Each year, tens of thousands of children in San Bernardino County are reported to Child Protective Services. At Loma Linda University Children’s Hospital, a specialized medical team has become one of the most influential forces in identifying abuse, protecting young victims, and guiding families toward long-term healing.
Now, with a $7.5 million investment from San Bernardino County, that team is preparing to expand its reach even further.
For nearly 30 years, Loma Linda University Health (LLUH) has served as the county’s lead agency for forensic medical evaluations in suspected child abuse cases. Today, the program, anchored by the Resiliency Institute for Childhood Adversity (RICA), is responsible for examining children, determining whether injuries are accidental or abusive, and coordinating with law enforcement and social services to ensure safety.
“These evaluations are an essential part of the process that ensures child abuse is recognized and a child’s immediate safety is secured,” said Amy Young, MD, chief of the division of forensic pediatrics and founder of RICA. “But more importantly, they open the door to healing. What matters to us is not only diagnosing abuse, but understanding what the child and family need next.”
As the population has risen and awareness has grown, so has the demand for forensic medical expertise. Young recalls a time when the team handled about 500 cases annually. That number is now nearing 4,000 children a year, reflecting both increased access to specialized care and the county’s growing coordination with LLUH.
To meet this demand, the program has expanded steadily. What began as a one-physician service is now staffed by five attending child abuse pediatricians, five nurse practitioners, and two physicians currently in training, making it one of the more robust teams of its kind in the nation. There are less than 350 practicing child abuse pediatricians nationwide, according to Young.
“It takes specialized training to interpret injuries, interview children appropriately, and understand the complexities of trauma,” Young said. “The larger our team, the more children we can serve with timeliness and accuracy.”
This fall, San Bernardino County approved a $7.5 million commitment over five years to help expand staffing and plan for new service sites that bring care closer to families across the region. The Board of Supervisors voted unanimously in support after touring RICA and meeting with hospital leaders.
“With San Bernardino County’s population on the rise and more families seeking support, we must ensure our child protection resources grow as well," said Dawn Rowe, San Bernardino County Board of Supervisors Chairman and Third District Supervisor. "Expanding the RICA team means we’re ready to respond to the increased need and heightened awareness around child abuse."
“We want to build a system where every child, no matter where they live, receives immediate, coordinated expert care,” Young said. “This partnership allows us to move toward that vision.”
A key focus of the expansion will be plans to develop a coordinated system of care throughout the county with possible planned satellite locations, reaching regions where families often face hours-long travel to reach LLUH.
“Our county is the largest geographic county in the nation,” Young said. “If a child is in Barstow and there’s concern for abuse, we want them to have access to a trained evaluator without having to be transported 80 miles away. That matters for trauma, for safety, and for timely decision-making.”
The plan includes:
- Training and hiring additional physicians
- Creating more practice sites staffed by specialists
- Building remote and regional clinical locations
- Strengthening coordination with Children and Family Services (CFS), law enforcement, and the District Attorney’s Office
RICA’s integrated approach, combining medical evaluations, long-term primary healthcare, mental health support, family advocacy, research, and community partnerships, has gained statewide recognition. The program was recently named one of 10 exceptional trauma-informed care models in California through a state grant designed to formalize best practices.
“We work hand in hand with Child Protective Services, law enforcement agencies, prosecutors, county administrators, and community partners,” Young said. “Children deserve a system that speaks to one another, not siloed services. That’s what RICA represents.”
Young says the work is as much about the future as it is about the child in front of her.
“We see kids years later who didn’t have someone to guide them, who aged out of foster care alone or missed opportunities they deserved,” she said. “Our responsibility is not just to identify abuse, it’s to make sure they have the support to thrive.”
As RICA prepares to expand, Young hopes the model will inspire other counties to create their own systems.
“If every child in California had access to comprehensive, coordinated care like this,” she said, “we could change the trajectory of countless lives.”
If you witness or suspect a crime, contact the law enforcement jurisdiction responsible for that area. Additionally, if the child involved resides in San Bernardino County, please contact Child Welfare Child Protective Services for that county. This means that if you believe the crime occurred in Riverside County, but the child lives in San Bernardino County, you'll need to report to two different entities.
The child abuse hotline is accessible by dialing 211. By stating that you want to report a suspected case of child abuse, your call will be directed to child welfare or child protective services.
More stories about: Children’s Hospital Children's health
Related Articles
