Navajo Nation Council hears child sexual abuse services report from Tséhootsooí Medical Center’s Family Advocacy Center
24th Navajo Nation Council
Dr. Renee Ornellas, a child abuse pediatrics specialist at the Tséhootsooí Medical Center in Fort Defiance, reported to the Naabik’íyáti’ Committee of the 24th Navajo Nation Council November 17 observations from five years on the Navajo Nation as a mandated reporter of child sexual abuse cases.
“The services we provide for children are generally evaluations that take three to four hours. They’re comprehensive and involve a detailed history from the parents, which includes a history of the concern of child sexual abuse and all their physical and behavioral concerns,” said Ornellas.
Children arrive at the Family Advocacy Center through an appointment or walk-in basis, with some children arriving to the emergency room. Referrals are also received from the surrounding areas through law enforcement, social services, schools or word-of-mouth.
The report, called for by Council Delegate Amber Kanazbah Crotty (Cove, Toadlena/Two Grey Hills, Red Valley, Tsé’ałnáoozt’i’í, Sheepsprings, Beclabito, Gad’ii’áhí/Tó Ko’í), focused on children aged 12 years-old and younger who received care by Ornellas and the Family Advocacy Center. In the years 2017 to 2019, Ornellas said 98 children were seen, with only three cases requiring her expert testimony in court.
“I feel there are a number of very serious cases of child sexual abuse that, for some reason, aren’t rising to the level where they have justice being pursued for these children and their families,” said Ornellas. Over 28 years working in Albuquerque, Ornellas delivered 30 to 50 court testimonies during a given three-year period. Most appearances were in criminal courts because child sexual abuse is a felony.
As a provider of comprehensive child sexual abuse evaluations, Ornellas works with local advocates, social workers and police departments in Zuni, Window Rock, Gallup, and Crownpoint. “I’m the only one who does pediatric cases, I think, on the Navajo Nation. So, when I’m not here, the children have to go to Albuquerque, Farmington or Flagstaff,” said Ornellas.
“I did my job, as a mandated reporter, of filling out a report form to make all the agencies aware of the fact that we had this child here, because many of the children came and nobody had talked to them or taken a report or let the official investigators know. And that’s still the case,” stated Ornellas.
When she started on the Navajo Nation, Ornellas noted the Federal Bureau of Investigation (FBI) took child sexual abuse cases and decided which children would be given comprehensive evaluations.
In many cases, perpetrators are trusted family members or relatives that parents leave children with to look after. “That’s who does this, not strangers in the street, that’s not who we leave our children with. We leave them with people we trust,” Ornellas added. “The problem is that there’s perpetrators who have never had to answer or who have never been held accountable for the harm that they’ve caused.”
Council Delegate Elmer Begay (Dilcon, Indian Wells, Teesto, Whitecone, Greasewood Springs) sought recommendations from Ornellas regarding historical child sexual abuse studies and how the center’s services can be expanded. “That’s one of the main social ills that we have on the reservation, not only today, it’s been like that ever since I was growing up,” said Begay.
Responding to Begay’s request, Ornellas described the center’s current makeup, “It’s myself, a provider, a nurse, two advocates and an admin assistant for the entire program, and we’re on-call 24 hours a day, seven days a week.” The center is a focused clinical program that collects forensic evidence.
Ornellas acknowledged the limited scope of the current program, stating, “It takes legislative decisions, I think, to mandate, to say, ‘this is how we’re going to do it,’ ‘this is what we’re going to do,’ ‘this is what our expectations are,’ and it starts with something like that.”
Council Delegate Eugenia Charles-Newton (Shiprock) noted, as a former prosecutor for the Navajo Nation, “Indian Health Service does work directly with the department of public services, with social services, with the prosecutor’s office.” She described regular meetings of the multidisciplinary team (MDT) comprised of prosecutors, law enforcement, criminal investigators, social service providers and medical doctors that brief child sexual abuse cases so none were overlooked.
Multidisciplinary teams, responded Ornellas, were created to reduce the number of times a child was interviewed. In participating in local multidisciplinary teams, she said meetings used to be monthly but are now quarterly. “I would not describe the meetings that we’re having as multidisciplinary team meetings because an multidisciplinary team meeting should be a two-hour meeting” that includes case review in the first hour, said Ornellas. The second hour is composed entirely of administration, which includes every decision maker from the various agencies.
Local police departments and criminal investigators are frequently absent at the table during multidisciplinary team meetings, said Ornellas. Additionally, only cases involving social services are included in the list of case reviews, where most cases she sees do not involve social services because the children are safe.
“I can’t get them on the list. So, respectfully, I would not call the meetings I have been a part of for the last five years multidisciplinary teams. I would call them case reviews, and they’re important, but they don’t represent all the patients that are seen,” said Ornellas.
Council Delegate Nathaniel Brown (Dennehotso, Kayenta, Chííłchinbii’tó), vice chair of the Navajo Sexual Assault Prevention Subcommittee (NSAPS), acknowledged the continuing oversight by the Law and Order and the Health, Education, and Human Services Committees in the area of child sexual abuse, in addition to the Navajo Nation Council and Division of Social Services.
“These are the children that are going to be taking care of us. These are the youth that will be dictating how Navajo’s future is going to be, the decisions that will be made,” said Brown. He asked of Ornellas, “What else do you need in your toolbox?”
Ornellas requested time to compile input and recommendations for legislative consideration. “It’s a long discussion,” said Ornellas. “This would be a bigger conversation, a longer conversation, with many different partners, agencies, collaborators who are all working on the same issue in good faith.”
“We have heard the challenges from the Navajo Nation programs, and we want to make sure that we can support them and so we can provide justice to our people who experience violence,” concluded Crotty, chair of the Navajo Sexual Assault Prevention Subcommittee.
Support and coordination will also be assisted through the Diné Action Plan, a Navajo Nation effort to improve programs relating to suicide, violence and substance addiction services.
The Naabik’íyáti’ Committee accepted the report by a vote of 20 in favor and 0 opposed.