AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006
BEN TANZER: We want to preface this by saying that we are extremely excited about the project we’re talking about, but this is also the first presentation we’ve ever done on it, so. What we also appreciate is any commentary you have about whether you’re getting information that you think is actually helpful to people. We are completely buried under all sorts of stuff and we have spent a couple of weeks sort of thinking, what do people want? And you can help us, just be letting us know whether you, in fact, find this information helpful at all. This is the first of a number of presentations we’re doing over the next two months and intend to keep doing over the next couple of years as this project grows. But we appreciate all of you being our first audience and not even our normal, natural audience, since we tend to work more directly with folks who are focused exclusively on the Prevention of Child Abuse. So we’re very excited to be here. We think this is a cool project.
And I’m going to take a moment here and introduce us and then we will get into this fully. My name is Ben Tanzer. I am the Director of Chapters at Prevent Child Abuse America. And under CDC jargon, the principal investigator for the Because Kids kind of project, which we’re going to talk about today. I’m joined by my colleague, Lori Friedman in our Research Department who’s the primary researcher on this project. And so, as you all know means she is doing all the work that’s most important. And she’s going to; we’re both going to spend some time today talking about this project.
I should ask. How’s the temperature here for folks? That’s the only housekeeping thing I can think of. Is it good, better, is it improved? When we walked in we were freezing and it’s much colder in Chicago, but I was wondering if we were just nervous, so I wanted to make sure. I’m checking in with all of you. Oh, I’m supposed to tell people to turn their cell phones off. I can’t believe we’re doing that. Last time I said that out loud, someone’s cell phone rang as I was saying it and they were not a plant, but it worked out very, very well for that workshop.
We are calling this workshop today, Effective Strategies to Prevent Child Abuse in the (inaudible), so we hope you’re in the right room. We spend our time working on the prevention of child abuse. We are working a project that’s focused on that and we’re going to get into that detail today. But, here we are. This project is called Because Kids Count. And, this is an acronym that the CD’s, The Centers for Disease Control came up with, this is their project. We’ll talk a little bit more about that, for this is Building and Enhancing Community Alliances United for Safety and Empowerment. That is a mouthful, BECAUSE is a great acronym. So we tend to just call this BECAUSE. And I can only imagine the focus group they had coming up with that name. We were not part of that process.
For those of you who do some of the work we do, there’s also something called Kids Count. And Kids Count tracks statistics around the country, around abuse and prevention. The CDC folks have apparently not heard of that project, which has been around for a long time. So we’ve had some interesting conversations with them. Our objectives today, and I hope these meet your objectives coming in here. We’re going to make sure you get some information on this project BECAUSE, and you’ll get a better sense of what we’re doing.
And we’re going to give you a brief overview of just who we are at Prevent Child Abuse America, very brief. I will not bore you with that, but just so you get a sense of who we are and why we’re doing this. We’re going to talk to you about our progress to date. And we were just talking before this, you know, we are not even in a phase yet where we are fully making concrete recommendations about going forward, but we’ve got some great information and we’re hearing some wonderful things. And it will be interesting to hear from you, what you think about what we’re already learning. And then we’ll discuss your reaction to things, answer your questions and again, I just want to stress that we don’t want to limit that to, you know, 15 minutes into this and an hour into this. So if you have something, please ask. We want this to be interactive and again, we’re excited to talk about this. We’ve been talking to each other quite a bit. So this is, this is great.
I thought we’d take a second to make sure we knew who you were and we won’t do full introductions or anything, but I think we wanted to get a sense of where you all work. And I pulled this list out from the conference registration that apparently people are supposed to check off. And so I thought I’d ask some questions. Do we have Title V Directors here? Great. Do we have Title V staff here? Excellent. WIC Directors? Okay. Medicaid staff? Family liaisons. I’m not even sure what that is. So if there is one, good, you’ll tell us I hope during the session or afterwards what that means because I’m really curious. Do we have healthcare providers, nurses, or doctors in the room? Wonderful. Research folk, University folks, academics? Great. Anyone from associations doing this sort of work, which is kind of where we come from a little bit? Great. And finally, any Federal employees? So we’ve got everybody.
Okay, this, everyone on their list is in the room. That’s great. And again, where Lori and I come from, and Lori is actually, has a Public Health background, and I have more of a non-profit background, but we focus on, how do you prevent child abuse before it occurs? And let me ask. How many folks out there in your roles have gotten involved in prevention of child abuse work? Great. We are very, very happy to hear that. That’s good. We’re thrilled. And hopefully we’ll be able to engage you in some conversation around that.
