Dozens of kids died from abuse and neglect in KY last year. Why weren’t they helped?
Last year in Kentucky, well over two thirds of the 54 children who died and 82 who nearly died after suspected abuse or neglect had prior involvement with the state’s child protective services, according to a new report.
The 2019 annual Child Fatality and Near Fatality External Review Panel report released Dec. 2 shows that of the 136 cases from June 2017 to June 2018, 78 percent had a history with the Department for Community Based Services, the child welfare branch of state government.
That’s 15 percent more than the year prior, when 51 deaths and 83 near deaths were identified by the panel, 63 percent of which had prior involvement with child protective services. Panel members noted in the report, however, that “prior history does not equate culpability.”
The panel convened in 2012, a year after the state’s two largest newspapers sued the Cabinet for Health and Family Services to get more information about children who were abused or neglected to death under the state’s care. It’s comprised of 20 lawmakers, mental health, law enforcement, medical and social service professionals. Their report details trends among victims, causes of injury, specifics of where abuse or neglect should’ve been detected but wasn’t, and 32 recommendations the state should heed to avoid these cases in the future.
Rates of child deaths resulting from abuse or neglect have climbed steadily over the last seven years, from 18 in fiscal year 2011 to a high of 59 in 2016. More than three quarters of victims in the newest report were under the age of 4, a constant since 2012, and most were white boys.
The vast majority of this year’s cases — 89 percent of the deaths and 95 percent of the near deaths — were deemed by the panel as “potentially preventable.” Part of that has to do with a “prevailing” lack of quality caseworker visits with many of these families. If those visits had occurred, abuse, neglect or the likelihood of either probably would’ve been detected and safety planning could’ve taken place, the report said.
Other cases were subject to a turnstile of caseworkers, which also delayed services. Heavy workloads, high turnover rates (27 percent in 2018) and a deficit of resources among DCBS workers were major factors, the report found. The panel, as it has in years past, again recommended the state invest more money in child welfare.
“Previous annual reports have addressed workload issues and advocated for additional resources,” the panel wrote. “Regretfully, there appears to have been little improvement over the years.”
In addition, the state’s “array of services is not adequate or accessible to children and families in all areas of the state.”
These challenges faced by DCBS workers led to oversight and neglect, but the report also highlighted systemic failings on the part of bystanders, law enforcement and medical providers to detect and properly report maltreatment.
In 20 percent of the cases where law enforcement was called, officials didn’t communicate with a child protective services worker. In the majority of those cases, officers failed to fully investigate the incident.
“Law enforcement agencies need additional training on how to properly investigate overdose cases and a clearer understanding of the potential criminal charges applicable,” the panel recommended.
Similar to law enforcement, in more than half of incidents where medical attention was sought for a child who had sustained some sort of injury, providers failed to notify child protective services. Twenty-six percent of hospitals failed to perform required assessments on the victim or their siblings.
In one case, a 2-year-old who was later found to have been abused was taken to an emergency room by his mother with symptoms of vomiting, “shakes” and a reported history of his ears turning purple. He was diagnosed with an ear infection, given antibiotics and discharged.
His mom brought him back the following day saying he hadn’t stopped vomiting. New bruising was found on his ears, back, thighs, neck and jawline. He was later diagnosed with skull fractures.
In Kentucky, everyone is a mandatory reporter, meaning if someone sees what they think is abuse or neglect, they’re required to report it to child protective services. The 2019 report found that bystanders failed to do this in nearly 30 percent of its cases.
As for causes, physical abuse and head trauma were leading causes of death. Nine children died from firearm injuries — half of those were from suicide, three were accidental, and two were homicides. Ten children died from drowning.
Accidental or intentional ingestion of a substance were primary drivers of the incidents examined by the panel — 31 near deaths and one death. Substance use was present in the homes of more than half the victims.
Though many ingested more than one substance, the drug that was most recurring (10 of the 32) was Suboxone, or buprenorphine — a Food and Drug Administration-approved opioid agonist used to treat opioid use disorder in adults.
Clonidine, a drug used to treat hypertension and Attention Deficit Hyperactivity Disorder, was ingested in 7 cases, and opiates in five. Exposure to drugs has been the primary driver for deaths and near deaths in Kentucky for the last four years, peaking in 2016 at 34 and dropping to 22 in 2017.
In 2018, the Poison Control Center received reports of nearly 5,000 children being exposed to a drug. Roughly 900 kids through the age of 12 were treated for drug exposure in emergency rooms across Kentucky.
Multi-year trends noted in the report include the high rate at which referrals for suspected abuse or neglect in Kentucky are “screened out” by Central Intake staff. These staff members field reports of suspected abuse or neglect, and their job is to judge whether an allegation warrants an investigation. Kentucky screens out 49 percent of these calls, compared with the national average of 42 percent. Last year, 57,626 reports of child maltreatment were reported statewide.
Of this year’s cases, most (30) came from Jefferson County, followed by Hardin County with 12 and Henderson County with seven. Laurel County outpaced the rest of Eastern Kentucky with five cases. Fayette County had four cases.
How to report abuse and neglect
Child abuse or neglect reports should be made to the Kentucky Statewide Child Abuse Hotline: 1-877-597-2331. For more information about reporting, visit https://prdweb.chfs.ky.gov/ReportAbuse/.
This story was originally published December 11, 2019 at 12:23 PM.
