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I haven't responded to this yet because I think this is such a difficult area. As you probably know, neglect can be a source of child death and can be extremely dangerous. Our Trust Fund does require all grantees to include an understanding of the five protective factors in their practice, and I think the home visiting programs we fund (a very small % of our state's home visiting) do this; some to a great degree. Neglect would be one of the main concerns of these programs, so in that sense we're doing something. We've also introduced the concepts to our HUGS program in our Health Department which serves many more at risk families, I don't know if it's truly integrated into their daily practice, it takes time.

The more severe neglect cases come to the attention of DCS and we have worked to embed SF in DCS, but it's slow. I think DCS really has made strides, both in their training and practice, but this is a feeling and I don't have measurable results to brag about.

In PA, we don't have any current efforts focused specifically on neglect issues. However, many of our local programs have agreements with their county child welfare agency for routine referrals to their programs when parents become involved with the child welfare system. The majority of these referrals involve low functioning and/or low income families who are doing the best that they can with their children, but have ended up in the child welfare system due to neglect issues. In many cases, our Family Center programs (funded by state child welfare) are the first line of help for these families. There is ongoing concern that these programs (who experienced funding cuts in this year's budget) are being called on to intervene with families without adequate financial resources. I don't have any numbers to share with you, but may be able to obtain additional information, if needed.

In Rhode Island the issue of chronic neglect is discussed but not overtly addressed in any special way. We talk about it, we address it through public awareness and education related to child supervision, child safety and discussion of parental roles related to raising children. The Dept. of Children, Youth and Families has been transforming its service delivery system to have much stronger wrap around services for families regardless of their legal status with the dept. We now have what is called Family Community Care Partnerships. Families that are referred to DCYF for suspected situations of child maltreatment may be referred to the FCCP for services. In those cases, child neglect is dealt with in a variety of ways. Prevent Child Abuse RI and Strengthening Families RI addresses neglect on a surface level through our Parenting Rules newsletter topics and in our professional development training when we talk about resources, family strengths and parenting and child development. But we are not doing anything that is specifically dealing with the topic of chronic neglect. Lack of resources is our primary reason, I think.

(contributed by Maggie Sprattmoran: maggie@leelanauchildrenscenter.com / MichiganMaggie Sprattmoran, Leelanau Children's Center (231) 357-2732):

While our local approach is not squarely focused on neglect, it is focused on universal family health in the broadest sense and the prevention of neglect is an outcome of promoting comprehensive family health. We program with a universal approach- one that honors the belief that all families seek to do their very best for their families and that all families may appreciate support or various kinds of assistance. This universal approach takes the "them and us", the "needy and the capable" dichotomous or polarizing views off the table, and we believe that it means that more families participate, rubbing shoulders with one another, welcoming new ideas, supports and sometimes even direct assistance or difficult conversation. This approach seems to invite more and deeper relationships- and creates the platform for meaningful relationship-based work, which feels like the only way to deal with neglect, which is typically either due to lack of information, a different value about kids needs/rights, an overwhelmed household or a concrete needs issue? When our beloved Five Protective Factors are strong, neglect wanes.

Actually, we are working toward NOT having identified programs for those at risk of neglect or abuse or this or that-- but merging all of our family support/prevention efforts under the umbrella of a general family support program that has specialized supports embedded into it. A big task, but one well worth the conversation that ensues.

We talked about this universal and unstigmatizing approach in New Orleans. I suppose to some it feels like an expensive and indirect route to a conversation about neglect, but it's the most effective and humane strategy we have found.

(contributed by Jeanette B. Meyer, Project Coordinator, Strengthening Families Georgia - 678-524-6141 (mobile))

Here in Georgia, it is hard to tease out work to prevent/address neglect from general child maltreatment. Prevent Child Abuse (PCA) Georgia has done some neglect-specific work by presenting a very well attended webinar statewide and making neglect the main topic of education and discussion at our past two annual meetings of our chartered councils(local chapters of PCA Georgia that usually cover one or a few counties). The direct service program that addresses neglect in terms of the underlying conditions is First Steps. Initial contact is made with mothers in the hospital and then follow-up contact is made, usually by phone, multiple times in the first three months. Here are a few of the program outcomes that address neglect:

Referrals to community resources
Babies linked to a medical provider
Parents are given a parent packet which includes written information on the following topics:
· SIDS
· Shaken Baby Syndrome
· Importance of fatherhood
· Infant brain development
· Postpartum care
· Child development
· Infant crying
· Child and home safety
· Parent and infant health and wellness
· Family relationships
· Selecting caregivers

Content of followup contacts focus on at least one of the following topics:
· Parenting practices
· Parenting support
· Parent and infant health and wellness
· Child development
· Child and home safety
· Family relationships
· Selecting caregivers

In Idaho we became especially concerned about neglect after seeing the results of the NIS-4 that showed substantial movement on physical and sexual abuse--areas that people have focused their attention on--and virtually no movement on neglect. Still we are just taking the first actions to see what we can build in our network. First, we are having three speakers do workshops at our Strengthening Families Training Institute. Our Colleague Chris Jamieson with the trust fund in Washington and a partner of theirs will be presenting on Post Partum Depression and their Speak up When You're Down campaign. We are also having Dee Wilson from Casey Family Programs in Washington speak on negelct and poverty. I hope these will be a catalyst for some new thinking on the subject. Second, in the wake of a pretty horrific neglect case in north Idaho, we are organizing a community meeting in Coeur d'Alene to develop a community strategy to address future child abuse or negelct issues. We will work with people around the protective factors based on a developing model of a Strengthening Families community.

This question is a timely one for me. Currently, we do not have any special initiatives addressing neglect although 73% of our substantiated reports of harm are for neglect. That being said, I am involved in several small projects being developed that could have potential in this area. Substance abuse is a huge issue for us in Alaska, which of course, is related to neglect.