Kathy J. Weinman Childrens Advocacy Center

Annual Report (fiscal year 2006-2007)

Annual Report FY 2006-2007 PDF

CASGSL Winter 2007 Newsletter PDF

 

CHILDREN’S ADVOCACY SERVICES OF GREATER ST. LOUIS

ANNUAL REPORT

AY 2006-2007

AGENCY OVERVIEW

Children’s Advocacy Services of Greater St. Louis is a non-profit agency which serves the St. Louis community as the nationally accredited Child Advocacy Center for the metropolitan area.  Established in 1995 as the Children’s Advocacy Center of St. Louis for the purpose of conducting forensic interviews in St. Louis City and County, the Center merged with the Kathy J. Weinman Child Advocacy Center on the campus of University of Missouri - St. Louis in 1997 to become Children’s Advocacy Services of Greater St. Louis (CASGSL).  Following the merger, CASGSL began offering affordable trauma informed counseling to victims of childhood sexual abuse.  In October 2005, the agency expanded its forensic interviewing and counseling operations and began providing services to child victims of physical abuse, severe neglect, traumatic bereavement, domestic  violence, community violence and other forms of trauma such as natural disasters and accidents.   

The Mission of Children’s Advocacy Services of Greater St. Louis is to reduce the effects of trauma experienced by children and adolescents through: trauma informed assessment and counseling, child-sensitive forensic interviews and medical exams, consistent victim advocacy, utilization based research, quality undergraduate and graduate training, responsive community outreach, and relevant advocacy to influence public policy.  The agency’s Vision is that communities will respond to families impacted by childhood trauma in a prompt, coordinated manner that ensures physical and psychological safety, promotes justice and supports recovery.  The Center’s instructional, research and service activities advance the region’s awareness, knowledge, understanding and applications of Best Practices in the field of Child Maltreatment and Child Trauma.  The Center is committed to Core Values which emphasize promotion of the Child First doctrine that places the best interest of the child above all else; professional and scientific integrity that ensures the high quality clinical and forensic services; and synergy that promotes interdisciplinary collaboration which empowers children and families.
As a unit of the Psychology Department, CASGSL provides a number of undergraduate and graduate training opportunities for students at University of Missouri - St. Louis and other area universities. Likewise, In addition to service to the community and clinical training, CASGSL maintains an ongoing research database of its clients to be used in utilization based program evaluation and graduate student thesis and dissertation projects. 

 

 

2006-2007 HIGHLIGHTS

  • In response to recommendations made during the Five Year Academic Program Review, CASGSL has welcomed several new staff members to round out the agency’s administrative infrastructure.  Positions filled through recruitment or promotion include: Manager of Clinical Services,  Manager of Clinical Operations, Senior Accounting Clerk and Communications Specialist.  Successful searches for a Manager of Forensic Services and Outreach Specialist were recently concluded.

  

  • CASGSL significantly increased its capacity for clinical appointments by scheduling counseling services at the West Pine office for the first time in agency history.  Five part-time therapists joined the forensic staff in the building and offer evening and Saturday appointments for individual and group counseling services. 
  • In order to accommodate the increased need for clinical services, renovations were made to the physical plant at both the Weinman and West Pine buildings to install one way mirrors and audio-visual equipment which allow for observation of sessions.  

 

  • CASGSL was selected as one of six agencies from across the country to participate in a Learning Collaborative sponsored by the National Child Traumatic Stress Network to learn and implement a promising new evidence based group treatment for traumatized youth.  A team of five CASGSL therapists and supervisors traveled to New York City for three collaborative sessions to deliver SPARCS (Structured Psychotherapy for Adolescents Responding to Chronic Stress).  The SPARCS team successfully conducted three cycles of SPARCS groups at the agency sites.
  • CASGSL staff successfully presented the 9th Child Trauma Symposium which featured distinguished speakers from the United States and Canada who hosted workshops on forensic and clinical child trauma topics.  The Symposium was held on the UM-St. Louis campus and was attended by over 200 individuals.

