More than a decade before the Penn State University child sex abuse scandal broke, an assistant football coach told his supervisors that he had seen Jerry Sandusky molesting a young boy in the shower. When this was revealed during Sandusky’s criminal trial in 2012, it prompted public outcry: Why hadn’t anyone reported the abuse sooner?

In response, Pennsylvania lawmakers enacted sweeping reforms to prevent anything like it from ever happening again.

Most notably, they expanded the list of professionals required to report it when they suspect a child might be in danger, broadened the definition for what constitutes abuse and increased the criminal penalties for those who fail to report.

“Today, Pennsylvania says ‘No more’ to child abuse,” then-Gov. Tom Corbett declared as he signed the legislation into law in 2014.

A flood of unfounded reports followed, overwhelming state and local child protection agencies. The vast expansion of the child protection dragnet ensnared tens of thousands of innocent parents, disproportionately affecting families of color living in poverty. While the unintended and costly consequences are clear, there’s no proof that the reforms have prevented the most serious abuse cases, an NBC News and ProPublica investigation found.

Instead, data and child welfare experts suggest the changes may have done the opposite.

The number of Pennsylvania children found to have been abused so severely that they died or were nearly killed has gone up almost every year since — from 96 in 2014 to 194 in 2021, according to state data. State child welfare officials say more vigilance in documenting severe cases of abuse likely contributed to the increase. But child safety advocates and researchers raised concerns that the surge of unfounded reports has overburdened the system, making it harder to identify and protect children who are truly in danger.

In the five years after the reforms took effect, the state’s child abuse hotline was inundated with more than 1 million reports of child maltreatment, state data shows. More than 800,000 of these calls were related not to abuse or serious neglect, but to lower-level neglect allegations often stemming from poverty, most of which were later dismissed as invalid by caseworkers.

The number of children reported as possible victims of abuse or serious neglect increased by 72% compared to the five years prior, triggering Child Protective Services investigations into the well-being of nearly 200,000 children from 2015 to 2019, according to a ProPublica and NBC News analysis of federal Department of Health and Human Services data. From this pool of reports, child welfare workers identified 6,000 more children who might have been harmed than in the five previous years. But for the vast majority of the 200,000 alleged victims — roughly 9 in 10 — county agencies dismissed the allegations as unfounded after inspecting families’ homes and subjecting parents and children to questioning.

The expanded reporting requirements were even less effective at detecting additional cases of sexual abuse. Some 42,000 children were investigated as possible sex abuse victims from 2015 to 2019 — an increase of 42% from the five years prior — but there was no increase in the number of substantiated allegations, the analysis of federal data showed. In other words, reforms enacted in response to a major sex abuse scandal led to thousands more investigations, but no increase in the number of children identified as likely victims.

Child welfare experts say these findings cast doubt on the effectiveness of the primary tool that states rely on to protect children: mandatory child abuse reporting. These policies, the bedrock of America’s child welfare system, were first implemented more than half a century ago in response to growing national awareness of child maltreatment. The thinking was simple: By making it a crime for certain professionals to withhold information about suspected abuse, the government could prevent vulnerable children from falling through the cracks.

Over the past decade, at least 36 states have enacted laws to expand the list of professionals required by law to report suspicions of child abuse or imposed new reporting requirements and penalties for failing to report, according to data compiled by the National Conference of State Legislatures, a group representing state governments.

Some legal experts and child welfare reform activists argue these laws have created a vast family surveillance apparatus, turning educators, health care workers, therapists and social services providers into the eyes and ears of a system that has the power to take children from their parents.

“I don’t think we have evidence that mandated reporting makes children safer,” said Kathleen Creamer, an attorney with Community Legal Services, a Philadelphia nonprofit that provides free representation to parents accused of abuse and neglect. “I actually think we have strong evidence that it puts child safety at risk because it makes parents afraid to seek help, and because it floods hotlines with frivolous calls, making it harder for caseworkers to identify families who really do need services.”

In a yearlong investigation, ProPublica and NBC News are examining the extraordinary reach of America’s child welfare system and its disproportionate impact on the lives of low-income families of color. The stream of reports generated by mandatory reporting is so vast, and so unevenly applied, public health and social work researchers estimate that more than half of all Black children nationally will have been the subject of a child protective services investigation by the time they turn 18 — nearly double the rate of white children.

