educate parents regarding stress in the parenting role and
providing information on where to obtain help. These efforts also increase
awareness and alert professionals regarding the dynamics of abuse and neglect.

DISTRICT I

\

CHILD PROTECTION TEAM-PREVENTION PROJECT
y.AIN OFFICEE LOCATED IN OKALOOSA COUNTY
111A SOUTH AVENUE
FORT WALTON BEACH, FL 32548

Satellite Offices

Santa Rosa County (Milton)
808 Caroline Suite 9
Milton, FL 32579

Escambia County (Pensacola)
3902 N. 9th Avenue Suite 4
Pensacola, FL 32503

Prevention Project Staff located in
Pensacola, Escambia
Gulf Breeze, Santa Rosa
Milton, Santa Rosa
Fort Walton Beach, Okaloosa
Crestview, Okaloosa
Santa Rosa Beach, Walton
DeFuniak Springs, Walton

DKALOOSA WALTON
3 4

Crestview

DeFuniak Springs

-.Walton c

*Sa ta Rosa Bch.

Child Protection Team-Prevention Project (Preve.ntion Programs District I)
1 2 3 4
Programs Escambia Santa Rosa Okaloosa Walton

Educational Programs/Children X X X X

Training for Professionals X X X X

Community Coordination X X x

Community Presentations/Public Aware. X X X X

Mother to Mother X X X

Tots N Teens X X

Infant Learning Project X

Tots Time X

Family Outreach X

Parent Education X X

Family Supp d Care X X X X

Cheleene/. Shembera Peggy NkUir, Ph.D, Chairpers6n
District Administrator District Chil Abuse & Neglect
17 Prevention Task Force

District I Child Abuse and Neglect Prevention
Task Force Members

John Bilbrey
Lakeview Center, Inc.
1221 West Lakeview
Pensacola, FL 32523
432-1222, Ext. 480

Flora Conger
Post Office Box 1341
DeFuniak Springs, FL
892-2174

32433

Karen M. Garber
105 Silverthorn Road
Gulf Breeze, FL 32561
438-6094

Maureen Goodwin
Regional Coordinator
Parents Anonymous
4405 Soundside Drive
Gulf Breeze, FL 32561
932-2947

Kathleen G. Haight
2515 Edgewater Drive
Niceville, FL 32578
678-2671

Roger Hinote
HRS Children, Youth and Families
District I
Post Office Box 8420
Pensacola, FL 32505-8420
436-8250

Eleanor Johnson
Fort Walton BeachHousing Authority
Section 8
112 Sleepy Oaks
Fort Walton Bch., FL 32548
244-5886

Judy Mastronomico
594 Fairway Court
Ft. Walton Bch., FL 32548
(904) 862-9307

Lelia Montes
104 Berryhill
Milton, FL 32570
(904) 623-0124

Judy Murphy
COPE, Inc.
Post Office Box 607
DeFuniak Springs, FL 32433
892-5333

Sally Putters
CPT
3902 North 9th Avenue
Suite #4
Pensacola, FL 32504
(904) 434-0850

Grace Roden, Coordinator
FDLRS
30 East Texas Drie
Pensacola, FL 32503
434-3732

Fran Walker
GAL Program
1800 St. Mary's Street
Box 8
Pensacola, FL 32501
434-3461, Ext. 242

Peggy Walker, Ph.D.
Children's Home Society
5375 North 9th Avenue
Pensacola, FL 32504
(904) 476-3133

Grace Allen
HRS Children, Youth and Families
District I
Post Office Box 8420
Pensacola, FL 32505-8420
436-8238

I. DOCUMENTATION OF THE PROBLEM

During fiscal year 1986-87, this district received abuse and neglect reports on 4,596
children. During fiscal year 1987-88, this district received reports on 5,327 children.
This indicated an increase of 732 children or a 16% increase for the district. Specific
numbers of children reported as abused or neglected are listed by county as follows:

FY 86-87
County Children Reported

Escambia

Santa Rosa

Okaloosa

Walton

TOTAL

2,499

485

1,280

333

4,595

FY 87-88
Children Reported

2,777

729

1,458

363

5,327

% Increase

11%

51%

15%

9%

16%

The data clearly indicates that this district is continuing to see a significant increase
in the reports of the children abused or neglected each year. The most dramatic
increase has been in Santa Rosa County (51%). The reports are broken down into the
following categories:

Physical
Abuse

27%

Sexual
Abuse

11%

Emotional
Abuse

7%

Neglect

55%

Neglect continues to be the most reported maltreatment, followed by physical abuse,
then sexual abuse and emotional abuse.

Additional statistics by county regarding births to teenage mothers, infant deaths,
infant mortality and number of children below the poverty level are listed as follows:

County

Escambia

Santa Rosa

Okaloosa

Walton

Teenage
Births
(1987)

637

142

262

67

Infant
Mortality
Infant
Deaths
(1986)

44

7

16

7

Number
Children
Rates Per
1000 Births
(1986)

10.0

6.0

6.7

19.6

As our prevention efforts in this district turn toward working with young mothers,
this data reflects different needs in each county. The largest numbers of teenage
mothers and children living in poverty is in Escambia County, but the highest

Percent
Children
Below
Poverty
Level

19,619

5,042

6,785

2,649

Below
Poverty
Level

27%

27%

16%

38%

percentage within the county of teenage mothers and children living in poverty is in
Walton County. The infant mortality rate is also the highest in Walton County. The
infant mortality rate has been increasing for the past five years as have the number
of births to teenage mothers in that county. This points out the need to offer services
at the onset of pregnancy in that county.

Also, this district completed a comprehensive study of client deaths which occurred
between January 1, 1987 and June 30, 1987. The findings confirmed that children at
the highest risk are under five (5) years of age. All eleven (11) children who died
during the review period were under age five. Of the eleven children only a few
were actual cases where cause of death was listed as abuse or neglect, but it was
apparent in most of the cases that a lack of parenting skills on the part of the parents
(especially young mothers with medically complex children) may have contributed in
some way to the death of their children.

The death study clearly pointed out that young children with young parents are at
the highest risk that services for this group should have high priority in this
prevention plan.

II. PROGRAM DESCRIPTIONS

AGENCY: Northwest Florida
Comprehensive Services for Children, Inc.
(the Child Protection Team-Prevention Project)

CONTACT PERSON: Sheryl Ebeoglu

PHONE: (904) 863-3109

CONTRACT AMOUNT: $219,462.00 ($218.363 actual
reimbursement)

PERCENT OF ADMINISTRATIVE OVERHEAD: A separate amount for administra-
tive overhead is not identified in the contract. No fee is charged to the
Project by Northwest Florida Comprehensive Services for Children, Inc.
Estimated administrative costs are $76,113 which is 35% of the budget. Each
program area is charged a percentage of the total administrative cost
proportionate to the amount of time, effort and resources expended on that
particular program. Administrative costs are defined as rent, utilities,
maintenance supplies and equipment, new office equipment and repairs, audit,
insurance, bonding, consultations, conferences and conventions, communication,
freight, advertising, and a portion of salary and fringe for certain staff
positions.

* The Child Protection Team-Prevention Project is a multi-faceted child abuse
prevention agency funded primarily through the Mills Bill. Percentages of funds
for the various programs as well as number of hours of direct client contact are
estimated.

PROGRAM: Educational Programs for Children and Adolescents

NUMBER OF SITES: 75 Elementary, 20 Junior and Senior High Schools

COUNTY/COUNTIES SERVED: Escambia, Santa Rosa, Okaloosa, Walton

IMPACT: Age appropriate personal safety programs for students grades K-6;
programs for 7th grade students on prevention of sexual abuse, assertiveness
and the use of support systems; programs for Life Management Classes on child
abuse and neglect indicators, abuse prevention, reporting procedures, support
systems, community resources; personal safety programs for Life Management
Classes; miscellaneous programs for latchkey children, special education
students, church youth groups, Scouts, child development classes and teen
pregnancy programs.

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #9 Life Skills Training

NUMBER OF STUDENTS SERVED: 35,654

NUMBER COMPLETED: Same

ECONOMIC STATUS: N/A

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 2,164 (one hour preparation
allowed for each hour of lecture)

PROGRAM COST: $38,103 (staff), $1,068 (educational supplies), $2,011 (travel) =
$41,182

PERCENT OF ADMINISTRATIVE OVERHEAD:
$11,417

15% of administrative budget -

ESTIMATED COST PER UNIT OF SERVICE: $1.16 per student; $19.03 per hour;
with administrative costs $1.48 per student, $24.31 per hour

REFERRAL SOURCESS: N/A

PROGRAM: Training for Professionals:

NUMBER OF SITES: 83

COUNTY/COUNTIES SERVED: Escambia, Santa Rosa, Okaloosa, Walton

IMPACT: Training for school personnel in recognition of child abuse and neglect,
reporting laws and handling disclosures of abuse; two to six hours of the 20-
hour state mandated training for child care providers on child abuse and
neglect, community resources and positive discipline methods. Similar training
provided for HRS personnel and other professionals. A six-hour workshop on
the Infant Death Crisis was provided for area professionals.

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #13 Public Information

NUMBER OF PROFESSIONALS SERVED: 2,410

NUMBER COMPLETED: Same

ECONOMIC STATUS: N/A

ESTIMATED NUMBER OF DIRECT SERVICE HOURS:
preparation allowed for each hour of lecture), plus
Death Crisis Workshop.

384 hours (one hour
6 hours for the Infant

PROGRAM COST: $3,119 (staff), $170 (educational supplies), $670 (travel) = $3,959
plus $912 for workshop expenses

PERCENT OF ADMINISTRATIVE OVERHEAD:
budget of $76,113 = $3,806.

5% of the total administrative

ESTIMATED COST PER UNIT OF SERVICE: $1,70 per professional, $10.30 per
hour. Including administrative overhead $3 per professional, $20.22 per hour.
Workshop $10.73 per attendee, $152 per hour.

REFERRAL SOURCESS: N/A

PROGRAM: Community Coordination

NUMBER OF SITES: 7

COUNTY/COUNTIES SERVED: Escambia, Santa Rosa, Okaloosa, Walton

IMPACT: Seven Child Abuse Prevention Task Forces; newsletters; resource
directories for each county; coordination of multi-agency in service programs;
participation in interagency organizations Council on Infant Preschool
Services, Family Planning Advisory Council, SEDNET, Child Care Continuum,
Governor's Constituency for Children, JOBS, Child Care Training Advisory
Committee, Interagency Council for Pre-Kindergarten, Community Services
Coordinating Council, etc.

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #12 Community organization

NUMBER OF PERSONS SERVED:

Directories 1400
Newsletter 325/issue
In service newsletter 200
participants 116

NUMBER COMPLETED: N/A

ECONOMIC STATUS: N/A

ESTIMATED NUMBER OF DIRECT SERVICE HOURS:

792 hours
Task Forces 248
Newsletter 40
Directories 280
In service 24
Interagency
participation 200

PROGRAM COST: $10,167 (staff), $1,341 (travel) $11,508

PERCENT OF ADMINISTRATIVE OVERHEAD:
budget of $76,113 = $7,611

10% of the total administrative

ESTIMATED COST PER UNIT OF SERVICE: $14.53 per hour; with administrative
costs $24.14 per hour

REFERRAL SOURCE: N/A

PROGRAM: Community Presentations/Public Awareness

NUMBER OF SITES: N/A

COUNTY/COUNTIES SERVED: Escambia, Santa Rosa, Okaloosa, Walton

IMPACT: Presentations for civic, church, WIC and parent groups on child abuse
and neglect incidence, indicators, reporting, prevention and community
resources and positive discipline; newspaper articles, student assistance, fairs,
booths and exhibits.

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #13 Public Information

NUMBER OF INDIVIDUALS SERVED: 3,299

NUMBER COMPLETED: Same

ECONOMIC STATUS: 38% AFDC or low income (WIC participants), 62% middle
income

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 360 hours; 134 hours
presentations plus one hour preparation; 92 hours exhibits, fairs, interviews

PROGRAM COST: $1,521 (staff), $670 (travel), $505 (printing and reproduction) -
$2,696

PERCENT OF ADMINISTRATIVE OVERHEAD: 5% of the administrative budget -
$3,806

COST PER UNIT OF SERVICE: $.661 per participant; $6.08 per hour; with
administrative costs $1.81 per participant, $16.66 per hour

REFERRAL SOURCESS: N/A

PROGRAM: Mother To Mother

NUMBER OF SITES: 3

COUNTY/COUNTIES SERVED: Escambia, Santa Rosa, Okaloosa

IMPACT: A perinatal support program utilizing parent aides, volunteer and paid,
to provide in-home education and support and facilitate the use of community
resources by pregnant women and parents with babies aged birth to one year.
The program serves primarily parents identified by the referral source as high
risk.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE:

#3 In-home Education and Support
#2 Postnatal Education and Support
#1 Prenatal Support for Expectant Parents

NUMBER OF FAMILIES SERVED: 129 (22 limited to initial assessment)

NUMBER COMPLETED: 110

ECONOMIC STATUS: 20% AFDC, 30% low income (working), 20% middle income,
30% unemployed, not AFDC

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: (Does not include training
time) 3,130 staff, 664 volunteer 3,794

PROGRAM COST: (Does not include direct assistance to families paid by donations)
$25,198 (staff), $3,352 (travel), $50 (educational supplies) $28,600

PERCENT OF ADMINISTRATIVE OVERHEAD: 20% of the total administrative
budget of $76,113 = $15,262

COST PER UNIT OF SERVICE: $260 per family completing; with administrative
costs $398 per family. Cost per hour $9.14; with administrative costs $14.00
per hour. Including volunteer hours and administrative costs $11.55 per hour.

REFERRAL SOURCESS:

23% HRS
11% Child Protection Team or Prevention
Project Staff
28% Military Hospital or Social Services
18% Hospitals/Physicians
5% Public Health Unit
8% Self
6% Other

PROGRAM: Infant Learning Project

NUMBER OF SITES: 1

COUNTY/COUNTIES SERVED: Walton

IMPACT: Monthly home visits are made by parent aides to pregnant women for
support and education. Weekly home visits are made to families with babies
birth to one year to discuss a specific parenting topic and demonstrate an
infant stimulation activity. The program serves primarily low income, rural
parents, single parents, teen parents.

