Special Efforts Being Made in Ohio to Eliminate Child Abuse and Neglect Fatalities

In January 2017, Ohio enacted SB 332 to provide a safe haven for parents who want to surrender newborns through newborn safety incubators provided by specified entities.  Regulations will specify, among other things, procedures to provide emergency care for a child delivered to an incubator; design and function requirements that allow a child to be placed anonymously from outside the facility, lock the incubator after a child is placed in it so that a person outside the facility is unable to access the child, provide a controlled environment for the care and protection of the child, provide notification to a centralized location in the facility within 30 seconds of a child being placed in the incubator, and trigger a 911 call if a facility does not respond within a reasonable amount of time after a child is placed in its incubator; operating policies, supervision, and maintenance requirements; and any other requirement the Department considers necessary to ensure the safety and welfare of a child placed in an incubator. [Recommendation 5.3]

Ohio’s Timely Recognition of Abusive Injuries (TRAIN) Collaborative, funded by a $1 million grant from the Ohio Attorney General’s Office, is encouraging physicians and hospitals to pay special attention to a list of more than 50 “sentinel injuries” (minor injuries that could be potential warning signs of abuse) when children are brought into emergency departments. According to the Attorney General, sentinel injuries are particularly troublesome in infants younger than 6 months of age because infants lack mobility and typically do not injure themselves. For these reasons, injuries at this age should raise questions about whether an infant was in an accident or was being abused. The TRAIN Collaborative aims to make the screening process more routine and comfortable for health care providers whose training in child abuse may not be extensive. To ensure that sentinel injuries are not overlooked, the TRAIN Collaborative developed a recommended physical exam for infants under 6 months of age, as well as a recommended protocol—called the “bundle of care”—to follow when a medical provider discovers a sentinel injury. The bundle of care helps identify abuse and ensures the infant receives appropriate follow-up care. As a result of the work of the TRAIN Collaborative, doctors and nurses at 19 hospitals across Ohio will be trained to screen for signs of child abuse in infants 6 months of age or younger. TRAIN Collaborative researchers found that 1 in 10 victims of child abuse in Ohio have been seen before with a sentinel injury. Fewer than 1 in 3 babies with sentinel injuries receive the necessary physical examination and follow-up. The Attorney General is confident that giving all medical providers the tools and information created by the TRAIN Collaborative will significantly reduce child abuse.  [Recommendation 7.2]

Local effort in the City of Kettering: The first non-hospital setting in Ohio for the recovery of substance-exposed infants and their caregivers was launched in Kettering. Known as Brigid’s Path, the opiate recovery and rehab center will be able to house and treat up to 24 infants. [Recommendations 7.1l, 7.2f]

Local effort in Franklin and Hamilton counties: Ohio’s Franklin and Hamilton counties launched a pilot project with Eckerd Kids to implement Eckerd Rapid Safety Feedback®, a real-time data analytics tool to flag high-risk child welfare cases for intensive monitoring and caseworker coaching.[Recommendation 2.1]

Local effort in Montgomery County: Montgomery County leaders and area partners signed an interagency agreement to support CARE House, a regional child advocacy center, to help reduce child abuse and neglect fatalities. CARE House involves a partnership between Dayton Children’s Hospital, the Montgomery County Prosecutor's Office, Dayton Police Department, Montgomery County Sheriff's Office and Montgomery County Department of Job and Family Services. In addition, all County law enforcement agencies use CARE House for their child abuse investigations. This centralized, child-focused approach brings together all the services needed in a child abuse investigation — law enforcement, child protection, prosecution, mental health, medical professionals and victim advocates — to help reduce the trauma that victims experience. [Recommendation 7.3c]