[Senate Hearing 110-949]
[From the U.S. Government Publishing Office]
S. Hrg. 110-949
PROTECTING CHILDREN, STRENGTHENING FAMILIES: REAUTHORIZING CAPTA
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON CHILDREN AND FAMILIES
OF THE
COMMITTEE ON HEALTH, EDUCATION,
LABOR, AND PENSIONS
UNITED STATES SENATE
ONE HUNDRED TENTH CONGRESS
SECOND SESSION
ON
EXAMINING REAUTHORIZATION OF THE CHILD ABUSE PREVENTION AND TREATMENT
ACT (CAPTA) (PUBLIC LAW 93-247), FOCUSING ON PROTECTING CHILDREN AND
STRENGTHENING FAMILIES
__________
JUNE 26, 2008
__________
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Pensions
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COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS
EDWARD M. KENNEDY, Massachusetts, Chairman
CHRISTOPHER J. DODD, Connecticut MICHAEL B. ENZI, Wyoming,
TOM HARKIN, Iowa JUDD GREGG, New Hampshire
BARBARA A. MIKULSKI, Maryland LAMAR ALEXANDER, Tennessee
JEFF BINGAMAN, New Mexico RICHARD BURR, North Carolina
PATTY MURRAY, Washington JOHNNY ISAKSON, Georgia
JACK REED, Rhode Island LISA MURKOWSKI, Alaska
HILLARY RODHAM CLINTON, New York ORRIN G. HATCH, Utah
BARACK OBAMA, Illinois PAT ROBERTS, Kansas
BERNARD SANDERS (I), Vermont WAYNE ALLARD, Colorado
SHERROD BROWN, Ohio TOM COBURN, M.D., Oklahoma
J. Michael Myers, Staff Director and Chief Counsel
Ilyse Schuman, Minority Staff Director
______
Subcommittee on Children and Families
CHRISTOPHER J. DODD, Connecticut, Chairman
JEFF BINGAMAN, New Mexico LAMAR ALEXANDER, Tennessee
PATTY MURRAY, Washington JUDD GREGG, New Hampshire
JACK REED, Rhode Island LISA MURKOWSKI, Alaska
HILLARY RODHAM CLINTON, New York ORRIN G. HATCH, Utah
BARACK OBAMA, Illinois PAT ROBERTS, Kansas
BERNARD SANDERS (I), Vermont WAYNE ALLARD, Colorado
EDWARD M. KENNEDY, Massachusetts MICHAEL B. ENZI, Wyoming (ex
(ex officio) officio)
Mary Ellen McGuire, Staff Director
David P. Cleary, Minority Staff Director
(ii)
C O N T E N T S
__________
STATEMENTS
THURSDAY, JUNE 26, 2008
Page
Dodd, Hon. Christopher J., Chairman, Subcommittee on Children and
Families, opening statement.................................... 1
Prepared statement........................................... 2
Isakson, Hon. Johnny, a U.S. Senator from the State of Georgia,
statement...................................................... 4
Boyce, Cheryl Anne, Ph.D., Chief, Child Abuse and Neglect
Program, National Institute of Mental Health................... 5
Prepared statement........................................... 7
Long, Tanya, Parent, Columbus, OH................................ 10
Prepared statement........................................... 12
Foley-Schain, Karen, M.A., M. Ed., LPC, Executive Director,
Connecticut Children's Trust Fund, Hartford, CT................ 14
Prepared statement........................................... 15
Kaplan, Caren, MSW, Director of Child Protection Reform, American
Humane Association............................................. 21
Prepared statement........................................... 23
ADDITIONAL MATERIAL
Statements, articles, publications, letters, etc.:
Clinton, Hon. Hillary, a U.S. Senator from the State of New
York, prepared statement................................... 43
Alexander, Hon. Lamar, a U.S. Senator from the State of
Tennessee, prepared statement.............................. 44
Roberts, Hon. Pat, a U.S. Senator from the State of Kansas,
prepared statement......................................... 44
American Psychological Association (APA)..................... 45
Association of University Centers on Disabilities (AUCD)..... 46
Pion-Berlin, Lisa, Ph.D., President & Chief Executive
Officer, Parents Anonymous................................ 50
Child Welfare League of America (CWLA)....................... 59
Else, Sue, President, National Network to End Domestic
Violence (NNEDV)........................................... 66
Family Violence Prevention Fund.............................. 72
First Star and the Children's Advocacy Institute............. 75
National Child Abuse Coalition............................... 77
(iii)
PROTECTING CHILDREN, STRENGTHENING FAMILIES: REAUTHORIZING CAPTA
----------
THURSDAY, JUNE 26, 2008
U.S. Senate,
Subcommittee on Children and Families, Committee on Health,
Education, Labor, and Pensions,
Washington, DC.
The subcommittee met, pursuant to notice, at 2:40 p.m. in
Room SD-430, Dirksen Senate Office Building, Hon. Christopher
Dodd, chairman of the subcommittee, presiding.
Present: Senators Dodd and Isakson.
Opening Statement of Senator Dodd
Senator Dodd. I apologize to our witnesses and our guests
in the hearing room, and to my colleague from Georgia, for
being a few minutes late getting over here. I'm delighted
you're all here this afternoon for a very important hearing,
and I thank our audience as well as my colleagues and the staff
who are here.
Let me begin with a brief opening statement about the issue
before us today. I'll turn to my colleague Senator Isakson of
Georgia and then we'll turn to our witnesses here and ask them
for some opening comments and statements, and then have a good
conversation with each other about the importance of this
effort.
I'd like to welcome my colleague, as I said, to this
important hearing and thank our very distinguished witnesses
this afternoon for being with us today as well. Today's hearing
will look at the Child Abuse Prevention and Treatment Act and
hear from different perspectives, its successes, its
shortcomings, and how it is being implemented across the
country.
Today in the United States nearly a million children are
abused in some way each year. It's a stunning number. While
CAPTA has brought much-needed attention and change to the
issues of child maltreatment, this number is astonishingly and
unacceptably high.
We're here today to hear from an array of witnesses who
will discuss their experiences with CAPTA and suggest changes
that might be made during the reauthorization of this vitally
important piece of legislation. CAPTA was initially enacted in
1974 with a very simple purpose: creating a single Federal
focus to deal with the problems of child abuse and neglect.
CAPTA provides a Federal minimum definition of what constitutes
child abuse and neglect. It is composed of basic grants for
States to improve their child protective systems, grants for
community-based services, and activities to prevent child abuse
and neglect. It authorizes Children's Justice Act grants, for
States to create multidisciplinary task forces to address
sexual abuse, child abuse and neglect, fatalities, and abuse
and neglect cases involving disabled children. CAPTA also
provides discretionary grants to fund research, resource
centers, and demonstration projects related to preventing and
treating child abuse.
Over the past 34 years, CAPTA has been reauthorized and
changed to adapt to emerging trends and needs in this arena. We
continue to see changing needs, which we will begin to address
at this hearing.
CAPTA has improved the outcomes of rates of child
maltreatment, but disparities and concerning trends remain. The
rates of physical abuse have decreased in recent years, but the
rates of neglect have remained disturbingly constant and 60
percent of child maltreatment cases are due to neglect.
Minorities are impacted acutely by child maltreatment, with the
highest rates of child victims reported for African-American
children, totaling nearly 20 victims out of every 1,000
children, with other races not far behind. The rate of abuse
for white children is about half of that.
Other issues that need to be addressed include the role of
domestic violence and child abuse in neglect cases and the role
of fathers and men in these cases. Domestic violence is
involved in approximately half of all cases that are reported
to child protection services. In my home State of Connecticut,
in the home visiting population, 18 percent of fathers in urban
communities are in prison when their children are born and only
30 percent of the fathers in these programs live with their
children.
Perhaps the most disturbing finding is that the youngest
children in this country are the most abused and neglected--I
find that incredible--and I would add, the most vulnerable.
CAPTA can and should address these issues. States have
implemented CAPTA in a variety of ways and some are testing and
putting in place innovative programs to address these problems,
which we hope to encourage with this legislation. A number of
States are looking at what is known as differential response,
which recognizes that we cannot have a one-size-fits-all child
welfare system. In Philadelphia, for instance, an effort is
under way to screen every child reported to the child welfare
system, whether they be substantiated or unsubstantiated cases
of neglect or abuse.
Mental health is a major factor in child abuse and neglect.
Again, my home State of Connecticut will soon conduct a trial
on the in-home cognitive behavioral therapy for treating
mothers with depression. The goal of this effort is to address
the root cause of some child abuse and neglect, as research
shows that depression in mothers increases their risk for abuse
and neglect.
Although child abuse and neglect are preventable, they
currently cost this country an estimated $103.8 billion
annually in 2007 dollars. Of course, the true cost is far
beyond that. I only mention those numbers just for those who
wonder about this issue in purely financial terms. The larger
cost is largely an emotional one, of behavioral and
developmental effects that abuse and neglect have on children
long into their lives.
We convene this hearing today to hear how CAPTA is being
implemented in the field and how it can be changed and improved
to better address the needs of our children and families. The
needs of our children and families, of course, are paramount.
This is one of the most serious responsibilities that we have
as legislators.
Let me--if I can now turn to my colleague from Georgia for
his opening comments and then we'll be anxious to hear from our
witnesses.
[The prepared statement of Senator Dodd follows:]
Prepared Statement of Senator Dodd
I would like to welcome my colleagues to this important
hearing, and thank our distinguished witnesses for being with
us today. Today's hearing will look at the Child Abuse
Prevention and Treatment Act and hear, from different
perspectives, its successes, its shortcomings, and how it is
being implemented across the country.
Today, in the United States, nearly a million children are
abused in some way each year.
It is a stunning number. While CAPTA has brought much-
needed attention and change to the issues of child
maltreatment, this number is astonishingly and unacceptably
high. We are here today to hear from an array of witnesses who
will discuss their experience with CAPTA and suggest changes
that might be made during reauthorization of this vital
legislation.
CAPTA was initially enacted in 1974 with a simple purpose:
creating a single Federal focus to deal with the problems of
child abuse and neglect.
CAPTA provides a Federal minimum definition of what
constitutes child abuse and neglect. It is composed of basic
grants for States to improve their child protective systems,
grants for community-based services and activities to prevent
child abuse and neglect, and authorizes Children's Justice Act
grants for States to create multidisciplinary task forces to
address sexual abuse, child abuse and neglect fatalities, and
abuse and neglect cases involving disabled children. CAPTA also
provides discretionary grants to fund research, resource
centers, and demonstration projects related to preventing and
treating child abuse. Over the past 34 years, CAPTA has been
reauthorized and changed to adapt to emerging trends and needs
in this arena. We continue to see changing needs, which we will
begin to address at this hearing.
CAPTA has improved the outcomes and rates of child
maltreatment, but disparities and concerning trends remain. The
rates of physical abuse have decreased in recent years, but the
rates of neglect have remained disturbingly constant, and 60
percent of child maltreatment cases are due to neglect.
Minorities are impacted acutely by child maltreatment, with
the highest rates of child victims reported for African-
American children, totaling nearly 20 victims out of every
thousand children, with other races not far behind. The rate of
abuse for white children is about half.
Other issues that need to be addressed include the role of
domestic violence in child abuse and neglect cases, and the
role of fathers and men in these cases. Domestic violence is
involved in approximately half of all cases that are reported
to child protective services. In the State of Connecticut's
home visiting population, 18 percent of fathers in urban
communities are in prison when their children are born, and
only 30 percent of fathers in these programs live with their
children.
Perhaps the most disturbing finding is that the youngest
children in this country are the most abused and neglected.
And, I would add, the most vulnerable.
CAPTA can and should address these issues. States have
implemented CAPTA in a variety of ways, and some are testing
and putting in place innovative programs to address these
problems, which we hope to encourage with this legislation.
A number of States are looking at what is known as
``differential response,'' which recognizes that we cannot have
a ``one-size-fits-all'' child welfare system. In Philadelphia
an effort is underway to screen every child reported to the
child welfare system, whether they be substantiated or
unsubstantiated cases of neglect or abuse.
Mental health is a major factor in child abuse and neglect,
and my home State of Connecticut will soon conduct a trial on
an in-home cognitive behavioral therapy for treating mothers
with depression. The goal of this effort is to address the root
cause of some child abuse and neglect, as research shows that
depression in mothers increases their risk for abuse and
neglect.
Although child abuse and neglect are preventable, they
currently cost this country an estimated $103.8 billion
annually, in 2007 dollars. Of course, the true cost is the
emotional, behavioral, and developmental effects abuse and
neglect have on children long into their lives. We convene this
hearing today to hear how CAPTA is being implemented in the
field and how it can be changed and improved to better address
the needs of our children and families. This is one of our most
serious responsibilities as legislators.
Senator Dodd. I now turn to Senator Isakson for an opening
statement.
Statement of Senator Isakson
Senator Isakson. Well, thank you, Mr. Chairman. I'm honored
to be here with you today, and I want to welcome all of our
guests and our professionals, and in particular Ms. Tanya Long.
I had the occasion earlier today to read her compelling story.
Your courage to come forward is a great testimony to CAPTA and
the program that it funds, Parents Anonymous, and I'm looking
forward to everyone being able to hear the benefits of that
program and what it did for you and your life and the life of
your children and your grandchild. So welcome to you.
Thanks to all of you for being here today and I look
forward to the testimony.
Senator Dodd. Thank you very much, Senator.
Let me introduce our very distinguished panel of witnesses.
First of all, I'd like to welcome Dr. Cheryl Boyce. Doctor, we
thank you for being with us. Dr. Boyce is a child clinical
psychologist in the Division of Pediatric Translational
Research and Treatment and Development, the National Institutes
of Health. Dr. Boyce is here to discuss her research on child
abuse and neglect. We look forward to hearing what you've
learned through your research regarding intervention, home
visitation, and the effects of child abuse and neglect on
mental health and behavior.
Tanya Long we've already sort of introduced by Senator
Isakson and we welcome. I want to underscore the comments of
Senator Isakson. It takes a lot of courage to stand up and talk
about a personal journey. But, know full well, Ms. Long, that
your story is one that is not unique. I know that it seems that
way, but unfortunately it's not. There are literally thousands
and thousands of people that are going through, or have gone
through similar journeys.
Your presence here today and your sharing this story gives
us a dimension that is beyond the data and the numbers and the
statistics. I almost hesitate to use some of these numbers in
talking about the number of cases and how much it costs,
because it's important for people to understand this in real,
personal terms, and your presence and participation here make
that possible. You're performing a very, very valuable national
service by being here this afternoon and we're all very, very
grateful and honored you're here. We thank you very, very much.
I'd like to also introduce if I can Karen Foley--is it
``SHAEN''? Is that the correct?
Ms. Foley-Schain. Yes.
Senator Dodd. Karen Foley-Schain today is joining us from
Connecticut. She is the Executive Director of the Connecticut
Children's Trust Fund, the State agency that distributes CAPTA
Title 2 funding in Connecticut, where she has served as the
Executive Director since 1999. We thank you as well for being
with us, from my home State.
Caren Kaplan is the Director of Child Protection Reform at
the American Humane Association. She is leading a national
initiative on differential response, and she has done extensive
work on chronic neglect and the assessment of child safety,
risk, and comprehensive family functioning by child protection
agencies. Certainly your testimony will be tremendously
valuable.
We'll begin with you, Dr. Boyce, if we can, and ask you if
you would try and keep your opening statements down to 5 or 6
minutes or so. I promise you that your full remarks and any
supporting data and information which you think will be
valuable for our committee in its consideration of the
reauthorization of this program will be made a part of the
record.
That goes for all of the witnesses today. If you can kind
of abbreviate it a bit, we can get to some of the questions. We
thank you again for being with us.
Dr. Boyce, the floor is yours.
STATEMENT OF CHERYL ANNE BOYCE, PH.D., CHIEF, CHILD ABUSE AND
NEGLECT PROGRAM, NATIONAL INSTITUTE OF MENTAL HEALTH
Dr. Boyce. Good afternoon. Thank you, Chairman Dodd, and
thank you, Senator Isakson, for coming today. You've given me a
great introduction. In addition to being at the National
Institute of Mental Health, where I serve as Chief of the Child
Abuse and Neglect Research Program, I am a child clinical
psychologist who has seen these cases at Children's National
Medical Center in the past, not far from where we are today.
I serve as a co-chair on one of the larger inter-agency
efforts to combat child abuse and neglect through research
collaborations, the NIH Child Abuse and Neglect Research
Working Group, and I co-chair this along with Valerie Holmes,
who's at the partner institute, NICHD, which you may be
familiar with.
I oversee research that seeks to reduce and prevent the
negative consequences of child abuse and neglect, specifically
mental disorders, which you referenced in your opening
statement. We work routinely with ACF, the Centers for Disease
Control and Prevention, the Department of Justice, Department
of Education, and Department of Defense, as well as advocacy
groups and the public community.
We know, as you've just stated, that child abuse and
neglect can have a profound impact on children's immediate as
well as long-term mental and physical health. In 2006, as you
referenced in your statement, it's almost a million children
who were victims, 905,000. More than 60 percent of these
children experience neglect. This has been a specific emphasis
of our research efforts through a consortium that we've funded
for many years.
Furthermore, it's the youngest children that are at risk.
Ages birth to 3 years have the highest rates of victimization.
Most devastating is that 1,500 children die annually due to
child abuse and neglect. Those who have been exposed to neglect
are exposed to various risk factors and subsequent health
problems. They experience high rates of post-traumatic stress
disorder, depression, isolation, self-destructive behaviors,
and then co-morbid problems, including substance abuse, tobacco
use, alcohol abuse, and neurological impairments.
The youngest children are at highest risk. Neglect is the
most pervasive problem and children are suffering from
immediate and long-term problems over the course of development
and throughout their life.
This is a complex public health issue, and that was
highlighted previously by the Surgeon General, who held a
workshop to make child maltreatment a national priority. It is
caused by a myriad of factors, including individual, family,
community level elements. Research to combat child maltreatment
has included work in the basic area, biomedical area,
behavioral, social sciences, and includes areas such as mental
health, public health, prevention, alcohol and substance abuse,
neurology, injury, trauma, child development, gene-environment
interactions. We use all of these to inform prevention,
assessment, treatment, and services for this vulnerable
population of children and their families.
For example, right now we have announcements out there on
violence and trauma and on interventions to call for our best
research innovations to prevent child abuse and its potential
negative effects. It's the complexity of these interactions
that must be taken into account, so we can understand the
consequences of maltreatment and focus on those factors that
might promote resiliency in the face of this adversity.
We have longitudinal studies that offer critical
information not only on mental health and physical health, but
recent reviews suggest that there are adverse effects on the
academic and intellectual functioning and occupational
functioning of children who are abused.
When we look at services, we have some surprising and
unfortunate patterns of children who are maltreated when it
comes to services. Looking at the youngest children, 48 percent
of toddlers and 68 percent of preschool-aged children evidence
behavioral problems or developmental delays, but only 22
percent receive services. Looking at the children who are a
little older than 2 years, 48 percent have indicated mental
health problems, but only a quarter of those are receiving
services.
Then when you look at children who are 3 years out of their
first reports, 28 percent are reported as having already
chronic health issues, and 30 percent of school-age children
are identified as potentially in need of special education
services.
In summary, we know this is a complex, multifaceted problem
and we need to integrate knowledge at different levels of
analysis--biology, individual, family, and the neighborhood. We
need to intervene early, which is often the case for neglect,
and follow children over time to understand when to intervene
at key points of risk to impact their development and
trajectories and reduce the negative effects on mental and
physical health over time. When children are identified, we
need to make sure that they're getting effective services.
With that, I will close and I am available to answer any
questions you may have to help inform your decisionmaking now
and in the future.
[The prepared statement of Dr. Boyce follows:]
Prepared Statement of Cheryl Anne Boyce, Ph.D.
summary
Child abuse and neglect can have a profound impact on children's
immediate and long-term mental and physical health. It is a complex
public health issue, likely caused by a myriad of factors, including
elements involving the individual, the family, and the community.
Children and adolescents exposed to child abuse and neglect experience
high rates of post-traumatic stress disorder, depression, isolation,
self-destructive behaviors and co-morbid problems including tobacco
use; misuse of drugs and alcohol, as well as alcohol dependence; and
neurological impairments. Reviews suggest that child abuse and neglect
have adverse effects on academic and intellectual functioning and
occupational functioning, which are likely to impact subsequent
development and life trajectories as well.
Numerous prevention programs target caregivers to prevent
maltreatment. Research has also demonstrated that there are numerous
risk and protective factors that interact to affect maltreatment and
are potential targets for effective interventions. Understanding the
complexity of the many risk factors faced by children and families
forms the basis for developing a new generation of targeted prevention
and intervention research.
introduction
Chairman Dodd and members of the subcommittee, good afternoon and
thank you for the opportunity to speak to you today on research
conducted and supported by the National Institutes of Health (NIH) to
address the public health problem of child abuse and neglect. I am
Cheryl Anne Boyce, Chief of the Child Abuse and Neglect Research
Program at the National Institute of Mental Health (NIMH) within the
NIH, an agency of the Department of Health and Human Services (HHS), as
well as the co-chair of the NIH Child Abuse and Neglect Working Group.
I am also a member of the Federal Interagency Workgroup on Child Abuse
and Neglect led by the Office on Child Abuse and Neglect (OCAN) within
the Children's Bureau of HHS's Administration for Children and Families
(ACF) and a member of the technical working group for the National
Survey of Child and Adolescent Well-Being.
I oversee research seeking to reduce and prevent the negative
consequences of child abuse and neglect, specifically mental disorders.
We at NIH believe that research on child abuse and neglect should be
used to inform services and policy, and therefore, we work routinely
with other agencies, including ACF, the Centers for Disease Control and
Prevention (CDC), the Substance Abuse and Mental Health Services
Administration (SAMHSA), the Department of Justice, the Department of
Education, and the Department of Defense; advocacy groups; and the
public community to facilitate the dissemination of research knowledge
funded by NIH.
overview and consequences of child abuse and neglect
Child abuse and neglect can have a profound impact on children's
immediate and long-term mental and physical health. In 2006, an
estimated 905,000 children were victims of child abuse or neglect,\1\
and children ages birth to 3 years had the highest rates of
victimization. Approximately 1,500 children die annually due to child
abuse or neglect. Children and adolescents who have experienced abuse
and neglect are exposed to various risk factors for subsequent health
problems and experience high rates of post-traumatic stress disorder
(PTSD), depression, isolation, self-destructive behaviors and co-morbid
problems such as tobacco use; misuse of drugs and alcohol, as well as
alcohol dependence; and neurological impairments.\1\
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\1\ http://www.acf.hhs.gov/programs/cb/stats_research/
index.htm#can.
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research efforts to address child abuse and neglect
Because child abuse and neglect is a complex public health issue,
likely caused by a myriad of factors, including elements involving the
individual, the family, and the community, a research program focused
on understanding and addressing these problems must necessarily draw
upon interdisciplinary theories and approaches. In order to advance our
knowledge of child abuse and neglect, NIH-funded research facilitates
multi-disciplinary work in the basic biomedical, behavioral, and social
sciences, including areas such as mental health, public health and
prevention; tobacco use; misuse of drugs and alcohol, as well as
alcohol dependence; neurology; injury; trauma; and child development.
NIH research projects utilize rigorous scientific research designs that
can inform prevention, assessment, treatment, demonstrations, or other
types of service activities.
In 1997, NIH convened a working group of its major research
Institutes and offices supporting research on child abuse and neglect
to: (1) assess the state of the science; (2) make recommendations for a
research agenda; and (3) develop plans for future coordination efforts
at the agency. This group, the NIH Child Abuse and Neglect Working
Group, meets routinely to coordinate relevant NIH research efforts and
regularly meets with representatives of other Federal agencies. The
working group has sponsored a number of workshops to stimulate research
on child abuse and neglect. In addition, NIH Institutes are currently
participating in two specific program initiatives to promote research
related to child abuse and neglect. The first initiative, ``Mental
Health Consequences of Violence and Trauma,'' \2\ is designed to
enhance scientific understanding of the etiology of psychopathology
related to violence and trauma, as well as studies to develop and test
effective treatments, services, and prevention strategies. Along with
HHS partner agencies including SAMSHA, CDC, and ACF, NIH is the lead
agency on the second funding initiative, ``Research Interventions on
Child Abuse and Neglect,'' \3\ which is designed to stimulate research
on interventions that assist in changing the negative biological and
behavioral health effects of child abuse and neglect and may target
individuals or groups of individuals such as dyads, families,
communities, or service systems.
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\2\ http://grants.nih.gov/grants/guide/pa-files/PA-07-312.html.
\3\ http://grants.nih.gov/grants/guide/pa-files/PA-07-437.html.
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Child maltreatment received heightened attention as a result of a
March 2005 Workshop convened by the Surgeon General entitled, ``Making
Prevention of Child Maltreatment a National Priority--Implementing
Innovations of a Public Health Approach.'' \4\ The workshop
participants generated ideas for eliminating obstacles to change; and
identified opportunities for advancing innovations in science, service
delivery, care coordination, and prevention. As an outgrowth of the
workshop, the NIH Child Abuse and Neglect Working Group called for
additional studies to provide a solid evidence base for prevention and
intervention programs. The goal of this new initiative is to provide a
scientific basis for understanding the biological and behavioral
trajectories that can lead to child abuse and neglect in order to
intervene at an early age.
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\4\ http://www.surgeongeneral.gov/healthychild/workshop.html.
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A great deal of research has focused on identifying contextual
factors that protect against maltreatment, as well as individual
factors that better predict which children are likely to benefit from
intervention. Innovative research funded by NIH has explored complex
gene and environment interactions among maltreated children that may
account in part for these differences. For example, a recent study has
shown that past child abuse experiences plus a variation in a specific
gene accounted for more than twice the number of PTSD symptoms in
adults who had later undergone other traumas, compared to traumatized
adults who were not abused in childhood.\5\ A history of child abuse
was not enough alone to lead to increase in PTSD symptoms, nor was
variations in the stress-related gene enough by itself; it was the
interaction between the two factors. This is a single illustration of
the complexity of the interactions that must be taken into account to
understand the consequences of maltreatment and the factors that may
promote resiliency in the face of adverse experience.
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\5\ Binder EB, Bradley RG, Wei L, Epstein MP, Deveau TC, Mercer KB,
Tang Y, Gillespie CF, Heim CM, Nemeroff CB, Schwartz AC, Cubells JF,
Ressler KJ. Association of FKBP5 Polymorphisms and Childhood Abuse With
Risk of Posttraumatic Stress Disorder Symptoms in Adults. JAMA 299
(11): 1291-1305. March 19, 2008.
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A body of research that encompasses prospective longitudinal
studies have offered critical information about the developmental
trajectories of children who have been maltreated, as well as
information about their pathways. Reviews suggest that child abuse and
neglect have adverse effects on academic and intellectual functioning
and occupational functioning, which are likely to impact subsequent
development and life trajectories as well.\6\ Of these studies, the
National Survey of Child and Adolescent Well-Being (NSCAW), begun in
1999, includes a nationally representative sample of children and
families who are reported to child protective services.\7\ A grant from
NIMH allowed for the collection of additional contextual information
about the service systems for these children, as well as for data
analyses related to children's services. Some notable findings from
NSCAW are:
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\6\ Widom CS. (1998) Childhood Victimization: Early Adversity and
Subsequent Psychopathology. In B.P. Dohrenwend. (Ed.) Adversity,
Stress, and Psychopathology, (pp. 81-95) New York, NY: Oxford
University Press.
\7\ http://www.acf.hhs.gov/programs/opre/abuse_neglect/nscaw/
index.html.
48 percent of children older than 2 years with completed
child welfare investigations had indication of mental health problems,
while only a quarter of them received mental health services.\8\
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\8\ Burns B, Phillips S, Wagner R, et al.: Mental Health Need and
Access to Mental Health Services by Youth Involved With Child Welfare:
A National Survey. Journal of the American Academy of Child Adolescent
Psychiatry 43:960-970, 2004.
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48 percent of toddlers and 68 percent of preschool-aged
children in child welfare evidenced behavioral problems or
developmental delays, but only 22 percent received services.\9\
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\9\ Stahmer AC, Leslie LK., Hurlburt M, Barth RP, Webb MB,
Landsverk J, and Zhang J. (2005). Developmental and Behavioral Needs
and Service Use for Young Children in Child Welfare. Pediatrics 116(4),
891-900.
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28 percent are reported as having chronic health
conditions within the 3 years after a report to child protective
services.\10\ \11\
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\10\ Ringeisen H, Casanueva CE, Urato MP, and Cross TP
(Forthcoming). ``Special Health Care Needs Among Children in Child
Welfare.'' Pediatrics.
\11\ http://www.acf.hhs.gov/programs/opre/abuse_neglect/nscaw/
reports/special_health/special_health.html.
Nearly 80 percent of perpetrators of child maltreatment were
parents, according to data reports in 2006.\12\ Findings suggest that
among caregivers, partner violence, substance abuse, and parental
depression are robust risk factors for future maltreatment.\12\ By
unraveling the complex, multi-level risk factors faced by children and
families that may lead to child abuse and neglect, and understanding
the multitude of trajectories that may result from it, research
provides a solid underpinning for developing a new generation of
targeted prevention and intervention research.
---------------------------------------------------------------------------
\12\ http://www.childwelfare.gov/can/.
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conclusion
We know that we must continue to find ways to prevent child abuse
in this country and decrease its negative consequences. This is a
challenge that requires research translation, dissemination and
collaboration across Federal, State, and local agencies and entities. I
hope you will find the information that I have provided useful and
helpful. I would be pleased to answer any questions at this time.
Senator Dodd. Well, Dr. Boyce, thank you very, very much.
We will have some questions for you about that.
Ms. Long, thank you again for being with us and we're happy
to receive your testimony.
STATEMENT OF TANYA LONG, PARENT, COLUMBUS, OH
Ms. Long. Good afternoon.
Senator Dodd. Grab that microphone. I think we've got to
push a button there for you. Can someone?
Ms. Long. Good afternoon.
Senator Dodd. There you go.
Ms. Long. My name is Tanya Long. Thank you, Chairman Dodd
and Senator Isakson, for offering me this opportunity to put a
face, a human face, on the prevention of child abuse and
neglect by focusing on family-strengthening and child abuse
prevention.
I am honored to testify today as a parent from Columbus,
OH, and share my personal story of prevention and strengthening
of families. I am a mother of 4 children ages 9, 10, 18, 32,
and a grandmother of a 7-year-old. I am standing before you
today as just an example of one family who transformed their
lives for the better through a CAPTA-funded program. The
program that I found success through was Parents Anonymous,
which provides weekly support groups for parents and their
children. My testimony will focus on the importance of
prevention, how I have given back to my community to ensure
that programs meet the diverse needs of families, and
suggestions for strengthening the CAPTA statute.
Reaching out and engaging and empowering parents like me
are critical factors in protecting children and preventing
child abuse and neglect for future generations. CAPTA-funded
programs should build on people's strengths, help individuals
and families address their needs respectfully, and provide
vital supports to parents and children of any age, race, and
who reside in neighborhoods all across America.
I would like to share with you my personal journey. I
sought help, received support, gained strength, and found hope
for my family's future through Parents Anonymous. In 1998 I
became homeless and hit rock bottom. My addiction to crack
cocaine interfered with my ability to provide a safe and
nurturing environment for my children. To the outside world, I
appeared to be a highly functioning and supportive parent, but
when I used drugs I neglected my children's needs. I did not
want to be a parent any more because I was caught in the grips
of cocaine.
When I had my third and fourth children 18 months apart, I
felt overwhelmed and unprepared to take on the daunting task of
raising two more young boys. I was faced with the most
important choice of my life, my children or the drugs. I chose
my children.
Then the real work began. I made a commitment to become
clean and sober. I entered an outpatient drug program and moved
into a homeless shelter. I needed to face head-on my
inadequacies as a parent. I needed to move through the pain and
really take hold of my emotions and what was underlying my
actions.
My family and I were able to attend the weekly parent and
children's meeting at the shelter and then in the community
when I moved. Through the support, the mutual support of other
parents, I was able to share my deepest fears, insecurities,
and feelings of shame and guilt for neglecting my children
because of my drug addiction. I replaced my feelings of
helplessness with hope and found the courage and the strength
to make lasting changes in my life. The other parents in my
group helped me identify my strengths and find solutions that
worked for my family and me.
I am living proof of the effectiveness of CAPTA funding in
preventing child abuse and neglect. After 5 months I was able
to secure housing for my family. I had become a fully committed
parent. I had transformed my negative attitudes, gained new
parenting skills, and significantly improved my self-esteem.
I'm going on 9 years--sorry, on 10 years of recovery. With all
the positive changes in my life, I'm a stronger parent and my
children are thriving today. They became a joy to me.
My daughter is a confident young woman. By strengthening my
own family and receiving training and support I was able to
grow and develop leadership skills. I feel blessed to be able
to give back to other parents now by going through various
leadership roles, such as co-trainer, board member, and
advocate for prevention programs to strengthen families. I have
developed numerous publications and co-trained with Parents
Anonymous all over the country, focusing on the importance of
engaging parents in the planning, implementation, and
evaluation of programs and policy decisions as specified in
CAPTA.
My prevention journey began with a focus on my own
struggles and turning my life around by strengthening my
family. I believe I need to give back because I have been
blessed to receive so much. I am confident that when my
children grow up they will raise their children in a safe and
productive environment, free of abuse and neglect, and they
will give back to their own community.