TYPES OF PREVENTION: Primary and Secondary

TYPES OF SERVICE:

#2 Postnatal Education and Support
#3 In-home Education and Support
#1 Prenatal Support for Expectant Parents

NUMBER OF FAMILIES SERVED: 45

NUMBER COMPLETED: 10 during this fiscal year; others still on program

ECONOMIC STATUS: 49% AFDC, 42% low income (working), 4% middle income,
4% unemployed, 1% other

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 570

PROGRAM COST: $8,575 (staff), $43 (educational supplies), $402 (travel) $9,020

PERCENT OF ADMINISTRATIVE OVERHEAD: 8% of the total administrative
budget of $76,113 = $6,089

COST PER UNIT OF SERVICE: $200 per family, $15,82 per hour; with
administrative costs $336 per family, $26.50 per hour

REFERRAL SOURCESS: 14% HRS
9% Public Health Unit
3% Children's Home Society
74% Self, WIC, word of mouth

PROGRAM: Tots N Teens

NUMBER OF SITES: 5

COUNTY/COUNTIES SERVED: Escambia, Okaloosa

IMPACT: Parenting class support groups for teen parents and their children
sponsored by the Prevention Project and community organizations.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #2 Postnatal Education and Support
#1 Prenatal Support for Expectant Parents
#7 Self-help groups

NUMBER OF FAMILIES SERVED: 90

NUMBER ATTENDING REGULARLY: 54

ECONOMIC STATUS: 46% AFDC, 28% low income working, 19% low income -
unemployed, 7% middle income

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 128 meeting hours, 192
hours of preparation, 96 hours transportation, 228 volunteer hours 644 hours

PROGRAM COST: (Does not include $400 from Drop Out Prevention Grant used for
educational materials and child care) $11,512 (staff), $2,176 (transportation),
$50 (educational supplies) = $13,738

PERCENT OF ADMINISTRATIVE OVERHEAD: 15% of the total Administrative
budget of $76,113 = $11,417

ESTIMATED COST PER UNIT OF SERVICE: $254 per client attending regularly,
$33 per hour, $20 per hour when including volunteer hours. With
administrative costs $466 per client, $60 per hour, $36 per hour when including
volunteer hours

REFERRAL SOURCE(S): Cyesis (School Program for Pregnant Teens), 80%;
Children's Home Society, 10%; HRS, 10%.

PROGRAM: Tots Time

NUMBER OF SITES: 1

COUNTY/COUNTIES SERVED: Okaloosa

IMPACT: A socialization/enrichment group for 3 to 5 year old children who were
born to teen mothers and live in a high risk environment as determined by the
HSQ (Home Screening Questionnaire)

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #9 Life Skills Training

NUMBER PARTICIPATED REGULARLY: 13

ECONOMIC STATUS: 85% AFDC, 15% low income working

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 278 hours (102 staff, 25
travel, 24 vision and speech referrals and follow-up) plus 136 volunteer hours -
414 hours

PROGRAM COST: (Does not include $220 in donations) $2,715 (staff), $165
(transportation), $40 (educational supplies) = $2,920

PERCENT OF ADMINISTRATIVE OVERHEAD: 3% of the total administrative
budget of $76,113 = $2,283

ESTIMATED COST PER UNIT OF SERVICE: $225 per child; with administrative
costs $400 per child. $10.50 per hour; including volunteer hours $7.05 per hour;
with administrative cost $12.57 per hour

REFERRAL SOURCESS: 100% Tots N Teens

PROGRAM: Family Outreach

NUMBER OF SITES: 1

COUNTY/COUNTIES SERVED: Santa Rosa

IMPACT: A volunteer program using trained parent aides to work one on one with
families under stress.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #3 In-home Education and Support

NUMBER OF FAMILIES SERVED: 20 plus 4 emergency services only

NUMBER COMPLETED: 5; 13 remain open; 2 moved

ECONOMIC STATUS: 38% AFDC, 58% low income working,
4% middle income

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 576 (staff), 577 (volunteers)
(Does not include hours spent in training volunteers)

PROGRAM COST: (Does not include volunteer budget of $3,649 used for direct
assistance to families and volunteer expenses) $6,693 (staff); $395 (travel) =
$7,088

PERCENT OF ADMINISTRATIVE OVERHEAD:
$7,611

10% of administrative budget -

ESTIMATED COST PER UNIT OF SERVICE: $354.40 per family; with
administrative costs $735 per family. $6 per hour, staff and volunteer; $12.50
including administrative costs

REFERRAL SOURCESS:

64% HRS
4% Self
4% Military
4% Church
20% Medical (CMS, Dr., hospital)
4% other

PROGRAM: Parent Education

NUMBER OF SITES: 5

COUNTY/COUNTIES SERVED: Escambia, Okaloosa

IMPACT: Parentmaking Classes for New Parents, Basic Infant Care Classes for
Cyesis Programs in two sites; "Parenting for the Eighties" lecture series,
Responsible Parenting Series for Naval Base.

TYPES OF PREVENTION: Primary, Secondary and some Tertiary

TYPES OF SERVICE:

#2 Postnatal Education and Support
#1 Perinatal Support for Expectant Parents
#8 Parent Education and Training

NUMBER OF FAMILIES SERVED: Parentmaking 14
Basic Infant Care Classes 20
Parenting for the Eighties 142
Raising Responsible Children 19

NUMBER COMPLETED: N/A (each class designed to be complete within itself)

ECONOMIC STATUS: Parentmaking 17% AFDC, 17% middle income, 66% low
income-working; Basic Infant Care Classes 30% AFDC, 20% middle income,
30% low income unemployed, 20% low income working; Parenting for the
Eighties unknown; Raising Responsible Children 50% middle income, 50%
low income working

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 140 hours
Parentmaking 36 hours (one hour preparation included 'for each hour of
class)
Basic Infant Care 20 hours (one hour preparation for each hour of class
Parenting for the Eighties 72 hours (one hour preparation for each hour of
class)Raising Responsible Children 12 hours including preparation

COST OF PROGRAM: (including $200 from Drop Out Prevention Grant) $6,429
(staff, including curriculum development), $938 (travel), $120 (educational
supplies) $7,467

PERCENT OF ADMINISTRATIVE OVERHEAD: 5% of administrative budget -
$3,806

ESTIMATED COST PER UNIT OF SERVICE: $38 per client, $53 per hour; with
administrative costs, $58 per client, $81 per hour

REFERRAL SOURCES) Parentmaking
17% HRS
66% Self
17% Mother to Mother

Infant Care Classes
100% Cyesis

Parenting for the Eighties
22% HRS
28% Newspaper
2% Court
2% Base
12% Friend
16% Parenting Calendar or meeting
announcement
19% Child Care Newsletter

PROGRAM: Family Support Child Care

NUMBER OF SITES: 4

COUNTY/COUNTIES SERVED: Escambia, Santa Rosa, Okaloosa, Walton

IMPACT: Purchase of Service Agreements with West Florida Child Care and
Education Services, Inc. and Okaloosa-Walton Child Care Services, Inc. to
provide partial or complete funding for child care or respite services for high
risk children.
Consultations and behavior management training sessions given by
counselors and early childhood specialists through Purchase of Service
Agreements with the Prevention Project to benefit child care workers dealing
with high risk children.
Coordination of services for these children provided through regular
staffing.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #6 Child Day Care

NUMBER OF FAMILIES SERVED: 165 children child care or respite care, 20
consultations

NUMBER COMPLETED: N/A

ECONOMIC STATUS: All children served are Title 20 eligible through Protective
Services or Prevention Project Referrals

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 9,544 Child Care hours,
29.5 hours consultation, 17 hours training

PROGRAM COST: $7,700 child care; $443 consultation; $435 training

PERCENT OF ADMINISTRATIVE OVERHEAD: 2% of the administrative budget of
$76,113 = $1,522

ESTIMATED COST PER UNIT OF SERVICE: Child Care $47 per child, $.81 per
hour, assuming 10 hours of child care per day for regular child care. With
administrative costs $9,070, $55 per child, $.95 per hour. Consultation $15 per
hour; with administrative costs, $17.60 per hour. Specialized Behavior
Management Training $25.60 per hour; with administrative costs $30 per hour

REFERRAL SOURCE(S): 96% HRS, 3% CPT-Prevention Project, 1% other

PROGRAM: Family Support Miscellaneous Services

NUMBER OF SITES: N/A

COUNTY/COUNTIES SERVED: Escambia, Santa Rosa, Okaloosa, Walton

IMPACT: Amanda the Panda Parenting Pamphlets for new mothers delivering at
one hospital, co-sponsored by the Fort Walton Beach Junior League; Tel-Ed
Tapes on various topics available by phone in Pensacola office; car seat loan
program; direct assistance to families; consultation for individuals and
professionals pertaining to parenting, abuse/neglect and referral to community
resources.

TYPES OF PREVENTION: Primary, Secondary

TYPES OF SERVICE: #2 Postnatal Education and Support
#10 Family Crisis and Intervention Support

NUMBER OF FAMILIES SERVED: Amanda the Panda 300; Tel-Ed tapes 250; car
seat loan program 20; direct assistance 26; consultation -48

ECONOMIC STATUS: Amanda the Panda 10% AFDC, 20% low income-
working, 70% middle income; Tel-Ed Tapes 20% low income working, 80%
middle income; car seat loan 80% AFDC, 10% low income-working, 10% low
income-unemployed, consultation variable

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: A total of 298 hours:
Amanda the Panda 70, Tel-Ed 60, care seat loan 20, direct assistance -52,
consultation 96

PROGRAM COST: $4,562 $3,892 (staff), $670 (travel), (funds for Amanda the
Panda pamphlets and mailing are provided by the Junior League; direct
assistance is funded by donations $4,000 in fiscal year 87-88. Car seats are
purchased from funds realized by recycling donated aluminum cans).

PERCENT OF ADMINISTRATIVE OVERHEAD: 2% of the total administrative
budget of $76,113 = $1,522

ESTIMATED COST PER UNIT OF SERVICE: $20.42 per hour, $9.45 per client

REFERRAL SOURCESS: Self

III. PRIORITIES

PRIORITY 1. IN-HOME EDUCATION AND SUPPORT

Programs designed to reach isolated families in need of on-going support, while
providing information and assistance in basic child care, routine health needs,
nutrition and home management.

This priority reflects the need in District I for continued outreach and coordination
of services to families whose needs are not being met by existing services and/or fail
to seek out appropriate existing services. Those families are most at risk for
dysfunction and require in-home intervention and support to successfully move them
into the mainstream with the knowledge and support necessary to obtain services they
need.

In this priority, as with those that follow, our emphasis will be on outreach, non-
duplication of services, full utilization of existing services, and reaching the lower
socio-economic families. We believe this philosophy will maximize the effectiveness
of our limited resources by targeting these groups whose needs are as follows:

1. There is a continuing need for in-home service for families identified as
high risk because of chronic neglect, age, isolation, lack of knowledge or
education, non-involvement in other programs or being economically
disadvantaged. Services would include information and role modeling of
nurturing child guidance practices with emphasis on appropriate
disciplinary techniques, facilitating the use of community resources by
assisting with making medical appointments, application for economic
assistance, obtaining child care, utilizing the CMS Outreach program for
the medically complex and generally acting as an ombudsman to develop
life management skills and referral to wide range of services.

2. Parents of children with physical, intellectual or emotional problems are
recognized among those most at "risk." There is a need for outreach,
coordination of services and support for families of disabled children
who are not seeking our services. Emphasis will be placed on basic
parent education, child development, and education for extended family
members in regard to the disability.

3. There is a need for in-home parent education and support for all first-
time parents identified in 1 and 2 above. Parenting is particularly
difficult with the first baby and it is essential to begin a nurturing
relationship immediately between parents) and child. This is
particularly true when the child is born with a disability or born in a
family otherwise identified as high risk.

With all these target groups, the emphasis will be on early intervention with
instruction in specific parenting skills and on disciplinary methods, basic child care
and infant stimulation, child development education, familiarity with local support
services, and linkages with other parents who have similar problems. Within all target
groups, lower socio-economic clients will receive top priority. Research indications
are that child abuse and neglect are strongly related to poverty, in terms of
prevalence and severity of consequences (Palton, 1978). For teen parents, the

evidence also suggest it's socio-economic status rather than age that influences
mother-child interaction (National Committee for the Prevention of Child Abuse).

PRIORITY 2. POSTNATAL EDUCATION AND SUPPORT

Programs which provide support to new parents pertaining to infant medical care,
group and individual education, as well as providing information on available
community resources.

This priority will serve as a continuation and supplement to in-home education and
support. Families in the three target groups receiving in-home education and support
will be encouraged to participate in groups. Group interaction will assist in breaking
down isolation and help develop needed social skills. As group norms develop,
families can loosen their dependence on professionals for support. For example,
parents who have experienced the birth of a disabled child can be .of support to other
parents at a time of emotional crisis to make an early adjustment to the reality of
having a child with special needs.

Similarly, those parents identified as high risk need a continuation of in-home
education and support services with postnatal education and support via group
activities. Those families identified as high risk because of chronic neglect, age,
isolation, lack of knowledge or education, non-involvement in other programs or who
are economically disadvantaged will be worked with in groups toward the goal of
being able to access needed resources on their own.

It is important, particularly for first time parents, to receive information on
community resources at their point of need. This includes facilitating access to
medical and dental care, education, jobs, counseling and economic assistance.
Communication and cooperation with all community resources and agencies is
necessary. Earlier intervention is an important key to success. The immediate in-
home education followed by postnatal education and support combines individual
outreach, group instruction, and maintains a supportive relationship with the families.
This will serve to decrease family stress to promote nurturing parenting practices,
decrease the incidence of low birth weight babies, reduce unwanted pregnancies and
increase self-esteem. This continuum of services from in-home education and support
through postnatal education and support is seen as an important ingredient in
successfully assisting families in these three target groups. Within the context of the
on-going positive relationship that is established in the in-home education and support
phase, these families will hopefully make the transition successfully into group
activities in the postnatal education and support phase.

PRIORITY 3. PARENT EDUCATION AND TRAINING

Programs to provide education for parents and aid in the development of skills
needed to rear children at any age.

