CACTX FY21 Annual Report

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Building a Brighter Future


“CACTX has always been courageous in stepping up and taking on daunting challenges when they believe it’s what is best for the children of Texas.” - CAC Executive Director 1

Letter from the Board President and Chief Executive Officer

Dear friends and partners, For decades, we have seen the number of children served by a children’s advocacy center (CAC) across our state increase year-over-year. We have heard harrowing stories of child sexual abuse that bring us to our knees. Children’s Advocacy Centers of Texas (CACTX) and our CAC network have worked to help countless children and families achieve safety, justice, and healing in their greatest time of need. However, we also know that we are called to do more. This does not have to be the reality we accept; we have an opportunity to rewrite the script, implement real change that raises awareness, and embrace a shared responsibility to take meaningful action. It is our responsibility to lift everyone higher, help untangle the complexities, and find bright spots in often dark spaces. We have the opportunity to make bold, generational changes to prevent children from ever experiencing sexual abuse in the first place. It will take vision, leadership, and collective action to build a brighter future for all children. CACTX has taken up this mantle and will rise to the challenge. But we cannot do it alone.

As we lean into what we believe is our highest calling—to eradicate child sexual abuse in Texas— we commit to bringing an even more spacious and collective collaborative together to implement real, lasting change. It will take all of us including existing and new partners, supporters, and believers that we can and will build a brighter tomorrow, free of child sexual abuse, for future generations. With gratitude and hope,

Gina DeBottis Metts Board President

Joy Rauls

Chief Executive Officer

FY21 Board of Directors Gina DeBottis Metts, President Laura Squires, Vice President Michael Keener, President-Elect Michael Kelsheimer, Secretary Meredith Delk, Treasurer Kim Abernethy Steven Almrud Cary Baker Blaine Brunson Reed Clay Jane Donovan Julie Evans Tom Forbes Brent Ives Tracy King Denise Merriman Billy Millwee Lindsay Mullins Denise Rose Terri Smith Timothy Wilschetz

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About CACTX At CACTX, we believe in a future free of child sexual abuse, achievable through a universal understanding of the dynamics of child sexual abuse and a shared responsibility to take action to prevent it. Through research, education, and evidence-based strategies, CACTX is taking action to find solutions that make the most impact for individuals, families, and communities across Texas.

A TRUSTED 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 network’s efforts. GALVANIZING: For over 26 years, CACTX has provided the leadership needed to effectuate change, 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. We know success in the fight against child sexual 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 sexual abuse. Child sexual abuse is a preventable problem that demands a solution. 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 by forging a bold path forward to build a safer Texas for future generations.


Serving Texas’ Children

IN 2021,








As the membership association for the state’s 70 local CACs, CACTX provides a range of services and guidance to support the implementation of the CAC multidisciplinary team (MDT) approach to the investigation, intervention, and prosecution of child abuse cases across the state.

JOINT INVESTIGATION COORDINATION 252,398 Department of Family and Protective Services (DFPS) reports of abuse & neglect reviewed FORENSIC INTERVIEWS 46,512 children forensically interviewed 14% increase from FY20


MEDICAL EVALUATIONS 7,946 children received medical evaluations 4% increase from FY20

67% sexual abuse 17% physical abuse 20% 0-5


child witness to crime

45% 6-12



35% 13-17


sexual and physical abuse

<1% 18+





MULTIDISCIPLINARY CASE REVIEW 38,039 cases reviewed by the MDT and facilitated by CACs 14% increase from FY20 TRAUMA-FOCUSED THERAPY 23,609 children received mental health services 2% increase from FY20 TRAUMA-FOCUSED THERAPY


9,316 adults received mental health services (non-offending caregivers) children were victims of sex trafficking

98% of child victims knew their alleged perpetrator 19% of alleged perpetrators were juveniles

VICTIM SUPPORT AND ADVOCACY 62,500 families received family advocacy services 3% increase from FY20

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A Commitment to Partnership CACTX is dedicated to continually identifying and addressing challenges and building solutions to further develop and implement strategy and programming, as well as improve partnerships to better serve children and families, and prevent child sexual abuse.