Several years ago, I received the greatest complement from
my own mother and family members when they acknowledged the
positive changes in me. After seeing the way I handled my
youngest boys, my mom says she wishes she'd hugged my brothers
more so they would have become better men.
I am currently attending college full-time, committed to
obtaining a degree in communications. My oldest son is a
loving, caring father and my 18-year-old daughter is a self-
assured and confident young woman on her way to college. My
younger boys are healthy, happy and successful students.
Through my role modeling, they are all following in my
footsteps and taking on leadership roles in their schools and
the community.
My story is not unique. I am no more special than the
hundreds of thousands of other parents who are out there
working to conquer their own personal demons. I am here giving
a voice today to the family-strengthening message as one
example of hope and change, but we cannot forget the thousands
of parents who are struggling with their parenting and other
problems right now and do not have the courage to ask for our
help or there is no program or supportive person in their lives
to turn to. Strengthening CAPTA so that vital Federal dollars
support prevention programs like Parents Anonymous will save
the lives of thousands of children and their parents.
Before closing, I thank you for your commitment and
leadership on these critical issues facing families. Your help
is desperately needed in order to prevent child abuse and
neglect. Together we can strengthen families all across America
to prevent child abuse and neglect for generations to come.
Thank you.
[The prepared statement of Ms. Long follows:]
Prepared Statement of Tanya Long
Good afternoon, my name is Tanya Long. Thank you Chairman Dodd,
Ranking Member Alexander and distinguished members of the Subcommittee
on Children and Families for offering me this opportunity to put a
human face on the prevention of child abuse and neglect by focusing on
the effective family strengthening program: Parents Anonymous.
I am honored to testify today as a Parents Anonymous parent from
Columbus, OH and share my personal story of prevention and
strengthening of families. I am a mother of four children, ages 9, 10,
18 and 32 and a grandmother of a 7-year-old. I am standing before you
today as an example of just one family who has transformed their life
for the better through the evidence-based Parents Anonymous Program, a
CAPTA-funded program that provides weekly support groups for parents
and their children serving millions nationwide for nearly 40 years. My
testimony will focus on the importance of prevention, how I have given
back to my community to ensure that programs meet the diverse needs of
families and suggestions for strengthening the CAPTA statute. Reaching
out, engaging and empowering parents like me are critical factors in
protecting children and preventing child abuse and neglect for future
generations. The unique philosophy and practices of mutual support and
shared leadership ensure the success of Parents Anonymous by building
on people's strengths, helping individuals and families address their
needs respectfully and providing weekly and on-going vital supports to
parents and their children of any age, ethnicity, and who reside in
neighborhoods all across America.
I am proud to continue the legacy first begun by Jolly K., the
founding mother of Parents Anonymous. This year marks the 35th
anniversary of Jolly K.'s groundbreaking testimony before Congress when
she put a human face to the complex problem of child maltreatment. A
hush fell over the room when Jolly K. testified before Congress about
her abusive behavior toward her child and how she successfully turned
her life around through Parents Anonymous. She was considered by
leading experts as the single most effective witness because her
personal story humanized the problem of child maltreatment by focusing
on effective prevention programs (Public Policy, Harvard University,
1978). This courageous testimony in 1973 ensured the passage of the
first Federal legislation to focus on prevention: The Child Abuse
Prevention and Treatment Act of 1974 (CAPTA). Her moving Senate and
House testimony reported on nationwide television and in the Los
Angeles Times caught the attention of the Nation and had a major impact
on Congress and on public opinion.
I would like to share with you my personal journey. I sought help,
received support, gained strength and found hope for my family's future
through the proven effective solution provided by Parents Anonymous.
In 1998, I became homeless and hit rock bottom. My addiction to crack
cocaine interfered with my ability to provide a safe and nurturing
environment for my children. To the outside world I appeared to be a
highly functioning and supportive parent. But, when I used drugs, I
neglected my children's needs. I neglected my only daughter's emotional
needs over the years given all my insecurities. My last two pregnancies
were the straw that broke the camels back so to speak. I did not want
to be a parent anymore because I was caught in the grips of my cocaine
addiction. When I had my third and fourth children 18 months apart, I
felt overwhelmed and unprepared to take on the daunting task of raising
two young boys. I was faced with the most important choice of my life--
my children or the drugs. I chose my children. Then the real work
began.
First, I made a commitment to become clean and sober then I entered
an outpatient drug treatment program and moved into a homeless shelter.
I needed to face head on my inadequacies and problems as a parent. I
needed to move through the pain and really take hold of my emotions and
what was underlying my actions. Parents Anonymous is truly a
prevention program open to any parent before or after abuse or neglect
has occurred. Thankfully, they reached out to me and my children. We
were able to attend the weekly Parents Anonymous group and Children's
Program at the shelter and one in the community after we found housing.
Through the mutual support of the other parents, I was able to share my
deepest fears, insecurities and feelings of shame and guilt for
neglecting my children because of my drug addiction. I replaced my
feelings of helplessness with hope and found the courage and strength
to make lasting changes in my life. Parents Anonymous was there for me
through all of my ups and downs. They believed in me and gave me
support in ways that I had never thought about. The other parents in my
group helped me identify my strengths and find the solutions that
worked for my family and me. I am living proof of the effectiveness of
Parents Anonymous in preventing child abuse and neglect.
After 5 months I was able to secure housing for my family. I had
become a fully committed parent. Through my active participation in
Parents Anonymous, I had transformed my negative attitudes, gained new
parenting skills, and significantly improved my self esteem. I am now
going on 10 years in recovery. I now am an Alcoholics Anonymous sponsor
of 6 individuals committed to recovery. With all the positive changes
in my life, I am a stronger parent and my children are thriving. My
children became a joy to me. I've learned that if you treat children as
valued human beings, you're going to get it back. Be fair, honest and
respectful and your children will grow up to be productive and caring
adults. By strengthening my own family and receiving training and
support from Parents Anonymous Inc., I was also able to grow and
develop my leadership skills. I feel blessed to be able to help other
parents now, by giving back through various leadership roles such as
co-trainer, board member and advocate for prevention programs to
strengthen families. I have developed numerous publications such as
Shared Leadership in Action curricula, training Manuals for Group
Facilitators and Children's and Youth Program, and the National Parent
Leadership Month Toolkit. Also I have co-trained and provided extensive
technical assistance with Parents Anonymous Inc. staff all over the
country for national, State, and county agencies and initiatives on the
development and enhancement of evidence-based, community-based
prevention programs and the importance of engaging parents in the
planning, implementation and evaluation of programs and policy
decisions as specified in CAPTA. My prevention journey began with a
focus on my own struggles and turning my life around by strengthening
my family--but I believe I need to give back because I have been
blessed to receive so much. Locally, I am serving on several Boards of
Directors, including: Legal Aid of Columbus, OH, Columbus Child
Development Council that oversees Head Start Programs, and the Godman
Guild Community Center. I am also the co-founder of a Recovery
Ministry. On a national level, I serve on the board of Parents
Anonymous Inc., National Center on Shared Leadership, founding member
of the National Birth Parent Advocacy Organization and the Research
Advisory Committee of Casey Family Programs.
I am confident that when my children grow up, they will raise their
children in a safe and productive environment free of abuse and neglect
and they will give back to their own community. Several years ago, I
received the greatest compliment from my own mother and family members
when they acknowledged the positive changes in me. After seeing the way
I handle my youngest boys, my mother said that she wished she had
hugged my brothers more so that they would have become better men. I am
currently attending college full-time--committed to obtaining a degree
in communications. My 18-year-old daughter is now very self-assured and
confident. She has just graduated from high school and is going on to
college. My daughter is also contributing to our community in various
ways: she is a peer counselor at her high school, a camp counselor for
several years and a Children's Program volunteer for Parents Anonymous
in Columbus, OH. My younger boys are happy, healthy and successful
students. Both are very active in our church and one of my son's is
currently helping to co-lead art classes at his school. Through my role
modeling, they are all following in my footsteps and taking on
leadership roles in their schools and the community.
My story is not unique. I am no more special than the hundreds of
thousands of other Parents Anonymous parents who changed their life
forever since we began in 1969 or any one else out there working to
conquer their own personal demons. I am here giving a voice today to
the family strengthening message as one example of hope and change. But
we cannot forget the thousands of parents who are struggling with their
parenting and other problems right now and do not have the courage to
ask for help or there is no program or supportive person in their life
to turn to. Strengthening CAPTA so that vital Federal dollars support
evidence-based programs like Parents Anonymous will save the lives of
thousands of children and their parents. Before closing, I thank you
for your commitment and leadership on these critical issues facing
families. Your help is desperately needed in order to prevent child
abuse and neglect. Together, we can strengthen families all across
America to prevent child abuse and neglect for generations to come.
Senator Dodd. Well, if I were a university you just
graduated. That was a great, great statement, Tanya.
Ms. Long. Thank you.
Senator Dodd. Thank you immensely. Very proud of you.
You've got some lucky kids, too.
Ms. Long. I'm very proud of them.
Senator Dodd. I know you are. I could hear that in your
voice.
Ms.--is it ``Foley-Schain''?
STATEMENT OF KAREN FOLEY-SCHAIN, M.A., M. ED., LPC,
EXECUTIVE DIRECTOR, CONNECTICUT CHILDREN'S
TRUST FUND, HARTFORD, CT
Ms. Foley-Schain. Yes.
Senator Dodd. Do you pronounce both names?
Ms. Foley-Schain. Yes.
Senator Dodd. Welcome.
Ms. Foley-Schain. Thank you, Senator Dodd and Senator
Isakson. I am here today to tell you a good news story. It
sounds like the second good news story of the day. The good
news is this: The State of Connecticut has been making steady
progress in its efforts to prevent child abuse and neglect.
What's behind this progress? CAPTA. CAPTA has provided the
State the opportunity to show that prevention programs make a
real difference in the lives of children and families and to
help us make the case that those prevention efforts must be
supported.
As a result, the State has increased its investment from
less than $1 million a decade ago to more than $14 million
today. National and local foundations and individual donors
have also joined in this cause.
The Children's Trust Fund is Connecticut's lead agency for
CAPTA Title 2, community-based grants for the prevention of
child abuse and neglect. The trust fund currently receives
about $700,000 in CAPTA funds each year. CAPTA Title 2 has
provided the vision for everything we do at the Children's
Trust Fund. This program has led us to finding the most
effective means of strengthening families, funding a broad
range of organizations to implement these programs, conducting
research to assess their effectiveness, and developing
strategies to improve our efforts.
At this time CAPTA funds are supporting three major
initiatives. They include: preventing ``shaken baby syndrome,''
an effort to get the word out to every parent that they should
never under any circumstance shake their baby; preventing
childhood sexual abuse, a program that gives adults information
about how molesters successfully offend against children and
giving parents steps that they can take to keep their children
safe. We also offer training for human services staff so that
they can better support and engage parents preventively.
CAPTA funds have enabled Connecticut to set a proactive
agenda for the prevention of child abuse and neglect. This
agenda also grew out of the recognition that more and more
resources and more and more funding were going to address the
needs of children and families after a crisis had occurred,
when it is much more costly and difficult to do so. This led
many policymakers to ask if more could be done to avoid these
problems.
The search for this type of solution, which is at the heart
of CAPTA, was a perfect match for the mission of the efforts of
the Children's Trust Fund. As a result, the trust fund was
given additional resources and responsibilities for a number of
new programs.
I'd like to briefly tell you about one of these programs,
the Nurturing Families Network. The Nurturing Families Network
focuses on providing intensive home visiting services to high-
risk families at a critical time in their lives, when their
first child is born. The program grew out of the Healthy
Families America model and it has been modified and
strengthened to address the mixed results shown by a number of
national evaluations. In addition, the highly regarded parents
as teachers curriculum has been fully integrated into this
effort.
The program has been rigorously researched and the results
have been consistently strong. The research shows that the
program is reducing the instance of child abuse and neglect,
improving parent-child relationships, and leading to better
outcomes for both parents and children. The program is
providing services in 42 locations to families giving birth at
all 29 birthing hospitals in the State of Connecticut.
While the trust fund has made significant progress, we
recognize that there is still much to be done and we have
identified two priorities for further development. The trust
fund is working with researchers at the Cincinnati Children's
Hospital to offer and study an in-home cognitive behavioral
therapy for mothers with depression who are participating in
the Nurturing Families Network. Research shows that depression
has dramatic negative effects on maternal functioning,
including an increased risk for child abuse and neglect, and
also negative effects on child development.
A second area of focus is on fathers and men. The trust
fund is taking steps to develop a component within the home
visiting, the Nurturing Families Network, that would offer a
full service of home visiting and groups to fathers and men who
are significant in the lives of children participating in the
program.
In closing, I would recommend that States be encouraged to
work on these two areas through CAPTA reauthorization. It seems
that once the field is focused on an issue, we learn very
quickly what works, what doesn't, and what is worth a try.
These issues merit that type of thinking and exploration. We
hope that you will reauthorize CAPTA at the highest level
possible, which would allow us to expand into these and other
new areas. With your support, the Children's Trust Fund and the
trust and prevention funds across the country can continue to
make a unique and important contribution to children and
families in the United States.
Thank you.
[The prepared statement of Ms. Foley-Schain follows:]
Prepared Statement of Karen Foley-Schain, M.A., M. Ed., LPC
Thank you Senator Dodd and Senator Alexander, and members of the
Subcommittee on Children and Families for this opportunity to testify
today on the reauthorization of the Child Abuse Prevention and
Treatment Act (CAPTA).
I am here today to tell you a good news story. The good news is
this:
The State of Connecticut has been making steady progress in its
efforts to prevent child abuse and neglect.
What is behind this progress? CAPTA.
CAPTA has been a catalyst for increasing the State's efforts to
prevent child abuse and neglect. CAPTA has enabled us to raise
awareness of the need to prevent child abuse and neglect and to enlist
the support of many in this cause.
CAPTA has provided the State with the opportunity to show that
prevention programs make a real difference in the lives of children and
families and to make the case that those prevention efforts must be
supported.
As a result the State has increased its investment in child abuse
and neglect prevention from less than $1 million a decade ago to more
than $14 million today. National and local foundations and individual
donors have also supported this cause by contributing more than $1
million dollars in just the past few years.
CAPTA funds, and the additional State and private sector donations
they have been able to attract, are an investment paying real
dividends. These dividends come in the form of reduced numbers of new
cases of child abuse and neglect, and better outcomes for children and
families.
The Children's Trust Fund is Connecticut's lead agency for CAPTA
Title II--Community-Based Grants for the Prevention of Child Abuse and
Neglect (CBCAP). The Trust Fund currently receives about $700,000
dollars in CAPTA funds each year.
The Trust Fund is a State agency in the executive branch of
government. The Trust Fund reports to the Governor and the Connecticut
General Assembly. A 16-member council made up of legislative and
executive branch appointees, who represent the business and social
services community, parents and a pediatrician, oversees its efforts.
CAPTA Title II
community-based grants for the prevention of child abuse and neglect
(cbcap)
The CAPTA CBCAP program has provided the vision for everything we
do at the Children's Trust Fund. This program had led us to finding the
most effective means of assisting and strengthening families in order
to prevent child abuse and neglect, funding a broad range of
organizations to implement these programs, conducting research to
assess their effectiveness and developing strategies for improving our
efforts.
We primarily use the CAPTA funds to implement and test innovations
in the field and to support the professional development of our State
contracted and other human services staff.
At this time CAPTA funds are largely being used to support three
major initiatives. They include:
Preventing shaken baby syndrome.
Preventing childhood sexual abuse.
Training human services staff to better engage and support
families in prevention efforts.
The funds are also being used to research the effectiveness of
these initiatives and to develop strategies to improve them.
shaken baby syndrome
Inspired by the work of Dr. Mark Dias in up-state New York, the
Children's Trust Fund launched a multifaceted program to prevent shaken
baby syndrome. The goal of this effort is to get the message to all new
parents--and those who care for children--that they should never under
any circumstance shake a baby.
Shaken baby syndrome is the most lethal and severe form of child
abuse. Experts estimate that several children die and that hundreds
more are hospitalized and face debilitating and permanent injuries each
year in Connecticut as a result of this tragic problem.
Research also shows that this problem is more wide spread than is
often thought. Many children who are diagnosed with shaken baby
syndrome are found to have histories of head injury and other symptoms
related to milder shaking.
Through the Shaken Baby Prevention Project the Trust Fund staff has
trained hospital and medical professionals and community service
providers throughout Connecticut on methods to prevent shaken baby
syndrome. This effort has led to ongoing programs and research efforts
within several hospitals.
In addition hundreds of high school and middle school students and
parents of young children have participated in community education
programs on this topic. The Trust Fund has embedded these strategies
into the home visiting program for new parents and encouraged other
service providers to do the same.
The Trust Fund is working with the University of Connecticut to
examine the effectiveness of these efforts.
the stranger you know
The Trust Fund, in collaboration with several State agencies and
children's organization, conducted a research project to assess the
nature of childhood sexual abuse in Connecticut and programs that were
available to prevent it.
The research found that most child sexual abuse prevention programs
promoted a fear of strangers and relied on children to say ``no'' to
molesters by teaching them the difference between ``good and bad
touch.''
This approach seemed at odds with what we learned about childhood
sexual abuse in the State.
We found that it was unrealistic to expect children to protect
themselves when they were emotionally, and sometimes physically,
overwhelmed by someone much larger.
We also found that the greatest threat to children does not come
from strangers. In fact, we learned that about 90 percent of children
personally knew their molester--about half were relatives and half were
trusted adults known to the child and their family through school,
sports, religion and other social ties.
As a result we developed The Stranger You Know . . . a program that
reflects the understanding gained through the research. The program
transfers the responsibility for keeping children safe from children to
adults.
The program gives adults information about how child molesters
successfully offend against children. It helps parents see patterns of
behavior that represent danger and provides them with steps to take to
keep their children safe.
The Stranger You Know . . . began as a pilot program in one
Connecticut community.
A study of the pilot found that participants were more aware of
child sexual abuse and how to keep children safe. The study also found
that the program's message extended beyond the individuals who attended
the presentation as a result of word of mouth exchanges.
To date the program has reached 1,000 parents in Connecticut.
family development training and credentialing (fdc)
The Children's Trust Fund is working with the University of
Connecticut Center for the Study of Culture, Health and Human
Development, to teach human service providers new skills for working
with families.
This training program teaches skills that help service providers
engage families on a voluntary basis before they become involved with
State-mandated services. The program teaches providers how to best
assist families to build on their strengths and to develop a healthy
self-reliance and interdependence with others in their community.
Organizations have found that this training leads to a more
cohesive workplace, that staff do a better job, and the interventions
with families become more successful.
This year the Trust Fund will work with the 12 Community Action
Agencies (CAP) in Connecticut to provide this training to more than 500
front line and leadership staff.
Connecticut has credentialed roughly 600 students in this program.
leveraged funds--state and private sector funding
CAPTA funds have enabled Connecticut to set an agenda for the
prevention of child abuse and neglect. It has helped create a real
momentum for the development of additional programs to support children
and families.
This effort also grew out of a recognition that the courts, the
Department of Children and Families, our school and other helping
agencies are stretched beyond the limits in attempting to deal with the
wide variety of issues facing children and families. They have seen
more and more resources and more and more funding being directed to
addressing children and families after a crisis has occurred--when it
was much more difficult and costly to intervene. This has led many
policymakers to ask if more can be done to avoid these problems.
The search for this type of solution--which is at the heart of
CAPTA--was a perfect match for the efforts and mission of the
Children's Trust Fund. As a result, the Trust Fund was given additional
resources and responsibilities for a number of programs focused on
preventing child abuse and neglect and ensuring the healthy development
of Connecticut's children.
the nurturing families network (nfn)
Chief among these has been the development of Nurturing Families
Network. The program's focus is on providing intensive home visiting
services to high risk families at a critical time in their lives--when
their first child is born.
Why home visiting?
The Trust Fund choose to focus on home visiting because this
approach has been shown to reduce the incidence of child abuse and
neglect, to improve parent-child relationships and lead to better
outcomes for both parents and children.
A number of evaluations have found that children whose parents
participate in a home visiting program have better birth outcomes,
stronger literacy skills, more social competence, and higher levels of
school readiness than their peers whose parents were not enrolled in
this type of program.
Evaluations have also shown significant achievements for parents
who participate in home visiting programs. These include gains in
employment and education, stable households, and access to health care.
Initially the Trust Fund implemented the Healthy Families America
home visiting model. Given the mixed results of national evaluations
and issues identified through our own research we decided to go in a
different direction.
We considered using a program of nurse home visitors. However,
given high nursing salaries and a severe shortage of nurses in
Connecticut we decided it was not feasible to go this way.
We also considered programs that focused on child development.
While these programs had strong results in some areas, research
suggested that they were not as effective when working with high risk
populations--and they did not have a strong focus on preventing child
abuse and neglect.
As a result the Trust Fund worked closely with researchers at the
University of Hartford Center for Social Research and a continuous
quality improvement team to begin the work of establishing a new model.
Through these efforts we fleshed out the strengths of Healthy
Families and identified gaps and barriers in the model. We changed,
modified and revised these areas. We added ``best practices'' that were
identified in the field. We tested these new approaches, worked on
implementation strategies, developed a comprehensive training program
for all staff and developed an integrated set of program policies and
practice standards that would ensure program quality.
As a result we have established a home visiting model that reflects
state-of-the-art practice. The model is based on a solid theory of
change, recognizes the value and importance of the relationship between
the families and the staff, while applying the most recent science on
child development and parenting practices, employing master level
clinical supervisors, and requiring extensive training and
credentialing for its home visiting staff and other staff.
The program model integrated the highly regarded Parents as
Teachers curriculum into the home visiting service. We see the addition
of this curriculum as a real strength of the program.
Let me tell you a bit about the Nurturing Families Network in
Connecticut.
The Nurturing Families Network is providing services to families
giving birth at all of the 29 birthing hospitals in the State. Services
are offered at 42 locations with expanded programs in the cities of
Hartford and New Haven.
The Nurturing Families Network provides parent education and
support for 5,000 new parents each year, including Nurturing Parenting
groups that are open to the community. The Nurturing Parenting group
program has received proven program status through the Office of
Juvenile Justice and Delinquency.
The program offers intensive home visiting for high risk and hard
to reach families living in poverty. The program connects high-risk
parents with a home visitor who meets with the family on a weekly basis
for up to 5 years. Roughly 1,300 new parents are receiving home visits
under this program.
The home visitors work against a backdrop of unwanted babies,
domestic violence and the high potential for child abuse or neglect to
assist the parents to address many issues and to help break the
family's social isolation. Through ongoing contact a trusting and
meaningful professional relationship is formed. This relationship is at
the core of the program's success.
The Nurturing Families Network has been rigorously researched and
evaluated by the University of Hartford Center for Social Research. The
results have been consistently strong.
Among the positive outcomes for this program are:
The rate of child abuse and neglect is far lower for high-
risk NFN participants than for similar families not in this type of
program.\1\
---------------------------------------------------------------------------
\1\ This finding is based on comparative data from 3 studies of
abuse and neglect rate for families identified at high risk using the
Kempe Family Stress Checklist. The incidence of child abuse and neglect
in the high-risk families identified by the Kempe participating in the
Nurturing Families Network is 1.6 percent in 2006. University of
Hartford, 2007. A 2-year study of prenatal mothers categorized into
low- and high-risk groups based on the Kempe found that 22 percent of
the high-risk mothers had abused or neglected their children versus 6
percent of the low-risk parents. Steven-Simon, Child Abuse and Neglect,
2001. A 2-year study comparing medical charts 2 years after the
children's birth to families defined at-risk on the Kempe and those
defined as no risk found that 25 percent of the children in the at-risk
group had been victims of abuse, neglect, or failure to thrive. The
rate was 2 percent for the no-risk group. Murphy, Child Abuse and
Neglect, 1985 Neglect, 1985
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Program participants experienced a significant decrease in
parental frustration, sadness and loneliness and an increase in coping
and stress management skills, developed more realistic expectations of
their children, and had fewer difficulties in relationships.\2\
---------------------------------------------------------------------------
\2\ This finding is based on pre-post measures on the Child Abuse
Potential Inventory and the Community Life Skills Scale. The Child
Abuse Potential Inventory (CAPI) is a standardized instrument designed
to measure someone's potential to abuse or neglect children. The CAPI
is widely used and well researched. The Community Life Skills Scale
(CLS) is a standardized instrument designed to measure someone's
knowledge and use of community resources and support. The outcome data
on program participants is positive. The data suggest that the mothers
are developing strategies to better cope with stress, are developing
less rigid attitudes and expectations about their children, and are
taking more responsibility for their lives. The results of the
Community Life Skills Scale are also positive. Mothers showed an
increased awareness and use of resources in their community.
Specifically the mothers had greater access to public and private
transportation, more supportive relationships with friends and families
and a decrease in social isolation.
---------------------------------------------------------------------------
Program participants made statistically significant gains
in education and employment.\3\
---------------------------------------------------------------------------
\3\ The University of Hartford examined mother's employment and
education data by age cohort, analyzing data for mothers who were 19 or
younger when they had their child and those who were 20 and older.
Among the younger cohort 83 percent enter the program without a high
school diploma. Roughly 50 percent of this group were in high school or
a GED program during their first year of parenthood to receive their
diploma. Among the older cohort 50 percent more mothers were enrolled
in school after a year in the program than at the time of program
entry--including high school, college, vocational and other schools.
Among both cohorts the number of mothers enrolled in and completing
school continues to increase with each program involvement. Among the
younger cohort the percentage of the mothers in the workforce increases
form 11 percent to 35 percent.
We will continue to offer and study this program. The Nurturing
Families Network is a program that can help more families and more
children have a better life.
In addition to State funding this program received grant support
from the Hartford Foundation for Public Giving, several local United
Ways, and municipal governments.
family school connection
I would also like to tell you about a new program the Trust Fund
has recently piloted in Hartford, Connecticut--the Family/School
Connection (FSC).
The program provides home visiting and support services to families
whose children are struggling with truancy, behavioral or academic
issues at school--and are likely to be struggling at home.
Family School Connection is modeled after the highly successful
Nurturing Families home-visiting program. Family School Connection
extends the Nurturing Families model to families with elementary school
children (ages 5-12).
Performance measures for this program have found that parents who
participated made statistically significant gains in the following
areas:
The participants had healthier parenting attitudes and
experienced less parenting stress.\4\
---------------------------------------------------------------------------
\4\ The University of Hartford Center for Social Research is using
the Parenting Stress Index- Short Form \1\ (PSI-SF) to measure
parenting and family characteristics that fail to promote normal
development and functioning in children. The Parenting Stress Index is
significantly correlated with measures of neglectful parenting and
other measures of abusive parenting. Outcome data from the families
participating in the program at entrance and 6 months show a
significant (p < .05) change in the desired direction indicating
healthier parenting attitudes.
---------------------------------------------------------------------------
The participants were more accepting and had more
realistic expectations of their children.\5\
---------------------------------------------------------------------------
\5\ The PSI-SF also identifies parents who are at risk for
dysfunctional parenting. The Parent-Child Dysfunctional Interaction
subscale measures parents' perceptions of whether their child meets
their expectations and the degree to which parents feel their children
are a negative aspect of their lives. Higher scores on this subscale
indicate an inadequate parent-child bond. Outcome data from the
families participating in the program at entry and 6 months show a
significant (p < .05) change in the desired direction indicating that
parents are more accepting and have more realistic expectations of
their children.
---------------------------------------------------------------------------
The participants were more involved in their child's
academic life.\6\
---------------------------------------------------------------------------
\6\ The researchers used the Parent-School Involvement Survey to
examine parent's perception of their school involvement. The survey
assessed the parents' perceptions of their child's school, the time
they spend with their child doing school-based activities such as
reading, helping with homework or volunteering at the school. The
outcome measures were administered when families entered the program
and then after 6 months of program involvement. There was change in the
desired direction indicating that parents had become more involved in
their child's academic life.
This program shows a great deal of promise. The Children's Trust
Fund is in the process of expanding this from a pilot program based at
Betances Elementary School in Hartford to four new sites in Middletown,
Windham, Norwich and New Haven.
This program was developed in collaboration with the Jr. League of
Greater Hartford and Hands on Hartford, formerly, Center City Churches.
We are also working with Deveroux Foundation to incorporate a new
tool for assessing the social and emotional development of school-age
children into the program.
help me grow
The final program I want to discuss is Help Me Grow.
Help Me Grow is a prevention program for all children who
experience the developmental challenges that go hand-and-hand with
growing up. Children who are facing behavioral, learning or other
developmental issues are connected to local programs that can provide
expertise and assistance.
Help Me Grow trains parents, pediatric and other providers to
recognize the early signs of developmental problems and to contact Help
Me Grow when they have a concern.
The research on Help Me shows:
The demand for the program has grown. Help Me Grow
received 3,300 calls last year, up by 16 percent from the previous
year. The number of services requested by each caller also increased.
As a result there was a 60 percent increase in referrals to community-
based services.
There is a high level of success in connecting families to
services. Eighty-six percent of families referred to Help Me Grow
during the past year were connected to services.
Participation rates in the Help Me Grow ``Ages & Stages
Child Monitoring Program'' increased by 4 percent from last year. This
figure is up by 13 percent from 2 years ago.
It is also worth noting that research on the training efforts of
Help Me Grow indicate that following the training pediatric providers
identify children with developmental and behavioral risks twice as
often. The training increases their awareness and this allows them to
recognize more children and families in need.
Over the next 2 years the Children's Trust Fund plans to distribute
the ``Ages and Stages Child Monitoring'' tool to all pediatric
providers across the State. Through this effort the Trust Fund will
encourage all pediatric providers to monitor child development and to
provide the ``Ages and Stages'' kits to all parents when their babies
are 4 months old.
The Children's Trust Fund received a grant award from the W.K.
Kellogg Foundation to enhance the capacity of Help Me Grow to reach and
engage hard to reach families. These include families who do not have a
phone or who have complex needs. The Trust Fund is currently piloting
this effort in the city of Hartford.
In addition the Commonwealth Fund in Boston is funding an effort to
replicate Help Me Grow nationally. The Children's Medical Center will
be administering this effort. We are glad to see that our work in
Connecticut will be of help to others.
next steps
While Trust Fund efforts to prevent child abuse and neglect have
made significant strides over the past decade, we recognize that there
is still much to be done. The Trust Fund has identified two priorities
for further program development.
The Children's Trust Fund will be working with Drs. Frank Putnam
and Robert Amerman at the Cincinnati Children's Hospital to offer and
study an in-home cognitive behavioral therapy for treating mothers with
depression who are participating in the Nurturing Families Network.
Research on mothers shows that depression has a dramatic negative
effect on maternal functioning, including an increased risk for abuse
and neglect. In addition, maternal depression has negative effects on
the social, emotional, and cognitive development of children. Despite
these findings most depressed mothers do not receive treatment.
Programs like the Nurturing Families Network were built on the
assumption that this type of service could be found in the community
and that the role of the program was to help mothers receive these
services.
At the current time, however, there are few options for mothers to
receive this type of service. As a result we have determined that the
service must be integrated into the home visiting program itself.
The in-home cognitive behavioral approach we will be testing is
designed to be closely aligned with the home visiting service. The
program has been successfully implemented in Ohio where 85 percent of
the mothers received the full number of treatment sessions, and 85
percent had full or partial remission of their depression.
A second area of focus is on fathers and men.
Research shows that children fare better when both parents are
involved in their lives. The Children's Trust Fund is taking steps to
research and develop a program component within the Nurturing Families
Network specifically for fathers and men who are significant in the
lives of children participating in the program.
This component would be well integrated in the Network but would be
different in several important ways--the staff would develop outreach
strategies and activities tailored to men, work with fathers who are
not living with their children, and offer a full range of home visiting
and group services.
While Connecticut and other States have important efforts focused
on fathers and men they tend to be for those that have developed
significant problems with child support, the courts, and child
protective services. The fathers tend to be estranged from their
children. In Connecticut the average age for fathers in this type of
program is 31.
In the Nurturing Families Network the average age of fathers is 21.
This age difference gives us a full decade to prevent some of these
problems from developing and to help fathers and men have meaningful
and nurturing relationships with the children in their lives.
I would recommend that States be encouraged to work on these issues
through CAPTA reauthorization. It seems that once the field is focused
on an issue we learn very quickly what works, what doesn't and what is
worth a try. These issues merit that type of thinking and focus.
in closing
As you can see, the programs administered by the Trust Fund are
working.
We are strongly committed to the goal of CAPTA, offering a solid
program, getting strong results, helping to improve the lives of
children and families all across the State of Connecticut and
preventing child abuse and neglect.
CAPTA has given us an important focus and a helpful hand to build
on our efforts over the years.
We hope that you will reauthorize CAPTA at the highest level
possible and continue to support our efforts and those of children's
trust and prevention funds across the country who are also
administering this important program.
Your support allows each of us to make a unique and important
contribution to children and families across the United States.
Thank you.
Senator Dodd. Very excellent testimony. Thank you.
Ms. Foley-Schain. Thank you.
Senator Dodd. I'm proud of my fellow Nutmegger there. Thank
you.
Ms. Kaplan.
STATEMENT OF CAREN KAPLAN, MSW, DIRECTOR OF CHILD PROTECTION
REFORM, AMERICAN HUMANE ASSOCIATION
Ms. Kaplan. Chairman Dodd and Senator Isakson, my name is
Caren Kaplan and I am the Director of Child Protection Reform
at American Humane. I am honored to provide comments on the
reauthorization of the Child Abuse Prevention and Treatment Act
and thank the Chairman and the subcommittee members for the
invitation to do so.
