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Oregon’s Response to Child Abuse: A Short History (#NCAPM)

This is the second installment of a six-week National Child Abuse Prevention Month (#NCAPV) blog series about child abuse and how we are working to prevent it. Dr. Skinner is a child abuse pediatrician who has practiced for more than 30 years, nine of them at the Children’s Center. She is currently a medical consultant for the Child Advocacy Center of Jackson County and now serves on Children’s Center’s Board of Directors.

Guest post by: Sue Skinner, MD and Children’s Center Board Member

In the 1980s, professionals in the Portland metro area began regular meetings to discuss how to best serve the needs of children.  It was noted that child victims were receiving multiple exams and multiple interviews during the course of the investigations. Members of law enforcement, prosecution, child protection, medical providers and interviewers worked to find commonality in order to help children. Thus, they were working as an informal multidisciplinary team (MDT). As a result, CARES Northwest was the first child abuse center to open in the state in 1987.  CARES was initially housed in a single room at Legacy Emanuel Children’s Hospital, where staff office space also doubled as the interview room.  Today, CARES Northwest is one of the oldest Child Advocacy Centers in the nation.

Legislation was passed in the state in 1989 which mandated the creation of child abuse MDTs in each of Oregon’s 36 counties.  In 1993, the Child Abuse Multidisciplinary Intervention (CAMI) program was created under the Department of Justice (DOJ).  Grant funds would flow from the DOJ to the CAMI account, and then to counties in order to help fund child abuse assessments, investigation, treatment and prevention.  Oregon Revised Statutes (ORS) stated that “there will be sufficient community assessment centers in Oregon to ensure that every child reasonably suspected to have been subjected to child abuse receives a skilled, complete and therapeutic child abuse medical assessment,” and that ability to pay should not be a deterrent for a child to receive services.

As a result, the number of CACs in Oregon quickly grew, with the mandate of county MDTs and some revenue stream from the state. In the mid-1990’s, Oregon Child Abuse Solutions (OCAS) became established as a non-profit organization linking the Executive Directors from all the CACs in order to provide consistency, support and mentoring.  Currently, we have 20 Child Advocacy Centers (CAC) serving Oregon’s 36 counties and OCAS supports medical providers, interviewers, and Executive Directors.

Oregon voters and the legislature have continued to be active and at the forefront of issues regarding child abuse and neglect.  In 1994, ballot measure 11 was passed by the voters, which provided mandatory minimum sentencing for some sex crimes.  The result of this was children having to testify in criminal court less often.

Professionals in the state worked together to produce the first version of Oregon Interviewing Guidelines (OIG) in 1998, a standardized training for all forensic interviewers who conduct interviews within a center.  In addition, the first edition of the Oregon Medical Guidelines was published in 1999.  Oregon Interviewing Guidelines have gone through multiple revisions in an effort to provide a best-practice model for all those who interview children.  The training module of Oregon Child Forensic Interviewer Training (OCFIT) is a model for other states and ensures that children are interviewed in a consistent, developmentally appropriate forensically-sound fashion.

In 2006, Oregon adopted Jessica’s Law, legislation that originated in Florida and provides mandatory sentencing for child sexual abuse victims under age 12.  In 2008, Oregon passed Karly’s Law, legislation named for Karly Sheehan, a toddler from Corvallis who died from physical abuse injuries inflicted by her mother’s boyfriend.  Karly’s Law was landmark legislation that mandated how first responders (law enforcement and DHS) work together with CACs when there are concerns of physical abuse regarding a child.

From 2009-2015 multiple legislative efforts have focused on educating and empowering children to better understand child sexual abuse and also sexual violence.  These include Oregon Safe Schools Act (2009), Human Sexuality Education (2009), Healthy Teen Relationship Act (2013) and Erin’s Law (2015), which mandates that children receive age-appropriate education on sex abuse each year they are in school.

What is really remarkable in Oregon, is the collaborative effort across professionals who are providing a strong safety net for children.  This includes all of those who sit on an MDT:  prosecution, victim’s assistance, child protection, law enforcement, medical providers, the CAC, public health, mental health, schools, and juvenile services.  In addition to members of the MDT, there are groups teaching children and adults about abuse prevention, and home visitors reaching out to families in need.  We recognize we have far to go but those who work in the field are committed each day to doing their best to ensure children are given the right to a happy and safe childhood.  Become a partner!

– Sue Skinner, MD


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