Rationale:

In order to promote appropriate parenting skills and change inappropriate behaviors,
parents must first be provided with the knowledge to change their attitudes. While
there are excellent high school and college classes available, they are limited to those
who are motivated. There is no systematic or institutionalized program of parent
education. Parents are passing on inappropriate parenting techniques to their
children and there are prevailing cultural myths regarding physical punishment.

Parent education as a group activity provides reinforcement for parents, decreases
isolation, provides support and allows a parent to get input from sources outside their
family.

While many families may benefit from family support services, economically
disadvantaged parents especially need these services, because their children are at
greater risk of abuse and neglect. Nearly 60% of the families involved in abuse and
neglect had been on welfare in the past year, according to a study by family violence
expert David Gil.

Other factors, especially when combined with poverty, that place families at risk of
abuse and neglect and therefore in need of prevention services include, but are not
limited to the following:

o Being new parents, especially teen parents
o Misuse of alcohol or drugs
o Having children with physical, intellectual or emotional problems
o Having a low birth weight infant
o Being a single parent without supplementary caregivers
o Being a parent who was abused as a child
o Families with economic difficulties which may include unemployment
and/or inadequate housing
o Parents without effective support systems

Studies show that direct intervention should be as near the birth of the first child as
possible. Parenting programs should offer instruction in specific parenting skills such
as disciplinary methods, basic child care and infant stimulation, child development
education, familiarity with local support services, and linkages to other new parents
in the community. Parent educators must be selected who are adept at working with
parents of all socio-economic and educational levels, and who are able to
communicate effectively, and serve as appropriate role models.

PRIORITY 4. LIFE SKILLS TRAINING

Programs which provide training and education to children, adolescents and young
adults. These types of programs provide students with knowledge and interpersonal
skills to aid. in the prevention of abuse, to prepare them for adulthood, as well as
preparing future parents for their roles.

Rationale:

Life Skills training is essential in our society today because of the high level of
violence that affects children and their families. There are large numbers of children
who have been abused, become teen parents, or turn to the use of drugs and/or
alcohol. An increasing number of babies are born to cocaine-addicted mothers, a
factor in low birth weight and child abuse. It is important to promote nurturing
interpersonal relationships at all levels. This includes responsible decision making,
appropriate coping skills and utilization of community resources.

Although "One can never truly know the responsibilities of parenthood until one
becomes a parent," educators can strive to make students more aware of the skills of
parenting, through classes in child development.

Awareness on the part of professionals and volunteers is also essential to the
effectiveness of a community's prevention programs. It is particularly important that
those who come into contact with families, such as teachers and physicians, receive
training in the dynamics of child abuse and information on the availability of
prevention programs in the community.

Parents need to learn how to teach their children personal safety skills and children
must learn to recognize abusive situations and to be able to resist and report abuse.
Systematic programs on personal safety should be an essential part of the elementary
through high school curriculum.

Rank order of remaining priorities:

PRIORITY

5. COMMUNITY ORGANIZATIONS

PRIORITY

6. PTTRT.TC TNFORMATTON

PRIORITY

7. PRE-NATAL SUPPORT FOR EXPECTANT PARENTS

PRIORITY 8. SELF-HELP GROUPS

PRIORITY 9. CHILD DAY CARE

PRIORITY 10. EARLY SCREENING

PRTORTTY

II. FAMILY CRISIS AND INTERVENTION

PRIORITY

PR OP TY13. TREATMENT AND INTERVENTION

12. MEDICAL AND PSYCHOLOGICAL SERVICES

PRIORITY

5. COMMUNITY ORGANIZATI S

PRIORI

11. FAMIL CRISIS A INTER ENTION

PRIORIT

13. TREATMENT AND INTER E TION

PRI ITY

IV. BARRIERS AND V. ACTION PLANS

PRIORITY 1. IN-HOME EDUCATION AND SUPPORT

Barrier: Volunteers are limited in terms of availability and appropriateness
to work with the targeted groups.

Action Plan 1: Expand the role of paid parent aides.

Action Plan 2: Pursue coordination with U.S.D.A. Cooperative Extension which has
trained volunteers to work with new parents.

Barrier: Funding problem in expanded utilization of paid parent aides.

Action Plan 1: The activities of the parent aides must be focused on needed
services without duplication of effort.

Action Plan 2: Change funding priorities to increase funding for parent aides.

Barrier: Poor families living in substandard housing.

Action Plan: Develop linkages with HUD to emphasize the need of our client
groups.

Barrier: Some of the highest risk families may be referred or contacted but
choose not to accept the services.

Action Plan 1: Services will be made attractive, non-threatening and non-
judgmental.

Action Plan 2: Services must remain voluntary

Barrier: Clients without phones.

Action Plan: Increased utilization of post cards to make appointments for home
visits.

Barrier: Identification of first-time parents.

Action Plan 1: Follow up on all first time parents referred by hospital staff, HRS
and Public Health Department staff in District I.

Action Plan 2: Expand current regular contracts with these referral sources with
formal referral mechanism.

Barrier: Identify children with developmental delays.

Action Plan 1: Volunteer and parent aides will be trained to use a Denver pre-
screening.

Action Plan 2: If indicated in th pre-screening, the Direct Service Coordinator will
follow up with a full screening when the child is at least six
months of age.

PRIORITY 2. POSTNATAL EDUCATION AND SUPPORT

Barrier Transportation for the rural population to attend group meetings.

Action Plan: Strategic locations for meeting places that are accessible,
inexpensive and safe.

Barrier: Child care for disabled children is especially difficult during group
meetings.

Action Plan: Develop in-service training for parent aides to handle child care for
the disabled children.

Barrier: Lack of trained group facilitators to serve groups and the high cost
of training or hiring qualified persons.

Action Plan: Utilize trained group facilitators from other agencies and local
communities (student interns) to train parent aides and county
volunteers.

Barrier: Lack of telephone contributes to client isolation and inability to
plan efficiently.

Action Plan: Utilization of post cards to make appointments for home visits and
notification of appointments and meetings.

Barrier: Lack of child day care for disabled children.

Action Plan: Project staff will make appropriate referral for day and encourage
development of day care for the disabled.

PRIORITY 3. PARENT EDUCATION AND TRAINING

Barrier: Lack of participation by those families most "at risk."

Action Plan 1: Make classes immediately available at minimal or no cost. Classes
should be non-threatening and accessible. Aggressively promote
attendance by holding classes at locations accessible to "at risk"
families (housing projects, health department, community centers).

Action Plan 2: Send Parent Education Calendars to all agencies involved with high
risk families (HRS, court system, probation/parole, health
department) and encourage agencies to make referrals to programs.

Barrier: Lack of public transportation which limits access to services.

Action Plan 1: Survey organizations that have vans or buses to determine whether
they can transport participants to programs.

Action Plan 2: Hold parenting classes at locations near families so transportation
would not be needed in order to attend programs.

Barrier: Lack of awareness of available parenting classes

Action Plan:

Barrier:

Action Plan:

Barrier:

Send notices through welfare checks and food stamps. Encourage
peer promotion by word of mouth publicity.

A percentage of the population has limited learning skills and is
unable to adequately use materials offered.

Secure audio visual and written materials geared to the interest and
understanding level of the population served. Coordinate efforts
with community literacy programs.

Lack of district wide information and referral system.

Action Plan:

Barrier:

Action Plan:

Pursue the establishment of I and R systems to link, enhance and
expand existing systems.

Stigmas are attached to participation while there are few incentives
for attending classes.

Develop publicity campaigns emphasizing positive aspect of parent
education. Provide social time and snack or free day care as
incentive. Provide recognition through certificates of attendances,
awards, etc.

PRIORITY 4. LIFE SKILLS TRAINING

Barrier:

Action Plan:

Barrier:

Action Plan:

Barrier:

Action Plan:

Barrier:

The school systems are not required to provide child development,
marriage or family planning classes. There is limited enrollment in
child development classes.

Promote awareness with the educational community concerning the
need for pre-parenting education.

There is no community consensus on issues pertaining to sex
education. In some school systems teaching is at best inadequate.

Skill and knowledge building should be stressed in areas of child
development, family and life management, self-development, self
actualization and methods of seeking help for preadolescents and
adolescents. Education and sexuality, pregnancy prevention and
issues relating to parents should be provided in each school system.

Lack of opportunity for preschoolers of teenage parents to learn
positive socialization in their home environment.

Provide socialization/enrichment program for preschool age
children of teenage parents who aren't being served in other
programs.

Local task force members have limited volunteer time to spend on
long term protection and prevention issues.

Action Plan:

Barrier:

Action Plan:

Coordinate efforts with community resources. Broaden community
participation by use of such agencies as community colleges,
churches, service groups, etc.

Lack of staff for such programs as "personal safety" and "latch key"
to continue and expand services.

Recruit and train personnel from other resources to expand and
assist with the presentation programs.

VI. RECOMMENDATIONS PERTAINING TO DEPARTMENTAL
POLICY AND LEGISLATIVE ACTION

1. Ban corporal punishment in the schools and provide training for alternative
discipline strategies for all educational personnel.

2. Require parent education classes as part of the Life Management Skills
sequence.

3. Provide incentives for Day Care Centers to provide slots for disabled children.
This would require appropriate training for-center staff and necessary special
equipment for the child.

4. Expand school dropout prevention programs.

5. Make day care rules (10M-12) and school licensing standard compatible so that
schools can routinely be used for latch key programs.

6. Restore funding for the 20-hour child care training course for child care
workers.

7. Mandate instruction in child abuse awareness and prevention for all Florida
institutions of higher learning for every student involved in a profession that
deals with children.

8. Designate additional funds for subsidized child day care for at-risk children.

9. Make provision for interagency coordination at the State level as well as the
District level.

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District II Child Abuse and Neglect Prevention
Task Force Members

AGENCY/DISCIPLINE
REPRESENTED

NAME AND ADDRESS

TBA

Terry Dicerchio
Apalachee Center for Human Services
P.O. Box 1782
Tallahassee, FL 32302
487-2930

Louise Boone
Jackson County School Board
P.O. Box 36
Bascom, FL 32423
569-2630

Janet Boyd
Bay County Sheriff's Department
Panama City, FL 32401
785-4351

Norman Boyd
Alternate: Stephanie Farque
Parents Anonymous
1106 Thomasville Road
Tallahassee, FL 32303
488-5437

Emergency/Runaway Shelter

Community Mental Health 2-B

County School Board

Law Enforcement

Parents Anonymous

Phyllis Crooms
Community Coordinated
1241 N. East Avenue
Panama City, FL 32401
769-8316

Child Care

Child Day Care 2-A

John Haines
Children's Home Society
370 Office Plaza
P.O. Box 3474
Tallahassee, FL 32303
877-5176

Don Klein
HRS-Developmental Services
2005 Apalachee Parkway
Suite 218
Tallahassee, FL 32301

Private Child Welfare Agency

HRS-District II Development
Services

Sara French
Alternate: Dawn Sorchych-Hoffman
Allied Family Services
247 East 7th Avenue
Tallahassee, FL 32303
222-3822

Margaret Hall
HRS- Children, Youth and Families
Bonifay, FL 32425
488-0078, SC-221-2200
(904)547-3641

Robert Haddock
Washington County Sheriff's
Department
P.O. Box 626
Chipley, FL 32428
638-0610

Elizabeth Jackson
Child Protection Team
1329 E. 6th Avenue
Tallahassee, FL 32303
487-2838

Arthur Trunkfield
Brehon Institute for
Human Services
425 E. Call Street, Suite 22
Tallahassee, FL 32301
222-6685

Meredith Martin
Gadsden County Health Department
P.O. Box 1360
Quincy, FL 32351
627-7521, 488-1003

Kathy Mayne
Child Protection Team
219 Harrison Avenue
Panama City, FL 32401
763-8449

Pat Newell
Jefferson County Health Department
P.O. Box 156
Monticello, FL 32344
997-2744, 997-5422

Human Rights Advocacy
Committee

HRS Subdistrict 2-A

Law Enforcement

Child Protection Team 2-B

District II "Mills Bills"
Provider

Maternal and Infant Health

Child Protection Team, 2-A

Maternal and Infant Health

Kerry Nobles
Tallahassee Police Department
234 Seventh Avenue
Tallahassee, FL 32303
681-4251

TBA
Alternate: Betty Huffman
HRS- Children, Youth and Families
2005 Apalachee Parkway, Suite 225
Tallahassee, FL 32301
488-9800, SC-278-9800

Ruth Pestle
Florida State University
Center for Family Services
College of Home Economics
Tallahassee, FL 32306
644-5778, 644-3280

TBA
Alternate: June Lashbrook
Guardian-Ad-Litem
P.O. Box 2466
Panama City, FL 32401
785-7409

Kay Rifken
State Attorney's Office
500 First Florida Bank
215 S. Monroe Street
Tallahassee, FL 32301
488-6701

Alice Marquis
Life Management Center of
Northwest Florida, Inc.
525 East 15th Avenue
Panama City, FL 32405
769-9481

Nancy Fowler
Children's Medical Services
2639 N. Monroe Street
Suite 200-A
Tallahassee, FL 32303
487-1756; SC-277-1756

Patty White
Community Coordinated Child Care
2003 Apalachee Parkway
Suite 207-209
Tallahassee, FL 32301
878-0636

Law Enforcement

HRS-Subdistrict 2-B

In-Home Service Provider 2-B

Guardian-Ad-Litem, 2-A

State Attorney's Office
Victim Witness Program

Community Mental Health, 2-A

HRS-District II Children's
Medical Services

Child Day Care 2-B

Lat Penland
HRS-Children, Youth and Families
2639 N. Monroe Street
Suite 200-A
Tallahassee, FL 32303
488-0577, SC-278-0577

Michael Thomas
HRS-Alcohol, Drug Abuse
and Mental Health
2639 North Monroe Street
Suite 200-A
Tallahassee, FL 32303
488-2419

HRS-District II
CYF Program Office

HRS-District II
Alcohol, Drug Abuse
and Mental Health

I. DOCUMENTATION OF THE PROBLEM

District II is one of 11 geographically defined organizational units in the Department
of Health and Rehabilitative Services. The District is responsible for the provision of
health, social and rehabilitative services to citizens in 14 predominantly rural counties
in Northwest Florida.

