Doctor: NM’s child abuse problem ‘absolutely’ preventable

ALBUQUERQUE (KRQE) – The quiet, timid eyes of Omaree Varela, staring from an open doorway or from behind his stepfather, have haunted New Mexico all winter and into the spring.

The 9-year-old boy died in December, allegedly at the hands of his mother. His family had been on the radar of those in charge of protecting this state’s children for years before Synthia Varela-Casaus, in her own words, “kicked him the wrong way.”

Omaree was not the first.

Long before his story began to dominate the headlines, cases like those of Baby Brianna and Ty Toribio forced into public view an uncomfortable fact: New Mexico has a long and troubled history with child abuse.

Since 2009, according to statistics compiled by the New Mexico Child Death Review Board, more than 50 children have died at the hands of abusers. More than 80 percent of those deaths could have been prevented, and that means the system failed more than 40 children it should have protected.

But in New Mexico, child abuse prevention has not been a priority. That isn’t by accident.

By The Numbers

  • Since 2009, more than 50 children have died at the hands of abusers; more than 80% could have been prevented
  • At least 27 other states are using at least some version of alternative response to reduce the instance of child abuse
  • CYFD’s Child Protective Division has a $113 million annual budget. Less than $1 million is spent on prevention services
  • 5 out of every 1,000 New Mexico children in the care of the Child Protective Division will get preventive services- the national average is 43 kids per 1,000
  • CYFD staff responds to 4,500 reports a month
  • Staff levels are down 17% down

“Really, our mandate is to intervene, not prevent,” state Children, Youth and Families Department Secretary Yolanda Berumen-Deines told KRQE News 13 earlier this month. “Because of the amount of abuse and neglect that there is, the state’s mandate is to intervene when there is a report of abuse or neglect so that we can determine if a child is being harmed, and then step in to prevent further abuse or neglect.”

Berumen-Deines said CYFD is understaffed, and the department’s case workers are responding to an ever-growing number of calls that has swollen to more than 4,500 a month. That means stepping in to intervene after a child has been abused is, by necessity, CYFD’s primary focus, the secretary said.

There is, however, another way.

“Alternative response,” also called “differential response,” is a model in which the system places more emphasis on identifying risk factors and providing services to families before a child is abused.

For example, if a parent in a young family is struggling with drug addiction — a common risk factor in child abuse cases — the parent gets treatment. The same applies for a parent who needs anger management therapy, or a teen mother who needs financial assistance.

At least 27 other states are using at least some version of alternative response to reduce the instance of child abuse, according to the National Conference of State Legislatures.

Some of those states have seen positive results, according to a 2011 report prepared by the New Mexico Legislative Finance Committee. In Ohio, the rate of children being removed from homes after abuse fell by 50 percent, and the recurrence of maltreatment dropped by 16 percent.

Bernalillo County tried the model in a small-scale pilot program that ran from 2005 to 2007. According to the LFC report, alternative response was working here, too. The families that accepted services had a lower rate of repeat maltreatment of children, half as many repeat reports to CYFD and fewer children taken away and placed in foster care.

It’s unclear why officials didn’t continue or expand that program.

But since 2011, the LFC has been recommending that Republican Gov. Susana Martinez’s administration explore the idea of including alternative response and other prevention programs in its approach to child abuse.

The administration, Berumen-Deines said, has had its focus elsewhere.

“We didn’t initiate because we were really struggling to man up our staff,” she said. “We were in such a hole with our staff that that was our primary focus: to get people out to conduct the investigation and to get investigations completed. Initially, our focus was to restaff an agency that had been so seriously depleted from” a hiring freeze at the end of former Gov. Bill Richardson’s second term in 2010.

Berumen-Deines also pointed to budget constraints within CYFD as a reason for not pursuing more prevention programs.

“We’re a poor state,” she said. “We have a limited amount of money available. And like I said before, I need to have staff that can respond to 4,500 reports a month. And I need to have staff that can get out there and investigate and make a determination of the safety of children.”

State Rep. Gail Chasey (D-Albuquerque), who works as an attorney on child abuse and neglect cases, said the money argument doesn’t hold up. She points out that it costs far more to incarcerate an increasing number of child abusers and to house more and more children in foster care than it does to try and prevent child abuse.

“With the alternative response approach to abuse and neglect, the evidence has shown in the states that use it, that within one year, there’s a 99.9 percent return on investment,” Chasey said. “Let’s just say there’s a child who is removed from the home and, eventually, parental rights are terminated, or the family relinquishes parental rights, and then the child is adopted. The cost from the beginning to the end for that one child is $107,000. That’s a lot of money.”

New Mexico spends far less on preventive services for children than other states do, according to an April 2014 report from the LFC.

CYFD’s Child Protective Division has a $113 million annual budget. Less than $1 million is spent on prevention services. The rest is allocated to programs that focus on keeping kids safe after they’ve been abused, such as investigations, foster care and adoption.