American Humane, a national nonpartisan membership
organization, was founded 130 years ago to protect the welfare
of children and animals. Our testimony reflects over a century
of history progressively advocating at the Federal, State, and
local levels for laws that protect children and animals from
abuse and neglect.
In 1974 Congress passed what was and still remains the
preeminent Federal legislation addressing child abuse and
neglect. The reauthorization of CAPTA allows for opportunities
to engage families and provide effective, responsive services
earlier in order to diminish both the initial occurrence of
maltreatment and subsequent recurrence.
American Humane has embraced several large-scale
initiatives that advance the Nation's child welfare system. We
promote the inclusion of these items through amendments to the
most recent reauthorization of CAPTA, the Keeping Children and
Families Safe Act of 2003.
The traditional child protection response on investigation
is perceived as overly accusatory as an initial response to low
and moderate risk reports of maltreatment. Differential
response is an approach typically used with reports that do not
allege serious and imminent harm, that allows child protective
services to respond differently to accepted reports of child
abuse and neglect and tailor the response to the needs and
circumstances of the family without fault-finding.
Services, including those services related to economic
hardship such as housing assistance, transportation, child
care, and others, may be provided to families without a formal
determination that maltreatment has occurred, labeling someone
as a perpetrator, and listing them in the State's central child
abuse registry.
Differential response has been implemented either statewide
or in selected jurisdictions in about 20 States and the number
is increasing rapidly. Although research is in its infancy,
random assignment design studies involving control and
experimental groups, a rarity in our field, have indicated that
child safety is not compromised and in some instances attained
sooner, repeat cases of abuse and neglect decrease, family
cooperation and participation increase, placement rates of
children in foster care are lowered, costs are reduced over
time, and satisfaction both by families involved with the child
welfare system and child welfare workers increases.
Our current child protection system needs widespread
integration of family involvement and leadership models that
reclaim the family's roles and responsibilities as
decisionmakers about their children. These models are grounded
in the belief that children are best protected within the
context of their families and that the family group has a right
to be active partners in making decisions about their
children's safety, permanency, and well-being.
There is an urgent need to build knowledge, policy, and
prevention and intervention practices to address the unique
safety and protection needs of children who are chronically
neglected by their families. Chronic child neglect refers to
the ongoing serious pattern of deprivation of a child's basic
physical, developmental, and emotional needs by a parent or
caregiver.
The system's inability to reach these families and impact
the well-being of their children is a fundamental gap.
Intervening with these families for short periods of time in an
incident-driven system will not work. Prerequisites for success
include a comprehensive, community-based approach with
specialized assessment, skilled staff, manageable workloads, an
expansive service array, and long-term involvement.
A comprehensive approach to address child maltreatment
recognizes the link between family and animal violence and
involves the vital partnership between animal welfare and child
protection agencies. When animals in a home are abused or
neglected, it is a warning sign that others in that household
may not be safe.
Funding of CAPTA, as has been said, should be appropriated
at the authorized level. Greater balance is needed between
investments in child maltreatment prevention, identification,
and early protective interventions compared to the investments
in interventions after a child has been separated from his or
her family.
The first goal of any child protection system response is
to keep children safe from harm. American Humane hopes that the
CAPTA reauthorization serves as a foundation and an impetus to
reduce the number of maltreated children and increase the
number of families who have sufficient strengths, capacities,
and supports to keep their children safe from harm.
Thank you very much.
[The prepared statement of Ms. Kaplan follows:]
Prepared Statement of Caren Kaplan, MSW
Chairman Dodd, Ranking Member Alexander and members of the
subcommittee, my name is Caren Kaplan and I am the Director of Child
Protection Reform at American Humane. I am honored to provide comments
on the Reauthorization of the Child Abuse Prevention and Treatment Act
(CAPTA) and thank Chairman Dodd, Ranking Member Alexander and the
members of this subcommittee for the invitation to do so.
American Humane, a national, nonpartisan membership organization,
was founded 130 years ago to protect the welfare of children and
animals. Our testimony today reflects over a century of history
progressively advocating at the Federal, State and local levels for
laws that protect children and animals from abuse and neglect.
In 1974, Congress passed what was, and still remains, the pre-
eminent Federal legislation addressing child abuse and neglect. This
landmark legislation sets forth a minimum definition of child abuse and
neglect and authorizes Federal funding to States in support of
prevention, identification, assessment, investigation, and treatment
activities.
Through its provisions--the Basic State Grants, the Community-Based
Prevention Grants and the Research and Demonstration Grants, CAPTA
provides State, local, and tribal public child welfare agencies with a
foundation for quality child protective services, enhancements of the
formal and informal preventive, community-based services, the
opportunity for systemic and practice improvements, and expansion of
our understanding and knowledge that will guide our State statutes,
policies, practices and customs. This is the essence of CAPTA and the
promise of our Nation's ability to keep children safe and families
together.
improving the child protection system
The first goal of any child protection system response is to keep
children safe from harm. In fiscal year 2006, an estimated 3.3 million
referrals, involving the alleged maltreatment of approximately 6.0
million children, were made to Child Protective Services (CPS) agencies
[US HHS, 2008]. An estimated 3.6 million children received an
investigation or assessment. In 2006, an estimated 905,000 children
were determined to be victims of abuse or neglect. Of the children who
received post-investigation services, nearly 60 percent (58.9 percent)
were victims and 30.3 percent were nonvictims. Forty percent of the
905,000 victims received NO post-investigation services. Of the
children who were placed in foster care, more than 20 percent (21.5
percent) were victims and 4.4 percent were nonvictims. The number of
reports and the number of child victims has remained relatively stable
over the past decade.
American Humane has dedicated the past several years to the
successful launch of large-scale initiatives that advance our Nation's
child welfare system in order to effectively protect children and
support families. I would like to detail several of these issues and
opportunities to be responsive through the reauthorization of CAPTA.
differential response systems
American Humane advocates for the implementation of Differential
Response Systems in Child Welfare as an effective way to respond to
reports of abuse and neglect. Differential response also referred to as
``dual track,'' ``multiple track,'' or ``alternative response'' and
``family assessment,'' encourages families to recognize their own needs
and seek services to enhance parenting skills, mental health concerns,
substance abuse issues, work/day care issues and/or other distinct
needs of each family. Differential response encourages family
participation in agency- and community-based services. By alleviating
the concerns raised without a formal determination or substantiation of
child abuse and neglect, these ``alternatives'' to traditional child
protection investigative response achieve or maintain child safety
through family engagement and collaborative partnerships.
Differential Response Systems (DRS) is an approach that allows CPS
to respond differently to accepted reports of child abuse and neglect.
The child protection agency assesses the needs of the child or family
without requiring a determination that maltreatment has occurred or
that the child is at risk of maltreatment [US HHS, 2003]. Services may
be provided to families without a formal determination of abuse or
neglect or labeling someone as a perpetrator and listing them in the
State's central child abuse registry. [CWLA, 2005].
Children and their families who come to the attention of public
child welfare agencies have diverse life circumstances, strengths,
challenges and needs. Differential Response allows agencies to respond
to accepted or ``screened in'' reports of suspected child abuse and
neglect in more than one way, with the intent on being most responsive
to the situations of families. Without embracing an allegation,
incident-driven approach, families are, in general, more receptive to
the receipt of and involvement in needed services. As differential
response systems evolve, child welfare systems are incorporating a
third pathway to respond to the families whose reports do not meet the
statutory threshold of alleged abuse and neglect.
Differential Response is typically used with reports that do not
allege serious and imminent harm. Factors such as the type and severity
of the alleged maltreatment, the number of previous reports, the source
of the report, and the willingness of the parents to participate in
services determine the appropriateness of this response and suggest a
non-adversarial, cooperative approach to meet each family's unique
needs. By providing interventions that correspond to the severity of
the concern being reported, differential response results in
appropriate services to resolve the family issues thereby easing the
cause or likely reoccurrence of the original concern.
Differential Response has been implemented, either Statewide or in
selected jurisdictions in about 20 States and this number is rapidly
expanding. Although research is in its infancy, random assignment
design studies involving control and experimental groups have indicated
the following positive results:
Child safety is not compromised and in some instances
attained sooner.
Fewer repeat cases of abuse and neglect.
Higher rates of family cooperation and participation.
Increase and changes in service provision; greater focus
on basic needs and economic hardship.
Lower placement rates of children in foster care.
Reduced costs over time.
Increased satisfaction, both by families involved with the
child welfare system and child welfare workers.
Community stakeholders preferred the dual-response
approach.
Opportunities for CAPTA Reauthorization
Title I of CAPTA authorizes grants to States to help improve their
child protective service systems. Within the eligibility requirements,
there is opportunity to encourage States to develop and implement
differential response to families who come to the attention of the
child protection system.
Title II of CAPTA authorizes grants to States to develop community-
based prevention services including home visitation, parent education,
and respite care. Since the intent is to develop a continuum of
preventive services for children and families through State and
community-based collaborations and partnerships, statutory language can
promote the development of community response pathways--a third
response to families--established by State and local public child
welfare agencies.
In CAPTA's Research and Demonstration Activities, there is an
opportunity to build the knowledge and evidence on the multitude of
differential response approaches that are currently being planned and/
or implemented across the Nation.
family involvement and leadership
American Humane strongly advocates for the widespread integration
of family involvement and leadership models committed to
institutionalizing fair and transparent planning and decisionmaking
processes that recognize and build on the protective capacities of the
family group and provides them with opportunities to reclaim their
roles and responsibilities as decisionmakers about their children.
In the past 10 years, public child welfare and community-based
organizations have been implementing numerous family involvement and
leadership models as a way to provide inclusive and culturally
respectful processes when critical safety and permanency decisions are
being made about children. Family group involvement and leadership
models are based on a commitment to ensuring that children's rights to
the resources of their families and communities are honored, respected,
and actively cultivated, especially when children and their families
are involved with formal systems, in particular child welfare. They
recognize the inherent right of children and families to be connected.
These models are grounded in the belief that children are best
protected within the context of their families and that the family
group has the right to be active partners in making decisions about
their children's safety, permanency and well-being. These models also
provide a family perspective for understanding and responding to the
unique developmental needs of children and their family. Family Group
Decision Making offers communities an evidence-based approach to reach
the goals of positioning families and young people as drivers of
services, creating individualized, family-driven service plans,
promoting cultural and linguistic competence and building partnerships
among systems.
Opportunities for CAPTA Reauthorization
The State Grant eligibility requirements provide an opportunity to
advance the involvement and leadership of families as a principle
practice of quality child protection.
chronic neglect
American Humane advocates for the building of knowledge, policy,
prevention and intervention practices that address the unique safety
and protection needs of children who are chronically neglected by their
families. Through the identification and monitoring of specialized
child protection practices nationwide, the development of best practice
guidance, and the creation of strategic alliances with traditional and
non-traditional partners, comprehensive, community-based approaches can
prevent neglect and the recurrence of neglect, reduce the risks of
chronicity, support and strengthen families in which neglect occurs,
and facilitate system change that is more responsive to, and effective
with, families that chronically neglect their children.
Chronic child neglect'' refers to the ongoing, serious pattern of
deprivation of a child's basic physical, developmental and/or emotional
needs by a parent or caregiver. While definitions of chronic child
neglect and the implementation of these definitions, vary by State,
county and local child welfare systems, several dimensions include the
duration of neglect, the time period covered by multiple Child
Protective Services reports, the number of reports (not just
substantiations), the referral for multiple types of maltreatment, the
documentation of non-adherence in medical or school records, and the
child's developmental indicators.
While the lack of definitional clarity and the use of various
dimensions to identify chronic neglect compromise a shared
understanding, the system's inability to reach these families and
impact the well-being of their children is a fundamental gap.
Prerequisites for success include: Differential assessment; skilled
staff; manageable workloads; service array; and long-term intervention.
For more than a decade, State reports to the National Child Abuse
and Neglect Data System have indicated that more than half of all child
victims in the United States suffered neglect.
Given the enduring prevalence of neglect in child maltreatment
cases, there has been a long-standing need to focus on prevention,
assessment, treatment and interventions targeting neglect in child
welfare. According to the National Incidence Study-3 (1996), children
from families with incomes less than $15,000/year were 44 times more
likely to be victims of neglect compared to children from families with
incomes greater than $30,000/year.
Although a growing body of literature illustrates some evidence-
based best practices for decreasing neglect, such limited endeavors
fall short of the comprehensive and integrated approach that is
essential to command the visibility, political will and system reform
to improve the safety, permanency and well-being of families in which
neglect occurs. With few notable exceptions, advancements in the
specialized practice and research of neglect are in their infancy. The
magnitude of this need increases exponentially when addressing the
chronicity of neglect.
The enormous human toll is compounded by the significant economic
toll, as resources are disproportionately devoted to families that
chronically neglect their children. Costs associated with these
families have been determined to be seven times that of other families
that neglect their children [Loman & Siegel, 2004]. There is an
undeniable need for more sustained and broad-ranging approaches to
families that go beyond immediate safety issues, as well as more
relevant literature and research to provide a base of knowledge that
informs our practices and policies.
Opportunities for the Reauthorization of CAPTA
An increasing number of States are struggling to confront the
insidious nature of chronic neglect. The Federal Government can provide
leadership and guidance to States in the CAPTA reauthorization by
providing a clear definition of chronicity or chronic neglect.
While there has been a significant amount of work on neglect at the
Federal level, there are insufficient connections between Federal
efforts and what happens on the ground at the State and local levels.
There is an opportunity in CAPTA's Research and Demonstration
Activities to enhance the connections between research and practice;
target the efforts on chronicity; and assure broader dissemination of
that which is known and that which is a promising practice.
the link between child and animal maltreatment
American Humane actively addresses the internationally recognized
link between animal abuse and family violence. Through its campaigns
against violence, American Humane is a leader in raising public
awareness, advocating for stronger legislative initiatives, and
providing tools for decisionmakers, social service providers, animal
care and control professionals, veterinarians, parents, and other
concerned citizens to recognize problems and take appropriate steps to
end abuse and protect its both human and non-human victims.
Child and animal protection professionals have recognized this link
and cycle of violence between the abuse of both children and animals.
This link also expands to violence against women by domestic partners
and violence to elders in the home. One of the first research studies
to address the link found that 88 percent of 57 families being treated
for incidents of child maltreatment also abused animals in the home.
[Deviney, Dickhert, and Lockwood, 1983]. And a 1997 survey of 50 of the
largest shelters for battered women in the United States found that 85
percent of women and 63 percent of children entering shelters discussed
incidents of pet abuse in the family. [Ascione, F. R. 1997]
When animals in a home are abused or neglected, it is a warning
sign that others in the household may not be safe. In addition,
children who witness animal abuse are three times more likely of
becoming aggressive or abusive. [Currie, C.L., 2006].
Opportunities for the Reauthorization of CAPTA
In detailing the comprehensive approach required to address child
abuse and neglect, title I should acknowledge the vital partnership
between animal welfare agencies and child protection agencies. Much
like the recognition of the relationships between and among domestic
violence, mental illness, substance abuse and child maltreatment, CAPTA
should include language that supports and enhances interagency
collaboration between the child protection system and animal welfare
agencies in identifying child abuse and neglect.
funding and investment
American Humane advocates for the funding of CAPTA at the
authorized level and greater balance in the investments in child
maltreatment prevention, identification and early protective
interventions compared to investments in interventions after a child
has been separated from their family.
It has been a long-standing battle cry of advocacy organizations
and their constituents that the child protection system is woefully
under-funded. The merits of this statement can be demonstrated by the
following four statements.
The annual number of child victims has remained relatively
constant over the past decade.
Historically, there has been a significant gulf between
the appropriated levels of funding and that which is authorized in
statute.
The conservative estimated annual cost of child abuse and
neglect is $103.8 billion in 2007 value [Prevent Child Abuse America,
2008] and CAPTA appropriations for fiscal year 2007 were approximately
$100 million.
A study Total Estimated Cost of Child Abuse and Neglect in
the United States. [Prevent Child Abuse in America, 2008] calculates
that investments in the prevention of child abuse and neglect can save
the Nation over $100 billion per year.
Opportunities for the Reauthorization of CAPTA
While we understand the appropriated levels of funding do not come
out of this committee, it is significant to note when discussing levels
of funding with your colleagues, that 362,000 children identified as
victims of maltreatment received no post-investigative services.
In order to diminish both the initial occurrence of maltreatment
and subsequent recurrence, it is essential to engage families and
provide effective, responsive services before their challenges become
severe and the risks of maltreatment expand and/or escalate.
conclusion
As a longstanding member of the National Child Abuse Coalition
(NCAC), an alliance of 30 organizations committed to strengthening the
Federal response to the protection of children and the prevention of
child abuse and neglect, American Humane lends its enthusiastic support
to NCAC's recommendations for the reauthorization of CAPTA. NCAC's
testimony has been provided to the subcommittee in writing.
American Humane appreciates the opportunity to offer our testimony
and comments to the subcommittee in regard to the reauthorization of
the Child Abuse Prevention and Treatment Act. Given that CAPTA is the
pre-eminent Federal legislation addressing child abuse and neglect and
expires this year, it is our hope that its reauthorization is given the
highest priority and completed before the 110th Congress ends. As this
legislation progresses, we look forward to a continued dialogue with
Chairman Dodd, Ranking Member Alexander, members of the subcommittee
and the entire Congress.
We hope this reauthorization serves as a foundation and impetus for
the reduction of children who experience abuse and/or neglect and an
increase in the number of families who have sufficient strengths,
capacity, and supports to keep their children with them, safe from
harm.
Senator Dodd. Thank you very much, Ms. Kaplan. Very, very,
very good testimony.
Well, we've got some questions for you. I'll announce in
advance, by the way, that obviously other members of this
committee have a strong interest in the subject matter as well
and I'm going to leave the record open as well for additional
questions that we may submit in writing to you and ask you in a
timely fashion to get back.
I was just talking to staff about the plans for all of
this, and obviously we want to get as much information and data
together here, to then finish the bill. Lamar Alexander, who is
normally the Ranking Republican, the Senator from Tennessee, on
this committee, has a strong interest in this subject matter,
has been very supportive historically. I think this is an issue
which is going to enjoy some broad bipartisan support, because
it's had a wonderful history and record of making a difference.
Obviously, your testimony today gives us some additional ideas
on how we can even improve upon the work that's been done.
Again, my hope would be that we could put something
together. Obviously, this is going to be somewhat of a
truncated session, for all the obvious reasons. Our ability to
get this done--I'm hopeful we can before we adjourn. Then of
course, the level of approach with appropriations as well
requires separate effort. Nonetheless, people like Senator
Harkin on this committee are very supportive of CAPTA and sit
on the Appropriations Committee, and other members as well.
We'll be anxious to move along and develop as quickly as we can
some ideas as part of this reauthorization effort.
With that in mind, let me begin if I can with you, Dr.
Boyce. It's two or three questions, but let me frame them as
one for you if I can. Given, as you point out, the majority of
the maltreatment cases fall into the neglect area, I wonder how
your research effort at NIH has addressed child neglect per se,
just focusing on that, and do we have a better understanding of
how to prevent neglect or how to provide support to families
where children suffer neglect?
Third, are there new areas of research that we should be
pursuing regarding child abuse and neglect that we could
possibly make a part of this reauthorization effort that today,
for whatever reason, would be less available to you and to
others doing the kind of research in this area?
Dr. Boyce. Those are very important questions. Neglect is
an issue that has been near and dear to my heart, something
that, as I said, we've focused on specifically for the problems
in terms of the prevalence. There is currently and was a
special request for announcements that created a consortium of
neglect researchers. What was special about this, it was the
first time that we had researchers that were across all domains
working on this issue.
For instance we had researchers who looked at indicators in
terms of dental neglect, so that we could think about the
earliest ways that we could identify it through dentists,
through schools, so that we could intervene early. That is
clearly the message here.
We also had grants that looked at neglect and its effects
in adolescence. We do know that it occurs early in life
usually, but we also wanted to make sure that if we do not
catch those families and children early that we are able to
intervene at different times along the developmental
trajectory, so that we can stop this life course issue in terms
of those negative effects that we've seen in terms of health.
To answer the last part of your question in terms of new
areas of research, of course with more we can always do more.
We can try to do it faster. We've continued the neglect
consortium work and we've continued to bring new researchers
in. We do try to fund excellent research that addresses neglect
and also other related indicators in terms of early
intervention and looking at things such as maternal depression,
parental depression, substance use, and all those risk factors.
I applaud you for specifically pointing out neglect because
that's something that we have, a focused inter-agency effort to
work on and continue to work on today.
Senator Dodd. Obviously, economic factors play a very
important role in all of this. I mentioned in my opening
comments about the disproportionate share of racial and ethnic
minority children experiencing maltreatment. I wonder if any
research has been done at NIH that looked into this issue, and
additionally disabled children. Again, I find this, that very
young children and disabled children--I was reading the
testimony last evening and some of the staff memos in
preparation for this hearing and I find it just so hard to
believe that the youngest of our children are the ones that are
suffering, and also the disabled children are at higher risk of
being maltreated.
I wonder if NIH has addressed this in any way.
Dr. Boyce. Yes, we do. Like I said, there's always more
research and more we can learn. Just for example, we did fund a
grant that looks specifically at racial disproportionality to
try to unpack what's happening there in terms of ways we could
better target services based on culture and environmental
factors, because we know that's important. In terms of
disabilities, we also do look at that. In terms of physical
abuse, you'll see some neurological impairments. We do look at
the brain and thinking about how early neglect really will
impact the brain and impact education, impact functioning. This
is going to be something that if the injury is severe enough
will impact a child over their development and then over the
life course.
Senator Dodd. Give us some ideas in terms of what you're
finding in the study and how we might begin? One of the things
we all want to do obviously is prevent this.
Dr. Boyce. Yes.
Senator Dodd. Identifying and treating it is obviously a
major focus of our attention, but the most important job I
think we could do is obviously to prevent it.
Dr. Boyce. Yes.
Senator Dodd. To what extent--and again, I get this idea of
the one-size-fits-all worries me in many ways. I like the idea
that we're able to respond to this with understanding the
localities differences that occur and different needs. What are
you finding that might be worthwhile for us to know here as a
committee about different approaches we might take,
particularly in the area of the disabled and the ethnic
minority communities if these numbers are as high as they are.
What aren't we doing right that we ought to be doing right to
reduce these percentage numbers?
Dr. Boyce. I think some of the things we are doing right is
early intervention and looking for those families who are at
risk. Research has shown us which families are most at risk for
interventions. National data really helps us, so we know where
to go in terms of looking at risk. That can help with
prevention. We want to work with families when they're at risk.
We want to work with families once there's one incident, so
there's not another incident or this doesn't happen with other
children in the family.
Then in terms of thinking about disability, we know that
there is an overlap in terms of these children will often need
special education services. There are areas that we can explore
and do more research and do more intervention on, but that's
where we have found, with the research thus far, the key points
and the key places where prevention efforts currently exist.
Those are areas that we could look at the research and think
about ways to do that better always, but those are the key ways
to do it, early intervention and thinking about when we have
identified a child in terms of disability.
Senator Dodd. Well, what about some of the ideas--I
mentioned the Philadelphia case, and that may seem a little
excessive to some, but just without getting into the issue of
whether or not there's been substantiated cases or not, that
just when people are coming into that system, given the fact
there have been higher percentages--if you've got a disabled
child, and again there are certain factors here, wouldn't that
flag that issue almost immediately? Not to identify and label
necessarily a family, but nonetheless, given the rates that are
occurring, even before the problem emerges to flag it and to
begin to work with it immediately.
Dr. Boyce. Right, because substantiation differs by States
and that's always been an issue as we try to work with this. We
really worked on making sure that there were definitions that
didn't matter about substantiation. We know in terms of
research what risk is and we don't worry about the court
definitions because that's not always an accurate indicator
because of the differences across States.
When families enter with any risk factor there's always an
opportunity to intervene, and it doesn't have to reach
substantiation for someone to intervene. There are models
across the United States where, whether it's substantiated or
not, a family can receive services, and we're happy to see that
because then we know this is a family at risk and that we can
start with interventions or prevention right away.
Senator Dodd. Last on this point before I turn it over to
my colleague, are you familiar with this Philadelphia case I
talked about?
Dr. Boyce. I'm not familiar with the specific case. Maybe
you could--
Senator Dodd. What they do, they're dealing immediately
with children in the child welfare system. They begin right
then and there. I'm wondering if that's going over the top, is
that going too far. I don't know what the costs associated with
that, but there are some obvious questions people might raise.
Well, I can come back to that in a minute.
Senator Isakson. Thank you, Senator.
You had said, Dr. Boyce, that the most common form of abuse
is neglect and the most neglected are those between ages 1 and
3.
Dr. Boyce. Birth to 3, yes.
Senator Isakson. Is that correct?
Dr. Boyce. Yes.
Senator Isakson. I suspect all of these programs depend on
a referral to get the neglected child to some area of help, but
the hardest place to get a referral would be somebody 1 to 3, I
would think, because they're not in school yet. Where do these
referrals come from and where do they go to?
Dr. Boyce. There are various places where these referrals
can come. They can come through pediatric offices. All young
children see doctors. There are a lot of models for where there
is early identification. We do think about different
associations in terms of looking at pediatricians, who are
often the ones who are seeing kids early. I also mentioned
schools, but when we talk about schools there's also
opportunities in day care.
There are models and ways to identify early and identify
risks and not wait for a substantiated case, because by that
point we know that there may have been multiple risks that are
already causing damage to the child's functioning and their
development.
Senator Isakson. Ms. Long, how did you find Parents
Anonymous, or how did they find you?
Ms. Long. When I went to live in the homeless shelter with
my children, Parents Anonymous was there as a support group for
the mothers. The thing about it was we were all in the same
boat, so there was no embarrassment in attending this group. I
had no idea what it was about until I attended, and it was
there for me with mutual support.
Senator Isakson. Your comment in your testimony, your talk
about your peers giving you support made all the difference in
the world, I think that's what's so important in this. Whether
it's an infant or whether it's someone on drugs, if you're all
alone and you don't have a support group the chances of you
making it out are almost nil. You've got to have that support
element.
So your referral really came I guess from the homeless
shelter, then?
Ms. Long. It didn't--it wasn't a referral as much as
parents were strongly suggested to attend as part of their
agreement to be in the shelter. But, that is not how Parents
Anonymous works. It's just the way it was in that shelter.
Parents Anonymous in Columbus is under the umbrella of
Catholic Social Services and any parent all over the country,
but in Ohio, can access them through--their in the phone book.
Some States have help lines. Parents Anonymous is currently
trying to have a national help line, and that's one of the ways
that you can--and it's word of mouth. Mostly it's word of
mouth, because parents are so grateful to receive that support
because someone, another parent, understanding what they're
going through. They're happy to tell other parents who are
struggling that it's there for them.
Senator Isakson. I don't want to get too personal, but if I
may ask, are you married?
Ms. Long. No, sir, I am not.
Senator Isakson. Were you married when you had your first
child?
Ms. Long. Yes, I was.
Senator Isakson. That was the one that's 32 years old?
Ms. Long. Yes.
Senator Isakson. The others you raised alone?
Ms. Long. Yes, I have.
Senator Isakson. I make this point, Mr. Chairman. I chaired
the State Board of Education. I worked with a lot of outreach
groups and worked with a lot of troubled kids. It always
troubled me that the root cause of a lot of our problems are
never in attendance at things like that, and that's men.
You know, the number of broken homes and single moms that
end up having to raise their kids in a very difficult world--
and Morehouse University in Atlanta is beginning a study about
the patterns of children born out of wedlock, the
responsibilities of the male role model with families and the
difference it can make.
I just had to--reading your story, I suspected that was the
case. That male role model can make so much difference and the
family--the support group you got in the homeless shelter was
the group that replaced what would have been there if there was
a family. I think that's probably a fair statement to say, all
right?
Ms. Long. Could you repeat that last part?
Senator Isakson. The support that you got from the Parents
Anonymous group and your peers who were in that program kind of
supplanted what was the family relationship that you didn't
have at that time, because the husband was gone; is that
correct? Or was he still around?
Ms. Long. No. Parents Anonymous is for anyone in a
parenting role and there are men who come to the Parents
Anonymous groups. It encompasses whole families, anyone in a
parenting role. We have groups for foster parents,
grandparents, parents with children with disabilities. Anyone
in a parenting role. We have fathers groups.
I wouldn't say that it supplanted it. What it did was
provided mutual support, which was other parents sharing how
they felt about raising their children. In that shelter it just
so happened that it was for mothers and children. There are
shelters around the country that take in families and there are
Parents Anonymous groups there as well.
Senator Isakson. Thank you.
Can I have one last question?
Senator Dodd. Ask away.
Senator Isakson. Ms. Foley-Schain, you mentioned the
Nurturing Families Network was a referral network that most of
your referrals came from. Is that a Connecticut entity or is
that a national entity?
Ms. Foley-Schain. The Nurturing Families Network is a
Connecticut entity. There are similar programs operating in
different States around the country. In terms of how we engage
families in the program, we have staff who are employed by
Nurturing Families Network sites, who are called ``nurturing
connections coordinators. Their whole job is about connecting
with families and connecting those families to the program or
other services.
Those staff go into prenatal clinics. They're on the halls
of the maternity ward. They're available, as soon as we
identify that a mother is pregnant, to try to engage her, and
if we miss her at that point we try again at the time she gives
birth to her child.
The connections coordinators also go to other human
services organizations in the locality where they're operating,
say for example a WIC office, or to ob-gyns and other clinics.
Senator Isakson. Thank you very much.
I look forward to working with you on the reauthorization,
Mr. Chairman.
Senator Dodd. Thank you very much, Senator.
Let me digress just for a second. These are not under-aged
staff members of the Senate committee here. These are students
from Connecticut who are here today, and I'm delighted they're
with us. Thank you for being here. I hope you're enjoying the
hearing and learning something from it.
We've got students from--it sounds like ``The Bury's'' from
Connecticut--from Woodbury, Southbury, and Middlebury, and
Seymour. It's nice to have you with us. Their teacher is with
us. Is it Lisa Peters?
Ms. Peters. I'm not their teacher, but we do have a teacher
with us.
Senator Dodd. Well, great. Thank you, thank you for being
with us. Nice to have you with us.
Let me pick up. I want to pick up on, Ms. Long, on the
question that Senator Isakson raised about the support
services. I think it's one thing to wrestle, as you pointed
out, your own substance abuse issues, and that in itself,
overcoming that and getting support is absolutely essential,
but also to learn how to be a supportive, strong parent is a
critical element in this, and to be taking on the
responsibility of, one, moving away from the substance abuse
and simultaneously learning, that's an awful lot to be saddled
with. I wanted to know how that worked.
I know it's one thing to be around other parents who are
struggling with this, but sometimes that can be in itself--it's
good and it's encouraging to know you're not alone. I don't
mean to minimize that. It seems to me there needs to be more
than just that to make this work right, to be providing you
with the guidance and support on what you need to be doing and
how you could do this to become a stronger and a more
supportive parent.
I wonder if you might talk about that a bit. Maybe you did
and I just missed it, but it seemed to me you were wrestling
with the addiction issue, you were meeting wonderful people who
were going through this as well, so that in itself has its own
source of strength. Beyond that, was there anything else here
that made a difference for you in terms of getting back on your
feet and becoming that parent that you've described?
Ms. Long. Yes, sir. It was--along with the mutual support
that I received through Parents Anonymous, as well as my
recovery program, which I did work and share with other addicts
and alcoholics and that recovery program, all of that was
support. For me and I think countless other parents who are in
Parents Anonymous, it's four basic principles that Parents
Anonymous adheres to, which is mutual support, shared
leadership, mutual respect, and personal growth.
Coupled with all of these, parents see themselves growing.
There was a study done on parents where they did this 10-step
type of--it wasn't a program, but it was 10 steps that they
took to becoming fully committed parents. One of those steps--
one of the things that they noticed was that parents when they
had trusted others who believed in them, then their confidence
grew and they were able to mirror back strengths that they saw
in others, and that the parents were given--we would trade with
each other, debrief, say. We would do trainings together. We
would ask each other how did we do.
For me, that just gave me confidence in myself that
someone, (A), wanted to know my opinion, and then trusted and
believed in what I had to say. Gaining that confidence gave me
the leadership skills, not only with Parents Anonymous, but
helped me also, enabled me to reach out and empowered me to
reach out to my own community, where I began advocating for my
own family and eventually for my community as well as
nationally.
I had been able to get a bus stop changed for my daughter
because I was nervous about her going, catching the bus in the
dark in a bad neighborhood, so much so that the poor woman when
I called her when my son started kindergarten and tried to walk
home by himself because the bus stop was so far away, as soon
as she heard my voice she said: ``OK, Ms. Long, where do you
want the bus stop? '' So that type of thing.
Senator Dodd. We could use you here.
[Laughter.]
Ms. Long. It was just because I felt empowered by the
professionals and Parents Anonymous who worked with me through
shared leadership, is what we call it.
Senator Dodd. Did you have a job during all of this? Were
you working?
Ms. Long. No, sir, I was not working at the time.
Senator Dodd. In terms of--what was the reaction as you
went out or others were going out and finding jobs within the
community? Do you have any evidence you can give to us about
how that--whether or not there's that kind of support as well?
Ms. Long. Because I am a full-time student, I do make time
to volunteer and work in my community. I have had offers for
employment.
Senator Dodd. Good. It was--to the best of your knowledge,
there's a responsive community?
Ms. Long. Oh, absolutely. As a matter of fact, people say
to us all the time either they want me to come and speak on
their behalf, and I won't because they have their own parents
and their own organizations that are just fabulous and that
have been empowered through supported programs, CAPTA-funded
programs.
