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What are CAC’s and why do they matter?

Guest post by: Pamela White, Children’s Center Development and Communications Director

I first learned about Children’s Advocacy Centers (CAC) in 1992 when my youngest daughter disclosed sexual abuse by a caregiver. This led us to CARES at Legacy Emanuel, the CAC serving all of the Portland Metro area at that time. We were extremely grateful for the expertise that was brought to the assessment by a specially trained physician, who did both the physical exam and the forensic assessment.

What I didn’t know then was that the CAC movement was in its infancy, having been started only 7-years earlier. At that time, the Alabama Madison County District Attorney (who later became a Congressperson) Robert E. “Bud” Cramer realized that there was a need for a better system for helping children who had experienced abuse. He saw that there was no coordination between medical, social services, and law enforcement, which often resulted in the retraumatizing of the very children they were trying to help.

Congressperson Cramer envisioned a place where everyone involved in a child abuse case (physicians, DA offices, law enforcement, child protective services, and others) could collaborate. So, in 1985 he established what we know now as the Child Advocacy Center/Multidisciplinary Team (MDT)Model in his home county. This model puts assessment and family support at the CAC and creates a regularly meeting MDT made up of representatives from all the agencies in the county who collaborate to support abused children.

Within a year, Congressperson Cramer and his supporters were training practitioners from all over the country. Fast forward 36 years of growth and discovery to find the practice of medical and forensic assessments at 924 CACs across the United States most of whom practice with a local MDT. In 2020, these CACs served 338,209 children (and are on track this year to serve a record number of children and their families).

Local CACs (usually organized by county) are individual non-profits or hospital associated organizations that are loosely affiliated both statewide and nationally. The national organization, National Children’s Alliance (NCA), works on behalf of all CACs offering an accreditation process, community awareness and advocacy, training & technical assistance, and funding to CACs across the country.

Accreditation is a rigorous process that uphold high standards of practice for CACs providing medical and forensic assessment and mental health treatment to children who have experienced abuse. Additionally, NCA works on behalf of CACs by providing training, offering communication support, and advocating at the national level to sure child abuse laws protect children and that federal funding remains stable.

In addition, most States also have state networks that bring CACs across their state together to collaborate, as well as to advocate at the state level. Oregon’s network is known as Oregon Child Abuse Solutions (OCAS). In the last legislative session, Children’s Center joined a (successful) OCAS -led campaign to increase Statewide CAC funding by reaching out to legislators serving Clackamas County.

The increased 6 million dollars allotted to the 20 CACs across Oregon will help us to meet the responsibilities of providing assessment under Karly’s Law. This is an Oregon law passed in 2008, which requires that any child who has physical injuries associated with abuse be seen within 48 hours.

Children’s Center is proud to be an accredited member of the wide network of committed, professional, and visionary CACs. Like our colleagues all across Oregon and the US, we are committed to offering services that are evidence based and trauma informed as we assess and treat children who have experience abuse. Supporting them and their safe caregivers as they embark on a journey of healing that offers hope for a healthy, safe future.



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