Children’s Justice Act The Children’s Justice Act (CJA) is a federally funded program that improves the investigation and prosecution of child abuse cases, particularly child sexual abuse and exploitation cases. CJA was established to help states develop and operate programs to improve handling cases of suspected child abuse and abuse-related fatalities. Starting in 2021, CACTX became the CJA Program Administrator for the state of Texas. As part of this transition, CACTX merged our Statewide Multidisciplinary Team with the existing CJA Task Force to create the robust Statewide Multidisciplinary Task Force. This group is comprised of professionals from law enforcement, child protection, prosecution, medical, mental health, and CACs. With CACTX’s leadership, the Statewide Multidisciplinary Task Force is responsible for identifying challenges or areas in need of improvement in the state’s response to child abuse, making recommendations for system-level improvements through a three-year assessment, monitoring the implementation of its recommendations, and continuing collaboration in carrying out the intent of the CJA program. We are honored to lead these efforts and have identified three critical topics upon which to focus CJA efforts: • Strengthen Workforce Capacity, Expertise, and Sustainability • Earlier Detection of Child Sexual Abuse Cases • Cases Involving Juveniles Who Have Perpetrated

CACTX Partnership Highlights from FY21 CACTX strives to build and grow strategic and collaborative partnerships with diverse stakeholders across Texas and beyond our state’s borders. Partners with Carrie Epstein, LSCW-R at Yale University, co-developer of Child and Family Traumatic Stress Intervention, to train our urban CACs in this innovative therapeutic model that is shown to prevent the development of post-traumatic stress disorder. 5

Developed a partnership with Penn State University to assist with program evaluation of their new PhaseBased Treatment model for children with problematic sexual behaviors developed by Brian Allen, PsyD. Collaborated with the Texas Commission on Law Enforcement to provide substantive updates to child abuse and sex trafficking curricula for law enforcement throughout Texas. Educated prosecutors across the state regarding the benefits of CAC MDTs at the Crimes Against Children Conference hosted by the Texas District & County Attorney’s Association. Continued to provide leadership on the Steering Committee of the Governor’s Sexual Assault Survivors’ Task Force, helping address systemic issues impacting child and adult survivors of sexual assault in Texas. Teamed up with the Texas Association Against Sexual Assault to ensure all eleven policy recommendations of the Governors’ Sexual Assault Survivors’ Task Force were successfully passed during the 87th Texas Legislative Session and signed into law. Served on the Advisory Board of the Texas Teleforensic Remote Assistance Center initiative hosted by Texas A&M University’s College of Nursing, expanding access to forensic medical exams in rural and underserved communities in Texas. Continued our collaboration with the Office of the Governor’s Child Sex Trafficking Team to develop a statewide response to combat child sex trafficking, including the implementation of Care Coordination to meet the immediate and long-term needs of child victims of sex trafficking. Currently, 40 CACs and their communities are engaged in Care Coordination, with 16 Care Coordination teams fully implemented, providing trafficking victims with a continuum of care. Developed and implemented a new Strategy Development and Evaluation team that includes four new staff members focused on developing strategies for prevention and intervention efforts and determining how CACTX will measure progress toward eradicating child sexual abuse. Solidified our partnership with the Department of State Health Services to include two vital questions related to the experience of child sexual abuse to the Youth Risk Behavior Surveillance System, a federally funded classroom-based survey conducted bi-annually. The questions that are now part of the survey ask students if they have experienced sexual abuse perpetrated by either a peer or adult. Adding these questions to the survey helps establish a baseline prevalence rate for child sexual abuse specific to Texas and monitor CACTX’s efforts to eradicate child sexual abuse over time.

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Knowledge is Power During the 2021 fiscal year (September 1, 2020 to August 31, 2021), CACTX orchestrated or coordinated over 900 hours of training for CAC staff, family advocates, and partners, both in-person and virtually. Here is a snapshot of some of the training provided.

Our core curriculum training for family advocates, forensic interviewers, mental health, and MDT professionals included 71 training courses. These training courses provided a range of information to best support each scenario and diverse need. Our family advocates had the opportunity to attend advanced training courses regarding “Navigating Sudden Loss” and “Trauma and Healing in the Lives of People with Intellectual and Development Disabilities.”

CACTX facilitated three “Multi-Session Forensic Interviewing” training sessions that provided techniques for conducting one forensic interview over multiple sessions. This training is effective for children who may require more than one opportunity to disclose relevant information regarding abuse allegations.

