CACTX 2020 Annual Report

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A Story of Resilience


“Children’s Advocacy Centers of Texas is a leader in how we approach child protection topics. By creating the Statewide Multidisciplinary Team, a diverse group of professional subject matter experts can collaborate to exchange ideas and challenge the process. As a result, new training, service provision, investigations, and public awareness approaches are identified and developed to create a safer environment for children.” 1

- Statewide Law Enforcement Partner

Letter from the Board President and Chief Executive Officer

Dear friends and partners, Every day, Texas children come forward to disclose their experiences of trauma, violence, and abuse. These reminders of bravery continuously ground us and reinforce our appreciation for partners and supporters like you who have helped build a strong children’s advocacy center (CAC) network so these children can seek safety, justice, and healing. Through hurricanes, tornadoes, mass shootings, wildfires, and now a global pandemic, the Texas CAC network has remained resilient and focused on protecting and seeking justice for child victims no matter what, serving nearly one million children impacted by abuse since 1995. Like everyone, Children’s Advocacy Centers of Texas (CACTX) and the CAC network were called upon to traverse uncertainty, loss, and ambiguity this year. But through it all there was also hope, newfound grit. The 71 CACs in Texas stood together to overcome enormous hurdles and serve a total of 61,891 children impacted by abuse – a 3% increase from the year before. Thank you for standing with us even during times of crisis to make this growth possible.

While we celebrate bringing restoration and healing to these children, we know there are still tens of thousands of child victims just out of reach. That is why, in late 2019, CACTX decided to take up the mantle to build a future where all Texas children are free from sexual abuse. This was the obvious path forward until COVID-19, when CACs and their multidisciplinary team partners began facing extraordinary challenges that required our immediate attention. Nevertheless, when asked if we should press pause or proceed with these plans, CAC leadership and key stakeholders unanimously insisted that moving forward was the only option – we know what the roadmap to ending child sexual abuse looks like, and we owe it to Texas children to see this vision for the future realized. We are continuously amazed by the unwavering resilience and compassion of this statewide team, including you. Together, we can build a safer Texas for all children.

FY20 Board of Directors Gina DeBottis Metts, President Revlynn Lawson, Vice President Billy Millwee, Secretary Michael Keener, Treasurer Jim Kimbell, Past President Kim Abernethy Cary Baker Elizabeth Brock Blaine Brunson Reed Clay Meredith Delk Jane Donovan Julie Evans Tom Forbes Brent Ives Michael Kelsheimer Tracy King Dave McGee Denise Merriman Lindsay Mullins Denise Rose Terri Smith Laura Squiers

With gratitude,

Gina DeBottis Metts

Joy Rauls

Board President

Chief Executive Officer

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About CACTX For over 25 years, Children’s Advocacy Centers of Texas (CACTX) has served as the membership association for the state’s 71 local children’s advocacy centers (CACs), ensuring access to safety, justice, and healing for nearly one million Texas children impacted by abuse. As we continue to serve these children, CACTX is casting our vision far upstream: to build a future where all children are free from sexual abuse. Through collaborative partnerships and visionary, evidence-based prevention, awareness, and education strategies, we are working to stop child sexual abuse before it starts.

A PARTNER: Cross-sector collaboration is the cornerstone of the CAC model, and CACTX is focused on bringing a variety of voices to the table and empowering partners and members to create scalable, adaptable strategies to further our efforts. GALVANIZING: CACTX provides the leadership needed to effectuate change and empower communities to make the issue of child abuse a top priority and work together to end child sexual abuse. EVIDENCE-INFORMED: Research and evidence-based strategies are at the forefront of everything CACTX does because we know success in the fight against child abuse requires the continual evaluation of current efforts and exploration of new, more effective methods to serve and protect children. INESCAPABLE: CACTX recognizes the sense of urgency that surrounds the issue of child abuse. Child sexual abuse is a preventable problem that demands a solution, and CACTX is working to sustainably support CACs to help young victims while also casting our efforts upstream to prevent children from ever being victimized. VISIONARY: CACTX aims to create lasting systemic change and is passionate about blazing a path to build a safer Texas for future generations.


