KDA Today

KDA Today

For Immediate Release

Date: Feb 21st, 2020
Contact: Dr. Beverly Largent
Phone: 800-292-1855
Email: kda@kyda.org

Child Abuse and Neglect: Kentucky is Number One

Early in January of 2020, Attorney General Daniel Cameron held a news conference announcing that he would create a Tool Kit, or a Prosecutors Manual to help state prosecutors handle child abuse cases. His announcement made the evening news in most areas of the state, but in some news outlets more time was given to animal abuse cases in the community. The dirty little secret is that Kentucky ranks number one in the nation in reported cases of child abuse and neglect. According to Cameron and multiple other sources, the problems in Kentucky are multidisciplinary, including law enforcement, the Department for Community Based Services (DCBS), medical providers and bystanders who are often related to the abused child. In Kentucky, anyone who is suspicious of a child being abused is required by law to make a report.

The obvious solution for these cases is to remove the child from the abusive situation—problem solved. This quick and easy fix is often not in the child’s best interest. Locating a secure and stable home for the child in one hurdle cannot be accomplished with a single investigation. Removing a child from the home is a traumatic event for the child which can cause life-long problems. The greatest benefit from intervention is to aid the family, so that the family unit remains, and the issues causing the abuse are resolved. This could be as simple as finding appropriate childcare. Currently in Kentucky, more than 100,000 children are in foster care.

As a dental professional, dealing with social services can be a frustrating experience, especially if timely response is desired. A deeper look into the situation may provide answers. Social workers in Kentucky are pushed to the limits of their time and ability. The recommended case load for one worker is 20. In Kentucky, a worker may be asked to handle as many as 100 cases. Turn over for social workers is at 27%. This is costly, not only for training, but for the children involved in the cases. It is commonplace for multiple workers to be assigned to the same case. Cases with more than two workers consecutively assigned have virtually no measure of success. Prevention plans that are made with the families involved in an abuse or neglect case cannot be monitored, informal placement (placement with family members) becomes lengthy, and there is a lack of timely engagement of courts. Burnout for the workers is high, and they, themselves, experience trauma associated with experiences related to their job. The average salary for a social worker in Kentucky is $35,000. The lack of funding for DCBS is related to budget cuts made in 2008. Last year in Kentucky, there were 137,000 reports of suspected abuse or neglect, nearly doubling from the numbers five years ago. There has been much political rhetoric about the dismal state of the funding, but, to date, no decisive action has been taken.

In 2012, Child Fatality and Near Fatality External Review Panel was established. This panel consists of 20 multidisciplinary professionals who meet six times per year. The purpose of the panel is to conduct comprehensive reviews of child fatalities and near fatalities suspected as the result of abuse and or neglect and recommend system and process improvements. Cases are referred by the Cabinet for Health and Family Services and the Department of Public Health. The panel’s chief recommendation is for better communication between social services, law enforcement and the courts. For example, arrests made for drug use should be coordinated with social services to determine the state of the child in the home. The panel has also called on coroners to relate to social services when violent deaths are investigated. The panel recommends that law enforcement be more vigilant when investigating accidents, and issue citations when children are not properly restrained in a vehicle.

The opioid crisis in Kentucky not only affects the user, but the family, and is cited as one of the main issues related to the rising incidence of child abuse and neglect. In Kentucky, 53.4% of child victims have substance abuse by a caregiver as a risk factor. Nationally, the percentage is at 30.8%. Ninety percent of children who die or are severely injured by a drug overdose are less than six-years-old and the primary drug ingested is Suboxone –a drug used in the treatment of opioid use. The review panel also noted that Neonatal Abstinence Syndrome babies are released from the hospital without a Safe Care Plan. These infants are difficult to manage and require a lot of care, creating added stress for a parent who is a recovering addict.

While nearly 65% of neglect and abuse cases are reported by professionals, there continues to be children who are overlooked by medical professionals. The external review panel cites the case of a two-year-old boy who was brought to the emergency room with an earache. The child was given an antibiotic and sent home, even though he had purple ears and multiple other bruises on the face and neck. The child died two days later of a skull fracture. The panel also reports that 23% of the cases reviewed for the past year revealed a missed opportunity by medical providers. Dentist are likely to see more neglect than abuse, especially since 75% of the children who suffer in this state, suffer from neglect. This does not, however, relieve the dentist of reporting physical abuse.

Abuse knows no demographic and may appear in any socio-economic group. There are a few simple rules to keep in mind when meeting with parents and children. The phrases Ten-4, and “those who don’t cruise, don’t bruise” are important to keep in mind.

The acronym TEN-4 reminds that bruises to the torso, ears and neck in a child four or younger is a red flag for physical abuse. Children who fall, tend to have bruises on the shin, elbow and forehead. Any bruising anywhere on a non-mobile infant or child who is not yet pulling up or taking steps is a sign of abuse. Those who don’t cruise, don’t bruise. Children in their first year of life have the highest rate of victimization. An alert professional can, potentially, save a life.

Anyone who has a suspicion that a child is the victim of abuse or neglect can call the Cabinet for Health and Family Services at 1-877-KYSAFE1. The number is toll free. There have been reports of lengthy waits for this number, extending into hours. If a child is thought to be in an emergency situation, local law enforcement may be contacted.

Deborah Yetter, in her series for the Courier Journal this past summer, lists five things needed to make reporting more successful:

1. The child’s name and approximate age
2. The name of the person believed to be responsible for the abuse or neglect
3. A description of the injury, neglect or threatened harm to the child
4. The current location of the child, day care, school or home address
5. Any immediate risk to the child or a worker going to ensure the child’s safety such as firearms or other potential risk.

“In order for the Cabinet to investigate child abuse, neglect or dependency, the alleged perpetrator must be the parent, guardian or have supervisory responsibilities for the child. The only exception is with human trafficking allegations.” (Child Abuse, Neglect and Dependency Training; Cabinet for Health and Family Services)

Child abuse and neglect, along with the rising opioid epidemic threatens the moral fiber of our Commonwealth. The responsibility for the solution of this problem lies, not only with Attorney General Cameron, but with every citizen.

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