Spotlight on the Safety Net

“When you fail to plan, you plan to fail.”

— Benjamin Franklin

Innovation happens at the local level in North Carolina. Our state has a state-supervised and locally administered system for human services delivery in 100 counties, 96 departments of social services, 82 health departments, and 4 local combined human services agencies—a multitude of laboratories with varied cultures, resources, and strengths to experiment with new approaches to strengthening families and keeping children safe.

As important as it is to be trauma-informed and provide appropriate interventions and treatment, the best possible outcome is to strengthen families so that adverse childhood experiences (ACEs) are prevented as often as possible. The growing awareness about the ACE Study [1] and the human and financial impacts downstream have led us at the local level to experiment with ways to invest upstream to prevent ACEs, particularly child abuse and neglect.

North Carolina is spending more than $2 billion annually on a preventable problem [2]. Our state and counties spend considerable time and money investing in interventions, treatments, programs, and services to address the downstream consequences, but without a comprehensive plan to actually prevent ACEs like abuse and neglect. Cumberland County has tackled this head on by creating a Community Child Abuse Prevention Plan (CCAPP). After nearly 2 years of organizing, meeting, goal-setting, and training, 22 local public and nonprofit agencies came together to present a plan that was unanimously and enthusiastically endorsed by the Board of County Commissioners on November 20, 2017.

The CCAPP was built by a local committee known as SOAR, which stands for Strengthen Families, Provide Optimal Child Development, And Reduce Child Abuse and Neglect. It was built around the principles of Sound Science, Strong Families, and Stronger Services. The CCAPP provides a guiding framework, an overview of child maltreatment as a public health concern, and opportunities for improving prevention efforts. Most important, as a living document, it provides a shared vision, strategic goals, and strategic objectives to guide prevention efforts in Cumberland County. Cumberland County's CCAPP is framed around 6 strategic areas: 1) build a nurturing community bringing coherence, sustainability, and consistently higher performance; 2) cultivate expanded prevention-focused partnerships to implement a shared vision, engage in shared action, and strengthen networks and partnerships; 3) focus on protective factors in families so that all children who live there will have the safe, stable, nurturing environments they deserve; 4) influence the community with a continuum of evidence-based or evidence-informed prevention strategies at the societal, community, family, and individual levels; 5) network with prevention partners in all sectors of the community to embrace the role they can play to strengthen families and keep children safe; and 6) act collectively to maximize the effectiveness of prevention efforts to ensure optimal child development, increased family strengths, a responsive service system, and a decrease in child abuse and neglect.

The CCAPP steers the efforts of prevention partners and will be used as a vehicle for promoting community dialogue, problem solving, and planning at the local level. With support from the Cumberland County Partnership for Children, the SOAR Team is using Pathways to Grade Level Reading indicators, like safety and family support, to evaluate their progress.

The CCAPP was made possible with leadership from 2 local nonprofit agencies, The Child Advocacy Center of Fayetteville and the Cumberland County Partnership for Children, with strong participation from county public health, social services, and public schools, along with police, military, pediatric, judicial, business, and faith community representation. Prevent Child Abuse North Carolina catalyzed the process by leading Community Cafés, training the planning team on the Strengthening Families Protective Factors, and providing guidance and support to the local SOAR Committee. Their planning reflects the African proverb, “It takes a village to raise a child.”

The CCAPP is really just the start. The real work begins as the community invests and implements awareness, programs, and services that go upstream to foster the safe, stable, nurturing relationships and environments that all children need to thrive. By focusing their lens on prevention rather than treatment 25 years from now, we hope Cumberland County and many more communities have fewer children in foster care, less family violence, less addiction, and safer communities. Other counties, including New Hanover (with the highest opioid overdose rate in the country), Halifax, and Buncombe have initiated local CCAPPs as well, with many others interested.

These local laboratories may follow similar processes but will surely create different solutions based on their community needs and strengths. By coming together based on evidence and science, communities can reduce ACEs and help children grow to be healthy, productive adults.

• ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.