Issue 26 | September 2023

Western Regional Children’s Advocacy Center (WRCAC) works throughout the west to provide training and technical assistance which strengthens a trauma-informed, coordinated community response and promotes the National Standards of Accreditation for Children’s Advocacy Centers (CACs). In 2023, the National Children’s Alliance’s (NCA’s) revised accreditation standards went into effect. The standards, which were first put into place over twenty years ago and have been updated approximately every five years, help guide the work of CACs nationwide. The ten standards help ensure that children who experience abuse have high-quality, evidence-based services available to them when they enter the doors of the over 750 accredited CACs in the country to begin the healing process. 

As mentioned in a recent edition of the WRCAC Roundup, there is a greater focus on the role of the MDT Facilitator in the updated standards. However, the 2023 standards include several other new elements that are important to plan for as CACs prepare to go through the accreditation process. The list below is not meant to be an all-inclusive list, but rather, are key areas a CAC may want to focus on as they work to be compliant with all the standards. Essentially, we have “rounded up” some resources that may be helpful for you as you prepare for your CAC’s accreditation journey. For a more comprehensive overview of the changes, please click here.

NCA has two publications to help CACs understand the intent of all ten standards and ideas for implementation of these standards. The red book (National Standards of Accreditation for Children's Advocacy Centers - 2023 Edition) and blue book (Putting Standards Into Practice: A Guide for Implementing the 2023 National Standards of Accreditation for Children’s Advocacy Centers- 2023 Edition) as they are often called are incredibly helpful as you go through the application process. There is also a green book (National Optional Standards for Accreditation for Children's Advocacy Centers - 2023 Edition) that provides information on the optional standards NCA has included for the first time ever. NCA has also provided a checklist to help CACs track documents that are needed as part of the application process.

In this Roundup, we will be covering the first five standards. We will release another Roundup in the coming weeks that covers standards six through ten. 

For the first time in accreditation history, there is a training requirement for MDT Facilitators/Coordinators. Each CAC is required to have an MDT Facilitator /Coordinator of the MDT who facilitates information sharing between team members and coordinates the team. The Regional Children’s Advocacy Centers define this role as the individual who tends to the relationships, communication and accountability of the MDT while fostering an inclusive environment to improve outcomes for children and families impacted by abuse. This may or may not be the same person who runs or facilitates case review. If the MDT Coordinator/Facilitator is an employee of a CAC, that person must meet the required eight hours of foundational training plus ongoing training requirements of eight hours every two years. If the MDT Facilitator/Coordinator is not a CAC staff member, this training requirement does not apply. Regardless of which agency employs this role, the training is highly recommended for all MDT Facilitators/Coordinators. In most instances, a CAC has a designated staff member who focuses on team coordination even if this person does not manage case review meetings. For information on ways to meet this training requirement, the RCACs have put together an MDT Facilitator Training Guide. NCA also provides a list of topics that may be appropriate for training in their red book.

Another new requirement under this standard is that the CAC must have a formal onboarding or orientation process for new MDT members. This is to provide them with important information about the policies and procedures of the MDT or protocol and the code of conduct. Our collaborative partners at the Northeast Regional Children’s Advocacy Center (NRCAC) have developed a guide to create an onboarding manual if that is something that may be helpful. As we shared in a previous Roundup, onboarding is an essential element to creating an effective MDT. Having a code of conduct for the MDT is another new requirement for this edition of the standards.

The biggest change in this standard is that the MDT is now required to be involved in the development of the community assessment required as part of this standard. How the MDT is involved is up to the CAC, but the CAC must be able to demonstrate that the MDT was involved in some way. This could be through surveys, having them be part of a committee that creates and reviews the plan and numerous other ways. A community assessment template is available through NRCAC.

Under this standard, CAC staff are required to have eight hours of DEI training every two years. DEI training must also be offered to the MDT. CACs are required to provide documentation demonstrating that training was offered, but do not need to provide training certificates for MDT partners, only staff. The standard does not require training on specific topics other than they be related to diversity, equity and access. NCA has made free training available online to help CACs meet this requirement.

This standard has stayed relatively the same except for some updates regarding live observation and tele-forensic interviews. However, it is important to note that in Essential Component C there is a list of requirements that the CAC’s Forensic Interview (FI) Protocol must include. Comparing this list to what is in your CACs protocol early on can help make sure that updates are completed if needed before submitting an application. Essential Component F, which states that 75% of cases that meet the CAC’s case acceptance criteria must receive a forensic interview at the CAC or through a secure tele-forensic method, continues to be challenging for some CACs. Remember that this is based on your CAC’s case acceptance criteria and not set by NCA. NCA has posted a sample document to help you track this on NCA Engage. By tracking this percentage over time and reviewing and/or updating your case selection criteria well before your application is due, you will be better prepared to meet this requirement.

The updates to this standard include some additional training requirements for advocates. For those who completed Victim Advocacy training a few years ago or more, it is likely that they will need training on the new requirements which include cultural responsiveness and addressing implicit bias in service delivery, caregiver resilience and domestic violence/family violence/children’s exposure to domestic violence and poly-victimization  For information on ways to meet this training requirement, please see the Resources for Meeting the Victim Support and Advocacy Standard guide put together by the RCACs. In addition, NCA created a self-assessment for help in documenting compliance with the advocacy standard.  

The biggest change in the medical standard is that now 100% of medical exams that are abnormal or show evidence of abuse must receive an expert review. If you have a medical provider who needs a resource for expert review, the National Children’s Alliance has endorsed a program called myCasereview through the Midwest Regional Medical Academy as a way to meet this requirement. The myCasereview program allows medical providers to get timely review of forensic medical exams with abnormal or findings indicative for sexual abuse. For more information visit https://www.mrcac.org/medical-academy/mycasereview/.

Additionally, all medical records must be stored in a way that is HIPAA (Health Insurance Portability and Accountability) compliant. 

If you are a CAC going through accreditation or reaccreditation and need some support, please reach out to your state chapter. If you have additional needs related to accreditation that the Chapter cannot support, please contact WRCAC or your regional CAC for more resources or support.

WRCAC is supported by cooperative agreement #15PJDP-22-GK-03062-JJVO awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice.

The opinions, findings, and conclusions or recommendations expressed in this product are those of the authors and do not necessarily reflect those of the Department of Justice.