By Beth Lawrence
AWAKE Child Advocacy Center hopes it has found the solution to a problem faced by similar organizations statewide, thanks to a partnership with other local advocacy centers.
AWAKE, KARE of Haywood County and Kid’s Place of Macon County have teamed up to create the Child Medical Collaborative to provide medical services to their young clients.
The agencies work with survivors of physical and sexual abuse.
When abuse is reported, advocacy centers conduct forensic interviews with the child and gather evidence to possibly build a legal case against alleged abusers. They also provide support and counseling to clients and their families.
As a result of the situation, these children often need medical exams, and having exams done onsite is best for the child and the work advocates do.
“It’s very important if we can get the forensic interview to be part A and the child medical evaluation to be part B of these services; then, that makes a really strong opportunity for the medical provider and hopefully the forensic interviewer to be able to testify on the stand if it ever goes to court,” said Renee Coward, executive director of AWAKE.
Having medical exams conducted in the same place is less taxing for the child.
“In the old days, that child would have to go to the guidance counselor, to the principal’s office, to the sheriff’s office, to the Department of Social Services, then to a medical doctor,” Coward said. “So, they were having to often go to places that are really scary. (Sometimes) an abuser would say, ‘If you tell, you’re going to go to jail.’ Then they show up at the sheriff’s department so what’s the child going to say? ‘Oh my God, I’m going to jail.’ There are so many subtle things (authorities) didn’t realize we were doing to children back then when we weren’t looking at being a victim’s advocate for children.”
Advocacy centers are designed to make children feel safe so they feel free to share what has happened.
Last year AWAKE conducted 207 forensic interviews; of those 69 children required a medical exam. KARE served 224 children; only 42 of those were able to receive medical evaluations at the center, 10 were required to go to Mission Hospital or another advocacy center for forensic and medical interviews.
The nature of these exams often leads to high turnover among medical staff.
“Having a specialized medical team available to small rural counties is an incredible asset,” Coward said. “In my past six and a half years of serving as AWAKE executive director, I have worked with six different medical providers. It is extremely difficult to find, train and retain qualified medical providers … Having a team of providers will give us the security of knowing that no matter how late the call comes in the middle of the night, we will be able to ensure all potential victims of child abuse get immediate medical assessments.”
Doctors and practitioners burn out because examining abuse victims on a regular basis can be distressing.
“It’s very traumatic work,” board Member Heather Baker said. “They don’t have anybody to share their stories and their experiences with.”
Additionally, doctors working with these centers are often required to take time away from their practices, and in small towns they are often the only doctors performing such services.
Advocacy groups in small towns typically cannot afford a full-time medical staff.
The solution was to create a network of providers who could help all agencies and alleviate the burden on providers, agencies and children.
“We saw all the other centers having the same issues with needing medical help, so we kind of said ‘Why don’t we just all come together and form this Child Medical Collaborative?’” Baker said.
The project commenced in summer 2020. Dogwood Health Trust awarded the group a $150,000 planning grant in Dec. 2020. The collaborative received 501c3 status in February and contracts with medical providers were signed.
The three agencies created a team of medical professionals with expertise in the areas of child abuse and trauma. The team includes a pediatrician, a nurse practitioner, a physician’s assistant and a part-time provider. The team will be available to all three agencies.
Having an established team could have an added benefit.
“We believe knowledge about the services of Child Medical Collaborative will attract other medical providers to this essential career and serve as a means to inform candidates in nursing schools about potential careers as nurse practitioners in this field,” Coward said.
The group is working on funding to support salaries of providers and establish Medicaid reimbursement so the agencies do not have to use their operational funds to finance exams.
The effort has caught the eye of the state. Child Advocacy Center North Carolina, the state’s advocacy agency, is following the project. They have met with the collaborative hoping to bring the model statewide.