Who Texas CACs Served








JOINT INVESTIGATION COORDINATION 251,147 reports of abuse and neglect from the Department of Family and Protective Services were reviewed

FORENSIC INTERVIEWS 40,786 children were able to tell their story of abuse to a specially trained forensic interviewer

children were victims of sex trafficking

19% of alleged perpetrators were juveniles

VICTIM SUPPORT AND ADVOCACY 60,493 families received crisis intervention and family advocacy services



TRAUMA-FOCUSED THERAPY 23,231 children received mental health services

66% sexual abuse

9,983 adults received mental health services (non-offending caregivers)

98% of child victims knew their alleged perpetrator

17% physical abuse 21% 0-5


child witness to crime

46% 6-12



33% 13-17



<1% 18+


sexual and physical abuse



MEDICAL EVALUATIONS 7,627 children received medical evaluations

MULTIDISCIPLINARY CASE REVIEW 33,330 cases were reviewed by the Multidisciplinary Team and facilitated by CACs 4 5

Backbone Support Organization

CACTX Highlights from FY20 85

trainings provided to 2,448 CAC professionals, a 27% increase from FY19.


CACTX provides programming and guidance to ensure that local CACs across the state have the support needed to deliver the highest standard of care to children who have been impacted by abuse. This year it was more vital than ever for CACTX to remain steady and dependable in providing Texas CACs with the ongoing support needed to maintain forward momentum toward our collective goal of reaching every child, providing every service, and making every effort.

in state and federal funding secured and passed through to Texas CACs by CACTX.

56 CAC leaders attended the Director’s Summit, an annual gathering hosted

by CACTX that strives to build the unity necessary for achieving systemic impact and sustaining and progressing the CAC model in Texas.

90 CAC leaders and staff benefitted from Committee of the Whole, a statewide event that fosters connection between members and CACTX and facilitates information sharing and impact alignment.

36 office hours held for 25 CACs, offering CAC staff a weekly opportunity to delve into their specific questions about tracking and reporting client information in the statewide case management system.



6 monitoring reviews were conducted in-person and virtually to assess

CACTX’s rigorous standards and reputation as a strong state chapter created the opportunity to partner with the National Children’s Alliance, the organization that sets national CAC standards to ensure high-quality service delivery, to facilitate national accreditation for all 71 Texas CACs this year. Through this recognition, our network will have access to national legislative efforts, specialized training opportunities, technical assistance, and grant funding prospects, and the children they serve will be guaranteed the best possible care.


CAC programs and provide recommendations for improvement.

requests for support with the statewide case management system answered by CACTX staff.


of CAC leadership reported satisfaction with the value of their statewide membership.


of MDT members reported that the CAC approach results in more collaborative and efficient case investigations.


of caregivers felt that their CAC facilitated healing for their child and themselves.

Working Toward a Common Goal In order to best support the CAC network and children they serve, CACTX strives to build strategic and collaborative partnerships with a variety of stakeholders across the state. By capitalizing upon our unique specializations and diverse strengths, we can find innovative solutions that improve outcomes for children and families who have been impacted by violence and abuse.

Partnership Highlights from FY20


Cultivated a new partnership with the Texas Commission on Law Enforcement to provide substantive updates to child abuse and sex trafficking curriculum for law enforcement throughout Texas.

Over 1,300 dedicated CAC staff members

Fostered relationships with various law enforcement organizations to help facilitate better engagement and understanding of the CAC model.

More than 230 district and county attorneys

Continued to partner with the Office of the Governor’s Child Sex Trafficking Team to strategically collaborate, develop, and implement a statewide response to combat child sex trafficking, including supporting the ten Care Coordination Teams across the state that provide victims with a continuum of care. Served on the Office of the Governor’s Sexual Assault Survivor’s Task Force Steering Committee, helping to address systemic issues impacting child and adult survivors of sexual assault.

Over 1,000 law enforcement jurisdictions Countless medical and mental health professionals Every Department of Family and Protective Services region in the state, Child Care Investigations, and Adult Protective Services.

Served on the Advisory Board for the Tex-TRAC (Texas Teleforensic Remote Assistance Center) initiative hosted by Texas A&M University’s College of Nursing, intended to expand access to sexual assault forensic exams in rural and underpopulated communities. Collaborated with the Criminal Justice Department at Texas Christian University and Alliance For Children to examine the length of time devoted to investigating child abuse cases and adequate resources needed to better support local multidisicplinary teams. Met with members of the Statewide Multidisciplinary Team four times throughout the year to collaborate, discuss, and strategize ways to identify and overcome barriers unique to investigation, assessment, intervention, and prosecution of child abuse and neglect cases. 6 7

COVID-19 Impact on Texas CACs As COVID-19 started affecting communities across Texas, reports of child abuse took a deep dive while stories of child fatalities, severe abuse, and domestic violence started circulating more frequently throughout our CAC network. While this year taught us to expect the unexpected, it also confirmed what we already knew – child abuse does not stop during times of crisis. CACs and the communities they serve have been significantly impacted by the pandemic, facing a slew of unique challenges in bringing safety and healing to the children who are still being harmed during this time.