This is a slide, just to give you a sense of this. This may be obvious but this project, and we’ll talk a little bit more about some of the detail but not too much, is a Centers for Disease Control Prevention Project. The CDC came to us or came to the nation and decided that out of their Violence Prevention Division, that child abuse, the prevention of child abuse, was something they needed to focus more on. And they had two sort of chunks of this. They knew lots of people were doing the work of prevention but didn’t know how much of that was occurring before abuse happens. Much of the time the work we encounter and you encounter is sort of intervention or treatment. And the question was, how many people are actually focusing on abuse before it occurs, which is why we were created, Prevent Child Abuse America.
They also wanted to get a better handle on sort of the systems and strategies that people were actually utilizing. So if people claim that they’re trying to prevent child abuse, how are they doing that? And so, they are bringing both the Public Health and a very sort of researchy approach to this and we want to know more and, you know, we couldn’t be happier about that. We have nurtured a relationship with them for many years, but this is the first time a project of this size immerged from the center. And the cause gets kind of particularly, well, here’s the goal. Make sure we tell you what their goal was. They came to us and they came to everybody and they said, we want to expand the capacity of the grantees national organizations and their state and local and regional affiliates to effectively address the prevention of child maltreatment. So they, sorry. So they put out an RFA, a request for proposals and they said, we want national organizations that have affiliate structures around the country. What we’re trying to get a handle on is how does your national office interact with people at the local and grassroots and statewide level and how do all of you prevent child abuse together.
So the folks who applied were other, were national programs. And the folks who immerged were ourselves, Prevent Child Abuse America, and our two fellow grantees, Parents Anonymous Inc, which is, now primarily, I don’t want to misrepresent them. But their focus is mutual self-help, family support. Giving parents a chance to come together and learn more about how they’re going to prevent child abuse and how they’re going to deal with whatever issues they’re dealing with. Also, the National Alliance of Children’s Trust and Prevention Funds also known as the Alliance. Not every state has an Alliance. But most every state has a children’s Trust that focuses on distributing money to prevent child abuse. And so the three of us are the grantees and the partners on this project and there’s all sorts of elements we’ll touch on, but one interesting thing is this is a cooperative agreement. Now, we don’t have a history of those kind of agreements. I just want to share how this has been interesting for us.
The CDC is very much a partner and very much in our business on this project. I’m sure like many of you, you are accustomed to being handed a check and then reporting back to someone six months, a year, or two years later. We are regularly talking to the CDC. We’re on the phone with them every month. We’re going to grantees meetings. The three grantees talk all the time. It’s actually been a great experience but it is completely foreign to how we’ve operated for much of our 30 years, which is, I hope, diligent, but certainly now with this level of intensity.
Some other pieces we’ll touch on is, there’s a prevention work group that Lori and I work with that help drive the work and serve as a sounding board for us. We have done an inventory of all the prevention activities happening around the country in our network. Lori is going to touch on that more specifically. We’re currently running through assessment fees, which we’ll touch on as well. And then the goal of this, of BECAUSE, and now it’s actually considered BECAUSE One, because even though we haven’t finished this, they’ve already put out an RFA for BECAUSE 2, which we had to write even though we were only one year into the project.
So, it’s a two-year project and at the end of two years we’re supposed to have a National Prevention Plan, child abuse prevention plan that at least initially would be implemented by our network. And each grantee is going to come up with a plan for their network. And that’s what we’re in the middle of right now, and in fact, we’re coming off a meeting just two weeks ago in Chicago where we pulled together our prevention work group and said this is what we’re finding, how do we start creating a plan out of this?
This, we want to make sure you know why we are happy to do this. You know, this is causing us to stop, catch our breath, and actually look, at the work going on around the country. We don’t always do that. It’s giving us a chance to think about how we can be better leaders in the field as well as with our network. It’s forcing us to ask more questions about evidence-based practice. So, how many of these activities actually have any sort of basis at all in evaluation of research? Has anyone stopped to find out why these programs work, or might work. And it strengthened our collaboration with the CDC, which we were very excited about. They’ve been great partners and they are very interested in this issue and when we’re thrilled about that. And as I said, we’ve been nurturing a relationship for many years and we’re seeing some fruition there.
