[House Hearing, 111 Congress]
[From the U.S. Government Publishing Office]
PREVENTING CHILD ABUSE AND IMPROVING RESPONSES TO FAMILIES IN CRISIS
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HEALTHY
FAMILIES AND COMMUNITIES
COMMITTEE ON
EDUCATION AND LABOR
U.S. House of Representatives
ONE HUNDRED ELEVENTH CONGRESS
FIRST SESSION
__________
HEARING HELD IN WASHINGTON, DC, NOVEMBER 5, 2009
__________
Serial No. 111-38
__________
Printed for the use of the Committee on Education and Labor
Available on the Internet:
http://www.gpoaccess.gov/congress/house/education/index.html
U.S. GOVERNMENT PRINTING OFFICE
53-040 WASHINGTON : 2010
-----------------------------------------------------------------------
For sale by the Superintendent of Documents, U.S. Government Printing
Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; DC
area (202) 512-1800 Fax: (202) 512-2104 Mail: Stop IDCC, Washington, DC
20402-0001
COMMITTEE ON EDUCATION AND LABOR
GEORGE MILLER, California, Chairman
Dale E. Kildee, Michigan, Vice John Kline, Minnesota,
Chairman Senior Republican Member
Donald M. Payne, New Jersey Thomas E. Petri, Wisconsin
Robert E. Andrews, New Jersey Howard P. ``Buck'' McKeon,
Robert C. ``Bobby'' Scott, Virginia California
Lynn C. Woolsey, California Peter Hoekstra, Michigan
Ruben Hinojosa, Texas Michael N. Castle, Delaware
Carolyn McCarthy, New York Mark E. Souder, Indiana
John F. Tierney, Massachusetts Vernon J. Ehlers, Michigan
Dennis J. Kucinich, Ohio Judy Biggert, Illinois
David Wu, Oregon Todd Russell Platts, Pennsylvania
Rush D. Holt, New Jersey Joe Wilson, South Carolina
Susan A. Davis, California Cathy McMorris Rodgers, Washington
Raul M. Grijalva, Arizona Tom Price, Georgia
Timothy H. Bishop, New York Rob Bishop, Utah
Joe Sestak, Pennsylvania Brett Guthrie, Kentucky
David Loebsack, Iowa Bill Cassidy, Louisiana
Mazie Hirono, Hawaii Tom McClintock, California
Jason Altmire, Pennsylvania Duncan Hunter, California
Phil Hare, Illinois David P. Roe, Tennessee
Yvette D. Clarke, New York Glenn Thompson, Pennsylvania
Joe Courtney, Connecticut
Carol Shea-Porter, New Hampshire
Marcia L. Fudge, Ohio
Jared Polis, Colorado
Paul Tonko, New York
Pedro R. Pierluisi, Puerto Rico
Gregorio Kilili Camacho Sablan,
Northern Mariana Islands
Dina Titus, Nevada
Judy Chu, California
Mark Zuckerman, Staff Director
Barrett Karr, Republican Staff Director
------
SUBCOMMITTEE ON HEALTHY FAMILIES AND COMMUNITIES
CAROLYN McCARTHY, New York, Chairwoman
Yvette D. Clarke, New York Todd Russell Platts, Pennsylvania,
Robert C. ``Bobby'' Scott, Virginia Ranking Minority Member
Carol Shea-Porter, New Hampshire Howard P. ``Buck'' McKeon,
Paul Tonko, New York California
Jared Polis, Colorado Brett Guthrie, Kentucky
George Miller, California David P. Roe, Tennessee
Judy Chu, California Glenn Thompson, Pennsylvania
C O N T E N T S
----------
Page
Hearing held on November 5, 2009................................. 1
Statement of Members:
McCarthy, Hon. Carolyn, Chairwoman, Subcommittee on Healthy
Families and Communities................................... 1
Prepared statement of.................................... 3
Additional submissions:
Report from the National Network to End Domestic
Violence........................................... 51
Report, ``Meeting Survivors' Needs: A Multi-State
Study of Domestic Violence Shelter Experiences,''
Internet address to................................ 64
2007 series of AP articles on child sex abuses....... 64
Cates, Sheryl, chief executive officer, National
Domestic Violence Hotline, prepared statement of... 98
The Child Welfare League of America (CWLA), prepared
statement of....................................... 98
The Family Violence Prevention Fund, prepared
statement of....................................... 103
The National Association of Public Child Welfare
Administrators, prepared statement of.............. 108
The National Network to End Domestic Violence
(NNEDV), prepared statement of..................... 110
Melmed, Matthew, executive director, Zero to Three,
prepared statement of.............................. 115
Platts, Hon. Todd Russell, Senior Republican Member,
Subcommittee on Healthy Families and Communities........... 3
Prepared statement of.................................... 4
Statement of Witnesses:
Hammond, Rodney, Ph.D., Director, Division of Violence
Prevention, National Center for Injury Prevention &
Control, Centers for Disease Control & Prevention, U.S.
Department of Health and Human Services.................... 6
Prepared statement of.................................... 8
Kaplan, Caren, MSW, director of child protection reform,
American Humane Association................................ 16
Prepared statement of.................................... 19
Oliva, Sandra, executive director, Nassau County Coalition
Against Domestic Violence.................................. 23
Prepared statement of.................................... 25
Sawyer, Robert Quinn, MSW, LICSW, Olmsted County Child and
Family Services............................................ 35
Prepared statement of.................................... 37
Smith, Teresa M., LSW, coordinator executive director,
Children's Advocacy Center................................. 32
Prepared statement of.................................... 34
Spigner, Carol Wilson, DSW, Kenneth L.M. Pray professor,
University of Pennsylvania School of Social Policy and
Practice................................................... 12
Prepared statement of.................................... 14
PREVENTING CHILD ABUSE AND IMPROVING RESPONSES TO FAMILIES IN CRISIS
----------
Thursday, November 5, 2009
U.S. House of Representatives
Subcommittee on Healthy Families and Communities
Committee on Education and Labor
Washington, DC
----------
The subcommittee met, pursuant to call, at 10:05 a.m., in
room 2175, Rayburn House Office Building, Hon. Carolyn McCarthy
[chairwoman of the subcommittee] presiding.
Present: Representatives McCarthy, Tonko, Chu, Platts,
Guthrie, and Roe.
Also Present: Representatives Woolsey and Moore.
Staff Present: Tylease Alli, Hearing Clerk; Calla Brown,
Staff Assistant, Education; Adrienne Dunbar, Education Policy
Advisor; Ruth Friedman, Senior Education Policy Advisor (Early
Childhood); David Hartzler, Systems Administrator; Fred Jones,
Staff Assistant, Education; Joe Novotny, Chief Clerk;
Alexandria Ruiz, Administration Assistant to Director of
Education Policy; Melissa Salmanowitz, Press Secretary; Kim
Zarish-Becknell, Policy Advisor, Subcommittee on Healthy
Families and Communities; Stephanie Arras, Minority Legislative
Assistant; Alexa Marrero, Minority Communications Director;
Ryan Murphy, Minority Press Secretary; Susan Ross, Minority
Director of Education and Human Services Policy; Mandy
Schaumburg, Minority Education Counsel; and Linda Stevens,
Minority Chief Clerk/Assistant to the General Counsel.
Chairwoman McCarthy. Good morning. I would like to welcome
our witnesses to this hearing. Today, we are dealing with a
very difficult and upsetting subject--abuse and neglect--and we
know sometimes, unfortunately, it results in fatalities. We
will hear from witnesses on how to improve response for and
prevent violence and abuse in families in crisis. Abuse,
neglect, and fatalities are of significant social concerns in
our Nation.
The official number of children killed from abuse or
neglect nationwide in 2007 is 1,760. In 2001, the total was
1,300. Three-quarters of the fatalities are children under
four.
As a nurse for over 30 years, I have seen firsthand the
risks and illnesses that can result due to abuse and neglect.
We know that children who experience abuse or neglect and
children that witness abuse have their sense of security,
trust, and safety shaken to the core. Studies have shown that
young children are more likely to be reported as victims. In
fact, of all cases, the maltreatment rate for infants was 21
percent. For children ages one to three it was 13 percent.
The majority of child victims experience neglect. In fact,
more than 60 percent of the children who come to the attention
of child welfare authorities are victims of neglect. They are
victims of acts of omission in terms of their care, in terms of
their well-being. Sometimes these instances of neglect happen
due to the simple fact the parents need assistance. These
parents are not monsters. Rather, they need to be connected
with available services or perhaps they need help with basic
parental know-how.
We know from studies that the impact of chronic,
long-term neglect is devastating to the development of
children. Victims of abuse and neglect are more likely to have
developmental delays and impaired language and cognitive
skills. They are more likely to be arrested for delinquency and
violent criminal behavior as adults. We also know they have
poor health outcomes as adults.
Over 35 years ago, Congress enacted the Child Abuse
Prevention and Treatment Act, or CAPTA, with a very simple
purpose: Creating a single Federal focus to deal with the
front-end issues associated with abuse and neglect. I like to
think of CAPTA prevention programs as the first line of defense
in the child welfare system.
The CAPTA formula and competitive grants focus on the
prevention of child abuse and ensuring continued well-being and
safety of children. The CAPTA programs consists of two major
grant programs, as well as targeted research, data collection,
and technical assistance to the States. These grant programs
provide funding for improvements to child protection services,
promising prevention efforts, and community-based efforts to
prevent abuse and neglect.
CAPTA provides grants to States for technical assistance
and requires States to have laws related to reporting child
abuse investigations and procedures and resources for working
with affected families. In order to receive funds, States must
meet a minimal definition of child abuse and neglect.
While CAPTA has brought much-needed attention and change to
the issues of child maltreatment, this number still remains too
high. The rates of physical abuse have decreased in recent
years, but the rates of neglect have remained conservatively
consistent, and we know that difficult financial times can
certainly aggravate violence in victims, with fewer personal
resources becoming increasingly vulnerable.
For example, since the economic crisis began, it has been
reported that three out of four domestic violence shelters have
reported an increase in women seeking assistance from abuse.
That means we have more work to do, which is why I am holding
this hearing today.
I want to thank you all for being here, and I look forward
to the testimony that we will hear.
I now recognize the distinguished gentleman from
Pennsylvania, Ranking Member Platts, for his opening statement.
[The statement of Mrs. McCarthy follows:]
Prepared Statement of Hon. Carolyn McCarthy, Chairwoman, Subcommittee
on Healthy Families and Communities
I'd like to welcome our witnesses to this hearing. Today are
dealing with a very difficult and upsetting subject, abuse and neglect,
which sometimes result in fatalities.
We will hear from witnesses on how to improve responses for and
prevent violence and abuse in families in crisis.
Abuse, neglect and fatalities are of significant social concerns in
our nation. The official number of children killed from abuse or
neglect nationwide in 2007 is 1,760. In 2001, the total was 1,300.
Three-quarters of the fatalities are children are under four. As a
nurse for 30 years, I have seen firsthand the risks and illnesses that
can result due to abuse and neglect.
We know that children who experience abuse or neglect, and children
that witness abuse have their sense of security, trust and safety
shaken to the core.
Studies show that young children are more likely to be reported as
victims. In fact, of all cases, the maltreatment rate for infants was
twenty one percent and for children ages one to three it was 13
percent.
The majority of child victims experience neglect. In fact, more
than 60 percent of the children who come to the attention of child
welfare authorities are victims of neglect.
They're victims of acts of omission in terms of their care, in
terms of their well being.
Sometimes these instances of neglect happen due to the simple fact
that parents need assistance.
These parents are not monsters, rather they need to be connected
with available services or perhaps they need help with basic parental
know-how.
We know from studies that the impact of chronic, long-term neglect
is devastating to the development of children.
Victims of abuse and neglect are more likely to have developmental
delays, and impaired language or cognitive skills. They are more likely
to be arrested for delinquency and violent criminal behavior as adults.
We also know they have poor health outcomes as adults.
Over thirty-five years ago Congress enacted the Child Abuse
Prevention and Treatment Act--or ``CAPTA''--with a very simple purpose:
creating a single federal focus to deal with the front end issues
associated with child abuse and neglect.
I like to think of CAPTA prevention programs as the first line of
defense in the child welfare system. The CAPTA formula and competitive
grants focus on the prevention of child abuse and ensuring continued
well-being and safety of children.
The CAPTA programs consist of two major grant programs, as well as
targeted research, data collection and dissemination and technical
assistance to the states.
These grant programs provide funding for improvements to child
protective services, promising prevention efforts and for community-
based efforts to prevent abuse and neglect.
CAPTA provides grants to states for ``technical assistance'' and
require states to have laws related to reporting child abuse,
investigation procedures and procedures and resources for working with
affected families.
In order to receive funds, States must meet a minimal definition of
child abuse and neglect.
While CAPTA has brought much needed attention and change to the
issues of child maltreatment, this number remains too high.
The rates of physical abuse have decreased in recent years, but the
rates of neglect have remained disturbingly constant.
And we know that difficult financial times can certainly aggravate
violence and victims with fewer personal resources become increasingly
vulnerable.
For example, since the economic crisis began, it has been reported
that three out of four domestic violence shelters have reported an
increase in women seeking assistance from abuse.
That means we have more work to do, which is why I am holding this
hearing today. Thank you all for being here and I look forward to the
testimony.
______
Mr. Platts. Thank you, Madam Chair. I first want to thank
and commend you for your continued leadership and focus on this
very important issue as we seek to work with partners
throughout the Nation in protecting our children and helping
our Nation's families do right by their children.
I am going to submit my full statement for the record
because, as I mentioned, I want to apologize up front to you
and to the witnesses. I am against human cloning, but for me, I
am supposed to be in about four spots right now, so I only have
about a half hour before I run out, and hopefully I will get
back for a later part of the hearing this morning.
I want to very much thank our witnesses for being here to
share your expertise and your knowledge, but most importantly,
I want to thank you for day in and day out working to help
protect our Nation's children and to serve them and their
families so that we can all be part of the same team.
Your work is critically important to the safety of so many
children throughout this country. Each day you are making a
difference, and I commend you for your efforts.
With that, I will submit my statement for the record and
allow us to move forward.
Thank you, Madam Chair.
[The statement of Mr. Platts follows:]
Prepared Statement of Hon. Todd Russell Platts, Ranking Minority
Member, Subcommittee on Healthy Families and Communities
Good morning. I would like to welcome you all to our hearing today.
Today we will examine ways to prevent child abuse and improve
responses to families in crisis. As we all know, child abuse comes in
many different forms. Child abuse can be physical, sexual, or emotional
in nature, and occurs in all segments of our population, crossing
ethnic, racial, and even economic lines in some cases.
According to the American Academy of Pediatrics, each year more
than 2.5 million cases of child abuse and neglect are reported. Recent
studies show that twenty-five percent of girls and one in eight boys
will be sexually abused before they reach eighteen years of age. We
know that these children suffer both short and long-term physical and
emotional damage. Many children become depressed well into adulthood.
Others become violent, and even suicidal. Children who are abused are
at a higher risk of abusing drugs and alcohol.
Congress has made progress on this issue over the last several
decades with the Child Abuse Prevention and Treatment Act (CAPTA),
first passed in 1974. This legislation provides minimum standards that
states must incorporate in their statutory definitions of child abuse
and neglect. CAPTA defines child abuse and neglect as, ``any recent act
or failure to act on the part of a parent or caretaker, which results
in death, serious physical or emotional harm, sexual abuse, or
exploitation, or an act or failure to act which presents an imminent
risk of serious harm.'' The last authorization of CAPTA in 2003 focused
on three major goals: preventing child abuse and family violence before
it occurs; maintaining local projects with demonstrated value in
eliminating barriers to permanent adoption; and addressing the
circumstances that lead to child abandonment.
We will hear today from several experts on the successful
prevention and treatment of child abuse. For example, the Differential
Response System has received bipartisan support and demonstrated
effectiveness with its approach that allows child protective services
to respond differently to confirmed reports of child abuse and neglect.
Child protective services take into consideration the type and severity
of abuse reported, number of sources of reports and willingness of the
family to participate. Results have shown a reduction in
investigations, repeated reports of maltreatment, court involvement,
child in-placements, while at the same time increasing family
involvement and the number of children served.
Despite the considerable work that has been done on this issue at
both the federal and local level, child abuse is still on the rise. As
such, we must continue to explore innovative ways to prevent child
abuse in our communities. Teresa Smith, Coordinator and Executive
Director of the Pinnacle Health Children's Resource Center in
Harrisburg, Pennsylvania, has joined with us today. Currently the Co-
Chair of the Pennsylvania CAPTA Workgroup, I am grateful for her
sharing with us the importance of implementing CAPTA in states
nationwide, including Pennsylvania.
I look forward to hearing the testimony from all of our witnesses
today. As we move toward the reauthorization of CAPTA, we must take
into consideration the current trends in child abuse and neglect and
remain focused on prevention at the local level. Thank you, Chairwoman
McCarthy.
______
Chairwoman McCarthy. Thank you. Pursuant to committee rule
7(c), any member may submit an opening statement in writing at
this time, which will be made a part of the permanent record.
Without objection, all members will have 14 days to submit
additional materials or questions for the hearing record.
I would like to briefly introduce our distinguished panel
here this morning. The complete bios of the witnesses will be
inserted into the report.
Today, we will hear from six witnesses, each of whom will
focus on abuse and neglect prevention and action. I want to
thank all of you for taking the time out to be here in front of
this panel.
I also ask unanimous consent for a member of the full
committee, Ms. Woolsey, and a member who is not on a committee,
Representative Gwen Moore, to sit on the dais and ask
questions. Each of these members have been leaders in domestic
violence and child welfare issues.
Again, I welcome you to our committee. In the interest of
time, given the large number of witnesses today, I will keep my
formal introductions short.
Our first witness is Dr. Rodney Hammond, the Director of
Violence Prevention at the National Center for Injury,
Prevention, and Control at the CDC. He has held this position
since 1996. At the CDC, Dr. Hammond is responsible for research
and programs to prevent homicide, suicide, family, intimate
partner and sexual assault, child abuse, and youth violence.
Through his professional career, efforts have been focused on
youth violence, prevention, and it is a public health concern.
Our next witness is Dr. Wilson Spigner of the University of
Pennsylvania School of Social Policy and Practice,
Philadelphia, Pennsylvania. Prior to her arrival at Penn, Dr.
Spigner was the Associate Commissioner of the Children's Bureau
at the U.S. Department of Health and Human Services,
Administration for Children and Families, and was responsible
for the administration of Federal child welfare programs.
Our next witness is Caren Kaplan. She has almost 30 years
experience in child welfare and policy and practice. As the
Director of the Child Protection Reform at the American Humane
Association, Caren oversees the National Initiative on Chronic
Neglect. Caren manages several efforts to examine and refine
the assessments of child safety, risk, and comprehensive family
functioning by child protection agencies.
Our next witness is Sandra Oliva from Hempstead, New York,
which is part of my district. Sandra is the Executive Director
of the Nassau County Coalition Against Domestic Violence. She
served in that role for nearly 25 years. Under her leadership,
the Nassau County Coalition Against Domestic Violence has grown
into a multifaceted, comprehensive domestic violence service
organization, helping over 3,000 adults and children annually.
Sandra's vision, insight, and commitment have encouraged
the agency to develop individualized and tailored services to
meet the needs of adults and youth victims in crisis. These
services include crisis intervention, counseling, advocacy
services, safe homes, transitional housing, community education
and outreach, legal services, and legislation and legal
advocacy.
I now yield to Ranking Member Platts to introduce our next
witness, Ms. Smith.
Mr. Platts. Thank you, Madam Chair. I am delighted to have
the opportunity to introduce a fellow Pennsylvanian, Ms. Teresa
Smith. Ms. Smith is Executive Director of the PinnacleHealth
Children's Resource Center and has been an employee of
PinnacleHealth system for 24 years. She
cofounded the hospital-based Children's Advocacy Center
Program in Harrisburg, Pennsylvania, in 1994, and since that
time she has been working to ensure that children are safe and
well cared for.
The Children's Advocacy Center in Harrisburg is one of the
most renowned children advocacy centers in Pennsylvania, and a
great model program for other centers around the State, and
including in my congressional district. The Center collaborates
with partners in the community to prevent, investigate, and
treat child abuse. Ms. Smith is also a site reviewer for the
National Children's Alliance and the cochair of the
Pennsylvania CAPTA Working Group.
Ms. Smith, we are delighted to have you here. Thanks for
your work back home and for your testimony here today.
I yield back.
Chairwoman McCarthy. Finally, I would like to introduce Rob
Sawyer from Olmsted County Child and Family Services in
Minnesota. Welcome. Mr. Sawyer is the former Director of Child
and Family Services in Minnesota and has spent years working on
child abuse prevention issues in his State. He brings a wealth
of the ground experience in our discussion today. And we
welcome you.
Let me explain the lighting system that is in front of you.
For those of you who have not testified in front of Congress
before, everyone, including the members, is limited to 5
minutes of presentation of questions. The green light will
illuminate when you start speaking. The yellow light will go on
when your time is just about up. And when you see the red
light, you will need to conclude your testimony.
We will be more lenient on allowing members to finish their
thoughts. So we want to hear all of your testimony.
Please be certain to turn on your microphones when you
start to speak to us.
We will now hear from our first witness.
Dr. Hammond.
STATEMENT OF RODNEY HAMMOND, PH.D., DIRECTOR OF DIVISION OF
VIOLENCE PREVENTION NATIONAL CENTER FOR INJURY PREVENTION AND
CONTROL, CENTERS FOR DISEASE CONTROL AND PREVENTION
Mr. Hammond. Thank you and good morning, Chairwoman
McCarthy, Ranking Member Platts, and other distinguished
members of the subcommittee. On behalf of CDC, it is an honor
to be here.
I serve as the Director of the Division of Violence
Prevention at CDC's Injury Center. Today, I will highlight that
public health can complement child welfare and protective
services by bringing proven prevention strategies to scale.
This involves three key points. First, that public health
has an important role to play in preventing child
maltreatment. Second, that we have the opportunity to put
in place innovations in how we prevent child maltreatment
through evidence-based strategies. Third, that scaling up these
approaches necessitates partnerships between public health,
social services, and child-serving entities to ensure quality.
We know that child maltreatment has significant short- and
long-term health consequences. For example, in 2007, an
estimated 1,760 children younger than 18 years old died as a
result of maltreatment. We also know that approximately 794,000
children were determined by State and local Child Protective
Services to be victims of child maltreatment. These numbers, no
doubt, are an underrepresentation because the data only reflect
cases that are reported to the Child Protective Services
system.
But we also know that exposure to child maltreatment has
long-term health consequences into adulthood, such as heart
disease, cancer, drug abuse, and depression. Moreover, studies
show that exposure to child maltreatment is linked to other
forms of violence, including youth violence and intimate
partner violence.
There is a wealth of evidence showing the needs of children
for healthy development. First, we know that children need to
be safe from physical and psychological harm. Secondly, we know
that children need a degree of stability in their environment.
And, third, they need a nurturing parent or other caregiver
that is consistently available to meet their needs.
The way to reduce child maltreatment is to promote child
health. We can do this by fostering safe, stable, nurturing
relationships using a public health approach. We are at a
critical juncture because we now have prevention programs that
work. Now is the time to focus on wide-scale implementation of
those programs.
Recent CDC studies show that child maltreatment rates
actually fall when parents have access to interventions that
address problems with child behavior. For example, PPP, a
parenting program, combines broad social campaigns with
targeted parenting support services. In addition, early
childhood home visitation programs are effective. For instance,
the nurse-family partnerships focus on first-time mothers
during pregnancy, working to promote positive health and
interactions between mother and child.
Although there are promising interventions, there are still
some opportunities for improvement. We need data that provides
a comprehensive understanding of the ideal settings for
interventions, and we need a better understanding of risk
surrounding child maltreatment.
We need to continually evaluate promising strategies,
including programs and policies that target at the individual
and community levels so that we can widely implement. We need
to develop public health capacity to support prevention
programs that complement Child Welfare and Child Protective
Services. We must work to make prevention accessible,
especially to parents, without stigma.
So, in conclusion, public health can lessen the burden on
child welfare and protective services by bringing prevention
strategies to scale and ensuring that they are accessible to
all families that need and want them. Scaling up these
approaches necessitates collaboration between public health,
social services, and child serving agencies. A partnership
between public health and child protection services will allow
more people to access programs that strengthen families and
help children to live life to their fullest potential.
I would like to thank the subcommittee for its continued
support of CDC and its injury and violence programs, and I
would be happy to answer any questions that you may have. Thank
you.
[The statement of Mr. Hammond follows:]
Prepared Statement of Rodney Hammond, Ph.D., Director, Division of
Violence Prevention, National Center for Injury Prevention & Control,
Centers for Disease Control & Prevention, U.S. Department of Health and
Human Services
Good morning Chairwoman McCarthy, Ranking Member Platts and
distinguished Members of the Subcommittee. My name is Dr. Rodney
Hammond, and I am the Director of the Division of Violence Prevention,
a Division of the National Center for Injury Prevention & Control
(NCIPC) within the Centers for Disease Control & Prevention (CDC).
Thank you for the opportunity to appear before you on behalf of CDC to
discuss our Agency's research and prevention activities addressing
child maltreatment. At CDC, we work to ensure that all people achieve
their optimal lifespan with the best possible quality of health at
every stage of life.