After a hotline report comes in, it’s the job of child welfare investigators to determine whether a child is truly in danger. These caseworkers aren’t held to the same legal or training standards as law enforcement, but they can wield significant power, ProPublica and NBC News found, sometimes pressuring their way into homes without court orders to comb through closets and pantries, looking for signs of what’s lacking.

Under this system, child welfare agencies investigate the families of 3.5 million children each year and take about 250,000 kids into protective custody, according to federal data. Fewer than 1 in 5 of these family separations are related to allegations of physical or sexual abuse, the original impetus behind mandatory reporting. Instead, the vast majority of removals are based on reports of child neglect, a broad range of allegations often tied to inadequate housing or a parent’s drug addiction.

In response, a growing movement of family lawyers, researchers and child welfare reform advocates have called for a radical change in the approach to child protection in America, starting with the abolition of mandatory reporting. This idea has grown in popularity among both progressive activists and conservatives who oppose what they call excessive government intrusion in the lives of families. Other critics support less dramatic reforms, such as limiting which professionals are required to report and providing better training for mandated reporters.

The fallout from Pennsylvania’s expansion of mandatory reporting has become something of a cautionary tale among those calling for a system overhaul. Even some proponents of the changes have begun to question their impact.

State Rep. Todd Stephens, a Republican who helped spearhead the post-Sandusky reforms, said the impact of the changes warranted closer examination. In response to NBC News and ProPublica’s findings, he said he would lead a legislative effort to take a “deep dive in the data” to ensure the laws are protecting children as intended.

But Stephens said he believes the legislation is working, citing the massive increase in hotline reports and the 6,000 additional children with substantiated findings of abuse or serious neglect over five years.

“The goal was, if people thought children were in trouble or in danger, we wanted the cavalry to come running,” Stephens said. “That’s 6,000 kids who are getting help who might not have otherwise.”

Child welfare experts, however, cautioned against drawing conclusions based on the increase in substantiated abuse cases because those are subjective determinations made by caseworkers that children were more likely than not to be at risk of being abused and do not indicate whether the findings were ultimately dismissed by a judge.

Dr. Rachel Berger, a professor of pediatrics at the University of Pittsburgh who served on a task force that paved the way for the 2014 reforms, said the state has not produced evidence to show the changes have made children safer.

In 2020, while testifying before the Pennsylvania House of Representatives, Berger warned lawmakers that the reforms “may have inadvertently made children less safe” by straining the system and siphoning resources away from genuine cases of abuse.

“We are continuing to tell mandated reporters, ‘Report, report, report,’ and nobody can handle it,” Berger said in an interview.

Jon Rubin, deputy secretary at the Pennsylvania Department of Human Services’ Office of Children, Youth and Families, which oversees the state’s ChildLine call center, said it’s “really hard to evaluate” whether the 2014 reforms succeeded in making children safer overall. Rubin said he’s aware of the concern that the changes overwhelmed the system and may have contributed to the increase in child abuse deaths. But he cautioned against drawing conclusions without considering other factors, such as the strain on the system caused by the fentanyl epidemic beginning in 2017.

Rubin said his agency is studying ways to reduce the number of hotline reports related to poverty and housing issues, in part by encouraging mandatory reporters to instead connect families directly with resources. The state has also made it a priority to keep struggling families together by providing access to services such as mental health counseling and parental support groups, Rubin said. He worries about the potential impact of more dramatic changes.

“How many children’s lives are we willing to risk to, as you said, abolish the system, to reduce the overreporting risk?” Rubin said. Would preventing unnecessary reports, he asked, be worth “one more child hurt or killed, five more children hurt or killed, 100 more children hurt or killed?”

But Richard Wexler, the executive director of the National Coalition for Child Protection Reform, a Virginia-based advocacy group, said that this logic ignores the harm that comes with unnecessary government intrusion in the lives of innocent families. Simply having an investigation opened can be traumatic, experts say, and numerous studies show that separating young children from their parents leads to increased risk of depression, developmental delays, attachment issues and post-traumatic stress disorder.

It isn’t necessary to threaten educators, social workers, doctors and other professionals with criminal charges in order to protect children, Wexler argued.