So, I’m just going to take a moment and I’ll talk a bit about Prevent Child Abuse America, not more information than you need, I hope. But any questions at this point? I just want to make sure I touched on BECAUSE, where it came from, who’s pushing it, is there any questions about that? Is that clear? All right. Great. Prevent Child Abuse America for those of you who don’t know, our mission is simple. We’re trying to prevent child abuse neglect of our nation’s children and we’re trying to prevent it before it occurs. It doesn’t mean that we also don’t get involved in work that is after it occurs. But, our focus is trying to raise awareness, trying to educate parents, trying to work in systems where we address prevention issues.
Our values, our core values, evaluate children, strengthening families, engaging communities. We want to believe that we can do those things even semi well, people start focusing, how are we going to raise healthy families and how are we going to prevent abuse before it occurs? You know, as you are well aware, it’s been a great challenge.
Some of the pieces we do. We work on developing community-based programs focused on prevention of child abuse. We do advocacy work, in fact, one of our great victories a couple of years ago was getting a million dollars out of the federal budget to CDC just for child abuse and maltreatment work. That was the first time they’d ever gotten money specifically around that. It was about four or five years ago but we do advocacy on both national and state level and we are constantly doing advocacy work. We do research. We have a research center. And we’ve been trying to do research in this field since this field was created.
Public education, you know, the classic PC America public awareness piece is it shouldn’t hurt to be a child. I’m sure people have memories of that, especially if you’re up at 4:00 in the morning like me and you’re watching late night television and you will see our PSA’s all the time. And then we have a network of chapters. So we have developed a network of statewide prevention chapters who really do the work of the national organization and serve as a springboard for any success we can claim or not claim.
Right now we have a mix of 40 statewide chapters. Some of those are provisional chapters, so they are working towards full chapter status. These budgets range from under $100,000 to 3.5 million dollars, so while the blueprint for creating a chapter is very similar, the things they focus on, it is very state dependent, leadership dependent on how big that budget is. Some of the staff is as small as one to three people. Some are over 26, that was the most recent survey, so I know some folks are much bigger than that. That was as far as we went. Some of our chapters have dual affiliations. They may also be the children’s trust fund in their state, which I mentioned earlier.
They may be associated with the Exchange Club for folks who know that. That’s sort of a, like a Rotary Club or a Kiwanis Club, but the Exchange Club, their mission is the prevention of child abuse. And so all the business folks in these local communities, that’s what they drive their volunteer work towards. In Oklahoma they created a prevention center that then merged with our chapter. We have a mix, some of the chapters are independent, 51C3’s, all they do is do the work of prevention of child abuse, the work of Prevent Child Abuse America. Others, which may be of interest to some of you folks particularly, are more hybrids or mixes. So, for example, in Ohio the chapter is part of an advocacy center, which is part of Columbus Children’s Hospital. And they’ve got a wonderful chapter doing great work in collaboration with other folks focused on children. In Nebraska the chapter is part of a foundation focused on children and families.
In Nevada, and some of you already know more about this than we do, our chapter is part of the Area Health Education Center, or AHEC. So that was a completely new entity to us. Those are federally funded entities that look at health education. And they felt that in their state the prevention of child abuse fit under that banner. What was fascinating about them, and then I’ll move on, is that they were doing all sorts of really fascinating prevention work when we met them, but none of it had to do with child abuse, but it was the kind of things we care about. So, you know, we want people to develop statewide plans for prevention. Well, they had done that, but they had done that around bio-terrorism. You know, we want people to educate parents. Well, they were educating parents about HIV and pregnancy, but not necessarily about prevention. So, when we met with them the question was, can you take this vast set of skills you have and sort of invert it and start applying it to abuse as well, and they’ve been wonderful partners for us.
Chapters look different in all sorts of way. We have many chapters that look like us at the state level. So, in Minnesota, Georgia, Kentucky, North Carolina, they’ve got their own state systems. They’ve got their own affiliates. I think Kentucky has something like 80 different organizations affiliated with them. So they look like us. In Louisiana, which has been particularly interesting over the last six months, they had statewide offices. And their New Orleans office has really suffered, as you would imagine, but they’re still there doing business and those folks are still in place. So, that’s been very interesting for them.
Any questions about our national organization? You know, we can also take questions offline, or we’re happy to talk after this workshop is over. We’re certainly, you know, more than happy to take emails or phone calls on anything we talk about today, whether it’s about the organization itself or this project. But anything you need or want or are interested in knowing about Prevent Child Abuse America itself. We’ve been around for about 30 years now.
LORI FRIEDMAN: Thirty-six, I think.
BEN TANZER: Thirty-six? Okay, I lost six years there. You can tell, I have a five-year old, almost five-year old, so that whole, the whole last five years has disappeared. We have, we do have it 36 years. The first chapter was actually in Kansas in 1976 and we’ve been building ever since then, so.