Regardless of gender, race or economic status, injuries are a
leading cause of death for young Americans. Violence is a particularly
serious threat to the health and well-being of children and adolescents
in the United States. Furthermore, violence such as child maltreatment
is preventable. CDC is leading the nation's efforts in reducing
premature death, disability, human suffering and the medical costs
associated with violence. Working with state and local governments,
nonprofit organizations, academic institutions, private entities, other
federal agencies and international organizations, CDC continues to
document the rates of violence including identifying the risk and
protective factors for child maltreatment, finding effective prevention
strategies, and promoting widespread adoption of these solutions. We
strongly believe that every child deserves to live his or her life to
their fullest potential. Preventing child maltreatment is one major
step toward that end.
I will begin my testimony today by giving an overview of child
maltreatment and explaining CDC's unique public health role in its
prevention. I will share updates on promising interventions and gaps
within the field, and I will close by highlighting that the widespread
adoption of proven interventions is an effective solution to preventing
a majority of childhood injuries and deaths from maltreatment.
Child Maltreatment: Definition
``Child abuse'' is deliberate and intentional words or overt
actions that cause harm, potential harm, or threat of harm to a child.
``Child neglect'' is the failure to provide for a child's basic
physical, emotional, or educational needs or to protect a child from
harm or potential harm.\1\ CDC defines child maltreatment as any act or
series of acts of commission or omission by a parent or caregiver that
results in harm, potential harm, or threat of harm to a child. Much of
the child maltreatment field divides acts of commission into three
broad categories--physical, sexual, or emotional abuse. Acts of
omission are often referred to as child neglect and divided into two
categories--failure to provide for a child's basic needs and failure to
protect a child. Thus the term ``child maltreatment'' as used in this
testimony applies to a broad range of harmful activities including
``child abuse'' and ``neglect''.
The Burden of Child Maltreatment in the U.S.
The magnitude of child maltreatment in the United States is not
easily determined, but it is clearly substantial. In 2007, an estimated
1,760 children younger than 18 years old died as a result of
maltreatment and approximately 794,000 children were determined by
state and local child protective services agencies to be victims of
child abuse or neglect.\2\ It is likely that the actual number of
children who experience maltreatment each year is even larger, because
many cases go unreported or undetected. Survey data provide a more
troublesome picture of the problem of child maltreatment. Estimates
based on a 2008 national survey of children aged 2--17 years indicate
that approximately one in ten children reported having experienced
maltreatment and one in sixteen were victimized sexually.\3\ Child
maltreatment through blunt trauma to the head or violent shaking (also
known as abusive head trauma or shaken baby syndrome) is the leading
cause of head injury among infants and young children. Additionally,
homicide was the fourth leading cause of death for children ages 1-9
years in 2006.
In addition to injuries and related health issues during childhood,
child maltreatment can increase the risk factors for many of the
leading causes of death among adults. CDC research shows that children
who experience maltreatment are at an increased risk for a variety of
health problems, including heart disease, cancer, chronic lung disease,
liver disease, alcoholism, drug abuse, and depression. In addition,
child maltreatment is closely linked with other forms of violence in
adulthood such as intimate partner violence. Furthermore, studies have
also shown that witnessing or experiencing abuse as a child can
increase the risk factors for becoming a victim or perpetrator of
violence. Addressing violence issues at an early stage would aid in
assuring optimal prevention and wellness for individuals throughout
their lifespan.
CDC's Role in Child Maltreatment Prevention: Promoting Safe, Stable,
Nurturing Relationships
CDC's child maltreatment prevention program aims to prevent
maltreatment and its consequences through data monitoring to understand
the problem and its trends over time, research and development,
capacity building to ensure organizations and entities are equipped to
engage in prevention efforts, communication, and leadership. CDC's
public health approach emphasizes rigorous science and complements
other approaches such as those of the child welfare system, criminal
justice and mental health systems. CDC achieves these primarily through
data monitoring and sharing; research on possible interventions;
community implementation and evaluation of interventions; and
widespread adoption of proven interventions. This multi-pronged effort
adds to the knowledge base regarding violence and how to prevent it.
The long-term goal of CDC's work in child maltreatment prevention is to
achieve lasting change in the factors and conditions that place
children at risk through making changes at individual, family,
community, and societal levels to reduce rates of child maltreatment.
Within this field, there is a great need for primary prevention
strategies that stop abuse and neglect before it occurs. Developing
effective prevention programs is essential. CDC in consultation with
national experts has identified safe, stable, and nurturing
relationships (SSNRs) between caregivers and children as the foundation
of a unified strategic approach and message to empower parents and
caregivers and to reduce child maltreatment. This approach is aimed at
motivating change in parenting behavior and increasing parents' skills
and knowledge to lower incidents of child maltreatment. SSNRs
strengthen parenting practices that prevent child maltreatment by
focusing on positive caregiving behaviors. Accordingly, promotion of
SSNRs can have synergistic effects on health problems as well as
contribute to development of skills that enhance acquisition of healthy
habits and lifestyles throughout the lifespan. It should also be noted
that SSNRs are not only about the direct relationship parents have with
their child but also the environment and context within which they
parent (e.g., community support such as accessible childcare). Rather
SSNRs becomes a comprehensive approach that focuses on making changes
at the individual, family, community, and societal levels to reduce
rates of violence in populations.
Promising Interventions
CDC recognizes a number of promising and effective strategies for
the prevention of child maltreatment. There is substantial evidence
that promoting SSNRs can be effective in reducing child
maltreatment.\4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21\ The most
basic approach to facilitating SSNRs is teaching parents positive child
rearing and management skills and strategies that are safe and
nurturing. There is substantial evidence that parent training programs
or behavioral family interventions delivered in clinical settings and
focused on influencing children's behavior through positive
reinforcement are effective at influencing the child rearing practices
of families.\22,23\
In fact, a new CDC-funded study shows that when parents have access
to proven parenting interventions designed to address problems with
child behavior (e.g., tantrums), key measures of child maltreatment
fall. For example, Triple P, the Positive Parenting Program, uses a
multi-level strategy focusing on parenting and family support that aims
to prevent behavioral, emotional and developmental problems in children
by enhancing the knowledge, skills and confidence of parents. Triple P
incorporates a wide range of support mechanisms for parents including
local media, brief public seminars, and parent consultation by
specially trained providers in clinics, schools, churches, and
community centers. Research results showed that implementing Triple P
in an area containing 100,000 children could translate annually into
688 fewer cases of child maltreatment, 240 fewer out-of-home
placements, and 60 fewer children with injuries requiring
hospitalization or emergency room treatment.
In addition, early childhood home visitation programs show strong
evidence of effectiveness in reducing violence against visited
children. These programs are designed to decrease the likelihood of
child maltreatment by providing parents with guidance for and examples
of caring and constructive interaction with their young children. This
approach facilitates the development of parental life skills,
strengthens social support for parents, and links families with social
services. Nurse-Family Partnership, or NFP, is one example of an
evidence-based early childhood home visitation program that was
developed based on evidence from randomized, controlled trials. NFP
focuses on first-time mothers during pregnancy and works to promote and
teach positive health and development behaviors between a mother and
her baby. Additionally, NFP is delivered by registered nurses over a
period of time (typically from the mother's first trimester to the
child's second birthday), thereby fostering a bond between nurse and
mother.
This early intervention during pregnancy allows for any critical
behavioral changes needed to improve the health of the mother and
child. Several randomized controlled trials have found this program to
effectively reduce abuse and injury, improve cognitive and socio-
emotional outcomes in children and have a very favorable benefit-cost
ratio. An evaluation of NFP documented a 48 percent decline in rates of
child abuse and neglect at the time of a 15-year follow-up study.
Furthermore, studies found reduced rates of crime and antisocial
behavior among both children and mothers.
Recognizing the significant benefits of home visiting programs such
as the NFP, the President has proposed in his 2010 budget, a home
visiting program designed to support the establishment and expansion of
evidence-based programs in states and territories. The President's
proposal gives priority to models that have been rigorously evaluated
and shown to have positive effects on critical outcomes, such as the
reduction in child abuse and neglect. This new home visitation program
will create long-term positive impacts for children and their families
as well as positive impacts for society as a whole.
Areas for Improvement in the field of Child Maltreatment Prevention
Although there are promising interventions within the field of
child maltreatment prevention, there are still some areas for
improvement.
Improved Monitoring
Routinely collected data for monitoring the rates of fatal and non-
fatal child maltreatment are limited. Simply put, better data on child
maltreatment will strengthen the ability to measure the true costs of
maltreatment; target crucial programs and policies to populations or
areas most in need to determine if progress is made; and help make the
best use of limited resources. Improved ability and capacity to monitor
nonfatal and fatal child maltreatment at the national and state levels,
will inform efforts to operationalize, measure, and monitor the
implementation of SSNR activities. CDC is working to address this gap
by funding the development and implementation of the National Violent
Death Reporting System, which monitors fatal child maltreatment across
18 states.
Development and Evaluation of New Approaches to Prevention
Caregiving behaviors occur in many different contexts and develop
with time. Understanding the development of caregiving behaviors and
how the contexts in which they occur influence child development is key
to understanding which interventions and policies promote SSNRs and
reduce child maltreatment. To gain a full understanding of the ideal
times and settings for intervention strategies, research is needed that
examines how SSNRs and negative caregiving behaviors, including child
maltreatment, develop. Understanding the development of different forms
of child maltreatment perpetration (i.e., physical abuse, neglect, and
sexual abuse) is critical because the different forms of child
maltreatment might have varying causes and thus require different
intervention strategies and timing. Moreover, although many parenting
programs have been evaluated, evaluation research is beneficial to
determine if such approaches are effective for the prevention of child
maltreatment and for the promotion of SSNRs, paying special attention
to whether these approaches are effective in different settings and
with different populations.
Building Community Capacity
The concept of a public health approach to child maltreatment
prevention is still relatively new, and capacity to address prevention
in community settings is not yet robust. Building community receptivity
and capacity for preventing child maltreatment facilitates the
implementation of evidence-based prevention strategies. Ensuring
community participation requires clarification of barriers to
cooperation and outlining key actions to foster a multidisciplinary,
collaborative approach to child maltreatment prevention and the
promotion of SSNRs. Working with experts within the field of child
maltreatment, CDC is developing evidence-based strategies needed to
help communities and their leaders understand the magnitude of the
problem and the long-term benefits of investments in primary
prevention, including tools that can be used to apply public health
approaches to child maltreatment and the promotion of SSNRs. For
example, some tools that CDC is reviewing include strategy guidance
products that help community planners and practitioners select the
appropriate type and mix of SSNR promotion strategies in their
community.
Conclusion
As you have heard, there is a strong and growing scientific basis
for the primary prevention of child maltreatment. In looking toward the
future, preventing such adverse exposures as maltreatment by ensuring
that all children are protected and raised in a safe, stable, and
nurturing environment is strategic for achieving measurable and lasting
impacts on health throughout life. It is critical to develop the
evidence for interventions that work and then get these interventions
into the hands of parents and caregivers who can use them effectively
to prevent child maltreatment. CDC is working to improve the gap
between research and practice and between discovery and delivery and to
continue progress in preventing and controlling violence. To save
lives, parents, caregivers, and providers need support for adopting and
maintaining interventions over time. Violence is preventable, and thus
should not happen.
I would like to use this opportunity to thank the Subcommittee for
its continued support of CDC and its injury and violence prevention
programs. I would be happy to answer any questions that you many have.
Thank you.
endnotes
\1\ Leeb RT, Paulozzi L, Melanson C, Simon T, Arias I. Child
Maltreatment Surveillance: Uniform Definitions for Public Health and
Recommended Data Elements, Version 1.0. Atlanta (GA): Centers for
Disease Control and Prevention, National Center for Injury Prevention
and Control; 2008.
\2\ Department of Health and Human Services, Administration on
Children,Youth, and Families. Child Maltreatment 2007 [online].
Washington (DC):Government Printing Office; 2009. [cited 2009 Apr 15].
Available from:www.acf.hhs.gov.
\3\ Finkelhor, D., Hammer, H., and Sedlak, A. 2008. Sexually
Assaulted Children: National Estimates and Characteristics. Washington,
DC: U.S. Department of Justice, Office of Justice Programs, Office of
Juvenile Justice and Delinquency Prevention.
\4\ National Scientific Council on the Developing Child. Young
children develop in an environment of relationships. Working Paper No.
1. [online] 2004. [cited 2006 Aug 10]. Available from url:
www.developingchild.net/reports.shtml.
\5\ Board on Children, Youth, and Families, National Research
Council and Institute of Medicine. From neurons to neighborhoods: the
science of early childhood development. Committee on Integrating the
Science of Early Childhood Development. In: Shonkoff JP, Phillips DA,
editors.Washington, DC: National Academy Press; 2000.
\6\ Barnard KE, Solchany JE. Mothering. In: Bornstien MH, editor.
Handbook of Parenting. Vol. 3. New Jersey: Lawrence Erlbaum Associates,
Publishers; 2002. pp. 3--25.
\7\ Ainsworth M.Patterns of infant-mother attachments: antecedents
and effects on development. Bulletin of the New York Academy of
Medicine 1985;61:792--812.
\8\ Bowlby J. Developmental psychiatry comes of age. American
Journal of Psychiatry 1988;145:1--10.
\9\ Antonovsky A.How the sense of coherence develops over the
lifespan in: unraveling the mystery of health. How people manage stress
and stay well. San Francisco: Jossey-Bass; 1987. pp. 89--127.
\10\ Widom CS, Maxfield M.An update on the ``cycle of violence.''
National Institute of Justice Research Brief. Washington (DC): National
Institute of Justice, 2001:1--8.
\11\ Sidebotham P, Heron J.Child maltreatment in the ``children of
the nineties'': a cohort study of risk factors. Child Abuse and Neglect
2006;30:497--522.
\12\ Seagull EAW.Social support and child maltreatment: a review of
the evidence. Child Abuse and Neglect 1987;11:41--2.
\13\ Waters E, Kondo-Ikemura K, Posada G, Richters JE.Learning to
love: mechanisms and milestones. In: Gunnar M, Sroufe L, editors. Self
processes and development. Minnesota Symposium on Child Psychology.
Vol. 23. New Jersey: Erlbaum; 1991. pp. 217--55.
\14\ Shaw DS, Gilliom M, Ingoldsby EM, Nagin DS.Trajectories
leading to school age conduct problems. Developmental Psychology
2003;39:189--200.
\15\ Dawson G, Asman DB.On the origins of a vulnerability to
depression: the influence of the early social environment on the
development of psychobiological systems related to risk of affective
disorder. In: Nelson CA, editor. The effects of early adversity on
neurobehavioral development. Minnesota Symposia on Child Psychology
2000. New Jersey: Erlbaum. pp. 245--79.
\16\ Dawson G, Frey K, Panagiotides H, Yamada E, Hessl D, Osterling
J.Infants of depressed mothers exhibit atypical frontal electrical
brain activity during interactions with mother and with a familiar
nondepressed adult. Child Development 1999;70:1058--66.
\17\ Seeman TE, Singer B, Horwitz R, McEwen BS.The price of
adaptation-allostatic load and its health consequences: McArthur
studies of successful aging. Archives of Internal Medicine
1997;157:2259--68.
\18\ Widom CS, Maxfield M.An update on the ``cycle of violence.''
National Institute of Justice Research Brief. Washington (DC): National
Institute of Justice, 2001:1--8.
\19\ Kotch JB, Browne DC, Ringwalt CL, Dufort V, Ruina E.Stress,
social support, and substantiated maltreatment in the second and third
years of life. Child Abuse and Neglect 1997;21(11):1025--37.
\20\ Garbarino J, Kostelny K. Child maltreatment as a community
problem. Child Abuse and Neglect 1992;16:455--64.
\21\ Cohen S, Wills TA. Stress, social support, and the buffering
hypothesis. Psychological Bulletin 1985;98(2):310--57.
\22\ Taylor TK, Biglan A.Behavioral family interventions for
improving child-rearing: a review of the literature for clinicians and
policy-makers. Clinical Child and Family Psychology Review
1998;1(1):41--60.
\23\ Lundahl B, Risser HJ, Lovejoy MC.A meta-analysis of parent
training: moderators and follow-up effects. Clinical Psychology Review
2006;26:86--104.
______
Chairwoman McCarthy. Thank you.
Dr. Spigner.
STATEMENT OF CAROL WILSON SPIGNER, MSW, DSW, ASSOCIATE
PROFESSOR/CLINICIAN EDUCATOR, UNIVERSITY OF PENNSYLVANIA SCHOOL
OF SOCIAL POLICY AND PRACTICE
Ms. Spigner. Good morning. Chairwoman McCarthy and Ranking
Member Platts, it is an honor for me to be back here in this
forum. I speak based on my experience. I have been working in
child welfare 40 years, including my service as Associate
Commissioner of the Children's Bureau. Since I left the
Children's Bureau, I have been focusing on assisting large
child welfare systems attempt to improve their services.
I want to talk a little bit about the background related to
CAPTA and then offer four areas that I think would be useful to
consider in improving Child Protective Services.
CAPTA was originally enacted in 1974 to assure that all
children experiencing maltreatment have the protection of the
State. CAPTA encouraged the development of systems that could
receive reports of abuse and neglect, evaluate them, and
provide protection for children.
CAPTA has facilitated effectively the development of child
protective systems across the country, as well as the
development of knowledge and practice strategies to address
this problem. Over the years, CAPTA has been modified to
include adoption, abandoned infants, and homeless children. It
provides funding for prevention, research, and program
development.
We have heard the statistics already on maltreatment today,
but I want to underscore several ideas. First, that neglect is
the largest category of child maltreatment. Secondly, I want to
underscore that the data tells us that the children under four
are the most vulnerable. They comprise 75 percent of the
children who die. They are unable to protect themselves and
often invisible to the community because of their age.
For the children at greatest risk, child protection
involves using the police power of the State to intervene in
family life. Through a combination of assessment,
decisionmaking and service, protective service agencies
operate to help families and children.
The four areas of concern I would like to speak to briefly
are decisionmaking; interstate referrals for abuse and neglect;
support for workers; and then, finally, the issue of
partnership with communities.
Let me just say that we have made significant progress in
terms of decisionmaking and developing
decisionmaking protocols to guide child protective service
workers, but we are not where we need to be. We now have the
capacity through technology and other resources to begin to
apply actual science to the predictive aspects of child
protection. We need an additional focus on decisionmaking to
improve the way judgments are made.
Secondly, I want to speak to the question of interstate
referrals. What we have found--I live and work in an area that
involves two jurisdictions. If the child, the location of the
event, and the perpetrator are not in the same jurisdiction,
cases are likely to fall through the cracks because one
jurisdiction will say, Well, the child is not in your
jurisdiction; another will say, Well, the event didn't occur
here. So in a time of mobility, there is a real problem that
cases get--reports get lost and potential perpetrators don't
get tracked. So that is an area that I would encourage you to
look at.
The third area I would encourage you to look at is really
improving the capacity of supervisors to support
frontline workers. This is very difficult work. Workers are
exposed to difficult situations; to child trauma repeatedly.
They are at risk of burnout, they are at risk of secondary
trauma.
I think the most critical thing that we can do in terms of
that is strengthen the supervisors' ability not only to manage
work, but to support them.
The next area has to do with partnerships with communities.
Child protection cannot be done by the child protective service
system alone. Communities shape the values and attitudes that
we have toward children. A number of jurisdictions have been
quite effective in sharing information about the conditions of
children in their neighborhood and organizing the neighborhood
to begin to create new messages and new structures to protect
children and to create neighborhood ownership of the
responsibility for child protection.
So one of my recommendations is that you use the
discretionary resources of CAPTA to promote more focus on
neighborhood-based strategies to child protection. They will
complement prevention strategies. They will also complement the
work of the child protective agency in attempting to increase
the safety of children.
I want to thank you for the opportunity and look forward to
any questions you may have.
[The statement of Ms. Spigner follows:]
Prepared Statement of Carol Wilson Spigner, DSW, Kenneth L.M. Pray
Professor, University of Pennsylvania School of Social Policy and
Practice
Chairwoman McCarthy and Ranking Member Platts: I am pleased to have
the opportunity to participate in this hearing with its focus on issues
that need to be considered in the reauthorization of the Child Abuse
Prevention and Treatment Act (CAPTA). I speak based on over forty years
of experience working with or on behalf of children and families in
distress. I continue to work with a number of child welfare agencies in
their efforts to improve the quality of service to children and
families. I wish to thank you both for your leadership on this issue.
Background
CAPTA was originally enacted in 1974 to assure that all children
experiencing maltreatment had the protection of the state. CAPTA
initially encouraged the development of systems that could receive and
evaluate allegation of abuse and provide protection to children. The
focus was on identification of children at risk, prevention and
intervention. CAPTA has facilitated the development of child protection
systems across this nation and the development of knowledge and
practice strategies to address this problem. Over the years the CAPTA
has been modified to include a focus on adoption, abandoned infants,
homeless children and children with disabilities. By providing funding
for prevention, research, program development, this legislation has
been a major building block for child protective services.
CAPTA authorizes in Section 106, the provision of formula grants to
states and territories to help improve their child protective service
(CPS) systems. To receive funding States must establish a child
protective service system and be able to comply with various
requirements related to the intake, screening, reporting,
investigation, and treatment of child maltreatment cases. Among the
requirements for funding of the basic grant States must define child
abuse and neglect, at a minimum, to include any ``recent act, or
failure to act, on the part of a parent or caretaker, which results in
death, serious physical or emotional harm, sexual abuse or
exploitation, or an act or failure to act which presents an imminent
risk of serious harm.'' States are required to provide ``to the maximum
extent practicable'' annual state data reports to the Secretary.
Section 106 requires the Secretary to annually compile this State data
in a report.
CAPTA does not direct the specific practices of state child
protective agencies but rather identifies the essential components of a
child protective service system. States have considerable discretion in
the design of their systems consistent with the values of their
community and the available resources. As a result all of the states
have the shared goal of protecting children, but structure their
responses differently.
Maltreatment Today
Today we continue to struggle to make sure that every child has a
safe and stable environment in which to grow up. According to Child
Maltreatment 2007, during fiscal year 2007 the number of referrals
received was nearly 3.2 million and involved 5.8 million children.
794,000 children were found to be maltreated. The most frequent problem
was neglect (59%) followed by physical abuse (10.8%) and sexual abuse
(7.6%).
Children of all ages are affected, but young children age of three
and under are the most vulnerable. Their vulnerability stems from their
age, dependency and their inability to protect themselves or speak out.
Because may of these children are not in school or child care setting,
they can be hurt without anyone recognizing injury, trauma and neglect.
There were an estimated 1760 deaths attributed to maltreatment in 2007.
Children under the age of one are had the highest rate of maltreatment
related deaths and children under the age of 4 comprised 75% of the
children who died.
For children at greatest risk, child protection involves using the
police power of the state to intervene into the privacy of the family.
We have an obligation to intervene and should do so with attention to
the child's safety, stability and well being. We want to protect them
and to do so in a manner that does the least damage. Most children are
helped by working with their families to improve safety and the quality
of care they receive. One in five maltreated children was placed in
foster care in 2007.
Through a combination of assessment, decision making and service,
child protective service agencies work to help vulnerable families and
children. Staff must assess the safety and risks to children; determine
whether it is safe to leave the child with the family or if placement
is necessary; and decide which services are provided to increase safety
and reduce risk in families. The work is complex.
I would like to identify four areas of concern that could be
improved if addressed in the reauthorization of CAPTA: decision making,
responsibility for inter-state allegations, support for frontline
workers and partnerships with communities.
Issue #1: Decision-making
CAPTA can assist in strengthening the capacity of state child
protection programs to conduct systematic decision making related to
the safety of children and selecting service options.
Several years ago, the City of Philadelphia was plagued by child
fatalities. I was asked to head a review team to identify needed
reforms. In reviewing the operation of the Department of Human
Services, we learned that the agency was not consistent in its decision
making. During investigations some children who were unsafe were being
not served while other children whose families were struggling with the
problems which were not related to safety and risk but rather material
needs were being accepted for protective services. The resources of the
agency were not being used in a focused way contributing to failure to
identify some of the most vulnerable children. The criteria being used
to screen for safety were not clear. As a result the purpose of child
protection was not clear and the agency's ability to protect children
was compromised.
Nationally, we have made progress in developing systematic decision
making tools which identify factors that need to be assessed and the
criteria for assessment. The tools have been developed for screening
referrals and assessing risk and safety. The tools guide the worker's
examination of important areas that are thought to be predictive. With
some of the newer technology, we now have the ability to apply
actuarial science to maltreatment to improve our protocols and decision
making and to begin to identify which services work for which families.
Moving this forward will require focused investments.
Recommendation: Create within CAPTA opportunities to enhance the
development of decision making protocols that are empirically based;
have the ability to predict future abuse; and identify appropriate
services. Such tools can allow child protective services to focus
resources on the families where children are at greatest current and
future risk and to provide services that foster the outcomes of safety,
permanency and well being.
Issue #2: Unclear responsibility for investigation of reports that
cross state lines.
