When police or child protective services believe a child is being abused, the child is brought to the CAC by a caregiver or other “safe” adult. At the CAC, the child tells his/her story once to a trained interviewer who knows the right questions to ask. Based on the interview, a multidisciplinary team decides how to help the child, drawing on a wide range of services, such as therapy, medical exams, courtroom preparation, victim advocacy, and case management. In 2018, CACs served 367,731 abused children. From 2017 to 2018, the number of counties served by NCA member CACs increased by 62, from 2,021 counties in 2017 to 2.083 counties in 2018. A map shows the location of CACs across the United States. At the NCA 2018 Leadership Conference, the SHINE Campaign was announced. This is a national, survivor-focused, CAC-led campaign that will transform the conversation around child abuse and the stigma for victims, treat the trauma, and inspire hope. This campaign will begin in 2019. At the state level, NCA has worked closely with CACs to draft legislation and secure state funding. Statutory definitions of CACs, immunity from civil liability, statute of limitations reforms, and funding increases are a few of the policy priorities that have made progress in 2018. Reports on the work of specific CACs are provided. A statement of financial activities is included in this report, and staff members are profiled.