 

  • CASGSL initiated and maintained collaborative relationships with St. Louis Metropolitan Police Department, St. Louis County Police Department, St. Louis City Family Court,  St. Louis City and County Children’s Division, Urban League of St. Louis Head Start Programs, Father’s Support Center, BJC Behavioral Health, Bridgeway Counseling, and Grace Hill Settlement House Head Start. 
  • CASGSL Staff updated hundreds of client accounts in the agency’s database in order to accurately submit insurance claims and bill clients 

 

  • CASGSL’s Communication Specialist  worked with the University’s IT department to revamp the agency’s website (www.stlouiscac.org) to fit within UM-St. Louis’ website infrastructure.  The website features programming summaries, staff biographies, location maps, and child safety tips.  The site boasts user friendly links to request training presentations, access information about training and volunteer opportunities and make online donations.
  • Efforts to reinvigorate the Development Advisory Board and charge it with the mission of raising funds for the Center culminated in the 1st Annual Keep Kids Safe and Families Strong walk in Forest Park to kick off Blue Ribbon month activities to commemorate Child Abuse Prevention month in April.  The walk raised over $10,000 for agency programming.
  • CASGSL entered into a collaborative relationship with Evangelical Children’s Home and Washington University School of Social Work to mount a demonstration pilot research study exploring the implementation of a trauma informed intervention in a residential care setting. 

 

 

EXTERNAL FUNDING OVERVIEW

During FY 2006-2007 CASGSL secured $ 678,933 in external funding.  Grant dollars were appropriated as follows:

St. Louis Mental Health Board         $138,280       Trauma informed counseling for                                                                                                      caregivers and children in St. Louis City

St. Louis Mental Health Board         $155,459       Counseling for complex trauma victims                                                                                          with serious emotional disturbance for                                                                                           St. Louis City residents

Missouri Dept of Social Service     $241,320       Forensic interviewing services

Missouri Dept of Public Safety        $ 53,093         Group therapy for child victims of crime

Missouri Dept of Public Safety        $ 40,666         Victim advocacy services

Missouri Dept Health/Sr Service     $    6,615        Sexual assault victims services

Missouri Dept Health/Sr Service     $  21,000        Sexual assault prevention services

National Children’s Alliance $ 10,000         Forensic program support

Norman J. Stupp Foundation           $   7,500         Follow-up research project

Boeing Community Fund                 $   5,000         Counseling scholarships

 

 

PROFESSIONAL SERVICES OVERVIEW

For the second year in a row, CASGSL has increased its overall capacity of individual client service units by over 25% .  The graph below illustrates recent growth in forensic interviews and sessions of individual and family counseling.  Group therapy sessions are not included in this graph.  

Forensic Services
     
During FY 2006-2007, CASGSL staff completed 322 forensic interviews to assist local law enforcement and child protection services investigations of child abuse and neglect.  Approximately 90% of the forensic interviews conducted involved allegations of sexual abuse with the remaining 10% focusing on allegations of physical abuse or witnessing violent crimes.  A number of investigations from FY 07 continue to work their way through the system but data from 2005 indicate that approximately 51% of the adult cases we interview result in formal charges being filed.  In 2005, investigations assisted by CASGSL forensic interviews resulted in 295 charges being filed against adult suspects. 

Demographic data from forensic interviews indicate that African American children are disproportionately overrepresented when compared to the overall number of children CASGSL interviews regarding their allegations sexual abuse.   Data trends indicate that the average age of victims being interviewed at CASGSL is younger than in previous years.  As in years past, the vast majority of alleged perpetrators are known to the child with particularly large percentages falling in the categories of step parent or paramour. 

 

Counseling Services
During FY 2006-2007, over 200 children, adolescents and their caregivers received individual and/or family counseling services at CASGSL.   A total of 2,449 client episodes of care were provided which represents a 28.8% increase in capacity from the year before.  CASGSL has responded to additional demand for services by increasing operational hours in the evenings and Saturdays, offering services at the West Pine location and hiring additional therapists.  Despite these efforts, the number of children on the waiting list for individual counseling services hovers between 30-45.

In addition to the families served through individual counseling sessions, over 100 children and 90 caregivers received group counseling services through CASGSL’s three group treatment programs (e.g. FLARES-Families Learning About REcovery Strategies, SPARCS- Structured Psychotherapy for Adolescents Responding to Chronic Stress, CSBP- Children with Sexual Behavior Problems) which address various trauma related issues.    