INCREASED LIKELIHOOD OF CHILD ABUSE Even though reports initially dropped during COVID-19, the 71 CACs in Texas served 3% more child victims of abuse compared to the prior year, reaching a total of 61,891 children. Across the state, we are seeing how isolation and economic volatility are creating circumstances that increase the likelihood of child abuse and other forms of violence. With limited opportunities for adults to intervene, children are also experiencing a longer duration of abuse before it is recognized and reported.

MORE COMPLEX CASES & MENTAL HEALTH NEEDS CACs are one of Texas’ largest providers of mental health services for children and families impacted by sexual abuse. On average, mental health sessions increased per child throughout 2020, with clients requiring more sessions to address their trauma and other stressors caused by the pandemic. As a result, new clients are facing longer mental health waitlists as CACs struggle to keep up with demand. The number of children presenting with suicidal ideation has also increased, citing abuse in the home, stress, lack of support, and isolation as primary causes.

FUNDING CHALLENGES FOR LOCAL CACS Texas CACs have faced a sharp decrease in funding due to cancelled events and a reduction in private donations. As CACs face budget concerns and make difficult staffing decisions while simultaneously facing a greater demand for services, there is the immediate consequence of a reduced ability to deliver core services to children and families. This issue highlights the importance of support at the individual, local, state, and federal levels - child abuse is a community problem that needs community investment. 7

“When COVID started shutting down in-person meetings, our local CAC quickly started utilizing innovative technology to continue doing the great work they do with survivors. The way they delivered services to children and families changed, but the care and attention that those families received did not.” - Prosecution Partner 8 9

CACTX Response to COVID-19 Designated as essential personnel by the Office of the Governor and the Texas Division of Emergency Management at the start of the pandemic, CAC staff have worked tirelessly to adapt services to continue serving child victims. CACTX quickly began providing COVID-specific resources, trainings, and support throughout the CAC network and communities across the state.

MEETING IMMEDIATE NEEDS OF CACS CACTX provided daily technical assistance and guidance for COVID-19 related needs, including the Paycheck Protection Program, personal protective equipment for offices, funding and budgeting, virtual trainings, and more. Distributed an additional $1,321,643 in Victims of Crime Act funds throughout the CAC network.

Helped CACs make over 100 amendments to grant contracts, making funds more flexible for each CAC’s specific needs. Created 16 COVID-specific technical assistance guides to help CACs with grants administration. Utilized membership-wide surveys to understand the ever-evolving needs of CACs during the pandemic and how CACTX could provide support.

PROTECTING CHILDREN DURING A PANDEMIC In 2020, there was a 26% decrease in reports of child abuse made by teachers and school employees – a group that typically makes up the second highest number of reports annually. The switch to virtual learning severely limited the ability to recognize and report abuse, highlighting the importance of helping all Texans understand the dynamics of abuse so they can protect the children in their lives. Partnered with the Texas Education Agency to create child abuse education and awareness resources for educators and school personnel, with more than 60,000 brochures in English and Spanish distributed by CACs. Created resources for parents and caregivers, available in English and Spanish, including 20,500 copies of flyers on managing stress during COVID-19 that were distributed to CACs. Participated in 7 interviews with media outlets across the state to discuss how child abuse is more likely to go unreported during the pandemic and what everyone can do to help keep kids safe.


TACKLING SERVICE PROVISION CHALLENGES CACs have faced new complications in making sure children have access to forensic, medical, and mental health services. CACTX partnered with CAC leaders and experts to identify and implement strategies to eliminate barriers to these services while balancing health and wellbeing. Transitioned to a fully virtual training program to ensure accessible, continuous, and quality professional development and core training opportunities.

Hosted a series of 14 calls to help CACs transition to tele-mental health services and led 3 tele-health trainings with 375 attendees. Facilitated an educational forum on tele-forensic interviewing through a call with over 150 attendees.

PROMOTING NETWORK-WIDE RESILIENCY CAC staff regularly experience secondary trauma through their work with children and families, but the emergence of a global pandemic and disruption of everyday life quickly added to the already existing need of support for leaders, staff, and partners. Based on inputs from CACs, CACTX launched regular efforts offering CAC staff and multidisciplinary team partners resiliency resources. Provided access to online courses, resources, and tools to address secondary trauma to 1,135 individuals. Provided 186 CAC leaders and staff members training from nationally recognized secondary traumatic stress experts, educating them on techniques and tools to share with their teams. Launched Project Resiliency, a podcast to provide wellness recommendations and tips for statewide multidisciplinary team partners.