Child maltreatment is no respecter of state lines. Given the
mobility of our society, it is not unusual for an incident of
maltreatment to occur in a state other than the one which the child
resides. For example a custodial parent may learn of abuse that
occurred in an adjacent state during a visit to other members of the
family. If the parent makes a report in the state where she resides,
she may find that the state is without jurisdiction because it was not
the location of the abuse. On the other hand, if the report is made to
the state in which the abuse occurred, they may indicate that they have
no jurisdiction because the child is not currently living in their
state.
The result is that neither of the jurisdictions will investigate
the allegation and the opportunity for protection is lost. Future abuse
may continue for this child or others. It is difficult to document how
often this occurs, but in the absence of a clear federal standard or
interstate agreements which provide clarity about responsibility,
children in these situations do not have access to investigations or
assessment that will evaluate the need for protection.
Interstate compacts have been developed in other areas of child
welfare such as foster care and adoption, which clarify
responsibilities among the states when a child moves beyond the
original jurisdiction.
Recommendation: Using the authority of CAPTA, the federal
government work with the states to develop clear guidelines that
establish responsibility for investigation of allegations of child
maltreatment in instances when the location of the abuse, the location
of the victim and the location of the perpetrator involve more than one
state.
Issue #3: Supervisory Support for Frontline Workers
Frontline workers go out into communities every day and confront
families and children where sexual and physical abuse and neglect are
suspected. We expect workers to be fair and engage families who did not
invite them into their lives and are understandably angry and
defensive. Every day workers have to look at the consequences of
maltreatment on children including physical injury; sexual trauma; the
sadness, depression and anger.
Workers are asked to deal with trauma, conflict and hostility
repeatedly in the course of their work. The work is stressful and over
time can lead to secondary trauma and burnout and reduce effectiveness.
In order to be productive and objective, frontline workers need to have
supervision that focuses not only on the work tasks and decision
making, but also on the impact of repeated stress on their performance.
Key to providing this kind of support and guidance are supervisors.
Most supervisors are good at managing the flow of work but not as
skilled at managing the emotional aspects and it impact on performance.
There is general recognition that the work force needs to be
supported and strengthened. One way to do this is to assist supervisors
in developing the skills needed to assess and assist staff in dealing
with the emotional impact of their work so that they can continue to
work effectively.
Recommendation: Provide training and technical assistance resources
that focus on the role of the supervisor in managing not only the
administrative and practice requirement of the work, but also the soci-
emotional aspects of the work.
Issue # 4: Partnership with communities
Finally, the prevention of child abuse and neglect cannot be done
by agencies alone. In the communities where children experience the
greatest risk, there is a need for both agency and community leadership
and residents to address the problem. We need to begin to change the
cultural attitudes that make it easy to victimize children. This will
require partnerships that extend beyond the usual collaborators. We
need to develop strategies for child protection that focus on
neighborhoods; and include decentralized services and the inclusion of
neighbors, community institutions, faith-based organization and
community leaders in the discussions about improving the safety and
well being of children.
In the past, child protective services have operated with little
interaction with residents. The work has been invisible except when
children disappeared from the community or a tragedy occurred. We have
come to recognize that how children are valued and cared for is more
influenced by the attitudes of the community than the state or local
government. When communities are provided data and information on the
status of children, they mobilize to act and bring about change. In
communities that have built partnerships with residents, there is a
real interest in the conditions of children and leadership develops
which offers new ideas and underscores the importance of raising
children well. Houston, Texas has used this approach to deal with child
safety and disparities in the child welfare system. We need to continue
to expand and test this approach.
Recommendation: Establish demonstration grants to support
neighborhood partnerships based on shared responsibility for child
protection. These grants will be used for the purpose of adapting
current approaches to new communities and evaluating the impact in
order to better document and understand this approach.
Madam Chairwoman, Thank you again for the opportunity to address
this Committee.
______
Chairwoman McCarthy. Thank you.
Ms. Kaplan.
STATEMENT OF CAREN KAPLAN, MSW, DIRECTOR OF CHILD PROTECTION
REFORM, AMERICAN HUMANE ASSOCIATION
Ms. Kaplan. Good morning. Chairwoman McCarthy, Ranking
Member Platts and members of the subcommittee, my name is Caren
Kaplan, 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
chairwoman, ranking member, and subcommittee members for the
invitation to do so.
American Humane is a national, nonpartisan membership
organization that was founded 132 years ago to protect the
welfare of children and animals. Our testimony reflects over a
century of progressively advocating at the Federal, State, and
local levels for laws that protect both children and animals
from abuse and neglect.
In 1974, Congress passed what was and still remains the
preeminent Federal legislation addressing child
maltreatment. Throughout the United States, a primary
responsibility of child protection agencies is to receive and
respond to all reports of alleged child abuse and neglect.
Historically, there has been one response by the Child
Protection Agency to accepted reports: An investigation.
Given that the majority of families who come to the
agency's attention are at low or moderate risk of
maltreatment and are not experiencing immediate safety
issues, a trend has emerged since 1993 among child welfare
agencies to respond to these families differentially--in a way
that is much more responsive to the needs they present.
Differential response--I will also refer to it as DR--is
based on several foundational tenets. Families are not all the
same and the severity of the family situation is not identical
across families who come to the attention of the agency. It is
important to be responsive to the specific differences.
Another foundational tenet of differential response is
based on the fact that the child welfare data nationally
collected annually indicate that many families receive no post-
investigation services. After being identified and labeled as
child abusers, these families refuse services and the case is
closed.
A significant proportion of these families will return to
the agency, as there is no intervention to the immediate
difficulties they have. Some will eventually be involved in the
court, and they will be ordered to comply with court decisions.
Thus, our historical approach with these families has been to
produce incentives to meet an obligation instead of promoting
cooperation and motivating families to change, which is the aim
of differential response.
Differential response emphasizes the value of child and
family assessments without a determination that
maltreatment has occurred. It allows for access for
available resources and services rather than solely
investigating the occurrence of maltreatment. Services are
provided to families without labeling a perpetrator, a victim,
and without listing anyone in the central registry.
Thirty-eight percent of victims, or over 300,000 children
nationwide, received no post-investigative services. This was
data from 2007. In States that have mature differential
response practices, much like Minnesota--my colleague, Rob
Sawyer will speak to this--between 60 and 80 percent of the
families screened by the county child welfare agencies receive
this family assessment response. And that is the name used in
Minnesota to refer to their differential response system.
Families who come to the attention of the CPS agency
because the child has poor hygiene is inadequately supervised,
harshly disciplined, are examples of families that can receive
a non-investigation response. Families who come to the
attention of the CPS agency because the child has been sexually
abused will receive an investigatory response.
The likelihood of any criminal activity requiring
involvement of law enforcement is not considered appropriate
for differential response. Families for which there is
substance abuse or domestic violence or family violence of any
kind may receive one or the other response, depending on the
specific situation and the characteristics of the family.
Differential response has been implemented Statewide and in
selected jurisdictions in 20 States nationwide. The number
continues to grow. Although research is in its infancy, random
assignment design studies, a rigor that is not common in the
child welfare system, show the following positive results:
Child safety is not compromised. In some instances, safety is
achieved sooner. Repeat cases of abuse and neglect decrease.
There are higher rates of family cooperation and participation.
There are lower placement rates in foster care. The costs to
the system are reduced over time. And there is increased
satisfaction both by the workforce and the families that are
participating in a differential response system.
On behalf of American Humane, I respectfully request that
the subcommittee entertain four recommendations: Support the
efforts of State, local, and tribal child welfare agencies to
provide differential responses to individual families who come
to the attention of the Child Protection Agency. Many families,
through no fault of their own, lack the personal history, know-
how, and resources to protect their children from harm or risk
of harm. Differential response systems allow for and promote
the use of interventions that do not alienate nor demonize
parents, but rather engage parents in addressing the needs so
they can successfully and safely parent their child.
Support flexibility to front load the system. The current
Federal child welfare funding streams provide incentives to
place children outside their home. The primary way to prevent
removal of children from their families' origin is to invest
resources, whether they be staff time in an intervention,
concrete and therapeutic services, and formal and informal
supports, at the beginning of families' involvement with the
Child Protection System.
The identification of service needs in a differential
response begins at the first contact with the family, without
delaying the availability of service provision until an
investigation or any other agency procedures are completed. To
the extent possible, encourage modifications in the State
Automated Child Welfare Information System, better known as
SACWIS, that allows recapturing the data of those children who
are part of a differential response.
With the implementation of differential response, the
current child welfare data systems require modification in
order to collect and produce quality data so that we can
understand and assess what is happening with these families.
While we understand that appropriated levels of funding do
not come out of this committee, it is significant to note that,
as I said previously, 300,000 children identified as victims of
maltreatment receive no post-investigative services. Therefore,
we request your support for the increase of allocations.
American Humane hopes this CAPTA reauthorization serves as
a foundation and impetus for the reduction of children who
experience abuse and neglect and an increase in the number of
families who have sufficient strengths, capacity, and supports
to keep children safe from harm.
Thank you.
[The statement of Ms. Kaplan follows:]
Prepared Statement of Caren Kaplan, MSW, Director of Child Protection
Reform, American Humane Association
Chairwoman McCarthy, Ranking Member Platts 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 Chairwoman McCarthy, Ranking Member Platts and the members of
this Subcommittee for the invitation to do so.
American Humane, a national, nonpartisan membership organization,
was founded 132 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
preeminent 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 2007, an estimated 3.2 million
referrals, involving the alleged maltreatment of approximately 5.8
million children, were made to Child Protective Services (CPS) agencies
[US HHS, 2009]. An estimated 1.86 million children received an
investigation or assessment. In 2007, an estimated 792,000 children
were determined to be victims of abuse or neglect. Of the 792,000
victims, 38% of the victims (300,960 children) received no post
investigation services.
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.
Historically, there has been one response by the child protection
agency to accepted reports of alleged maltreatment--an investigation.
Given that the majority of families that come to the attention of the
child protection agency are deemed to present low or moderate risk of
maltreatment, and are not experiencing immediate child safety issues,
there has been a developing trend for the past 15 years to respond to
these families differentially in a manner that supports families.
Differential Response is based on several foundational tenets.
Families are not all the same--and in particular the severity of the
family situation is not identical across families who come to the
attention of the child protection agency and therefore, it is important
to be responsive to the differences among the families that come to the
attention of the child protection agency. Another foundational tenet of
Differential Response is based on the notion that over the many years
in which we have collected data--the 2009 report of the Children's
Bureau on Child Maltreatment that examines 2007 data and is the 18th
issuance of this official report--many families (38% of victims in
2007) received no post-investigation services. After being identified
and labeled as `child abusers', these families refuse services and the
case is closed. A significant proportion of these families will return
to the CPS agency as there was no intervention to remediate their
difficulties. Some will eventually require juvenile or family court
involvement and they will be ordered to comply with court decisions.
Thus, our historical approach with these families has produced
incentives to `meet an obligation' and resist anything that resembles
comparable interference and enforcement instead of breeding the
cooperation and motivation of families to change--which is the aim of
Differential Response systems.
Differential Response Systems is an approach that allows CPS to
respond differently to accepted reports of child abuse and neglect. It
emphasizes the value of the assessment of the child and his/her family
without requiring a determination that maltreatment has occurred or
that the child is at risk of maltreatment [U.S. Department of Health
and Human Services, 2003]. It allows for access to available resources
and services rather than solely investigating the occurrence of
maltreatment. 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]. It is accompanied by greater efforts to identify, build, and
coordinate formal and informal services and supports that respond to
the families self-identified needs.
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 almost twenty states and this number is
rapidly expanding. 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.
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 the reauthorization of CAPTA
Support the efforts of states, local and tribal child
welfare agencies to provide Differential Responses to individual
families who come to the attention of the child protection agency. The
preponderance of families is not individuals who have committed
egregious harm to their children. Many, through no fault of their own,
lack the personal history, know-how and resources to protect their
children from harm or the risk of harm. Differential Response systems
allow for and promote the use of interventions that do not alienate or
demonize parents but rather engage the parent in addressing their needs
so they can successfully and safely parent their children.
To the extent possible, encourage modifications in State
Automated Child Welfare Information System in Differential Response
jurisdictions that allow for capturing the expanded child protection
responses. Recognize that with the implementation of Differential
Response, the current child welfare data systems require modifications
in order to collect and produce quality data to better understand and
assess these reforms. Without essential modifications, workers may be
entering case data in an automated system and documenting by hand the
data of other cases. This dual approach is ripe for errors and should
be eliminated.
Support flexibility to `front load' the system. The
current federal child welfare funding streams, such as Title IV-E,
provide incentives to use of out of home placement. It is important to
recognize that the primary way to prevent removal of children from
their families of origin is to invest resources--whether they be staff
time and intervention, concrete and therapeutic services, and/or formal
and informal supports--at the beginning of the families' involvement
with the child protection system.
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 300,960
children identified as victims of maltreatment received no post-
investigative services. Therefore, we request your support for the
increase in allocations. Greater balance is needed in the investments
in child maltreatment prevention, identification and early protective
interventions compared to investments in interventions after a child
has been separated from his/her family.
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 decision making
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 decision makers 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 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 decision makers, 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% 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%
of women and 63% 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.
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
The first goal of any child protection system response is to keep
children safe from harm. American Humane hopes this CAPTA
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 safe from harm.
As a longstanding member of the National Child Abuse Coalition
(NCAC), an alliance of over 30 organizations committed to strengthening
the federal response to the protection of children and the prevention
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
preeminent 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 111th Congress ends. As this
legislation progresses, we look forward to a continued dialogue with
Chairman McCarthy, Ranking Member Platts, Members of the Subcommittee
and the entire Congress.
______
Chairwoman McCarthy. Thank you, Ms. Kaplan.
Sandra.
STATEMENT OF SANDRA OLIVA, EXECUTIVE DIRECTOR, NASSAU COUNTY
COALITION AGAINST DOMESTIC VIOLENCE, INC.
Ms. Oliva. Thank you, Chairwoman McCarthy and the
distinguished members of the committee, for the opportunity to
testify about the Family Violence Prevention and Services Act,
known as FVPSA. I am Sandy Oliva. I am the Executive Director
of the Nassau County Coalition Against Domestic Violence, a
full-service domestic violence and rape crisis agency serving
all of Nassau County, New York.
I have been in that role for 25 years, but I come here
today not to speak for my agency but to speak on behalf of all
of my colleagues across the country and of course all of the
survivors whom we serve.
I am testifying to support the FVPSA's swift
reauthorization. It expired in 2008. So swiftness is important.
FVPSA is the only Federal funding dedicated to domestic
violence shelters and services, and for 25 years it has been
the lifeblood of programs that are at the heart of our Nation's
effort to prevent and end domestic violence. With 1.5 million
American women and some 800,000 men physically abused by their
spouses or partners, 15.5 million children exposed to that
violence annually, and an average of three women a day being
murdered by former or current partners, it is clear that the
work is essential.
While FVPSA-funded domestic violence programs have saved
and transformed millions of lives, great needs remain. As the
economic crisis that we are in further widens, the gap between
the growing demand and available resources, it is more
important than it ever was before to invest in these cost
saving programs so that advocates across the Nation are
supporting the FVPSA reauthorization bill that will allow us to
continue to provide these vital services and build upon our
strengths to improve and expand services.
Let me tell you about a couple of the people that we have
served and their families. First, Anita. My agency helped her.
She had been in a very long-term abusive, terribly violent
marriage, and one night her husband told her, It's time for
couples therapy, we are going together; put her in the car, but
took her to a remote area and shot her, left her for dead.
Fortunately, she was found and rushed to the hospital. The
hospital knew to call our
hotline and one of our advocates went to her side.
Eventually, she came into our safe home, where she was
reunited with her terrified young daughter and was able to heal
from her physical injuries and begin to plan for her future.
Now she is living in a safe location, one of our transitional
homes, and has moved from crisis to stability. There is a woman
who was left for dead and got a new chance at life with her
child.
There are approximately 1,400 FVPSA-funded programs like
ours across the Nation. In 2007 and 2008, these programs
sheltered almost 600,000 adults and children. Last year, my
agency served over 3,000 individuals, adults and children, and
answered over 6,000 hotline calls.
Domestic violence programs across the country are available
24/7 and respond to both the immediate crisis needs of victims
in danger and their longer term needs to become safe and self-
sufficient. And for almost every story like Anita's, there is a
gut-wrenching story of a victim who cannot receive lifesaving
services because programs simply don't have the resources.
According to Domestic Violence Counts 2008, on just one day
in 2008, while over 60,000 victims were served by DV programs,
almost 9,000 requests for services went unmet because programs
lacked adequate resources to serve them. So I strongly support
the recommendation to increase the funding authorization level
at FVPSA to meet the needs of all victims.
Another one of our clients, I will call her Mary, she came
to her safe home with her five children after her 2-month old
baby was released from the hospital with 16 broken bones. The
abuser, who had been violent with every member of that family
for years, threatened to kill them all if she ever told anyone
about the abuse that had been going on.
She was at the shelter for a while, received individualized
counseling, case management, advocacy, legal services from our
agency, and the children had to have a great deal of therapy as
well. But now this once victimized, terrified, and tormented
family is thriving in a safe environment with the tools they
need to rebuild their lives.
Excitingly, I am thrilled to be able to say, especially in
this company, that we, our domestic violence agency, is about
to collocate with the local Coalition Against Child Abuse and
Neglect so that both of our agencies can work with families
like Mary's in an efficient and effective way. And we are very
excited about the collocation and the collaborative effort,
which we hope will be a model across the country.
We support the recommendation to include a funding
set-aside for specialized services for abused children and
their parents in the FVPSA reauthorization so that programs
have the resources to provide age-appropriate services to
children in a supportive environment for the nonabusive parent
and break the cycle of violence. You cannot have safe children
if you don't have safe parents.
To successfully meet the needs of all victims, programs
must be able to target resources, and the FVPSA statute must be
reflective of all victims needs. Throughout FVPSA the language
should be more inclusive of children and youth, as well as
victims from underserved populations.
State plans to distribute FVPSA funding should reflect
steps taken to meet the needs of all victims, including those
who are marginalized. Specifically, we recommend that it
include appropriate definitions of domestic violence, dating
violence, and youth, to ensure that victims, regardless of age,
can receive vital tailored services. We also recommend enhanced
and improved targeted resources for culturally specific
programs and services so that all victims can be safe.
Finally, the DELTA grants, prevention grants, are a key
component of FVPSA reauthorization. They help communities and
States make strides toward preventing domestic
violence, and we think prevention is probably the most
important thing that can happen. They do this by changing the
community and personal attitudes about relationships and abuse.
Therefore, we strongly support the recommendation to enhance
and expand DELTA.
To sum up, in the words of one little boy, when asked what
he liked about the shelter that he and his mom had been in in
Maryland, he responded, Well, I can sleep at night now.
All victims and their children deserve to be able to sleep
at night and feel safe. To move closer to achieving this goal,
we urge the committee to prioritize the swift reauthorization
of FVPSA, inconclusive of the recommendations with an adequate
funding level.
Thank you very much.
[The statement of Ms. Oliva follows:]
Prepared Statement of Sandra Oliva, Executive Director, Nassau County
Coalition Against Domestic Violence
Chairwoman McCarthy, Ranking Member Platts, Chairman Miller,
Ranking Member Kline and distinguished members of the Committee, my
name is Sandra Oliva and I thank you for the opportunity to appear
before the Subcommittee to discuss the importance of swiftly
reauthorizing the Family Violence Prevention and Services Act (FVPSA).
As an advocate for victims of domestic violence, I am honored to
address Representatives who have demonstrated phenomenal leadership on
behalf of victims. I thank Representative McCarthy for inviting me to
testify and want to report that victims in New York's 4th district are
proud of your brave and tireless efforts to enact sensible firearms
legislation that is so important to domestic violence victims, who are
at extreme risk when perpetrators have and use guns against them.
I am Sandra Oliva, Executive Director of the Nassau County
Coalition Against Domestic Violence (NCCADV). I have served in the role
of director for almost 25 years. NCCADV, founded in 1977, serves all of
Nassau County, which with over 1.3 million inhabitants, is the most
heavily populated suburban area in the country. I am a member and
former Board Member of the New York State Coalition Against Domestic
Violence and, in turn, I work in partnership with the National Network
to End Domestic Violence (NNEDV) and the National Coalition Against
Domestic Violence (NCADV). Having been a part of the movement to end
violence against women for almost 30 years, I hope to speak on behalf
of my colleagues across the country and, of course, on behalf of the
survivors that we serve.
I am testifying to support the swift reauthorization of the Family
Violence Prevention and Services Act (FVPSA), which expired in 2008.
First authorized in 1984, FVPSA is the only federal funding dedicated
to domestic violence shelters and services and has been the lifeblood
of programs that have been preventing and ending domestic violence for
25 years. While FVPSA has helped programs save and transform countless
lives, significant needs remain. A FVPSA reauthorization bill should
build on FVPSA's successes while improving to meet the complex and
diverse needs of all victims of domestic violence. FVPSA's swift
reauthorization, with key improvements and adequate funding allocation,
will ensure that victims across the country have continued access to
services that save lives.
Domestic Violence--Across the nation and in Nassau County
When I began working in this field, much less was known about
domestic violence and few resources existed to help victims as they
endured life-threatening violence. While we now know more about
domestic violence and our society has acknowledged it as a crime,
domestic violence is still widely underreported. The statistics are
alarming. Annually, approximately 1.5 million American women and
800,000 men are physically abused by their spouses or partners\1\ and
15.5 million children are exposed to this violence.\2\
Estimates based on population reveal that there are likely 100,000
women currently at risk of domestic violence in Nassau County alone.\3\
Domestic violence is serious, degrading and life-threatening.
Domestic violence and dating violence includes threats, coercion, and
physical and sexual assaults against a current or former intimate
partner. All too often domestic violence ends in death. In 2005 alone,
1,181 women were murdered by an intimate partner in the United
States\4\--an average of 3 women a day. In Nassau County, in 2008 and
2009, 16 adults and children lost their lives in domestic violence
homicides. The numbers across the country seem to indicate an upward
trend of senseless loss of life as a result of domestic violence. For
example, advocates from STAND! Against Domestic Violence in Concord,
California, are shocked and appalled by the level of violence they have
seen this year--domestic violence homicides have claimed the lives of
10 adults and children in 2009. Last year, in York County Pennsylvania,
10 individuals were murdered in domestic violence-related incidents and
in Minnesota 35 people lost their lives in domestic violence homicides.
Domestic violence is more than a crime--it is a public health
crisis. Such violence and trauma have immediate and long-term costs on
our communities through lost productivity, medical and health related
costs and law enforcement and court interventions. The Academy on
Violence and Abuse estimates the cost of abuse to the healthcare system
alone to be between $333 billion and $750 billion.\5\ Many social ills
ravaging our country are connected to domestic violence, and as the
cycle of violence is perpetuated through children who witness the
violence, these costs continue to multiply.
The Legacy of FVPSA--Sustaining lifesaving services
Although the incidence, prevalence and severity statistics paint a
grim picture, there is hope for victims and for a world free from
domestic violence. For many victims, this hope starts with the help of
a trusted advocate from a local domestic violence organization. These
vital organizations, which are at the heart of our nation's response to
domestic violence, are sustained by the dedication of the staff,
volunteers and community and the consistent funding provided by FVPSA.
NCCADV, along with approximately 1,500 domestic violence shelters
and programs across the country, has been sustained by the funding and
support provided by FVPSA, specifically through the state formula
grants. Since FVPSA first passed in 1984, it has provided a stable,
modest funding source to ensure that our lights would be on and that
someone was there to answer crisis calls in the middle of the night.
NCCADV, like most domestic violence programs, provides lifesaving
services that have evolved to meet both the immediate crisis needs of
victims in danger and their longer-terms needs to become safe and self-
sufficient. We offer comprehensive services to help victims rebuild
their shattered lives, including emergency safe housing/shelter, 24-
hour hotlines, counseling, transitional housing, legal and education
services, and systems and legislative. Domestic Violence Counts 2008, a
24-hour census of domestic violence shelters and services conducted by
the National Network to End Domestic Violence (NNEDV) across the nation
reveals that NCCADV's services are typical of those provided to victims
in almost every community. The consistency and flexibility of FVPSA
funding make this modest funding stream far more valuable than some of
NCCADV's larger funding sources. Because it is unrestricted funding, it
is used by many domestic violence agencies to fill gaps in funding and
sustains agencies that literally save lives.
The scope of FVPSA-funded services is remarkable. In fiscal years
2007 and 2008, FVPSA-funded programs sheltered 593,597 adults and
children in crisis in America. In Nassau County, we provided 22,836
services to 3,217 adult and child victims of domestic violence and
answered 6,116 hotline calls. To date, NCCADV has responded to more
than 188,000 domestic violence hotline calls and has conducted over
23,130 intake interviews with victims. Over 2,740 women and children
fleeing from violent homes have turned to NCCADV's shelter, the Safe
Home for Abused Families (SHAF), since it first opened in 1981. We have
provided advocacy in more than 20,000 court proceedings. Of course,
NCCADV is just one program of 1,500. We are heartened to know that
millions of lives have been touched by FVPSA-funded services since
1984.
