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Issue 27 | September 2023

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Meeting NCA's 2023 National Standards of Accredtiation: Tips for CACs (Part 2)

In the last issue of the Western Regional Children’s Advocacy Center’s Roundup, we shared with you information that could be helpful in preparing your children’s advocacy center’s (CAC’s) accreditation application.


Before we dive into the second half of the standards, we wanted to share some information from the National Children’s Alliance based on the first group of CACs to apply for accreditation or reaccreditation under the new standards. During the first part of the year, nearly 73% of the CACs that applied for accreditation/reaccreditation were successful and 27% of the CACs that applied for accreditation/reaccreditation went into the pending status. Although the 27% number may seem high, the first part of the year did not see that many CACs go through the process. For those that went into pending status, the standard that proved to be the most challenging was the MDT standard with issues cited regarding protocols and how teams give feedback and how that feedback is formally reviewed. The second most common reason CACs went into pending status was the victim advocacy standard. Most cited here were issues with victim advocates not having the full range of training required and the ongoing training requirement.

Standard 6 - Mental Health

Under the new mental health standard, clinicians must monitor trauma symptom reduction while providing mental health services. For guidance on implementing evidence-based and evidenced informed assessments, NCA offers training through NCA Engage. Common assessments used at CACs include: The Trauma Symptom Checklist (TSCC), The Child PTSD Symptom Scale (CPSS 5 SR), and the Child and Adolescent Trauma Screen (CATS).


To meet this standard, the CAC’s protocol must indicate how the mental health provider will monitor and share the child and caregiver’s engagement and completion of treatment with team members. This could be accomplished by asking the caregiver to sign a release of information. Also, the new standards encourage including caregivers in the child’s treatment when appropriate by stating that “the CAC must provide services to caregivers when appropriate.” It would be helpful to describe this process in the MDT protocol as well. 

Standard 7 - Case Review and Coordination

The changes to this standard were minimal. NCA is requiring this time that CACs include in their protocol where MDT case review meetings will take place as well as the purpose of the MDT meetings. They also want to observe during case review discussions the team talking about the impact of the MDT process and MDT involvement on the family. Think about some questions that you can ask your team to help lead this discussion. For instance, you may want to ask, what has the family’s experience been like working with our team or what does the family need further from our team to make sure that they receive the services they need and can move forward? 

Standard 8 - Case Tracking

The case tracking standard had minimal changes in this revision of the standards. NCA only added that MDT members must have a way to access aggregate data that is gathered and tracked by the CAC. How the CAC makes this data available to team members when it is requested is up to the team, but the process to access data must be included in the team’s protocol. 

Standard 9 - Organizational Capacity

The organizational capacity standard saw the most updates of the ten standards. The 2023 revision clearly outlines several new policies and procedures that CACs must have in place in terms of operations of the CAC. The policy requirements fall into four categories of requirements including additions to personnel policies and procedures which include job descriptions for each position, anti-discrimination, conflict of interest, whistleblower, and social media policies. Additionally, a credit card usage policy is required to be part of the financial policies. NCA also wants to see extensive safety and security policies in place for CACs. Although these are not all new, the policies must include, for the first time, a code of conduct that is meant to guide behavior between staff, staff and team members and staff and team members and clients. This code of conduct is in addition to the requirement mentioned in standard one for the MDT code of conduct. Additionally, the CAC is required to have a policy that is focused on child protection including the requirement to report abuse as well as emergency response policies, building security and safety procedures, anti-violence in the workplace, weapons on premises, drug usage and smoke-free environment policies. Many of these may be already in place at a CAC, but this is an opportunity to make sure that there are formal, documented policies in place.


Additionally, for the first time, CACs are required to have cyber liability insurance coverage as part of this standard and all staff, volunteers, and board members must have a national criminal background check on top of sex offender registry and child abuse registry checks. The CAC must also decide with the board and MDT as to what previous offenses may be allowable or not.


One other change raised the requirement for an audit to those CACs with budgets of $750,000 or more. Those with budgets between $200,000 and $750,000 can now submit a CPA financial review.


If you need examples of policies, please reach out to your state chapter and fellow CACs. Some examples have also been posted on NCA Engage. Please remember that creating and approving policies takes time, so, give yourself enough time to make sure you have all these updates in place before your application is due. 

Standard 10 - Child Safety and Protection

In the child safety and protection standard, the code of conduct for MDT and staff members is mentioned yet again as one of the requirements. In this standard, there are clear requirements for the code of conduct including the following:


  • Child safety and well-being must prioritized and be named as a value of the CAC. This is something that needs to guide policies and practices of all aspects of the CAC.
  • There should be no contact with CAC clients and staff outside of providing services.
  • Any physical contact between staff, MDT members and clients must be consistent with the well-being and safety of the client and all interactions with clients should be interruptible and observable.
  • All staff members are required to report any suspected child abuse.


To that matter, this standard also now requires that staff and volunteers not only be trained in mandated reporter laws, but now, any updates to these laws must be provided to staff, board members and volunteers annually if there are any changes. Standard 10 also clearly states for the first time that there must be separate, confidential spaces for case consultation, client meetings, etc.


One of the other updates to this standard addresses the fact that some CACs are now providing services to children or youth with sexual behavior problems. If your CAC is one of these centers, you must develop appropriate safety procedures to ensure that other children are kept safe just as you would have to have if you provided any kind of services to adult offenders on-site.


Another requirement under this standard is that CACs are required to do an annual safety assessment of their facility to make sure that it is safe and appropriate for children. This is something that needs to be documented. Some CACs have developed a safety checklist that they use to conduct this review annually. NCA members can see examples that have been shared on NCA Engage. If you are going through accreditation/re-accreditation, we urge you to use NCA Engage to connect with other CACs throughout the county to see how they are meeting these new and ongoing requirements. 

As mentioned in the last WRCAC Roundup, your state chapter can be helpful as you go through this process. NCA also has several trainings available online. If you cannot find the resources you need through your chapter or NCA Engage, please contact WRCAC or your appropriate regional CAC. NCA accreditation can be a daunting process, but it does not have to be. There are plenty of resources available to support you through the process. 

Joyce Prusak

Training Specialist

Western Regional Children's Advocacy Center

[email protected]

Joyce Prusak is a Training Specialist with Western Regional Children’s Advocacy Center (WRCAC). In this role, Joyce provides training and technical assistance focused on multidisciplinary teams (MDTs) and other issues related to strengthening the children’s advocacy center movement in the Western Region. Additionally, she works collaboratively on training and resources for MDT facilitators through WRCAC’s partnership with Regional Children’s Advocacy Centers across the country. Joyce has worked in the child advocacy field since 2007. She served as executive director of the Coffee County Children’s Advocacy Center for over fifteen years. During that time, she also served as Chair of the Children’s Advocacy Centers of Tennessee as well as interim director of the TN chapter. Joyce earned her bachelor’s degree in government from Georgetown University and her master’s degree in organizational leadership from Johns Hopkins University. Joyce spent the early days of her career life in Washington, D.C., on Capitol Hill and also worked on both state and national political campaigns.

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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.