Funding realities: Child abuse diagnostic evaluations in the health care setting

Objective: This study examines staffing, funding sources, reimbursement, an d financing of medically-oriented child protection teams. Method: A 16-item questionnaire on the composition, size, and services of t he team, program costs, revenue sources, reimbursement rates, and perceptio ns of funding stability was mailed to a sample of 118 medically-oriented ch ild protection teams. Results: After excluding 10 programs, an overall response rate of 68% was o btained. Teams varied in configuration, services, charges, and funding. Ove r 50% identified funding as being important, yet, demonstrated varying leve ls of awareness of budget and reimbursement issues. Many generally relied o n patient care reimbursement from health care and government payers. Some p rograms seemed to be doing well financially while others were struggling. A pproximately one-third of the respondents indicated that funding was unstab le. Conclusions: Many programs are innovatively knitting together patch-works o f funding and support to serve children and families in need. Team leaders should increase their knowledge of fiscal issues in order to be effective a dvocates at the institutional level for continued team support. A potential way of accomplishing this would be to utilize the existing structure of a national professional association and its national meeting to provide a for um for relatively successful programs to showcase their "ideal models" of t eam financing. (C) 1999 Elsevier Science Ltd.