KNOWING THE SIGNS OF ABUSE It is up to us to protect children from abuse and exploitation. With fewer chances of intervention due to the pandemic, it is more important than ever to know the signs of abuse, such as unexplained injuries, fear of certain people or places, or new risk-taking behaviors. You can find a variety of resources on signs of abuse on our website at If you suspect a child is being abused, report it by going to or calling 1-800-252-5400.

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Stories from Texas CACs We know child abuse does not stop during a pandemic, and many children have been trapped at home with their abuser and limited chances for any intervention. During one forensic interview, a teenager was asked about when she first started experiencing the reported abuse: “Do you remember when we left school for spring break and never came back? That’s when the abuse started.” Throughout the year, CACs across the state heard similar accounts, but they also saw countless examples of resilience like the stories on this page.

THE BRIDGE AMARILLO, TEXAS In early May, The Bridge received a report of a 12-year-old who had taken the brave step to reach out to her teacher about being sexually abused by her father. The abuse had started before COVID-19, but with near constant access to the child as the family sheltered in place at home, the abuse was now happening far more frequently. After she came in for a forensic interview, her father was arrested, and the CAC’s multidisciplinary team partners began a coordinated investigation to seek justice. The girl has been receiving mental health services at The Bridge to address her trauma from enduring this long-term sexual abuse.

MIDLAND RAPE CRISIS AND CHILDREN’S ADVOCACY CENTER MIDLAND, TEXAS In the spring of 2020, a teenage female client was in crisis. Shortly after receiving a forensic interview for sexual abuse she experienced at the hand of her father, he committed suicide. Her immediate family did not provide any support, and she was staying with a friend. In addition to her extreme situation, she was also considered high-risk due to losing a friend by suicide the past year. Due to COVID-19, therapy services had moved to a virtual platform, but her therapist recognized the need for an in-person crisis session. After using screening protocols and safety measures, the client was able to meet with her therapist at the CAC and receive the support needed for stabilization.


Counties officially served by Children’s Advocacy Centers Counties receiving/eligible for courtesy services

ALLIANCE FOR CHILDREN FORT WORTH, TEXAS Last summer, a 16-year-old girl frantically called 911 from an Arlington hotel, explaining that she was being raped and held against her will. She was from Houston and had been trafficked throughout Texas and Louisiana by three different traffickers. During her forensic interview she was able to provide such thorough details that detectives were able to not only identify the traffickers here in Texas, but also partner with detectives in Louisiana to identity and locate her traffickers there, protecting countless other victims. Alliance For Children helped reunite the girl with her mother in Houston who had reported her daughter missing and was anxiously awaiting her return.

CHILDREN’S ADVOCACY CENTER OF HIDALGO AND STARR COUNTIES EDINBURG, TEXAS A teenage boy was taken to his local CAC after his mother committed suicide at home while he was present. While at the CAC, both the boy and his father, who had traveled down from San Antonio, disclosed experiences of sexual abuse, something neither of them had ever discussed with anyone before. The CAC advocates contacted the CAC in San Antonio to get the family set up with support there and help with the boy’s transition. The boy began receiving grief and grieving counseling, and both him and his father began counseling to address their trauma from sexual abuse so they can heal together.

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What’s Next: Eradicating Child Sexual Abuse in Texas What will it take to build a future where children are free from sexual abuse? CACTX spent 2020 diving deep into research and consulting with subject matter experts to answer that question. Everything we learned kept coming back to the need to invest time and talent into three overarching focus areas: awareness and education, perpetration prevention, and child sexual abuse response and intervention.

Awareness and Education Our vision for the future: Individuals, families, and communities across Texas have a universal understanding of the dynamics of child sexual abuse, and every person feels a shared sense of responsibility and takes meaningful action within their role to prevent it. What it will take: The public perception of child sexual abuse needs to shift so it is viewed as a public health issue rather than a criminal justice matter. When sexual abuse is viewed solely through a criminal justice lens, intervention is delayed until after a child has been harmed. A public health approach invests resources in evidence-based prevention – stopping child sexual abuse before it starts. This strategy includes reaching adults and children of all ages and across all communities through comprehensive child sexual abuse prevention education. These educational efforts will focus on preventing victimization, reporting abuse when it occurs, and helping children develop healthy relationships and personal boundaries.

Perpetration Prevention Our vision for the future: Every person who is at-risk to offend sexually receives intervention that is appropriately matched to their unique circumstances and level of risk and that reduces the likelihood of them offending to the greatest extent possible.


What it will take: Decision-makers, funders, and the public need to understand the realities of sexual offending. Research strongly suggests that many sexual offenses, especially those committed by young people, can be prevented. Some interventions exist - and others are in development - that target distinct types of offending behavior and risk, but sexual offending is such a taboo topic that these programs are not widely understood by the public or available to those that need them.