The sparsely populated counties cover over 9,459 square miles. The district has two
urban centers: Tallahassee in Leon County and Panama City in Bay County. The
district also provides services in the following counties: Calhoun, Franklin, Gadsden,
Gulf, Holmes, Jackson, Jefferson, Liberty, Madison, Taylor, Wakulla and Washington.

The district's estimated population is 510,282. Children between the ages of 0-17
comprise 27.4 percent (140,274) of the total district population. Bay County showed
the largest growth for the period of 1980-1986, ranking 26 statewide and followed by
Leon at 42, Wakulla at 48 and Jackson at 49. Population projections for 1990 suggest
that all 14 counties will continue to experience some growth but the largest growth
rate is expected to occur in Bay and Leon Counties.

The family income level of District II residents significantly affects the need for
social services. The state average of families living below poverty-level is 9.9%.
Eleven of the 14 counties have a rate twice that of the state average, and six counties
in District II have over 20% of their families with incomes below the poverty level.
All District counties have a poverty level exceeding that of the state.

In 1986, 17.6% of all live births in District II were to mothers age 19 or less. Of these
births, 39.5% were to unwed teenage mothers. District II had 4% of all births in the
state for 1986, and 5% of all stillbirths in the state. While District II's infant
mortality accounted for 5% of the state total, five of the fourteen counties had infant
mortality rates exceeding 10% in 1986. Jefferson County had a rate of 22.3% and
Madison County led the state with an infant mortality rate of 25.5%.

During fiscal year 1986-1987 there were 7,635 reported allegations of abuse or neglect
in District II. These reports involved 4,847 children which is 3% of the 140,274
children in District II. District II reports account for 5.7% of the report allegations
statewide while District II has 5.25% of the state's children. This indicates a slightly
higher incidence of reported abuse in District II than the statewide average. District
II's unique demographic factors concerning poverty and teenage pregnancy make it
likely that the reported number of abuse and neglect allegations will continue to
increase. This suggests that we should fund and implement programs aimed at
prevention, thereby reducing human suffering and providing cost savings as compared
to the large expenditures required to treat and/or rehabilitate the adults who were
abused as children.

FAMILIES AT POVERTY LEVEL, 1979

Percent of Families
With Income Below
Poverty Level

Florida 9.9%
Bay 12.6%
Calhoun 19.6%
Franklin 23.6%
Gadsden 26.3%
Gulf 18.3%
Holmes 21.5%
Jackson 18.5%
Jefferson 23.7%
Leon 11.8%
Liberty 17.9%
Madison 26.4%
Taylor 18.0%
Wakulla 15.9%
Washington 20.7%

Source: Florida Department of Commerce, Division of
Economic Development Florida County
Comparisons, 1987

II. DESCRIPTION OF PROGRAMS

Description of Child Abuse and Neglect Prevention Programs Funded with State
Dollars:

AGENCY: Brehon Institute for Human Services

PROGRAM: Child Abuse Prevention Project

o Educational Support Programs and Community Awareness Programs

o Newborn Risk Prevention Program

CONTACT PERSON: Art Trunkfield, Executive Director

PHONE: (904) 222-6685

COUNTIES SERVED: Bay, Franklin, Gulf, Calhoun, Gadsden, Liberty, Jackson,
Washington, Holmes, Jefferson, Madison, Taylor, Leon and Wakulla

NUMBER OF SITES: In 1987-88, six local prevention offices served the 14-county
area. The offices were in high traffic business areas of Panama City, Chipley,
Quincy, Tallahassee, and Madison.

IMPACT: In Educational Support Programs and Community Awareness Programs
there were 7,592 outreach, training, and community education contacts. Those
contacts ranged from Early Pregnancy, Childbirth Preparation and Parenting
Skills Training to Pregnancy Prevention Presentations, Child Abuse Prevention
Presentations and Staff Training for School, Day Care and Law Enforcement
Personnel.

In the Newborn Risk Prevention Program 152 clients were served. This was
more than twice the total number projected for this program in 1987-88.
Although complete demographic data is not available the following is known.
The largest age group served was the 16 to 17 year olds, closely followed by
the 15-and- under age group. Almost twice as many blacks as whites were
served. In all counties, the large majority of clients were single. Please refer
to the attached Table 1 which provides data on 144 of the 152 clients served
by the Newborn Risk Prevention Program.

TYPES OF PREVENTION: Brehon Institute conducted both Primary Prevention and
Secondary Prevention Programs in 1987-88. The Educational Support Programs
and the Community Awareness Programs were Primary Prevention Programs
whereas, the Newborn Risk Prevention Program was a Secondary Prevention
Program. Please note that in 1988-89 Brehon Institute will only conduct the
Newborn Risk Prevention Program, a Secondary Prevention Program.

TYPES OF SERVICE: The Educational Support Programs and Community
Awareness Programs addressed three continuum areas: Prenatal Support for
Expectant Parents (#1), Postnatal Education and Support (#2) as well as Public
Information (#13). The Newborn Risk Prevention Program primarily addresses
two areas on the continuum: Prenatal Support for Expectant Parents (#1) and

Postnatal Education and Support (#2). Please refer to the attached Table 2 for
a partial listing of services provided by the Newborn Risk Prevention Program.

ESTIMATED NUMBER OF FAMILIES SERVED: The Newborn Risk Prevention
Program served 152 families. Please refer to the attached Table 3 for a
geographical breakdown of clients. The Educational Support Programs and
Community Awareness Programs had 7,592 outreach, training and community
education contacts. It is uncertain how that would translate in number of
families served.

ESTIMATED NUMBER OF FAMILIES COMPLETING PROGRAM: 1987-88 was the
first year the Newborn Risk Prevention Program was implemented across HRS
District II. By intervening early, that is, working with mothers by their
twentieth week of pregnancy, the program seeks to insure newborns with a
gestational age of 37 weeks, an Apgar score of 7 or above at 5 minutes after
birth, and a birth weight of at least 5.5. pounds. Of the 152 clients served only
78 clients delivered in 1987-88. Of the 78 clients that delivered, only 53
clients met the criteria established for measuring pregnancy outcomes. Please
refer to the attached Table 4 for a summary of services provided to families.

ECONOMIC STATUS OF FAMILIES SERVED: Exact figures are not available but
clearly 90% or more of the families served were low income families eligible
for AFDC and other Economic Services.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: In the Newborn Risk
Prevention Program there were 3,786 client contacts. Participant contacts for
Educational Support Programs and Community Awareness Programs was 7,592.
The total for Direct Client/Participant Contact was 11,378. Contacts are
detailed on the attached Table 4; Summary of Services.

COST OF PROGRAM: The FY 1988-89 contract with the Brehon Institute for
Human Services was for $223,230.00

ESTIMATED COST PER UNIT OF SERVICE: $19.53

PERCENTAGE OF ADMINISTRATIVE OVERHEAD: 18.8%

REFERRAL SOURCES: Total number of clients for Newborn Risk Prevention
Program is 152. Breakdown as follows:

Health Department 53
Hospitals 23
Friends or self 11
Teen Parent Program 39
Schools 8
Community Agencies 13
HRS 7

Referral Information not kept on community awareness clients..

III. PRIORITIES

$1,000 of the FY 88-89 Prevention Contract with the Brehon Institute was used to pay
for a needs assessment survey. This survey was conducted by Valerie Smith, Ph.D.,
who prepared the questionnaire sent it to 940 people directly or collaterally involved
in social services in all 14 counties in the district, she also compiled and interpreted
the response data from the 148 questionnaires which were returned in the survey.
The urban counties of Leon and Bay accounted for 33% of the responses. Many
respondents were able to address needs in more than one county. Those receiving the
survey were involved or employed in: child-care, churches, drug abuse treatment,
education, financial services, Girl Scouts, health, hot-line agencies, law enforcement,
legal system, medicine, mental health treatment, recreation and social services. There
was a 70% response rate for child care, education, health, medicine and social service
personnel receiving survey questionnaires. The survey instrument itself was designed
to ask the respondent to rank their preference of 13 services in the continuum of
services, as well as to identify available and unavailable services.

On each survey returned, the six highest ranked areas were assigned point values; on
each response, the program area designated as the most important received six points.
The program named as second received five, and so on to number six, which was
assigned one point. All responses were then tabulated and the 13 programs are listed
according to descending point totals.

Points
1. Family Support and Crisis Services 315
2. Programs for Abused Children 303
3. Early and Regular Child/Family Screening and Treatment 263
4. Support Programs for New Parents 225
5. Child Care Opportunities 221
6. Ongoing Parent Education 216
7. Life Skills Training for Children and Young Adults 200
8. Public Information and Education 193
9. In-home Educational Support 177
10. Self-Help and Other Neighborhood Support Groups 147
11. Group Education for New Parents 125
12. Coordination of Professional Education 121
13. Community Organization Activities 104

PRIORITY 1. FAMILY SUPPORT AND CRISIS SERVICES.

Included in this program area are emergency shelter facilities, private homes
available as emergency shelters, crisis hotline/helpline services, and crisis nursery
facilities. It is recommended that additional beds be made available in existing
facilities or that new facilities be developed to expand available emergency shelter
services.

There are presently five family operated emergency shelter homes in District II,
providing a total of 17 beds. There are presently three agency-operated emergency
shelter programs providing 20 beds for district needs. There has been a steady trend
for the past several years toward utilization of agency- operated emergency shelter
homes. This is in large part due to family operated homes dropping out of service
and fewer families having an interest in being emergency shelter home parents.

Those who do so must constantly face many demands and requirement from both HRS
and the children placed in their care. Often, the only placements available to
children who are placed in emergency shelter care are in family foster homes. The
foster homes are oriented toward long-term placements, and using their homes for
emergency shelter placements can be very disruptive to the already difficult
adjustment of foster children already in the homes. The stress placed on foster
parents when they agree to accept emergency shelter children causes them to "burn
out" quickly.

In FY 86-87 there were 670 children placed in emergency shelter care in District II.
Costs for placements varied as to the type of placement utilized. The range of
expenditures is significant. Family emergency shelter homes receive $10.50 each day
for each shelter bed. Due to the fact that fewer families are willing to provide
emergency shelter care it is necessary for HRS to develop placement in agency-
operated facilities., At present, there are agency-operated programs in Leon County
and Bay County. In 1989 it is expected that Gadsden County and Jackson County
will also open agency-operated shelter programs. Based on present per diem costs, an
additional 20 emergency shelter beds would have an annualized cost of $382,520.00.
It is the sense of this task force that such funding should be provided to assure
placement availability to children in need of emergency shelter care.

Parents at-risk of abusing or neglecting their children need the availability of crisis
nursery services. An attempt should be made to enlist commercial day care centers to
donate such care. No cost would be incurred to request donated nursery slots from
licensed day care providers.

There are some helpline/hotline services available in all areas of the district. There
is a problem in making the appropriate families aware of the services which are
available. The District Office and the Task Force should work with other
organizations to better publicize the available services, e.g. Parents Anonymous,
Telephone Counseling and Referral, Life Management Center, Apalachee Center for
Human Services.

PRIORITY 2. PROGRAMS FOR ABUSED CHILDREN.

In FY 87-88 there were two programs funded through HRS Children's Medical
Services to treat victims and perpetrators of sexual abuse. The programs were located
in Tallahassee and in Panama City and were established through the auspices of the
Child Protection Teams of subdistricts 2A and 2B. Each program was limited by
funding to 80 hours of group therapy for victims of sexual abuse and 80 hours for
perpetrators considered amendable to treatment. The number of juveniles referred to
HRS Delinquency Intake units for perpetrating sex offenses in District II during FY
87-88 was 88. The number of child victims of sexual abuse in District II during FY
87-88 was 754. The CMS funded programs were the only child sexual abuse and
perpetrator treatment programs available during this time in the public sector. No
other funding has been available through HRS, nor any specific funding through
victim's programs in state attorneys offices in the judicial circuits.

PRIORITY 3. EARLY AND REGULAR CHILD/FAMILY SCREENING AND
TREATMENT.

This priority addresses itself to the need for earlier detection of child abuse and
other health and developmental problems. Again, we perceive that strengthened area
mental health services are necessary to meet this need. Waiting lists for troubled

children to receive initial screening are not desirable. Specialists in this field must be
hired and trained by area mental health services to ensure that detection and
treatment can take place in a timely fashion. The primary resources available through
services purchased by the department are contracts with the community mental health
center networks in the district. Apalachee Center for Human Services is
headquartered in Tallahassee and Life Management Center of Northwest Florida is
headquartered in Panama City. Each agency has satellite clinics in most surrounding
counties. Contracts for FY 87-88 purchased counseling services for CYF referrals for
220 clients at Apalachee and 131 clients at Life Management. In December, 1988
there were 496 families with 814 children under Protective Services supervision. This
lone component of CYF would absorb the total contracted services. The various other
programs in CYF must also compete for these limited services, causing delays in
services and long waits by clients. In no contracted counseling center are any
professional staff designated specifically to deal with the issue of child abuse.

Secondly, restrictive Medicaid guidelines that allow only Community Mental Health
Services to provide screening and treatment are adding to the problem. We
recommend that steps be taken to broaden guidelines to include all qualified
providers. Currently, the only public agencies meeting required Medicaid guidelines
are the Community Mental Health centers. The staff available is typically the same
staff who carry a large backlog of referrals on the contracted counseling services
with CYF. Only physicians and those under their direct supervision may qualify as
Medicaid providers under the present limitations of state and federal law and policy.
Experienced, non-physician therapists do not qualify and are typically excluded from
eligibility. The guidelines could be changed by our state legislature to include these
non-physicians.

Thirdly, we recommend follow-up of all clients served by the current Newborn Risk
Prevention Program. These clients are at very high risk for abuse and neglect, as well
as health and developmental problems. During the period before the child starts
school, regular screening is appropriate. The services are currently being provided in
a demonstration project in Gadsden County. This task force recommends expanding
the project to include at least one of the high population counties in the district
(Leon or Bay). By expanding the sample group in this longitudinal study a more
accurate appraisal of the intervention program is likely. Gadsden County is not
wholly representative of the other counties served in urbanization, racial composition,
available support services, unemployment rates, etc. In addition to improved validity
for the longitudinal study outcomes, better projections for future programs could be
developed.