Demographic data indicate that African American children are overrepresented in the CASGSL client population with over two thirds of child clients falling in that category.  Although recent years have seen an increase in the number of male victims seeking treatment, the bulk of the child victims treated at CASGSL are girls.  The average age of child clients has lowered during the last year with more children in the preschool age group seeking services. Socio-economic indicators show that over 60% of the families seeking services at CASGSL fall below the federal poverty line and have annual household incomes of less than $20,000.  Income at this level means that most uninsured families fall at the lower end of CASGSL’s sliding fee scale which goes down to $5.00/ hour, markedly below the typical private practice charge of $90-$110 per hour.   Assessment information indicates that the vast majority of children treated at CASGSL have been exposed to multiple, chronic or sequential episodes of trauma. 

TRAINING AND INSTRUCTION OVERVIEW

CASGSL offers a number of graduate and undergraduate training experiences for students wishing to learn about child maltreatment and trauma.  Undergraduate opportunities include research assistantships and administrative/ Intake assistance.  In FY 2007, CASGSL funds supported one Graduate Research Assistantship and two Clinical Clerkship placements for advanced doctoral students in the Clinical Psychology program.  These positions allowed these capable graduate students to supervise research operations, co-facilitate groups and learn a variety of evidence based trauma informed treatment modalities such as Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Integrated Treatment for Complex Trauma (ITCT), Parent Child Interaction Therapy (PCIT), Trauma Informed Play Therapy, and group treatments for caregivers and children with sexual abuse histories (FLARES) , sexual behavior problems (CSBP) and chronic stress (SPARCS).   In addition to paid positions, CASGSL staff supervised seven unpaid practicum experiences for undergraduate and graduate students including clinical and forensic internships, experiences for intake clinicians, group facilitators and research assistants.  CASGSL practicum students hailed from Social Work, Counseling, and Criminal Justice programs from UM-St. Louis and other area universities.
In addition to formal training opportunities for students, CASGSL staff provided community based training for over 300 professionals  through our Community Education programming that presents trauma related topics through CASGSL’s monthly Child Trauma Colloquium series and workplace seminars arranged upon request. 

SCHOLARSHIP OVERVIEW

CASGSL supports scholarly efforts of faculty, staff and students.  Below are listed papers, posters, and presentations  accepted in FY 2006-2007.
 
Faculty/Staff Papers, Posters and Presentations

      Drewry, K. and Schmitt, A.  PRIDE in Parenting: Parent- Child Interaction Therapy.  March 13, 2007,  Missouri Children’s Trust Fund Be Aware Now conference,  Jefferson City, MO.

      Dunn, J. (2007).  Adding insult to injury: The Plight of Mothers Coping with Domestic Violence.  A review of Radford and Hester (2006) Mothering Through Domestic Violence .  PsychCritiques 

      Dunn, J. (2007).  First Do No More Harm: How Evidenced Based Interventions Reduce the Impact of Trauma. March 14, 2007, Missouri Children’s Trust Fund Be Aware Now conference,  Jefferson City, MO.

      Kliethermes, M., Bruce, S., Haynes, S., Burr-Harris,A & the principal investigators and program directors of the National Child Traumatic Stress Network (2006).  The National Child Traumatic Stress Network (NCTSN): Baseline Demographic and Clinical Characteristics. Poster presented at the International Society for Traumatic Stress Studies (ISTSS) 22nd Annual Meeting, November,2006.

      Wamser,R. & Kliethermes, M.  Factors in premature termination of child trauma-focused treatment.  Poster presented at the International Society for Traumatic Stress Studies (ISTSS) 22nd Annual Meeting, November,2006.

 

Student Papers, Posters and Presentations

      Broome, M.  Varied expression of PTSD symptoms in children related to developmental, biological, and child sexual abuse characteristics and how best to measure PTSD in children.  Specialty Paper.    2006

      Kliethermes, M., Bruce, S., Haynes, S., Burr-Harris,A & the principal investigators and program directors of the National Child Traumatic Stress Network (2006).  The National Child Traumatic Stress Network (NCTSN): Baseline Demographic and Clinical Characteristics. Poster presented at the International Society for Traumatic Stress Studies (ISTSS) 22nd Annual Meeting, November,2006.

      Schact, M.M.  The Impact of Sexual Abuse and How Children Cope:  Different Perspectives from Caretakers and Children.  Dissertation.  2006.

