Child Abuse and Neglect Prevention Program Cost Calculator

Guide to the results table: Population and Program

• Number of children in program: This is either the default estimated number of children eligible for the selected intervention program in the selected state or a user-defined estimate. The default estimate is based on US Census data and is the estimated size of the target population for the selected intervention program in the selected state. For example, the target population for Nurse-Family Partnership is first-time pregnancies to low-income mothers.
• Children with substantiated abuse and neglect without program: This is the estimated number of children who may experience abuse and neglect in the absence of intervention. This estimate is based on observed rates of abuse and neglect among programs’ target populations during research studies that examined the impact of these programs.
• Children with substantiated abuse and neglect with program: This is the estimated number of children who may experience abuse and neglect if the eligible population initiates participation in the selected intervention program. This estimate is based on observed rates of abuse and neglect among programs’ target populations during research studies that examined the impact of these programs.
• Cases avoided: The calculator calculates the number of children that might avoid abuse and neglect if the selected intervention program is initiated among the target population of the selected state.

Guide to the results table: Lifetime budget/economic impact

• Program cost per child: This is the estimated cost for each child to participate in the selected intervention program in the selected state. This cost is based on research studies, and adjusted for inflation since the research study was conducted and also adjusted for the location of the research study relative to the selected state for analysis (for example, some states have higher labor costs than other state). Program costs are presented in terms of budget costs (or, costs to public payers) and economic costs (or, inclusive of additional costs; for example, the cost to parents to participate in an intervention).
• Total program cost: This is the estimated cost for each child to participate in the selected intervention program in the selected state multiplied by the number of children in the program (also reported in the Results table).
• Program benefit per avoided child abuse and neglect case: This is the estimated lifetime cost per child that experiences abuse or neglect (including health care, special education, criminal justice costs) in a given area paid by public payers (for example, state government budget, presented as “Budget impact”) and society (for example, lost tax revenue due to a child’s morbidity and mortality, presented as “Economic impact”).
• Total program benefit: This is the estimated lifetime cost per child that experiences abuse or neglect multiplied by the number of children estimated to avoid abuse and neglect based on implementation of a selected intervention program.
• Net cost (negative values indicate lifetime cost savings): This is the estimated lifetime total cost of the selected intervention program in the selected state minus the total monetary benefit of the program. Future costs are discounted to present value by 3%

Find more information on calculator methods and data: Cost-Benefit Analysis of Two Child Abuse and Neglect Primary Prevention Programs for US States

Child-Parent Centers

Child-Parent Centers: Taxpayer costs including all outlays for staff, family and community support, administration, operations and maintenance, instructional materials, transportation and community services, schoolwide services, school district support, capital depreciation and interest, and parent opportunity costs [economic cost estimate only]. Inflation-adjusted estimates were derived from operational budgets of the Chicago Public Schools in 1985–1986 (preschool) and 1986–1987 (school-age).

References:

Reynolds, A. J., Temple, J. A., Robertson, D. L., & Mann, E. A. (2002). Age 21 Cost-Benefit Analysis of the Title I Chicago Child-Parent Centers. Educational Evaluation and Policy Analysis, 24(2), 267-303.

Reynolds, A. J., Temple, J. A., White, B. A., Ou, S. R., & Robertson, D. L. (2011). Age 26 cost-benefit analysis of the child-parent center early education program. Child Dev, 82(1), 379-404.

Nurse-Family Partnership

Nurse salaries, fringe benefits, administration and supervision, offices, supplies, travel, and NFP National Services Office fees. Costs assessed 2009-2010 in six U.S. states.

Reference:

Miller, T. R., & Hendrie, D. (2015). Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up. Journal of Primary Prevention, In press.

Preschool only—Children begin at age 3, program lasts through age 4 years

Preschool + school age—Children begin at age 3, program lasts through age 9 years

An analysis of budget impact estimates the monetary costs and benefits for a government payer. For example, health care costs paid by Medicaid are included. An analysis of economic impact includes costs beyond those that appear in a government payer's budget but nonetheless are important from a societal perspective, such as lost or lower earnings among adults who experience child maltreatment during their youth.

The monetary value of averted child abuse and neglect includes the cost of health care, child welfare, criminal justice, special education, and lost productivity that victims incur. There is no documented evidence about the timing of these costs. Some child abuse and neglect costs, like medical care for acute treatment of physical injuries, occur in the immediate aftermath of a child maltreatment incident. But even these costs are hard to account for in a budget timeline because child abuse and neglect is measured between ages 0-17. Other child abuse and neglect costs, like victims’ lost work productivity due to physical or mental impairment resulting from the abuse, are not incurred until the child reaches working age in adulthood. Even then, the cost of such lost productivity is spread over the victim’s working life. Therefore the calculator present costs and benefits (reduced child abuse and neglect) over the span of a lifetime, with future costs discounted to present value by 3%.

This allows you to investigate the potential cost and benefit of these programs based on the estimated recipient count in your local area; for example, a U.S. metropolitan area, rather than a U.S. state. The benefit and cost results from an analysis that uses a hand-entered population count will still be based on your selection of state because program cost and child abuse and neglect incidence is calculated at the state level.

• This calculator includes selected prevention programs with demonstrated effectiveness and published cost data.
• Program cost data are the most recent available and are adjusted for inflation. But program costs for CPC, in particular, are based on data collected many years ago.
• This calculator focuses on savings accruing only as a result of reduced child abuse and neglect incidence, and did not include the monetary value that might accompany other desirable health and developmental outcomes also associated with these programs.
• This calculator does not include the value of non-monetary costs of child abuse and neglect, including the pain and suffering of children, missed school among victims, conduct or emotional problems stemming from maltreatment, and victims’ decreased quality of life.
• Program cost estimates for economic evaluation ideally employ incremental, rather than average, costs of program implementation in a target population. CPC and NFP program costs are average program costs per child; therefore, to the extent these programs replace existing alternative services these results may overestimate the cost of the programs.
• Cost estimate studies were based on relatively small populations; it is possible that larger-scale implementation of these programs could yield lower costs per participating child or family.
• More information on the timing of child abuse and neglect incidence, as well as more information on the timing of associated costs (i.e., medical care, child welfare, etc.) could improve forecasts about the impact these programs could have.
• The reference study estimate for the lifetime cost of child abuse and neglect is an underestimate, based on limited data to estimate the full range of effects for victims and associates, as well as documented undercounting of child abuse and neglect through official reporting of substantiated cases (Reference: Fang, et al., 2012).
• When interpreting the results of this analysis, decision makers should weigh the non-monetary benefits of reduced child maltreatment and consider the range of benefits documented from these programs.

Find more discussion on the limitations of this analysis: Cost-Benefit Analysis of Two Child Abuse and Neglect Primary Prevention Programs for US States