• Involuntary termination of parental rights for parents required to register as sexual offenders (Act 29) • Requirements that all schools display approved posters with information for reporting suspected child abuse (Act 54) • New policies to allow indefinite maintenance of child protective services reports (Act 54) Health-care professionals play a crucial role in the health and well-being of children, youth, and families. Their contact with children and families during the different stages of a child's life gives them a unique opportunity to observe families' resilience and progress and to provide education and support. 2 When necessary, health-care professionals must report suspected child abuse and neglect. This CME monograph on recognizing and reporting child abuse will cover the most recent Pennsylvania state guidelines for reporting child abuse based on the most recently-available version of the CPSL. It will review signs and symptoms of child abuse as well as the prevalence of the problem in Pennsylvania. It will familiarize course participants with some of the characteristics of
individuals who may be victims of, or perpetrators of, child abuse. Finally, it will describe current mandatory reporting requirements, processes, and penalties for physicians and other professionals practicing in Pennsylvania. This program offers state-defined mandatory reporters, including physicians and other healthcare personnel, training for meeting their responsibilities for protecting vulnerable children from child abuse. What Is Child Welfare? Child welfare is an array of services designed to ensure that children are safe and that families have the necessary support to care for their children successfully. Child welfare agencies typically: 2 • Support or coordinate services to prevent child abuse and neglect • Provide services to families that need help protecting and caring for their children • Receive and investigate reports of possible child abuse and neglect and assess child and family needs, strengths, and resources • Arrange for children to live with kin or with foster families when safety cannot be ensured at home • Support the well-being of children living with relatives or foster families, including ensuring that their health and educational needs are addressed • Work with the children, youth, and families to achieve family reunification, adoption, or other permanent family connections for children and youth leaving foster care Each state or locality has a public child welfare agency responsible for receiving and investigating reports of child abuse and neglect and assessing child and family needs, however the child welfare system is not a single entity. Public child welfare agencies often collaborate with private child welfare agencies, community-based organizations, and other public agencies to ensure that families receive the services they need, such as supportive child care, parenting programs, in-home family preservation services, health and mental health services, and substance abuse treatment. 2 The administrative framework for child welfare services and programs varies from state to state. All states are responsible for compliance with federal and state requirements, however, they may differ in the way child welfare services are operated and delivered. The different types of administration determine the degree of centralization of authority and responsibility for child welfare funding, policymaking, licensing, and training for workers. Federal Child Abuse Prevention and Treatment Act The key federal legislation addressing child abuse and neglect is the Child Abuse Prevention and Treatment Act (CAPTA), originally enacted in 1974 (Public Law 93-247). 3
Introduction The problem of child abuse and victimization is nationwide in scope but of particular interest in the Commonwealth of Pennsylvania. In 2020, Pennsylvania received 32,919 reports of suspected abuse or neglect, 4,593 of which were substantiated, which was a percentage increase from 11.5% in 2019 to 14% in 2020. 1 There were 73 substantiated child fatalities in 2020 and 115 near-fatalities. 1 Sexual abuse remains the leading type of child abuse in Pennsylvania (39.1%), followed by physical abuse (28%). Parents continue to be the persons most responsible for abusing children. 1 Pennsylvania’s Child Protective Services Law (CPSL) continues to evolve, with the following legislative changes being approved by the Governor in 2018: 1 • Expansion of the definition of child abuse to include when a person leaves a child unsupervised with an individual, other than the child’s parent, who they know or reasonably should have known, to be a sexually violent predator or to be subject to lifetime registration (Act 29)
Figure 1. Trends in Child Abuse in Pennsylvania 1
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