“Abolishing mandatory reporting does not mean abolishing reporting,” he said. “Anybody can still call ChildLine. What it does, however, is put the decision back in the hands of professionals to exercise their judgment concerning when to pick up the phone.”

The Cost of Seeking Help

April Lee, a Black mother of three in Philadelphia, said she has seen and experienced firsthand the way mandatory reporting and the prospect of child removals create a culture of fear in low-income communities.

In Philadelphia, the state’s most populous city, Black children were the focus of about 66% of reports to the city’s Department of Human Services, its child welfare agency, even though they make up about 42% of the child population, according to a 2020 report commissioned by the department.

Over time, Lee said, moms in neighborhoods like hers get used to having child welfare agents show up on their steps.

“It’s a shame,” she said. “You get to the point where it’s almost normalized that you’re going to have that knock on your door.”

Lee estimates that she’s personally had about 20 such reports filed against her in the two decades since she gave birth to her first child at the age of 15. In most instances, she said, the caseworkers didn’t leave her with paperwork, but she said the accusations ranged from inadequate housing to concerns over her son’s scraped knee after a tumble on the front porch.

The agency never discloses who files the reports, but Lee believes it was a call from a mandatory reporter that triggered the investigation that resulted in her children being taken away. In 2013, a year after the birth of her third child, Lee said, she was drugged at a bar and raped. In her struggle to cope with the trauma, she said, she confided in a doctor.

“I was honest,” Lee said. “Like ‘I’m fucking struggling. I’m struggling emotionally.'”

She suspects someone at the clinic where she sought mental health care made the hotline call, most likely, she said, believing that the city’s child welfare agency would be able to help.

The agency opened an investigation and determined that Lee — who at one point had left her three children with a friend for several days — was not adequately caring for her children. The agency took them into protective custody, according to court records reviewed by NBC News and ProPublica. Afterward, Lee said, she spiraled into drug addiction and homelessness.

At her lowest point, Lee slept on a piece of cardboard in the Kensington neighborhood, the epicenter of Philadelphia’s opioid crisis. It took two years to get clean, she said, and another three before she regained custody of all of her children.

Lee said people like to tell her she’s proof that the system works, but she disagrees.

“My children still have deficits to this day due to that separation,” she said. “I still have deficits to this day due to that separation. I still hold my breath at certain door knocks. That separation anxiety is still alive and well in my family.”

Now Lee works as a client liaison at Community Legal Services, guiding parents through the system. The job is funded by a grant from the city agency that took her children. Virtually all of the mothers she works with have one thing in common, she said: They’re struggling to make ends meet.

“We see that in a lot of our cases,” Lee said. “You have someone that went to their doctor to say, ‘Hey, I relapsed.’ That’s a call to the ChildLine. Or you have a family that might go into a resource center saying, ‘Hey, we’re homeless.’ That’s a call to the ChildLine. You have children that show up to school without proper clothing. That’s a call to the ChildLine.”

But mandatory reporting, and the fear that it provokes, makes it harder for them to get the help they need.

“The solution to poverty,” Lee said, “should not be the removal of your children.”

Policies Driven by Outrage

In 1962, a pediatrician named C. Henry Kempe published a seminal paper identifying a new medical condition that he called “the battered-child syndrome.” Drawing on a survey of hospital reports nationwide and a review of medical records, Kempe warned that physical abuse had become a “significant cause of childhood disability and death” in America and that this violence often went unreported.

The paper led to widespread media attention and calls to address what some experts began calling the nation’s hidden child abuse epidemic. In the rush to take action, one solution emerged above all else: mandatory reporting.

Within four years of Kempe’s paper, every state had passed some form of mandatory child abuse reporting. In 1974, despite a lack of research into the effects of these new policies, the approach was codified into federal law when Congress enacted the Child Abuse Prevention and Treatment Act, which requires states to have mandatory reporting provisions in order to receive federal grants for preventing child abuse.

It became conventional wisdom among child welfare policymakers that more reporting and investigations would make children safer. States gradually expanded reporting requirements in the decades that followed, adding ever more professionals — including animal control officers, computer technicians and dentists — to the list. They also expanded the definition of child maltreatment to include emotional abuse and neglect.