PRIORITY 4. SUPPORT PROGRAMS FOR NEW PARENTS.

Currently, the Brehon Newborn Risk Prevention Program provides services to many
new parents. One limitation in the project is a lack of transportation for many
parents in the program. A budget request in the amount of $10,000.00 to provide
transportation for low income Newborn Risk Prevention Program clients district-wide,
should be pursued. Transportation is needed to medical, mental health, economic, and
other services. Generic transportation funds for District II in FY 87-88 totaled
$42,000.00 for funds administered through HRS client services transportation
contracts. Jackson, Gulf and Franklin counties had no transportation contracts with
HRS. The primary purpose of transportation was to medical services, especially
clients needing kidney dialysis, chemotherapy and cardiac care. There was a short-
fall in funding for these primary clients and no surplus which could have been made

available to abuse prevention program clients who were not income eligible or able to
arrange their own transportation.

The Task Force also recognizes a need for increased and improved child care in the
community. Dependable and trustworthy child care is essential for the working
parent or the parent requiring respite.

We also recognize a need for improved training of doctors and nurses to improve their
awareness of parents' need for support and their awareness of the community's
available resources. These medical practitioners are sometimes the only professionals
who come into significant contact with these parents and therefore, must be prepared
to make meaningful referrals to support services.

PRIORITY 1

Barrier:

Action Plan:

Barrier:

Action Plan:

PRIORITY 2.

IV. BARRIERS AND V. ACTION PLAN

FAMILY SUPPORT AND CRISIS SERVICES.

There is a severe shortage of family emergency shelter homes for
placing abused/neglected children in District II. Funds are needed
to pay the per diem costs for additional homes. Increased
recruitment and licensing of shelter homes by direct services staff
causes conflicts in the allocation of already limited power.

Seek an appropriation to recruit and fund an additional 20 beds in
licensed emergency shelter homes or programs within District II.
Allocate one FTE within each Subdistrict to specifically recruit,
license and help retain emergency shelter homes and shelter parents.
Each position should have sufficient funding to enable recruitment
and training to succeed. These positions would also have the
responsibility for identifying and recruiting respite care and crisis
day care slots in District II.

Hot-line and help-line telephone services have been under-utilized
by families in crisis. Many services are in place and are available
but are not widely known throughout each community within the
District.

Establish and fund district-wide Information and Referral (I & R)
contracted services.

PROGRAMS FOR ABUSED CHILDREN.

There are no identified programs or funded
specifically address the treatment needs of victims
are at high-risk of later themselves becoming abusers.

Action Plan:

resources to
of abuse who

Establish and fund specialized counseling programs to treat victims
of abuse, whether such abuse occurs inside or outside the victim's
home.

PRIORITY 3. EARLY AND REGULAR CHILD/FAMILY SCREENING AND
TREATMENT.

Barrier: There are lengthy waiting lists for children and families referred
for mental health screening related to abuse/neglect problems.

Action Plan:

Barrier:

Action Plan:

Identify mental health contract service providers which are readily
accessible to clients referred for screening due to abuse/neglect
problems.

There is no continuity in screening, treatment and follow-up in
mental health interventions in abuse/neglect cases.

Mental health providers contracted for services must take the
initiative to reduce their employee turnover, to provide increased
staff training and to improve continuity of services.

Barrier:

______ AMIL SUPPORT A CRISIS SE ICES._____

1 RIIVR\III I

Barrier: Medicaid guidelines are too restrictive and thereby greatly limit the
number of approved mental health service providers.

Action Plan: Recommend legislative and policy modifications of Medicaid
guidelines to expand the number of eligible providers.

PRIORITY 4. SUPPORT PROGRAMS FOR NEW PARENTS.

Barrier: There is a serious lack of transportation services for rural, low-
income, non-medicaid eligible clients within District II.

Action Plan: As a model program to enhance outcomes, provide at least
$10,000.00 for purchased transportation services to clients served by
Newborn Risk Prevention Programs in District II.

Barrier: Due to the great geographic distance between services and potential
clients in District II, many are not being served with prevention
services.

Action Plan: Request additional funding for four FTE positions to serve an
additional six counties within the District by the Child Abuse
Prevention Project. The annualized cost of expanding this service
would be $134,000.00.

Barrier: There continues to be a serious lack of subsidized day care slots in
District II.

Action Plan: Increase number of subsidized day care slots, along with
prioritization for placement for child at-risk of abuse or neglect.

The remaining program areas are prioritized in the following order:

PRIORITY 5. CHILD CARE OPPORTUNITIES.

PRIORITY 6. ONGOING PARENT EDUCATION.

PRIORITY 7. LIFE SKILLS TRAINING FOR CHILDREN AND YOUNG
ADULTS.

PRIORITY 8. PUBLIC INFORMATION AND EDUCATION.

PRIORITY 9. IN-HOME EDUCATIONAL SUPPORT.

PRIORITY 10. SELF-HELP AND OTHER NEIGHBORHOOD SUPPORT GROUPS.

PRIORITY 11. GROUP EDUCATION FOR NEW PARENTS.

PRIORITY 12. COORDINATION OF PROFESSIONAL EDUCATION.

PRIORITY 13. COMMUNITY ORGANIZATION ACTIVITIES.

VI. RECOMMENDATIONS PERTAINING TO DEPARTMENTAL
POLICY LEGISLATIVE ACTION

A) Program Areas on the National Committee for the Prevention of Child Abuse
Continuum

1. On-going Parent Education Coordinate with state DOE on curriculum
standards for skills, values and techniques associated with child rearing,
for middle and high school students.

2. Life Skills Training for Children and Young Adults Utilize the state
university system to help prepare culture-specific responses to social
pressures regarding sex, drug/alcohol abuse, etc. through departments of
education and social sciences.

3. In-home Educational Support Encourage local health departments to work
with cable television local access channels to provide regular programming
on issues of prenatal care, child health, child development and parenting
skills issues.

4. Coordination of Professional Education Develop professional education
and specific C.E.U. requirements for physicians, nurses and other health
care providers on topics of preventing and detecting abuse of children.

5. Child Care Opportunities Increase mandated safeguards for children by
incremental implementation of licensing standards for family day care
homes. Mandatory inspections by County Health Department Units should
be initiated as the first step in the licensing process.

B) General Recommendation

Professional education on child abuse issues The Department of Health and
Rehabilitative Services training staff could offer training on topics of child
abuse to community colleges, public and private colleges/universities to
contribute to curriculum development for criminology, nursing, education and
law school courses.

DISTRICT III

DISTRICT III CHILD ABUSE PREVENTION PROJECT PROGRAM SITES

F ----- ""Each co
HAMILTON f 1 resident
Coordin
.4 Jasper parents
service
S J-ANNEE I county
SUW EE COLUMBIA

unty is served by a
t County Service
ator. Direct services to
and professional education
s are offered in every
in District III.

S Live. Oak Lake City '
ive UNION
L vAFAYT. f( Lake B -er
M -u*. / Sjarke
I Mayo j -- R
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OIXIE I ALACHUA
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IJ I HRIT Gainesville
STrerqton Pal,
Cross City -----_.-
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C lan ARION
Chiefland A

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(As of 9/88, positions in
Lafayette and Hamilton Counties
are vacant. Interim services
are provided as needed by
neighboring county personnel.)

zanne Casey
District III Administrator

TRUS ---
\SUMTER LAKE

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Inverness ",i

HERNAPOH)

Brooksville I

Marianne Bennink
Chairperson
District III Child Abuse & Neglect
Prevention Task Force

t,
i \

District III Child Abuse and Neglect Prevention
Task Force Members

Marianne Bennink, Chairperson
Guardian Ad Litem
Room 203, Alachua County Courthouse
Gainesville, FL 32601
(904) 374-3656

Carol Balbes
Marion Citrus Mental Health
2760 S.E. 17th Street, Suite 500
Ocala, FL
(904) 629-8893

Smaro Bloodworth
Contract Manager, Legal Services
J. Hillis Miller Health Ctr.
Box J-303
Gainesville, FL 32610
(904) 332-2158

Kerry Clifford
Bradford-Union Guidance Clinic
105 North Lake Avenue
Lake Butler, FL 32504
(904) 496-2347

Betty Cluster
Marion County School Board
1245 S. E. 12th Court
Ocala, FL 32671
(904) 629-6209

Kerry Dunning
H.C.A. Putnam Community Hospital
Post OFfice Drawer 778
Palatka, FL 32078
(904) 328-5711

The Honorable Thomas Elwell
Court Judge
Alachua County Courthouse
Gainesville, FL 32601
(904) 374-3607

Lauren Strickland
Lake County School Board
201 West Burleigh Boulevard
Tavares, FL 32778
(904) 343-3531

Ivory Gray, Headstart, Director
Community Action Agency
Post Office Box 905
Brooksville, FL 34298-905
(904) 796-1425

Ronald Hobbs, Principal
Central Hamilton Elementary
Route 2, Box 136
Jasper, FL 32052
(904) 792-2627

Craig Lee, Foster Parent
8072 South Bedford Road
Floral City, FL 32636
(904) 726-7608

Louise Paulus
Alachua Council on Child Abuse
1125 N.W. 23rd Terrace
Gainesville, FL 32603
(904) 372-5596

Diana Rivera
Private Pscyhotherapist
Post Office Box 1773
Lake City, FL 32056
(904) 755-5718

James G. Spencer, Director
Child Protection Team
5700 S. W. 34th Street, Suite 1310
Gainesville, FL 32608
(904) 392-5960

Evelyn Starke
Lake County School Board
201 W. Burleigh Boulevard County
Tavares, FL 32778
(904)343-3531

Claire Walsh
Student Health Services
University of Florida
232 Infirmary
Gainesville, FL 32611
(904) 392-1161

Robert Taylor
Private Citizen
12203 Bonview Lane
Springhill, FL 33526
(904) 686-7525

Margaret Timmerman
Job Training Program
8055 Kennedy Boulevard
Brooksville, FL 34601

Linda Webster
Medical Association Auxiliary
2324 S. E. 15th Street
Ocala, FL 32671
(904) 622-3470

Wayne Whiffen, M.D.
Optometrist
207 South Walnut Street
Starke, FL 32091
(904) 964-6311

Ex-Officio Non-Voting Status

Department of Health and Rehabilitative Services

James Pearce
Contract Manager
1000 N. E. 16th Avenue
Building I
Gainesville, FL 32601
(904) 395-1020

Diane Kezar
Program Analyst
1000 N. E. 16th Avenue
Building I
Gainesville, FL 32601
(904) 395-1024

Child Abuse Prevention Project/University of Florida

F. Thomas Weber, M.D.
Medical Director
5700 S.W. 34th Street
Suite 1310
Gainesville, FL 32608
(904) 392-7286

Barbara Alterman, LCSW
Director
5700 S.W. 34th Street
Suite 1310
Gainesville, FL 32608
(904) 392-7286

I. DOCUMENTATION OF THE PROBLEM

District III is a large geographical area in the North-Central region of Florida that
covers sixteen counties. Although the District is primarily composed of rural
communities, it also includes a state university and major medical center/teaching
hospital which attracts specific populations that often fall in the category of high-
risk for child abuse and neglect. The estimated population of the District is 724,987,
and out of these 202,051 are children between the ages of 0 and 17. This group
comprises 7.5% of Florida's children.

In reviewing the statistics related to the occurrence of child abuse and neglect over
the past three years, it becomes clear that efforts in the area of prevention have been
effective, at least in terms of an overall reduction in the number of reports made. At
the same time, further study reveals an increasing population of children that are
considered to be at-risk for child abuse and neglect. In addition, there seems to be a
decrease in out-patient mental health services to accommodate the therapeutic needs
of this at-risk population. All of this has resulted in a focus of prevention services
and resources towards the needs of these families.

In terms of allegations and indicated cases of child abuse and/or neglect for District
III, refer to the statistics below:

FY '84/85 FY '85/86 FY '86/87 % of
tate
Dependency Referrals
to HRS 22,306 25,196 11,052 8.25

Referrals Disposed
(Investigations 12,477 13,538 7,046 N/A
Completed)

Indicated Referrals Not Not 2,874 9.20
Available Available

Although the number of referrals to HRS has decreased in the last fiscal year, the
complexity and severity of cases reported have increased. As shown above, District
III has 9.2% of the indicated cases in the state. Current efforts in the area of
prevention need to continue to encourage reporting of child abuse and neglect. At
the same time, the primary focus needs to now shift to promoting community services
that will aid families who are at-risk for child abuse and neglect by providing parent
enhancement programs.

This new emphasis on parent education and parent enhancement programs addresses
the identification of increased numbers of high-risk families. In particular,
population groups that have been targeted are teen parents, single parents,
economically deprived families, and families with emotionally disturbed and/or
developmentally disabled children. The statistics show an increase in these
populations both within the state, and specifically in District III.

% of state
1986 1987 (1987)

# of births to mothers
under age 25 5,613 5,992 12.6

# of births to teen
mothers (under age 19) 1,914 2,062 9.3

# of births to mothers
under age 15 54 59 11.4

In addition to large numbers of teen mothers, young mothers under the age of 25 with
several children, and single mothers, there are also statistics showing that there
remains a significant percentage of babies born each year that are considered to be
at-risk due to low birth weights. In 1986, 7% of the babies born were considered to
be below the accepted birth weight. And while it is true that this percentage has
decreased over the past four years, it has only decreased 1%. Likewise, the infant
mortality rate has decreased from 12.4% in 1983 to 11.3 in 1986.

It is clear from the above statistics that the known population of at-risk families and
at-risk children are of significant proportions. In terms of teen parents and single
parents, the numbers are rising. In terms of low birth weight babies and infant
mortality rates, the numbers have changed very little. In addition, it is significant
that 29% of District III's children fall below the poverty level.

All of this would suggest a need for increased services to high risk families in the
above categories to prevent an increase of child abuse and neglect. In addition,
although reports of child abuse have decreased, the seriousness and complexity of
cases reported has increased requiring more intensive services. If we are to continue
to prevent child abuse and neglect, we must stay committed to child abuse prevention
programs and resources.