CACTX piloted “Phase-Based Treatment for Problematic-Sexual Behavior of Children,” which is a culturally sensitive, trauma, and evidence-informed intervention. The training spanned twelve months and included monthly consultation calls. Finally, our advanced offerings for our Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) trained clinicians on “TF-CBT & Considerations When Preparing for Court” and “Using TF-CBT to Address Child Traumatic Grief & Ambiguous Loss.”


CACTX coordinated 29 regional peer reviews for our family advocates, forensic interviewers, and mental health professionals.

71 Trainings for CAC professionals - 1,289 participants 63 Consultation calls hosted - 583 participants 6 Trainings for MDT partners - 583 participants

CAC Support CACTX remains steady and dependable in providing Texas CACs with ongoing support to maintain forward momentum, when it comes to evaluation and assessment, training, technical assistance, and funding.


monitoring reviews were conducted in-person and virtually to assess CAC programs and provide recommendations for improvement.

OUR TEXAS CAC NETWORK BRINGS TOGETHER: Over 1,400 dedicated CAC professionals Over 1,000 law enforcement jurisdictions


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


More than 230 district and county attorneys More than 300 medical and mental health professionals

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

Every Department of Family and Protective Services region in the state, including Child Protective Investigations, Child Care Investigations, and Adult Protective Services

“CACTX is an amazing organization and I greatly value this partnership. I would not be successful in leading our local CAC without their wisdom and support. ” - CAC Executive Director 8 9

CAC Bright Spots Child abuse is a societal issue that affects all of us, including child victims and their families, advocates, partner agencies, communities, and CAC professionals. Until we end child abuse for all Texas children, finding “bright spots” keeps us motivated and guides us to a better tomorrow. The CAC Director’s Summit is a learning and sharing opportunity for all CAC Executive Directors to connect and enhance their collective efforts to support child abuse victims. In 2021, CAC Executive Directors shared some of their bright spots.

CHILDREN’S ADVOCACY CENTER FOR ROCKWALL COUNTY ROCKWALL, TEXAS | ROCKWALL COUNTY We added additional staff to support our mission and revamped our Sexual Assault Response Team.

CHILDREN’S ADVOCACY CENTER OF GREATER WEST TEXAS SAN ANGELO, TEXAS | REGAN, RUNNELS, SCHLEICHER, SUTTON, AND TOM GREEN COUNTIES Phase I of the construction of the Children’s Advocacy Center of Greater West Texas, newly named Stephens Campus for Children & Families, was completed.

CHILDREN’S ALLIANCE OF SOUTH TEXAS FLORESVILLE, TEXAS | ATASCOSA, FRIO, KARNES, LA SALLE, AND WILSON COUNTIES We expanded outreach and education in the community, which provided a window into the everyday world of a CAC and what staff and families go through daily.

ADVOCACY CENTER FOR CRIME VICTIMS AND CHILDREN WACO, TEXAS | FALLS, FREESTONE, HILL, LIMESTONE, AND MCLENNAN COUNTIES Like many other CACs, our agency continued to serve clients in person despite the spike of COVID cases. Our MDT partners continued working through the pandemic, maintaining ongoing collaboration as our internal team adjusted to ensure proper safety measures for our clients and staff.

Counties officially served by CACs 9

Counties receiving/eligible for courtesy services





Started renovation on a new Fort Worth CAC, a step toward extending the network of healing and support services provided to child abuse victims and their families.

We created a new medical response by hiring a Director of Medical Services in May 2021 to provide sexual assault medical exams and follow-up medical care. We developed a comprehensive strategic plan for 2022-2025 to deliver a nimble response to serving children and families. We have expanded our service area and changed our name to reflect this growth across the region.

THE CHILDREN’S ADVOCACY CENTER OF PARIS PARIS, TEXAS | LAMAR AND RED RIVER COUNTIES We added a second therapist and a new therapy treatment for children with problematic sexual behaviors. In addition, our Board of Directors focused on identifying new opportunities to diversify our funding sources.

CRISIS CENTER OF ANDERSON AND CHEROKEE COUNTIES JACKSONVILLE, TEXAS | ANDERSON AND CHEROKEE COUNTIES Our CAC provided the first in-house medical exam conducted by a Sexual Assault Nurse Examiner in Anderson County.

ELLIS COUNTY CHILDREN’S ADVOCACY CENTER WAXAHACHIE, TEXAS | ELLIS COUNTY Completed the development of working protocols to respond to commercial sexual exploitation of children; through the support of CACTX have expanded mental health services and added new staff to support our mission; and started an endowment to create long-term sustainability for our CAC.

