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PREVENTION

Some child protection agencies are working to monitor potentially abusive parents before problems start. One such program has been underway in Elmira, N.Y., for nearly 20 years.

Targeting young women pregnant for the first time, a specially trained nurse visits their homes an average of nine times, with two dozen more trips in the first two years after the child’s birth. Nurses work with the mother on health behaviors, child-care practices, family planning, educational and job strategies and self-confidence.

A 1997 study that tracked the Elmira mothers for 15 years found they had 80% fewer reports of child abuse or neglect than similar women not in the program. Women in the study group had fewer children, were less likely to use welfare, have substance abuse problems, engage in crime, or be unemployed.

The cost: $3,200 a year, a taxpayer outlay that was recouped by the first child’s fourth birthday under the old welfare system, says David L. Olds, chief researcher and University of Colorado Health Sciences Center pediatrics professor.

With such encouraging results, the program has begun catching on. The state of Oklahoma now uses it, and the U.S. Department of Justice last year provided start-up money for pilot programs in six cities (including Los Angeles). The hope: preventing abuse will curtail massive foster care, law enforcement and incarceration costs down the line.

Still, this and another promising visitation program are subsidized mostly with private monies and serve a minuscule fraction of the nation’s high-risk families.

It is “absolutely stunning” that government and taxpayers haven’t opted for this approach rather than allow child welfare agencies to continue clearly ineffective policies, says Richard Krugman, former chair of the U.S. Advisory Board on Child Abuse and Neglect.

PUNISHMENT

Some officials are resorting to punitive approaches. Recognizing that most abuse is inflicted by parents addicted to drugs or alcohol, South Carolina’s attorney general has begun prosecuting and jailing women for child abuse who

harm a fetus by using illegal drugs during pregnancy. The state’s Supreme Court upheld the practice two months ago.

Los Angeles County Sheriff Sherman Block says he is trying to find a California legislator willing to sponsor a bill that would allow him to incarcerate women who abuse substances during pregnancy. He says women should be punished if they repeatedly give birth to drug-exposed infants who must then be reared in foster care on the taxpayer’s dime. Critics say this approach will only keep addicted women who are pregnant from seeking prenatal care for fear of law enforcement detection, thus potentially causing even more damage to their unborn children.

IMPROVED ACCOUNTABILITY

Many of the nation’s child welfare agencies are grossly mismanaged and underfunded, says Marcia Robinson Lowry, executive director of Children’s Rights Inc., a New York advocacy group. One indicator: up to one-third of children found to be abused are again reported to hotlines within the same year, says Deborah Daro, Research Director of the National Committee to Prevent Child Abuse.

This recidivism rate occurs, in part, because in nearly 300,000 cases each year in which mistreatment is confirmed, no counseling or other services are provided to the family, says Daro.

To turn this corner, a handful of government child welfare agencies are imposing stronger standards on themselves by becoming sanctioned by the nonprofit Council on Accreditation of Services for Families and Children Inc. By doing so, the agencies hope to raise their operations to a level that makes them less vulnerable to lawsuits.

To become accredited, the agencies must beef up staffing to allow workers to spend more time on each family. Every four years, the accreditation group monitors the agency’s effectiveness.

By 1996, according to the Child Welfare League of America, as few as 15 public child welfare systems--including those in Baltimore, Atlanta, Houston and Miami--were accredited.

In the West, California’s Stanislaus County is the only child protective agency to obtain accreditation, according to the Child Welfare League of America.