Senator Dodd. Let me if I can, I'm going to turn to Karen
and let me chat with you a little bit. I mentioned this earlier
to Dr. Boyce, but I want to give you a chance to give us a
Connecticut perspective if you can in talking about the
disproportionate share of child abuse and neglect in the
minority communities, and certainly the problem is acute in
Connecticut, as you pointed out. What can the Children's Trust
Fund or CAPTA do in your view to address this problem?
Ms. Foley-Schain. I think there is a couple of different
areas to look at here. I think when you're talking about
children with special needs and children with disabilities,
you're looking at an additional hardship on the parent, and
raising children who have complicated medical problems or other
special needs require an awful lot from parents. One of the
things that we've attempted to do is to include special
curriculum to help parents look at those things, but also to
have an intensive home visiting program that enables the home
visitors to have flexibility when working with families, so if
there's a special needs situation we can go out two, three
times a week and support that parent until they're on their
feet and feel that they have the ability to cope with what is a
demanding situation to begin with, having a child, and then the
extra demands of dealing with a child with special needs.
These efforts try to make sure that they understand what
the parents is dealing with, the sense of maybe being
overwhelmed by what's going on, the sense of being isolated,
being alone in that, and then really jumping in, not to do the
work for the parent, but to help the parent be in a place where
they can feel better about managing that situation.
I think when we talk about racial and ethnic communities
we're really talking a lot about the impact of poverty. In
Connecticut we've been fortunate to have researchers tied to
our program since its inception, and what we've found is that
when we look at the families who come into our program from
communities where there is not--the balance is white, Caucasian
mothers, the risk factors with the families in the minority
communities are the same. We really feel that poverty is a huge
underlying issue here.
We think that, at the most basic level, intensifying
services in areas where there is higher poverty and therefore
more risk is the most basic step that we can take. In
Connecticut we have enhanced our Nurturing Families. We've also
done other programs. We have Parents Anonymous in some shelters
and things like that, too.
Thinking about this one, we've really intensified the
numbers of sites and the services that are available in the
cities of Hartford and New Haven and hope to continue that.
Senator Dodd. The risks are the same. That's what I was
looking for.
Ms. Foley-Schain. The risks are the same. The risks are the
same.
Senator Dodd. Economics are the driving factor in what
we're talking about?
Ms. Foley-Schain. That's right.
Senator Dodd. Let me ask you this. Again, we're talking
about an authorization bill here. We've got to get to some
appropriations. I was interested, I mentioned in Philadelphia,
what certain States are doing differently to deal with the
prevention, to really, how can we do a better job. I want to do
a better job in this bill on the prevention side of this, so
we're not coming back year after year and looking at constant
numbers here, but how we in Congress can make a real dent in
these numbers.
One of the things that strikes me here is obviously whether
or not we're providing, to what extent the States are going to
be able to take with CAPTA funds and do more prevention or--as
you pointed out, in our State we've gone from a million to $14
million in State resources on this issue. I don't know what the
numbers are around the rest of the country.
What I want to get at with you here is whether or not there
is adequate resources--and again, I'm not trying to drive for
an answer here; the answer is obviously, anyone who stands
before you looking for money, there's never adequate resources.
To what extent within that context can States use these dollars
to then create the kind of innovative programs at a local level
that really drive toward the prevention part of this.
Are there some ideas you might have as to how we might
incentivize that a bit, so that we can maybe encourage States
to be more involved in the prevention side of this, either
through awarding or rewarding States that, in fact, step up to
this in providing additional help--I don't know. They're just
ideas I'm trying to think of on how we encourage greater local
involvement, supporting what we do with CAPTA, fully
recognizing that, even with the money we've committed to this,
it's going to come up short if you're really trying to get at
the prevention side of this. I don't know if I'm saying that
very well.
Ms. Foley-Schain. No, absolutely clear, and I agree. I
think resources is a huge issue. I think the field of child
abuse and neglect prevention is a relatively new field.
However, over the last 20 years I think we have tested and
researched and developed some very solid programs, and that now
is the time to seriously invest in these programs and bring
them to scale.
I think when we look at the balance between what we're
investing in child abuse prevention versus the other side of
the coin after a child's been involved in the child protective
services system, it's huge, and that States and perhaps the
Federal Government will need to maintain those investments in
child protection services while increasing the prevention side.
Hopefully, ultimately we would see that change.
In terms of the incentives, one of the things I think that
was very helpful to the Children's Trust Fund initiative was
that CAPTA was an incentive-driven program. Initially for every
dollar that the State was able to leverage new moneys for new
efforts, CAPTA matched a dollar. Then over the years it went
down to 20 cents on the dollar and now it's about 2 cents on
the dollar.
It still matters. However, I think if that were to go back
up or maybe around particular efforts that your committee felt
you wanted to target and try to get some momentum behind, that
that might be a way to do it. It's helpful for a funder like
the Children's Trust Fund to go to others and say: ``For every
dollar you give us toward this effort, we'll partner with you
around, we're going to be able to bring down another dollar in
Federal funds.''
I think the third thing is that we've found that, again
referring back to the Nurturing Families Network, that we would
be eligible for Medicaid reimbursement for 85 percent of the
efforts that we're providing, and we would be able to claim
that at 50 percent. However, there are some challenges with the
way the Medicaid program is structured and our ability to make
those claims and to work with very small organizations to do
that.
The 50 cents on the dollar is also a huge incentive for
States to, I think, make investments into these programs. If
there was a way to have some sort of a funding stream for those
programs that did meet the criteria for Medicaid or other
Federal programs to bring that in on a matched basis, I think
it would be tremendous.
Senator Dodd. Well, those are some good ideas. We've proven
in the past in other areas that this works as a way of securing
additional funding.
Dr. Boyce provided some several findings in her testimony
about the mental, behavioral, and physical effects of
maltreatment on a child. On an again sort of related question
to the last one, I'm curious about the infrastructure through
CAPTA, the Child Abuse Prevention and Treatment Act--we should
say that more often for our audience that may be listening; we
talk in acronyms here and not everyone always understand
exactly what we're talking about, but ``CAPTA'' is the Child
Abuse Prevention and Treatment Act--the infrastructure
currently in place that could provide the services, funding
levels aside, that have been identified by the information that
Dr. Boyce has provided as necessary for improving children's
health.
Is that infrastructure in place in your view?
Ms. Foley-Schain. If I'm understanding your question, is
there an infrastructure through this country, through CAPTA, to
be able to funnel funds into these kinds of efforts?
Senator Dodd. Right, in the area identified by Dr. Boyce.
Ms. Foley-Schain. I would think that they are. I think the
children's trust and prevention funds have done a tremendous
job, and it's really on the backs or the heels of those efforts
across the country that we've learned as much as we have. Each
of the States receives a CAPTA allotment and they've pursued
efforts to engage other partners to raise other money and to
build infrastructures for reaching out to different families
and also through different avenues, too, reaching different
families.
Senator Dodd. Let me ask as well if I can, and I think
you're the right person to ask about this, but I'll ask anyone
else who has knowledge of this to step in. In the last CAPTA
reauthorization, Congress added a provision that required
States to refer children under the age of 3 who are involved in
substantiated cases of child abuse and neglect to early
intervention services funded under Part C of the Individuals
with Disabilities Education Act. Yet the most recent child
maltreatment report in 2006, rather, reveals that children with
disabilities are 54 percent more likely to be victims of
maltreatment than children without disabilities.
In light of these statistics, what progress has been made
with regard to the implementation of these provisions, and do
we have any suggestions on how to strengthen the evaluation of
the implementation so that children with delays and
disabilities can be served properly and ultimately have safe
and successful lives?
Ms. Foley-Schain. I can tell you a bit about what I know
has happened in Connecticut as a result of this legislation.
This is actually through CAPTA I and our Department of Mental
Retardation. They came together and recognized that there were
some limitations around how the Part C is set up in the State
requiring that children either have certain medical conditions
or have a referral because there's some concern about a
developmental delay. Together these groups came up with a
protocol that's now in the Department of Children and Families
policies that there would be a co-occurring visit to a
pediatrician when there's any investigation of maltreatment and
then, based on the pediatrician's assessment, the child would
be referred for Part C.
In terms of children who come into the care of the child
protective services agency and go into foster care, they do an
extensive assessment which includes developmental assessment,
looking for developmental delays, and would also make those
kinds of referrals.
Senator Dodd. Dr. Boyce, do you have any comment on this at
all?
Dr. Boyce. I'm not going to speak specifically to that part
of the bill. I can talk a little bit about services research,
and some of the services research we have. What we do see is
that children are often in multiple areas, so they might be in
one system and another system at the same time. We have some
innovative researchers who have been able to capture all that
data and get it all in one stream, so that we can see where
there's duplication and so that we can identify better which
systems work best, which we can capture earlier.
Services research is beginning to tackle some of this issue
that you're speaking to in terms of how do you capture kids who
are in one set of services for educational developmental
disability. The issue is usually they're often in other service
systems.
Senator Dodd. I make that case so often, not on this
matter, but I can't tell you how many times I've gone to
colleagues and asked for their support and they'll say: ``Look,
I'll help you with the WIC money, but I can't help you out with
the Section 8 money.'' And I'll say: ``We're talking about the
same family here in some ways. So, in some ways you're helping
me on the one hand and taking it away with the other, and the
net effect is I'm a loser in those terms.'' I'm trying to make
people understand exactly.
I should have made that point myself in my opening
comments, that sometimes we have a tendency to pigeonhole
people, not recognizing that child or family may actually be in
a lot of those categories.
Ms. Kaplan. Well, if I can draw on that point--
Senator Dodd. Yes, I was going to ask you as well, Ms.
Kaplan.
Ms. Kaplan. The issue is, you mentioned infrastructure
before. Any time there is a provision in CAPTA, obviously to
make a change in the way the children are treated there has to
be the infrastructure within the agency to support that change.
In the way that the wording was provided, there was no mandate
on the side of policy providers. It really was a one-way
agreement in which there was a desire to go ahead and put this
in place.
Many institutional changes have to be made for workers to
have protocols. I will tell you that Massachusetts has done a
wonderful job at doing this, but they started long before the
provision was in place in CAPTA. They realized the
vulnerability of these children beforehand.
What's difficult is, to be very candid, the money stays the
same and the list of prerequisites--
Senator Dodd. Grows.
Ms. Kaplan [continuing]. Keeps going. There are additions.
And there's no incentive to do more things with less money,
because that's how it ends up. You have more, so you have less
to do for each thing. When you don't have a partner on the
other side who understands that they need to be doing this too,
it's really hard to make that happen.
Senator Dodd. Well, why don't you share? What would you
recommend we include here to make that happen?
Ms. Kaplan. I'd like to think about that, because I have
many responses, but they're not--
Senator Dodd. We don't tolerate people thinking about
things.
[Laughter.]
Ms. Kaplan. Oh, sorry about that.
Senator Dodd. This is Washington.
Give it some thought, will you?
Ms. Kaplan. I will.
Senator Dodd. Because it really is--you know, you're in
Massachusetts and there are certain States that have histories
of being involved in these matters early on and engaged in it,
and we all know in this room here today there are other States
that aren't as, for a variety of reasons, aren't as engaged. It
doesn't mean they wouldn't be or couldn't be. I think if we
provide the right kind of incentives and so forth you can get
that kind of partnering that we're talking about, that I think
is absolutely critical, given the levels that we're going to be
able to provide.
Candidly here, I'm not going to tell anyone in this room
anything you don't know already. We've got huge deficits in
this country. We've got expenditures that are occurring in
places that I have serious disagreements with, but nonetheless
are occurring, and I'm not going to be able to change it
myself. We're battling for scarce resources to commit on
serious problems, this being one.
I happen to care deeply about this issue and what goes on.
My service in Congress correlates directly to the life of
CAPTA. I was elected to Congress in the year this bill became
law, in 1974. In the 27 years I've been in this body and on
this committee, I've fought year after year after year for this
program.
We need better partners. We need more partners, candidly.
How we get that--I'd love to think that I could just--that it
would happen because someone gives a great speech in some State
legislature someplace and miraculously the resources appear. I
think we're more likely to get cooperation through exactly what
Ms. Foley-Schain was talking about, those incentive ideas that
see people seeing the financial reward in effect for stepping
up to the plate.
I couldn't agree with you more. I think it's a very good
point you make on that, having the infrastructure and the
greater demands and resources remain rather flat. It's a very--
Ms. Kaplan. May I comment on one of the questions you asked
another witness?
Senator Dodd. Certainly you may. This is open. This is a
very relaxed gathering here.
Ms. Kaplan. When I made my remarks I talked a little bit
about differential response.
Senator Dodd. I wanted to ask you about that, in fact. So
go ahead now.
Ms. Kaplan. Do you want me to wait until you ask?
Senator Dodd. No, no. I want you to go. No, because it's a
concept I was reading about last night and trying to understand
the differential response. The language itself--for those who
are not as well informed about it, would you explain it, first
of all?
Ms. Kaplan. Well, yes, that's what I was going to say. I'll
back it up and I'll explain it a little bit.
As you know, there are reports that come to the child abuse
and neglect agency and the first decision that is made is a
screening decision. If there is a screening decision to accept
a report, then this child, this family, is involved in the
child welfare system. What we have done over the course of our
lives in the child welfare system is treat every family the
same. So a child that's sexually abused is treated the exact
same way as a parent who is not supervising his or her child.
What we've come to know is that there is only about 10
percent of the families that come to our attention that really
have egregious harm. We have a fairly intrusive system that is
adversarial, that does identify fault, and the last time I
looked I wasn't able to partner with anyone who is going to
blame me for something. It doesn't surprise me that many
parents are not willing to cooperate with a child welfare
system when it's really a ``gotcha.``
What differential response realizes is that there are many
families who don't have the severity of the problem that this
10 percent have, and that we can provide services to these
families at the front end once they are accepted and therefore
lessen the risk to the family for future reports. Oftentimes we
never see these families again.
The issue becomes, as my colleague Karen said, ``the issue
is a lot about poverty.'' These families have increased
surveillance because of the poverty issue. Many of the families
that come to the attention of the child welfare agency have
economic hardship issues. They need housing assistance, they
need transportation, they need child care. It's not so much an
issue of that they beat their child near death. It's really an
issue of needing the supportive services that we've been
talking about.
What differential response does is allow those families to
have a different response, a family-friendly response, a
partnership response, one in which the family is allowed to own
the process as best we are able, given that we are a mandated
system, and they get to decide what services they need. What a
surprise, when we give families voice they feel better about
what we've done with them.
I want to mention one thing to go with the prevention side
that Minnesota has done, because Minnesota's been doing this
for about a decade now. Minnesota is probably one of the most
researched systems of differential response. They call their
system a family assessment response. They now have a third
track that was established in 2005 called a parent support
outreach program. These are for cases that are not accepted by
the child welfare agency. So there's a report, it does not meet
the statutory threshold, and there is a community pathway.
We all know that a lot of these families that need the
preventive services come to our attention and we typically
close our doors and say, ``you don't qualify,'' and then the
risk escalates, and then there is harm to the child, and then
we'll pay attention.
With differential response, you not only have a way to
address those low- to moderate-risk families, but you also have
a way in which you can address families that have needs that do
not meet the statutory threshold for accepting, and yet they
still need help. That's the first step, because research says
that the greatest predictor of recurrence is the first report--
not the first substantiation; the first report.
Senator Dodd. That's helpful. Very good. That helps a lot.
How do you hope to see the reauthorization of this
legislation address these issues of identification?
Ms. Kaplan. American Humane has worked very closely with
the National Child Abuse Coalition and we do have some
suggested language that we'll be happy to provide to you if you
would like--
Senator Dodd. Absolutely.
Ms. Kaplan [continuing]. About encouraging these front-door
approaches so that we're able to intervene with families
earlier.
Senator Dodd. Dr. Boyce, how do you--once again, I'm going
back to NIH. What's your reaction to this, what Ms. Kaplan
said?
Dr. Boyce. You said a lot, so I can speak a little bit to
prevention, just to get back to thinking about models. I think
that might be helpful in terms of some of what we've learned
about prevention. There are different models of prevention. You
can intervene in a very broad way in terms of thinking about
prevention, in terms of parenting. Then we do have levels of
prevention where once there's a risk or there's an indicator
that we intervene.
I think a little bit of what you're talking about in terms
of how families can come to the attention to get resources or
refer themselves, which is another option, is a very important
idea in terms of thinking about services, so that we don't see
these numbers not getting services. When I was talking a little
about services and not using services, and we know there's a
problem, there's this disconnect in finding ways to broaden
that, to broaden services and reduce the gap between when we
know a family has problems and being able to give them
services, whether it be at the first report, the first risk,
but early.
Senator Dodd. Do you agree with Ms. Kaplan about the first
report?
Dr. Boyce. In terms of the data?
Senator Dodd. Yes.
Dr. Boyce. It's clear that once we have one report, one
substantiation, it's likely to happen again. We don't want that
second one to happen.
Senator Dodd. But she said something different. She said it
was the first report, not the first substantiated, that's the
indicator.
I'm not trying to be cute about a distinction here, but I
thought you made a distinction.
Ms. Kaplan. There is--that is the distinction, you are
correct.
Senator Dodd. Do you agree with that?
Dr. Boyce. I would have to doublecheck. My data looks at
substantiation. In terms of reports, I've seen that data, too.
There are multiple data sources and national surveys.
Senator Dodd. Yes.
Ms. Long, did you want to comment? I saw you kind of
chafing at the bit to jump into this and say something.
Ms. Long. I was agreeing with both the ladies, particularly
on the prevention, because we know that there's less money
spent on prevention than actually in the treatment of child
abuse and neglect cases, and we know, through programs that
have prevention in them, that families are strengthened, and
that when there is evidence-based practices that are used that
prevention works.
A national study done for Parents Anonymous by the National
Council on Crime and Delinquency showed, proves statistically
that there is a reduction in the risk factors, there is
improvement in protective factors, and in situations where
people were physically and emotionally abused these behaviors
were significantly reduced.
Senator Dodd. Well, that's good.
I thank you. This has been helpful this afternoon. Ms.
Kaplan, we'll look forward to those suggestions you've got, and
from you, Karen, as well, some thoughts and ideas on how we
incentivize as well.
Ms. Long, you've been very, very helpful. We just are
thrilled with how your journey is going. As the father of a 3-
year-old and a 6-year-old, I'm learning here in this process.
I'm a late bloomer in the father business. When I was on the
presidential trail, I used to say I was the only candidate that
got mail from AARP and diaper services.
[Laughter.]
Ms. Long. My mom told me when you have children later in
life they keep you young.
Senator Dodd. Well, they're doing that, I'll tell you.
They're keeping me up.
Ms. Long. Yes, they do.
Senator Dodd. Dr. Boyce, thank you very, very much, and for
the work you're doing as well.
Again, I'll leave the record open for a little bit because
I know other colleagues may have some additional questions for
you. Please feel that the record remaining open also is an
opportunity for you to add any additional thoughts and ideas
you have as we get closer. As I said, I'm going to try and
craft something here, and we'll obviously keep all of you very
well-informed as to that process, and we'll be soliciting your
advice and suggestions on how we write this up, this
reauthorization bill, and then try and get as much support as
we can and if possible do something before this session ends,
and certainly with the possibility of appropriations as well.
It's going to be an important time here to get this right.
We'll be calling on you in a more informal setting for your
ideas and suggestions.
That goes for people in the audience as well. I know
there's a lot of collected wisdom and expertise on this issue
that's in this room, not just reflected by those who testified
on the panel here today. We'll be calling on you and asking--
I'm asking. Let me use this opportunity. I'm asking, if you've
got some thoughts and ideas on what we ought to add to this, we
welcome your suggestions, your advice. The staff here will
certainly respond to any thoughts that you have on the subject
matter.
We thank you for your presence in the room today as well.
With that, the committee will stand adjourned.
[Additional material follows.]
ADDITIONAL MATERIAL
Prepared Statement of Senator Clinton
I'd like to thank subcommittee Chairman Dodd and Ranking
Member Alexander for organizing this important hearing. I'd
also like to thank our witnesses for joining us to share their
research, experience, and knowledge surrounding the critical
issue of child abuse prevention and treatment.
Since its enactment in 1974, the Child Abuse Prevention and
Treatment Act (CAPTA) has been the backbone of Federal support
for child abuse prevention. States have used these funds to
improve their child protection infrastructures, to research
innovative approaches to prevention, and to implement
community-based programs targeted to meet the needs of families
at risk.
Though CAPTA has helped States make great strides, there is
still an incredible amount of work to be done. In fiscal year
2006, over 900,000 children were victims of child maltreatment.
According to HHS' Annual Child Maltreatment Report, nearly 40
percent of victims never receive post-investigation services.
Child welfare systems struggle to retain qualified staff and to
provide services targeted to the needs of individual families.
In this reauthorization, Congress must give CAPTA the power
it needs to address these problems. I have introduced
legislation that helps us get started. My Child Welfare
Workforce Improvement Act amends CAPTA by calling for a
nationwide study of the child welfare workforce, so that we can
assess the needs of the professionals charged with helping
families at risk. Another area that needs critical attention in
this reauthorization is the intersection of child protection
and domestic violence services. Currently, 30 to 60 percent of
families who come into contact with the child welfare system
also experience domestic violence, yet these two types of
agencies face considerable barriers in working together to help
support such vulnerable children and families. Due to this
alarming connection, we must do more to facilitate
collaboration between child protection and domestic violence
services so that families receive the help they need.
Reunification of children in foster care is yet another topic
to tackle in CAPTA. Reunification promotion represents an
effort at child abuse prevention and treatment within the
context of foster care. As we concentrate on promoting family
engagement and endeavor to bring family-centered practices into
the spectrum of child welfare services, we must not ignore the
fact that successful reunification depends on parent
engagement.
All these improvements in the child welfare system require
a dramatic increase in CAPTA authorization levels. We cannot
continue to underfund one of the most important tools we have
available to protect vulnerable children from abuse and
neglect.
Throughout my career, I have been a champion for improving
child welfare, and the 110th Congress has been no exception. In
this Congress I've introduced the Adoption Improvement Act of
2007, legislation that supports States in retaining prospective
adoptive parents who inquire with public child welfare agencies
about adopting children from foster care. My Focusing
Investments and Resources for a Safe Transition (FIRST) Act
provides grants for Individual Development Accounts for youth
aging out of foster care so that these young adults have a
financial resource for independent living.
Today's panelists have brought to our attention the myriad
topics that need our attention in reauthorizing CAPTA. I am
eager to work with my colleagues in the Senate to improve
Federal support for child abuse prevention and treatment.
Working together, we can ensure that vulnerable families
receive the help they need.
Prepared Statement of Senator Alexander
Mr. Chairman, thank you for holding this hearing and thank
you to all of our witnesses for being here.
The Child Abuse Prevention and Treatment Act (CAPTA) has a
long history of strong bipartisan support. I am very pleased
that we are having this hearing today to learn about the
successes of the program and to learn about any changes we may
need to make to ensure that the program remains a strong part
of our national efforts to protect children and strengthen
families.
I look forward to learning about what CAPTA has
accomplished since we last reauthorized the law in 2003 and
what Congress can do to ensure that we prevent the maltreatment
of children and that abused children are appropriately and
quickly identified and referred for appropriate services.
The CAPTA programs are a vital part of the effort to help
States protect children and prevent child abuse. Funds have
helped States develop better data systems to analyze their
child abuse statistics which helps States identify abused
children, detect patterns in what leads to abuse so that we can
prevent its occurrence, and identify ways to improve training
and assistance for social workers, community leaders, school
officials, and parents themselves. CAPTA also supports research
projects to improve professional development and training of
social workers, identify new trends in child abuse and neglect,
and operate the National Incidence Study to keep track of State
efforts to reduce and prevent child abuse.
All of this, in turn, protects our most precious resource,
our children.
Last year, Tennessee received $1.3 million under the CAPTA
programs to serve 1.4 million children. Tennessee does a lot of
innovative things with these funds, including the establishment
of the Tennessee Children's Trust Fund Advisory Committee. The
mission of the Advisory Committee is ``to take the leadership
role in ensuring that statewide child abuse prevention efforts
have coordination and support, reflect evidence-based
practices, involve both public and private community partners
and are available to all Tennessee children.'' Funding for the
Advisory Committee comes from many sources, with CAPTA playing
a significant role.
It is my hope that we can work to improve CAPTA's
successful implementation and continue to make progress to
reduce and prevent child abuse both in Tennessee and the rest
of the Nation.
Prepared Statement of Senator Roberts
Mr. Chairman, thank you for holding this hearing today on
an issue that greatly affects children and families in my State
and throughout the Nation. I recognize the importance of the
Child Abuse Prevention and Treatment Act (CAPTA). It assists
States in addressing the prevention and treatment of child
abuse and neglect.
In 2007, the State of Kansas received $268,698 through
CAPTA. This funding has assisted the State in preventing,
investigating, and treating child abuse. In 2007, the Kansas
Department of Social and Rehabilitation Services received
53,048 reports of children in need of care. Over half of these
reports are assigned for investigation. According to the Kansas
Department of Social and Rehabilitation Services, 33 percent of
the assigned reports involved instances of physical abuse.
It is my hope that we reauthorize and strengthen CAPTA to
ensure that States have the adequate tools and resources to
address child abuse. We all have an obligation to protect our
Nations' children from harm and abuse.
Prepared Statement of the American Psychological Association (APA)
On behalf of the 148,000 members and affiliates of the American
Psychological Association (APA), we thank you for holding this
important hearing to discuss the upcoming reauthorization of the Child
Abuse Prevention and Treatment Act (CAPTA).
APA is the largest scientific and professional organization
representing psychology in the United States and is the world's largest
association of psychologists. Comprised of researchers, educators,
clinicians, consultants, and graduate students, APA works to advance
psychology as a science, a profession, and a means of promoting health,
education, and human welfare.
APA has a longstanding commitment to the prevention of child
maltreatment. Efforts include journal publications, public policy
statements, Federal advocacy initiatives, co-sponsorship of national
programs, such as Adults and Children Together Against Violence and the
National Conference on Child Abuse and Neglect, and membership in the
National Child Abuse Coalition. Our members are also actively engaged
in service delivery, research, policy development, prevention, practice
and community intervention initiatives related to helping children and
families impacted by abuse and neglect, and have formed a separate
membership section on child maltreatment as well as an Interdivisional
Task Force on Child Maltreatment Prevention.
Originally enacted in 1974, CAPTA is the most important law
addressing child abuse and neglect. It provides Federal funding to
States in support of prevention, assessment, investigation,
prosecution, and treatment activities and also provides grants to
public agencies and nonprofit organizations for demonstration programs
and projects. Additionally, CAPTA identifies the Federal role in
supporting research, evaluation, technical assistance, and data
collection activities; establishes the Office on Child Abuse and
Neglect; and mandates the National Clearinghouse on Child Abuse and
Neglect Information.
The need for these important services remains urgent, and the
stakes for our Nation are high. According to the U.S. Department of
Health and Human Services, an estimated 3.3 million reports of possible
child abuse or neglect were made to child protective agencies in 2006.
Of those reports, 905,000 were substantiated. Fatalities from child
maltreatment remain high with an estimated 1,530 child deaths resulting
from abuse or neglect each year. Of those fatalities, 78 percent were
among children under 4 years of age. However, our child protection
system remains sorely in need of resources as funds for child abuse
prevention and treatment programs have not kept pace with the needs of
communities. In fact, children already known to child welfare services
are repeatedly harmed and return for help. In 2006, children who had
been prior victims of maltreatment were 96 percent more likely to
experience a recurrence of maltreatment than those who were not prior
victims. These data reveal a public health crisis warranting concerted
national attention and an increased focus on prevention.
Child abuse and neglect may result in significant short- and long-
term physical, psychological and behavioral health problems.
Psychological consequences of child maltreatment may include
depression, anxiety and dissociative disorders, post-
traumatic stress disorder, substance use, and suicidal ideation. In
addition, child abuse and neglect may adversely impact a child's
physical, cognitive, emotional, and social development. Timely
identification and appropriate prevention and intervention with
individualized assessment and tailored supports are required to
minimize negative consequences of child maltreatment.
As the subcommittee moves to reauthorize CAPTA, increased emphasis
on child neglect and on prevention and early intervention services is
of paramount importance. Child neglect is the most common form of
maltreatment from substantiated cases, accounting for 64 percent of
cases, with 60 percent of all perpetrators of child maltreatment having
neglected children. Of the deaths related to child maltreatment in
2006, 43 percent were attributed to neglect or medical neglect. Yet,
little emphasis or direction is currently given to neglect in CAPTA.
The urgent need to focus on prevention is evident not only in the
numbers of children who are abused and neglected but also in those who
receive no follow-up services. In 2006, approximately 40 percent of
children with substantiated cases of child abuse or neglect did not
receive post-investigation services. Clearly, prevention and early
intervention services for children and families are critical.
Prevention programs, such as home visitation and parent education
programs have proven effective in preventing child maltreatment
especially for populations at elevated risk and for families that
remain intact. We strongly support the ability of States to use CAPTA
funds to support a wide range of effective alternative models,
including alternative or differential response, multiple track, or
concurrent planning services, to better serve the needs of children and
families and decrease instances of child abuse and neglect.
In addition to an increased emphasis on child neglect and
prevention and early intervention services, we encourage the
subcommittee to consider provisions to further enhance CAPTA. These
provisions would include: increased collaboration among agencies
involved with abused and neglected children; mandatory attorney
representation for victims of child abuse and neglect; culturally
competent and linguistically appropriate services for children and
families; prevention of maltreatment of children with disabilities;
development and implementation of collaborative procedures between
child protective services and domestic violence services in the
investigation, intervention, and delivery of services provided to
children and families; and a Federal study through the Centers for
Disease Control and Prevention (CDC) to evaluate the effectiveness of
different models (including international models) of mandatory
reporting and the ways in which specific models apply to research
(e.g., reporting mandates by researchers versus research exemptions).
In closing, the American Psychological Association would like to
thank you for the opportunity to share our comments related to the
reauthorization of the Child Abuse Prevention and Treatment Act. We
appreciate the subcommittee's ongoing commitment to the prevention of
child maltreatment and look forward to serving as a resource and
partner as you work on this and other important issues affecting
children and their families.
Prepared Statement of the Association of University Centers
on Disabilities (AUCD)
The Association of University Centers on Disabilities (AUCD),
formerly American Association of University Affiliated Programs
(AAUAP), is pleased to submit written testimony on the reauthorization
of the Child Abuse Prevention and Treatment Act (CAPTA) to Chairman
Dodd and the other distinguished members of the Senate Subcommittee on
Children and Families of the Health, Education, Labor, and Pensions
Committee.
AUCD supports and promotes a national network of university-based,
interdisciplinary programs. Network members consist of: 67 University
Centers for Excellence in Developmental Disabilities Education,
Research, and Service; 35 Maternal and Child Health Leadership
Education in Neurodevelopmental and Related Disabilities (LEND)
Programs; and 20 Developmental Disabilities Research Centers.
Collectively, these programs perform an array of functions, such as
academic preparation, community outreach and training, clinical and
community services, research and evaluation, information dissemination,
policy analysis, and advocacy. The purpose of these various functions
is to enhance the independence, productivity, and quality of life of
individuals with disabilities and families.
For the programs represented by AUCD, addressing the issue of child
abuse and neglect is an integral part of promoting the well-being of
individuals with disabilities and their families, as well as preventing
disabilities that occur as a result of abuse and neglect. Indeed, cause
and effect are intertwined when it comes to child maltreatment and
disabilities. Children with disabilities are particularly vulnerable to
child abuse, and child abuse may result in the acquisition or
development of disabilities, which may, in turn, make children even
more vulnerable for further abuse.
In 2006, HHS reports that child victims who were identified as
having a disability were 52 percent more likely to experience
recurrence than children without a disability. (Nearly 8 percent of
victims--7.7 percent--had a reported disability.)
Maltreatment of children adversely affects their health and
development (Halfon & Klee, 1987; Shonkoff & Phillips, 2000). Studies
of children in foster care suggest that maltreated children have high
rates of illness, injuries, and developmental delays (Chernoff, Combs-
Orme, Risley-Curtiss, & Heisler, 1994; Halfon, Mendonca, & Berkowitz,
1995; Hochstadt, Jaudes, Zimo, & Schachter, 1987). Chernoff and others
examined the results of health examinations provided to children
younger than 5 years of age at the time of entry into foster care and
found 23 percent had abnormal or suspect results on developmental
screening examinations (Chernoff et al., 1994).
Findings regarding the development of children involved with child
welfare who are not in foster care have only recently become available.
Using data obtained from the National Survey of Child and Adolescent
Well-Being (NSCAW), Stahmer and others (2005) found high rates of
developmental and behavioral problems among young children who had been
investigated for maltreatment. Also using NSCAW, Rosenberg, Smith, and
Levinson (2007) found 47 percent of children who had been substantiated
for maltreatment and were younger than 3 years of age had developmental
delays that made them likely to be eligible for Part C early
intervention.
Such alarming statistics on the child maltreatment/disabilities
nexus provide a cogent argument for attending to disability concerns in
CAPTA.
AUCD worked with House and Senate staff during the 2003
reauthorization to address abuse and neglect of children with
disabilities and to refocus the law on primary prevention activities.