II. PROGRAM DESCRIPTIONS

The District III Child Abuse Prevention Project is a joint Department of Health and
Rehabilitative Services/University of Florida Department of Pediatrics project. The
prevention funds are distributed under a single contract through the University of
Florida to serve all 16 counties in the District. The Project is staffed by a medical
director, director, assistant director, training specialist, parent education specialist, 16
county service coordinators, six parent educators, an office manager and two
secretaries. The administrative staff is housed in an office complex in Gainesville
with the county service coordinators each residing in one of the 16 counties. They
operate either out of their homes or in donated office space. The parent educators
are located in Alachua, Bradford, Citrus, Dixie, Marion and Putnam Counties.

The following is a description of all of the program areas covered under this single
contract. The actual descriptions are of either particular programs and/or service
areas. The figures under the category of administrative overhead under each of the
descriptions are estimated amounts. In actuality, all of the administrative overhead is
calculated from a single budget which includes all of the programs and service areas.

AGENCY: Child Abuse Prevention Project

PROGRAM: Public Awareness and Education

NUMBER OF SITES: 16

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Alachua, Bradford, Citrus, Columbia, Dixie,
Gilchrist, Hamilton, Hernando, Lake, Levy, Lafayette, Marion, Putnam,
Sumter, Suwannee, Union

IMPACT: Provides education to the public at large regarding child abuse and
neglect. Includes information on the history of child abuse and neglect, the
Florida system for dealing with reported cases, reporting procedures, abusive
family dysfunctions, programs available for the prevention and/or treatment
of child abuse and specific local referral information. Groups and/or events
targeted are civic clubs, county fairs, health fairs, the media (radio, television,
and newspapers), the clergy, and any other group requesting education.

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #13 (Public Information)

ESTIMATED NUMBER OF FAMILIES SERVED: 25,000 individuals

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: N/A

ECONOMIC STATUS OF FAMILIES SERVED: Not collected.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 2,882

COST OF PROGRAM: $51,777

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Civic Clubs, County Fairs, Health Fairs, the Media,
Clergy, and any public group.

AGENCY: Child Abuse Prevention Project

PROGRAM: Community Organization

NUMBER OF SITES: Sixteen

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Alachua, Bradford, Citrus, Columbia, Dixie,
Gilchrist, Hamilton, Hernando, Lake, Levy, Layfayette, Marion, Putnam,
Sumter, Suwannee, Union

IMPACT: Builds a community base of support for child abuse prevention
activities. Provides coordination of efforts by various community agencies
with the goal of avoiding duplication of services. Also assists with the
development of new prevention services for children and families. Serves to
provide continued support and resource for prevention services already intact.

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #12 (Community Organization)

ESTIMATED NUMBER OF FAMILIES SERVED: N/A

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: N/A

ECONOMIC STATUS OF FAMILIES SERVED: N/A

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 3,600

COST OF PROGRAM: $47,211

ESTIMATED COST PER UNIT OF SERVICE: $13.11

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Community organization activities involve all children's
service agencies and groups in the effort to build and support services. Private
sector groups and organizations are also involved when possible.

AGENCY: Child Abuse Prevention Project

PROGRAM: Child Assault Prevention/Life Skills

NUMBER OF SITES: Sixteen

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Alachua, Bradford, Citrus, Columbia, Dixie,
Gilchrist, Hamilton, Hernando, Lake, Levy, Lafayette, Marion, Putnam,
Sumter, Suwannee, Union

IMPACT: Provides child assault prevention programs to children in pre-school,
elementary school, middle school and high school. Also provides basic
information on self-esteem, parenting and family functioning to high school
students through life skills classes provided in the school setting.

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #9 (Life Skills Training)

ESTIMATED NUMBER OF FAMILIES SERVED: 10,212 children served

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: N/A

ECONOMIC STATUS OF FAMILIES SERVED: Not known; however, it is known
that 29% of District III's children are economically deprived.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 2,042

COST OF PROGRAM: $36,481

ESTIMATED COST PER UNIT OF SERVICE: $3.57

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Requests for these services come directly from teachers,
guidance counselors, principals and pre-school administrators.

AGENCY: Child Abuse Prevention Project

PROGRAM: Professional Education/Training

NUMBER OF SITES: 16

CONTACT PERSON: Randi Cameon

COUNTY/COUNTIES SERVED: Alachua, Bradford, Citrus, Columbia, Dixie,
Gilchrist, Hamilton, Hernando, Lake, Levy, Lafayette, Marion, Putnam,
Sumter, Suwannee, Union

IMPACT: Provides education and training regarding the identification and
reporting of child abuse, abusive family dysfunctions, strategies for preventing
child abuse through child safety programs and parent enhancements programs,
and high-risk assessment of new parents. Training is provided for

professionals who are involved in children services or related fields. In
particular, priority is given to HRS workers, school personnel, law
enforcement, day-care workers, mental health professionals, medical personnel,
students, clergy, and recreation personnel (Boy and Girl Scout, Boy's and Girl's
Clubs, etc.).

TYPES OF PREVENTION: Primary

TYPES OF SERVICE: #13 (Public Information)

ESTIMATED NUMBER OF FAMILIES SERVED: 6.024 professionals served

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: N/A

ECONOMIC STATUS OF FAMILIES SERVED: N/A

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 4,196

COST OF PROGRAM: $75,273

ESTIMATED COST PER UNIT OF SERVICE: $12.50 (Professional is unit.)

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Professional training and educational sessions are the
result of both direct requests from various groups of professionals themselves
(which is generally the case), or in response to contact with professional groups
by county service coordinators.

AGENCY: Child Abuse Prevention Project

PROGRAM: The Nurturing Program

NUMBER OF SITES: Seven

CONTACT PERSON: Shena MacLeod

COUNTY/COUNTIES SERVED: Alachua, Bradford, Citrus, Columbia, Dixie, Levy,
Putnam

IMPACT: Provides home-based, individualized parent education and support for
high-risk families with children between the ages of birth and five years.
Targeted populations are first-time parents, economically deprived families,
teen parents, and single parents.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #3 (In-Home Education and Support)

ESTIMATED NUMBER OF FAMILIES SERVED: 75 families

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: 33 families

ECONOMIC STATUS OF FAMILIES SERVED: 52% on AFDC
38% low income working
10% middle class

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 5,625

COST OF PROGRAM: $73,275

ESTIMATED COST PER UNIT OF SERVICE: $977 (Family is unit.)

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCESS: 45% Hospital
28% Public Health Departments
9% -HRS
8% Preschool/School Programs
10% Other (Private physicians,
mental health, etc.)

AGENCY: Child Abuse Prevention Project

PROGRAM: Parent Support/Self-Help Groups

NUMBER OF SITES: Nine

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Alachua, Citrus, Columbia, Dixie, Gilchrist,
Hernando, Marion, Suwannee, Union

IMPACT: Provides support services to high-risk parents in the group format.
These groups have an educational component. Types of groups offered are
Mother's Day Out, Parent's Anonymous, Pressured Parent's, etc. Many groups
are conducted in conjunction with other agencies. Parent's served are
primarily single parents, isolated parents, and HRS clients.

TYPES OF PREVENTION: Secondary and Tertiary

TYPES OF SERVICE: #7 (Self-Help Groups)

ESTIMATED NUMBER OF FAMILIES SERVED: 150

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: Difficult to assess.
These are open ended groups with a fluctuating memberships. It is estimated
that approximately 60% of the participants complete five or more group
sessions.

ECONOMIC STATUS OF FAMILIES SERVED: Not collected

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 720

COST OF PROGRAM: $9,855

ESTIMATED COST PER UNIT OF SERVICE: $13.69

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Primary referral sources are HRS and the public health
departments. Some referrals come from mental health and hospitals. Some
parents are self-referred.

AGENCY: Child Abuse Prevention Project

PROGRAM: Pre and Post-Natal Parenting Education

NUMBER OF SITES: Six

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Alachua, Dixie, Lake, Putnam, Sumter, Suwannee

IMPACT: Provides both individualized and group education/ support for new and
expectant mothers within the public health department setting. Mothers are
initially involved prenatally with the intent of continued involvement in
classes during the first year after birth. Serves primarily high-risk mothers
including teen parents, single parents, economically deprived parents, and
parents with low birth weight babies.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #1 and 2 (Prenatal Support for Expectant Parents and
Postnatal Education and Support)

ESTIMATED NUMBER OF FAMILIES SERVED: 150

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: 65

ECONOMIC STATUS OF FAMILIES SERVED: Not collected, although almost all
parents served fell within either the AFDC category or low-income working
category.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 600

COST OF PROGRAM: $9,200

ESTIMATED COST PER UNIT OF SERVICE: $15.33

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Public Health Departments and Hospitals.

AGENCY: Child Abuse Prevention Project

PROGRAM: Parent Education Classes

NUMBER OF SITES: Seven

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Citrus, Columbia, Lake, Marion, Putnam,
Suwannee, Union

IMPACT: Serves voluntary family service and protective service clients in Lake,
Marion, Putnam, and Suwannee Counties. Serves foster parents in Citrus
County. Serves prison guards in Union County. Provides specific curriculum
content tailored to the client population.

TYPES OF PREVENTION: Secondary and Tertiary

TYPES OF SERVICE: #8 (Parent Education and Training)

ESTIMATED NUMBER OF FAMILIES SERVED: 100

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: 55

ECONOMIC STATUS OF FAMILIES SERVED: Not collected.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 760

COST OF PROGRAM: $10,000

ESTIMATED COST PER UNIT OF SERVICE: $13.15

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): HRS and the Department of Corrections

AGENCY: Child Abuse Prevention Project

PROGRAM: Parent Education and Training

NUMBER OF SITES: 16

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Alachua, Bradford, Citrus, Columbia, Dixie,
Gilchrist, Hamilton, Hernando, Lake, Levy, Lafayette, Marion, Putnam,
Sumter, Suwannee, Union

IMPACT: Provides parent education and training seminars, presentations,
workshops and general campaigns. These services are oriented to serve both
high-risk parents and the general population. Services generally consist of one
to four part presentations on various parenting related topics.

TYPES OF PREVENTION: Primary and Secondary

TYPES OF SERVICE: #8 (Parent Education and Training)

ESTIMATED NUMBER OF FAMILIES SERVED: 7,399

ESTIMATED NUMBER OF FAMILIES COMPLETED PROGRAM: 7,200

ECONOMIC STATUS OF FAMILIES SERVED: Not collected.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 4,476

COST OF PROGRAM: $79,379

ESTIMATED COST PER UNIT OF SERVICE: $11.02 per family

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Referrals come mostly from human service agencies
and/or via advertisements in the local media. Primary referral groups are
HRS, schools, mental health, public health, guardian ad litem, legal system,
community colleges, physicians and child protection teams.

AGENCY: Child Abuse Prevention Project

PROGRAM: Lowell Prison Parenting Education Project

NUMBER OF SITES: One

CONTACT PERSON: Randi Cameon

COUNTY/COUNTIES SERVED: Marion

IMPACT: Program specifically designed to serve the needs of mothers in prison
due to be released to their families and children. Clients were primarily
incarcerated for reasons other than child abuse; however, most of them
reported moderate to severe dysfunctional family relationships with multiple
and long-term separations from their children. Many were economically
deprived and/or single parents.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #8 (Parent Education and Training)

ESTIMATED NUMBER OF FAMILIES SERVED: 57

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: 53

ECONOMIC STATUS OF FAMILIES SERVED: Not collected, although concern for
many of the participants were related to securing jobs upon release from
prison, lack of job skills and general economic security.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 60

COST OF PROGRAM: $1,056

ESTIMATED COST PER UNIT OF SERVICE: $18.53

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): This program was directly requested by the staff
psychologist at the Forest Hills Division of Lowell Prison in Marion County.
Participation in the classes was voluntary.

AGENCY: Child Abuse Prevention Project

PROGRAM: Teen Parenting Education/Support

NUMBER OF SITES: Three

CONTACT PERSON: Barbara Alterman

COUNTY/COUNTIES SERVED: Columbia, Hernando, Putnam

IMPACT: Provides parent education to teen mothers as part of school-based teen
parent programs. Targets teen parents who are finishing high school through
special programs within their school. Offers parenting, pregnancy prevention,
day-care and referral services.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #2 (Postnatal Education and Support)

ESTIMATED NUMBER OF FAMILIES SERVED: 45

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: 43

ECONOMIC STATUS OF FAMILIES SERVED: All teen parents served were
dependant on their own families.

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 550

COST OF PROGRAM: $7,519

ESTIMATED COST PER UNIT OF SERVICE: $13.67

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): Public School System

AGENCY: Child Abuse Prevention Project

PROGRAM: Welcome Baby

NUMBER OF SITES: One

CONTACT PERSON: Carol Hyde

COUNTY/COUNTIES SERVED: Gilchrist

IMPACT: Provides limited home visits to all new mothers within the county.
Services provided are high-risk assessment, liaison with post-natal medical care
facility, parent education, information and referral to community resources
and support.

TYPES OF PREVENTION: Secondary

TYPES OF SERVICE: #2 (Postnatal Education and Support)

ESTIMATED NUMBER OF FAMILIES SERVED: 65

ESTIMATED NUMBER FAMILIES COMPLETED PROGRAM: N/A

ECONOMIC STATUS OF FAMILIES SERVED: 15% AFDC
57% low income working
28% middle class

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 975

COST OF PROGRAM: $9,550

ESTIMATED COST PER UNIT OF SERVICE: $9.80

PERCENT OF ADMINISTRATIVE OVERHEAD: 18%

REFERRAL SOURCE(S): 80% Public Health Departments
17% Hospitals
3% Self-Referral

III. PRIORITIES

The following is a ranking of priorities for services for District III. The top four
priorities include a rationale and estimated budget amount for meeting the District
needs.

PRIORITY 1. POSTNATAL EDUCATION AND SERVICE.

Services should be offered to all new parents within the first year after birth, with
extended services and follow-up to high risk parents during the second and third
years after birth.