Child Sexual Abuse Response and Intervention Our vision for the future: Every child who is sexually abused receives access to safety, justice, and healing and is supported in achieving resiliency and well-being. What it will take: We need every Texan to understand the dynamics of sexual abuse and to feel comfortable talking about it, so that children are empowered to come forward when something does happen and so that adults always take action to report suspected abuse and support children who need help. We need to ensure that CAC multidisciplinary teams across Texas responding to these cases are strong and well-resourced so perpetrators are held accountable, and children and families impacted by sexual abuse can heal.

Our vision for the future is informed by the fact that one in ten children will be sexually abused before their 18th birthday, but only around a third of these incidents are identified and even fewer are reported and investigated. The cases that are identified, reported, and investigated represent only a small fraction of the full breadth of child sexual abuse in Texas, meaning there are tens of thousands of children who are not receiving the support they deserve to heal and thrive. Addressing gaps in understanding about the risk factors and circumstances that lead to child sexual abuse is essential to protecting all Texas children.

UNDERSTANDING THE ISSUE Around 90% of children who are victims of sexual abuse know their abuser.

Children who participate in sexual abuse prevention education programs are 6 times more likely to demonstrate protective behavior.

Only 10% of new arrests for sex crimes against children involve individuals with prior sex offense records.

Around 40% of children who experience sexual abuse are abused by older or more powerful children.

Around 98% of adolescent offenders who receive appropriate treatment do not go on to re-offend in adulthood.

Children who are sexually abused are at significantly higher risk for mental and physical health problems, such as post-traumatic stress, anxiety, heart problems, stroke, and more.

CACTX is committed to a future where all children are free from abuse and we are actively working to eradicate child sexual abuse for every child through collaborative, high-impact efforts with Texas CACs and strategic partners. Learn more at 14 15

CACTX Financials For the period of September 1, 2019 through August 31, 2020.

Statement of Financial Activities

Statement of Financial Position



Grants and Contracts $3,770,519

Cash and Short-Term Investments

Pass-Through Grants* $62,701,119

Receivables, net

Fundraising $270,731

Receivables, Pass-Through Grants*

Membership Dues


Prepaid Expenses/Other

Other Income/Investment Income


Land, Building, and Equipment, net



Endowment/Investments TOTAL ASSETS

$396,834 $599 $13,301,004 $61,939




EXPENSES Program Services




Accounts Payable, Accrued Expenses



Accounts Payable, Pass-Through Grants*


Fundraising $282,581

Deferred Revenue





Pass-Through Program Services*

Management and General


*As the membership organization for all 71 CACs in Texas, CACTX oversees the acquisition, distribution, and reporting of state and federal grant and contract revenue to local CACs. In addition to other sources of funding secured by individual CACs, these pass-through funds help our network sustainably provide services to children and families impacted by abuse.

NET ASSETS Unrestricted


Temporarily Restricted


Permanently Restricted






“I have been amazed at how the different CACs we partner with have managed to continue their great work in the face of COVID. We have had to hurdle the challenges... [but] our medical team has been able to accommodate all patients while following strict COVID guidelines. The kiddos still come first.” - Medical Partner

The achievements reflected in this report were made possible through the hard work of an extraordinary team of committed professionals working on behalf of Texas children. We are honored that these professionals have chosen to dedicate their talents to ensuring safety, justice, and healing for Texas children. To learn more about Team CACTX, please visit

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Our Supporters Thank you to the generous donors who help strengthen the CAC response throughout Texas. Because of your support, more than 60,000 children were able to seek safety, justice, and healing in 2020.


Billy Millwee & Associates


FY20 CORPORATE AND FOUNDATION SUPPORT, CONTINUED Association of Electric Companies of Texas, Inc.

Molina Healthcare

Children’s Hospital Association of Texas

Overflow Communications

Higher Order Consulting, Lauren Paver

Sellers Dorsey

Maximus, Inc.

PUBLIC PARTNERS Office of the Governor—Criminal Justice Division

Texas Health and Human Services Commission

Office of the Attorney General—

National Children’s Alliance

Crime Victim Services Division

Southern Regional CAC

Texas Children’s Justice Act

SPECIAL THANKS We are grateful for our Women of Courage members who serve as ambassadors for children victimized by abuse through increasing community awareness, promoting prevention, and financially strengthening the coordinated efforts of CACTX and local CACs throughout Texas. To learn more about Women of Courage, visit 18 19

1501 West Anderson Lane, Bldg. B-1 Austin, Texas 78757 P 512-258-9920 E WWW.CACTX.ORG