Following are some of the provisions promoted by AUCD that are now
included in the law:
Grants to States may now be used for supporting
collaboration among public health agencies, the child protection
system, and private community-based programs to provide child abuse and
neglect prevention and treatment services and to address the health
needs, including mental health needs, of children identified as abused
or neglected, including supporting prompt, comprehensive health and
developmental evaluations for children who are the subject of
substantiated child maltreatment reports.
New eligibility requirements and support for training,
technical assistance, research, innovative programs regarding linkages
between CPS and community-based health, mental health, and
developmental evaluations.
Authorization for research on effects of maltreatment on
child development and identification of successful early intervention
services.
Provision for referral of a child under age 3, in a
substantiated case of abuse or neglect, to early intervention services
funded under IDEA Part C.
Emphasis throughout the law on community-based and
prevention-focused activities, including the importance of respite as a
critical component of child abuse and neglect prevention.
Families of children with disabilities, parents with
disabilities, and organizations who work with such families are
strongly emphasized.
These changes make CAPTA a stronger law. Unfortunately, although
more requirements and optional activities for States have been added,
there has been no corresponding increase in funding to actually
implement these activities. Therefore, many of the activities listed
above have not yet been fully implemented. There is also a lack of
current data on how States are dealing with these new requirements.
One of the changes that has received some attention and evaluation
is the new requirement for States to refer children who are younger
than 3 years old with developmental delays and who are ``involved in a
substantiated case of child abuse or neglect to early intervention
services funded under Part C'' (Keeping Children and Families Safe Act
of 2003, 114[v][1][B][xxi]).
Our University Center at the University of Colorado Denver, under
the direction of Dr. Cordelia Robinson, has been tracking the impact of
this provision since the enactment of the Keeping Children and Families
Safe Act of 2003. (Please see the attached article, ``Rates of Part C
Eligibility for Young Children Investigated by Child Welfare.'' ) This
research shows that substantiated and unsubstantiated children have
similar rates of delays. Another 2004 article by Robinson & Rosenberg
2004 indicate that a relatively small proportion of substantiated
children are enrolling in Part C and these are mostly children in
foster care. Unfortunately, Part C does not currently have the capacity
to serve all the substantiated children--much less the larger number of
children who are likely to be Part C eligible but who are not
substantiated.
One of the challenges identified in this study is that families who
have neglected or abused their children are difficult to engage in Part
C services. Most early intervention programs are voluntary and these
families need a great deal of support and encouragement to get them
involved in services. Few agencies have been successful in engaging
these families. For example, in February Arapahoe County, Colorado
child welfare referred 28 children under 3 to the local Part C agency.
The Part C staff could not reach 8 children and another 8-10 refused
Part C services. This example demonstrates that additional resources
will be required to ensure enrollment of maltreated children who live
with their biological families. We believe this challenge can be met,
but it must be funded. &
The need for additional funding to make the goals of this
legislation a reality are brought home by data from Connecticut, where
it is estimated that it would require an additional 1 million dollars
to cover the cost of the evaluations for children referred by child
welfare.
Child welfare professionals also need better information about the
services that Early Head Start, IDEA Part C and Part B 619 provide and
how to refer families, including those that do not reach
``substantiation,'' for early intervention services. Conversely, early
intervention professionals need training that leads to their ability to
understand and collaborate with the CPS system and culture. Training
should be targeted in competency areas. For example for the Part C
providers, training needs to be delivered on the culture of poverty and
family abuse and neglect. These areas are rarely covered in the
traditional early intervention professional preparation programs.
Likewise, CPS and other CAPTA providers should receive training in
developmental disabilities and developmental screening and referrals.
Current law requires States to develop infrastructures to link
child protective service agencies with an array of health care, mental
health care, and developmental service agencies to improve screening,
accurate diagnosis and provide comprehensive health and developmental
services. These could include Early Head Start, Head Start, Part B
Section 619 Preschool of IDEA, Title V agencies and the network of
University Centers for Excellence in Developmental Disabilities that
provide research, education, training, and direct services. States need
more technical assistance and incentives to develop these
infrastructures and to collaborate between the early intervention and
child welfare systems. These systems should be encouraged to develop
joint referral mechanisms, conduct joint trainings, utilize technical
assistance to understand each others systems, support screenings/
evaluations, understand the complexities of the families involved, and
iron out system-related issues (surrogate parents, for example). States
that are most successful have also learned how to tap into other
funding sources to provide screenings and evaluations, such as
Medicaid.
In addition, AUCD provides the following recommendations for the
2008 reauthorization of CAPTA:
Comprehensive health and developmental evaluations.--Each
child under the age of 6 for whom there is an open case, not just
substantiated case, with Child Protective Services should be referred
for a comprehensive health and developmental evaluation, if one has not
already been done. These screenings and evaluations can be conducted
through the CAPTA system as well as the medical or other appropriate
system.
Comprehensive Health Evaluation.--A definition for
``comprehensive health evaluation'' should be added to mean a process
equivalent to the Early and Periodic Screening, Diagnosis, and
Treatment requirement, and should encompass, at a minimum, the child's
gross motor skills, fine motor skills, cognition, speech and language
function, self-help abilities, emotional well-being and overall mental
health, oral health, coping skills, and behavior.
Respite care services.--Respite care should be more
available, accessible, and affordable for families who are at risk of
abuse and neglect, particularly families of children and/or parents
with disabilities. Respite should be considered a core service of child
abuse prevention programs.
Equal protection for all children.--Extend protection to
all children from medical neglect by removing language from CAPTA with
the effect of allowing States to permit parents to withhold medical
care from sick and injured children on religious grounds in the
provision stating that there is no ``Federal requirement that a parent
or legal guardian provide a child any medical service or treatment
against the religious beliefs of the parent or legal guardian . . .'',
in accord with the U.S. Supreme Court holding that the first amendment
does not allow one's religious practices or beliefs to endanger one's
children.
Differential responses.--Promote the implementation of
policies and procedures which encourage the development of
differential, multiple responses for referral of family to a community
organization or voluntary preventive services where the child is not at
risk of imminent harm.
Research.--Support more research to examine rates of Part
C eligibility and participation in early intervention among children
who are investigated for maltreatment. Data must be collected to verify
services data specific to CAPTA activities for EI, health and
developmental evaluations.
State Incentives.--Provide incentives to States that fund
all the core services in title II.
In addition to requesting Chairman Dodd and his colleagues on the
Health Subcommittee to include the above recommendations in CAPTA, AUCD
also requests that Chairman Dodd and the other distinguished
subcommittee members encourage their colleagues on the Appropriations
Committee to increase funding for CAPTA. Without such increases, the
above listed and all other provisions in CAPTA will be stripped of
their ability to make a meaningful difference in the lives of children
and families.
Federal funding to help States and communities protect children and
prevent child abuse and neglect has been woefully inadequate. Current
appropriations for child abuse and neglect are only at half the
authorized amounts. In fiscal year 2008, basic State grants are funded
at $27 million, discretionary grants at $33.7 million, and community-
based grants at $37 million. These levels of funding demonstrate a
complete disregard for prevention, when compared to billions of dollars
spent on foster care and institutionalization at the far end of the
child welfare services continuum.
As a result, hundreds of thousands of children remain in serious
jeopardy and are even at risk of losing their lives. The U.S.
Department of HHS received 3.3 million reports of suspected child abuse
and neglect. The report states that substantiated cases of child abuse
and neglect investigated by child protective service (CPS) agencies
numbered an estimated 905,000 children nationally in 2006. States
report that nearly half (41 percent) of the child victims or their
families in confirmed cases of child abuse and neglect receive no
treatment or any other kind of services following investigation of the
report. Deaths from child maltreatment remain unacceptably high: an
estimated 1,530 children died of abuse or neglect in 2006 alone. Near-
fatal child maltreatment leaves thousands of children permanently
disabled each year.
Therefore, at a minimum, we urge your support to fund the Child
Abuse Prevention and Treatment Act (CAPTA) programs at the authorized
levels in the FY 2009 Labor, Health and Human Services, and Education
Appropriations Bill:
CAPTA basic State grants at $84 million,
CAPTA discretionary research and demonstration grants at
$37 million, and
CAPTA Title II community-based prevention grants funding
at $80 million.
To begin to close the gap between what Federal, State and local
dollars currently allocate to protect children and treat child victims,
and resources necessary to implement CAPTA, Federal funding levels for
the reauthorized CAPTA should be increased to $500 million for title I
and $500 million for title II.
The current early intervention system is struggling to serve the
families now enrolled. The new CAPTA requirements have substantially
increased the workload for providers of Part C evaluation and
intervention services. Currently, Part C serves about 200,000 children
nationwide. The Department of Education has established a benchmark for
each State to serve 2 percent of the population of children under the
age of 3. Unfortunately, one-half of the States are not meeting this
benchmark. In addition, most States are only getting 10 percent (or
less), of Federal funds to support the Part C system. Congress should
increase appropriations for Part C of the Individuals with Disabilities
Education Act (IDEA) so that all eligible children can be served under
the program.
AUCD urges Chairman Dodd and his colleagues on the subcommittee to
include the provisions outlined above and to fund CAPTA and Part C at
meaningful levels. Failure to do so is to allow our Nation's most
vulnerable children to continue to be subjected to the most egregious
violations of their human rights and to strap the American taxpayer
with the ever-increasing price tag of responding to the devastating and
far-reaching effects of child maltreatment.
Thank you for considering these observations and recommendations.
AUCD would be happy to provide further input as you begin to draft
legislation to reauthorize CAPTA. Please contact Kim Musheno, Director
of Legislative Affairs, in our national office for more information at
301-588-8252; [email protected].
Prepared Statement of Lisa Pion-Berlin, Ph.D., President & Chief
Executive Officer, Parents Anonymous Inc.
Good afternoon, my name is Dr. Lisa Pion-Berlin, President and
Chief Executive Officer of Parents Anonymous Inc., the oldest family
strengthening program in America dedicated to the prevention of child
abuse and neglect. Thank you Chairman Dodd, Ranking Member Alexander
and distinguished members of the Subcommittee on Children and Families
for offering me this opportunity to share the stories of hundreds of
thousands of families who have changed their lives forever through
evidence-based Parents Anonymous Programs and dedicated themselves to
giving back to improve the systems designed to help families
nationwide.
Through the extraordinary efforts of Jolly K., a courageous mother
seeking help for her family and working in partnership with her social
worker, the first Parents Anonymous group was started in 1969. From
these humble beginnings, Parents Anonymous Inc. launched a national
prevention network of accredited and affiliated community-based
agencies to operate Parents Anonymous adult and children and youth
programs to successfully reach millions of parents and their children,
partner with professionals, and effectively engage local communities to
provide help, support, strength and hope to diverse families. We are
the Nation's oldest child abuse prevention organization dedicated to
strengthening families, with an almost 40-year track record of
successfully providing leadership in preventing maltreatment, including
physical abuse, emotional abuse, neglect and sexual abuse. Parents
Anonymous is truly a prevention program open to any parent before or
after abuse or neglect has occurred. Parents Anonymous Inc. is the
Nation's premier child abuse prevention program dedicated to
strengthening families, with research demonstrating its effectiveness
and national standards to ensure quality programs.
Tanya Long, National Parent Leader is testifying today to continue
the legacy first begun by Jolly K., the founding mother of Parents
Anonymous. This year marks the 35th anniversary of Jolly K.'s
groundbreaking testimony before Congress when she put a human face to
the complex problem of child maltreatment. A hush fell over the room
when Jolly K. testified before Congress about her abusive behavior
toward her child and how she successfully turned her life around
through Parents Anonymous. She was considered by leading experts as
the single most effective witness because her personal story humanized
the problem of child maltreatment by focusing on effective prevention
programs (Public Policy, Harvard University, 1978). This courageous
testimony in 1973 ensured the original passage of The Child Abuse
Prevention and Treatment Act of 1974 (CAPTA). Her moving Senate and
House testimony reported on nationwide television and in the Los
Angeles Times caught the attention of the Nation and had a major impact
on Congress and on public opinion.
The unique philosophy and practices of mutual support and shared
leadership ensure the success of Parents Anonymous by building on
people's strengths, helping individuals and families address their
needs respectfully and providing weekly and on-going vital supports to
parents and their children of any age, ethnicity, and who reside in
neighborhoods all across America. Our history, principles and model of
mutual support and shared leadership have also had significant impact
on our Nation's policies and practices related to child maltreatment
prevention by emphasizing a strengths-based approach and engaging
parents in meaningful leadership roles to ensure we respond effectively
to the needs of families. From its inception, Parents Anonymous Inc.
has led the way with a proactive, preventative approach to responding
to diverse issues facing parents. Parents serve in significant
leadership roles in all policymaking and program operations decisions
and activities of Parents Anonymous Inc. Our unique, evidence-based
shared leadership approach is the cornerstone of the CAPTA-Title II
language that promotes meaningful parent involvement in planning,
program development, oversight, evaluation and policy decisions of the
Lead Agencies and the locally funded programs.
Moreover, Parents Anonymous Inc. has developed another program:
Shared Leadership in Action is designed to ensure meaningful roles for
parent consumers to work with private and public agencies across all
human service sectors (child welfare, justice, health, mental health,
and schools) to better meet the needs of families through program
development, policy-changes and creating long-term positive outcomes
for families. Training, technical assistance and evaluation services
are provided through shared leadership teams of Parents Anonymous Inc.
Research results on the Shared Leadership in Action Program include
statistically significant increases in knowledge and abilities to
engage in successful shared leadership efforts that create systems
reform. Furthermore, 20 States that have participated in Shared
Leadership in Action have improved their child welfare systems by
making organizational changes and strengthening services to address
families' unique needs. We have developed Parent Advocacy Programs
within child protective service systems to increase the re-unification
of children by partnering with the family in the Child Protective
Services system.
Today, Parents Anonymous Inc. leads a dynamic Network of nearly
200 accredited and affiliate organizations that implement Parents
Anonymous programs annually to nearly 20,000 parents and children of
diverse economic, ethnic and social backgrounds throughout the United
States. Our affiliates are seasoned State, regional, and local public
and private organizations with broad-based expertise in social
services, mental health, and child development. The Parents Anonymous
prevention model serves the entire family through free, weekly ongoing,
community-based Parents Anonymous Mutual support groups for adults
based on the helper-therapy principle and shared leadership, and
specialized Children and Youth Programs.
Our Programs have been successfully replicated to meet the needs of
families in diverse settings including community centers, mental health
settings, substance abuse programs, military installations, social
service agencies, faith-based organizations, schools, child care
centers, adult and juvenile correctional facilities, shelters, and
Native American Reservations. We serve parents and children of any
type, age, race, circumstance, and physical and/or mental challenge
(who have the ability to function in a group), ensuring the broadest
prevention impact: from primary to secondary to tertiary.
For almost four decades, Parents Anonymous Inc. has successfully
collaborated with: (1) Parents of varied cultural and ethnic
backgrounds to ensure meaningful leadership roles for parents in their
communities and at the State and national levels; (2) Accredited
Parents Anonymous affiliates to ensure quality child abuse prevention
programming; (3) Public child welfare, health and mental health
agencies to improve service delivery systems; (4) Government and
private foundations to develop and expand Parents Anonymous prevention
programs and collaborate on public awareness campaigns; (5) Citizens to
encourage volunteerism so that others in need can be helped; and (6)
Public officials at the local, State and Federal levels to develop and
implement responsive public policies that build on the strengths of
families. For 40 years, Parents Anonymous has played a role nationally
in shaping the child maltreatment prevention agenda from one of ``blame
and shame'' to one that emphasizes the protection of children by
building on the strengths of parents, resulting in strong families that
nurture and promote positive relationships with their children and
youth.
Parents Anonymous Inc. has been recognized nationally for our
leadership capabilities in child abuse and neglect prevention. The
Federal Office of Child Abuse and Neglect highlighted our Parent
Leadership Program and Children's Program in their Emerging Practices
Initiative to Prevent Child Maltreatment (2003) as a promising strategy
for national replication. The National Crime Prevention Council
identified the Parents Anonymous Group as one of the top 50 strategies
to prevent domestic crimes (2002). The Federal Center for Substance
Abuse Prevention selected the Parents Anonymous Program as a Promising
Family Strengthening Program to prevent substance abuse (2000). Also
the U.S. Commission on Child and Family Welfare identified the
exemplary Parents Anonymous Parent Leadership Program as a National
Model for helping parents and fostering meaningful leadership (1996).
The Federal Office of Juvenile Justice and Delinquency Prevention
selected Parents Anonymous Programs as a National Model Family
Strengthening Program for the prevention of juvenile delinquency
(1995).
Child maltreatment prevention is addressed by Parents Anonymous
Inc. through national child abuse prevention public awareness campaigns
with the purpose of educating and calling the public to action. We
obtain national media coverage, including television, radio, newspaper
and magazine to offer parenting tips on everyday stressors and
highlight personal stories on families that instill hope and strength
to prevent any act of child maltreatment. Parents Anonymous Parent
Leaders and staff have been interviewed and published in The New York
Times, Washington Post, Los Angeles Times, Life Magazine, Parenting,
Redbook and Better Homes and Gardens, just to name a few. Also we have
been on a Good Morning America Special Segment, The Today Show, CNN
News, Geraldo Rivera, Leeza Gibbons Show, and numerous public affairs
programs. Interviews have covered a broad range of topics such as how
to control your anger toward your children, dealing with your
teenagers, behavior problems in young children and promoting prevention
through the idea that Asking For Help is A Sign of Strength. Parents
Anonymous emphasizes prevention as the central goal verses
sensationalism that leaves viewers including parents, staff and
citizens, feeling helpless and inhibits ones' ability to seek or offer
help early before abuse or neglect occurs.
Parents Anonymous was the first innovative prevention program to
exemplify an ecological systems approach by recognizing the essential
need to partner with parents, promoting shared leadership and building
on the strengths of families to successfully address child maltreatment
prevention, parenting concerns and other violence-related issues across
all levels of society. In Parents Anonymous Groups, parents and their
children express their feelings, model positive behaviors and mutually
support one another to create long-term positive growth and
development. Any issue of personal violence and topics regarding the
prevention of physical, emotional and sexual abuse and neglect are
addressed in the weekly Parents Anonymous Programs. Parents Anonymous
Inc. has demonstrated the effectiveness of engaging parents and staff
in meaningful leadership roles to ensure better outcomes for families.
We have successfully created and promoted meaningful parent leadership
roles throughout the Parents Anonymous Inc. Network and the field of
child abuse prevention. We have conducted several research studies
based on a conceptual framework for parent leadership and shared
leadership and numerous evaluations of trainings on leadership
practices and the sustainability of leadership behaviors, resulting in
the development of standardized instruments for measuring parent
leadership and shared leadership potential. Parents Anonymous Inc. is
nationally recognized for its expertise on parent leadership and shared
leadership and has responded to numerous requests to conduct trainings
and design technical assistance for public and private agencies and
communities on effective strategies, skills and outcomes. Major Federal
and State agencies and national organizations are now following our
lead, embracing the important concepts of parent leadership and shared
leadership and looking for creative ways to partner with parents to
prevent child abuse. We utilize our expertise on parent leadership and
shared leadership to raise awareness about child abuse prevention,
shape the direction of child welfare reform, improve the foster care
system and integrate child abuse prevention strategies into child
health and child well-being programs including public health.
Research substantiates only a few family strengthening programs as
evidence-based to prevent child abuse and neglect (U.S. Office of Child
Abuse & Neglect, 2001). Over the past 39 years, several studies have
been conducted on the effectiveness of Parents Anonymous. The most
recent National Outcome Study in 2007 was conducted by the National
Council on Crime and Delinquency and funded by the Office of Juvenile
Justice and Delinquency, U.S. Department of Justice. This study
demonstrated that Parents Anonymous is an evidence-based program that
prevents child abuse and neglect by reducing risk and increasing
protective factors. This research included a national representative
sample of diverse parents new to Parents Anonymous followed over a 6-
month period. Statistically significant results for parents who
participated in Parents Anonymous were: Reduced Child Maltreatment
Outcomes: 73 percent of parents decreased their parenting distress, 65
percent of parents decreased their parent rigidity, 56 percent of
parents reduced use of psychological aggression towards their children,
and for parents who reported using physical aggression: 83 percent
stopped physically abusing their children; Reduced Risk Factors: 86
percent of the high stressed parents reduced their parental stress, 71
percent of parents reduced their life stressors, 40 percent of parents
reduced any form of domestic violence, and 32 percent of parents
reduced their drug/alcohol use; and increased protective factors: 67
percent of parents improved their quality of life; for parents starting
out needing improvement: 90 percent improved in emotional and
instrumental support, 88 percent improved in parenting sense of
competence, 84 percent improved in general social support, 69 percent
improved in use of non-violent discipline tactics, and 67 percent
improved in family functioning. Also a qualitative study was conducted
with Latino parents confirming the aforementioned results. In
conclusion, parents who continued to attend Parents Anonymous groups
over time showed improvement in child maltreatment outcomes, and risk
and protective factors compared to those who dropped out. Strong
evidence suggests that parents benefit and strengthen their families
through Parents Anonymous regardless of their race, gender, education
or income. The researchers found that 22 percent of the families were
involved with the juvenile justice system and as a result of their
children's exposure to the Program, they had significantly less child
behavior difficulties over time (NCCD, 2007). This ground-breaking
longitudinal study of Parents Anonymous is the only independent
outcome research conducted nationwide to assess the impact of parent
mutual support-shared leadership groups on child abuse and neglect
prevention. Furthermore, Parents Anonymous utilizes a program fidelity
tool to ensure that our program is being implemented based on the model
and principles that yield these positive results.
Through national collaborations, we have worked tirelessly to
refine, expand, and enhance CAPTA without giving up its critical
prevention focus. Parent Leaders have continued to testify before
Congress on CAPTA and other prevention issues to inform and educate
lawmakers on the effectiveness of strengths-based prevention programs.
The 1996 Conference Report on the Reauthorization of CAPTA emphasized
the importance of meaningful, ongoing and effective parent involvement
in program and policy issues with a separate section and identifies
Parents Anonymous as the organization who can assist in achieving
these goals.
In 2008, we believe legislative intent regarding effective
prevention programs, meaningful partnerships with parents and
accountability can be strengthened by the following of recommended
changes to CAPTA. Input from Parents Anonymous Parents, volunteers and
organizations as well as members of the National Child Abuse Coalition
have shaped the following proposed legislative changes:
I. EMPHASIZE SHARED LEADERSHIP
SEC. 105. GRANTS TO STATES AND PUBLIC OR PRIVATE AGENCIES AND
ORGANIZATIONS. [42 U.S.C. 5106]
a. Grants for Programs and Projects.--The Secretary may make grants
to, and enter into contracts with States, public agencies or private
agencies or organizations (or combinations of such agencies or
organizations) for programs and projects for the following purposes:
3. Mutual Support Programs.--The Secretary may award grants to
private organizations to establish or maintain a national network of
mutual support, shared leadership and self-help programs as a means of
strengthening families in partnership with communities.
II. STRENGTHEN PREVENTION GOAL AND CREATE ACCOUNTABILITY BY ADDING AN
APPROVAL PROCESS FOR THESE ACTIVITIES
SEC. 106. GRANTS TO STATES FOR CHILD ABUSE AND NEGLECT PREVENTION
AND TREATMENT PROGRAMS. [42 U.S.C. 5106a]
a. Development and Operation Grants.--The Secretary shall make
grants to the States, based on the population of children under the age
of 18 in each State that applies for a grant under this section, for
purposes of assisting the States in improving the child protective
services system of each such State. Each State shall implement any of
these improvement strategies utilizing these funds to partner with
community-based prevention agencies and families affected by abuse and
neglect in--
Add new section on accountability: There is no clarity as to what
these funds are used for since the separate application requirement was
removed. No reporting is done--so the impact on families' lives cannot
be even described nor can measurable impact be assessed regarding the
prevention of child maltreatment.
III. STRENGTHEN PURPOSE, REQUIREMENTS, AND MEANINGFUL PARENT LEADERSHIP
OF TITLE II--COMMUNITY-BASED CHILD ABUSE PREVENTION PROGRAMS
SEC. 201. PURPOSE AND AUTHORITY. [42 U.S.C. 5116]
[This section was amended by sec. 121 of P.L. 108-36.]
(a) Purpose.--It is the purpose of this title--
(1) to support community-based efforts to develop, operate,
expand, and enhance programs and initiatives focused on the
prevention of child abuse and neglect, that strengthen and
support families to reduce the likelihood of child abuse and
neglect in partnership with families; and
(2) to foster an understanding, appreciation, and knowledge
of diverse populations in order to be effective in preventing
and treating child abuse and neglect.
(b) Authority.--The Secretary shall make grants under this title on
a formula basis to the entity designated by the State as the lead
entity (hereafter referred to in this title as the ``lead entity'')
under section 202(1) for the purpose of--
(1) developing, operating, expanding and enhancing community-
based and prevention-focused programs and activities designed
to strengthen and support families to prevent child abuse and
neglect that are accessible, effective, culturally appropriate,
and build on existing strengths that--
(A) offer assistance to families by building on their
strengths;
(B) provide early, comprehensive support for parents;
(C) promote the development of parenting skills,
especially in young parents and parents with very young
children;
(D) increase family stability;
(E) improve family access to other formal and
informal resources and opportunities for assistance
available within communities;
(F) support the additional needs of families with
children with disabilities through respite care and
other services;
(G) utilize parents in meaningful leadership roles in
the planning, implementation, oversight, evaluation and
policy decisions of the Lead Agency and local funded
programs, including parents of children with
disabilities, parents with disabilities, racial and
ethnic minorities, and members of other
underrepresented or underserved groups; and
(H) provide referrals to early health and
developmental services;
(2) fostering the development of a continuum of preventive
services for children and families through State and community-
based collaborations and partnerships both public and private;
(3) financing the start-up, maintenance, expansion, or
redesign of specific child abuse and neglect prevention
programs and activities (such as parent education, mutual
support and leadership services, respite care services home
visiting and other similar services and other activities)
identified by the inventory and description of current services
required under section 205(a)(3) as an unmet need, and
integrated with the network of community-based child abuse and
neglect prevention programs and activities program to the
extent practicable given funding levels and community
priorities;
(4) maximizing funding through leveraging of funds for the
financing, planning, community mobilization, collaboration,
assessment, information and referral, startup, training and
technical assistance, information management, reporting and
evaluation costs for establishing, operating, or expanding
community-based and prevention-focused programs and activities
designed to strengthen and support families to prevent child
abuse and neglect; and
(5) financing public information activities that focus on the
healthy and positive development of parents and children and
the promotion of child abuse and neglect prevention activities.
SEC. 202. ELIGIBILITY. [42 U.S.C. 5116a]
[This section was amended by sec. 122 of P.L. 108-36.]
A State shall be eligible for a grant under this title for a fiscal
year if--
(1)(A) the chief executive officer of the State has
designated a lead entity to administer funds under this title
for the purposes identified under the authority of this title,
including to develop, implement, operate, enhance or expand
community-based and prevention-focused programs and activities
designed to strengthen and support families to prevent child
abuse and neglect (through networks where appropriate);
(B) such lead entity is an existing public, quasi-public, or
nonprofit private entity (which may be an entity that has not
been established pursuant to State legislation, executive
order, or any other written authority of the State that exists
to strengthen and support families to prevent child abuse and
neglect) with a demonstrated ability to work with other State
and community-based agencies to provide training and technical
assistance, and that has the capacity, resources and identified
roles to ensure the meaningful involvement of parents who are
consumers and who can provide leadership in the planning,
implementation, and evaluation of programs and policy decisions
of the applicant agency in accomplishing the desired outcomes
for such efforts;
(C) in determining which entity to designate under
subparagraph (A), the chief executive officer should give
priority consideration equally to a trust fund advisory board
of the State or to an existing entity that leverages Federal,
State, and private funds for a broad range of child abuse and
neglect prevention activities and family resource programs, and
that is directed by an interdisciplinary, public-private
structure, including participants from communities; and
(D) in the case of a State that has designated a State trust
fund advisory board for purposes of administering funds under
this title (as such, title was in effect on the date of the
enactment of the Child Abuse Prevention and Treatment Act
Amendments of 1996) and in which one or more entities that
leverage Federal, State, and private funds (as described in
subparagraph (C)) exist, the chief executive officer shall
designate the lead entity only after full consideration of the
capacity and expertise of all entities desiring to be
designated under subparagraph (A);
(2) the chief executive officer of the State provides
assurances that the lead entity will provide or will be
responsible for providing--
(A) community-based and prevention-focused programs
and activities designed to strengthen and support
families to prevent child abuse and neglect composed of
local, collaborative, public-private partnerships
directed by interdisciplinary structures with balanced
representation from private and public sector members,
parents, consumers and public and private nonprofit
service providers and individuals and organizations
experienced in working in partnership with families
with children with disabilities;
(B) direction through an interdisciplinary,
collaborative, public private structure with balanced
representation from private and public sector members,
parents, consumers, public sector and private nonprofit
sector service providers, and parents with
disabilities; and
(C) direction and oversight through identified goals
and objectives, clear lines of communication and
accountability, the provision of leveraged or combined
funding from Federal, State and private sources,
centralized assessment and planning activities, the
provision of training and technical assistance, and
reporting and evaluation functions; and
(3) the chief executive officer of the State provides
assurances that the lead entity--
(A) will utilize parents in meaningful leadership
roles in the development, operation, oversight and
evaluation of the community-based and prevention-
focused programs and activities designed to strengthen
and support families to prevent child abuse and neglect
and in the policy-decisions of the Lead Agency;
(B) has a demonstrated ability to work with State and
community-based public and private nonprofit
organizations to develop a continuum of preventive,
family centered, comprehensive services for children
and families through the community-based and
prevention-focused programs and activities designed to
strengthen and support families to prevent child abuse
and neglect this is ill-defined and a hold over from
other language;
(C) has the capacity to provide operational support
(both financial and programmatic) training, technical
assistance, and evaluation assistance, to community-
based and prevention-focused programs and activities
designed to strengthen and support families to prevent
child abuse and neglect through innovative, interagency
funding and interdisciplinary service delivery
mechanisms; and
(D) will integrate its efforts with individuals and
organizations experienced in working in partnership
with families with children with disabilities, parents
with disabilities, and with the child abuse and neglect
prevention activities of the State, and demonstrate a
financial commitment to those activities.
SEC. 203. AMOUNT OF GRANT. [42 U.S.C. 5116b]
[This section was amended by sec. 123 of P.L. 108-36.]
(a) Reservation.--The Secretary shall reserve 1 percent of the
amount appropriated under section 5116i of this title for a fiscal year
to make allotments to Indian tribes and tribal organizations and
migrant programs.
(b) Remaining Amounts.--
(1) In general.--The Secretary shall allot the amount
appropriated under section 5116i of this title for a fiscal
year and remaining after the reservation under subsection (a)
of this section among the States as follows:
(A) 70 percent of such amount appropriated shall be
allotted among the States by allotting to each State an
amount that bears the same proportion to such amount
appropriated as the number of children under the age of
18 residing in the State bears to the total number of
children under the age of 18 residing in all States
(except that no State shall receive less than $175,000
under this subparagraph).
(B) 30 percent of such amount appropriated shall be
allotted among the States by allotting to each State an
amount that bears the same proportion to such amount
appropriated as the amount of private, State, or other
non-Federal funds leveraged and directed through the
currently designated State lead entity in the preceding
fiscal year bears to the aggregate of the amounts
leveraged by all States from private, State, or other
non-Federal sources and directed through the current
lead entity of such States in the preceding fiscal
year.
(2) Additional requirements.--The Secretary shall provide
allotments under paragraph (1) to the State lead entity.
(c) Allocation.--Funds allotted to a State under this section--
(1) shall be for a 3-year period; and
(2) shall be provided by the Secretary to the State on an
annual basis, as described in subsection (b) of this section.
Need to add a section on the return of funds not in compliance by a
lead agency: to be put back into program funds not into the general
Federal treasury. Many other Federal programs have these types of
provisions.
SEC. 204. EXISTING GRANTS. [42 U.S.C. 5116c]
[Note: This section was repealed by sec. 124 of P.L. 108-36.]
SEC. 205. APPLICATION. [42 U.S.C. 5116d]
[This section was amended by sec. 125 of P.L. 108-36.]
A grant may not be made to a State under this title unless an
application therefore is submitted by the State to the Secretary and
such application contains the types of information specified by the
Secretary as essential to carrying out the provisions of section 202,
including--
(1) a description of the lead entity that will be responsible
for the administration of funds provided under this title and
the oversight of programs funded through the community-based
and prevention-focused programs and activities designed to
strengthen and support families to prevent child abuse and
neglect (through networks where appropriate) which meets the
requirements of section 202;
(2) a description of how the community-based and prevention-
focused programs and activities designed to strengthen and
support families to prevent child abuse and neglect (through
networks where appropriate) will operate and how child abuse
and neglect prevention programs and activities services
provided by public and private, nonprofit organizations, will
be integrated into a developing continuum of family centered,
holistic, preventive services for children and families;
(3) a description of the inventory of current unmet needs and
current community-based and prevention-focused programs and
activities to prevent child abuse and neglect, and other family
resource services operating in the State;
(4) a budget for the development, operation and expansion of
the community-based and prevention-focused programs and
activities designed to strengthen and support families to
prevent child abuse and neglect that verifies that the State
will expend in non-Federal funds an amount equal to not less
than 20 percent of the amount received under this title (in
cash, not in-kind) for activities under this title;
(5) an assurance that funds received under this title will
supplement, not supplant, other State and local public funds
designated for the start up, maintenance, expansion, and
redesign of community-based and prevention-focused programs and
activities designed to strengthen and support families to
prevent child abuse and neglect;
(6) an assurance that the State will utilize funds from these
and other sources and implement activities to ensure the
meaningful involvement of parents who are consumers and who can
provide leadership in the planning, implementation, and
evaluation of the programs and policy decisions of the
applicant agency in accomplishing the desired outcomes for such
efforts;
(7) a description of the criteria that the entity will use to
develop, or select and fund, community-based and prevention-
focused programs and activities designed to strengthen and
support families to prevent child abuse and neglect as part of
network development, expansion or enhancement;
(8) a description of outreach activities that the entity and
the community-based and prevention-focused programs and
activities designed to strengthen and support families to
prevent child abuse and neglect will undertake to maximize the
participation of racial and ethnic minorities, children and
adults with disabilities, homeless families and those at risk
of homelessness, and members of other underserved or
underrepresented groups;
(9) a plan for providing operational support, training and
technical assistance to community-based and prevention-focused
programs and activities designed to strengthen and support
families to prevent child abuse and neglect for development,
operation, expansion and enhancement activities;
(10) a description of how the applicant entity's activities
and those of the network and its members (where appropriate)
will be evaluated;
(11) a description of the actions that the applicant entity
will take to advocate systemic changes in State policies,
practices, procedures and regulations to improve the delivery
of community-based and prevention-focused programs and
activities designed to strengthen and support families to
prevent child abuse and neglect services to children and
families and the utilization of parent and family advocates;
(12) an assurance that the applicant entity will provide the
Secretary with reports at such time and containing such
information as the Secretary may require.