The first five years of life are of primary importance in the overall physiological,
emotional, and social development of a child. Developmental tasks related to ego-
formation, initial cognitive development, and the internalization of a healthy
mothering object are paramount to the functioning of the individual throughout his
or her life. Studies related to these developmental stages can be found in The
Psychological Birth of the Human Infant (Margaret Mahler, 1975). The first year of
life, and particularly the time just before and after the birth of a child offer a
unique situation for intervention with parents. It is a time when parents are usually
most focused and interested in establishing a relationship with their child, and it is
also the time when caregivers are most likely to be available to the parents. This time
is described by Ray Helfer as a "window of opportunity," (Heifer, "The Perinatal
Period, A Window of Opportunity for Enhancing Parent-Infant Communication: An
Approach To Prevention," 1987). In view of the access of caregivers to parents during
this time (as well as the opportunity for monitoring through the medical system) and
the importance of parent-child bonding and interaction during the first year, it is
concluded that postnatal assistance to parents is an excellent avenue for preventing
child abuse and neglect.

As was noted in the first section of this plan, District III has a rising population of
high-risk parents and at-risk children. Births to teen mothers represent 9.3% of the
live births; 7% of the births are under acceptable birth weight; 29% of the District's
children are below the poverty level; and there is an increase in unwed mothers under
the age 25. The incidence of low-birth weight babies and teen parents would indicate
a greater need for postnatal services to these parent groups in particular.

Postnatal education currently is being conducted in this District through two
locations: 1) public health departments, and 2) schools. Some local hospitals offer
their own limited services to parents; however, they usually rely on public health
departments for these services. It is estimated that it would cost approximately $500
per year to serve one family in a group format on a weekly basis (2 hours per session)
including baby-sitting. Using the above statistics, there are 2,062 teen mothers and
approximately 419 low birth weight babies born to mothers under age 25. To serve
these families would cost $1,240,500 annually, with more funding needed for long-
term follow-up. This is, however, cost effective considering the high cost of child
abuse and neglect and is ultimately more productive for our society as a whole.

PRIORITY 2. IN-HOME EDUCATION AND SUPPORT,

There is a need to increase parent education and support services to high-risk families
with children under the age of five. Home-based services should be made available
for new parents, single parents, and economically deprived parents.

The rationale for using the home-based model of parent education and support in
District III consists of several factors. First, District III consists primarily of rural
communities in which there is a good degree of social isolation and lack of
motivation to become involved in institutionalized services requiring regular
participation and attendance. Secondly, most of the parents referred are single, poor,
uneducated and with a propensity toward child neglect. This particular type of client
responds more readily to one-on-one, longer-term intervention which allows fcr direct
modeling, teaching, and support (Daro, "Intervening with New Parents: An Ei fective
Way to Prevent Child Abuse," 1988). Third, basic issues on child safety and child
care can be dealt with in the home-setting where the home visitor is able to obsrve
and influence safety strategies.

Children under the poverty level represent 29% of District III's children. Births to
teen mothers represent 9.3% of the live births in the District, and births to mothers
under the age of 25 represent 12.6%. The risk of these children is increased when we
consider that 7% of the live births fall into the low-birth weight categories. These
statistics combined with the characteristics of the population as described above
further indicate the use of home-based services.

It has been shown that these programs can be successfully conducted using para-
professional home visitors (Daro, 1988). It is estimated that it costs approximately
$1,300 to serve one family for a one-year period. In 1987 there were 2,062 births to
teenage mother, 5,992 births to mothers under 25, and 59 births to mothers under 15.
In addition, there were 2,874 indicated reports of child abuse and/or neglect. Current
funding levels allow home-based services for approximately 50 families per year.
Using a conservative estimate, there are at least 2,000 families who need home-based
parent education and support services at a total cost of $2,600,000. Research supports
the use of family-based early interventions to eliminate "factors associated with
higher rates of maltreatment," (Daro, 1988).

PRIORITY 3. LIFE SKILLS TRAINING.

Life Skills training should be expanded and increased to serve all middle and high
school students.

According to research, (Johnson, Loxterkamp, and Albanese, "Effect of High School
Student's Knowledge of Child Development and Child Health on Approaches to Child
Discipline, 1982), the propensity for child abuse can be reduced by offering education
to high school students regarding child development, child health knowledge, and
realistic developmental expectations, as they relate to discipline practices.
Specifically, this early education and intervention reduces the occurrence of harsh
disciplinary methods in later parenting practice.

Life skills training needs to be developed into a regular and comprehensive
curriculum to include basic self-esteem building, assertiveness training and decision
making, more specific information on child development and parenting and
pregnancy prevention. A curriculum should be designed for both middle and high
school levels. "If potential parents are to be exposed to cognitive knowledge about

childbearing, child development and child health maintenance, educational programs
should begin before the age when pregnancy is a possibility," (Johnson, Loxtgerkamp,
Albanese, 1982).

In District III, 2,062 children were born to teen mothers in 1987. Of these 59 were
born to mothers under the age of 15. Adequate life skills training would impact on
both the incidence of teen pregnancy and on abusive parenting practices by young
parents. To develop and implement a comprehensive curriculum would require at
least a full-time master's level staff person in each county. At a cost of $20,000 per
county per year, this would require $320,000 for District III.

PRIORITY 4. PARENT EDUCATION AND TRAINING.

Services should be provided for parents with children of all ages to aid in dealing
with specific issues related to child development and child rearing.

Many parents who are assessed to be high-risk for child abuse and neglect and/or in
need of assistance come to the attention of caregivers once their children enter day
care or school. For many of these parents, home-based services are indicated and is
the treatment of choice. For others, parent education services ranging anywhere from
single presentations on various basic parent-child issues, to longer term parent
education groups and/or seminars are preferable. Services of this type that have been
offered usually have a specific curriculum such as S.T.E.P. or Active Parenting.
They offer concrete parenting information regarding specific issues of child-rearing.
These services have long been used by mental health services in conjunction with
pyschotherapy. For parents who are not able to make use of home-based services, or
who need instructions and assistance in relation to particular topics, education
services seem to be more helpful.

Currently, parent education services are most likely to be offered through the effort
of several community agencies at once. In District III, they have most successfully
worked through a coordinated system to provide an instructor, a location, baby-
sitting, and sometimes transportation. The Child Abuse Prevention Project usually
provides an instructor and curriculum, while child care and transportation are
provided by other agencies. The services are lower in cost due to community
assistance when available.

District III is currently spending $79,379 on parent education and training. There are
202,051 children in District III which would mean that we are now spending $.39 per
child for parent education. If we were to serve the 29% of children who are
estimated to live in families below the poverty level at the current funding level, we
still would only be allowing $.53 per child. At the minimum, $50 per child is needed
to provide basic parent education services. Assuming that we are to serve one-third
of the current population of children, which is a conservative estimate for children
at-risk, we would need $3,364,149.

PRIORITY 5. COMMUNITY ORGANIZATION.

Community-based planning or coordinating bodies which are representative of
different community groups and agencies. The primary goals are to increase the
availability of social services, health and education resources which address the
reduction of family stress.

PRIORITY 6. PUBLIC INFORMATION.

Public awareness efforts, through the aid of media campaigns, which educate parents
regarding stress in the parenting role and providing information on where to obtain
help. These efforts also increase awareness and alert professionals regarding the
dynamics of abuse and neglect.

PRIORITY 7. SELF-HELP GROUPS.

A variety of social networks and peer supports created to reduce the isolation of
parents at risk, as well as offer group activities and aid in their establishment of
social contacts.

PRIORITY 8. PRENATAL SUPPORT FOR EXPECTANT PARENT.

Programs which provide support to parents during the prenatal period for maternity
medical care and education for expectant parents, including information about
community resources.

PRIORITY 9. CHILD DAY CARE.

Programs to furnish parents regular or occasional respite, out-of-home care, for their
children.

PRIORITY 10. EARLY AND REGULAR EDUCATION, MEDICAL AND
PSYCHOLOGICAL SCREENING.

Programs geared toward early and regular detection of health, developmental and
psychological problems.

PRIORITY 11. MEDICAL AND PSYCHOLOGICAL SERVICES.

Programs which provide comprehensive therapeutic services for all children at risk
and their families based on individual needs.

PRIORITY 12. FAMILY CRISIS AND INTERVENTION SUPPORT.

Programs that provide immediate assistance to parents in times of stress. These
programs are available on a 24-hour basis and provide referral to long-term services.

PRIORITY 13. TREATMENT AND INTERVENTION SERVICES.

Programs designed to minimize the long-term effects of abuse and neglect through a
variety of age-appropriateness and situation-appropriate services, including individual
and group treatment and therapeutic child day care.

IV. BARRIERS AND V. ACTION PLANS

PRIORITY 1. POSTNATAL EDUCATION AND SUPPORT.

Barrier:

Lack of trust by high-risk parents of State programs.

Action Plan 1.

Action Plan 2.

Barrier:

Action Plan 1.

Action Plan 2.

Barrier:

Action Plan 1:

Barrier:

Action Plan 1:

Action Plan 2:

Action Plan 3:

Increase public education to promote the helping rather than the
"punitive" image of these parent programs.

Increase professional education regarding services thereby building
an effective referral network.

Difficulty in keeping high-risk parents involved in services beyond
the perinatal period.

Increase efforts to build supportive/ productive relationships with
parents during the perinatal period through consistency on the part
of caregivers in terms of personnel and services

Promote the message during the initial services that regular
assistance to parents is both helpful and positive throughout the
first five years of their child's life.

Difficulty in reaching high-risk parents.

Set up services in locations where high-risk parents are most likely
to be accessed such as schools, public health departments, hospitals,
housing projects, etc.

Lack of funding for postnatal services that are extensive enough to
be thorough in their intent and results.

Participate in county efforts within the district to support
referendum for a Juvenile Welfare Board, with taxing authority in
each county.

Encourage community involvement in raising funds for service
projects.

Consolidate services with other agencies.

PRIORITY 2

IN-HOME EDUCATION AND SUPPORT.

Barrier:

Action Plan 1:

Action Plan 2:

Inability to serve the number of families referred due to lack of
personnel.

Document cases turned away to make funding sources(s) aware of
real needs.

Recruit, private funds through donations from community groups,
organizations, corporations, etc.

I

PRIORITY

Action Plan 3:

Barrier:

Action Plan 1:

Action Plan 2:

Action Plan 3:

Barrier:

Action Plan 1:

Action Plan 2:

Action Plan 3:

Barrier:

Action Plan 1:

Action Plan 2:

Action Plan 3:

Barrier:

Action Plan 1:

Action Plan 2:

Encourage the establishment of 501a-C non-profit organizations on
the local level for purposes of expanding services.

Difficulty in dealing with the wide range of problems existing
within high-risk families such as poverty, substance abuse,
characterological disorders, health concerns, etc.

Increase funding to hire Bachelor and Master level parent educators
with clinical training and experience.

Increase training and education of para-professional home visitors
in the areas of human development, psychopathology, crisis
intervention, case management, etc.

Increase support services through health departments, HRS,
community mental health, private psychotherapists, crisis centers.

Lack of trust by clients for State programs.

Increase public and professional education regarding the helping
aspects of home-based programs.

Present home-based programs with their own names such as "The
Nurturing Program" as opposed to home-based services provided by
the Child Abuse Prevention Project.

Emphasize the parent-aid aspects of the programs to the clients.

Difficulty in evaluating the success of these programs due to the
wide range of characteristics of client populations as well as in
many cases the low level of reading skills and cognitive
development of clients which inhibits valid use of written pre- and
post-tests.

Promote statewide development of valid and viable evaluation
techniques to be used with high-risk families.

Make greater use of written documentation of observable changes
affected in client populations during the course of program
implementation.

Consult with national experts in the field of child abuse and
neglect program evaluation.

Keeping clients in the program long enough to affect desired
change.

Set up a system for timely follow-up of cases once clients have
dropped out of program.

Attempt to contract and re-contract with families for short time
limited services.

PRIORITY 3. LIFE SKILLS TRAINING.

Barrier:

Action Plan 1:

Action Plan 2:

Action Plan 3:

Barrier:

Action Plan 1:

Action Plan 2:

Action Plan 3:

Barrier:

Action Plan 1:

Barrier:

Action Plan 1:

Action Plan 2:

Action Plan 3:

PRTORTTY 4

Resistance by parents for their children's involvement in education
programs that teach information regarding pregnancy prevention,
parenting, etc.

Institute a well-organized public campaign to promote the value and
necessity of life skills training.

Increase community and professional education regarding the
content and value of life skills training in order to gain a broad
base of community support.

Gain the support of local PTA groups.

Resistance of school boards to added curriculum.

Include key school board members on local child abuse advisory
boards and district task forces.

Offer the services of CAPP personnel to local schools in assisting
with the writing of curriculum for life skills classes.

Volunteer to make presentations to life skills classes.

Competition with other prevention efforts attempting to work
through life skills training such as drug abuse prevention, drop-out
prevention, sexually transmitted disease prevention, teen pregnancy
prevention and suicide prevention.

Develop 'a single curriculum promoting a broad base of skills
related to self-esteem building, decision making, and assertiveness
training followed by separate modules related to specific areas of
prevention listed above including child abuse and neglect
prevention.

Provision of life skills training usually begins beyond the age at
which these problems develop.

Develop specific age appropriate curricula beginning with the fifth
grade and extending through the twelfth grade.

Educate the public as to the need for early intervention.

Educate the community and professionals as to the need for early
intervention.

PARENT EDUCATION AND TRAINING.

Barrier:

Action Plan 1:

Lack of participation by high-risk families in group setting.

Find natural settings to hold classes such as housing projects, low-
security prisons, adolescent half-way houses, pre-natal clinics, Pre-K
programs, etc.

PRIO IT 4

Action Plan 2:

Barrier:

Action Plan 1:

Barrier:

Action Plan 1:

Barrier:

Action Plan 1:

Action Plan 2:

Promote the immediate benefits to the parents) for participation by
combining social/support activities with education.

Lack of transportation in rural communities which limits access to
services.

Seek help from other community organizations which may provide
vans or buses and volunteer drivers to transport parents to
programs.

Lack of child-care and/or babysitting for parents while they attend
parent education groups.

Recruit local volunteers through either churches, clubs or volunteer
organizations to provide on-site baby-sitters during services.

Referral of significantly problemed parents to parent education
groups as the sole source of rehabilitation.

Increase local therapeutic services to parents by reinstituting sliding
scale outpatient services to families through community mental
health.

