Skip to main content



Child-Maltreatment-Research-L (CMRL) List Serve

Browse or Search All Past CMRL Messages

Welcome to the database of past Child-Maltreatment-Research-L (CMRL) list serve messages (10,000+). The table below contains all past CMRL messages (text only, no attachments) from Nov. 20, 1996 - September 14, 2018 and is updated quarterly.

Instructions: Postings are listed for browsing with the newest messages first. Click on the linked ID number to see a message. You can search the author, subject, message ID, and message content fields by entering your criteria into this search box:

Message ID: 8603
Date: 2010-08-27

Author:Larry Breitenstein

Subject:Re: New bulletin: Updated Trends in Child Maltreatment, 2008

In research I have yet to publish, I compared Pennsylvania counties operating under a Medicaid managed care model to similar sized counties outside of the Medicaid managed care model and found a significant decline in some types of reported abuse (bruises and contusions) and indicated findings of abuse. My thought was since managed care (and health care policy) is directing kids away from hospitals (changing the front door for who sees the child first), those treating the kids (and those kids not receiving medical treatment) are being excluded from what in the past would have been reported. Pennsylvania law requires a medical finding to substantiate most reports. Thus these systemic changes could be making it too hard for CPW to get all that is needed to substantiate a finding of abuse. These changes with health care could be indirectly forcing CPS workers to focus more on the most serious cases and/or preventing them from using what is available. My findings suggested managed care had no affect on serious injuries like fractures.

In research I have yet to publish, I compared Pennsylvania counties operating under a Medicaid managed care model to similar sized counties outside of the Medicaid managed care model and found a significant decline in some types of reported abuse (bruises and contusions) and indicated findings of abuse. My thought was since managed care (and health care policy) is directing kids away from hospitals (changing the front door for who sees the child first), those treating the kids (and those kids not receiving medical treatment) are being excluded from what in the past would have been reported. Pennsylvania law requires a medical finding to substantiate most reports. Thus these systemic changes could be making it too hard for CPW to get all that is needed to substantiate a finding of abuse. These changes with health care could be indirectly forcing CPS workers to focus more on the most serious cases and/or preventing them from using what is available. My findings suggested managed care had no affect on serious injuries like fractures.