SEC. 206. LOCAL PROGRAM REQUIREMENTS. [42 U.S.C. 5116e]
[This section was amended by sec. 126 of P.L. 108-36.]
(a) In general.--Grants made under this title shall be used to
develop, implement, operate, expand and enhance community-based, and
prevention-focused programs and activities designed to strengthen and
support families to prevent child abuse and neglect that--
(1) assess community assets and needs through a planning
process that involves parents and local public agencies, local
nonprofit organizations, and private sector representatives;
(2) develop a strategy to provide, over time, a continuum of
preventive, family centered services to children and families,
especially to young parents and parents with young children,
through public-private partnerships;
(3) provide--
(A) core child abuse and neglect prevention services
such as--
(i) parent education, mutual support, shared
leadership, and self help, and parent
leadership services;
(ii) respite services, including crisis
nurseries;
(iii) voluntary home visiting services;
(iii) outreach services;
(iv) community and social service referrals;
and
(v) follow-up services; and
(B) access to optional services, including--
(i) referral to and counseling for adoption
services for individuals interested in adopting
a child or relinquishing their child for
adoption;
(ii) child care, early childhood development
and intervention services;
(iii) referral to services and supports to
meet the additional needs of families with
children with disabilities and parents with
disabilities;
(iv) referral to job readiness services;
(v) referral to educational services, such as
scholastic tutoring, literacy training, and
General Educational Degree services;
(vi) self-sufficiency and life management
skills training;
(vii) community referral services, including
early developmental screening of children; and
(viii) peer counseling;
(4) develop, support maintain on-going leadership roles for
the meaningful involvement of parent consumers in the
development, operation, evaluation, and oversight of the
programs and services and policy decisions of the Lead Agency;
(5) provide leadership in mobilizing local public and private
resources to support the provision of needed child abuse and
neglect prevention programs and activities; and
(6) participate with other community-based and prevention-
focused programs and activities designed to strengthen and
support families to prevent child abuse and neglect in the
development, operation and expansion of networks where
appropriate.
(b) Priority.--In awarding local grants under this title, a lead
entity shall give priority to effective community-based child abuse and
neglect prevention programs serving low income communities and those
serving young parents or parents with young children.
SEC. 207. PERFORMANCE MEASURES. [42 U.S.C. 5116f]
[This section was amended by sec. 127 of P.L. 108-36.]
A State receiving a grant under this title, through reports
provided to the Secretary.--No accountability: If States do not use
these funds properly or meet the obligation period, what are the
consequences, can funds be held back by Federal authority. The Federal
Government has no compliance authority to take any action in the case
of noncompliance to any provision of this section of the statute.
(1) shall demonstrate the effective development, operation
and expansion of a community-based and prevention-focused
programs and activities designed to strengthen and support
families to prevent child abuse and neglect that meets the
requirements of this title;
(2) shall supply an inventory and description of the services
provided to families by local programs that meet identified
community needs, including core and optional services as
described in section 202;
(3) shall demonstrate that they will have effectively
addressed unmet needs identified by the inventory and
description of current services required under section 205(3);
(4) shall describe the number of families served, including
families with children with disabilities, and parents with
disabilities, and the involvement of a diverse representation
of families in the design, operation, and evaluation of
community-based and prevention-focused programs and activities
designed to strengthen and support families to prevent child
abuse and neglect, and in the design, operation and evaluation
of the networks of such community-based and prevention-focused
programs;
(5) shall demonstrate a high level of satisfaction among
families who have used the services of the community-based and
prevention-focused programs and activities designed to
strengthen and support families to prevent child abuse and
neglect;
(6) shall demonstrate the establishment or maintenance of
innovative funding mechanisms, at the State or community level,
that blend Federal, State, local and private funds, and
innovative, interdisciplinary service delivery mechanisms, for
the development, operation, expansion and enhancement of the
community-based and prevention-focused programs and activities
designed to strengthen and support families to prevent child
abuse and neglect;
(7) shall describe the results of a peer review process
conducted under the State program; and
(8) shall document the leadership roles, responsibilities and
results of parent consumers and funds utilized to ensure the
continued leadership of parents in the on-going planning,
implementation, and evaluation of such community-based and
prevention-focused programs and activities of the Lead Agency
and local programs designed to strengthen and support families
to prevent child abuse and neglect.
SEC. 208. NATIONAL NETWORK FOR COMMUNITY-BASED CHILD ABUSE AND
NEGLECT PREVENTION PROGRAMS. [42 U.S.C. 5116g]
[This section was amended by sec. 128 of P.L. 108-36.]
The Secretary may allocate such sums as may be necessary from the
amount provided under the State allotment to support the activities of
the lead entity in the State--
(1) create, operate and maintain an information
clearinghouse;
(2) to fund a yearly symposium on State system change efforts
that result from the operation of the community-based and
prevention-focused programs and activities designed to
strengthen and support families to prevent child abuse and
neglect;
(4) to create, operate and maintain a computerized
communication system between lead entities; and
(5) to fund State-to-State technical assistance through bi-
annual conferences.
SEC. 209. DEFINITIONS. [42 U.S.C. 5116h]
[This section was amended by sec. 129 of P.L. 108-36.]
For purposes of this title:
(1) Children With Disabilities.--The term ``children with
disabilities'' has the same meaning given the term ``child with a
disability'' in section 602(3) or ``infant or toddler with a
disability'' in section 632(5) of the Individuals with Disabilities
Education Act.
(2) Community Referral Services.--The term ``community referral
services'' means services provided under contract or through
interagency agreements to assist families in obtaining needed
information, mutual support and community resources, including respite
care services, health and mental health services, employability
development and job training, and other social services, including
early developmental screening of children, through help lines or other
methods.
(3) Community-Based and Prevention-Focused Programs and Activities
to Prevent Child Abuse and Neglect.--The term ``community-based and
prevention-focused programs and activities to strengthen and support
families to prevent child abuse and neglect'' includes organizations
such as family resource programs, family support programs, voluntary
home visiting programs, respite care programs, parenting education,
mutual support programs, and other community programs or networks of
such programs that provide activities that are designed to prevent or
respond to child abuse and neglect and have evidence demonstrating
their effectiveness to prevent all forms of abuse and neglect with
diverse families nationwide.
(4) Respite Care Services.--The term ``respite care services''
means short-term care services, including crisis nurseries, provided in
the temporary absence of the regular caregiver (parent, other relative,
foster parent, adoptive parent, or guardian) to children who--
(A) are in danger of abuse or neglect;
(B) have experienced abuse or neglect; or
(C) have disabilities, chronic, or terminal illnesses.
Such services shall be provided within or outside the home of the
child, be short-term care (ranging from a few hours to a few weeks of
time, per year), and be intended to enable the family to stay together
and to keep the child living in the home and community of the child.
SEC. 210. AUTHORIZATION OF APPROPRIATIONS. [42 U.S.C. 5116i]
[This section was amended by sec. 130 of P.L. 108-36.]
There are authorized to be appropriated to carry out this title,
$150,000,000 for fiscal year 2009 and such sums as may be necessary for
each of the fiscal years 2010 through 2013.
Prepared Statement of Child Welfare League of America (CWLA)
Chairman Dodd and Senator Alexander and members of the
subcommittee, the Child Welfare League of America submits this
statement on the reauthorization of the Child Abuse Prevention and
Treatment Act (CAPTA).
CWLA represents hundreds of State and local direct service
organizations including both public and private, and faith-based
agencies. Our members provide a range of child welfare services from
prevention to placement services including adoptions, foster care,
kinship placements, and services provided in a residential setting.
CWLA believes that keeping children safe from child abuse and
neglect should always be the first goal of any child protective
services response. The best ways to ensure that children are safe from
all forms of maltreatment are comprehensive, community-based approaches
to protecting children and supporting and strengthening families. As a
collective, public and private agencies, in collaboration with
individual citizens and community entities, can prevent and remedy
child maltreatment, achieve child safety and promote child and family
well-being.
history of child protection
Child protection can trace its origins back to the nineteenth
century when, in 1875, the Society for the Prevention of Cruelty to
Children was established in New York City.\1\ After publicity
surrounding the treatment of a young child captured the attention of
the public, the President of the American Society for the Prevention
and Cruelty to Animals was approached and as a result of his support,
existing State legislation to protect children was vigorously enforced
for the first time. Other States and jurisdictions would eventually
follow in enacting their own laws. In 1899, Illinois became the first
State to create a Juvenile Court to address issues of dependence,
delinquency, and neglect. By 1907, 26 States had followed with their
own juvenile court laws.
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\1\ Child Welfare League of America (CWLA). (1999). CWLA Standards
of Excellence for Services for Abused and Neglected Children and Their
Families. Washington, DC: Author.
---------------------------------------------------------------------------
In 1909, the first White House Conference on Children was convened
and one of the results of that Conference was the creation of a
Children's Bureau at the Federal level. Part of the mission of the new
Bureau at the urging of the White House Conference was to ``investigate
and report on all matters relating to the welfare of children and child
life among all classes of people.'' \2\
---------------------------------------------------------------------------
\2\ Ibid.
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Throughout the following decades other laws where enacted at the
Federal and State level but, in 1960, Dr. C. Henry Kempe's work on
``battered child syndrome'' raised the importance of communities in
their efforts to protect children and led the medical community to
improve methods of identifying and protecting children from abuse. In
1974, the Congress acted with the adoption of the first Child Abuse
Prevention and Treatment Act (CAPTA). That landmark law enacted through
this committee established national standards for specific reporting
and response practices for States to include into their child
protection laws.
the role of legislation
CAPTA, as significant as it is, is only one part of a system we
call the child welfare system. Other important laws that play a direct
or indirect role in child protective services (CPS) include enactment
of the 1935 Social Security Act which included the Aid to Dependent
Children section that required public agencies to provide child welfare
services to protect children who were neglected, dependent, homeless or
in danger of becoming delinquent. Later changes were made to that law
as it became Aid to Families with Dependent Children (AFDC) and States
were required to provide for children in foster care. The Social
Services entitlement was a source of funds to States to address some of
the support services that might assist families in leaving AFDC, it
also served as the major source of funds for State CPS systems. In
1981, this funding became the Social Services Block Grant (SSBG), Title
XX of the Social Security Act. SSBG still remains the single biggest
Federal source of funds for CPS. In 1978, Congress recognized some of
the earlier injustices carried out under Federal law against Native
Americans and passed the Indian Child Welfare Act (ICWA--P.L. 95-608).
Two years later P.L. 96-272 created title IV-E foster care and adoption
assistance. Throughout the last three decades numerous amendments have
been made to these laws and CAPTA has been reauthorized six times.
the challenges before us
A few months ago the latest national data on child abuse and
neglect were released by the Department of Health and Human Services
(HHS). The numbers tell a familiar story: over 900,000 children
substantiated as abused and neglected, out of the more than 3.3 million
child abuse reports made. In 2006, children in the age group of birth
to 1 year had the highest rate of victimization at 24.4 per 1,000
children of the same age group in the national population; More than 40
percent (41.1 percent) of the estimated 1,530 child fatalities in 2006
were attributed to neglect; physical abuse also was a major contributor
to child fatalities.\3\
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\3\ Administration on Children, Youth, and Families (ACYF). (2008).
Child Maltreatment 2006, Available online. Washington, DC: U.S.
Department of Health and Human Services (HHS).
---------------------------------------------------------------------------
Of the child victims almost 9 percent were sexually abused and 16
percent were physically abused. It is little recognized that nearly 65
percent of the 900,000 children are victims of neglect. These are
children whose mistreatment can be just as serious as those victims of
sexual or physical abuse. It also tells us that we are not doing enough
to prevent these children from coming into care or being brought to the
attention of the Child Protective Services (CPS) system.
A consistent statistic from year to year, including 2006, is that
of the 900,000 abused and neglected children which identified that
nearly 40 percent did not receive follow up services.\4\ There are
several reasons for this including the way in which data is collected,
how States provide services, and in some instances the reluctance on
the part of some families to access services. Still with such a high
and consistent percent going without follow-up help, it is clear that
services are not being adequately provided at the front end of the
child welfare system. For some that may mean they will return to the
child welfare system.
---------------------------------------------------------------------------
\4\ Ibid.
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In 1996, the U.S. Department of Health and Human Services released
the Third National Incidence Study (NIS) of Child Abuse and Neglect.
The NIS is a congressionally mandated, periodic research effort to
assess the incidence of child abuse and neglect in the United States.
The fourth study is currently underway and is expected to be released
later this year. The NIS gathers information from multiple sources to
estimate the number of children who are abused or neglected and to
provide information about the nature and severity of the maltreatment,
the characteristics of the children, perpetrators, and families, and
the extent of changes in the incidence or distribution of child
maltreatment since the previous NIS.
In the 1996 study, a significant correlation was found between the
incidence of maltreatment and family income. It found that 47 percent
of children with demonstrable harm from abuse or neglect and 95.9
percent of endangered children came from families whose income was less
than $15,000 per year.
Children from families with annual incomes below $15,000 as
compared to children from families with annual incomes above $30,000,
were over 22 times more likely to experience some form of maltreatment
that fit the study's harm standard and over 25 times more likely to
suffer some form of maltreatment as defined by the endangerment
standard.\5\
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\5\ Sedlack, A.J. & Broadhurst, D.D. (1996). Third National
Incidence Study of Child Abuse and Neglect: Final report. Washington,
DC: U.S. Department of Health and Human Services.
---------------------------------------------------------------------------
The stress created by living in poverty may play a distinct role in
child abuse and neglect. Parents who experience prolonged frustration
in trying to meet their family's basic needs may be less able to cope
with even normal childhood behavior problems. Those parents who lack
social support in times of financial hardship may be particularly
vulnerable. Parents who are experiencing problems with employment are
frequently rated by child protective services staff as being at
moderate to high risk of child maltreatment.
These figures also tell us that we can prevent more children from
coming into the system with the right kind of investments both in
services and in the CPS system.
key issues for capta reauthorization and the committee
Funding for CAPTA
CPS systems in the 50 States are funded by a variety of sources.
The Social Services Block Grant (SSBG) serves as a major source of
funding with 41 States spending $257 million in SSBG funds in 2005 for
child protection.\6\ SSBG is once again threatened with a potential
reduction of $500 million in the President's proposed fiscal year 2009
budget as it was in the previous two budgets. At one point, shortly
after CAPTA was created and before SSBG became a block grant it was the
primary source of funding for State CPS systems. At $1.7 billion SSBG
is well below its historic high levels that came close to $3 billion.
In fact, SSBG supports more than 30 different types of human services
and populations, well beyond child protective services.
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\6\ Administration for Children and Families (ACF). (2007). SSBG
2005: Annual report on expenditures and recipients, 2005. Available
online at http://www.acf.hhs.gov/programs/ocs/ssbg/annrpt/2005/
index.html. Washington, DC: U.S. Department of Health and Human
Services.
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The CAPTA State grants that are intended to support State child
protective services systems stands at little more than $27 million.
There has been little change in the last decade, actually little change
in funding levels since 1974. The table below indicates the allocation
that States represented by Senators on the full committee receive. In
comparison you will notice the State grants represent a very small part
of your respective State's budgets and what they need for CPS. Yet it
is on this less than modest money that we hang numerous mandates and
policies.
If Congress is serious about the practices we hope to promote
through the reauthorization of this act, then the appropriations
process must work in conjunction with this reauthorization. Perhaps in
considering improvements in CAPTA the committee should consider some
form of funding triggers that might cause this program to receive
greater support. There are a number of requirements in CAPTA including
those around mandatory reporting of child abuse, data collection and
services for vulnerable children. These mandates may become more
enforceable and in fact realistic if Congress can give this law the
priority it deserves.
------------------------------------------------------------------------
State
State Allotment \7\
------------------------------------------------------------------------
Alaska................................................ 111,280
Colorado.............................................. 433,800
Connecticut........................................... 323,076
Georgia............................................... 809,391
Iowa.................................................. 273,535
Illinois.............................................. 1,180,108
Kansas................................................ 274,538
Massachusetts......................................... 531,011
Maryland.............................................. 508,218
North Carolina........................................ 745,961
New Hampshire......................................... 150,196
New Mexico............................................ 211,725
New York.............................................. 1,552,099
Ohio.................................................. 963,019
Oklahoma.............................................. 332,482
Rhode Island.......................................... 130,161
Tennessee............................................. 507,429
Utah.................................................. 293,335
Vermont............................................... 94,351
Washington............................................ 538,575
Wyoming............................................... 88,445
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The Foundation of Prevention, Protection and Child Welfare: Workforce
Whatever the challenge in child welfare whether we are discussing
preventing abuse from taking place, moving children from foster care
toward reunification with his or her family, placing a child in a
kinship or adoptive family, finding more foster families, training of
parents, or investigating abuse effective services are built on a
strong workforce.\7\
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\7\ Administration for Children and Families (ACF). (2007) CAPTA
State Allotments. Available on line at http://www.acf.dhhs.gov/
programs/cb/programs_fund/index.htm#state. Washington, DC: U.S.
Department of Health and Human Services.
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The investigation and prevention of child abuse including acting
and making decisions that should always be about the best interest of
the child, come down to a strong and competent workforce. A competent
workforce includes being fully staffed, with adequate and competent
supervision with training that prepares the new worker and assists the
current worker with on-going skills.
Although CWLA recommends caseload/workload measures for each area
of child welfare practice, workloads are best determined through
careful time studies carried on within the individual agency. They
should be based on the responsibilities assigned to complete a specific
set of tasks, or units of work, for which the worker is responsible.
For those agencies interested in developing their own specific workload
figures, time required for the conduct of the following tasks should be
calculated to include:
Direct contact with children and families;
Travel;
Collateral visits, outreach activities, and court
schedules;
Emergencies that interrupt regular work schedules;
Supervision, case conferences, consultation, and
collaboration;
Work with community service providers;
Attendance at staff meetings, staff development,
professional conferences, and administrative functions; and
Telephone contacts, reading of records, dictation, reports
of conferences and consultations.
Services for Abused or Neglected Children and Their Families (Includes
CPS)
------------------------------------------------------------------------
------------------------------------------------------------------------
Initial Assessment/Investigation.......... 12 active cases per month,
per 1 social worker.
On-going Cases............................ 17 active families per 1
social worker, and no more
than 1 new case assigned
for every 6 open cases.
Combined Assessment/Investigation and On- 10 active on-going cases and
going Cases. 4 active investigations per
1 social worker.
Supervision............................... 1 supervisor per 5 social
workers.
------------------------------------------------------------------------
Whatever actions this subcommittee takes in regard to CAPTA
reauthorization and increased funding, there are actions both the
committee and Congress can and must take to address the workforce
issue.
Perhaps the best place to focus this discussion is in this
subcommittee and the full committee because this is not just a human
service issue but also a workforce issue. We need a national strategy
that will build on the work of experts in the field of child welfare
but also other human service fields facing some of the same challenges
that are brought on by our ever changing society. We must also
strengthen child welfare work with and between the higher education
communities. There are few CWLA meetings held with our membership on
the biggest challenges within child welfare that do not include a
discussion of what many of our member agencies label ``a workforce
crisis.'' Regardless of whether we are talking to local agencies, local
governments or State agencies, we hear their on-going concerns about
where the next set of workers will come from and how to maintain a
current well-trained staff.
What we need most of all is leadership at the national level that
will make this part of our national agenda and national economic
strategy for the 21st century.
Fortunately, Congress is beginning to take some first and
significant steps. In the remaining months we urge members of both
parties in both houses to follow through on some key initiatives.
First, the HELP Committee is working diligently with their House
counterparts to complete a final reauthorization of the Higher
Education Act. Within these discussions is the possible inclusion of a
House proposal to provide for loan forgiveness to social workers who
work and remain at a child welfare agency. Under the proposal a worker
would receive a loan forgiveness benefit of $2,000 for each of the
first 5 years the worker continues in the field. We urge Congress to
include this in a final Higher Education bill. It is an important tool
and can become a building block to a workforce strategy in this area.
Second, in recent days the House, working through the Ways and
Means Committee, has passed a bipartisan child welfare bill, the
Fostering Connections to Success Act (H.R. 6307). This bill includes an
important provision that will allow the current title IV-E foster care
and adoption assistance training funds to be used for private agencies
as well as public agencies. Similar to child care, child welfare has
built much of its services on a combination of non-profit and faith-
based agencies as well as public agencies. This extension of training
funds, long a part of the CWLA agenda, is also found in legislation
recently introduced by a member of the committee, Senator Hillary
Rodham Clinton (D-NY), as part of the Child Welfare Workforce
Improvement Act (S. 2944). We encourage the Senate leadership and
members of the committee to get behind this proposal. This source of
funding would assist in both on-going training of current workers as
well as offer an incentive for these workers to remain in their
occupations.
Third, S. 2944, also calls for a national workforce study by the
National Academy of Sciences. This study would examine contributing
factors to staff turnover, make recommendations on appropriate
workloads and caseloads, examine training needs, and examine the use of
data. The resulting findings and the directives to the Department of
Health and Human Services could enhance a national strategy in the area
of child welfare workforce development. This proposal could be adopted
through the CAPTA reauthorization and we urge members to assure that
the needed funding is provided so that it is carried out.
Promise in Prevention and Intervention
CAPTA reauthorization can serve as a way to encourage innovation
but we also point out that there are other legislative proposals
currently before Congress and this committee that could enhance CAPTA.
One example of a program that could help address prevention of
child abuse and that is currently under consideration as part of
another bill is home visitation. Home visitation programs refer to
different model programs that provide in-home visits to targeted,
vulnerable, and new families. Home visitation programs--either stand-
alone programs or center-based programs--serve at least 400,000
children annually between the ages of 0 and 5.\8\
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\8\ Chapin Hall Center for Children at the University of Chicago.
(2006). Challenges to Building and Sustaining Effective Home Visitation
Programs: Lessons Learned From States. Chicago, IL: Author.
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The eligible families in these home visitation programs may receive
services as early as the prenatal stage. Because a child's early years
are the most critical for optimal development and provide the
foundation necessary for success in school and life, home visiting can
make a lifetime of difference. Nurses and other trained members of the
community conduct home visits on a weekly, bimonthly, or monthly basis.
Program goals include an increase in positive parenting practices,
improvement in the health of the entire family, increase in the
family's ability to be self-sufficient, and enhanced school readiness
for the children.
We recognize the value both in human and economic terms, and the
great benefits to our Nation and to vulnerable families and children by
enacting policies that prevent the need for ever placing a child in
foster care. There is no simple model for prevention of child abuse and
in fact we believe that a commitment to preventing child abuse will
involve multiple efforts and strategies. Greater investment and support
for home visitation is one critical part of such a strategy.
Currently home visitation programs rely on a range of Federal,
State and local funds. Unfortunately these funding sources can be
unreliable, even for programs that are demonstrating effectiveness in a
range of areas. In recent years, States have utilized funding sources
including the Social Services Block Grant (SSBG), title IV-B part 1,
Child Welfare Services, title IV-B part 2, Promoting Safe and Stable
Families (PSSF), the Child Abuse Prevention and Treatment Act (CAPTA)
State grants and Community-Based Family Resource and support grants.
All of these funding sources are used to fund a range of other
services, and all have been subject to reductions or proposed
reductions in each of the last five budgets. This highlights the need
for specific funding for home visiting programs to strengthen and
stabilize the funding.
All families benefit from information, guidance, and help in
connecting with resources as they meet the challenges of parenthood and
family life. For families with limited resources, or those that face
additional challenges, the need for support and assistance is even
greater.
Families are central to child safety and well-being. Children
develop the ability to lead productive, satisfying and independent
lives in the context of their families. Family ties especially those
between parent and child are extremely important in the development of
a child's identity. Through interaction with parents and other
significant family members, children learn and come to subscribe to
their most cherished personal and cultural values and beliefs. They
learn right from wrong, and gain competence and confidence. Family
relationships must be nurtured and maintained to meet the needs of
children for continuity and stability, which support healthy
development.
Home visitation services stabilize at-risk families by
significantly affecting factors directly linked to future abuse and
neglect. Research shows that families who receive at least 15 home
visits have less perceived stress and maternal depression, while also
expressing higher levels of paternal competence.\9\ Research shows that
participating children have improved rates of early literacy, language
development, problem-solving, and social awareness. These children also
demonstrate higher rates of school attendance and scores on achievement
and standardized tests. Studies show that families who receive home
visiting are more likely to have health insurance, seek prenatal and
wellness care, and have their children immunized. Home visitation
programs may also reduce the disproportionality or overrepresentation
of children and families of color in the child welfare system, while
improving outcomes for these families.
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\9\ Daro, D., Howard, E., Tobin, J., & Hardin, A. (2005). Welcome
Home and Early Start: An Assessment of Program Quality and Outcomes.
Available online. Chicago, IL: Chapin Hall Center for Children at the
University of Chicago.&
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The HELP Committee has before it S. 667, the Education Begins at
Home Act, sponsored by Senator Clinton and Senator Christopher Bond (R-
MO). Its companion bill, H.R. 2343, passed the House Education and
Labor Committee last week. We encourage the HELP Committee to build on
this action.
Reauthorizing CAPTA provides an opportunity to explore a number of
issues involving child abuse and neglect. Some States use the
differential response method to address reports of abuse and neglect.
Differential response is a form of practice in child protective
services that allows for more than one method of response to reports of
child abuse and/or neglect. Also called ``dual track,'' ``multiple
track,'' or ``alternative response,'' this approach recognizes the
variation in the nature of reports and the value of responding
differentially.
There is great variation in State and county implementation of
differential response, which generally involves low- and moderate-risk
cases that receive a non-investigation assessment response without a
formal determination or substantiation of child abuse and neglect.
While States are attempting several approaches in this area the basic
policy difference is in how complaints of abuse and neglect are dealt
with and screened into or out of the CPS system. In some instances
responses to reports of child abuse and neglect may result in greater
family support and services to address the underlying causes.
Another innovation to be examined under reauthorization is Family
Group DecisionMaking (FGDM). FGDM offers a new approach to working with
families involved with the child welfare system. Families are engaged
and empowered by child welfare agencies to make decisions and develop
plans that protect and nurture their children from enduring further
abuse and neglect. The FGDM approach recognizes that families are the
experts of their own situation, and therefore, are able to make well-
informed decisions about their circumstances.
We propose that the committee examine ways to assist States in
developing policies and procedures which encourage the development of
differential, multiple responses for referral of families and children
not at risk of imminent harm to a community organization or voluntary
prevention services; and policies and procedures encouraging the
involvement of families in decisionmaking pertaining to cases of abuse
and neglect of children.
Again, additional funds must be increased if the committee is
serious about making improvements in child abuse prevention, even if
such funding is suggested as a pilot or experimental use.
The Disproportional Representation of Children of Color and Ethnic
Groups in the System
CAPTA reauthorization also offers policymakers an opportunity to
address the issue of disproportionality and disparate outcomes in the
child welfare population. A recent study issued by the Government
Accountability Office (GAO) found that while African-American children
make up only 15 percent of the national child population, they
represent 34 percent of the foster care population.\10\ Similar
statistical profiles exist for Native American and Hispanic children in
certain States or parts of the country when there is a higher
concentration of Native Americans and Hispanic populations.
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\10\ U.S. Government Accountability Office. (2007). African-
American Children in Foster Care: Additional HHS Assistance Needed to
Help States Reduce the Proportion in Care. [GAO-07-816.] Washington,
DC: Author
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The Congressional Research Service (CRS) \11\ and GAO have found
that there are several factors contributing to a disproportionate
number of African-American children entering and remaining in foster
care, including bias or cultural misunderstandings between child
welfare decisionmakers and the families they serve. GAO noted in its
study that in all of the States they visited a lack of adequate support
services contributed to disproportionality and disparate outcomes. The
report notes ``GAO was told that poorer families without access to
supportive services may have a more difficult time weathering problems
of substance abuse or emotional issues.''
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\11\ Congressional Research Service. (2005). Race Ethnicity and
Child Welfare. Washington, DC: Author.
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CAPTA may provide a way to reduce the over representation of
certain children in the entire child welfare system through the use of
family group decisionmaking, deferential response, home visitation, and
other emerging practices. If policymakers only deal with this fact when
children are already in foster care or being moved toward adoption,
then we will have missed the key avenue to address this, when children
enter care.
The White House Conference on Children and Youth
CWLA indicated in its opening comments that the best ways to ensure
that children are safe from all forms of maltreatment are
comprehensive, community-based approaches to protecting children and
supporting and strengthening families.
We believe any action you take on this reauthorization as well as
any action that may be taken to reform the title IV-E programs will not
be enough. That is not a reflection on Congress or your efforts but it
is a reality that whatever happens in Washington can only be complete
if there is engagement and commitment from communities all across
America.
To be sure, CWLA believes the Federal Government could be doing
much more in the area of child welfare, including greater investment of
Federal dollars in the system. That includes investment for prevention
and it also means a commitment to children already in care and families
struggling to come back together. Commitment to the front end of
services should not be conditioned on a lack of commitment at the other
end or parts of the system.
CWLA also recognizes that dollars and Federal action alone cannot
reduce the level of child abuse or the number of children in foster
care. This has to be a partnership at the Federal, State and local
levels. It is for that reason that late last year CWLA called on
Congress to act to restore the oldest White House Conference, the White
House Conference on Children and Youth and to focus it on these most
vulnerable families and children.
There are now twin bills in Congress. In the House, H.R. 5461 has
been introduced by Congressman Chaka Fattah (D-PA) and Congressman Jon
Porter (R-NV) along with its 50 other cosponsors, and on the Senate
side, S. 2771 has been introduced by Senator Mary Landrieu (D-LA) and
Senator Chuck Hagel (R-NE) along with more than a dozen other sponsors
including the Chair of this subcommittee and several other HELP
Committee members.
This Conference was once held every 10 years but has not been held
since President Nixon called it in 1970. Its results have been
noteworthy. We listed earlier its call for the creation of a Children's
Bureau in 1909 and the Bureau's mission in regards to child protection.
It should also be of interest to this subcommittee that one of the
results of the 1970 convening was a recommendation to create a
designated Senate committee on children's issues and we are sure the
members of this subcommittee recognize their own value over the years
since.
The White House Conference would be, like its cousin the Conference
on Aging, a 2-year event. In 2009, there would be several focused State
and national meetings. In addition to official meetings, the policy
committee that the legislation establishes would provide an opportunity
for communities and States to organize their own focused events
resulting in perhaps hundreds of meetings across the country. Meetings
and events that would allow systems of health and mental health,
providers of housing, substance abuse treatment experts, social service
providers, schools, churches as well as other parts of the child
welfare community to open a dialogue on how their cities and
neighborhoods can come together to address these needs of these
families in crisis. If we can get it right for our most vulnerable
children and families we can get it right for all. Only after all of
these voluntary efforts and official gatherings would there then be a
national gathering or convention at the White House.
We urge the subcommittee and the full committee to act on this
legislation this year. It is bipartisan and bicameral and offers
Congress an opportunity to reach beyond the politics of this year. But
there is a much more significant reason for this White House
Conference. It represents a vision of how communities can come together
all across the country to engage in a discussion of not just needed
Federal support but local community action; how systems can coordinate
and communicate to prevent abuse and neglect wherever possible; and
when not possible how to act in the best interest of the child so that
he or she has a permanent and loving family.
The Child Welfare League of America thanks the subcommittee for
these hearings and its attention and we look forward to working with
you on these key issues.