But critics say these policy decisions too often have been guided by public outrage and politics, not by data and research.

“Reporting has been our one response to concerns about child abuse,” said Dr. Mical Raz, a physician and professor of history at the University of Rochester who has studied the impact of mandatory child abuse reporting. “Now we have quite a bit of data that shows that more reporting doesn’t result in better identification of children at risk and is not associated with better outcomes for children, and in some cases may cause harm to families and communities.”

The Sandusky scandal, Raz said, demonstrates how a high-profile atrocity and public outcry can drive policy decisions.

The longtime Penn State assistant football coach was convicted in 2012 on 45 counts of child sexual abuse tied to the repeated rape and molestation of boys over a 15-year period. An investigation commissioned by the Penn State Board of Trustees found that several university officials, including legendary Nittany Lions football coach Joe Paterno, had known about allegations of sex abuse against Sandusky as early as 1998, but had shown a “total and consistent disregard” for “the safety and welfare of Sandusky’s child victims.”

In response, Pennsylvania passed a raft of reforms. It clarified and expanded the definition of abuse and added tens of thousands of additional people to the state’s roster of mandated reporters — which now includes virtually any adult who works or volunteers with children. It also increased the criminal consequences for failing to report child abuse, with penalties ranging from a misdemeanor to a second-degree felony, punishable by up to 10 years in prison. Although such prosecutions are rare, child welfare officials said the threat is effective in driving more professionals to report.

But the state failed to include additional funding to handle the anticipated increase in hotline calls and investigations, despite warnings from county officials that the reforms “were going to put a massive strain on their workers and would require additional resources,” according to a 2017 report from the state auditor general.

Those warnings proved prescient. In early 2015, after the changes went into effect and thousands of additional reports flooded Pennsylvania’s child abuse hotline, state officials estimated 4 in 10 callers were placed on hold for so long that they hung up before getting a caseworker on the line.

Some ChildLine workers reported an uptick in calls from mandated reporters who openly acknowledged they did not really believe that a child was in danger. Haven Evans, now the director of programs at Pennsylvania Family Support Alliance, which trains mandatory reporters across the state, was working at the state’s hotline center that year.

“There were a lot of mandatory reporters who would even admit on the phone call that they were making this report because they were concerned with the changes in the law and the penalties being increased,” Evans said. “They just wanted to, for lack of a better word, cover their butt.”

In the months and years that followed, the state added funding and workers and upgraded call center technology to keep up with the deluge. But taking a report is just the first step of the process — what some refer to as the child welfare system’s “front door” — and not enough attention has been paid to studying whether the system as a whole leads to better outcomes, said Cathleen Palm, founder of the Center for Children’s Justice, a nonprofit in Bernville, Pennsylvania, that advocates for government interventions to protect children.

In 2018, Palm came out against proposed legislation to further expand mandatory reporting that had been introduced in the wake of the Catholic clergy sex abuse scandal and grand jury investigation. Even though Palm is herself a survivor of child sexual abuse, her calls for a formal study before passing more reforms made her a target of attacks, she said.

“I literally got called by a senior official at the attorney general’s office, who called me screaming at me, equating me to a friend of the pedophile,” Palm said. “I was floored. Do you have any sense of who you’re talking to?”

The following year, state lawmakers acted anyway, passing a law that expanded when failure to report is a felony.

The same dynamic has played out across the country: High-profile media coverage of child abuse deaths and child sexual abuse have created overwhelming political pressure to ramp up mandatory reporting, in red and blue states alike.

Eighteen states have gone so far as to implement universal child abuse reporting requirements, deputizing every adult in the state as a mandatory reporter. But a 2017 study published in the American Journal of Public Health found that universal reporting requirements led to more unfounded reports while failing to detect additional confirmed cases of child maltreatment.

Kelley Fong, an assistant professor of sociology at the University of California, Irvine, has done extensive research into the impacts of mandatory reporting policies. When Fong interviewed dozens of impoverished mothers in Rhode Island and later Connecticut, they described how mandated reporters are “omnipresent” and how the fear of a call to Child Protective Services leads some to avoid seeking public assistance.

But when she spoke to professionals who had filed reports against parents, Fong found a disconnect.