      Springman, R. & Wherry, J.(2006).  The effects of interviewer race and child race on sexual abuse disclosures in forensic interviews.  Journal of Child Sexual Abuse, 15,  (3), 99-116. 
     
      Wamser,R. & Kliethermes, M.  Factors in premature termination of child trauma-focused treatment.  Poster presented at the International Society for Traumatic Stress Studies (ISTSS) 22nd Annual Meeting, November,2006.

 

FINANCIAL OVERVIEW

Revenues and Expenses

Total revenues for CASGSL in FY07 were $ 1,258,110.  Total expenses were $947,640.
CASGSL ended FY 2006-2007 with a surplus of $310, 470.  This surplus represents significant progress toward the agency’s goal of putting enough funds in reserve to cover six months of operating expenses (i.e. approximately $500,000).  Building and maintaining a secure reserve fund will ensure that CASGSL will avoid the fiscal vulnerability that necessitated significant staff lay offs and disruption of client care following the loss of SAMHSA funding in September 2005.      

Significant funding sources include $ 678,933.00 in external funding secured through successful grant applications, $275, 338.00 in Rate funding through the University,
$30,262.00 in individual, foundation and corporate donations (which includes approximately $10,000.00 in proceeds from the Keep Kids Safe Walk) and $ 22,066.00 in fees collected from clients and insurance claims.

Salaries and benefits in the amount of $ 755,510 represent the bulk (79%) of CASGSL expenses.    CASGSL supports the salaries and benefits of fifteen full time positions including the Executive Director, the Manager of Clinical Services, the Manager of Clinical Operations, two Forensic Interviewers, two therapists, the Victim Advocate, the Outreach Specialist, the Communication Specialist, the Administrative Assistant, the Sr. Accounting Clerk and two front desk receptionists.  Additionally, CASGSL covers the salaries and benefits of fifteen part time and student employee including seven part time therapists, three graduate student employees, and four evening and Saturday receptionists.  Additionally, in FY07 CASGSL paid portions of the salaries of Departmental chair, Robert Calsyn, Departmental Administrative Assistant, Melinda Bowen and Community Psychological Service Director, Robert Harris, all of whom provided consultation and support through FY07.

Operating expenses of 20% include Building Maintenance, Utility and Computing Expenses, Professional services of the contracted medical staff, Supplies for programming and general office supplies,  as well as Staff Development and travel expenses.  Less than 1% of the CASGSL budget was used for funding efforts during FY 07. 

FY 2007-2008 Goals

  • Enhance collaborations with Criminal Justice, Social Work and Counseling programs to expand research opportunities and student training experiences.
  • Secure faculty appointments of Assistant Clinical Professor for qualified staff members to enable them to teach courses and work with graduate student research committees.
  • Consider the fiscal viability of mounting an academic search for a Research Director for the Center who would help secure external funding for child trauma research.
  • Improve fiscal sustainability by enrolling qualified therapists on insurance panels.
  • Revise the CASGSL Policy and Procedure manual and implement actions to ensure HIPPA compliance.
  • Raise funds to replace the carpeting and worn furniture and update décor at both sites. 
  • Develop a plan to more systematically seek funding through foundations and philanthropic organizations.
  • Recruit 5-10 additional candidates to serve on the Developmental Advisory Board to assist with fundraising efforts for the Center.
  • Explore the feasibility of initiating certification programs to recognize specialized training for Child Advocacy and/or Child and Adolescent Trauma Studies
  • Develop and implement Quality Assurance practices to improve client services including exploring options for electronic record keeping for client files.

 

BUDGET - FY 2007-2008

In 2007-2008, CASGSL will continue to build capacity, seek higher reimbursement rates for clinical services from insurance panels, actively seek donations from individuals and foundations and implement systematic billing and collection procedures to increase revenues.   Anticipated additional expenses include covering the salary and benefits of the Manager of Forensic Services, Senior Accounting Clerk and additional Therapists to handle the caseload generated by capacity building efforts.  Anticipated operational expenses include costs associated with carpet replacement at both buildings (approximately $80,000 to $100,000) and installing additional video equipment in therapy rooms (approximately $10,000).  Anticipated staff development costs include travel and lodging costs associated with staff members participation in two Learning Collaboratives sponsored by the National Child Traumatic Stress Network (approximately $25,000).