THE URGENT NEED IN ILLINOIS FOR UNIT-BASED MULTIDISCIPLINARY TEAMS TO INVESTIGATE CHILD ABUSE Recommendations to the Illinois General Assembly per Public Act 099-0023 By The Illinois Children’s Justice Task Force February 2016 TABLE OF CONTENTS Acronyms ...................................................................................................................................................................... 1 Acknowledgements ....................................................................................................................................................... 2 Executive Summary ....................................................................................................................................................... 6 Introduction .................................................................................................................................................................. 8 What is a Unit-Based Multidisciplinary Team? ....................................................................................................... 11 Child Maltreatment in Illinois: Priorities for Unit-Based MDT Investigations ......................................................... 12 Vision for Statewide Unit-Based Multidisciplinary Teams .......................................................................................... 15 Guiding Principles and Strategies ........................................................................................................................... 17 Unit-Based MDT Partners: Roles, Strengths, and Challenges ................................................................................. 20 Law Enforcement ................................................................................................................................................ 21 Department of Children and Family Services ..................................................................................................... 23 Pediatric Child Abuse and Neglect Medical Centers of Excellence ..................................................................... 26 Children’s Advocacy Centers .............................................................................................................................. 33 Prosecution ......................................................................................................................................................... 39 Recommendations ...................................................................................................................................................... 40 References ................................................................................................................................................................... 47 Appendix A: Public Act 099-0023 ................................................................................................................................ 50 Appendix B: Statewide Needs Assessment ................................................................................................................. 51 Figure B: Top 10 areas of improvement in child abuse and neglect identified ....................................................... 51 Appendix C: Children’s Advocacy Centers and Their Use of MDTs ............................................................................. 52 Appendix D: Illinois Children’s Advocacy Center Act ................................................................................................... 53 Appendix E: Certified Child Abuse Pediatricians (CAPs) in Illinois ............................................................................... 59 Appendix F: Multidisciplinary Pediatric Education and Evaluation Consortium (MPEEC) ........................................... 60 Appendix G: Child Death Investigation Task Force in the DCFS Southern Region ....................................................... 62 Appendix H: Relevant OIG Recommendations ............................................................................................................ 63 Appendix I: DCFS Maltreatment Allegations Targeted for MDT Response ................................................................. 64 Table I: DCFS codes of abuse and neglect allegations prioritized for MDT review ................................................. 64 Appendix J: Illinois Child Maltreatment Statistics from DCFS ..................................................................................... 65 Table J1: Child abuse and neglect trends in Illinois ................................................................................................. 65 Table J2: Child death trends in Illinois .................................................................................................................... 65 Table J3: Reported child sexual abuse victims ........................................................................................................ 66 Appendix K: Supplemental Child Maltreatment Analyses for Task Force: Serious Harms .......................................... 67 Table K1: Child reports in FY14 involving serious harms for children ≤ 3 years old, by DCFS region ...................... 67 Table K2: Legend for Table K3 ................................................................................................................................. 68 ii Table K3: Number of children under 3 years and population rates with specific types of serious harms by county for FY14 ................................................................................................................................................................... 69 Figure K1: Number of serious harms reports for children under 3 in FY14, by DCFS subregion ............................ 72 Figure K2: Rate of serious harms reports for children under 3 in FY14, by DCFS subregion .................................. 72 Appendix L: Supplemental Child Maltreatment Analyses for Task Force: Sexual Abuse ............................................ 73 Table L1: Child reports involving at least one sexual abuse allegation and indication rates by DCFS region and subregion and fiscal year ........................................................................................................................................ 74 Table L2: Rates of child sex abuse reports and indicated reports per 10,000 children under 18 years, by DCFS region and subregion .............................................................................................................................................. 75 Table L3: Sexual abuse reports and indicate findings by allegation ....................................................................... 75 Appendix M: Supplemental Child Maltreatment Analyses for Task Force: Abusive Head Trauma ............................. 76 Table M1: Non-pending abusive head injury (physical abuse allegation #2): Reports in Illinois and indication decision by fiscal year ............................................................................................................................................. 76 Figure M1: Abusive head trauma (abuse allegation #2) from 7/1/2012-4/1/15: Number of non-pending reports and number of indicated reports, by subregion ..................................................................................................... 77 Figure M2: Abusive head trauma (abuse allegation #2) from 7/1/2012-4/1/15: Percent of non-pending reports indicated, by subregion ........................................................................................................................................... 77 Figure M3: Abusive head trauma (abuse allegation #2) from 7/1/2012-4/1/15: Average (mean) number of days to complete investigation by DCFS, by subregion ................................................................................................... 78 Figure M4: Abusive head trauma (abuse allegation #2) from 7/1/2012-4/1/15: Number of non-pending reports and number of indicated reports, by child age ....................................................................................................... 79 Figure M5: Abusive head trauma (abuse allegation #2) from 7/1/2012-4/1/15: Percent of non-pending reports that were indicated, by child age ............................................................................................................................ 79 Figure M6: Abusive head trauma (abuse allegation #2): Number of reports and indication rates by age of infant less than 1 year ....................................................................................................................................................... 80 Appendix N: CQI Flow Chart ........................................................................................................................................ 81 Appendix O: The Need to Link Databases Across Organizations ................................................................................. 82 Figure O: MPEEC determinations and DCFS indicate decisions in cases with abusive head trauma allegations .... 83 Appendix P: Children’s Hospital Association Standards of Care ................................................................................. 84 Appendix Q: Maps ....................................................................................................................................................... 85 Figure Q1: DCFS region and subregion map 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