“Almost to a person, every single mandated reporter said, ‘I reported because I wanted to help the family,'” Fong said. “For the most part, these mandated reporters are in their jobs because they want to help people, they want to improve conditions for children and families. And so here is this agency that offers them this possibility of getting help to parents and children.”

Fong compared this approach to sending armed police officers to assist people struggling with homelessness, mental illness and addiction — a practice that’s drawn increased scrutiny since 2020’s nationwide demonstrations for racial justice and police reform. But while there’s growing awareness of the consequences of what activists view as the overpolicing of Black communities, Fong said fewer people have applied that same critical lens to child welfare.

That’s starting to change.

In 2019, in response to concerns that Massachusetts wasn’t doing enough to protect children, the state legislature voted to create a special commission to study how best to expand mandatory reporting requirements. For two years, the commission was progressing toward that goal — until they agreed to hear public comments on their plans.

During four hours of virtual testimony in April 2021, the commission heard from dozens of parents, social workers, legal experts and reform activists, most of whom expressed deep concerns about the potential harms of expanded reporting requirements. Raz was among those who testified, citing as a warning the dysfunction that followed the Pennsylvania reforms.

Afterward, members of the commission said they were “shocked” and “taken aback” to learn about potential problems associated with expanding the child welfare system. As a result, when the commission delivered its final report to lawmakers in June 2021, it made no formal policy recommendations.

Instead, it called for further study of the unintended impacts of mandatory reporting.

The Strain on Philadelphia’s System

Few places were harder hit by Pennsylvania’s surge of new child abuse reports after 2015 than Philadelphia.

Kimberly Ali, commissioner of the Philadelphia Department of Human Services, the city’s child welfare agency, acknowledged in an interview with NBC News that the change in the state’s mandatory reporting policies put a strain on Philadelphia’s system. She said the local hotline managed by her department “imploded” after the Sandusky reforms. It took the agency years to recover.

“That was a difficult time at the Department of Human Services, just trying to manage the number of calls and the number of investigations,” Ali said.

In a city where nearly a quarter of residents live in poverty, the deluge of new reports disproportionately involved Black families and led to a sharp increase in the number of Philadelphia children being taken from their parents. In 2017, the city’s child welfare agency removed the most children per capita among the 10 largest cities in the U.S. — at three times the rate of New York and four times that of Chicago, according to data compiled by the National Coalition for Child Protection Reform.

Five of those children belonged to Lisa Mothee.

On Aug. 21, 2017, a mandatory reporter employed by the Einstein Medical Center in Philadelphia called in a hotline report flagging that Mothee’s newborn baby had tested positive for opioids. The hospital later reported that Mothee had also failed to provide her baby with proper medical care, because she declined vaccinations and other medical screenings typically provided to newborns, according to court records.

At a court hearing a month later, Mothee, who is Black, told a judge that she had taken a Percocet to cope with pain late in her pregnancy. She explained that she’d stopped consenting to vaccines after one of her children had an adverse reaction several years earlier, which she believed was her right as a parent. After a lawyer for the city’s child welfare agency acknowledged in court that they didn’t have reason to believe Mothee’s children were in danger, she figured the case would be dismissed.

Instead, the judge ordered Mothee and the father of four of her children to be handcuffed and held in court for several hours while child protection agents picked up all five of her kids from school and a babysitter.

“What? No!” Mothee called out, according to a court transcript. “You can’t take my kids! You can’t take my kids!”

Eight months would pass before a different judge ordered her children to be returned. Years later, Mothee said she’s still struggling with the trauma of the ordeal. “It’s like a death,” she said. “You never get over that feeling.”

Mothee’s case was part of a statewide trend post-Sandusky.

The number of Pennsylvania children reported as possible victims of serious medical neglect — a blanket term describing a parent’s failure to provide adequate medical care — nearly quadrupled after the reforms went into effect in 2015, triggering Child Protective Services investigations into the well-being of about 9,600 children over a five-year span, according to the ProPublica and NBC News analysis of federal data.

This surge followed a change in how the state defined when neglect, including medical neglect, can be considered a form of child abuse. Lawmakers lowered the threshold from any failure to care for a child that endangers their “life or development,” to any failure that “threatens a child’s well-being.” Critics say the change has usurped parents’ right to make medical decisions for their children and has punished people who lack easy and affordable access to health care.

