Child abuse deaths in Pennsylvania skyrocketed during the pandemic, according to a new report, which is driving calls for more reforms to the state’s troubled child welfare system.

The report, released by state Department of Human Services last week, found child abuse deaths increased by 43% from 2019 to 2020, with at least 73 children dying and 115 children nearly dying as a result of abuse.

A majority of the children died from “a violent act” but many others died or nearly died from ingesting prescription drugs or illegal narcotics, according to the report.

Last year, 43 children reportedly almost died from illegal or prescription drugs, according to the report, compared to 21 near fatalities in 2019. In 2020, at least 11 children died from ingesting drugs, while in 2019 three died.

State health officials say the data is reflective of the impact of the opioid epidemic on the state, which has surged amid the pandemic.

“Drug use in the home has been the highest reason for the significant injuries to children,” Jon Rubin, DHS deputy secretary, told reporters during a news briefing.

Meanwhile, reports of suspected child abuse to the state Child Protective Services fell 22%, from 32,919 reports in 2019 to 42,252 reports in 2020, according to the report.

The report is the latest development in Pennsylvania’s troubled child welfare system, which has been rocked by a series of scandals in recent years.

Last year, Gov. Tom Wolf’s administration revealed that it had failed to advertise an amendment to the state’s constitution extending the statute of limitations for child sex abuse victims to file in civil court against abusers.

The constitutional amendment, which would have put before voters on the May state primary ballot, was aimed at helping victims of sexual abuse by Catholic priests and others to seek redress in the courts.

The mistake prompted the resignation of Secretary of State Kathy Boockvar earlier this year and a public apology from Wolf, who said the mistake will “be heartbreaking for thousands of survivors of childhood sexual assault, advocates and legislators.”

In a news release accompanying the report, the Wolf administration noted efforts that have improved outcomes for abused children in foster care and their families, citing an increase in the percentage of children in foster care who are placed in kinship care with family.

As of April 2021, 44% of children in foster care were placed with relatives – compared to 31.5% in 2015, according to the Wolf administration.

Pennsylvania officials also point to a decline in the use of congregate settings – such residential group homes – in the state’s foster care system.

In 2015, 17.1% of children in foster care were in congregate settings in the state. By 2019, that dropped to 12.7%, according to state data.

About 14,000 children are currently in foster care in the state in 2020, nearly 2,800 fewer than in 2019, the Wolf administration said.

DHS acting Secretary Meg Snead also touted that the state has implemented the Family First Prevention Services Act, a federally funded program enacted in 2018 that prioritizes keeping children in abusive situations out of foster care by providing mental health or substance abuse treatment for abusive parents.

“The implementation of our plan will enhance the impact of work we were already doing to strengthen families and keep children safe with their families, in their homes, whenever and however possible,” Snead said in a statement.