“It’s not enough, and I think when we start spending our money wisely on prevention, then we will start seeing a turnaround,” said Dr. Susan Miller said, a child psychologist at University of New Mexico Hospital and founder of the nonprofit New Mexico Child Prevention Partnership.

Child abuse, Miller said, is “absolutely” preventable. “It is not a disease. It is something people choose to do.”

The 2014 LFC report cites another difficult statistic: Five out of every 1,000 New Mexico children in the care of the Child Protective Division will get preventive services. That’s far below the national average of 43 kids per 1,000.

Berumen-Deines’ chalks that up to her belief that some prevention models are best left out of the hands of the state, the high volume of calls to CYFD — which has caseworkers tied up with intervention — and state statutes that somewhat restrict CYFD’s role.

“We have to get a report, we can’t just show up at someone’s door and say: ‘We’re here to make sure you’re taking care of your kids,'” she said. “We have to get a report first of all, that’s what starts the ball rolling. At that point with our central intake system, we have to make a determination whether it falls in the purview of CYFD intervention.”

However, Omaree’s case and other recent high-profile child abuse deaths have the state taking notice anyway.

Last month, CYFD rolled out several pilot programs that lean toward prevention. In Bernalillo County, a team of 10 family support workers will be hired to regularly check in with families who have been the subject of three or more child welfare investigations in the past 10 years. The goal of the support team will be to connect the families to services and visit their homes.

“With this, we’ll have more engagement than we’ve had in the past,” Deines said. “Our investigators have simply been involved in conducting the investigation, making the determination and if they find the services are needed, they do the referrals and try to get the family engaged, but there is no follow up.

“Our family support workers will be there to engage in relationship with the family, help the family to see that we’re not a threat, we’re not someone to be feared, but that we’re there to help.”

Governor Martinez also established a child advocacy center pilot program in Valencia County that aims to improve coordination between CYFD caseworkers, law enforcement and community partners who work with families on child abuse cases. Under that program, support services are to be offered under the same roof, which officials hope will allow better daily communication between all stakeholders, according to a governor’s press release.

Another change would require any family who has been the subject of two CYFD investigations to have any subsequent investigation be reviewed by a high-level supervisory team, which includes the county office manager, supervisor, caseworker and children’s court attorney. CYFD caseworkers are also now required to review police reports related to cases before making a final investigative decision.

As child abuse cases have dominated the headlines, the issue has become increasingly politicized.

“We have deep divisions politically, where there is increasingly strident divide over the role of government,” Representative Chasey said. “My argument would be: if we look at all of the good that governmental programs or governmental funding can do — going through community programs and through the public schools and through the universities and through the public health programs — to build families up, I really think that we begin to address our whole poverty issue by investing in New Mexico’s families at the very earliest stage.”

What’s happening in New Mexico, she said, clearly isn’t working.

“If we don’t want to lose generations of children, If we don’t want to continue down this path, we have to shift dramatically,” Chasey said. “You have to shift the focus from that moment of reporting to before it’s necessary to report.”

Berumen-Deines said she’s not against the idea of preventive services. But she sees the state’s role differently.

Do we want state employees out there doing prevention?” she said. “I’m not sure I agree with that.”


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Communities and groups such as the partnership led by Dr. Miller from UNMH should take the lead on stepping in before children are abused, Berumen-Deines said.

“We want to partner with them, we don’t want to take over their business,” she said. “And in my mind, having the state take responsibility for all of those things, it’s really messing in people’s business more than we need.”

Dr. Miller and her colleagues at UNM Hospital started the New Mexico Child Abuse Prevention Partnership, known as NM-CAPP, three years ago.

“Just seeing so many traumatic brain injuries was devastating to me and to learn that most of them or a majority of them were caused by child abuse, I just finally couldn’t handle it anymore,” Miller said. “I went to my boss and said please would you allow me to start an organization for prevention so this never happens?”

Today, the group has more than 200 community partners whose singular focus is the prevention of child abuse.

“My vision for CAPP is that we would become an umbrella organization with many partners taking part with each having their own specialty,” Miller said. “What my job is, I feel, is to kind of drive a wagon train with many horses, and I’m trying very hard to get everyone to travel in the same direction. That’s hard because we are very siloed here in New Mexico.”

But the group is gaining momentum. NM-CAPP was the recipient of $21,000 from the 2014 Governor’s Ball Award. The group also held its second annual Precious Gems Gala last week.

All proceeds will be put toward a child abuse prevention summit, which Miller hopes will be an annual event. The first likely won’t happen until fall 2015.

“What we’re looking for through the summit is best practices. If we’re using risk assessment, are we using the same ones so we can actually look at data and show that we’re making a difference? That would be wonderful,” Miller said.

 

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