Mothee’s case was among several cited in a scathing report issued in April by a special committee of the Philadelphia City Council that detailed the unintended consequences of mandatory child abuse reporting and alleged failures at Philadelphia’s child welfare agency.

City Councilmember David Oh pushed for the creation of the special committee after his own brush with a mandatory reporter in 2018. A hospital worker at the Children’s Hospital of Philadelphia had phoned in a hotline report after Oh, a Republican and the city’s first Asian-American councilmember, brought his son to the emergency room with a broken collarbone. Oh explained that his boy had been injured while practicing martial arts, but the hospital social worker said she had no choice but to notify the city, triggering what Oh viewed as a senseless investigation into a report that was ultimately deemed unfounded.

Afterward, Oh said, he heard from dozens of Philadelphia parents, including Mothee, who’d gone through similar ordeals.

Ali, the DHS commissioner, said her agency has reduced the city’s foster care rolls by about 29% since 2017, with an increased focus on providing families with services rather than removing children. But Oh said not enough has been done to mitigate the fear created by mandatory reporting, especially in poorer Black communities.

“In those neighborhoods, everyone knows about mandated reporters,” Oh said during an interview at his office. “So when your child falls off a bike, you’ve got to think, ‘Do we take him to the hospital or not?'”

Oh’s committee made several recommendations for reforms — including a call for the state to abolish mandatory reporting.

“They have a system where everyone pulls a fire alarm anytime they feel like there’s a potential for fire, and theoretically it’s great because we’re going to catch every fire before it begins,” Oh said. “But how it’s worked out is all our firefighters are running around to false alarms, and now buildings are burning and people are dying. It’s a bad system.”

“Mandatory Reporters Into Mandatory Supporters”

Some experts argue that the best way to reduce unfounded reports of child abuse and neglect is not by abolishing mandatory reporting, but by doing a better job of training professionals on when to report — and when it’s better to provide help to a family in need instead.

In Pennsylvania, medical professionals are required to complete a two-hour mandatory reporter training course every two years; other professionals must take a three-hour training every five years.

But Dr. Benjamin Levi, a pediatrician and former director of the Center for the Protection of Children, a research and policy group at Penn State Children’s Hospital, said such training programs typically lack a clear explanation of the “reasonable suspicion” of abuse that should trigger a report.

“‘Reasonable suspicion’ is a feeling — they don’t even define it,” said Levi, who developed an alternative training for mandatory reporters to help fill in the gaps.

“If you increase mandated reporting, and you don’t make sure that mandated reporters know what to report and what not to report, you’ve just made the problem worse.”

Educators, the largest source of child abuse reports nationally, in particular have struggled to correctly identify children in need of help. From 2015 to 2019 in Pennsylvania, 24 out of 25 children referred to Child Protective Services by education professionals had their cases dismissed by case workers as unsubstantiated — but only after children and parents had been subjected to questioning and home searches.

Ali, the head of the Philadelphia child welfare agency, said her department has heard from educators who felt unable to help struggling families because they feared potential criminal charges for not reporting to the abuse hotline. With the support of a federal grant, her department plans to create an alternative hotline that mandatory reporters can call when they believe a family is in need but don’t suspect children are in danger.

Adopting the language of reform activists, Ali said the goal is “turning mandatory reporters into mandatory supporters.”

But Benita Williams, former operations director of Philadelphia’s child welfare agency, warned against more radical change, stressing that mandatory reporters should never hesitate to make a report in cases of suspected child abuse.

“Just report,” said Williams, now executive director of the Philadelphia Children’s Alliance, which supports victims of child sexual abuse. “If you are not sure, report and let the professional screen that out. Don’t try to become a social worker.”

Phoebe Jones, who helps lead DHS-Give Us Back Our Children, a group that advocates on behalf of Philadelphia mothers and grandmothers who’ve had children taken from them for issues related to poverty and domestic violence, argues that the real solution is to address the issues underlying most ChildLine reports, by providing parents and caregivers with a universal basic income to ensure they have what they need to care for children.

“Rather than taking children from their mothers and paying foster parents to care for them,” Jones said, “why don’t we invest that money in families?”