LORI FRIEDMAN: How many of you are familiar with Prevent Child Abuse America? Is the name familiar or--
BEN TANZER: Which is good for us to know, good. We always worry about that. When we leave the ivory tower in Chicago, we’re curious if people have heard about us. Got a question?
UNKNOWN: Will you be describing the purpose of the chapters, or are they all different depending on what the state wants?
BEN TANZER: I’ll take a moment for that because, I mean, that was as far as I was going to go. Chapter, very interesting. Some have come about because somebody decided that they needed a chapter of our in that state. So in Florida, for example, and then I’ll back up, we had a chapter for many years that closed. And they had just had a big, they had a series of controversies there with their child welfare system. And apparently the Governor who knew the CEO of what’s now a chapter, called directly and said, I really cannot go before the press and say that we don’t have a chapter of Prevent Child Abuse America. So what do we need to do to make this happen? So in that case, that was the Governor and that doesn’t always happen, but the Governor called somewhere in particular and said I want you to connect with them and find out. Generally speaking, chapters are, I’ll put it this way. Our primary expectation is that there’s nine areas they are focusing in. You know, they’re doing advocacy work. They’re doing training work. They’re doing prevention programming. You know, they are, they’re doing research, but they’re doing that with a prevention bent, that minimally, and they may be doing a lot of things, they are focused on prevention work in these areas. And so most of the chapters go far beyond what PC America is looking for.
You know, an interesting example is Wyoming. Our Wyoming chapter is very interested, interested, involved in preventing suicide in that state. Now that is not something, teen suicide. That is not something I’m aware of any other chapter working on. But somebody did a research study in Wyoming and found out the greater proportion of teenagers committing suicide in that state were males who had been abused. And so now Wyoming is taking, you know, ownership over that issue. So, our main focus is, we want you to work in the following areas. On prevention and wherever else you go, we are flexible enough to work on that. But primarily, everyone we’re talking about starts with a focus on the prevention of child abuse before it occurs. And they may go in different directions and, of course, as you pointed out, every chapter thinks about that a little differently. Every state thinks about that a little differently. Certainly, to be a chapter of ours, it’s flexible enough to do that. Yes.
UNKNOWN: How do you distinguish between the role of a PCA chapter and the role of a Children’s Trust Fund in the state?
BEN TANZER: Generally speaking, these are separate but collaborative systems. So, Children’s Trust Funds, and I’m speaking a little out of turn in that, I know much more about our network then their network, but those have tended to come about by some sort of state governmental decision. We need to create a Trust Fund. So maybe that somebody in some department and I’ve had this experience, you know, has been assigned to run the Trust Funds or whatever that looks like in their state along with the 50 other things they have to do. In some places a statewide board has been created and they’ve hired someone to help figure out how to distribute that money. When we have a chapter that wears both hats, in our cases, it’s been a Trust Fund that has gotten big enough where they’ve decided to sort of cross over to our work as well, so they’re not just distributing money, but they’ve gotten bigger and more focused. So that’s a recent change and we’re thrilled about it. So there are maybe four or five states where people are wearing both hats, but these are sort of independent systems that have immerged.
The Trust Funds did spin out, spin out of some work that PC America did in the first place maybe 15 or 20 years ago. And now they are fully independent and they are their own national entity, but it started with a conversation that said, how come nobody sets money aside for prevention work? Couldn’t you sell license plates or, you know, take money from every birth certificate? And so they’ve slowly grown and we’ve all come back together. Does that help? Great.
I’m going to move us forward with a BECAUSE piece and then Lori can get into some of the details. This is not going to be quick but there are four significant chunks we’re working on here. We have a prevention work group, our advisory group. We did an inventory and we’re going to be able to share with you the results of that inventory. We have done an assessment and we’re building up some next steps, which we’ll come up to later. The prevention work group is made up the folks on here, I don’t know how well you can read that, but we’ve got academics in various schools from Columbia to Howard to Tufts. And we have representation from the American Humane Association, Circle of Parents, which is a mutual self-help support group.
The National Indian Child Welfare Association is at the table with us, which has been great. We have not done a good job of working with those folks prior to this. We have a parent leader from Prevent Child Abuse Illinois. They’re part of this, this woman actually works for that organization but comes representing the parent leader she works with around the country. Parents as Teachers is at the table. That’s a home visiting program. And then we have one chapter, Prevent Child Abuse North Carolina, that’s officially at the table and then our whole network is unofficially at the table. We meet; we’ve been meeting with them twice a year in person and twice a year by phone. And every phase, whatever we’re on, we use them as a sounding board. Does this make sense? What are we skipping?