The number of services provided, however, would have no relevance
if we weren't highly confident in their efficacy and their
transformative impact on people's lives. Our confidence in our services
was affirmed in a recently released multi-state study which shows
conclusively that the nation's domestic violence shelters are
addressing both urgent and long-term needs of victims of violence and
are helping victims protect themselves and their children.\6\
Of course, the strongest testament to our work is in the stories of
survivors saved by our programs. Recently NCCADV helped ``Anita'', who
was in a violent and abusive marriage. One night, her husband told her
he was driving them to marriage counseling but instead he drove to a
remote area. There, he shot her and left her for dead. Fortunately, a
jogger found her and she was rushed to the hospital. The NCCADV hotline
was contacted and one of our hospital advocates was soon by her side.
Our advocates helped her enter the Safe Home upon her release from the
hospital. She was reunited with her terrified young daughter who was
picked up by relatives. Her husband had disappeared and has still
eluded capture. At NCCADV, Anita was able to heal from her physical
injuries and begin to plan for her future. With the help of our
counselors, she and her child built their strength. We assisted them in
relocating to a safe location. NCCADV helped her from crisis to
stability--a woman who was left for dead, has a new chance at life.
Stories like Anita's happen every day at programs all over the country.
In fact, according to NNEDV's national Domestic Violence Counts 2008,
in one day:\7\
Advocates in Pennsylvania helped a woman obtain a 3-year
protection order after her abuser held her at knifepoint for a day,
broke her ribs and blackened her eye.
A father in Illinois turned to a local program to help him
obtain a protection order for his daughter who was critically injured
by her boyfriend.
An Arkansas woman found safety in an emergency shelter
after her abuser threatened to shoot her in the head and attach her
protection order to the hole in her head.
In addition, the benefits of FVPSA expand beyond the local work of
agencies meeting the immediate and long-term needs of victims. For
instance, the New York State Domestic Violence Coalition (NYSCADV),
along with 55 other state and territorial coalitions across the nation,
use FVPSA funding to coordinate statewide efforts to end domestic
violence. Through advocacy, technical assistance and training, NYSCADV
helps NCCADV and all service providers and victims in New York State.
Millions of lives have been saved and transformed in this country,
from Anchorage, AK to Portland, ME and everywhere in between, because
of the commitment of advocates and the Congressional and Executive
leadership that have supported FVPSA. Therefore, advocates across the
nation support a FVPSA reauthorization that will not only allow us to
continue to provide these vital services but that will also allow us to
build upon our strengths to improve and expand services. The
recommendations included in this testimony have been developed in
consultation with advocates and victims across the nation and we urge
Congress to pass a FVPSA bill reflective of these priorities. The
recommendations include, (1) an increased authorization level of $350
million, (2) targeted funding for specialized services for children and
abused parents, (3) improvements to meet the complex needs of all
victims, and (4) statutorily defining the DELTA prevention grants.
(1) Investment in services--Increasing the funding authorization level
FVPSA-funded programs, frankly, have had a remarkable impact
despite a lack of adequate resources. Often operating on shoe-string
budgets, domestic violence programs and shelters use public funding in
an efficient way and make the most of limited resources. But given the
paucity of funding, domestic violence programs simply cannot meet the
breadth and depth of demand on our services.
Even programs like NCCADV, which is a well-established, long-
standing agency with comprehensive services, struggle to meet all of
the needs of victims who come forward for services. Last year, at least
25 families reached out to us for emergency shelter but we couldn't
provide it because the shelter was full. We, like other domestic
violence agencies, always work with victims to help them find safe
alternatives but in some instances it is just not possible. With the
life-threatening nature of domestic violence, this is simply not
acceptable. Across New York State and across the country, however, it
is clear that many programs cannot meet the increasing demand for
services. According to Domestic Violence Counts 2008, 58% percent of
programs in New York State served over 5,300 victims on just one day.
On that same day, however, over 930 requests for services went unmet as
programs lacked the resources or space to meet the need. Nationally,
while over 60,000 victims were served on the census day, almost 9,000
requests for services went unmet.\8\ In fiscal years 2007 and 2008,
over 240,000 adults and children requested emergency shelter from
FVPSA-funded programs and were turned away due to a lack of space. For
those individuals who were not able to find safety that day, the
consequences can be extremely dire including continued exposure to
life-threatening violence or homelessness in many cases. It is
absolutely unconscionable that victims cannot find safety for
themselves and their children due to a lack of adequate investment in
these services.
The gap between adequate resources and increasing demand widens as
the economic situation worsens. A bad economy does not cause domestic
violence but financial strain can certainly exacerbate violence and
victims with fewer personal resources become increasingly vulnerable.
Since the economic crisis began, three out of four domestic violence
shelters have reported an increase in women seeking assistance from
abuse.\9\ Faced with shrinking budgets and reduced donor funding,
domestic violence programs simply cannot meet the needs of all of the
victims who come forward for help. A frightening trend across the
country reveals that many programs have had to reduce services, cut
staff and, in extreme cases, some have had to close their doors.
According to the National Center for Victims of Crime, 92% of victim
service providers have seen an increased demand in the last year, but
84% reported that cutbacks in funding were directly affecting their
work.\10\ This fall, advocates watched in horror as state budgets were
balanced by cutting funding for domestic violence programs. California
was the most extreme of these when the Governor completely eliminated
funding for domestic violence programs earlier this year. While we are
grateful that California State funding has now been reinstated, we know
that many programs in California have already had to close.
In rural, remote and impoverished communities, many programs can
only provide the most basic services. They use their FVPSA funding to
keep the lights on and their doors open. We cannot underestimate how
important this is--victims must have a place to flee to when they are
escaping life-threatening violence. The fact is that countless shelters
across the country would not be able to operate without FVPSA funding.
In Nassau County, we know that we could do more with more
resources. We estimate that there are 100,000 victims of domestic
violence in Nassau County at any given time. With more funding for
outreach, we know that we would see an increase in demand for services.
We know that young victims and victims from culturally specific
communities in Nassau County, and across the nation, are often
reluctant to come forward for services because the services are not
always provided in a way that is culturally responsive. Undoubtedly,
with more funding, organizations in Nassau County could go a long way
toward bridging this gap. Many of the recommendations for FVPSA's
reauthorization will expand the reach both in breadth and depth of
services to ensure that 1) ALL victims in crisis can receive immediate
support and 2) that those services are tailored, targeted and
comprehensive so that victims can rebuild their lives.
As funding for the criminal justice response to domestic violence
receives steady increases, more and more victims seek the critical
services they need to flee violence and rebuild their shattered lives.
While such safety net services, available 24 hours a day, 7 days a
week, are primarily supported by FVPSA, FVPSA funding remains
relatively stagnant. Without a matched investment in services, too many
victims are left with nowhere to turn. For the past 25 years, FVPSA
funding has allowed millions of victims to find immediate safety and
move from crisis to stability. In order to ensure that all victims are
served when they are in danger and to provide the comprehensive
services victims need to rebuild their lives after abuse, we need to
increase our investment in this vital funding stream.
Therefore, I strongly support the recommendation to increase the
funding authorization level of FVPSA to at least double its current
authorization of $175 million to $350 million.
(2) Specialized Services for Children--Intervening in the cycle of
violence
``Mary'' came to the Safe Home with her five children, after her 2
month old baby was released from the hospital. Child Protective
Services had referred her family to NCCADV. The baby had a broken arm
and other injuries from the abuser's violence. All the children had
scars and bruises, as did Mary. The abuser threatened to kill her, the
children and her family if she ever told anyone of the abuse. At
NCCADV, Mary received individualized counseling, case management and
advocacy to help her attend to the myriad of issues that arise from
abuse. At the same time, the children began to heal through play
therapy. After leaving shelter, they continued receiving counseling and
are now safe as the abuser is in prison. This once victimized and
tormented family is now thriving in safe a environment with the tools
they need to rebuild their lives.
We know that intergenerational violence is perpetuated as children
witness and experience violence. In fact, one study found that men
exposed to physical abuse, sexual abuse and adult domestic violence as
children were almost 4 times more likely than other men to have
perpetrated domestic violence as adults.\11\
Children who are exposed to domestic violence are more likely to
exhibit behavioral and physical health problems including depression,
anxiety and violence towards peers.\12\ They are also more likely to
attempt suicide, abuse drugs and alcohol, run away from home, engage in
teenage prostitution, and perpetrate sexual assault.\13\
One-half to two-thirds of residents of domestic violence shelters
are children, and FVPSA-funded services have always provided services
to the children in shelter. We know that the most important service you
can give to a child is to provide safety for her/his non-abusive parent
so that the child and parent can heal together. Children who witness
and experience domestic violence need specialized, age-appropriate
services in order to fully heal and break the cycle of violence. But
these services must be provided in the context of supporting the non-
abusive parent and child together. By empowering the parent to become
safe and stable, we help the child.
To that end, I am very excited about NCCADV's unique partnership
with the local child abuse agency, the Coalition Against Child Abuse
and Neglect. This month, we are moving to a shared space, where we will
offer adult, youth and child victims enhanced, seamless services in one
central location. At The Safe Place in Bethpage, NY, each organization
will maintain its independent identity and mission while streamlining
operations and collaborating on services provided to individuals and
families. Through joint case management, the entire family's issues
(emergency housing, counseling, legal representation, and parenting
skills workshops, for instance) can be addressed on an ongoing basis as
they work to piece together their broken lives and build a safe
supportive environment.
If we had more targeted resources for specialized children's
services, NCCADV could easily serve twice as many children as we
currently do. Such funding would allow programs like NCCADV to sustain
and enhance the essential services provided to children and their
families and would allow other domestic violence programs to develop
this critical work.
Therefore, we strongly support the recommendation to include a
funding set-aside (25% of excess funding over appropriations of $130
million) for the Specialized Services for Abused Children and Their
Parents in the FVPSA reauthorization.
(3) Enhancing FVPSA to meet victims' diverse and complex needs
To successfully meet the needs of all victims, programs must be
able to proactively target resources, and FVPSA must be reflective of
all victims' needs. Throughout FVPSA, the language should be more
inclusive of children and youth as well as victims from underserved
populations. The state plans that are developed to distribute FVPSA
funding should reflect steps taken to meet the needs of all victims,
including those who are marginalized. The additional recommendations
outlined below will help to ensure that all victims can be served by
FVSPA-funded programs.
(A) Teen and Youth Victims
At NCCADV, we serve victims of intimate partner violence,
regardless of age and legal relationship to the abuser. We are also
committed to reaching out to teens and youth, who are often very
reluctant to seek services. We have one teen counselor and one teen
educator but we desperately need additional resources to provide
counseling and outreach.
Recently, NCCADV helped a 17 year-old girl whose boyfriend was
extremely controlling and verbally and physically abusive. This young
survivor is currently attending our teen dating violence support group,
where she has begun to regain her strength and finds comfort and
validation in the company of her peers.
At the ACCESS-York domestic violence program in York, Pennsylvania,
an 18 year-old abused, malnourished and pregnant teen received services
after being referred by a local health clinic. At ACCESS, she found
transitional housing and was connected with community health services.
With good prenatal care, she gave birth to a healthy baby. She
completed her high school education and graduated with honors. ACCESS
was able to give her the services she needed to start her adult life
safely.
By providing early intervention services to youth and teens victims
of dating violence, we are able to help them define their relationships
boundaries and distinguish between healthy and abusive behavior. NCCADV
strongly believes in investing in these services, and we plan to
allocate additional resources to teen services. It is essential that
the FVPSA reauthorization allows us to continue to meet the unique
needs of youth victims and victims of dating violence, by explicitly
referencing youth and dating violence throughout the statute.
In order to continue to be able to provide services to teen and
youth victims, advocates support the recommendation to clarify the
definitions of domestic violence, dating violence and youth to ensure
that all victims, regardless of age, can receive vital, tailored
services.
(B) Resources for racial and ethnic minority communities
In racial and ethnic minority communities, service providers need
resources to develop programs and strategies that build upon cultural
and community strengths and eliminate barriers to information and
services. The proposed amendments to FVPSA and dedicated funding can
help ensure that appropriate services are available to victims in
ethnic and minority communities. In Nassau County, our population is
becoming increasingly culturally diverse. The Asian population in
Nassau County has increased to 6.3% of the total population. In 2007,
there were 162,564 Latino/Latina individuals in Nassau County,
comprising 12.4% of the estimated county population, and Spanish is the
language of 42% of the Nassau County families who speak a language
other than English in their home. Twenty-three percent of clients at
NCCADV are Latino/Latina.
NCCADV provides many of our services in Spanish, provides a
language line and partners with culturally-specific community-based
programs. We know, however, that many victims from racial and ethnic
minority communities do not seek services for fear of becoming isolated
from their cultural communities.
Therefore, we support recommendations to enhance and improve
targeted resources for culturally-specific programs and services so
that all victims can be safe.
(C) Resources for Victims from Marginalized Communities
We know that victims from underserved and marginalized communities,
including victims with mental and physical disabilities, victims from
rural areas, elderly and youth victims and those from marginalized
religious populations often struggle to access services.
Therefore, we support recommendations to make the FVPSA statute
reflective and inclusive of such needs and provide targeted resources.
(D) Resources for Victims and Programs in the U.S.
Territories
Resources are currently available for domestic violence programs
and Territorial coalitions in the U.S. Territories but the funding
formula is not fairly devised to provide adequate resources. Therefore,
victims from the U.S. Territories often cannot get the services they
need to flee violence.
We support recommendations to alter the current funding formula to
fairly distribute funding to services and coalitions in the U.S.
Territories of American Samoa, Guam, Northern Mariana Islands and the
Virgin Islands.
(4) Prevention--The Need to Stop Violence Before it Starts
Meeting the urgent needs of victims in crisis is vital in order to
save and rebuild lives. But we know that in order to end domestic
violence for good, we also have to invest in prevention work.
Therefore, advocates in New York and across the nation strongly support
the recommendations to enhance and expand the Demonstration Grants for
Community Initiatives/DELTA grants in the FVPSA reauthorization. DELTA
is authorized through FVPSA but is an independent funding line item.
These statewide prevention efforts, administered by the Centers for
Disease Control (CDC) and the National Center for Injury Prevention and
Control, have made bold strides toward preventing domestic violence by
changing community and personal attitudes about relationships and
abuse.
In Nassau County, we acknowledge a great need for prevention work.
Currently, we have a unique education program aimed at changing
attitudes about violence in primary and secondary school students.
However, we certainly do not have adequate resources to sustain all of
the prevention work that is necessary in our community. Fortunately,
because the New York State Coalition Against Domestic Violence
(NYSCADV) is a DELTA grant recipient, NCCADV and programs across the
state benefit from this statewide initiative. We are highly
anticipating the release of a state-specific primary prevention tool-
kit that NYSCADV will be releasing in spring of 2010. The primary
prevention tool-kit will contain exercises, activities, information and
resources to help individuals and groups think about what would prevent
domestic violence from happening in our communities. Tools and
resources are based on lessons learned from the New York State DELTA
Project and successes from DELTA-funded and non-funded domestic
violence programs throughout the state. The tool-kit will help
organizations to initiate their own process of discovery to determine
the role they wish to play in changing their communities. With
interactive, web-based tools, NCCADV will be able to connect with other
advocates to share successes and challenges with others across the
state and the country.
Each statewide DELTA project works with a number of local
initiatives to develop community-specific prevention plans. The local
projects learn from one another and depend on the guidance of state
domestic violence coalitions for support and technical assistance. For
instance, the California Partnership Against Domestic Violence (CPEDV)
and STAND! Against Domestic Violence in Concord, California are
involved with a local DELTA project called ``Men Mentoring Boys Into
Compassionate Men.'' This project is lead by men to encourage other men
to challenge violence against women. Their annual ``Men of Merit''
initiative has been recognized by the CDC as a successful prevention
strategy because of its positive emphasis on men's ability to reduce
the occurrence of intimate partner violence as well as its ability to
engage multiple partners, agencies and state representatives and
community. CPEDV's involvement in the project allows CPEDV to share
findings and best practices across the state of California.
New York and California are two of the fourteen current DELTA grant
recipients, which includes Alaska, Delaware, Florida, Kansas, Michigan,
Montana, North Carolina, North Dakota, Ohio, Rhode Island, Virginia and
Wisconsin. A partnership between CDC and the Robert Wood Johnson
Foundation is currently supporting additional states in a DELTA
``Prep'' project that is helping them to devise statewide prevention
plans. With additional funding, the DELTA Prep states will receive
resources they need to implement and execute their statewide plans.
Additional resources will also help to extend research findings and
tools to support community-specific prevention efforts to the rest of
the country.
Therefore, advocates support the recommendation that DELTA grants
become statutorily defined, reflect current best practice and are
authorized at $20 million annually.
Building on Strength while Embracing Change
Our nation depends on FVPSA-funded programs to meet the immediate,
urgent and long-term needs of victims of domestic violence and their
children. Domestic violence organizations, sustained by FVSPA funding,
have helped to save and transform countless lives. FVPSA has reduced
costs to taxpayers by stopping and preventing costly violence. While we
celebrate our successes, we are ever aware that victims' needs are
great and we have much to do to end domestic violence in this country.
In order to move closer to achieving this essential goal, we urge the
Committee to prioritize the swift reauthorization of FVPSA, inclusive
of the recommendations outlined in the testimony above with an adequate
funding authorization level.
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\ Based on 1 in 5 women experiencing DV in the U.S., Nassau
County's population of 1.3 million and Census data from 2000.
\4\ Bureau of Justice Statistics, Homicide Trends in the U.S. from
1976-2005. US Department of Justice. (2008).
\5\ Dolezal, T. McCollum D., Callahan, M., Edan Prairie, MN: The
Academy on Violence and Abuse; 2009.
\6\ Lyon, E., Lane S. (2009). Meeting Survivors' Needs: A Multi-
State Study of Domestic Violence Shelter Experiences. National Resource
Center on Domestic Violence and UConn School of Social Work. Found at
http://www.vawnet.org.
\7\ Domestic Violence Counts 08: A 24-Hour census of domestic
violence shelters and services across the United States. The National
Network to End Domestic Violence.
\8\ Domestic Violence Counts 08: A 24-Hour census of domestic
violence shelters and services across the United States. The National
Network to End Domestic Violence.
\9\ Mary Kay's Truth About Abuse. Mary Kay Inc. (May 12, 2009).
\10\ National Center for Victims of Crime. Crime and the Economy.
2009
\11\ Greendfeld, L. A. (1997). Sex Offences and Offenders: An
Analysis of Date on Rape and Sexual Assault. Washington, DC. Bureau of
Justice Statistics, US Department of Justice.
\12\ 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.
\13\ 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.
______
Chairwoman McCarthy. Thank you, Sandra.
Ms. Smith.
STATEMENT OF TERESA M. SMITH, LSW, COORDINATOR EXECUTIVE
DIRECTOR, CHILDREN'S ADVOCACY CENTER
Ms. Smith. Chairwoman McCarthy, Ranking Member Platts, and
all of the subcommittee members, I would like to thank you for
the opportunity to speak to you today on the Child Abuse
Prevention and Treatment Act and the impact this funding has
had on service provision locally, Statewide, and nationally for
child victims of abuse.
My experience as a former child welfare caseworker in
Pittsburgh, the director of a local children's advocacy center
in Harrisburg, and an accreditation site reviewer for the
National Children's Alliance, have helped to shape my
commitment to ensure children receive what they need to feel
safe, cared for, and believed. I have also had the privilege of
acting as cochair of the CAPTA Work Group in Pennsylvania and
observing firsthand the teamwork and perseverance necessary
from State and local government, nonprofit agencies, and
public-private partnerships to meet the requirements necessary
to become compliant and eligible under CAPTA.
Pennsylvania, as the 50th State to do so, submitted its
application and State plan for CAPTA in the spring of 2006.
Professionals from child-serving agencies and disciplines
across the State have been working diligently to meet the
requirements and have selected several areas for improvement to
Pennsylvania's child welfare response. Although our State is
early in this process, great strides have been made that
demonstrate the efforts of those committed to providing quality
services to child victims an their non-offending family
members.
The Pennsylvania CAPTA Work Group has selected several
areas for improvement. Among them, enhancing the Child
Protective Services system by developing, improving, and
implementing risk safety and developmental assessment tools.
Skill-based training for child welfare workers, State, public,
and private agency staff is critical to ensure children at risk
are identified and appropriate strategies and actions take
place for their health, safety, and welfare. Developing and
facilitating training protocols on mandated reporting target
audiences with children, such as primary medical providers,
schools, hospital staff, and first responders. Collaborations
among many child-serving agencies and community-based programs
support comprehensive physical and behavioral health needs of
children who are reported to be abused.
These are among just a few of the initiatives in progress
as Pennsylvania carries out CAPTA requirements for compliance.
CAPTA funding has allowed Pennsylvania the opportunity to move
forward with the establishment and training of citizen review
panels to provide recommendations for systemic change of the
Child Protective Services system.
Training of health care providers to report
drug-affected infants has increased the opportunities to
engage families that might have remained ``invisible'' in the
system, thereby improving outcomes for those that are addicted,
as well as their children.
I have conducted more than 70 accreditation site visits of
children's advocacy centers across the country over the past 7
years. I have met many dedicated professionals, community
members, and staff members from public and private agencies who
are charged with providing services to child abuse victims and
their non-offending family members. Many centers utilize
Federal funding for child abuse prevention and treatment
programs to reach underserved populations and develop public-
private partnerships to provide services in creative ways.
CAPTA compliance has allowed Pennsylvania to examine its
current child welfare system and develop improvements for the
benefit of children and families. In addition to child abuse
prevention and awareness efforts, CAPTA compliance will also
allow Pennsylvania to increase its impacts on providing a
coordinated response to child abuse across the State through
access to funding from the Criminal Justice Act.
The Children's Advocacy Center, or CAC, model is a
collaborative community response that coordinates
multidisciplinary partners in the investigative evaluation
and treatment of child victims of abuse. Thousands of child
abuse victims in Pennsylvania have benefited from the
collaborative team approach for child interviews, medical
exams, and mental health treatment.
CJA funding will be a welcome resource to assist those
communities in developing effective child abuse
multidisciplinary teams. The PinnacleHealth Children's Resource
Center, as an accredited CAC, has served a geographic region of
more than 20 counties for many years. In 2008, the Children's
Resource Center evaluated 883 children for many counties in
central Pennsylvania. Approximately 52 percent are referred for
services from Dauphin County, a third-class county. The CRC has
seen an increase in the numbers of children referred for both
sexual and physical abuse and an increase in requests to
interview siblings of children that have died.
Dauphin County has seen a 12.8 percent increase in the
numbers of indicated cases of child abuse thus far this year.
In 2008, there were four reported deaths in Dauphin County. In
the first 10 months of this year, there have already been 10
child deaths. Prior to 2009, Pennsylvania did not keep
statistics of child near deaths, but has kept them this year in
compliance with CAPTA. In Dauphin County alone there have been
eight near fatalities of children, four of which were indicated
cases of abuse. The increase in numbers of reported abuse cases
and the severity of this abuse inflicted is evident in this
community.
CAPTA and CJA provide support for local programs and is
essential to continuing the comprehensive quality services
provided to child abuse victims in Pennsylvania and throughout
the United States. Child abuse prevention efforts as well as
coordinated interventions are imperative to providing a safe
environment for children, families, and the communities in
which they live.
I welcome any questions you may have.
[The statement of Ms. Smith follows:]
Prepared Statement of Teresa M. Smith, LSW, Coordinator Executive
Director, Children's Advocacy Center
Thank you for the opportunity to speak with you today on the Child
Abuse Prevention and Treatment Act and the impact this funding has on
service provision locally, statewide and nationally for child victims
of abuse. My experiences as a former child welfare caseworker in
Pittsburgh, the director of a local Children's Advocacy Center in
Harrisburg, PA and as an accreditation site reviewer for the National
Children's Alliance have helped to shape my commitment to ensuring
children receive what they need to feel safe, cared for and believed. I
have also had the privilege of acting as co-chair of the CAPTA
workgroup in Pennsylvania and observing firsthand the teamwork and
perseverance necessary from state and local government, non-profit
agencies and public-private partnerships to meet the requirements
necessary to become compliant and eligible under CAPTA.
Pennsylvania, as the 50th state to do so, submitted its application
and state plan for CAPTA in Spring 2006. Professionals from child-
serving agencies and disciplines across the state have been working
diligently to meet the requirements and have selected several areas for
improvement to Pennsylvania's child welfare response. Although our
state is early in this process, great strides have been made that
demonstrate the efforts of those committed to providing quality
services to child abuse victims and those children at risk of abuse.
Pennsylvania CAPTA State Plan
The Pennsylvania CAPTA workgroup has selected several areas for
improvement that include:
Improving legal preparation and representation through the
expansion of the Court Improvement project statewide including training
for Guardians ad Litem in juvenile dependency matters.
Enhancing the child protective services system by developing,
improving and implementing risk, safety and developmental assessment
tools. Skill-based training for child welfare workers, state, public
and private agency staff is critical to ensure children at risk are
identified and appropriate strategies and actions take place for their
safety, health and welfare.
Developing and facilitating training protocols on mandated
reporting to target audiences that have regular and ongoing contact
with children such as primary medical providers, schools, hospital
staff and first responders.
Supporting and enhancing collaborations among many child-serving
agencies and community-based programs that include comprehensive
physical and behavioral health needs of children who are reported to be
abused.