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A Bold Path Forward: Building a future where no child in Texas experiences sexual abuse In 2021, CACTX continued its mission ensuring access to services for children and non-offending family members already impacted by abuse while continuing to move forward with a bold vision that embraces a public health approach that invests resources in evidence-based strategies associated with awareness and education, intervention, and primary prevention of child sexual abuse.


Awareness and Education Consistent, statewide child sexual abuse prevention education and public health awareness campaigns will play a significant role in achieving this goal. Awareness and education efforts will focus on preventing sexual abuse before it happens, reporting abuse when it occurs, and helping children develop healthy relationships and decision-making skills.

Primary Prevention

identified and provided with appropriate treatment. Some interventions exist and others are in development but due to the stigma they face, those at-risk of offending are rarely presented with a safe option for seeking assistance, so they do not harm children. Educating our society on the importance of these interventions is important to begin enhancing the process of perpetrator intervention.

Response and Intervention Every child who is sexually abused receives access to safety, justice, and healing and is supported in achieving resiliency and well-being. We continue to support access to services for children and non-offending family members already impacted by sexual abuse.

Every person who is at-risk to offend sexually receives intervention appropriately matched to their unique circumstances and level of risk, reducing the likelihood of them offending to the greatest extent possible. Research strongly suggests that many sexual offenses, especially those committed by young people, can be prevented if these individuals are


CACTX is committed to leading the charge to build the foundation to eradicate child sexual abuse.

UNDERSTANDING THE ISSUE To change public perception and stop the cycle of child sexual abuse, we need to understand that child sexual abuse is a public health issue, not just a criminal justice issue. A public health approach allows us to invest resources in evidence-based prevention—stopping child sexual abuse before it starts.

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 experiencing sexual abuse are at significantly higher risk for mental and physical health problems, such as post-traumatic stress, anxiety, heart problems, stroke, and more.

CACTX knows that to stop child sexual abuse, we must continue to push forward innovative solutions and evidence-based strategies to change the public’s perception. Learn more at 13 12

CACTX Financials From September 1, 2020 through August 31, 2021.

Statement of Financial Activities

Statement of Financial Position



Grants and Contracts


Cash and Short-Term Investments


Pass-Through Grants*


Receivables, net




Receivables, Pass-Through Grants*


Membership Dues


Prepaid Expenses/Other


Other Income/Investment Income


Land, Building, and Equipment, net








EXPENSES Program Services



Pass-Through Program Services*


Accounts Payable, Accrued Expenses


Management and General


Accounts Payable, Pass-Through Grants*




Deferred Revenue






*As the membership association for all 70 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 funding resources secured by individual CACs, these pass-through funds help our CAC network sustainably provide services to children and families impacted by abuse.

NET ASSETS Without Donor Restrictions


With Donor Restrictions




$13,585,788 $26,857,402

Our Supporters We have endless gratitude for our statewide partners and donors who have helped strengthen the CAC response throughout Texas. Because of your support, 68,018 children were able to seek safety, justice, and healing in 2021.

PUBLIC PARTNERS Office of the Governor—Criminal Justice Division

Texas Health and Human Services Commission

Office of the Attorney General—Crime Victim Services Division

National Children’s Alliance

Texas Children’s Justice Act

Southern Regional CAC

FOUNDATION SUPPORT Texas Bar Foundation CACTX received a grant from the Texas Bar Foundation to provide ongoing training and support on Health Insurance and Portability Accountability Act (HIPAA) compliance for all Texas CACs. This work helps balance the privacy and protection of personal health information while also ensuring the administration of justice for young victims.

The Meadows Foundation CACTX received a grant from the Meadows Foundation with the goal of maintaining and sustaining the critical safety net of CAC services to respond to the increase in victims needing support, particularly during and after the COVID-19 pandemic. This partnership helped maintain and grow state and federal funding for all Texas CACs, vital to ensuring the strength of our Texas CAC network. GIVING SUPPORTERS Women of Courage We are grateful for our Women of Courage members who provide ongoing financial support and sustainability to help strengthen the coordinated efforts of CACTX and our statewide partners. This community of women makes a lasting impact on children victimized by abuse and are vital to our evolving efforts to eradicate child sexual abuse in Texas. To learn more, visit 15

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