Children’s Division

Improvements at the Child Abuse and Neglect Hotline

The Child Abuse and Neglect (CA/N) Hotline was established in 1975 and operates under the authority of RSMo 210. Among other things, that statute specifically charges the Children’s Division (CD) with the responsibility of operating a single, statewide toll-free telephone number at all times for receiving reports of child abuse and neglect. Since August 15, 1975, the CA/N Hotline has been accepting calls 24 hours a day, 7 days a week, and currently accepts over 105,000 calls per year. The hotline is staffed by Children’s Service Workers who interview reporters, classify and prioritize calls to assure child safety, and then refer concerns of abuse and neglect to the Children’s Division field office where the child is located.

In addition to accepting CA/N reports specified in statute that require investigation or assessment, the hotline also accepts other non child abuse/neglect calls for field referral in an effort by the Division to assist families in need or in crisis. The remaining calls that do not meet either report or referral criteria (after thorough screening) are documented and retained for one year.

Calls are classified as CA/N reports when they meet the following statutory requirements for investigation or assessment:

• Allegation of abuse or neglect to a child victim as defined in RSMo 210.110:
  • Abuse is any physical injury, sexual abuse, or emotional abuse inflicted on a child other than by accidental means by those responsible for the child’s care, custody, and control except that discipline including spanking, administered in a reasonable manner, shall not be construed to be abuse.
  • Neglect is the failure to provide, by those responsible for the care, custody, and control of the child, the proper or necessary support, education as required by law, nutrition or medical, surgical, or any other care necessary for the child’s well-being.
• The child victim must be under age 18 at the time of the call;
• The abuse/neglect must have been inflicted or caused by a person exercising care, custody, and control (parent, adult relative, teacher, day care provider, etc.) over the child; and
• Sufficient identifying information (names, addresses, etc.) to locate the family to begin an investigation or assessment.

Calls are classified as non CA/N referrals in the following categories:

• Preventive Service Referrals-Effective July 1, 2010, these referrals are calls of concern about a child who is in CD custody, a child who is receiving CD services, or a child who may need placement (or an intervention to resolve the need for placement) when no child abuse or neglect is reported.
• Newborn Crisis Assessments-These referrals are situations in which a newborn, up to the age of one year, is being referred by a medical professional. There are two types: Drug-Involved Newborn Assessments when there are signs and symptoms of drug/alcohol involvement in the newborn at birth, or a positive drug screen performed on either the mother or newborn at birth; or Non Drug-Involved Newborn Assessments with allegations of concern for the well-being of a child under one year old immediately after being seen by a medical professional and when the concern does not rise to the level of a CA/N report.
• Non-Caretaker Referrals-These referrals are situations in which a child has been physically or sexually abused by a non-caretaker juvenile or adult. CD refers these calls to law enforcement or the juvenile office, but may also provide services.
• Non-CA/N Fatality Referrals-These referrals are calls reporting child fatalities but no child abuse or neglect is alleged.
• Administrative Referrals-These referrals are after-hours requests of an urgent nature to speak with a Children’s Division on-call worker regarding case management issues of children in CD custody, an in-progress investigation, etc.

Finally, the calls that do not meet the above criteria for a CA/N Report or Referral are classified as Documented calls. Hotline staff refers callers with these concerns to other appropriate resources. The following are some examples of Documented calls:

• the child is 18 or older and not in Children’s Division custody;
• the child/family cannot be located because of insufficient information;
• all subjects given in the call reside and are located out of state and the reporter is not a Missouri mandated reporter;
• there is no allegation that meets the definition of child abuse or neglect.

View a graphical summary of:

• Child Abuse Neglect Hotline Calls in State Fiscal Year 2011 (PDF)
• Child Abuse Neglect Hotline Calls in State Fiscal Year 2010 (PDF)
• Child Abuse Neglect Hotline Calls in State Fiscal Year 2009 (PDF)
• Child Abuse Neglect Hotline Calls in State Fiscal Year 2008 (PDF)
• Child Abuse Neglect Hotline Calls in State Fiscal Year 2007 (PDF)
• Child Abuse Neglect Hotline Calls in State Fiscal Year 2006 (PDF)
• Child Abuse Neglect Hotline Calls in State Fiscal Year 2005 (PDF)
• Child Abuse Neglect Hotline Calls in State Fiscal Year 2004 (PDF)
  

Protocol

In December 2003, a new Protocol intake screening tool was implemented to assist hotline staff in achieving greater consistency in the acceptance, prioritization, and classification of calls. The Protocol tool is based on structured-decision-making principles and uses decision trees for making key decisions to assess child safety and establish response times for the child to be seen. The Protocol tool utilizes a standard interview beginning with Entry questions, followed by a set of Key Questions for 30 maltreatment concerns (called Pathways), and ending with a Closing procedure that is specific to the classification of the call. This interviewing tool assists hotline staff in directing the interview so that pertinent information about a child is not missed and is gathered in a timely manner. The Protocol screening tool was developed to assure a thorough and professional assessment of all of the reporter’s child abuse or neglect concerns. The Protocol tool was automated in June 2005, allowing hotline workers to data enter information during the hotline call. The Protocol automation was developed to meet SACWIS (State Automated Child Welfare Information System) standards.

Call Management System

A new Call Management System was introduced at the Hotline during 2004. The Call Management System (CMS) was implemented in response to excessive busy signals given at the hotline during unpredictable periods of high incoming call volume. The previous hotline telephone system did not make use of queuing (placing callers on hold) nor did it provide any real-time call data. Call data reports were not available to supervisors until the following month. The CMS technology was selected for optimum call management and was implemented in stages during March through June of 2004. The first stage allowed for queuing of calls (with emergency calls placed at the front of the queue) and provided some basic real-time call data that improved customer service. Hotline staff could view the number of staff signed on, logon status, priority level of calls, number of callers in queue, and the number of seconds the longest call was holding in queue. CMS implementation was completed in June 2004 with the installation of the CMS server, providing additional real-time data for supervisors along with updated reports every thirty minutes. The CMS allows supervisors to manage calls by changing queue settings and sending alert signals to workers. Supervisors have access to specialized management reports that are available at 30-minute intervals for future planning. Hotline workers are provided with on-screen status displays and alerts via their desktop computer.

The implementation of the CMS resulted in remarkable improvement in responsiveness. Previously, the hotline answered on average less than 50% of calls offered and gave several thousand busy signals each month. During the first stage of CMS implementation in May 2004, the calls answered increased to 90%. By June 2004, the month of full implementation, the hotline answered 96% of calls offered and gave only 157 busy signals compared to 8,838 busy signals in June 2003. By July 2004, the hotline answered 97% of calls offered and gave only 92 busy signals compared to 12,196 in July 2003. In State Fiscal Year 2005, the hotline answered an average of 94% of calls offered and gave an average of 156 busy signals per month.

The hotline has continued to maintain a very high level of customer service. From July 2004 through June 2010, the hotline continued to answer an average of 94% of calls offered and gave an average of 214 busy signals per month.

• View a graph comparing activity pertaining to the number of hotline calls before and after implementation of the Call Management System (PDF).