Child protection agencies across the country are grappling with how to repair systems that failed to protect thousands of vulnerable children from repeated abuse.

Since 2012, directors of at least 16 state and county agencies have resigned or been fired. Nine states have passed sweeping reforms designed to protect more children. Those actions often followed public outrage over the deaths of children previously known to child protection agencies.

New York, Florida and Arizona overhauled their child protection systems this year, and now Minnesota is poised to follow their lead. Gov. Mark Dayton formed a child protection task force in September following the Star Tribune's report on 4-year-old Eric Dean, who was reported for abuse 15 times before he was murdered by his stepmother last year. And last week, Minnesota's Department of Human Services announced that it had hired a new assistant commissioner for Children and Family Services.

This is at least the third time Minnesota has looked to reform its system since the late 1980s. Nationwide, states have passed reforms or seen key leaders resign amid scandal, only to have children continue to die from repeated abuse and neglect.

Michael Petit, a former commissioner for the Maine Department of Human Services, estimates that up to 70 percent of the children who have died from maltreatment were known to child protection agencies, averaging at least one child a day. Since 2008, 1,046 children have died despite agencies knowing that the child was at risk or the caretaker was dangerous, according to federal data analyzed by Cornell University. Petit said there are likely thousands more.

"Child protection is in crisis," Petit said. "There are so many children being killed, nearly killed, so many who are profoundly neglected, millions of children injured each year. And yet there are hundreds of millions of dollars being spent on the system."

Congress steps in

Child protection is handled at the state and local level, but in 2013 Congress created a task force to help identify the best approaches to preventing the abuse and death of children. Petit is one of 12 members of the Commission to Eliminate Child Abuse and Neglect Fatalities, possibly the first such group of its kind.

Federal and state governments first began organizing child protection agencies in the 1960s, in response to physician reports about battered children. Ever since, there have been frequent calls to reform those services, Petit said, usually after headlines about institutional failures to prevent deaths.

Another commission member, Dr. Cassie Bevan, a child welfare fellow at the University of Pennsylvania, said if there's a child protection system operating that could serve as national model of how to prevent damage to children, she has yet to find it.

"The harm that's being inflicted on children in this country is not being taken seriously," Bevan said.

Commission Chairman Dr. David Sanders, a former head of Hennepin County's child protection unit, said the creation of the group is the response to the decades-long turmoil.

"That's why Congress put together this task force, to begin to say, 'Somebody needs to start connecting the dots here, that this isn't an isolated issue,' " Sanders said. "That this [crisis] is happening over and over, and we don't seem to be learning enough from it."

Sanders and the commission have been traveling the country working to identify how to better count the number of child abuse deaths, as well as study programs that have been successful in keeping kids safe. The group, which will visit Minnesota next year, has until the end of 2016 to report to Congress and President Obama, which Sanders said he hopes can be a model for child protection agencies.

To come up with an effective system, however, Bevan said the country needs to first answer two questions: How much is the public willing to pay for child protection, and how much government intervention in the life of a family is the public willing to tolerate?

One swing to the next

Child protection reforms often swing between two general approaches: Preserving families, even if it means keeping maltreated children with their parents, or removing children from the home and placing them in foster care. The latter may seem like the safest option, but children in foster care also have been maltreated. Taking children from their home also can create other, lasting damage, said Annette Appell, a professor at the Washington University School of Law in Missouri.

"When you're raised by the state you can still have wounds that aren't as visible as when a child is killed in the home," Appell said.

The last time Minnesota implemented child protection reforms, in the early 2000s, the state adopted an approach called "family assessment." It was intended to be used for less serious abuse cases. Instead of investigating a report and assigning blame, social workers try to stop further maltreatment by encouraging a child's caregivers to voluntarily participate in services, such as parenting classes.

Other states took notice of studies in 2004 and 2006 showing Minnesota's use of family assessment was a success. Now more than half of the child protection agencies in the country have adopted similar programs, according to a Colorado-based child protection research institute, and numerous others are working to implement it. At the same time, the number of kids in foster care in the country has steadily dropped.

Though initially meant as a response for less serious abuse reports, family assessment has become the predominant method of child protection in Minnesota. A Star Tribune investigation published in October found Minnesota has used family assessment for thousands of cases involving children who are considered at high risk for more abuse. A review of more than 400 child abuse cases found the program was used after children were reported to have been severely physically and sexually abused or abandoned. That review showed that dozens of children were later harmed, including at least 27 who were killed.

Now family assessment has come under scrutiny. Dayton's child protection task force is examining the use of the program, with some on the group calling for it to be completely overhauled.

"Minnesota is taking the hardest look at [family assessment] that I've seen," said Daniel Heimpel, publisher of the Chronicle of Social Change, which reports on child welfare.

Some child welfare advocates say use of family assessment needs to be re-evaluated nationwide. Elizabeth Bartholet, a Harvard law professor and director of the school's Child Advocacy Program, said offering voluntary services to abusive parents puts thousands of children across the country at risk for more abuse, and the pendulum needs to swing back.

"We're not removing enough children from dangerous situations," Bartholet said.

Deaths spark reforms

In some states, one child's death can spur reform. In others, it can take hundreds.

In January, Arizona Gov. Jan Brewer abolished her state's child protection agency and put that responsibility in a cabinet-level post following an Arizona Republic investigation that revealed a rash of child deaths and 6,000 abuse reports that went uninvestigated.

In June, the New York Legislature required child protection agencies to send all abuse reports to investigators, approved the hiring of more workers, and increased oversight of its system following the deaths of two children in the Buffalo area. In those cases, child protection ignored past warnings and closed investigations too soon.

That same month, Florida added child protection workers, bolstered oversight, opened up its records to the public and wrote into law that social workers could not put the rights of parents over the safety of children, the Miami Herald reported. Those reforms came after the Herald found 477 children were killed in the state since 2008 despite their families being known to child protection.

Susan Dreyfus, president of the Alliance for Strong Families and Communities, and another member of the federal commission to eliminate child deaths, said, "We have yet to come across a single jurisdiction that has a plan in place to prevent child fatalities."

But she said as she's been traveling with the commission she has seen promising attempts in several pockets of the country to address that problem, citing a Florida nonprofit as an example.

That agency, Eckerd, was tabbed to handle child protection in the Tampa area following a string of nine child abuse deaths from 2009 to 2011. Eckerd reviewed those cases and 1,500 others to develop a system of responding to children who had the highest probability of serious injury or death. In two years there have been no child abuse fatalities in Eckerd's jurisdictions, which covers a population of about 3 million people.

Despite that success, Eckerd's chief of quality and program performance, Ron Zychowski, cautioned that the approach is not the panacea for ending child protection failures.

"At the end of the day, child welfare professionals cannot be in a home 24/7," he said. "And unfortunately we have bad people in our communities who do bad things to children."

In Minnesota, Dayton's child protection task force will make preliminary recommendations by the end of December. Those recommendations are expected to be considered by the 2015 Legislature.

Brandon Stahl • 612-673-4626