Before we go to the chapters, we have them correct us. And then we go to the chapter network and say; this is what we’re thinking. This has been a great relationship for us and if anything, they have told us we’re not utilizing them enough. So, that gives us something to think about. The inventory piece of this, which is going to be a big chunk of where we’re going to go in terms of detail was, we worked with all of our chapters starting in August? Earlier? We spent several months where we developed a survey that we asked people to delineate the activities, the prevention activities they do. And the catch there, which was very interesting, was that they had to do a survey per activity. So if they did 25 things they considered to be prevention work, they had to do 25 surveys. And that was like six, seven hours of work for them. If they decided to down play or skip some things, it wasn’t as long. And Lori is going to talk about what we found, but it’s been fascinating. You know, we asked them about the type of strategies they do, what the catalyst for doing those strategies is, what the target population was and, haven’t we got off to all of you, but we really tried to push them. We’ve never done this. We really tried to say, we don’t want to just know what you’re doing. We want to know why you’re doing it. We want to know how you get it funded. We want to know how much staff it takes to accomplish that and whether you’re evaluating it.
The strategy for us was basically to use our executive directors as the point person. We asked them to engage staff as needed, but the goal was that someone at that chapter had to fill out a survey for every identified activity. And we did it online, web based, and so it became a real time process. We have this very organic fluid database where information is coming in and out all the time. And our, one of our longer-term goals, we’ll actually be running reports off of that for the network. Finally, we made the national office fill it out also, which was very interesting, because, you know, national offices never want to do that kind of stuff. And so we assigned people on our staff. We said, we know you do this. We want you to write about it. So part of the database is also what PC America is doing.
And, I think, finally the last page I’ll share, everybody tried the lower years, the kind of thing, you know, the data utilization that we started coming up was getting a larger scope of what’s happening around the country, much broader than we had any sense of. We tried to look at trends. We tried to look at how much information sharing is going on around the country. We tried to get, you know, on this (inaudible) I should say, too, how we’re going to use this. We’re trying to do presentations this being our first one. We’ve got this web-based data system, which I mentioned. And somehow, we need to come up with a prevention plan by September 30 when the BECAUSE 1 money runs out. And we hope BECAUSE 2 will be starting October 1, 2006. That proposal is in and we’re waiting to hear about that. That is the lead up to what we hope is the meat of this, which is really sharing with you what we’re seeing around prevention work. I just wanted, we wanted to make sure you knew what this project was, who PC America is, and what we’re doing to try to gather information. I’m going to pause here.
I’m just going to ask you, we don’t want to waste your time on that. I wanted to make sure you had it. Any additional questions. What Lori is going to get into are some of the findings we have, which, how many strategies we are we going to be hearing about?
LORI FRIEDMAN: Over 375.
BEN TANZER: Over 375 strategies were put in this database and we are sorting through that as we speak. Yeah.
UNKNOWN: Would you tell, are there federal agencies who do this work?
BEN TANZER: We, as far as federal agencies, we have not gone beyond the CDC or they have not gone beyond the CDC. One of our understandings is that these federal agencies don’t necessarily get along so well, and so that’s one of their goals, which is to figure out how they can all get along as we try to figure out how we can all get along at our level. So that’s one of the sort of over or underlying goals of all this, to actually build some collaboration that does not fully exist. Yes mam.
UNKNOWN: I was just going to suggest that that would be a really nice role for you guys is to bring different people to the table. And there’s a variety of resource centers, too, who will be certainly happy and I know you can contact with someone who would be really happy to work to help you with your goals.
BEN TANZER: Absolutely, and we, we will take recommendations while we’re here. And I would share that one of our goals, certainly Lori and I, is that this becomes a springboard not just for this project, but a greater level of collaboration across the field of prevention. I mean, the fact that we’re at the table of the Trust Fund and the Parents Anonymous is an enormous step. There’s just not a lot of that going on. And the fact that CDC is there for that is also an enormous step and our hope is that as this project evolves, we’ll go well beyond the people at the table. We’d be very excited about that. It hasn’t happened during our time in this work and it’s a good goal. And if people are buying into that, at least we’re already involved. So I appreciate that.
I’m going to have Lori step up because she’s got some really cool stuff we’ve been finding and, you know, I keep hearing about it over the phone. This is the first time I’ve really seen it written down. So I’m going to turn it over to her, Lori?