Educating both professionals and community members as to both
the effectiveness and limitations of parent education with
particular populations.

VI. RECOMMENDATIONS PERTAINING TO DEPARTMENTAL
POLICY OR LEGISLATIVE ACTION

A. Program Areas on the NCPCA Continuum.

1. Life Skills Training A comprehensive and expanded life skills program
should be developed and mandated for both middle and high school
students. All prevention areas could be covered including drug prevention,
pregnancy prevention, drop-out prevention, suicide prevention, STD
prevention and child abuse prevention. Specific modules on self-esteem,
child development and parenting should be included. Currently these
various programs are offered separately and sporadically depending upon
the individual schools involved.

2. Postnatal Education and Support Public health departments should have
as part of their health care programs for expectant and new mothers on-
going parenting training and support. Training should begin as early in
the prenatal period as possible and extend at least six months after the
birth date. These parenting programs could be developed and implemented
by other community agencies such as current child abuse prevention
providers at the public health department site. Services should be
coordinated with existing scheduled medical services to these mothers with
specific attention given to those considered to be high risk for child abuse
or neglect.

3. Treatment and Intervention Services Treatment and intervention services
to abused and neglected children are sadly lacking. The use of medicaid
funds could be broadened to include private practitioners who specialize
in this treatment area. Currently, medicaid funding for treatment can
only be used at local community mental health centers, many of which do
not have the means to offer qualified treatment intervention. At the same
time, there are a number of private practitioners who currently see abused
children through other compensation who would be willing to accept
medicaid for these services.

4. Child Day Care Consideration should be given to expanded eligibility for
subsidized day care services to include those high risk families identified
through secondary efforts.

5. In-Home Education and Support Every opportunity should be pursued to
increase these services as they are most effective with high risk families,
particularly in rural areas. Currently, a number of agencies statewide
have programs that focus on parents at home. It is suggested that these
various groups combine forces to both expand and increase home-based
services. This would include child abuse prevention providers, low-birth
weight service providers, home-extension agents, displaced homemaker
service providers, children's home societies and home-health agents. The
focus should be on a combined effort of providing health, parenting and
homemaker services to high risk families.

6. Parent Education and Training A campaign should be launched to
provide every new parent with information on the emotional care of
children. This material should be released to parents at the time of birth.

7. Community organization Legislators should be well-educated as to the
importance of creating and maintaining community support for direct
service prevention programs. The current structure which includes the
input of local task forces and citizen's advisory boards is not only vital to
the development of direct service programs, but allows for interagency
cooperation and private sector input that results in more effective service.

B. General Recommendations

1. Juvenile Welfare Boards Every attempt should be made to provide local
task force and advisory board members with information regarding the
development of juvenile welfare boards within their communities. These
boards could provide local services for children that far exceed those
which can be funded through state legislation.

2. Corporal Punishment Abolishment of corporal punishment should
continue at both state and local levels to be a primary goal. More training
materials should be offered to school personnel as to more appropriate and
effective means of discipline and corrective strategies.

3. Iniury Prevention A study of current practices and strategies for
pediatric injury prevention should be undertaken to assess the possible
interface of medical and child abuse prevention services to both
strengthen current efforts and avoid duplication where possible.

4. Prevention Program Evaluation Evaluation methods need to be uniform
and standardized using those strategies and testing materials already
established by the National Committee for the Prevention of Child Abuse.
In addition, evaluation of public awareness and community education
programs need to be given special attention as currently there are no
standards or methodologies established for evaluation of these programs.

DISTRICT IV

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District IV Child Abuse and Neglect Prevention
Task Force Members

Bonnie Arnold
Jax. Area Legal Aid
604 Hogan Street
Jacksonville, FL 32202
355-7688

Wilma Austin
Duval County Schools
1701 Prudential Drive
Jacksonville, FL 32207
390-2094

Steve Dannemon
Children's Haven of Clay Co.
3595 CR 215
Middleburg, FL 32068
282-1821

Charlotte Boorde
HRS-4DPOHE
5920 Arlington Expressway
Jacksonville, FL 32211
723-2067

Julie Buckey-Nelson
Children's Services
Visiting Nurse Assoc.
2105 Jefferson Street
Jacksonville, FL 32206
356-6355

Eric Casas, M.D.
Family Service Center
P.O. Box 216, Bldg. 1576
Mayport Naval Station, FL
241-6600

Corline Cole
Natl. Counsel of Negro Women
1577 W. 12th Street
Jacksonville, FL 32209
356-5046

Nancy Corley
HRS-4DASL
5920 Arlington Expressway
Jacksonville, FL 32211
723-5312

Madeline Cosgrove
Riverside Presbyterian Day School
830 Oak Street
Jacksonville, FL 32204
353-5511

Anne B. Davis
Children's Home Society
Post Office Box 5616
Jacksonville, FL 32247-5616
396-2641

Barbara Enos
Clay County Health Dept.
Post Office Box 566
Green Cover Springs, FL 32043
269-6340

Arlene Friedman
Guardian Ad Litem Program
1283 E. 8th Street
Jacksonville, FL 32206
630-0991

Dee McDonald
HRS Program Administrator
1023 Mason Avenue
Daytona Beach, FL 32017
254-3844

Barbara Grass
Nassau Co. Health Dept.
1201 Atlantic Avenue
Fernandina Beach, FL 32034
261-7633

Virginia Greiner
Childbirth & Parenting
Education Association
211 Flagler Boulevard
St. Augustine, FL 32084-4935
829-6236

Lucy Hadi
HRS-District Administrator
5920 Arlington Expressway
Jacksonville, FL 32211
723-2050

Allen Harmon, Jr.
Public Relations & Advertising
Prudential Insurance Co.
Post Office Box 4579
Jacksonville, FL 32231
391-2440

Linda Harrison
Carol Todd
State Attorney's Office
330 E. Bay Street
Jacksonville, FL 32202
633-2631

Hazel Johnson
Children's Home Society
201 Osceola Avenue
Daytona Beach, FL 32014-6185
255-7407

Kay Johnson
Jacksonville University
Jacksonville, FL 32211
744-3950

Camilla Sims Jones
Child Services Division
Human Services Department
421 W. Church Street
Town Center, 4th Floor
Jacksonville, FL 32202
630-1282

Geraldine Kelly
Jacksonville County Day School
8161 Southside Boulevard
Jacksonville, FL 32216
641-6644

Michael Lanier
Sexual Abuse Consultant
7820 Arlington Expressway
Suite 650
Jacksonville, FL 32211
727-0075

Theresa Pringle
HRS-4DPOCYF
5290 Arlington Expressway
Jacksonville, FL 32211
723-5335

Rachel Marcus-Hendry
Consumer Affairs Division
Dept. of Human Services
220 E. Bay, Rm. 611, City Hall
Jacksonville, FL 32202
630-1280

Ken McCollough
Human Resource Center
1220 Willis Avenue
Daytona Beach, FL 32014
255-6538

Paul Mercado
Post Office Box 445
Bunnell, FL 32014
437-4116

Bob Crimmins
Child Crisis Prevention Prog.
Post Office Box 1990
Daytona Beach, FL 32015
257-1700, Ext. 257

Pamela Mullarkey
St. Johns County School Board
4906 Duck Creek Lane
Ponte Vedra Beach, FL 32082
285-2877

Nancy Nowlan
Children's Crisis Center
Post Office Box 40279
Jacksonville, FL 32202
350-6666

Pam Paul
Post Office Box 1188
Ponte Vedra Beach, FL 32082
285-5653

Nick Prewatt
Child Services, CMHC
University Hospital
655 West 8th Street
Jacksonville, FL 32209
350-6899

Paige Reed-Degryse
Lighthouse Learning Center
900 Park Avenue
Orange Park, FL 32073
264-7932

Patsy Reynolds
Gateway Community Services
10455 Phillips Highway
Jacksonville, FL 32224
354-1669

Karen Selig, M.A.
Psychological Services
of St. Augustine
236 Park Circle E.
St. Augustine, FL 32084
824-7733

Joel Stein, M.D.
Child Guidance Clinic
1635 St. Paul Avenue
Jacksonville, FL 32207
724-9211

Jim Welu
St. Johns County Pupil Svcs.
St. Johns County Schools
St. Augustine, FL 32084
824-7201

John Wesley
Youth Crisis Center, Inc.
Post Office Box 16567
Jacksonville, FL 32245
725-6662

Jay M. Whitworth, M.D.
Children's Crisis Center
655 West 8th Street
Jacksonville, FL 32209
350-6666

Shelly F. Wilson
Episcopal Child Day Care Ctrs.
151 West 10th Street
Jacksonville, FL 32206
356-4222

Wanda J. Walker
Director, Exceptional
Student Education
Baker County Schools
392 S. Boulevard E.
Macclenney, FL 32063
259-6251

I. DOCUMENTATION OF THE PROBLEM

District IV is comprised of seven northeastern Florida counties: Nassau, Baker,
Duval, Clay, St. Johns, Flagler and Volusia. The largest of these areas is metropolitan
Jacksonville with an estimated 180,617 children (ages 0-17). The smallest is rural
Flagler with an estimated 3,635 children, many of whom are children of agricultural
workers living in poverty. The remaining child population figures for counties
ranked according to size are Volusia 66,261 (Daytona, Bunnell), Clay 29,372 (Orange
Park, Green Cove Springs), St. Johns 18,510 (St. Augustine, Hastings), Nassau 13,246
(Fernandina Beach, Callahan), Baker 5,875 (Macclenny).

The District received 5,535 child abuse and neglect referrals during the six month
period of March 1, 1988 through August 31, 1988.

Individuals living in poverty, the unemployed, teen and new parents, transient Navy
populations and drug and alcohol abusers are target groups for prevention services.
The 1,854 families identified by risk assessment who are directly served by contracted
prevention providers and those 2,158 assessed and referred to other agencies
throughout the District are an important adjunct to the protective services system.

The District is experiencing some significant problems in the areas of prenatal and
obstetrical care. Urban health facilities offering obstetrical care are expected to
serve the rural counties. This practice removes women from their family and
friends. The urban medical model and the insurance crisis in obstetrics impacts on
childbirth preparation and pregnancy outcome. The infant mortality rate in this
District is 17%.

The Child Abuse Prevention Task Force has watched closely the steady rise in teen
pregnancy and the lack of alternative programs for teens. The perinatal programs for
prevention of abuse make-a successful outreach effort to this population with support
groups, drug counseling and childbirth education classes. There were approximately
1,400 teens screened and offered prenatal and perinatal prevention services through
the indigent care hospital in Jacksonville. The teen birthrate for District IV is 23%
per live births. The rate per unwed mother rises to 36%.

Although there were 1,697 teen births in Duval county in 1987 only 288 girls enrolled
in school based alternative programs. Many communities in the District do not have
alternative programs. There are an estimated 1,000 teens in the District whose
children receive welfare benefits. These first time parents in poverty are a target
population for prevention.

There are 3,500 children receiving subsidized child care services in the District. Five
hundred (500) of these children were referred through HRS dependency units. The
prevention capabilities of subsidized child care are not fully realized. The prevention
providers do not have priority placement although they do have access through
referral to Voluntary Family Services. The major problem with placements are
budgetary constraints. There are 4,000 children on the subsidized child care waiting
list. One percent of the children waiting are protective services referrals. There is,
however, a large percentage of the protective service caseload that would be referred
if transportation barriers and additional funding of slots could be realized.

Child Abuse Prevention Funds continue to be provided to six direct service
contractors who are responsible for interfacing with agencies in all counties of the

District. Services are provided in three basic areas, prenatal/perinatal, in-home-
services and parent education. The District is apparently unique in that all clients
are prioritized for service by use of the FAMSER (a risk assessment instrument). The
prenatal/perinatal programs are housed within hospitals and health clinics with
assessment sheets completed by clients or by professionals of obstetrical units and
prenatal clinics. These clients, once screened and offered services, can be counseled
during clinic appointments, gradually progressing to support groups, parenting classes
or in-home services. The perinatal programs have experienced broad ranged
community acceptance and have interfaced easily with public health clinics, school
systems and other social agencies. The clients, especially young women, who are seen
prenatally, tend to be compliant and easy to work with, often because of their fear
of childbirth as well as the excitement and anticipation of birth. Follow up services
tend to be more complex and heavily impacted by economic and social pressures.

The District continues to lack sufficient funding to maintain the current effort not to
mention expanding staff and providing broad community access. The providers rely
heavily on grants, community fund raisers and their parent agencies to cover
workload increases, innovations and increased overhead.

II. PROGRAM DESCRIPTIONS

AGENCY: The Childbirth & Parenting Education Association

PROGRAM: Project OUTREACH, a child abuse and neglect prevention program
funded with Mills Bill monies

NUMBER OF SITES: 4

PROGRAM: (904) 829-6236

CONTACT PERSON: Virginia Greiner, Director

COUNTY/COUNTIES SERVED: St. Johns County

IMPACT: Project OUTREACH services are available to all families who are
found to be at risk. Target populations are: medically high risk infants, single
parents, teen parents, parents who are involved with HRS Voluntary Family
Services.

TYPES OF PREVENTION: P, S, T

TYPES OF SERVICE: #1, #2, #3, #7, #8, #11, #12, #13

ESTIMATED NUMBER OF FAMILIES SERVED: 230

ESTIMATED NUMBER OF FAMILIES COMPLETED PROGRAM: 47% successfully
completed parent education; 90% successfully completed in-home service

ECONOMIC STATUS OF FAMILIES SERVED: 95% AFDC
5% low income working

ESTIMATED NUMBER OF DIRECT SERVICE HOURS: 1,000

COST OF PROGRAM: $96,599

ESTIMATED COST PER UNIT OF SERVICE: $97.00

PERCENT OF ADMINISTRATIVE OVERHEAD: 5%

REFERRAL SOURCE(S): Health Department (40%); Hospital (18%); Private Doctors
(12%): HRS (20%); School System (8%); Self Referral (2%)

AGENCY: Children's Home Society, Buckner Division

PROGRAM: Parent Education

NUMBER OF SITES: 20

CONTACT PERSON: Mary Ann Denmark

	Front Cover
	Acknowledgement
	Preface
	Table of Contents
	Executive summary
	Main

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