These are among just a few initiatives that are in process as
Pennsylvania carries out CAPTA requirements for compliance. CAPTA
funding has allowed Pennsylvania the opportunity to move forward with
the establishment and training of Citizen Review Panels to provide
recommendations for systemic change of the child protective services
system. Training of healthcare providers to report drug-affected
infants has increased opportunities to engage families that might have
remained ``invisible'' in the system thereby improving outcomes for
those addicted and their children.
I have had the privilege of conducting more than 70 accreditation
site visits for the National Children's Alliance across the United
States over the past 7 years. I have had the met dedicated
professionals, community members and staff members from public and
private agencies charged with providing services to child abuse victims
and their non-offending family members. Many centers utilize federal
funding for child abuse prevention and treatment programs to reach
underserved populations and develop public-private partnerships to
provide services in creative ways.
Children's Advocacy Center Model: A Community Response to Child Abuse
CAPTA compliance has allowed Pennsylvania to examine its current
child welfare system and develop improvements for the benefit of
children and families. In addition to child abuse prevention and
awareness efforts, CAPTA compliance also allows Pennsylvania the
opportunity in the future to increase its impact on providing a
coordinated response to child abuse across the state through access to
funding from the Criminal Justice Act (CJA).
The Children's Advocacy Center (CAC) model is a collaborative
community response that coordinates multidisciplinary partners in the
investigation, evaluation and treatment of victims of child abuse.
Pennsylvania currently has 9 nationally accredited CACs and 10 centers
that have achieved Associate member status with the National Children's
Alliance. Thousands of child abuse victims in Pennsylvania have
benefited from the collaborative team approach for interviews, medical
exams and mental health treatment that CACs provide, yet many more
child victims live in communities without an established center. CJA
funding will be a welcome resource to assist those communities in
developing effective child abuse multidisciplinary teams.
PinnacleHealth Children's Resource Center (CRC), as an accredited
CAC, has served a geographic region of more than 20 counties for many
years and receives limited funding designated through the child
protective services needs-based budgets from 8 surrounding counties. In
2008, the CRC evaluated 883 children from many counties in Central
Pennsylvania. Approximately 52% are referred for services from Dauphin
County, a 3rd class county. The CRC has seen an increase this year in
numbers of children referred for both sexual and physical abuse and an
increase in requests to interview siblings of children that have died.
Dauphin County has seen a 12.8% increase in numbers of indicated cases
of child abuse thus far from last year. In 2008, there were 4 reported
child deaths in Dauphin County. In the first 10 months of this year,
there have already been 10 child deaths. Prior to 2009, Pennsylvania
did not keep statistics of child near deaths, but has kept them this
year in compliance with CAPTA. In Dauphin County alone, there have been
8 near fatalities of children, 4 which were indicated cases of abuse.
The increase in numbers of reported abuse cases and severity of the
abuse inflicted is evident in this community.
CAPTA and CJA provides support for local programs and is essential
to continuing the comprehensive quality services provided to child
abuse victims in Pennsylvania and throughout the United States. Child
abuse prevention efforts as well as coordinated interventions are
imperative to providing a safe environment for children, families and
the communities in which they live.
______
Chairwoman McCarthy. Thank you.
Mr. Sawyer.
STATEMENT OF ROB SAWYER, MSW, LICSW, DIRECTOR, CHILD AND FAMILY
SERVICES, OLMSTED COUNTY COMMUNITY SERVICES
Mr. Sawyer. Good morning, Chairwoman McCarthy, Ranking
Member Platts, and members of the subcommittee. My name is
Robert Sawyer, former Director of Child and Family Services in
Olmsted County, Minnesota. I appreciate the opportunity to
offer comments on the reauthorization of the Child Abuse
Prevention and Treatment Act, and thank Chairwoman McCarthy,
Ranking Member Platts, and the members of the subcommittee for
the invitation to do so. The comments that I will offer reflect
a local perspective on child welfare reform efforts and
differential response in child protection in particular.
For more than a decade, the Minnesota Department of Human
Services in collaboration with 87 counties and 11 tribes has
been actively engaged in child welfare reform. Minnesota is a
State-supervised, county-administered child welfare system
generating considerable local control on the provision of
services for children and families in the child welfare system.
Minnesota counties fund approximately 48 percent of all
child welfare services in the State. The State department and
counties enjoy a positive, constructive working relationship
that has facilitated a strong child welfare reform effort.
The Minnesota Department of Human Services, in cooperation
with the McKnight Foundation, supported the 4-year pilot
project in 20 counties from years 2000 to 2004. A rigorous
field study was conducted by the Institute of Applied Research
using control groups, participant interviews, and the review of
administrative data. Significant findings included: Child
safety was
uncompromised, fewer child maltreatment reports, less
costly approach in the long run, families liked the approach,
social workers supported the approach.
In 2005, Minnesota law was changed, requiring a
differential response system in child protection, with the
preferred way to approach families being a family assessment
for reports not alleging substantiation child endangerment.
What is differential response? A differential response
system organizes a child protection agency to respond in a
proportional manner to reports about possible child
maltreatment. At a minimum, an investigative response and a
family assessment response provides an agency option in how to
approach a family when there is an accepted report of child
maltreatment. An investigative response continues to focus on
reports alleging substantial child endangerment.
A family assessment response is a formal response of the
agency that assesses the needs of the child or family without
requiring a determination that maltreatment occurred or that
the child is at risk of maltreatment.
The majority of families reported for neglect or abuse
receive a family assessment response where fault finding is set
aside and replaced with a safety-focused family assessment and
services. In Minnesota, high risk reports continue to receive a
forensic investigation, but greater attention is now paid to
family and community engagement and the recognition of
strengths that could be used to promote safety and well-being.
During the 4 years, 2000 to 2004, that this program
transitioned from pilot to full implementation, out-of-home
placements in Minnesota decreased 22 percent. Olmsted County
initiated the countywide differential response system in 1999.
The differential response system is organized to provide an
investigative response, a family assessment response, and a
domestic violence response for those reports where a child is
exposed to intimate family violence.
The implementation of groups of provision, a consultation
framework, family involvement strategies, and group
decisionmaking for major decisions has supported the practice
model that strives for partnership with families and
collaboration with community resources.
Over the past decade, with the implementation of a
differential response system, Olmsted County has seen the
following positive results: Fewer investigations, less repeat
child maltreatment, less court involvement, less children in
placement, more family involvement, and more children served.
Perhaps the greatest lesson learned through the
implementation of a differential response system is that it is
not what we have to do alone that is important, but how we
choose to do it that makes a difference. We have changed how we
see and engage families and through that have reached better
results.
The following recommendations are respectfully presented
for consideration: One, support the efforts of States,
counties, and tribal child welfare agencies to establish
differential response systems and child protection. Two,
support the efforts of State, counties, and tribal child
welfare agencies to front load the system, providing supportive
interventions for at-risk families screened out of child
protection.
Thank you for the work you will do in the reauthorization
of CAPTA, continuing to enhance safety and well-being for
children and the strengthening of families to provide a safe,
nurturing home life.
[The statement of Mr. Sawyer follows:]
Prepared Statement of Robert Quinn Sawyer, MSW, LICSW,
Olmsted County Child and Family Services
Chairwoman McCarthy, Ranking Member Platts and Members of the
Subcommittee,
My name is Robert Quinn Sawyer, former Director of Child and Family
Services in Olmsted County, Minnesota. I appreciate the opportunity to
offer comments on the reauthorization of the Child Abuse Prevention and
Treatment Act (CAPTA) and thank Chairwoman McCarthy, Ranking Member
Platts and the members of this Subcommittee for the invitation to do
so.
The comments that I will offer reflect a local perspective on Child
Welfare Reform efforts and Differential Response in Child Protection in
particular.
For more than a decade the Minnesota Department of Human Services
in collaboration with the 87 counties and 11 tribes has been actively
engaged in Child Welfare Reform. Minnesota is a state supervised county
administered child welfare system generating considerable local control
in the provision of services for children and families in the child
welfare system. Minnesota counties fund approximately 48% of all child
welfare services in the state while the federal government contributes
36% and the state government 14%. The state department and counties
enjoy a positive constructive working relationship that has facilitated
a strong child welfare reform effort.
The Child Protection System since the 1960's saw a significant
increase in the reporting of child maltreatment as expanding reporting
requirements were added in an effort to address perceived child safety
concerns. The system was limited to an investigative response that
became an increasingly forensic process with a focus on procedure and
practices that were developed in response to the most severe forms of
child abuse and neglect. The Child Protection System had one way of
responding to all reports accepted for intervention. Nationally and in
Minnesota approximately one third of accepted reports of child
maltreatment were founded. In Minnesota approximately 65 to 70% of all
reports were concerned with child neglect.
In 1997 Minnesota legislation prompted child welfare reform in an
effort to improve child welfare outcomes. A pilot project in Olmsted
County experimented with an Alternative Response to child protection
reports of low or moderate levels of risk. In 1999 legislation
permitted counties to voluntarily engage in Alternative Response an
early name for Differential Response. The Minnesota Department of Human
Services in cooperation with the McKnight Foundation supported a four
year pilot project in 20 counties from 2000--2004. A rigorous field
study was conducted by The Institute of Applied Research, using control
groups, participant interviews and the review of administrative data.
Significant findings included:
1. Child Safety was uncompromised
2. Fewer new child maltreatment reports
3. Less costly approach in the long run
4. Families liked the approach
5. Social Workers supported the approach
In 2005, Minnesota law was changed requiring a Differential
Response System in Child Protection with the preferred way to approach
families being a Family Assessment for reports not alleging substantial
child endangerment. At the time of the law, all 87 counties in
Minnesota were voluntarily providing a Differential Response System.
What is Differential Response? A Differential Response System
organizes a child protection agency to respond in a proportional manner
to reports of possible child maltreatment. At a minimum an
Investigative Response and a Family Assessment Response provides an
agency options in how to approach a family when there is an accepted
report of child maltreatment. An Investigative Response continues to
focus on reports alleging substantial child endangerment. A Family
Assessment Response is a formal response of the agency that assesses
the needs of the child or family without requiring a determination that
maltreatment occurred or that the child is at risk of maltreatment.
Effective social work practice in child protection strives to
engage children and families in a constructive working relationship
that resolves the issues and challenges impacting child safety and
well-being. Collaborative working relationships with community
resources and families build supportive coordinated efforts to enhance
safety and well-being. Both an Investigative Response and a Family
Assessment Response utilize the same structured decision making tools
to provide a frame of reference for evaluating child safety and well-
being and the identification of family needs.
Minnesota is a leader in developing a Differential Response System
to reports of child maltreatment. The majority of Minnesota families
reported for neglect or abuse receive a Family Assessment Response
where fault finding is set aside and replaced with a safety focused
family assessment and services. High risk reports continue to receive a
forensic investigation but greater attention is now paid to family and
community engagement and the recognition of strengths that could be
used to promote safety and well-being. During the four years (2000--
2004) this program transitioned from pilot to full implementation, out
of home placements decreased 22%.
Olmsted County is one of 87 counties in the state of Minnesota with
responsibility for administering the child welfare system providing
intervention and services for children and families where there are
child protective concerns. Olmsted County initiated a county wide
Differential Response System in 1999. The Differential Response System
is organized to provide an Investigative Response, a Family Assessment
Response and a Domestic Violence Response for those reports where a
child is exposed to intimate family violence. The implementation of
group supervision, a consultation framework, family involvement
strategies and group decision making for major decisions has supported
a practice model that strives for partnership with families and
collaboration with community resources.
In recent years the Differential Response System has been enhanced
by the development of a Parent Support Out Reach effort to respond to
families screened out of child protection that may have needs that if
addressed now will prevent their future entry into child protection.
Targeted early intervention front load the child protection system
providing necessary service to families when they need them.
Over the past decade with the implementation of a Differential
Response System Olmsted County has seen the following positive results:
1. Fewer investigations
2. Less repeat child maltreatment
3. Less court involvement
4. Less children in placement
5. More family involvement
6. More children served
Perhaps the greatest lesson learned through the implementation of a
Differential Response System is it is not what we have to do alone that
is important but how we choose to do it that makes a difference. We
have changed how we see and engage families and through that have
reached better results.
The following recommendations are respectfully presented for
consideration:
1. Support the efforts of states, counties and tribal child welfare
agencies to establish Differential Response Systems in child
protection.
2. Support efforts of states, counties and tribal child welfare
agencies to ``front-load'' the system providing supportive
interventions for at-risk families screened out of child protection.
Thank you for the work you will do in the reauthorization of CAPTA
continuing to enhance safety and well-being for children and the
strengthening of families to provide safe, nurturing home life.
______
Chairwoman McCarthy. Thank you, Mr. Sawyer.
I thank you all for your testimony. As I said earlier, we
knew that this was going to be a difficult hearing, basically
hearing the issues that are facing our families and children in
our Nation. Like many of you, I believe that we all can do
better to protect our children. They are the future of this
Nation. I think it is extremely important that we have our work
cut out for us, but hopefully work with all of you as we go
forward on the reauthorization.
Dr. Spigner, one of the things you had said in your
testimony, especially talking about when a child abuse case
happens over State lines, even though they might live in your
State and how sometimes they are falling through the cracks and
the cases are not really followed through.
We also know that, unfortunately, we have seen many
stories. In fact, I have from the Associated Press a series of
reports from 2007 which discuss the shadow of sex abuse in U.S.
schools. Because one of the things we have seen, that someone
who might be a sex offender goes from one State to another
State and works at a school. And I have a great concern about
that. If you could talk about that a little bit on what can be
done and how we can improve on that.
Ms. Spigner. One of the critical issues in this whole
process of evaluating reports of child abuse is attempting to
identify the perpetrators. When people cross State lines--and,
generally, teachers, child care providers, when they go to a
new State, they have to go through a criminal records clearance
and a child abuse records clearance. If there has been no
identification because a case has fallen through the cracks,
then when they are reviewed their records come back as if there
was no problem.
So that the more we can resolve the interstate conflicts,
the more we can identify perpetrators that may be moving
around, and that is true in terms of teachers, child care
providers, as well as relatives. If a case is screened out
because it didn't occur in the right place or because the child
is not in a particular place, we have no track record on that.
We cannot even predict how many of these cases are lost because
there is no trail.
Chairwoman McCarthy. Thank you.
Sandra, you talked about your unique partnership we have in
Nassau County for the local abuse agencies and the coalition
against child abuse and neglect. Could you go into it on how
basically you came up with the idea and how you became the
partners and have a little more influence on the family and the
child?
Ms. Oliva. Yes. I would be happy to. We have actually been
planning and working on this I would say for 6 years now. Our
agency has had a long-term State grant, which we actually just
had doubled, to put domestic violence specialists within the
Nassau County Department of Social Services Child Protective
Services Unit.
So we have seen for a very long time how critical it is to
work on the issues of domestic violence and child abuse in
coordinated ways. So very often you have co-occurrence in the
same family. And if you don't have safe parents, if the non-
abusive parent isn't feeling safe, she is not going to be able
to protect the child.
So we began to work together with the local child abuse
agency, which has a child advocacy center, as has been
described today, to look at ways we could partner and determine
what we really need to do was not just have projects together
but really to work very closely to cross-train our staffs so
when we had a family come in we could identify the issues for
the children and the moms. And when they had children come into
their center who had been sexually assaulted, they could begin
to identify where the mothers also had been victims and been
unable to protect themselves or their children and also needed
help.
And so we are really looking--we are calling it the safe
place. And we are looking at one location where all families
will come. They will be served for their different specific
needs by the two different agencies, because we remain two
separate agencies at this point. But we would be able to--our
staffs will be working back and forth, we will be doing
programs together.
We are going to have a training institute about family
violence, which focuses both on domestic violence and child
abuse. We are going to be working with parents because the
issue of supporting families and working with parents and
strengthening parenting is critical in protecting victims and
in giving them--really enabling them to tap into their
strengths and live independently and live self-sufficiently,
which is also critical.
So this idea has been brewing between our two agencies,
myself and the director of the other agency, now for years and
years, trying to figure out the best way to do it. The State is
very excited about it because this is a model. It is really not
done anywhere else.
So we are hoping that we can develop something which other
agencies across the country will be interested also in
developing. And of course it is smart business. There is also
cost savings involved and there are efficiencies involved. In
these days, you need to save every penny you can for programs.
Why duplicate the cost of boardrooms and kitchens and bathrooms
and copiers and that kind of thing when there are smart ways to
do business?
Chairwoman McCarthy. Thank you.
Mr. Roe.
Mr. Roe. Thank you Madam Chairwoman for holding this very
important hearing. And thank every one of you all for being
here to participate. And I am sorry you have to be here. I am
sorry the issue is even out here.
My career and background is an Ob/Gyn physician. And you go
through a difficult pregnancy to deliver a healthy baby and
then you put it in an environment where it can't be healthy and
safe.
I was just--I don't know about Dr. Hammond. I noticed a CDC
definition of the threat of harm. I felt that maybe that kept
me in the straight and narrow. I felt the threat of harm
sometimes at home to keep me getting my homework and so forth.
One of the issues, Ms. Oliva, I want to talk to you about
which I think is extremely important are domestic shelters. At
home ours is called Safe Passage. And my job before I got here
was mayor of our city, and we almost passed the hat. I mean, we
would get a few Federal dollars, a few State dollars, a few
local dollars.
Two weeks ago my wife and I, I guess, attended a
fundraiser. We were the keynote people at the fundraiser to try
to raise a little money, because it is a life vest. It is not a
boat, it is a life vest, because these people are sinking, they
have no other place to go. And it needs to be open 24/7. And I
wholeheartedly support that program.
I mean, we have tremendous volunteers in Johnson City,
Tennessee, where I am from, that support this, very needed. And
also the Children's Advocacy Center also, great programs.
Just a comment about the funding, if you would. How, where
you are, are you able to fund your center?
Ms. Oliva. We are able to fund our center primarily through
TANF funds, because we are reimbursed on a per person, per day
basis. In New York State it is different from most in that
those women who go into a shelter, unless they have a lot of
money, and almost not ever come in with access even to that
kind of money, they have to go on to TANF, they have to go onto
welfare. And so we are reimbursed that way.
That is really a degrading process for so many people, and
it is shameful. But on the other hand, it has really produced a
supply of funding for the neighborhood shelters in New York to
survive. But I will tell you, it is not enough because you
can't have a shelter in isolation. And the FPSA money goes to
shelters and to programs that support it. You have got to have
a hotline running 24 hours a day. You have got to have
advocates able to work with women and to advocate for them with
all the many systems. You have got to be interacting with the
criminal justice system on behalf of these women; we provide
legal services. So especially with growing immigrant
populations we need--really we need specialized immigration
legal services for so many of our clients. So the funding for
these programs is essential.
Mr. Roe. And I agree with you.
Ms. Oliva. You can't live on volunteers. You must have paid
staff, and that is where most of the cost is.
Mr. Roe. Our problem is we can barely pay the staff.
Everywhere you are understaffed. And so I hear you loud and
clear.
A couple of just quick questions. A demographic I noted
years ago, if you are 18 years old when you have your first
child, you have a high school education and you are married,
those three things, you almost don't live in poverty. And those
things, I think, are missing. So when the children are abused,
is it educational level, is it drug abuse, is it poverty, is it
urban versus rural? I know you have got a model to tell us. And
anybody can answer this question. Someone who is at risk, I
guess, is what I am asking.
Ms. Oliva. You are asking what puts people at the greatest
risk.
Mr. Roe. Right.
Ms. Oliva. Well, in domestic violence it has a great deal
to do with the way in which people grow up, what they learn,
what they learn about how to channel their feelings, how to
channel their anger, how to use the power that they have within
their families. And so much of abuse is about that.
But there is no doubt that the economic issues are there.
And if you--we have so many women who are stuck in
relationships. They can't get out of marriages. They can't get
out of the house or the apartment that they are living because
where are they going to go, how are they going take care of
their kids? And so the economic issues are tremendous.
We find that being able to provide transitional housing
through Federal HUD dollars has been the key to helping women
not just escape on a temporary basis from the immediate danger,
but to become self-sustaining and really begin violence-free
lives with their family.
Mr. Roe. Dr. Hammond, one quick question. My time is about
out, but did you all have a demographic of that from an
educational level, drug abuse, all those factors that we know
may play a role?
Mr. Hammond. Well, there is no question that things like
substance abuse, level of income, et cetera, are contributors
to child abuse. But I want to underscore there is no absolute
profile of who is and is not an abuser. But what we try to do
in public health is look at the circumstances surrounding
families. The pressures of everyday parenting can be
exacerbated, for example, by economic conditions, interpartner
conflict in the home. And the more we can involve others, and
in particular I would suggest the primary health care system,
as an avenue for the support of parents, the more we can
provide some system for early intervention on these pressures.
So what we see is that it is possible to recognize some of
the very subtle risks that create the potential for child abuse
and neglect in families. But families, and parents
particularly, need a safe environment in which to get the help
where there is less risk of them, in fact, losing their kids.
So that is why I have been underscoring the need for public
health to complement what child protective services and child
welfare agencies can do.
Mr. Roe. Thank you.
Thank you, Madam Chair.
Chairwoman McCarthy. Thank you.
Representative Chu.
Ms. Chu. Thank you, Madam Chair.
Ms. Kaplan and Mr. Sawyer, you made a compelling argument
for the deferential response system, and you said that 20
States already have this, and it is kind of a no-fault system
where there is a front load of services in families where there
may be abuse or neglect. How do these States pay for it? Does
it require funding above and beyond the allocation that is
there? Can any CAPTA funds be utilized for it, or can this be
done through reallocation of funds?
Mr. Sawyer. In Minnesota about approximately half of the
funding for all child welfare services is raised through local
property tax. So the State county commissioners are in a
position to levy funding that is used. The second source of
funding comes from the State legislature and the appropriations
that it makes. And then the third source of funding in
Minnesota is the Federal revenue that comes into the State. And
it really is a stream of funds.
And I think the request to the Federal Government is that
the more flexible and the less caps that are put on funding
makes it easier for the system to access and be able to fund
programs at an appropriate level.
Ms. Kaplan. And I would just add that--I wanted Rob to go
first because I knew what he was going to say specific to
Minnesota. CAPTA Title I dollars can be used. CAPTA Title II
dollars cannot be used because they are targeted to children
that are not involved with the child protection system. And
that is by design so that there are monies that are dedicated
exclusively for the preventive arm.
But that is not typical. It is very much a patchwork where
people are taking dollars from the Children's Justice back,
they are taking dollars from Safe and Stable Families. There
are local and State revenue streams, but there is not a
dedicated source of dollars. And as you know, CAPTA dollars are
not aplenty, and so a small amount might have the ability to go
ahead and be targeted toward it. They are able to do it, but
there are not a whole lot of dollars to do that.
Ms. Chu. So are you saying that one part of the fund should
be more flexible, or that there should be targeted funds for
this.
Ms. Kaplan. I think that, frankly, the States would be very
pleased to have more flexibility, and that flexibility should
allow for using the dollars in this way.
Ms. Chu. Thank you.
Dr. Hammond, Prevent Child Abuse in California bought to my
attention a fundamental flaw in the structure of our child
protective services. They said that most funds are only
available after a case is made official; and that is to say
when Child Protective Services gets an initial phone call
making them aware of possible abuse or neglect, Federal funds
can't be used--can't be used to evaluate whether or not that
case should be pursued. And considering the fact that an
average investigation costs $1,200, it could be quite costly to
the tight budgets of child abuse agencies.
Can you talk about this? It basically would seem like the
incentive would then be to either make a finding of abuse to
pay for that investigation and evaluation. Shouldn't there be
funds for an initial evaluation?
Mr. Hammond. Thank you for the question.
I am not familiar with the details of the law and how the
money flows with respect to evaluations, but I can say that
everything that we can do to invest on the front end with
preventive services will--in the back end will lessen the cost
of families getting enmeshed in the child protective services
systems.
There is no question that the cost of investigations, et
cetera, are probably very, very high, but what would be very
helpful is if we had ways to identify support for preventive
services, perhaps through new ways of doing health care in the
primary health care system that would prevent the need for the
back-end cost that you are referring to. But I am happy to
refer your question to the Department of Health and Human
Services regarding the specifics of how costs are related to
child abuse investigations and what can be done there, and I
would be happy to provide that.
Ms. Chu. Thank you.
Chairwoman McCarthy. Mr. Platts.
Mr. Platts. Thank you, Madam Chair. And, again, my
apologies for having to run out and come back, but that is one
of the benefits of written testimony. I do apologize, though,
if I ask a question that was already addressed and is being
repetitive.
Ms. Smith, I want to start with your testimony. And you
talk about the numbers, staggering, a 12.8 percent increase in
indicated cases in Dauphin County, and then from 4 last year
deaths and already 10 this year, just a really heart-wrenching
statistic.
Are you able to try to identify, or would you be able to,
what you think is driving that? Is it added stress because of
the economic issues? Is it, you know, other, you know, social
issues, you know, what is really kind of an underlying thing we
need to look at?
Ms. Smith. Well, I think as Ms. Oliva had mentioned----
Chairwoman McCarthy. Could you put your mic on?
Ms. Smith. As Ms. Oliva had mentioned, she was talking
about economic stressors really having an impact, I think, on
the stress that people are feeling. I can't specifically say in
these cases in Dauphin County what those things were that
brought it to that point, but I know that the children that we
are seeing more in our advocacy center, and we are a hospital-
based center so we can provide the medical exams right there,
seem to be not only more frequent, but more severe cases,
particularly of physical abuse. And I believe that some of
those deaths were related specifically to physical abuse of
those children.