Prepared Statement of Sue Else, President, National Network to End
Domestic Violence (NNEDV)
Chairman Dodd, Ranking Member Alexander and members of the
subcommittee, thank you for the opportunity to submit written testimony
for this hearing on the reauthorization of the Child Abuse Prevention
and Treatment Act (CAPTA). We are grateful to the subcommittee for your
leadership and your ongoing work to improve the safety and well-being
of children and families across the Nation. The National Network to End
Domestic Violence (NNEDV) is a membership and advocacy organization
representing the 55 State and U.S. territory domestic violence
coalitions. NNEDV is the voice of these coalitions, there are more than
2,000 local domestic violence member programs, and the millions of
domestic violence survivors who turn to them for services. In their
work with victims and their families, our members see the impact that
abuse and violence have on the lives of children who are vulnerable
both as witnesses to violence and as victims themselves. In order to
address this violence and keep children and families safe, we support
the reauthorization of CAPTA as well as the Family Violence Prevention
and Services Act (FVPSA), legislation that has historically been
included in CAPTA. We hope to work with the subcommittee to ensure that
these critical Federal programs are reauthorized and strengthened to
address the needs of children and families.
family violence and children: the need to address both in capta
Domestic violence is a pervasive public health issue that affects
one in four women in their lifetime.\1\ It is estimated that a
staggering 15.5 million children are exposed to domestic violence every
year \2\ and slightly more than half of female victims of intimate
partner violence live in households with children under the age of
12.\3\ One-half to two-thirds of the residents of domestic violence
shelters are children. In 2007, the National Census of Domestic
Violence Services found that in one 24-hour period, 13,485 children
were living in a domestic violence shelter or transitional housing
facility, while another 5,526 received services at non-residential
programs.\4\
Too often children who witness abuse are victimized as well.
Research has found that over 50 percent of batterers physically abuse
their children versus only 7 percent of non-batterers.\5\ A batterer is
four to six times more likely than a non-batterer to sexually abuse his
children.\6\ According to research from the Bureau of Justice
Statistics, 96 percent of sexual assault survivors under the age of 12
and 85 percent of those ages 12 to 17 were raped by family members,
friends or acquaintances.\7\
Exposure to domestic violence causes other emotional and physical
problems among children. They are more likely than children who are not
exposed to domestic violence to attempt suicide, abuse drugs and
alcohol, run away from home, engage in teenage prostitution,\8\ and
exhibit behavioral and physical health problems including depression,
anxiety, and violence towards peers.\9\ The cycle of violence is
perpetuated as children witness violence and become perpetrators
themselves. Children who witness spousal assault and who have also been
the victims of parental assault are six times more likely to assault
other children outside their family.\10\ One study found that men
exposed to physical abuse, sexual abuse and adult domestic violence as
children were almost four times more likely than other men to have
perpetrated domestic violence as adults.\11\ Nearly half a million 14-
to 24-year-olds leave the juvenile justice system, Federal or State
prisons or local jails annually, and a high percentage of them have
experienced or witnessed violence at home.\12\
The high rate of co-occurrence of domestic violence and child abuse
demands that we have an integrated approach to addressing the needs of
both children and non-abusing parents. Therefore CAPTA must take steps
to address the needs of victims of domestic violence and FVPSA must be
improved to better meet the needs of children and families, especially
in underserved communities.
addressing domestic violence in capta
It is critical that the child welfare system ensure the safety of
both children and their parents who are victims of domestic violence.
Too often parents who are victims of domestic violence are re-
victimized by the child welfare system when it does not recognize the
dynamics of domestic violence and labels the non-abusive partner as a
child abuser. This in turn can cause further trauma for children and
families who may be separated rather than being able to focus on
supporting each other. When making provisions for services to children
exposed to domestic violence, child welfare programs need to also
support the care-giving role of victims of domestic violence. This is
essential to both the safety and well-being of the child as well as the
non-abusive parent. More data is needed to understand the co-occurrence
of this violence and to provide context and a deeper understanding of
the relationship between victims' experiences of violence and mental
health and substance abuse. In addition, training and education about
domestic violence must be provided at all levels of child welfare
agencies in order for these agencies to effectively address the needs
of the family where there is co-occurrence. CAPTA should also
standardize consultation with domestic violence experts within the
child welfare system and other programs dealing with child abuse, as
well as provide funding for consultations. Finally, it is important
that changes be made so that victims of domestic violence are not
entered into child abuse databases simply because they are victims.
Entering domestic violence victims into these databases is an
inaccurate practice that may jeopardize a victim's safety and can
seriously impede their ability to secure future employment.
There are promising examples of work on these intersections in the
field. In Connecticut, the Safe Families, Safe Homes curriculum has
been used to provide cross-training for Head Start Family Services
Staff on issues of domestic violence, child welfare and mental health
and substance abuse, enabling them to have a better understanding of
how these issues affect families coming into contact with the system.
In addition, the Connecticut Department of Children and Families has
supported the Devereaux Early Childhood Assessment (DECA) training
program that focuses on preventing abuse and violence by increasing
protective factors for children and supporting parents and children who
may be experiencing abuse.
NNEDV is a member of the National Child Abuse Coalition and we
support legislative proposals that have been developed with our
coalition partners in order to address these issues. We would like to
work with the subcommittee to ensure that these provisions are included
in the reauthorization.
fvpsa: keeping families and children safe
In order to ensure the safety of children and families, we also
encourage the subcommittee to include as part of CAPTA legislation a
reauthorization of FVPSA with improvements to better serve victims' and
children's needs. Thanks to the leadership of Chairman Dodd and other
members of the subcommittee, FVPSA was enacted by Congress in 1984 in
order to address public awareness and prevention of family violence,
provide services for victims and their dependents, and provide training
and resources to local agencies and nonprofit organizations working to
address domestic violence. Thanks to the ongoing leadership of this
subcommittee, reauthorization of FVPSA has been included in four
reauthorizations of CAPTA: the Child Abuse Prevention, Adoptions, and
Family Services Act of 1988; Child Abuse, Domestic Violence, Adoption,
and Family Services Act of 1992; Child Abuse Prevention and Treatment
Act Amendments of 1996; and, the Keeping Children and Families Safe Act
of 2003. FVPSA is administered by the Department of Health and Human
Services (HHS) Administration on Children and Families, and for over
two decades it has been the lifeblood of core domestic violence
programs, including shelters and outreach programs, in communities
nationwide. FVPSA includes three central programs: Formula Grants for
Shelter and Services; Community Initiatives to Prevent Abuse, which is
frequently referred to as Domestic Violence Prevention Enhancement and
Leadership Through Alliances (DELTA) Grants; and, the National Domestic
Violence Hotline. Working together, these FVPSA programs have made
significant progress toward ending domestic violence and keeping
families and communities safe. However, there are steps that should be
made to build on the success of FVPSA and improve services for victims
and their children.
the need for fvpsa-funded services for families
Despite the progress and success brought by FVPSA, a strong need
remains for FVPSA-funded services for victims. Research has shown that
one in every four women will experience domestic violence during her
lifetime.\13\ To respond to this pervasive public health issue, there
are over 2,000 community-based domestic violence programs for victims
and their children. These programs offer services such as emergency
shelter, counseling, legal assistance, and preventative education to
millions of women, men and children annually.\14\ The National Census
of Domestic Violence Services found that in one 24-hour time period
domestic violence programs across the Nation served over 53,200 women,
men and children. Unfortunately, due to a lack of resources, 7,707
requests for services were unmet during that same day.\15\ It is
critical that more victims be able to access these services because
they are effective at reducing violence and saving lives. Research
shows that shelter programs are among the most effective resources for
victims with abusive partners \16\ and that staying at a shelter or
working with a domestic violence advocate significantly reduced the
likelihood that a victim would be abused again and improved the
victim's quality of life.\17\ These programs keep children and their
non-abusive parents safe and allow families to rebuild their lives
after crisis.
key programs authorized in fvpsa
FVPSA State Formula Grants
Administered through the HHS, the FVPSA Formula Grants provide
funding to States, Territories and Tribes to support domestic violence
services in their communities using a population-based formula. FVPSA
Formula Grants enable communities to respond with lifesaving emergency
assistance when victims of domestic violence and their families reach
out for help. Over the past 30 years, shelters and local programs have
evolved to provide a wide spectrum of residential and nonresidential
services, which can include shelter or transitional housing, safety
planning, counseling, legal services, child care and services for
children, career planning, life skills training, community education
and public awareness, and other necessities such as clothing, food, and
transportation.
In addition, the FVPSA Formula Grants support essential resource
centers, institutes, and State, territorial and tribal coalitions that
help local programs and grantees better meet community needs. Despite
receiving only a small share of FVPSA funds, these programs ensure a
coordinated response to domestic violence, address emerging issues,
provide technical assistance to FVPSA grantees, train community
members, and meet the needs of underserved communities.
DELTA Grants
In addition to supporting emergency services through local programs
and shelters, FVPSA includes the Community Initiatives to Prevent
Abuse, which is also known as Domestic Violence Prevention Enhancement
and Leadership Through Alliances (DELTA) Grants program to expand
community-based primary prevention that address the underlying causes
of domestic violence in order to stop abuse before it starts. DELTA is
administered by the Centers for Disease Control and Prevention,
National Center for Injury Prevention and Control, and it is one of the
few funding sources for primary prevention work. DELTA programs are
guided by the principles of preventing violence through evidence-based
programs that are evaluated to inform future program planning. They use
innovative strategies including peer education programs for men about
family and relationships, community change initiatives focused on
engaging men in prevention efforts, school-based education to prevent
youth bullying that often carries into adulthood, and youth-led
initiatives to prevent dating violence and promote healthy
relationships.
National Domestic Violence Hotline
FVPSA also includes the National Domestic Violence Hotline, a 24-
hour, confidential, toll-free hotline, located in Texas. Using a
multifaceted telecommunications system, Hotline advocates immediately
connect the caller to a service provider in his or her area. Highly
trained Hotline advocates provide support, information, referrals,
safety planning, and crisis intervention to hundreds of thousands of
domestic violence victims and perpetrators. Through a national
database, advocates can link callers to more than 5,000 local shelters
and other service providers across the country that offer a wide range
of services to support and respond to victims' needs. Since opening in
1996, the National Domestic Violence Hotline has received over 1.8
million calls from individuals in need of support and assistance and it
now provides services in more than 170 languages. The Hotline averages
19,700 calls a month, and in 2007 the Hotline experienced a 10 percent
increase in the number of calls received. More than 60 percent of
callers report that this is their first call for help. Unfortunately,
in 2007 over 29,000 of those calls (14 percent of the total) went
unanswered due to a lack of resources.
In 2007, the Hotline launched the loveisrespect National Teen
Dating Abuse Helpline with support from Liz Claiborne Inc. One in five
high school females reports being physically and/or sexually abused by
a dating partner.\18\ This toll-free telephone resource was created to
help teens (ages 13-18) who are experiencing dating abuse and is the
only teen dating abuse helpline in the country serving the 50 States,
Puerto Rico, and the Virgin Islands.
addressing children's and families' needs in fvpsa reauthorization
FVPSA is scheduled to expire at the end of this year and immediate
congressional action is needed to reauthorize this critical legislation
and continue the progress we have made toward ending domestic violence
and protecting the lives of thousands of victims and their children who
come forward each day for help. Reauthorizing FVPSA presents an
exciting opportunity to stop violence before it starts and meet the
needs of underserved communities while continuing proven, successful
strategies. Our priorities for reauthorization include:
1. Maintain successful response to victims of domestic violence.
FVPSA has been intervening in and preventing domestic violence since it
was first authorized in 1984. It funds essential services that are at
the core of our Nation's work to end domestic violence: emergency
shelters, hotlines, counseling and advocacy, primary and secondary
prevention--immediate crisis response and the comprehensive support to
help victims put their lives back together. The reauthorization of
FVPSA must continue to support this successful approach to meeting the
needs of victims and their families.
2. Better addressing the needs of underserved victims. Underserved
victims, such as those with mental illnesses or disabilities, have
special needs that are not always met by traditional service providers
struggling to maintain enough funding to keep their doors open.
Throughout the statute, language should be more inclusive of children
and youth as well as victims from underserved populations. Victims from
marginalized racial, ethnic, and religious populations may not feel
safe reaching out for help beyond their communities because of pressure
from family, shame from their religious institutions and fear of
consequences from violating community values and norms. Furthermore,
service providers from marginalized communities often struggle to
access Federal funds. FVPSA reauthorization should dedicate a percent
of funding from the formula grants for culturally specific programs to
meet their needs.
3. Increasing access to funds for community-based programs.
Community-based (including faith-based) programs should have more
access to FVPSA funds in order to improve the diversity of available
services and create more options for victims to find safety. Outside of
the formula grants, a new pilot project designed to build community
capacity to provide both services and prevention should be created. In
addition, a new grant program called REACH should be created to support
evidence-based pilot projects to deliver critical services to victims
in underserved communities. REACH is modeled on other programs at the
Department of Health and Human Services and will bring services to
victims who might otherwise never seek help.
4. Enhancing children's services. FVPSA currently includes a set-
aside for children's services if appropriations reach $130 million, but
it is largely undefined. Battered women's shelters and domestic
violence programs provide safety and support for children, but struggle
to meet the demand for children's services. They see the needs of
children who are recovering from the trauma of witnessing or
experiencing abuse and they are eager to implement new and expanded
children's programming. FVPSA reauthorization should enhance children's
services and distribute funding efficiently to States and communities
to better meet these needs.
5. Improving the State planning process. FVPSA uses a State
planning process that is intended to bring together service providers,
experts, and other stakeholders to develop a plan for delivering
services throughout the State. Not all States and FVPSA State
administrators take advantage of this process to fully evaluate the
needs and create an effective plan. The State planning process used to
distribute FVPSA Formula Grants to local programs and the
administration of those grants should be improved to be more responsive
and accountable to grantees, advocates, and legislators alike.
6. Strengthening the provision of technical assistance to help meet
community needs. FVPSA currently funds several national resource
centers, culturally specific institutes, State coalitions, and Tribes
to ensure a coordinated response to domestic violence and respond
quickly to emerging issues. As FVPSA makes continued progress
addressing domestic violence, grantees and communities face new
challenges and need access to training and technical assistance on the
most up-to-date resources, models and research. To continue this and
improve the provision of technical assistance, the language authorizing
the institutes and resource centers should be restructured and combined
with dedicated funds.
7. Defining and expanding the focus on prevention in the DELTA
grants program. DELTA grants have made bold strides to prevent domestic
violence from ever happening by changing community and personal
attitudes about relationships and abuse. Community collaborations
funded by DELTA have produced innovative models that can be adapted and
replicated to strengthen domestic violence prevention efforts. In order
to leverage the successes and lessons learned thus far, the DELTA
grants should be statutorily defined and expanded to include a
secondary-prevention component.
8. Maintaining the Hotline and leveraging its strengths to address
teen dating violence. When a victim of domestic violence has the
courage to pick up the phone and seek help, it is imperative that
someone is on the other end of the line and is able to connect her with
resources and safety for herself and her family. The National Domestic
Violence Hotline should be maintained in order to respond to the
growing number of victims who are coming forward for help. In addition,
the Hotline should have the opportunity to build on its strengths and
expand its focus to include teen dating violence through the
loveisrespect National Teen Dating Abuse Helpline.
9. Re-organize and update the statute. The FVPSA code has been
significantly amended 6 times over the last 24 years and is now
difficult to interpret and language in some part of the bill is
antiquated. This reauthorization provides an opportunity to reorganize
the statute in a more logical fashion and update the language to
reflect current and emerging best practices. Doing so will ensure that
the legislation is more consistent and easier for HHS to implement and
Congress to oversee.
10. Increase the authorization levels of FVPSA programs. In order
to build on the success of FVPSA and continue to meet the needs of
victims and their families, programs need increased authorizations.
FVPSA Formula Grants to States should be authorized at $225 million.
Within this authorization there should be set-asides for grants to
Tribes, State and Territorial Domestic Violence Coalitions, and
Technical Assistance and Training Centers, as well as defined set-
asides for children's services and grants to underserved communities
that begin when funding reaches the level of $130 million. In order to
provide services to the increasing number of victims reaching out for
help, the National Domestic Violence Hotline should be authorized at $7
million annually. The DELTA grants must be authorized at $20 million,
with specific funding set-aside for community grants when
appropriations reach $8 million. In addition, $15 million should be
authorized to support the REACH grant program to create pilot projects
reaching victims in underserved communities.
conclusion
As a coalition of domestic violence advocates and service
providers, we recognize the critical need to address domestic violence
and child abuse in order to keep children and families safe. The cost
of intimate partner violence exceeds $5.8 billion each year, of which
$4.1 billion is for direct medical and mental health care services.\19\
Without effective intervention, this violence will repeat itself and
continue to impact successive generations. The reauthorization of CAPTA
provides an important opportunity to respond to the intersections of
domestic violence and the child welfare system as well as continue the
progress FVPSA has made toward meeting the needs of domestic violence
victims and their children. Together CAPTA and FVPSA can break the
cycle of violence affecting our children, families and communities. We
look forward to working with the subcommittee to reauthorize this
critical legislation and continue progress toward ending domestic
violence.
Endnotes
1. Tjaden, Patricia & Thoennes, Nancy. National Institute of
Justice and the Centers of Disease Control and Prevention, ``Extent,
Nature and Consequences of Intimate Partner Violence: Findings from the
National Violence Against Women Survey,'' 2000. The Centers for Disease
Control (CDC) (2008). Adverse Health Conditions and Health Risk
Behaviors Associated with Intimate Partner Violence, United States,
2005.
2. McDonald, R., et al. (2006). ``Estimating the Number of American
Children Living in Partner-Violence Families.'' Journal of Family
Psychology, 30 (1), 137-142.
3. Greenfeld, Lawrence, et al. ``Violence by Intimates: Analysis of
Data on Crimes by Current or Former Spouses, Boyfriends and
Girlfriends,'' Bureau of Justice Statistics Factbook, Washington, DC:
U.S. Department of Justice, Bureau of Justice Statistics, March 1998.
4. Domestic Violence Count 07: A 24-Hour Census of Domestic
Violence Shelters and Services Across the United States. The National
Network to End Domestic Violence. (Jan. 2008).
5. Straus, M. ``Ordinary Violence, Child Abuse, and Wife-Beating:
What Do They Have in Common? '' In D. Finkelhor, R.J. Gelles, G.T.
Hotaling, and M.A. Straus (Eds.) The Dark Side of Families: Current
Family Violence Research Beverly Hills: Sage, 1983.
6. Bancroft, Lundy R., ``The Connection Between Batterers and Child
Sexual Abuse Perpetrators,'' Unpublished article, precursor to Chapter
Four of ``The Batterer as Parent,'' Sage Publications, 1997.
Herman, Judith, M.D. Father-Daughter Incest Harvard University
Press, 1981; McCloskey, L.A., Figueredo, A.J., and Koss, M. ``The
Effect of Systemic Family Violence on Children's Mental Health'' Child
Development No. 66, pgs. 1239-1261; Paveza, G. ``Risk Factors in
Father-Daughter Child Sexual Abuse'' Journal of Interpersonal Violence
3 (3), Sept. 1988, pgs. 290-306; Sirles, E. and Franke, P. ``Factors
Influencing Mothers' Reactions to Intrafamily Sexual Abuse'' Child
Abuse and Neglect Vol. 13, pgs. 131-139.
7. Bureau of Justice Statistics, Child Rape Victims, (1994).
8. Wolfe, D.A., Wekerle, C., Reitzel, D. and Gough, R.,
``Strategies to Address Violence in the Lives of High Risk Youth.'' In
Peled, E., Jaffe, P.G. and Edleson, J.L. (eds.), Ending the Cycle of
Violence: Community Responses to Children of Battered Women. New York:
Sage Publications. 1995.
9. Jaffe, P. and Sudermann, M., ``Child Witness of Women Abuse:
Research and Community Responses,'' in Stith, S. and Straus, M.,
Understanding Partner Violence: Prevalence, Causes, Consequences, and
Solutions. Families in Focus Services, Vol. II. Minneapolis, MN:
National Council on Family Relations, 1995.
10. Widom, C (1989) ``Does Violence Beget Violence? ''
Psychological Bulletin. 106: 3-28.
11. Greendfeld, L.A. (1997). Sex Offences and Offenders: An
Analysis of Date on Rape and Sexual Assault. Washington, DC Bureau of
Justice Statistics, U.S. Department of Justice.
12. Rosewater, A., ``Promoting Prevention, TargetingTeens: An
Emerging Agenda to Prevent Domestic Violence,'' Family Violence
Prevention Fund (2003), 21.
13. Tjaden, Patricia & Thoennes, Nancy. National Institute of
Justice and the Centers for Disease Control and Prevention, ``Extent,
Nature and Consequences of Intimate Partner Violence: Findings from the
National Violence Against Women Survey.'' 2000.
14. National Coalition Against Domestic Violence, Detailed Shelter
Surveys (2001).
15. Domestic Violence Counts 07: A 24-Hour Census of Domestic
Violence Shelters and Services Across the United States. The National
Network to End Domestic Violence. (Jan. 2008).
16. See: Bennett, L., Riger, S., Schewe, P., Howard, A., & Wasco,
S. (2004). Effectiveness of hotline, advocacy, counseling and shelter
services for victims of domestic violence: A statewide evaluation.
Journal of Interpersonal Violence, 19(7), 815-829; Bowker, L.H., &
Maurer, L. (1985). The importance of sheltering in the lives of
battered women. Response to the Victimization of Women and Children, 8,
2-8; Gordon, J.S. (1996). ``Community Services for Abused Women: A
Review of Perceived Usefulness and Efficacy.'' Journal of Family
Violence 11(4): 315-329; Sedlak, A.J. (1988). Prevention of wife abuse.
In V.B. Van Hasselt, R.L. Morrison, A.S. Bellack, & M. Hersen (Eds.),
Handbook of Family Violence (pp. 319-358). NY: Plenum Press; Straus,
M.A., Gelles, R.J., & Steinmetz, S.K. (1980). Behind Closed Doors:
Violence in the American Family. NY: Anchor Press; Tutty, L.M., Weaver,
G., & Rothery, M. (1999). Residents' Views of the Efficacy of Shelter
Services for Assaulted Women. Violence Against Women, 5(8), 898-925.
17. See: Berk, R.A., Newton, P.J., & Berk, S.F. (1986). What a
Difference a Day Makes: An Empirical Study of the Impact of Shelters
for Battered Women. Journal of Marriage and the Family, 48, 481-490;
Bybee, D.I., & Sullivan, C.M. (2002). The Process Through Which a
Strengths-Based Intervention Resulted in Positive Change for Battered
Women Over Time. American Journal of Community Psychology, 30(1), 103-
132; Constantino, R., Kim, Y., & Crane, P.A. (2005). Effects of a
Social Support Intervention on Health Outcomes in Residents of a
Domestic Violence Shelter: A Pilot Study. Issues in Mental Health
Nursing, 26, 575-590; Goodkind, J., Sullivan, C.M., & Bybee, D.I.
(2004). A Contextual Analysis of Battered Women's Safety Planning.
Violence Against Women, 10(5), 514-533; Sullivan, C.M. (2000). A model
for effectively advocating for women with abusive partners. In J.P.
Vincent & E.N. Jouriles (Eds.), Domestic Violence: Guidelines for
Research-Informed Practice (pp. 126-143). London: Jessica Kingsley
Publishers; Sullivan, C.M., & Bybee, D.I. (1999). Reducing Violence
Using Community-Based Advocacy for Women With Abusive Partners. Journal
of Consulting and Clinical Psychology, 67(1), 43-53.
18. Jay G. Silverman, Ph.D.; Anita Raj, Ph.D.; Lorelei A. Mucci,
MPH; and Jeanne E. Hathaway, M.D., MPH, ``Dating Violence Against
Adolescent Girls and Associated Substance Use, Unhealthy Weight
Control, Sexual Risk Behavior, Pregnancy, and Suicidality,'' Journal of
the American Medical Association, Vol. 286, (No. 5, 2001).
19. Costs of Intimate Partner Violence Against Women in the United
States. (2003). Centers for Disease Control and Prevention, National
Centers for Injury Prevention and Control, Atlanta, GA.
Prepared Statement of the Family Violence Prevention Fund
As an organization represented by the National Child Abuse
Coalition, we support the recommendations included in the testimony of
the Coalition. However, we would like to take this opportunity to
highlight and expand upon the recommendation regarding increased
recognition of the role domestic violence plays in child abuse and
neglect and the importance of addressing domestic violence to improve
the safety and well-being of children and their non-abusing parents.
children exposed to domestic violence
In the United States, we know that about 15.5 million children are
exposed to domestic violence every year \1\ and that that exposure can
have severe and long lasting consequences. Children exposed to domestic
violence are far more likely to exhibit behavior and physical health
problems including depression, anxiety and violence toward peers.\2\ In
addition they are more likely to attempt suicide, abuse drugs and
alcohol, run away from home, engage in teenage prostitution and commit
sexual assault crimes.\3\ At the same time, children's responses to
exposure to domestic violence vary depending on age and circumstances;
many children are resilient.\4\ Importantly, we also know that when
provided appropriate services, particularly when in partnership with
their non-abusing parent or caretaker, children exposed to domestic
violence can go on to live lives full of purpose and free from violence
and many of the adverse outcomes associated with that violence.
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\1\ McDonald, R., et al. (2006) Estimating the Number of American
Children Living in Partner-Violent Families. Journal of Family
Psychology, 30(1), 137-142.
\2\ Jaffe, P. and Sudermann, M., ``Child Witness of Women Abuse:
Research and Community Responses,'' in Stith, S. and Strauss, M.,
Understanding Partner Violence: Prevalence, Causes, Consequences and
solutions. Families in Focus Services, Vol. II. Minneapolis, MN:
National Council on Family Relations, 1995.
\3\ Wolfe, D.A., Wekerle, C., Reitzel, D. and Gough, R.,
``Strategies to Address Violence in the Lives of High Risk Youth.'' In
Peled, E., Jaffe, P.G. and Edleson, J.L. (eds.), Ending the Cycle of
Violence: Community Responses to Children of Battered Women. New York:
Sage Publications, 1995.
\4\ Edleson, , J.L. (1999). The Overlap Between Child Maltreatment
and Woman Battering. Violence Against Women, 5(2), pp. 134 to 154.
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Domestic violence affects between 30 and 60 percent of families
involved in the child welfare system.\5\ However those who work in the
child welfare system rarely have systemic training on domestic violence
or even have a full understanding of how widespread it is among their
client families. In addition, when child protection systems do attempt
to address domestic violence, they often seek to impose blanket
policies that apply to all victims of domestic violence and frequently
blame the non-abusing parent or caretaker for the violence perpetrated
on her by another. These policies have now been shown to be illegal in
some States \6\ and impractical and unhelpful in others,\7\ however
good practice and policy is only now beginning to emerge. Given these
realities it is critical that the reauthorization of the Child Abuse
Prevention and Treatment Act significantly increase the knowledge of,
training around and resources to support innovative child abuse
prevention strategies that address the overlapping issues of domestic
violence and child maltreatment.
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\5\ Appel, A.E. and Holden, G.W. (1998). The Co-Occurrence of
Spouse and Physical Child Abuse: A Review and Appraisal. Journal of
Family Psychology, 12(4), pp. 578 to 599. Edleson, J.L. (1999). The
Overlap Between Child Maltreatment and Woman Battering. Violence
Against Women, 5(2), pp. 134 to 154.
\6\ See especially Nicholson v. Scoppetta 181 F Supp2d (EDNY 2002);
Nicholson v. Scoppetta 3 NY3d 357, 366 (2004).
\7\ Edleson, J., et al. Defining Child Exposure to Domestic
Violence as Neglect: Minnesota's Difficult Experience. Social Work,
Volume 51, Number 2, April 2006.
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Specifically, we suggest CAPTA be amended to include a focus on:
Increasing the availability of good data on the overlap of
domestic violence and child maltreatment and successful policies,
procedures and services that improve safety and well-being for children
and their non-abusing parents and caretakers;
Providing expertise to child protection systems and
workers on domestic violence and how to work successfully and safely
with families where there is domestic violence, including safety and
risk assessment, case consultation, co-location of domestic violence
staff and safe approaches to family group conferencing;
Funding for cross-training and collaboration so domestic
violence and child welfare systems can work better together to improve
safety and well-being for children and their mothers;
Ensuring that CAPTA funding is available to support
services for mothers and their children together, when that is most
appropriate; and
Increasing the awareness of and skills pertinent to
addressing the roles of fathers in the lives of children involved in
the child welfare system.
good data collection
The National Child Abuse and Neglect Data System (NCANDS) is the
basic vehicle that provides information about children and families who
come to the attention of local child welfare agencies. It is
increasingly apparent that, among other issues, domestic violence is a
characteristic of a large percentage of these families. While not
everything about a family's circumstances is known at the time of the
report, in many instances the presence of domestic violence in a family
may come to light during the report and investigation phases or at
decision points related to service provision or placement. Yet to date,
NCANDS provides very little if any information about domestic violence
and the context and impact of domestic violence in its annual reports.
Specifically, we recommend the collection and dissemination of data on:
The Relationship Between Domestic Violence and Categories of
Maltreatment
First, NCANDS breaks maltreatment into various categories.
Ideally we would want to identify in what percentage of reports,
substantiations and victimization, for each different category of
maltreatment, domestic violence is a factor. Community experience
suggests that often, exposure to domestic violence may automatically be
considered ``failure to protect'' by the mother and categorized as
``neglect.'' It would help if NCANDS could differentiate whether
neglect (or other maltreatment categories, including ``other'' ) are
being used as a ``proxy'' for a ``failure to protect'' or similar
allegation (not all States use the same terms).
Another reason it is important to distinguish which types
of maltreatment cases come to child welfare as a result of, or
accompanied by, domestic violence is that most reports or petitions are
filed in the mother's name, automatically ascribing the maltreatment to
her and making her the sole subject for compliance with case plans.
However in many instances she may not be an offender against a child
but may, indeed, be a victim of violence perpetrated by her partner,
and what she most requires is support, protection and the ability to
keep her child(ren) with her safely. Without clearer information that
helps identify these distinctions, it is difficult to develop or target
responses and services appropriately either to the non-offending
caretaker or her children.
Over time, NCANDS has improved its ability to display
factors that contribute to substantiation rates. In addition to
analyzing domestic violence from the various categories of maltreatment
reports, NCANDS should tease out whether and how domestic violence
factors into case substantiation or non-substantiation.
Finally, as an increasing number of States and counties
institute some type of multiple or differential response system, it
will be important to know if families with co-occurring domestic
violence are provided that alternative and also whether they have
repeat reports of maltreatment after the diversion to alternative
services.
With NCANDS we would also seek to find out:
the relationship between domestic violence and child
fatalities,
who the perpetrator is in cases of domestic violence,
the nature and extent of the services that are provided to
these families,
for families with co-occurring domestic violence who are
provided alternative response, the nature of the agenc(ies) to which
they were referred and whether or not the services were utilized, and
what percentage of cases where domestic violence is a
factor in removal and whether there are other characteristics
associated with the domestic violence that leads to the decision to
place a child outside of his/her home.
the emergence of best practices to address co-occurrence of domestic
violence and child abuse and neglect
For about 8 years the U.S. Departments of Health and Human Services
and Justice have pooled very limited resources to try and implement
best practices around the intersections of children welfare, domestic
violence and family courts. Through a demonstration initiative
nicknamed the ``the Greenbook'' (after the cover of the seminal
publication outlining recommendations for doing this collaborative
work), six test sites were funded and an evaluation conducted. From
this effort, new insights were developed about how best to improve
outcomes for children in families experiencing domestic violence.\8\
While many specific recommendations have been further developed and
refined based on the experiences of these sites, we would like to focus
here on two critical practice elements specific to CAPTA: (1) training
and education on domestic violence is critical to help already
overburdened CPS systems and case workers make good decisions and (2)
that the needs of abused mothers and their children cannot be
separated, despite funding streams and services systems that inherently
separate their interests.
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\8\ Known as the Greenbook Initiative, these recommendations were
initially developed and published by the National Council of Juvenile
and Family Court Judges (NCJFCJ) in 1999, in Effective Interventions in
Domestic Violence and Child Maltreatment Cases: Guidelines for Policy
and Practice. For the most up-to-date research and analysis from the
demonstration sites, go to www.thegreenbook.info.
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The Need for Domestic Violence Expertise
After several years of attempting to find one model that worked for
creating the information sharing, training and technical assistance
needed to better serve these families, we have concluded that there is
no one single right model for every system. But we have also learned
that it is absolutely ESSENTIAL that child protection systems have
access to expertise on helping families who are experiencing domestic
violence. Two common forms this has taken are the co-location of
staff--for instance, the placement of a domestic violence advocate in a
child protection agency (often referred to as a ``domestic violence
specialist'' ) \9\--and case consultations where supervisors or
technical experts are brought in to consult on particularly challenging
cases with domestic violence or where they may provide ongoing training
and technical assistance to staff that turn over on a regular basis.
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\9\ Rosewater, Ann for the National Council of Juvenile and Family
Court Judges and the Family Violence Prevention Fund (2008), Building
Capacity in Child Welfare Systems: Domestic Violence Specialists. See
also, Taggart, Shellie and Litton, Lauren for the National Council of
Juvenile and Family Court Judges and the Family Violence Prevention
Fund, Reflections from the Field: Considerations for Domestic Violence
Specialists (in press).
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The need for this additional expertise stems from the fact that
families experiencing domestic violence face particularly complex
challenges. While violence may be linked to other risk factors, such as
substance abuse or mental health issues, it often may present its own
threats. For instance, a caseworker may know a mother is being abused
and insist that she not let the child be alone with her abusive
partner. The courts, however, may have granted him unsupervised
visitation and she would be in violation of her custody agreement if
she refused to deliver the child to him unsupervised. By having a
domestic violence expert on hand, the caseworker may be able to see
that the woman gets advocacy and legal services to help change the
visitation order or can safely plan with the woman in a way that
addresses the concerns of the child welfare caseworker. What this
consultation may look like will differ by jurisdiction but the
importance of it is indisputable.