Mr. Platts. Is there any change in the age of a child--
children being abused, any variables in that sense?
Ms. Smith. We haven't done a study recently, but I think
the majority of the children that we are seeing, the average
age is still around 6 to 8 years old. We do seem to see a lot
of very young children. I know that we have evaluated children
as young as just a few weeks old.
Mr. Platts. Two weeks.
Ms. Smith. A few weeks. I believe one of the child deaths
in Dauphin County was of a 5-week-old infant.
Mr. Platts. Just heart-wrenching as a parent and hard to
imagine the harm of a parent doing that to their own child.
In the testimony you also reference the citizen review
panels.
Ms. Smith. Yes.
Mr. Platts. Could you expand on that and how that kind of
works, and the type of feedback or the structure?
Ms. Smith. Well, we are just in the process of doing that.
Actually letters have just gone out. There will be three panels
in Pennsylvania in different regions of the State. We are going
to be training the citizens in the child welfare system itself
and then asking for their input in what they see. The citizens
were sent letters requesting anybody that was interested. We
were hoping to have folks from various areas maybe that already
had some experience in their life of dealing with the child
welfare system, and utilizing that to help make changes and to
really look at the system.
Mr. Platts. So the panel, the goal is how to improve the
system in how we respond, prevent and respond to child abuse
more so than helping in the local communities to identify----
Ms. Smith. Well, regionally they will be pulled from those
regions. So hopefully we will be able to get some of the
information from the rural areas as well as from the urban
areas of what the specific issues are that are being dealt
with.
Mr. Platts. Again, about how to respond to, prevent and
respond to.
Ms. Smith. Yes. System improvement.
Mr. Platts. Right. What is working in their area and try to
have that shared in a broader sense.
Ms. Smith. They will be working with State officials from
the Department of Public Welfare and sharing that information.
And then the department will be looking at how to take that and
put it into action.
Mr. Platts. Somewhat related. Dr. Spigner, in your
testimony you talked about neighborhood-based strategies. Could
you expand, one, when you talk about neighborhood, do you mean
truly a local neighborhood or a local community, and how you
anticipate that working?
Ms. Spigner. That is a great question. A number of
jurisdictions have started this process by mapping where the
reports come from, because reports, sometimes they are
dispersed, but sometimes they are really aggregated in certain
neighborhoods or certain communities. So the first thing an
agency would do is to look at where the reports are coming
from, then to begin to identify those communities with the
greatest vulnerability in terms of child abuse and neglect.
Then the agency really recruits neighborhood leaders and
residents and shares information about what is happening to the
children and families in their community, and begin a process
of brainstorming and collaboration to begin to build strategies
that the neighbors can literally engage in to keep children
safe.
One of the problems we have in child protection is that we
have held onto this notion of privacy and confidentiality so
closely, that people really don't understand how many children
are being removed from the neighborhood, what the circumstances
are. So when data gets presented, it really surprises people,
because this has been kind of an invisible process.
And this is not about destroying privacy, but it is about
giving a picture of what is happening in a community. Then you
begin to see the community say, wow, we didn't know what is
happening to our kids. We need to begin to think together about
how we can use churches and civic clubs and actually
communities to work on this issue of safety, to begin to say to
a parent in a way we are not willing to do now, don't you
really think--let me offer you another way to talk to your
child about this, so that you begin to change almost the
culture of the neighborhood so that children's safety becomes
paramount. And it is a capacity-building process. But I think
we have got to recognize that communities are part of the
answer, and we need to begin that kind of discourse.
Mr. Platts. And empowering those communities and getting
that buy-in at the local level to respond, because I can equate
it to the difference today in growing up. When I was a kid in
our neighborhood, there was--I mean, the times are different.
And so if anything happened to anyone in that neighborhood with
any of us kids, it was immediately known by everybody. Also it
was different because moms were more present in the communities
because of different times, where now both parents are having
to work more. With both parents working or more single-parent
families, it is harder to have that type of engagement that
maybe we need to try to return to for the safety of children in
all ways, including when it comes to abuse.
Ms. Spigner. Let me just say that there are a number of
jurisdictions that have been working on this. In Jacksonville
it has been really interesting, because as they began to talk
to the community, the neighborhood, about what kids needed,
what was needed, people began to say, well, our kids really
don't have anything to do after school. So it kind of raises
the challenge of caring, and it puts pressure. And so they
began to organize within that community after-school programs
and got some city funding so that kids could stay in their
neighborhood, but there was someplace for them to go.
We have seen a similar strategy in Houston, where they
looked at the area where most of the kids are coming from, and
they began to talk about what was going on in that neighborhood
because of the high rates of entry of African American children
in the child welfare system. So they began to mobilize the
African American community. And now they are beginning to see
after a period of 3 to 5 years declines in reports and
increased safety in kids.
So we have got to think about new partnerships.
Mr. Platts. Thank you, Madam Chair.
Chairwoman McCarthy. Thank you. And thank you for that line
of questioning.
Before I call on the next questioner, I just want to say
with the testimony that you have all been saying, and Dr.
Hammond mentioned public health, primary care and nursing
services, and then working together, what Sandra was talking
about of bringing everything together, until we are able to
have--and also, Dr. Spigner, what you were talking about,
bringing the community together in one place so that you can
see the child and the family as a whole. I happen to think that
would certainly help each and every one of you in your job.
Mr. Tonko.
Mr. Tonko. Thank you, Madam Chair.
Ms. Oliva, you talked about in your testimony about the
importance of providing services to teens as it relates to
their being victimized by dating violence.
Ms. Oliva. Yes.
Mr. Tonko. Can you indicate for us where there might be
added efforts made for those who are victimized by dating
violence as opposed to domestic violence? Are there needed
professionals, or are there approaches that need to be taken to
address that population?
Ms. Oliva. Well, actually dating violence is a subset of
domestic violence, it is a form of, because domestic violence
has to really be seen as something broader than just a husband/
wife or two partners who are living together. It also involves
intimate partners, whether they are related, living together or
seeing each other, dating each other and having a relationship.
And as we all know, our kids are dating earlier and earlier,
you know, seem to be getting older faster. And this issue of
violence within teen relationships is growing exponentially. It
is the one place where we are really seeing significant
increase in the violence is in particularly for young women
between 16 and 24. This is a very high-risk population in high
schools and colleges.
And so we believe that early intervention through
prevention services, being able to reach young people, teens,
and not expect them to come to the schools for their help; but
to work with the schools, to be able to bring the issues, the
messages to the schools, to let the kids know who is there to
help them. But kids are not going to go for help to a school
counselor because of the stigma or the fear of ratting on the
guy, or the stigma of being seen by everyone as the young woman
who was raped or the young man who is being beaten.
So what we are really talking about is being able to work
collaboratively between schools and programs to do the kind of
outreach so that young people know about and learn about
healthy relationships early when they are beginning to have
relationships. And I am talking about, you know, young boys and
girls and working with them and giving them a place to come to.
And that is why the kind of funding we have been talking
about for domestic violence is so critical, because this
outreach and prevention and the ability to provide services. I
mean, so many young women now, especially with the advent of
technology, are being stalked. We had one girl who she had to
turn her cell phone on next to her pillow at night so that he
could hear her breathing any time he wanted to from his home
and she would never be out of reach.
I mean, these kinds of things are happening to our kids,
and we have to become aware of it. It is so critical to reach
them young. If you teach people young to be in healthy,
respectful, nonviolent relationships, then we won't need these
programs generations later. Prevention is key.
Mr. Tonko. So if there is a stigmatization that occurs
through the school networking, how do you best reach----
Ms. Oliva. Well, we go into the schools. We use some of our
FPSA money to go into the schools to do programs within, the
guidance programs within the social studies curricula. We are
working within different--depending on where in the school we
are invited in that we can get, at levels, at junior high
school, high school, college levels, and reach the kids and
talk with them and have sessions with them.
But we understand that the kids are not going to come out
publicly in front of their friends for the most part. But we do
get our kids coming up to us saying, my friend, this is
happening to her. And then we can reach out to the individual
through the guidance counselors and the social workers in the
schools and arrange for the children to come and work with us
on site or other sites near the school, make use of other
programs, because you have got to have--I mean, absolutely you
have got to have communities. This has got to be integrated
work. You cannot be isolated and have a program here and a
program there and a school here and a library there. You have
got to integrate all of the resources of a community in order
to work so that we can prevent this and we can have young
people growing up in healthy, safe relationships. And they in
turn will then provide healthy, safe environments for their
children.
Mr. Tonko. And how early in the networking with children,
youth?
Ms. Oliva. We start very early. We start in first, second
grades. But we primarily focus--because we know at that age
what we are really teaching them is things like hands are not
for hitting, not to be--you know, not to be physically hurtful
of each other.
But really our real focus is around the junior high school,
somewhere around the early teens, because kids 12 years old are
involved in relationships. At 13 and 14 they are in sexual
relationships, and if you don't reach them then when they are
beginning to form their ideas--children often replicate what
they have learned at home, and they also replicate what peers--
you know, what is the thing to do and how to be. And if they
don't all--if they don't begin to believe that the way to be
within relationships is loving and respectful and nonabusive,
then we are never going to--this issue is going to be
perpetuated in parents and children, and it is just going to go
on and on. So to stop it we have to get to the kids.
Mr. Tonko. And just a question about how perhaps boys,
young men, relate to the program as opposed to girls and young
women.
Ms. Oliva. We have been working on different projects over
the years that are very successful with young men. They are
primarily the kinds of programs that say, you know, real men
don't hit, real men don't hurt. It is that kind of using men
who are good role models for them to be there talking to the
kids in the schools. It is very effective when young men see
men they respect speaking to them about how--you know, how real
men are loving and kind and don't physically harm and hurt and
abuse.
And, of course, you know this is very complex. Abuse is not
always physical. There are an awful lot of other kinds of abuse
that go on that you don't see, that don't come to the attention
of the criminal justice system or the guidance counselors in
the school or the social workers and agencies, but people who
are in very painful, denigrating relationships.
So it is very critical to reach the young men and the
women, and they are both responsive. I do believe that people
want to learn and want to be happy and healthy, and what they
need is a hand. They need someone out there to reach them
personally. And we find what is especially effective at the
college level is working with the residential assistants, for
example, in the dorms, and to have someone there who has been
trained and understands, not to be the counselor, but to get
someone to the right help. So it is reaching out, letting
people know what is available in your community, whom you can
go to to help you get the help you need. And that, to me, is
the way it has to be.
Mr. Tonko. Thank you.
Chairwoman McCarthy. Ms. Moore.
Ms. Moore. Thank you so much, Subcommittee Chair McCarthy,
for allowing me to participate in this hearing.
I have so enjoyed working with the National Network to End
Domestic Violence, with all the domestic violence coalition
partners over the past several months to get this desperately
needed reauthorization of FPSA. And I certainly look forward to
working with the subcommittee and the committee in the months
ahead to do this.
I want to ask the panel some important questions, but I
just want to state for the record, Madam Chair, that I do think
we need to seek to increase, substantially increase, the
authorization levels for the FPSA program. And I think that
this hearing really substantiates and elucidates the reasons.
We have heard some really chilling testimony here today
about the kinds of dangers that women and children, and even
men, are in in domestic violence situations, and with some
staggering statistics that Ms. Oliva presented for the Academy
on Violence and Abuse stating, was it, $333 billion to $700
billion being the cost of abuse in our health care system. So
it is no wonder that these insurance companies want to treat
domestic violence as a preexisting condition and not pay for it
when you consider a $750 tab for the cost of domestic violence.
Dr. Hammond made a statement in his testimony, in his
written testimony and in his oral testimony, that these
children and families were at greater risk for cancer, heart
disease and other sorts of diseases you don't ordinarily
associate with domestic violence. And so, again, I think
prevention, as all of them have mentioned, is increasingly
important.
And, of course, Dr. Wilson Spigner talked about the
importance of getting the communities involved. I remember
Billie Holiday's song, you know, if I get beat up by my papa, I
ain't gonna call no coppa, and it ain't nobody's business if I
do. It is our business. Domestic violence is our business.
I guess in terms of reauthorizing the program, there is
increased monies for States and territories in a new grant
program to reach out to underserved communities. So I would ask
Ms. Oliva and Mr. Sawyer in particular, who has worked with 11
tribes in Minnesota, number one, what difference does having
cultural competent services make? I notice in the territories
there is a higher rate of domestic violence. And then I want
Ms. Oliva to tell us what happens to these families who they
are unable to serve because of the dearth of funding?
Mr. Sawyer. In Minnesota the Department of Human Services
and a number of the tribes have begun a new collaboration over
the last 2 or 3 years, and that collaboration is really focused
around trying to strengthen the tribes themselves, to build
capacity within the tribal community to provide outreach and
services to the members of its tribes.
I think that overall in the system there is a continuing
need for the personnel who work in the child welfare system to
reflect the populations that they work with, is probably a good
place to start in terms of reaching common ground, in terms of
understanding of each other. But I think it is that basic
appreciation that we are all different, and we have to be very
respectful of those differences and find ways to make sure that
we are approaching the work in a way that decreases issues
like----
Ms. Moore. My time may expire, so I want to make sure I
push you toward answering my question. I mean, is there a
consequence that we all need to know about in terms of not
having culturally competent services?
Ms. Oliva. You know, this is an issue which creates so much
shame and stigma and a sense of wanting to keep this private
and this ``behind closed doors'' concept. And it is very
difficult for people to reach out and make known that they--or
even to be able to feel safe doing so. So it is extremely
important that people have the ability to reach out in places
that they are comfortable. And culture competence and culture
familiarity and language familiarity certainly are critical for
that, because the important thing is to get people to reach
you, to reach out to you before the police come to the door
because the neighbor heard a shot or someone screaming. You
want people to be able to reach for help. And when they do come
out for help, or when they are brought for help, you want them
to feel safe and able to communicate what their needs are and
what is happening in their homes to themselves and their
children.
Ms. Moore. With your diligence, could you please answer my
second question: What happens when there is no room in the
shelter? Can you give us some examples?
Ms. Oliva. Domestic violence programs never turn somebody--
never say, sorry, we are busy, call back tomorrow, we don't
have room. However, more and more we are seeing shelters,
including my own, not able to meet the needs. So we need to--we
get very creative, and in every possible way we use much of our
discretionary money on helping people pay for transportation,
medicine, food, you know, that kind of thing, so that they can
be in some kind of emergency situation, they can be relieved of
it.
We have used motels for very short-term stays. We try to
work with everyone to find is there a safe place for you to be.
We have transported people all over the country. But--sometimes
because that is the safest thing for them, but also because
sometimes we just don't have the resources, and so we have to
scrounge and find. It is very difficult, it is extremely
difficult, and sometimes people give up when they don't get the
help they need right away, and it just feels easier to just go
back. And that is terrible, and we don't want that to happen.
That is why these resources are critical.
Ms. Moore. I yield back. Thank you, Madam Chair.
Chairwoman McCarthy. Thank you.
As you probably heard, bells are going off, and beepers are
going off. We are in the middle of a vote. So we usually have
time on this panel to actually go for a second round of
questions. That is the beauty of--I personally think of our
subcommittee anyhow. But with that, being that we are going to
be down there for 45 minutes, I want to thank each and every
one of you for coming in. It was heartbreaking testimony, but
it certainly gives us a good roadmap on what else it is we need
to do as we go forward on the reauthorization.
We heard the testimony today about the importance of good
prevention programs, the need for good decisions to be made by
our child welfare workers, and the need to consider all
appropriate avenues for families that are in crisis. As we move
towards reauthorization, we will have our work cut out, but by
taking a comprehensive approach to abuse, violence, prevention,
children, families and communities, we will be a healthier
Nation.
I want to thank again all of our witnesses for being here
today. Each of you have highlighted the very real concerns with
access and the issues we need to focus on during the
reauthorization process.
I want to mention that there has been a great deal of
interest in this hearing, and we have received many requests to
submit written testimony. I would also like to submit two
reports for the record, one from the National Network to End
Domestic Violence, which provides a snapshot of the lifesaving
work of domestic violence services and shelters across the
country. The second is called Meeting Survivors' Needs: A
Multiple State Study of Domestic Violence Shelter Experiences.
I would also like to introduce the 2007 series of AP articles
on child sex abuses in our schools. Without objection, so
ordered.
[The information follows:]
[The report, ``Meeting Survivors' Needs: A Multi-State
Study of Domestic Violence Shelter Experiences,'' may be
accessed at the following Internet address:]
http://www.ncjrs.gov/pdffiles1/nij/grants/225025.pdf
------
------
Chairwoman McCarthy. I am also expecting several other
groups will be submitting testimony towards this as we go
forward.
As previously ordered, Members will have 14 days to submit
additional materials for the hearing record. Any Member who
wishes to submit follow-up and questions in writing to the
witnesses should coordinate with the Majority staff within the
requested time.
Without objection, this hearing is adjourned. Thank you
again.
[Additional submissions of Mrs. McCarthy follow:]
Prepared Statement of Sheryl Cates, Chief Executive Officer,
National Domestic Violence Hotline
Dear Members: For over 13 years, victims have obtained 24-hour,
confidential and anonymous help through the toll-free National Domestic
Violence Hotline. Each year, highly trained Hotline advocates provide
support, information, safety planning, crisis intervention and
referrals to agencies for hundreds of thousands of victims and anyone
calling on their behalf. Assistance is available in English and Spanish
with access to more than 170 languages through interpreter services.
Help is available to callers 24 hours a day, 365 days a year by calling
1-800-799-SAFE (7233) or TTY 1-800-787-3224. The Hotline serves as the
only domestic violence hotline in the nation with access to a network
of more than 5,000 shelters and domestic violence programs across the
United States, Puerto Rico and the U.S. Virgin Islands. Advocates
receive approximately 21,000 calls each month.
The Hotline provides an essential first response to hundreds of
thousands of victims each year by directly connecting them to a life-
saving network of providers who assist them with a violence-free
future. Yet increasing call volume, combined with a lack of resources,
undermines the Hotline's capacity to answer each call for help.
In 2008, while the Hotline received 255,047 calls, there were over
42,500 calls (17%) that Hotline advocates were unable to answer due to
increased demand.
There were over 18,140 more callers in 2008 than in 2007 and the
Hotline has seen a 13% increase in callers needing assistance in
languages other than English.
Without increased resources, current call trends suggest the
Hotline will be unable to answer nearly 45,000 calls in 2009.
The loveisrespect, National Teen Dating Abuse Helpline (NTDAH)
managed by the Hotline was launched in February 2007 to address the
alarming and increasing trend of teen dating abuse. NTDAH is a national
24-hour resource that can be accessed by phone or the internet and is
specifically designed for teens and young adults ages 13-18.
loveisrespect.org offers real-time, one-on-one support from trained
Peer Advocates. Peer Advocates are trained to offer support,
information and advocacy to those involved in dating abuse
relationships as well as concerned parents, teachers, clergy, law
enforcement, and service providers.
Clearly the need for these life saving services has increased. The
Family Violence Prevention Services Act (FVPSA) remains the core
federal funding stream for this life saving aid to victims of intimate
partner violence. Your support of this funding will ensure victims get
the help they so desperately need and additional FVPSA funding will
enhance the capacity to meet growing demand and serve an increasing
volume of calls.
Thank you Chairwoman McCarthy and subcommittee members for this
opportunity to highlight the importance of increased Family Violence
Prevention and Services Act (FVPSA) funding to support the critical
services offered by the National Domestic Violence Hotline and the
National Teen Dating Abuse Helpline, loveisrespect.org.
Sincerely,
Sheryl Cates, Chief Executive Officer.
______
Prepared Statement of the Child Welfare League of America (CWLA)
The Child Welfare League of America (CWLA) is a ninety year-old
non-profit organization representing hundreds of state and local child
welfare organizations including both public and private, and faith-
based agencies. We are pleased to submit testimony to today's hearing
by the Subcommittee on Healthy Families and Communities on the topic of
Preventing Child Abuse and Improving Responses to Families in Crisis.
The U.S. Department of Health and Human Services (HHS) releases the
latest national data on child abuse and neglect every April. For 2007,
the numbers tell a familiar story: Nearly 800,000 children were
substantiated as abused and or neglected, out of the more than 3.3
million child abuse reports made. Children in the birth to age 1 year
had the highest rate of victimization at 21.9 per 1,000 children. Of
the estimated 1,760 child fatalities in 2007, 34.1% were attributed to
neglect only with physical abuse a major contributor to child
fatalities.\1\
Of the child victims, nearly 8% were sexually abused, and 11% were
physically abused. One consistent statistic that surprises some is that
nearly 60% of the 800,000 children are victims of neglect.\2\ In many
cases, neglect can be just as serious as sexual or physical abuse. It
also tells us we are not doing enough to prevent these children from
being brought to the attention of child protective services (CPS), and
thereby being placed into care.
Another consistent statistic is that of the 800,000 abused and
neglected children identified, more than 40% did not receive follow up
services.\3\ Reasons for this include 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 percentage going without follow-up help,
clearly 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 system.
In the near future, HHS is expected to release the Fourth National
Incidence Study of Child Abuse and Neglect (NIS). The Subcommittee may
want to review this study when it is released for the insight it may
provide into the need for greater prevention efforts. The last one was
published in 1996, and, like that one, this congressionally mandated
study is likely to tell us that more children suffer from abuse and
neglect than the official statistics indicate. The report will survey
professionals from dozens of U.S. counties, and the analysis will shed
some light on the number of children harmed by abuse and neglect;
characteristics of children, families, and perpetrators; report
sources; and CPS investigations.
The NIS includes children who were investigated by CPS agencies,
but it also obtains data on children seen by community professionals
who were not reported to CPS or who were screened out by CPS without
investigation. Therefore, NIS estimates provide a more comprehensive
measure of the scope of child abuse and neglect known to community
professionals, including both abused and neglected children who are in
the official statistics and those who are not.
The NIS follows a nationally representative design, and because all
four national studies have used comparable methods and definitions,
comparisons can be made about our progress or lack of progress, and
this likely will reinforce the need for greater preventive efforts.
Prevention as part of the child welfare continuum
Prevention of child abuse and neglect is perhaps the greatest
challenge in the continuum of the child welfare system. All too
frequently, prevention of abuse and neglect is an add-on service
instead of a core component of the range of needed services. The issue
of providing or addressing prevention too often is conditioned on
whether a child welfare agency or state agency can free up
appropriations or funds by reducing the cost, including what some would
describe as back-end services typically foster care. Instead, what is
required is an investment in the range of services.
Child protection can trace its origins to the 19th Century when, in
1875, the Society for the Prevention of Cruelty to Children was
established in New York City. After publicity surrounding the treatment
of a young child captured the public's attention, 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 by 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.\4\
The first White House Conference on Children was convened in 1909
and led to 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.''
\5\
Throughout the following decades, other federal and state laws were
enacted, 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, Congress
passed the first Child Abuse Prevention and Treatment Act (CAPTA). This
landmark law helped establish national standards for specific reporting
and response practices for states to include into their child
protection laws.
CAPTA is the only federal legislation exclusively dedicated to
preventing, assessing, identifying, and treating child abuse and
neglect--the continuum of child maltreatment services and supports.
Since 1974, CAPTA has been part of the federal government's effort to
help states and communities improve their practices in preventing and
treating child abuse and neglect. CAPTA provides grants to states to
support infrastructure and innovations in state child protective
services (CPS).
CAPTA includes three programs:
CAPTA authorizes grants to the states to develop
innovative approaches to improve their CPS systems. To qualify for
these grants, states must meet eligibility requirements, such as having
mandatory reporting laws, preserving victim confidentiality, appointing
guardian ad litems, and establishing citizen review panels.
CAPTA discretionary funds support state efforts to improve
their practices in preventing and treating child abuse and neglect.
These funds support program development, research, training, technical
assistance, and the collection and dissemination of data to advance the
prevention and treatment of child abuse and neglect. These funds also
support the National Child Abuse and Neglect Data System, the only
federal data collection effort to determine the scope of child abuse
and neglect. These funds support national initiatives, such as the
National Office of Child Abuse and Neglect, the National Resource
Center on Child Maltreatment, and the National Clearinghouse on Child
Abuse and Neglect.
The Community-Based Family Resource and Support Program
was created in 1996. The program provides grants to states to support
their efforts to develop, operate, and expand a network of community-
based, prevention-focused family resource and support programs that
coordinate resources among a range of existing public and private
organizations. Funding is allocated to states by a formula based on the
number of children in a state's population.
While CAPTA is intended to bolster child protection efforts and
invests some limited funds into preventing abuse from occurring, it's
funding and appropriations history has been dismal at best. Each
reauthorization results in adjustments in policy and practice but it
has not resulted in increased appropriations or commitment from past
congresses or administrations. We hope that will change in the 111th
Congress and with the President's next budget in February.
As significant as it is, CAPTA is only one part of the child
welfare system and ultimately our prevention initiatives. Over the
years laws such as Aid to Dependent with Dependent Children, (AFDC)
followed by Temporary Assistance to Needy Families (TANF), and the
Social Services Block Grant (SSBG) provide critical funding to child
welfare services including services to protect children. Overall, SSBG
is a major source of federal funding, representing 11% of federal
funding for child welfare services that addresses the needs of
vulnerable children and youth.\6\ SSBG frequently serves as a link
between government funding and private and charitable sources and helps
build and fund a network of private agencies. SSBG funds supplement
local and charitable efforts by providing federal dollars to fill a gap
these charities may not be able to meet. The breadth of services
provided by SSBG funds can also cover shortfalls left by other federal
social services programs.
Two other important sources of funding also found in the Social
Security Act along with TANF and SSBG are Title IV-B part 1, Child
Welfare Services (CWS), and Title IV-B part 2, Promoting Safe and
Stable Families (PSSF). Both are flexible funding streams that fund a
range of services. But even in these instances, with CWS funded at $281
million in annual appropriations and PSSF funded at $368 million in
combined mandatory and discretionary appropriations, funds have to be
shared between programs that might prevent abuse and those that assist
families and children through adoption and reunification services. It
should also be noted that both have actually been cut over the past
eight years.
Promising initatives
There are a number of important efforts taking place across the
country and we are encouraged that some of the Administration's new
initiatives are building on these efforts and we hope much more will be
done.
First and foremost is President Obama's proposal of $8.6 billion
over 10 years for a new mandatory program that provides funds to states
for evidence-based home visitation programs for low-income families.
Home visiting is just one of several other initiatives around child
care and early childhood education, which the Obama Administration is
proposing to advance their zero to five initiatives.
To date, Congress has been very supportive of this initiative as
well. Included in HR 3962, is a provision that would provide much
needed grants to states to improve the well-being, health, and
development of children by enabling the establishment and expansion of
high quality programs that provide voluntary home visitation for
families with young children and families expecting children. These
grants are intended to target at risk and vulnerable families and
communities who are in need of services that will not only reduce abuse
and neglect but also improve the overall health and development of
young children. Priority funding will provided for programs that adhere
to a model of home visitation with the strongest evidence of
effectiveness.
Funding for this provision is currently set at $750 million over
five years which is much less than what the Administration initially
proposed, and half of what the Senate bill's provision contains. CWLA
believes that this proposal and other proposals that place an emphasis
on evidence based practices and evidence informed innovation can serve
as a model for a major prevention initiative.
CWLA is also pleased that the President has proposed and it appears
the Congress will approve a new ``Promise Neighborhoods'' initiative.
This initiative, which President Obama raised during the campaign, is
based on the Harlem Children's Zone program. The program attacks
poverty through a comprehensive school-based model that provides wrap
around services for the entire family. It places a special emphasis on
early-learning, elementary and secondary education, and guides children
through the entire period of learning. The goal is to spread this model
to several communities across the country. The planning grants would go
to non-profits for one year. Only those grantees that developed
proposals that incorporated strong partnership and strong plans would
be eligible for larger implementation grants the following year.
CWLA is also very supportive of the Administration's emphasis zero
to five initiatives. Some of these efforts include the Early Learning
Challenge Grants, which the Education and Labor Committee has already
acted on, and other initiatives focused on pre-K funding as well as
next year's debate on child care. Although some of these important
initiatives that may not be thought of as child abuse prevention, they
are all critical components of assistance to the country's most
vulnerable families and children.
At the local level we also see examples that can be built on
through greater federal support. Some examples include Baltimore's
Family Connections program, which uses a range of funding sources from
the public, private, faith-based, foundation, and other community
partners to show some significant results. The Family Connections
program has shown positive results in reducing the instances of abuse
and neglect by using limited federal funds to better coordinate
communities and services. As the University of Maryland points out,
Evaluation results show Family Connections improves protective
factors such as parenting skills and attitudes, and reduces risk
factors such as parent depression, caregiver drug use, caregiver
stress, and children's behavioral problems. The program also
demonstrated reduced incidents of child abuse and neglect and increased
child safety and well-being.\7\
The results were enough to encourage HHS to fund eight additional
models with initial resources focused on an 11-month community-planning
process.
Differential response is one prevention strategy that holds promise
in protecting vulnerable children. This form of practice allows for
more than one method of response to reports of child abuse and 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.
Great variation exists 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.
Although 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.
Initiatives that combine the efforts of the courts and the child
welfare community also have shown promise. These initiatives, which
provide funds to train key personnel--including judges and child
welfare workers involved with the courts, such as court-appointed state
advocates (CASAs) and CPS workers--have yielded positive results in
keeping families together and addressing the abuse and neglect of
infants and the very young.
The Court Teams for Maltreated Infants and Toddlers Project,
spearheaded by ZERO TO THREE, has shown great promise and results; what
it lacks is a steady source of dedicated funding that can expand on
these efforts.
Another innovation being implemented in some areas, both in terms
of CPS and in placement decisions, is Family Group Decision Making
(FGDM). FGDM offers an approach of working with families and
communities 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 situations and therefore are often able to
make well-informed decisions about their circumstances with the support
of family members and others who have worked with the family.
The prevention challenge
Prevention can encompass services as basic as access to child care
and it can also include a range of other services that can help
families reduce the stresses of parenting. Providing respite for
parents can ensure a child's well-being when parents are working, in
school, or caring for other children.
There is an increasing level of research and work that is being
done in terms of prevention. The Children's Bureau highlights common
factors that can be found in successful prevention initiatives. This
research suggests that you must both reduce risk factors and promote
protective factors to ensure the well-being of children and families.
This work also shows that protective factors include efforts to
strengthen all families. This kind of approach when possible can extend
support beyond the most vulnerable families and reach other families
may not meet the criteria for the most vulnerable but are families that
are dealing with stressors that could lead them to abuse or neglect.
CWLA believes that some of the recent initiatives being advanced by
the Administration and some of the research now being developed offers
an opportunity to develop a new approach to preventing child abuse. A
model that requires and is driven by community-based partners, that
requires on-going research and that can implement and replicate proven
models but allows enough flexibility to invest in innovative and
emerging practices and programs.
Recommendations
First and foremost we hope Congress will act soon to reauthorize
CAPTA. More importantly however, is our belief that there needs to be a
genuine commitment to fund this law. That commitment must be shared by
the Administration, the Congress and the advocacy community. It offers
limited effectiveness to reauthorize the law and to fund the basic
state grants at $27 million, which would only provide in some states
enough to hire one or two social workers to carry out the important
tasks that can help address child abuse and prevent it in the first
place.
CWLA is encouraged and is hopeful that Congress will complete its
work this year to make the Administration's new home visitation program
a reality. We feel this legislation and the emphasis on outcomes and
research offers a way forward for other child abuse prevention
initiatives.
CWLA also hopes the Administration will encourage and lead states
to fully implement the provisions of the new child welfare legislation,
the Fostering Connects to Success Act (PL 110-351) passed late last
year. Although some of the provisions deal with children and families
already in contact with child welfare, they still have an impact on a
larger population. This is especially true of those provisions dealing
with health care, training for child welfare workers and other
personnel, and tribal funding. We also believe it will help Congress
and the Administration take the next step and reform the way we finance
child welfare so that we can include funding to address preventing
child abuse.
Finally we urge the Committee and the Congress will act soon to
pass legislation to re-establish a White House Conference on Children
and Youth. CWLA recognizes that dollars and federal action alone cannot
reduce the level of child abuse or the number of children in foster
care, and therefore this has to be a partnership at the federal, state
and local levels. It is for that reason that CWLA has 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 the needs of
the country's most vulnerable families and children.
This Conference was once held every ten years but has not been held
since President Nixon called it in 1970. Its results have been
noteworthy. It was mentioned earlier that the first White House
Conference on Children and Youth led to the creation of a Children's
Bureau in 1909 and subsequently 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.
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.
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.
endnotes
\1\ Administration on Children, Youth, and Families (ACYF). (2008).
Child Maltreatment 2006, Summary. Washington, DC: U.S. Department of
Health and Human Services (HHS). Online at www.acf.hhs.gov/programs/cb/
pubs/cm05/summary.htm.
\2\ Ibid.
\3\ ACYF. (2008). Child Maltreatment 2006. (Chapter Six, Services).
Washington, DC: HHS. Online at www.acf.hhs.gov/programs/cb/pubs/cm05/
summary.htm.
\4\ Child Welfare League of America (CWLA). (1999). CWLA Standards
of Excellence for Services for Abused and Neglected Children and Their
Families. Washington, DC: Author.
\5\ CWLA. (2007). History of the White House Conference.
Washington, DC: Author. Online at www.cwla.org/advocacy/
whitehouseconfhistory.pdf.
\6\ Scarcella-Andrews, B.R.; Zielewski, E.; & Geen, R. (2006). The
Cost of Protecting Vulnerable Children V: Understanding State Variation
in Child Welfare Financing (Assessing the New Federalism Occasional
Paper). Washington, DC: Urban Institute. Online at www.urban.org/
url.cfm?ID=411115.
\7\ Ruth H. Young Center for Families and Children. (n.d.) Family
Connections--National Program Replication Project Website. Baltimore:
University of Maryland. Online at www.family.umaryland.edu/ryc--best--
practice--services/family--connections--replication.htm.
______
Prepared Statement of the Family Violence Prevention Fund
Chairwoman McCarthy, Ranking Member Platts, and distinguished
members of the Committee, thank you for the opportunity to submit this
testimony regarding the importance of reauthorizing the Family Violence
Prevention and Services Act (FVPSA) and the Child Abuse Prevention and
Treatment Act (CAPTA). Your hearing on Preventing Child Abuse and
Improving Responses to Families in Crisis could not come at a more
opportune time. In 2007, 1,760 children died from neglect or abuse in
the United States.\i\ And on average, more than three women are
murdered each day in this country at the hands of a current or former
husband or boyfriend.\ii\
Violence against women and children is a serious problem in the
United States that is compounded by the stressors of today's economic
conditions. At a time when we need to escalate our response to the
emergencies at hand, we see all around us that resources and services
are dwindling.
The Family Violence Prevention Fund is a national non-profit
organization based in San Francisco, California, that has worked for
the last 30 years to end violence against women and children. Our focus
has been on preventing violence and abuse, and promoting the safety and
well-being of all family members in homes where violence has occurred.
We commend the Committee for its commitment to preventing child abuse
and improving responses to families in crisis, and thank you for
allowing us to submit testimony on these issues. We would like to take
this opportunity to highlight and expand upon the connection between
child abuse and domestic violence, and how imperative it is to use new
knowledge and increased resources to improve our intervention and
prevention strategies.
Intersection of Child Abuse and Domestic Violence
Research suggests a 30 to 60 percent overlap of child maltreatment
and domestic violence.\iii\ Further, when active universal screening
for domestic violence is used, child protection system case workers
identify a history of domestic violence in 45 percent of families they
see.\iv\ These statistics highlight the co-occurrence of domestic
violence and child abuse within families, and the large population that
is being seen by both the child welfare system and domestic violence
services programs. Often, this co-occurrence refers to both mothers and
children being abused by the father of the children or the mother's
boyfriend. In other cases, we see mothers unable to adequately care for
their children due to the stress of being abused. We also see parents
struggling to cope and parent within the context of their own past
histories of experiencing or witnessing violence.
In October, 2009, the National Survey on Children Exposed to
Violence documented the alarming rates at which children are exposed to
domestic violence in the United States. One in 10 children was exposed
to family violence in the past year and by the time children reached
age 17, more than a third had witnessed a parent being assaulted.\v\
Children who are exposed to domestic violence display a host of
problematic behaviors at far higher rates than children not exposed to
violence. These include being more likely to become a perpetrator of
such abuse (for boys) as well as displaying higher rates of violence,
aggression, suicide, school failure and mental health problems. At the
same time, children's responses to exposure to domestic violence vary
depending on age and circumstances; many children are resilient.\vi\
Importantly, we know that when appropriate services are provided,
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. What seems to help these
children most is the presence of a supportive and protective adult,
most often their mother.
The challenge, therefore, for many within the child welfare system
and child abuse prevention community is to better understand how
domestic violence is impacting children, and the best ways to respond
to children and their abused parent(s). However, most child welfare
workers do not have standardized training to help them understand the
dynamics of domestic violence and put this research into practice. In
addition, when child protection systems do attempt to address domestic
violence, they often seek to impose blanket policies that apply to all
victims, and frequently blame the victim rather than the perpetrator of
violence. These policies are now illegal in some states \vii\ and have
been proven impractical and unhelpful in others.\viii\ However good
practice and policy have emerged in many communities and states, and
the time to bring them to scale is now.
At the same time, domestic violence programs have an enormous
opportunity to reach the most vulnerable children who are witnessing
this abuse and help them and their abused parent--usually their
mother--become safe and begin to recover. By identifying and helping
these children, while simultaneously serving their mothers, domestic
violence agencies may have their best chance of truly breaking the
intergenerational cycle of violence. Yet, these agencies need the
direction and, importantly, funding, to start integrating in a holistic
way services for children into the work they already do with their
mothers.
The reauthorizations of the Child Abuse Prevention and Treatment
Act (CAPTA) and the Family Violence Prevention and Services Act (FVPSA)
serve as the perfect opportunity to make some of the necessary changes
in our nation's response to child abuse and domestic violence.
Best Practices to Address Co-Occurrence of Domestic Violence and Child
Abuse and Neglect
For about eight 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 child welfare,
domestic violence and juvenile 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. This work provided new insights about how to best improve
outcomes for children and their mothers in families experiencing
domestic violence.\ix\ While many specific recommendations have been
further developed and refined based on the experiences of these sites,
we focus here on three critical practice elements specific to CAPTA:
Training and education on domestic violence is critical to
help already overburdened child protection systems (CPS) and case
workers make good decisions;
The needs of abused mothers and their children cannot be
separated, despite funding streams and services systems that inherently
separate their interests; and
Child welfare systems and child abuse prevention programs
overall must do a better job in understanding and addressing the role
of men and fathers in the lives of families experiencing abuse--whether
the father is the primary perpetrator of the abuse or a potential
support system to the woman and child, or both.
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 no one
single model is right 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'') \x\--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 often.
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 presents its own
threats. For instance, a caseworker may know that 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 conflicting messages can be
illuminated and corrected through advocacy and legal guidance. The
advocate and the caseworker together can help both the mother and the
child stay safe by integrating their knowledge and skills. What this
consultation may look like will differ by jurisdiction, but its
importance is indisputable.
Supporting Mothers and Children Together
At the heart of CAPTA, like all efforts to prevent child abuse and
neglect, is the simple question: What do children need to be safe? And
the simple answer is that they need a loving and capable parent or
caretaker whenever possible. Unfortunately, child welfare systems have
often responded to domestic violence by either ignoring its
significance or over-reacting and blaming the mother for her own
victimization. They will often see the mother as the problem for her
``failure to protect'' the child from her victimization or blame her
for putting her child at risk, rather than placing the blame at the
hands of a violent or abusive partner, who in many instances is also
the child's father. This is problematic in that it both punishes the
mother for being a victim and removes from the child the most important
source of strength and comfort the child may need while going through a
particularly difficult time. Fortunately, recent research has
documented both the need to keep mothers and children connected when
there is domestic violence and successful programs that improve both
child outcomes and maternal safety. The needs of children and their
mothers must be viewed together and efforts to keep children safe must
begin with efforts to keep their mothers safe.
Betsy McAllister Groves at Boston Medical Center and Alicia
Lieberman at San Francisco General Hospital have created two model
programs to provide the therapeutic services these children need. While
their goal is to serve children, both programs work with mother and
children together whenever possible, as doing so provides better
outcomes for children, as well as their mothers,\xi\ and creates more
long-term stable environments to which the child can return.
Evaluations have documented positive results in ameliorating children's
trauma and improving their behavior, as well as improving their
mothers' interactions with their children.\xii\ Both programs success
is tied to their understanding of how children process trauma and their
need for connection to their primary caretakers, most often their
mothers.
The Role of Men and Fathers
For the most part, child welfare systems have been oriented toward
mothers. It is true that most mothers remain the primary caregivers of
their children. But ignoring men is a mistake. By largely dismissing
the roles of fathers and men in the lives of these children, systems
are both missing opportunities to constructively engage men, and
punishing battered mothers and children for men's abusive
behavior.\xiii\
Alternatively, some child welfare systems have been successful at
developing new fatherhood initiatives and reaching out to men who were
once invisible to them. While we applaud these efforts, we have learned
that it is dangerous to involve fathers without understanding the risk
they may pose to mothers and children. Some child welfare systems are
taking the lead and searching for new ways to engage both men and
fathers and simultaneously hold them accountable for their violence.
Through the Greenbook Initiative, several communities developed
treatment plans for fathers, and hired men who specialize in changing
violent behavior to help shift thinking in child welfare offices.\xiv\
CAPTA is in a unique position to drive new efforts that support
forward-thinking fatherhood initiatives that integrate what we know
about domestic violence.
Good Data Collection: NCANDS
Finally, we would like to address one of the least glamorous,
though most necessary, elements of preventing and ultimately ending
domestic violence and child abuse: 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 present in a large
percentage of these families. While not everything about a family's
circumstances is known at the time of the initial 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
little, if any, information in its annual reports about domestic
violence, and the context and impact of domestic violence.
This data has enormous consequences because it is likely we are
missing the link and making inappropriate and potentially dangerous
recommendations to families and juvenile and family courts. First, we
would want to identify in what percentage of reports, substantiations
and victimization, and for each different category of maltreatment,
that domestic violence is a factor. Community experience suggests that
often, exposure to domestic violence is automatically 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'') is 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 is not the offender against a child, but instead may
be a victim of violence perpetrated by her partner. In these cases, she
needs 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. When this happens, the mother may be put into a
database of child abusers, which unfairly labels her and may prohibit
her from seeking any job working with children.
Finally, as an increasing number of states and counties institute
some type of 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.
Given these concerns we would strongly recommend that data be
collected and disseminated on the relationship between domestic
violence and categories of maltreatment, including:
The relationship between domestic violence and child
fatalities;
The relationship between domestic violence and repeat
maltreatment;
The identity of the perpetrator in cases of domestic
violence;
The nature and extent of co-occurring domestic violence
and substance abuse;
The nature and extent of the services provided to these
families;
For families with co-occurring domestic violence who are
provided alternative response, the nature of the agency(ies) to which
they were referred and whether the services were utilized;
In what percentage of cases domestic violence is a factor
in removal, and whether there are other characteristics associated with
the domestic violence that lead to the decision to place a child
outside of his/her home; and
The percentage of domestic violence in the neglect
category.
CAPTA Recommendations
Given what we have learned around the intersections of domestic
violence and child abuse over the last 15 years, and emerging research
on best practices for addressing domestic violence as a means of
reducing child abuse and neglect and preventing future domestic and
sexual violence, we respectfully recommend that 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 of 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 and team
decision making;
Funding for cross-training and collaboration so domestic
violence and child welfare systems can better work together to improve
safety and well-being of 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 fathers can safely play in the lives of these
children.
The Family Violence Prevention and Services Act (FVPSA) Recommendations
The Family Violence Prevention Services Act (FVPSA) is the
lifeblood of domestic violence organizations in the United States.
FVPSA is the largest designated federal funding source for emergency
services for victims of domestic violence and their children, providing
shelters, crisis lines, counseling and victim assistance programs.
Every year, the demand for these services continues to rise, and
shelters and services must turn away families in danger because of a
lack of resources.
As previously discussed, domestic violence programs are an
important place to intervene early with children who have been exposed
to violence. In a single day in 2007, 13,485 children were living in a
domestic violence shelter or transitional housing facility, and another
5,526 sought services at a non-residential domestic violence
program.\xv\
Children who live in domestic violence shelters often have suffered
many losses. They have most likely left their communities, extended
families, friends, schools and all things familiar. It is difficult to
comprehend the extent of the consequences for these children. At a
minimum, these children need some individualized attention to assess
how they are doing and determine whether they require specific care
based on their needs. Their mothers, who are often under great stress,
need parenting support to repair any damage to their relationships with
their children created by the abuser. Without support, the attachment
between mothers and children can weaken and further complicate their
safety and healing. Therefore it is essential that domestic violence
programs have the dedicated resources to help the children in their
programs and the training and technical assistance to implement the
most effective programs.
The Need for Technical Assistance to Continue
Technical assistance and resource centers are also necessary to
help victims of domestic violence who may not access targeted domestic
violence agencies. Most victims of domestic violence never go to a
domestic violence shelter, and often call law enforcement only when it
has become a life or death situation. But they do go to the doctor,
either for themselves or their children. Reaching out to victims
proactively before they may reach out to domestic violence services is
another important prevention and early intervention strategy, and
health care providers play a critical role. The Family Violence
Prevention Fund's National Health Resource Center on Domestic Violence
(HRC), is a model for providing technical assistance and training
across systems on family violence. The HRC works to improve health and
public health responses to victims of family violence, and seeks to
directly impact individual, local, state and national health care
practice and policy as it relates to violence prevention and
intervention. The HRC provides technical assistance to thousands of
providers and advocates each year, as well as patient and provider
resources, including culturally relevant safety cards, educational
posters, quality assurance tools, national consensus guidelines on
domestic violence, and a national conference. We must maintain support
for these types of resource centers that provide cutting-edge technical
assistance, training and information to victims and those who assist
them, including health care providers and domestic violence service
providers.
FVPSA Recommendations
Specifically, we recommend that the Family Violence Prevention and
Services Act reauthorization:
Increase overall authorization to meet increasing needs
for services;
Include a specific funding stream dedicated to children's
services within domestic violence programs;
Maintain support for existing technical assistance
resource centers and culturally specific institutes to help identify
victims earlier and meet their needs in culturally and linguistically
appropriate ways.
Thank you for the opportunity to comment on these critical pieces
of legislation. For additional information, please go to
www.endabuse.org; or contact our Washington, D.C. office at 202-682-
1212.
endnotes
\i\ U.S. Department of Health and Human Services, Administration on
Children, Youth and Families. Child Maltreatment 2007 (Washington, DC:
U.S. Government Printing Office, 2009). Available at: http://
www.acf.hhs.gov/programs/cb/stats--research/index.htm#can.
\ii\ Catalano, S. 2007. Intimate Partner Violence in the United
States. U.S. Department of Justice, Bureau of Justice Statistics.
Available at http://www.ojp.usdoj.gov/bjs/intimate/ipv.htm.
\iii\ Edleson, J. Interventions and Issues in the Co-Occurrence of
Child Abuse and Domestic Violence, 4 CHILD MALTREAT. 91-182 (1999). See
also Anne E. Appel & George W. Holden, The Co-Occurrence of Spouse and
Physical Child Abuse: A Review and Appraisal, 12 J. FAM. PSYCHOL. 578-
599 (1998).
\iv\ Active screening at intake for domestic violence in the child
welfare system includes the use of formal policies, procedures, and
screening tools. See The Greenbook National Evaluation Team, THE
GREENBOOK DEMONSTRATION INITIATIVE, INTERIM EVALUATION REPORT 33
(2004).
\v\ Finkelhor D., Turner H., Ormrod R., & Hamby S. 2009. Violence,
Abuse, and Crime Exposure in a National Sample of Children and Youth,
Pediatrics, Volume 12, Number 5.
\vi\ Edleson, J. L. (1999). The overlap between child maltreatment
and woman battering. Violence Against Women, 5(2), pp. 134 to 154.
\vii\ See especially Nicholson v. Scoppetta 181 F Supp2d (EDNY
2002); Nicholson v. Scoppetta 3 NY3d 357, 366 (2004).
\viii\ Edleson, J., et al. Defining Child Exposure to Domestic
Violence as Neglect: Minnesota's Difficult Experience. Social Work,
Volume 51, Number 2, April 2006.
\ix\ 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.
\x\ 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).
\xi\ Ibid. p. 37.
\xii\ 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.
\xiii\ Rosewater, A. and Goodmark, L., p. 38.
\xiv\ Ibid. See also, www.thegreenbook.info.
\xv\ Domestic Violence Counts 07: A 24-hour census of domestic
violence shelters and services across the United States. 2008. National
Network to End Domestic Violence. Available at http://nnedv.org/docs/
Census/DVCounts2007/DVCounts07--Report--Color.pdf.
______
Prepared Statement of the National Association of Public Child Welfare
Administrators
On behalf of the American Public Human Services Association and its
affiliate, the National Association of Public Child Welfare
Administrators, we applaud the committee's interest in preventing child
maltreatment and improving responses to families in crisis. We
respectfully submit the following for your consideration.
APHSA is a nonprofit, bipartisan organization representing state
and local human service professionals for more than 79 years. NAPCWA,
created as an affiliate in 1983, works to enhance and improve public
policy and administration of services for children, youth and families.
As the only organization solely devoted to representing administrators
of state and local public child welfare agencies, NAPCWA brings an
informed view of the problems today's at-risk children and families
face.
More Resources Needed for Prevention and Protection
NAPCWA represents state public child welfare administrators
implementing child safety and protection programs. Our members depend
on a patchwork of federal funding streams, including CAPTA, to meet
families' needs. However, most prevention and protection services are
supported by state and local dollars. Child protection and safety
services include, but are not limited to, child abuse and neglect
hotlines and investigations, family intervention, differential
response, parent training, mentoring and coaching, and residential
substance abuse treatment centers, among others. Each public child
welfare agency works to reduce child abuse and neglect by supporting
and responding to families either not known to the system (primary
prevention); families known, but with no open case (secondary
prevention) and families already part of the system (tertiary
prevention).