Supporting Mothers and Children Together
At the heart of CAPTA as with all efforts to prevent child abuse
and neglect is the simple question: what do children need? And the
equally simple answer is that they need a loving and capable parent
whenever possible. Yet once the child welfare system intervenes to
protect children experiencing domestic violence it often has little to
offer those children in terms of resources to address their needs,\10\
and the system will often pit the needs of the child against that of
the parent even when everyone agrees that what would be best for that
child is for her or his mother to be safe and able to care for him or
her. It is both this orientation to see the needs of children and their
non-abusing mothers and caretakers as at odds as well as the lack of
funding and services available to address both of their needs and their
need to heal together that must be addressed.
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\10\ Rosewater, Ann and Goodmark, Leigh for the Family Violence
Prevention Fund, (2007) Steps Toward Safety: Improving Systemic and
Community Responses for Families Experiencing Domestic Violence, p. 36.
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In the face of violence, children need many things and often
different things. But their need to remain connected to a capable and
caring adult remains central. Some children particularly need to
maintain the regular rhythms of young life, regular opportunities to be
with their families, stay in the same school, see the same teachers and
coaches.\11\ For children experiencing the symptoms of trauma,
additional services are needed, yet few of those services exist and
where they do exist they need to be modified to meet the needs of
children exposed to domestic violence.
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\11\ Ibid.
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Two model programs have been created by Betsy McAllister Groves at
Boston Medical Center and Alicia Lieberman at San Francisco General
Hospital to provide these needed therapeutic services. While developed
to serve the needs of children, both programs work with the mother and
children together whenever possible, recognizing that it provides
better outcomes for children \12\ and creates more long-term stable
environments to which the children can return. Evaluations of these
programs have demonstrated their success in ameliorating the children's
trauma and improving their behavior, as well as improvement in the
mothers' interactions with their children.\13\
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\12\ Ibid. p. 37.
\13\ Lieberman, A.F., Van Horn, P.J. and Ghosh Ippen, C., ``Toward
Evidence-based Treatment: Child-Parent Psychotherapy and Symptom
Improvement in Preschoolers Exposed to Domestic Violence,'' Annual
Meeting of the International Association of Traumatic Stress Studies,
New Orleans, 2004.
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the role of men and fathers
Child welfare systems for the most part have been oriented toward
mothers. It is true that most mothers remain the primary care-givers of
their children and that most case files are opened in a mother's name
even if she is not the one doing any harm to the child. But ignoring
men is a mistake. By largely dismissing the rolls of fathers and men in
the lives of these children, systems are both missing opportunities to
constructively engage men and conversely punishing victims and children
for abusive men's behavior.\14\
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\14\ Rosewater, A. and Goodmark, L., p. 38.
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Some child welfare systems, however, are taking the lead and
searching for new ways to reach out to men and hold abusive men
accountable for their own behavior. Through the Greenbook Initiative,
several communities have started developing treatment plans for
fathers, and hiring batterer intervention staff to help shift thinking
in child welfare offices.\15\ While abusive men do need to be taken
seriously as potential risks to mothers and their children, it is
essential that that concern not defeat all efforts to engage with men
constructively and support efforts to help them change their behavior.
Rather, CAPTA should use its power to drive new practices to encourage
local programs to begin working more constructively with men but not
begin that work until they have the strong presence of domestic
violence advocates or in-house expertise.
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\15\ Ibid. See also, www.thegreenbook.info.
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Together we hope these recommendations aid the committee in
developing new policies within CAPTA to better serve the needs of
vulnerable families and most importantly prevent child abuse and
neglect.
Prepared Statement of First Star and the Children's Advocacy Institute
First Star and the Children's Advocacy Institute press for
amendments to the public disclosure requirement contained in the Child
Abuse Prevention and Treatment Act (CAPTA) that will provide States
more clarity regarding the proper balance between confidentiality and
disclosure in cases of child abuse death and near death. The U.S.
Department of Health and Human Services' Child Welfare Policy Manual
(the Manual), which directs States as to the proper implementation of
CAPTA, interprets the public disclosure mandates broadly. However, as
was revealed in a recent and widely-publicized report, State Secrecy
and Child Deaths in the U.S., many States currently fail to re-shift
the balance between confidentiality and public disclosure when a child
dies or nearly dies from maltreatment.\1\ Access to the facts regarding
these tragic incidents enables the public to hold child welfare systems
accountable and to drive systemic reform where warranted. Many States'
narrow reading of CAPTA frustrates the statute's purpose and ignores
the guidance provided by the Manual.
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\1\ State Secrecy and Child Deaths in the U.S.: An Evaluation of
Public Disclosure Practices About Child Abuse or Neglect Fatalities or
Near Fatalities, With State Rankings, a joint report of the Children's
Advocacy Institute and First Star (April 29, 2008).
---------------------------------------------------------------------------
In its current form, CAPTA's public disclosure mandate is overly
vague. The following amendments to CAPTA will help bring State policies
in line with the Manual and ensure more predictable, consistent, and
enforceable disclosure of this critical information:
Clarify that States are required to release both cases of
death and near death;
Clarify that public disclosure of such cases is mandatory;
Further clarify that States cannot grant themselves
discretion through restrictive conditions and limitations; and
Add language to direct the scope and nature of the
information authorized for release.
1. clarify that states are required to release both cases of death
and near death
CAPTA explicitly requires a State to adopt ``provisions which allow
for public disclosure of the findings or information about the case of
child abuse or neglect which has resulted in a child fatality or near
fatality.'' However, many States, such as, Colorado, Massachusetts, New
Mexico, Tennessee, Texas, Utah and Vermont, do not provide anywhere in
their public disclosure policy for the release of information on near
deaths.
This is a blatant violation of an express CAPTA condition. Language
must be added to CAPTA to better guide and inform States that the
release of findings and information is also required for near deaths.
2. clarify that public disclosure of such cases is mandatory
Section 2.1A.1, Question 1 of the Manual addresses CAPTA
confidentiality requirements generally.\2\ This Section specifically
distinguishes between situations in which a State ``may'' share
confidential child abuse and neglect reports and records and those
situations in which a State ``must'' provide certain otherwise
confidential child abuse and neglect information. The Manual indicates
that a State ``must'' release the findings or information about the
case of child abuse or neglect that results in a child fatality or near
fatality. Yet, States such as Alabama, Alaska, Arkansas, Kentucky,
Louisiana, Maine, Maryland, Missouri, Montana, Nebraska, New Jersey,
Rhode Island, South Carolina, South Dakota, Tennessee, Vermont,
Virginia, Wisconsin, and Wyoming use permissive language in their
public disclosure policies.
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\2\ U.S. Dept. of Health & Human Services, Administration for 4
Children & Families, ``Child Welfare Policy Manual,'' section 2.1A.1,
available at http://www.acf.hhs.gov/j2ee/programs/cb/laws_policies/
laws/cwpm/policy_dsp.jsp?citID=67.
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In accordance with the Manual, CAPTA must clarify that a State is
required to use mandatory language when constructing its public
disclosure policy.
3. further clarify that states cannot grant themselves discretion
through restrictive conditions and limitations
Currently, the exceptions, limitations and conditions that States
may impose on disclosure of information often makes the intended
information inaccessible and therefore ineffective in carrying out
CAPTA's legislative intent. Section 2.1A.4, Question #4 of the Manual
poses the question: ``Does a State have the option of disclosing
information on these child fatalities and near fatalities, for example,
when full disclosure may be contrary to the best interests of the
child, the child's siblings, or other children in the household?'' The
answer indicates that a ``State does not have discretion in whether to
allow the public access to the child fatality or near fatality
information; rather, the public has the discretion as to whether to
access the information. In other words, the State is not required to
provide the information to the public unless requested, but may not
withhold the facts about a case unless doing so would jeopardize a
criminal investigation.\3\ ''
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\3\ U.S. Dept. of Health & Human Services, Administration for 4
Children & Families, ``Child Welfare Policy Manual,'' section 2.1A.4,
available at http://www.acf.hhs.gov/j2ee/programs/cb/laws_policies/
laws/cwpm/policy_dsp.jsp?citID=68.
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In spite of this, the public disclosure policies of States such as,
Maine, Maryland, South Dakota, and Wisconsin presently include a
provision which allows them to withhold information if the release is
determined to be contrary to the bests interests of the child who is
the subject of the report, the child's siblings or any other child
residing in the same dwelling as the child who is the subject of the
report. As the Child Welfare Policy Manual makes clear, States are
expressly prohibited from exercising this type of discretion.
Additionally, some States, such as Minnesota and North Carolina,
will not release information about a child fatality or near fatality
unless the perpetrator is criminally charged. Disclosure simply cannot
be dependent on a district attorney's decision to prosecute. Criminal
proceedings are not relevant to the importance of disclosure and
furthermore these restrictions serve no public benefit. Making
disclosure contingent on criminal prosecution represents a gross
misinterpretation of CAPTA language.
To avoid such violations of the legislative intent of CAPTA and to
align State policies with the guidance provided by the Manual, language
must to be added to CAPTA that expressly prohibits any discretionary
withholding of information by a State.\4\
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\4\ Unless disclosure is likely to jeopardize a criminal
investigation.
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4. add language to indicate exactly what type information is authorized
for release
Section 2.1A.4, Question 2 of the Manual addresses whether States
have the option to disclose ``either the findings of the case, or
information which may be general in nature and address such things as
practice issues rather than provide case-specific information.'' The
answer states that ``the intent of this provision was to assure that
the public is informed about cases of child abuse or neglect which
result in the death or near death of a child'' and that a ``State must
provide for the disclosure of the available facts.'' \5\
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\5\ U.S. Dept. of Health & Human Services, Administration for 4
Children & Families, ``Child Welfare Policy Manual,'' section 2.1A.4,
available at http://www.acf.hhs.gov/j2ee/programs/cb/laws_policies/
laws/cwpm/policy_dsp.jsp?citID=68(emphasis added).
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However, many States violate this directive. For example, Delaware
authorizes only the release of ``systemwide recommendations'' and
provides that the facts and circumstances of each death or near death
shall be confidential. Additionally, Georgia limits its disclosure to
whether there is an ongoing or completed investigation of the child's
death and whether child abuse was confirmed or unconfirmed. Many States
argue that they cannot provide facts about the case because it would
violate their mandate for confidentiality. However, it is not the
identifying information that is needed for proper public discourse, but
rather the facts and circumstances of the case.
In order to avoid such violations of the legislative intent of
CAPTA, the public disclosure mandate should clarify exactly what type
of information the public is entitled to receive upon request. CAPTA
should be amended to read that the public is explicitly entitled to
receive information ``including, but not limited to, the cause of and
circumstances regarding the fatality or near fatality; the age and
gender of the child; information describing any previous reports made
to and investigations conducted by the child welfare agency regarding
the child and/or the child's family, and the results of any such
investigations; and information describing any services provided or
actions taken by the child welfare agency on behalf of the child and/or
the child's family, before and after the fatality or near fatality.''
\6\
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\6\ State Secrecy and Child Deaths in the U.S.: An Evaluation of
Public Disclosure Practices About Child Abuse or Neglect Fatalities or
Near Fatalities, With State Rankings, a joint report of the Children's
Advocacy Institute and First Star (April 29, 2008).
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First Star is a 501(c)(3) established in 1999 to strengthen the
rights and improve the lives of America's abused and neglected children
through education, public policy, legislative reform, and litigation.
The Children's Advocacy Institute was founded in 1989 as part of
the Center for Public Interest Law at the University of San Diego (USD)
School of Law. CAI's mission is to improve the health, safety,
development, and well-being of children. CAI advocates in the
legislature to make the law, in the courts to interpret the law, before
administrative agencies to implement the law, and before the public to
promote the status of children in our society. CAI strives to educate
policymakers about the needs of children--about their needs for
economic security, adequate nutrition, health care, education, quality
child care, and protection from abuse, neglect, and injury. CAI's goal
is to ensure that children's interests are represented effectively
whenever and wherever government makes policy and budget decisions that
will impact them.
Prepared Statement of the National Child Abuse Coalition
The National Child Abuse Coalition, representing a collaboration of
national organizations committed to strengthening the Federal response
to the protection of children and the prevention of child abuse and
neglect, calls on Congress to reauthorize the Child Abuse Prevention
and Treatment Act (CAPTA) programs to provide the core Federal policy
and support for:
1. strengthening the child protective services (CPS)
infrastructure;
2. promoting community-based services in prevention of child
maltreatment; and
3. initiating research and development of innovative programs to
advance the field of prevention and treatment of child abuse and
neglect.
Child maltreatment is a serious public health problem. The U.S.
Department of Health and Human Services (HHS) reports that CPS agencies
in 2006 received 3.3 million reports of suspected child abuse and
neglect. Following investigation, an estimated 905,000 of these reports
were found to be victims of abuse and neglect. Overall, the youngest
children suffer the highest rate of victimization. Infants aged birth
to 1 year are the most vulnerable victims of abuse and neglect, with a
rate of victimization (24.4 per 1,000 children) almost double that of
children aged 1-3. Almost 45 percent of children who died of abuse or
neglect had not reached their first birthday, and more than three-
quarters of children who were killed (78.0 percent) were younger than 4
years of age. Fatalities due to child abuse and neglect claimed the
lives of an estimated 1,530 children in 2006 (compared to 1,460
children in 2005)--4 deaths each day.\1\
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\1\ U.S. Department of Health and Human Services, Administration on
Children, Youth and Families. Child Maltreatment 2006. Washington, DC,
U.S. Government Printing Office, 2008.
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These are the abused and neglected children who come to the
attention of communities across the country for protection from
further, even more serious harm. HHS also reports that many more
children--whether known or unknown to protective services--are abused
and neglected each year: According to the Third National Incidence
Study of Child Abuse and Neglect, an estimated 2.8 million children are
the victims of abuse and neglect in the United States.\2\ These
numbers--and the lives of these children--can not be taken lightly or
dismissed.
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\2\ Sedlak, A. and Broadhurst, D. The Third National Incidence
Study of Child Abuse and Neglect. Washington, DC, U.S. Department of
Health and Human Services, Administration on Children, Youth and
Families, 1996.
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Preventing the abuse and neglect of children from happening in the
first place will keep children safe and avert the consequences of child
maltreatment. Research into the results later in life for children who
have been maltreated show that:
1. Child abuse prevention can help to prevent crime. Victims of
child abuse are more likely to become juvenile offenders, teenage
runaways, and adult criminals later in life.\3\
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\3\ Widom, C.S. (1992). The Cycle of Violence. Washington, DC:
National Institute of Justice.
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2. Ensuring that children are ready to learn means ensuring that
children are safe at home. Abused and neglected children may experience
poor prospects for success in school, typically suffering language and
other developmental delays, and a disproportionate amount of
incompetence and failure.\4\
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\4\ Morgan, S.R. (1976). The Battered Child in the Classroom.
Journal of Pediatric Psychology.
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3. Preventing child abuse can help to prevent disabling conditions
in children. Physical abuse of children can result in brain damage,
mental retardation, cerebral palsy, and learning disorders.\5\
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\5\ Martin, H.P. and Rodeheffer, M.A. (1980). The Psychological
Impact of Abuse in Children. In: G.J. Williams. Traumatic Abuse and
Neglect of Children at Home. Baltimore, MD: Johns Hopkins University
Press.
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4. Preventing child abuse helps prevent serious illnesses later in
life. Research links childhood abuse with adult behaviors which result
in the development of chronic diseases that cause death and
disability.\6\
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\6\ Felitti, V.J. and Anda, R.F., et al. (1998). Relationship of
Childhood Abuse and Household Dysfunction to Many of the Leading Causes
of Death in Adults. The Adverse Childhood Experiences (ACE) Study.
American Journal of Preventive Medicine.
We know that prevention works. Communities across the country have
developed preventive services which show success in support programs
for new parents, parent education, respite and crisis care, home
visitor services, parent mutual support, and family support services.
Evaluations of home visiting services have shown positive effects
in the areas of parenting and child abuse and neglect, birth outcomes,
and health care.\7\ Crisis nurseries have been demonstrated to protect
children against abuse at home. According to a recent evaluation funded
by the HHS Children's Bureau analyzing the number of substantiated
reports of child maltreatment in families using crisis nurseries with a
comparison group of families for whom crisis respite services were
unavailable, the families receiving crisis respite services were far
less likely to ever have a substantiated report of maltreatment than
the families without nursery services.\8\ According to a nationwide
longitudinal study conducted by the National Council on Crime and
Delinquency funded by the U.S. Department of Justice, parents who
participated over time in Parents Anonymous parent mutual support-
shared leadership groups showed improvement in child protective factors
and reduced child maltreatment and other risk factors.\9\
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\7\ Hahn, R.A., Bilukha, O.O., Crosby, A., Fullilove, M.T.,
Liberman, A., and Moscicki, E.K., et al. (2003). First reports
evaluating the effectiveness of strategies for preventing violence:
Early childhood home visitation. Center for Disease Control, Morbidity
and Mortality Weekly Report, 52, 109.
\8\ Crisis Respite: Evaluating Outcomes for Children and Families
Receiving Crisis Nursery Services. ARCH National Respite Network, 2007.
\9\ National Outcome Study of Parents Anonymous, 2007.
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The incidence of child abuse and neglect exceeds the capacity of
our system to respond adequately. HHS reports that the average time
from start of investigation to provision of service is 43 days. Less
than half (41.1 percent) of child victims receive no services. Just
over one-quarter (25.3 percent) of victims had a history of prior
victimization. According to the HHS report, ``. . . the efforts of the
CPS system have not been successful in preventing subsequent
victimization.'' An analysis of the factors influencing the likelihood
of recurrence includes the following results:
Children who had been prior victims of maltreatment were
96 percent more likely to experience maltreatment again than those who
were not prior victims.
Child victims who were reported with a disability were 52
percent more likely to experience recurrence than children without a
disability. (Nearly 8 percent of victims--7.7 percent--had a reported
disability.)
The oldest victims (16-21 years of age) were the least
likely to experience a recurrence.\10\
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\10\ U.S. Department of Health and Human Services, Administration
on Children, Youth and Families. Child Maltreatment 2006. Washington,
DC, U.S. Government Printing Office, 2008.
Federal officials have repeatedly cited States for certain
deficiencies: significant numbers of children suffering abuse or
neglect more than once in a 6-month period; caseworkers who are not
visiting children often enough to assess needs; and failure to provide
promised medical and mental health services. We, as a nation, can do
better. A CAPTA-funded 2001 study shows that job stress related to the
number and composition of a child protective service worker's caseload
affects decisions on substantiation of maltreatment reports. The same
study reveals that a perceived lack of service resources in a community
may be tied to an increased recurrence of reports.\11\
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\11\ Fluke, J. and Parry, D., et al. The Dynamics of
Unsubstantiated Reports: A Multi-State Study. American Humane
Association, Englewood, CO, 2001.
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In the 2003 reauthorization of CAPTA, the basic State grant section
was amended to require that children under the age of 3 involved in a
substantiated case of child abuse or neglect must be referred to early
intervention services funded under Part C of the Individuals with
Disabilities Education Act.
Unfortunately, the implementation of this essential provision has
been sorely lacking. Part C does not have the capacity, without
appropriate resources, to serve all children involved in substantiated
cases referred by CPS. Nor do Part C agencies necessarily possess the
knowledge and expertise to engage families referred by CPS. HHS needs
to provide guidance to the States on implementing these procedures, and
additional funding is essential in order to serve these children. Some
agencies are making this work, but more needs to be done to attend to
the important potential lying in these provisions in CAPTA.
Current Federal spending for child protective services and
preventive services falls far short of the dollars invested in
supporting the placement of children in foster care and adoptive
families. For every dollar spent by the Federal Government in subsidies
for the out-of-home placement of children, just 14 cents is spent on
prevention and protective services. Federal laws have created a system
of child welfare support heavily weighted toward protecting children
who have been so seriously maltreated they are not safe at home and
must be placed in foster care or adoptive homes. These are children
whose safety is in danger; they demand our immediate attention.
Increasing funding for CAPTA's basic State grants and community-based
prevention grants will help to begin to address the current imbalance.
It is time to invest additional resources to work in partnership with
the States to help families and prevent children from being abused and
neglected.
Unfortunately, far less attention in Federal funding and policy is
directed at preventing harm to these children from happening in the
first place, or providing the appropriate services and treatment needed
by families and children victimized by abuse or neglect. CAPTA must be
reauthorized to respond to the current demand for treatment and
prevention of child abuse and neglect. In 2008, many States are
reporting their largest budget shortfalls in almost a decade and about
half the State legislatures are looking to cut a variety of services to
avoid spending deficits. As housing foreclosures and other economic
stresses increase pressures on families, we are concerned that over the
coming months children will suffer as the funds for necessary services
will go down. CAPTA, with a focus on support to improve the CPS
infrastructure and our system of community-based prevention services,
should be the source to help in providing those resources for
prevention, intervention, and treatment.
capta basic state grant program
CAPTA should be the core source of funding for child protective
services, yet it is not. CAPTA funding for basic State grants at the
current level of $27 million is not up to addressing the scope of the
need for support of CPS. The National Child Abuse Coalition believes
that an annual authorized funding level of $500 million is a realistic
approach to developing the CAPTA basic State grant program as a source
of core funding for child protective services. A commitment at this
level of funding will begin to help close the gap between what Federal,
State and local dollars currently allocate to protect children and
treat child victims, and what those services cost.
CAPTA basic State grants are used for developing innovative
approaches in CPS systems. This is potentially an important source of
support for improving the child protective service system from State to
State. Through the CAPTA basic State grant program, the Federal
Government has the opportunity to step up to a leadership role in
providing support for the CPS system infrastructure and to begin to
rectify the imbalance in the Federal Government's response to the abuse
and neglect of children.
States report having difficulty in recruiting and retaining child
welfare workers, because of issues like low salaries, high caseloads,
insufficient training and limited supervision, and the turnover of
child welfare workers--estimated to be between 30 and 40 percent
annually nationwide.\12\ The average caseload for child welfare workers
has typically been nearly double the recommended level, and obviously
much higher in many jurisdictions.\13\ Because our system is weighted
toward protecting the most seriously injured children, we wait until it
gets so bad that we have to step in. Far less attention in policy or
funding is directed at preventing harm to children from ever happening
in the first place or providing the appropriate services and treatment
needed by families and children victimized by abuse or neglect.
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\12\ U.S. General Accounting Office (2003). HHS Could Play a
Greater Role in Helping Child Welfare Agencies Recruit and Retain Staff
(GAO-03-357).
\13\ Alliance for Children and Families, American Public Human
Services Association, Child Welfare League of America (2001). The Child
Welfare Workforce Challenge: Results from a Preliminary Study. Dallas.
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In addition to authorizing meaningful appropriations for the basic
State grants to help improve the CPS infrastructure, the National Child
Abuse Coalition proposes to address through those grants a variety of
activities essential to a responsive, efficient and appropriate
protective service system, enabling States to improve their CPS systems
through CAPTA grant support. In addition to the purposes for basic
State grants in current law which address CPS improvements, the
Coalition proposes that CAPTA funds be available to address the
following issues:
CPS and family violence services collaboration: recognizing that
domestic violence and child maltreatment co-exist in 30 to 60 percent
of the families among whom either is present; child welfare and
domestic violence prevention programs should adopt assessment and
intervention procedures aimed at enhancing the safety both of children
and victims of domestic violence, including, where appropriate,
developing and implementing collaborative procedures between child
protective services and domestic violence services, in the
investigation, intervention, and delivery of services and treatment
provided to children and families.
Data sharing: to develop systems of technology that support the
program and track reports of child abuse and neglect from intake
through final disposition and allow interstate and intrastate
information exchange.
Services to families: to promote the implementation of policies and
procedures which encourage the development of differential, multiple
responses for referral of family to a community organization or
voluntary preventive services where the child is not at risk of
imminent harm; and policies and procedures encouraging the involvement
of families in decisionmaking pertaining to cases of abuse and neglect
of children.
Linkages to animal welfare: to promote collaborations between the
child protection system and animal welfare agencies in recognizing
incidences of child abuse and neglect.
Legal representation: to require the appointment of an attorney to
represent the legal interests of the child, as well as a guardian ad
litem to represent the child's best interests.
Medical neglect: to extend protection to all children from medical
neglect by removing language from CAPTA with the effect of allowing
States to permit parents to withhold medical care from sick and injured
children on religious grounds in the provision stating that there is no
``Federal requirement that a parent or legal guardian provide a child
any medical service or treatment against the religious beliefs of the
parent or legal guardian. . . .'', in accord with the U.S. Supreme
Court holding that the First Amendment does not allow one's religious
practices or beliefs to endanger one's children.
capta community-based child abuse prevention program (title ii)
CAPTA should be the basic source of funding for community-based
prevention programs, yet its resources are inadequate. Current funding
for the community-based prevention program at $37 million is
insufficient on a significant scale to the task of preventing the abuse
and neglect of children from happening in the first place. The National
Child Abuse Coalition believes that annual authorized funding of $500
million represents a modest commitment to support prevention of child
abuse and neglect through CAPTA. Putting dollars aside for prevention
is sound investing, not luxury spending.
According to the Urban Institute, States reported spending $22
billion on child welfare in 2002, and they could categorize how $17.4
billion of the funds were used. Of that amount, $10 billion was spent
for out-of-home placements, $1.7 billion on administration, $2.6
billion on adoption, and $3.1 billion (about 18 percent) on all other
services, including prevention, family preservation and support
services, and child protective services.\14\ As one of the few
dedicated Federal funding sources for prevention, a proper investment
in CAPTA Community-Based Child Abuse Prevention grants would go a long
way towards correcting the current imbalance between funding services
for children after abuse and neglect have occurred, and funding
services to ensure that abuse and neglect do not happen in the first
place.
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\14\ Scarcella, C.A. (2004). The Cost of Protecting Vulnerable
Children IV: How Child Welfare Funding Fared During the Recession,
Washington, DC Urban Institute.
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The CAPTA Community-Based Child Abuse Prevention grants should
assist States and communities to develop tested successful approaches
to preventing child abuse and neglect through such essential community-
based, family-centered, prevention services as support programs for new
parents, parent education, respite and crisis child care, home visitor
services, parent mutual support, and other family support services.
To improve upon the ability of CAPTA to support State and local
preventive services, the Coalition proposes that CAPTA Title II should
be amended to:
Focus the Title II, Community-Based Child Abuse Prevention
grants on support of services aimed at prevention.
Allow for the redistribution of unexpended funds back
through the program.
Strengthen accountability provisions in the title II
program.
Strengthen title II language to include meaningful parent
involvement through all areas of preventive services.
Elevate home visiting and respite services to the same
level as other identified core services of activities, and add crisis
nurseries as a core service (removing the phrase ``as practicable''.)
capta research and demonstration grants for innovations
CAPTA is the only Federal program for support of research and
innovations to improve practices in preventing and treating child abuse
and neglect, yet funding remains insufficient. CAPTA dollars for R&D at
the current funding of $37 million is inadequate to satisfy the need
for advancing our knowledge and improving services for protecting
children. At the current funding level, HHS is able to fund only a
fraction of the applications for field-initiated research. The
Coalition proposes raising the authorized appropriations to the level
of $100 million, which would help to advance the field's knowledge
through support for research and program innovations, as well as
funding for the training, technical assistance, data collection and
information sharing functions also authorized by CAPTA out of this
money.
CAPTA funding is an efficient means of enabling States and
communities to improve their practices in preventing and treating child
abuse and neglect. The discretionary grant program is able to support a
broad array of leadership activities which are uniquely suited to the
Federal Government's national perspective and ability to address
current issues in order to advance the field of prevention and
treatment of child abuse and neglect. Public agencies beleaguered by
the crises of the day often do not have the capacity to undertake such
activities, but they benefit from tested approaches, like those CAPTA
supports. These discretionary grants help ensure that the CAPTA State
grant funds and other child protection investments will actually
benefit children.
Over the years, important strategies in child abuse prevention and
protection of children have developed with seed money from CAPTA. The
history of CAPTA funding demonstrates the value of this investment.
Early in the development of the Parents Anonymous program,
CAPTA support helped to enable this parent mutual support-shared
leadership organization to expand, through technical assistance and
training, beyond its beginnings in southern California to become today
an important prevention resource for tens of thousands of families in
communities nationwide.
An initial grant from CAPTA helped the first children's
advocacy center developed in Huntsville, AL by then-district attorney
and now-Rep. Bud Cramer (D) to serve as the model program for centers
protecting children in States across the country.
In Hawaii, seed money from CAPTA went to develop the
successful program of home health visitors. The research and knowledge
gained through this experience contributed to the development of the
Healthy Families America program now operating in hundreds of
communities in almost every State to help parents get their children
off to a healthy start.
Research, Training and Technical Assistance Grants
The National Child Abuse Coalition proposes amending CAPTA to focus
discretionary spending on current topics important to improving our
ability to protect children and prevent abuse and neglect. Among
appropriate topics which should be addressed by CAPTA funding are the
following:
1. training for domestic violence and for child protection
personnel in issues relating to child abuse and neglect and family
violence;
2. collect and disseminate information on effective programs and
best practices for developing and carrying out collaborations between
child protective services and domestic violence services; and
3. development of best practices for research and evaluation to
build on the base of evidence regarding differential response.
Training
The connection between workforce quality and family outcomes was
documented in a March 2003 report by the U.S. General Accounting Office
which states,
``A stable and highly skilled child welfare workforce is
necessary to effectively provide child welfare services that
meet Federal goals. [However,] large caseloads and worker
turnover delay the timeliness of investigation and limit the
frequency of worker visits with children, hampering agencies'
attainment of some key Federal safety and permanency
outcomes.'' \15\
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\15\ U.S. General Accounting Office. (March 2003). ``HHS Could Play
a Greater Role in Helping Child Welfare Agencies Recruit and Retain
Staff .'' Washington, DC.
It has been documented that a well-prepared staff is more likely to
remain in the field of child welfare, thus reducing worker turnover and
increasing continuity of services with the family. Some social workers
are able to take advantage of Federal assistance through the Title IV-E
and Title IV-B programs of the Social Security Act. These funds are
used to upgrade the skills and qualifications of child welfare workers
though their participation in training programs specifically focused on
child welfare practice. While these programs serve a useful purpose and
must be preserved, we know that these two programs alone cannot support
the entire field of child welfare workers.
A recent NASW study, Assuring the Sufficiency of a Frontline
Workforce: A National Study of Licensed Social Workers,\16\ shines a
bright light on issues related to workforce retention. The study warns
of an impending shortage of social workers that threatens future
services for all Americans, especially the most vulnerable among us,
children and older adults. Key findings include:
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\16\ Whitaker, T. Weismiller, T. and Clark, E. (2006). ``Assuring
the Sufficiency of a Frontline Workforce: A National Study of Licensed
Social Workers. Executive Summary.'' Washington, DC: National
Association of Social Workers.
The supply of licensed social workers is insufficient to
meet the needs of organizations serving children and families.
Workload expansion plus fewer resources impedes social
worker retention.
Agencies struggle to fill social work vacancies.
Congress should provide sufficient funds to allow for research,
training, and evaluation of services in the child welfare system. Also,
greater investments are needed to provide social workers with
professional development preparation and ongoing training
opportunities, particularly in the area of cultural competence. We
believe that valuable employment incentives, including pay increases,
benefits, student loan forgiveness, and promotional opportunities are
essential for the development of a highly skilled human services
workforce.
Demonstration Grants
In response to needs often overlooked in the prevention of child
maltreatment and the protection of abused and neglected children, the
National Child Abuse Coalition proposes amending CAPTA to address
priorities in:
1. evaluation and replication of models in the medical diagnosis
and treatment of child abuse and neglect; and
2. effective collaborations between child protective services and
domestic violence services, including attention to investigation and
intervention procedures, with regard for the safety of children and of
the non-abusing parent, and the necessary services to children exposed
to domestic violence.
The technical assistance offerings, evaluation measures, and
information dissemination functions supported by CAPTA should address
these priorities as well. The statute should focus on improving the
evaluations of CAPTA-funded demonstration grants, the replication of
successful model programs, and the distribution of information on
programs with potential for broad-scale implementation and replication.
definition of child abuse and neglect
The National Child Abuse Coalition proposes amending the definition
of ``child abuse and neglect'' in CAPTA to conform with the
preponderance of State child abuse reporting laws and to recognize the
value and import of early intervention in the protection of children
who have been maltreated or are at risk of more serious abuse or
neglect. We urge Congress to return the statutory definition to the
language of CAPTA as originally enacted in 1974 by removing the words
``serious,'' ``recent,'' and ``imminent'' in recognition of the reality
of practice in child protective services and the increased attention to
providing preventive services and a differential response to families
and children in need of support and assistance.
conclusion
CAPTA has an important role in the Federal response to the
prevention of child maltreatment and the protection of abused and
neglected children. Unfortunately, the Federal role bears almost no
relationship to the extent of the problem of child maltreatment in our
society. While the numbers of children abused and neglected each year
in the United States remain high, Federal budgetary policy remains
focused on paying billions of dollars for the removal of children from
homes where they are no longer safe. Relatively few Federal resources
are directed at helping States and communities in their response to
protecting children at the first instance of harm, or preventing that
harm from happening at all.
The prevention of child abuse requires intensive effort and the
commitment of resources such as we rarely see in government, certainly
more than is allocated to date through CAPTA. We are at a point now
where we can act to improve upon the Federal support and leadership. We
urge the adoption of legislation to amend CAPTA in ways that will truly
assist States and communities in their efforts to keep children from
harm. We stand ready to assist this subcommittee and your colleagues in
Congress in developing a responsive Federal role for protecting
children and preventing child abuse.
[Whereupon, at 3:58 p.m., the hearing was adjourned.]