Federal resources for prevention and protection are scarce and
support children placed in out-of-home settings such as foster care and
adoption. Ninety percent of all federal dollars are used for foster
care and adoption, while only the remaining 10 percent supports
prevention. This imbalance indicates the need for a stronger federal
role in providing resources for preventing and treating child abuse and
neglect, including an increase in funding for CAPTA.
Child Welfare's Role
Difficult economic times impact at-risk children and families the
most. Child welfare has witnessed first-hand how the economic downturn
negatively affects the entire family unit. Families struggle with job
security, mental and physical health as well as substance abuse issues.
States and localities are amplifying their efforts to expand child
protection programs and focus on better serving these vulnerable
populations.
In addition to supporting parents and other caregivers, the state
child welfare agency's primary responsibility is the safety, permanency
and well-being of children. Through referrals from the child abuse
hotlines as well as tips from mandated reporters such as teachers,
physicians and nurses, child protection workers investigate and assess
family situations and determine the child's imminent risk of serious
harm. It is the role of child welfare professionals to balance the
rights, roles and responsibilities of parents and the safety and well-
being of children.
Public agencies cannot ensure child safety alone. Therefore, child
welfare agencies collaborate with communities, nonprofit and private
agencies, and faith-based organizations to help support children and
families. Together, they provide a wide array of prevention and
protection activities such as public awareness campaigns, skills-based
courses, parent education and support groups, home visitation, family
resource centers and respite and crisis care programs.
State, local, federal and private resources help sustain these
programs to better serve children and families involved or at-risk of
becoming involved in the child welfare system. Below are best practices
and promising innovations states are using to keep families stable and
healthy, especially during difficult financial times.
Engaging Community Partners to Reduce Child Maltreatment
Los Angeles County Department of Children and Family Services
partnered with local community-based organizations to establish the
Prevention Initiative Demonstration Project. The partnership between
the DCFS and community-based organizations extends beyond traditional
parameters and contractual agreements. It builds a unique relationship
between committed entities to help strengthen families during times of
crisis. In 2003, the DCFS established agency-wide goals to reduce
reliance on foster care, and support children and families at home.
These partnerships were essential to expedite this mission. Through the
county's IV-E waiver, the PIDP receives $5 million a year to serve low-
income, at-risk families. The PIDP is known for its work using parent
advocates, cultural brokers and family visitation centers to assist
families in need.
The PIDP's basic principles to reduce child abuse and neglect
include increasing families' accessibility to adequate resources and
support; creating economically stable environments for families to
raise children in their own homes; and developing integrative
activities and resources to improve communities and build healthier
families. Los Angeles County's effort to engage private, public and
nonprofit organizations to collaboratively serve a common purpose is
one example of how states and localities are expanding their resources
to prevent child maltreatment.
Enhancing Child Protective Services by Implementing Differential
Response Models
Minnesota established differential response to transform its
approach to address child maltreatment reports by implementing a
strength-based, community-focused mechanism to effectively improve
child safety and well-being. This approach serves to identify families'
needs so children can safely remain in their homes.
Due to increased child maltreatment reports, Minnesota launched a
four-year differential response pilot project in 20 counties from 2000
to 2004. The pilot began in Olmstead County and provided family
assessments and parent support intervention services to families
determined to be at-risk. The Institute of Applied Research conducted a
rigorous field study on the effectiveness of this pilot program using
control groups, participant interviews and a review of administrative
data. The findings show that child safety was uncompromised; there were
fewer child maltreatment reports and minimal uses of costly approaches;
and families and social workers supported the model. Many states are
using similar models to reduce child protection reports by providing
early intervention.
Investing in Local Evidence-Based Initiatives to Enhance Child Welfare
Prevention and Child-Well Being
Ohio widely invests in evidence-based, multi-pronged initiatives
serving vulnerable children and families. The state has launched
various countywide child welfare reform efforts focusing on front-end
services to increase support for families in need. One of these efforts
includes the Ohio Children's Trust Fund, which supports local and
statewide prevention services to help empower families using positive
family engagement activities and promote an alternative response to
child maltreatment reports. The Incredible Years is an exemplary
evidence-based model that provides parent, teacher and child social
skills training and has proven to be effective in Ohio's counties. This
community-based model seeks to develop comprehensive treatment programs
for young children with early onset behavioral issues and works to
prevent juvenile delinquency, drug abuse and violence. The program has
been rigorously tested using randomized control evaluations and
produced evidence of high ratings and effectiveness. Local, federal and
state dollars assist the program's sustainability during tough economic
times.
Another protection and prevention aspect in Ohio is the Darkness to
Light program. This outcome-based program provides sexual abuse
prevention and intervention services to vulnerable communities. The
program raises awareness about preventing child sexual abuse by
educating adults about the prevalence and consequences of child
victimization. Darkness to Light offers online support group services
that focus on aiding current and past child abuse and domestic violence
victims. Outreach efforts include a sexual abuse hotline to serve
victims and media campaign to spread awareness. These local innovations
offer universal preventive approaches offering cost-effective, multi-
layered strategies to improve child well-being.
Preventing Child Abuse and Neglect Through Home Visitation Models
The New York State Office of Children and Family Services operates
a research-based, comprehensive home visitation model serving more than
20,000 low-income families since 1995. Healthy Families New York is
dedicated to provide child abuse and prevention services to expectant
parents and parents with infants from zero to three months of age.
These children and families are considered to be at-risk of abuse or
neglect and live in vulnerable communities with high poverty rates,
infant mortality and teen pregnancy. The HFNY's home visitors provide
families with support, education and linkages to community services
designed to address the following needs: (1) to prevent child abuse and
neglect; (2) to enhance parenting skills and parent-child interactions;
(3) to ensure optimal prenatal care and child health and development;
and (4) to increase parents' self-sufficiency.
The HFNY is rigorously evaluated and shows positive outcomes in
childbirth, child abuse and neglect, parenting practices and access to
health care. This nationally acclaimed program was featured in a
January 2009 issue of The American Journal of Preventive Medicine
showing that all mothers enrolled in the HFNY before their 31st week of
pregnancy were half as likely to have low-birth weight babies compared
to mothers in an unassigned control group. Another study published in
the March 2008 issue of Child Abuse and Neglect indicates that the HFNY
has seen a decrease in incidences of abuse and neglect during
children's first two years of life and reduced use of aggressive
parenting practices particularly involving first-time teen mothers. The
OCFS's home visitation model has proven to be successful in low-income
communities. New York is one state out of many that operate these
programs.
NAPCWA Guidance on Prevention & Protection
NAPCWA recently released national child safety guidance known as
Framework for Safety in Child Welfare. This manual provides tools for
states to define, assess and respond effectively to child abuse and
neglect. We believe that this guidance will assist states in reducing
the likelihood of child fatalities and instances of child maltreatment.
Child safety is paramount from the time children come to the attention
of state child protection agencies through case closure. However,
everyone is responsible for ensuring children's safety, regardless if
they are employed by the public or private sector.
Public child welfare agencies work diligently to ensure the safety
and well-being of children and families. These agencies respond to more
than a million reports of abuse and neglect each year. However, there
are minimal federal resources to support child protection and
prevention programs. Therefore, we encourage Congress to increase CAPTA
funding and restructure the child welfare financing system to better
support children and families. Thank you for your leadership and
commitment to child safety and family preservation.
______
Prepared Statement of the National Network to End Domestic Violence
(NNEDV)
Chairwoman McCarthy, Ranking Member Platts, Chairman Miller,
Ranking Member Kline, and distinguished members of the committee, thank
you for the opportunity to submit testimony for this hearing on the
reauthorization of the Family Violence Prevention and Services Act
(FVPSA). We are grateful for the subcommittee's leadership on behalf of
domestic violence victims and their families. The National Network to
End Domestic Violence (NNEDV) is a membership and advocacy organization
representing the 56 state and U.S. territory domestic violence
coalitions. NNEDV is the voice of these coalitions, their more than
2,000 local domestic violence member programs, and the millions of
domestic violence survivors, advocates and professionals that our
member programs represent.
In order to ensure the safety of domestic violence survivors, we
urge the Subcommittee to act swiftly to reauthorize FVPSA with
improvements to better serve victims' needs. FVPSA is the only federal
funding dedicated to domestic violence shelters and services and has
been the lifeblood of programs that have been preventing and ending
domestic violence for 25 years. Its reauthorization is urgently needed
to provide stable funding to address victims' needs. To that end,
advocates across the country praise the leadership of Representative
Gwen Moore (D-WI) who is leading the effort to draft a FVPSA bill,
likely to be introduced by the end of the month, reflective of
priorities outlined below. We urge the Committee to prioritize FVPSA
reauthorization this year. Reauthorizing FVPSA presents an exciting
opportunity to meet the needs of underserved communities while
continuing proven, successful strategies. FVPSA's swift
reauthorization, with key improvements and adequate funding allocation,
will ensure that victims across the country have continued access to
services that save lives.
FVPSA: Keeping Families and Children Safe
Thanks to the leadership of Committee, 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. 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 taken to
build on the success of FVPSA and improve services for victims.
The Need for FVPSA-Funded Services for Families
Since its passage in 1984 as the first national legislation to
address domestic violence, FVPSA has remained the only funding directly
for shelter programs. 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.\1\ Annually, approximately 1.5
million American women and 800,000 men are physically abused by their
spouses or partners\2\ and 15.5 million children are exposed to this
violence.\3\ This violence and abuse is devastating, costly and can be
deadly. Each day in this country an average of three women are killed
by a current or former intimate partner.
Domestic violence is more than a crime--it is a public health
issue. To address this issue, there are approximately over 2,000
community-based domestic violence programs for victims and their
children (approximately 1,500 of which are FVPSA-funded). These
programs offer services such as emergency shelter, counseling, legal
assistance, and preventative education to millions of women, men and
children annually.\4\
Domestic Violence Counts 2008, a 24-hour census of domestic
violence shelters and services, found that in one 24-hour time period
domestic violence programs across the nation served over 60,000 women,
men and children. Unfortunately, due to a lack of resources, almost
9,000 requests for services were unmet during that same day.\5\ For
those individuals who were not able to find safety that day, the
consequences can be extremely dire including continued exposure to
life-threatening violence or homelessness in many cases. It is
absolutely unconscionable that victims cannot find safety for
themselves and their children due to a lack of adequate investment in
these services.
The gap between adequate resources and increasing demand widens as
the economic situation worsens. A bad economy does not cause domestic
violence but financial strain can certainly exacerbate violence and
victims with fewer personal resources become increasingly vulnerable.
Since the economic crisis began, three out of four domestic violence
shelters have reported an increase in women seeking assistance from
abuse.\6\ Many programs across the country use their FVPSA funding to
keep the lights on and their doors open. We cannot underestimate how
important this is--victims must have a place to flee to when they are
escaping life-threatening violence. The fact is that countless shelters
across the country would not be able to operate without FVPSA funding.
By swiftly passing a FVPSA reauthorization inclusive of the
recommendations below and with an adequate authorization level,
Congress can work to ensure that victims can find safety and stability
after fleeing abuse.
Key Programs Authorized in FVPSA
FVPSA State Formula Grants Administered through the Department of
Health and Human Services, the FVPSA State 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.
The impact of FVPSA State Formula grants is phenomenal. The
flexible, consistent funding provided by FVPSA has helped millions of
victims find safety for themselves and their children. In fiscal years
2007 and 2008 almost 600,000 adults and children found safety in FVPSA
shelters. Research shows that shelter programs are among the most
effective resources for victims with abusive partners\7\ 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.\8\ These programs keep
children and their non-abusive parents safe and allow families to
rebuild their lives after crisis. A recently released multi-state study
which shows conclusively that the nation's domestic violence shelters
are addressing both urgent and long-term needs of victims of violence
and are helping victims protect themselves and their children.\9\
DELTA Grants In addition to supporting emergency services through
local programs and shelters, FVPSA includes Demonstration Grants for
Community Initiatives (also known as DELTA grants, administered by the
Centers for Disease Control and Prevention) to expand community-based
primary prevention that address the underlying causes of domestic
violence in order to stop abuse before it starts. DELTA is one of the
few funding sources for primary prevention work. Domestic violence
carries a high price tag, with costs exceeding $5.8 billion each
year,\10\ making it all the more important to stop the cycle of
violence before it starts.
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.
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. For
many callers, their call to the Hotline is the first time they open up
about the abusive relationship. One recent caller described how her
abuser had forced her to quit her job and monitored all of her phone
calls and conversations, saying ``He forced me to give up all my
relationships aside from him. I'm completely and utterly alone. Now
it's too late to go back to my friends and family. It's been 15
years.'' The advocate was able to assure her that she was not alone and
refer her to a local shelter in the area. The Hotline also provides a
helpline for teens who are experience dating abuse.
Since opening in 1996, the National Domestic Violence Hotline has
received over 2 million calls from individuals in need of support and
assistance and it now provides services in more than 170 languages.
While the National Domestic Violence Hotline answers an average of
21,000 calls a month, ever-increasing demand and dwindling resources
left 42,500 calls unanswered in 2008.
Priorities for Reauthorization
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. Our
nation depends on FVPSA-funded programs to meet the immediate, urgent
and long-term needs of victims of domestic violence and their children.
We urge the Committee to prioritize the swift reauthorization of FVPSA,
inclusive of the recommendations outlined and with an adequate funding
authorization level. Our priorities for reauthorization include:
1. Maintain the 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. Address the unique needs of underserved and marginalized
communities Victims from marginalized racial, ethnic and religious
populations may not feel safe reaching out for help beyond their
communities. To meet the needs of victims from underserved populations
and Communities of Color, FVPSA reauthorization should:
Dedicate 2.5% of funding from the formula grants to meet
the needs of victims from Communities of Color, through a program
entitled Grants to Enhance Culturally and Linguistically Appropriate
Services For Racial and Ethnic Approaches to Change, and include
language throughout that supports community-based and faith based
organizations; and
Include a pilot project, entitled the Grants for
Underserved Populations and Racial and Ethnic Approaches for Change,
which is designed to build community capacity to provide both services
and prevention for underserved communities.
3. Set-aside funding for specialized services for abused parents
and their children One-half to two-thirds of the residents of domestic
violence shelters are children, and approximately 15.5 million children
are exposed to domestic violence each year. FVPSA currently includes a
set-aside for services for children, but it is largely undefined. FVPSA
reauthorization should strengthen and clarify funding for services to
children and youth, including clarification of how such funds will be
distributed. Domestic violence programs provide safety and support for
children, but many 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.
4. Protect the confidentiality of victims It is absolutely
essential that victims' privacy and confidentiality is addressed in the
FVPSA reauthorization. We have recommended that the FVPSA
confidentiality is primarily based on VAWA confidentiality provisions
to ensure consistent administration among grantees, which often access
both funding sources for distinct projects.
5. Fairly distribute funding to the U.S. Territories The U.S.
Territories of the U.S. Virgin Islands, American Samoa, Guam, and the
Northern Mariana Islands are eligible for FVPSA funds but the
distribution formula does not provide adequate resources for
Territories or Territorial Coalitions. This inequality should be
rectified by amending the relevant funding formulas.
6. Enhance the state planning process The distribution of FVPSA
funding should be tied to a state planning process that adequately
addressing the unique needs of domestic violence victims, including
those who are underserved. The state planning should be made more
responsive and accountable to grantees, advocates and legislators
alike.
7. Strengthen 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 rapid
response 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.
8. Define the service population FVPSA must include distinct
definitions for Dating Violence and Youth to ensure that all victims in
danger can access services. In some states the definition of Domestic
Violence does not include those who are in ``dating'' relationships or
youth victims--yet we know that women between the ages of 16-24
experience the highest rate of intimate partner victimization. The
FVPSA reauthorization must ensure that technical definitions do not
exclude those in need.
9. Streamline and clarify FVPSA provisions The FVPSA code has been
significantly amended 6 times over the last 25 years and is now
difficult to interpret; language in some parts is antiquated. To
reflect current and emerging best practice, enhance consistent
implementation and monitoring by HHS and Congress, and make provisions
consistent with those of the Violence Against Women Act (VAWA) 2005, we
recommend streamlining the FVPSA statute.
10. Expand the emphasis on prevention 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 and
appropriations increased to continue expansion of these valuable
programs. DELTA grants should be authorized at $20 million.
11. Maintain the Hotline and leverage its strengths to address teen
dating violence When victims of domestic violence have courageously
chosen to pick up the phone and seek help, having someone on the other
end to answer the call and connect her resources is critical in keeping
her and her family safe. 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, funding should be available
to develop and deliver specialized services to teen victims through the
use of innovative technology. The National Domestic Violence Hotline
should be authorized at $7 million.
Conclusion
As a coalition of domestic violence advocates and service
providers, we recognize the critical need to address domestic violence
in order to keep families and communities safe. Without effective
intervention, this violence will continue to repeat itself and impact
successive generations. The reauthorization of FVPSA provides an
important opportunity to continue the progress that has made toward
meeting the needs of domestic violence victims and breaking 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 for Disease Control and Prevention, ``Extent,
Nature and Consequences of Intimate Partner Violence: Findings from the
National Violence Against Women Survey.'' 2000.
\2\ 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.
\3\ McDonald, R., et al. (2006). ``Estimating the Number of
American Children Living in Partner-Violence Families.'' Journal of
Family Psychology, 30(1), 137-142.
\4\ National Coalition Against Domestic Violence, Detailed Shelter
Surveys (2001).
\5\ Domestic Violence Counts 08: A 24-hour census of domestic
violence shelters and services across the United States. The National
Network to End Domestic Violence. (Jan. 2009).
\6\ Mary Kay's Truth About Abuse. Mary Kay Inc. (May 12, 2009).
\7\ 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.
\8\ 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.
\9\ Lyon, E., Lane S. (2009). Meeting Survivors' Needs: A Multi-
State Study of Domestic Violence Shelter Experiences. National Resource
Center on Domestic Violence and UConn School of Social Work. Found at
http://www.vawnet.org.
\10\ 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 Matthew Melmed, Executive Director, Zero to Three
Madam Chairwoman and Members of the Subcommittee: I am pleased to
submit the following testimony on best practices for the prevention of
child abuse and neglect as well as strengthening responses for those
families already touched by child maltreatment. My name is Matthew
Melmed. For the last 14 years I have been the Executive Director of
ZERO TO THREE, a national non-profit organization that has worked for
over 30 years to advance the healthy development of America's babies
and toddlers. I would like to start by thanking the Subcommittee for
all of its work to ensure that our nation's infants and toddlers are
safe. I commend you and the Subcommittee for tackling this difficult,
yet extremely important issue.
I would like to start by addressing the effects of abuse and
neglect on infants and toddlers and offer two sets of recommendations
(prevention and treatment) for your consideration as you look at
systemic changes to the way in which child abuse is addressed by this
nation.
Vulnerability of Infants and Toddlers to Abuse and Neglect
Unfortunately, children between birth and three years of age have
the highest rates of abuse and neglect in the United States.\1\
Specifically, although infants only account for 5.6% of the child
population, they represent double that percent of all child
maltreatment victims.\2\ In fact, infants are over four times more
likely to enter foster care than children of all other ages. Infants
and toddlers are particularly at risk, not only because they are
physically vulnerable, but also because of the important brain
development occurring during this period of life.
We know from the science of early childhood development that
infancy and toddlerhood are times of intense intellectual
engagement.\3\ A child's first years set the stage for all that
follows. During this time the brain undergoes its most dramatic
development, and children acquire the ability to think, speak, learn,
and reason. Future development in key domains--social, emotional, and
cognitive--is based on the experiences and relationships formed during
these critical years.
Contrary to the once-held belief that very young children do not
remember, and therefore experience no lasting effects from
maltreatment, infants and toddlers are extremely vulnerable to its
long-lasting consequences. Research shows that young children who have
experienced physical abuse have deficits in IQ scores, language
ability, and school performance, even when the effects of social class
are controlled.\4\ Furthermore, physical abuse extracts a substantial
toll on young children's social adjustment, as seen in elevated levels
of aggression that are apparent even in toddlers.\5\ The effects of
maltreatment are not just seen in children who are abused, however.
Neglected children may also exhibit a variety of emotional and
behavioral problems as well, including: poor coping skills, high levels
of dependence, self-abusive behaviors, unresponsiveness to affection,
lethargy, low academic achievement, fewer interactions with peers, and
unusual sleeping and eating patterns.\6\ Long-term negative outcomes of
abuse and neglect include school failure, juvenile delinquency,
substance abuse, and the continuation of the cycle of maltreatment into
new generations. In fact, one third of the individuals who are abused
and neglected as children can be expected to abuse their own
children.\7\
The effects of abuse and neglect are not just a bad memory, but
affect the developing brain architecture in the young child--effects
that we can actually see in Figure 1. This figure compares the PET scan
of the brain of a healthy child (left) with that of an abused and
neglected child in a Romanian orphanage (right). The brain of the
healthy child shows high activity (depicted in red) in the temporal
lobes. In contrast, the scan of the Romanian orphan shows very little
activity in these areas which are responsible for regulating emotions
and receiving input from the senses. Furthermore, the abused and
neglected brain has smaller brain volume, larger fluid-filled cavities,
and smaller areas of connection.
Figure 1.--Image reproduced with permission. Harry Chugani, M.D.,
Children's Hospital of Michigan.
Although the developmental impact of child abuse and neglect is
greatest among the very young, research confirms that the early years
present an unparalleled window of opportunity to effectively intervene
with at-risk children. Intervening in the early years can lead to
positive outcomes (e.g., secure attachments, healthy relationships,
school success, etc.) and significant cost savings over time through
reductions in child abuse and neglect, criminal behavior, welfare
dependence, and substance abuse. It is critical that child well-being
be the first priority in all child abuse and neglect cases.
The Effects of Fetal Alcohol Spectrum Disorders
I particularly want to call the Subcommittee's attention to a
condition that is a perennial problem, but often overlooked. Experts
estimate that one out of every one hundred US citizens is a victim of
Fetal Alcohol Spectrum Disorders (FASD), an array of physical
disabilities that is 95% under-diagnosed.\8,9\ Although very little
research has been done to document the prevalence of FASD among
children in the child welfare and juvenile justice systems, one study
suggests that almost one in four children in the juvenile justice
system is a victim of it.\10\
The brain damage caused by prenatal exposure to alcohol results in
poor judgment, impulsivity, difficulty learning from experience and an
inability to foresee the consequences of one's behavior. Furthermore,
children born with FASD are frequently premature and low birth weight,
both of which are risk factors for healthy development.\11\ Infants and
toddlers in particular can be delayed in reaching developmental
milestones, hyperactive, easily over-stimulated,\12\ and victims of
failure to thrive.\13\ Consequently, academic failure and social
impairments are common in childhood.
While policies often focus on illegal substance use and abuse, very
little attention is given to legal substances such as alcohol and its
effects on the healthy development of infants and toddlers. As with
child abuse and neglect, intervening early can and does make a
difference, both in terms of child development and in economic costs to
society. In fact, children who are diagnosed before the age of six are
much more likely to succeed in school, careers, and personal
relationships.\14\ In order to prevent developmental delays resulting
from FASD down the road, we must look beyond the limited focus on
illegal substances and include screening to detect FASD in infants.
Preventing Child Abuse and Neglect
In thinking about approaches to preventing child abuse and neglect,
we must recognize that efforts to reach this goal often will not be
labeled as child abuse prevention and, in fact, lie largely outside the
formal child welfare system. Prevention means reaching out to families
with risk factors and their accompanying stressors to connect them with
comprehensive services that work to reduce the stress and promote the
healthy early development of their young children. Except for a few
narrowly targeted initiatives, there is no such thing as a separate
program to prevent child abuse, another to promote cognitive
development, another to help parents be better parents, and yet another
to address social and emotional needs. For the very young child,
especially, all aspects of development are inextricably intertwined and
must be addressed as such.
I want to note that child maltreatment, in particular, does not
occur only in low-income families. All parents need support in
nurturing their children, just as all babies need supportive
relationships to promote healthy development. But some families and
their children are more at-risk because of poverty, substance abuse,
precarious housing or nutritional situations, or lack of education,
just to name a few hazards. We need to ensure that families who face
multiple risk factors are connected to appropriate services in the
community before abuse and neglect occur. In other words, there is not
a separate category of families in which abuse and neglect occurs.
These are the same families to whom we direct other early childhood
interventions. So I encourage you to think broadly about expanding
comprehensive solutions for early childhood development and family
support in which preventing abuse and neglect will be a natural
byproduct of connecting families to an array of resources.
While the bulk of funds to provide such services will not come from
the Child Abuse Prevention and Treatment Act (CAPTA) or other child
welfare funding streams, the limited funds available through Title II
of CAPTA can be instrumental in developing mechanisms and promoting
systems change to integrate services outside the child welfare system
to meet the needs of at-risk children and families, provide outreach to
those families, and help in accessing services.
I also want to emphasize the importance of social and emotional
development in young children, which forms the foundation for later
learning, and the mental health problems that can occur even when no
abuse or neglect is pinpointed. Early social and emotional development
is vulnerable to such factors as repeated exposure to violence,
persistent fear and stress, abuse and neglect, severe chronic maternal
depression, biological factors such as genetic prematurity and low
birth weight, poverty, and conditions associated with prenatal
substance abuse.
Healthy development occurs within the context of the family.
Supportive early relationships can protect against the effects of
stress and biological hazards beginning even prenatally. Therefore,
problems with social and emotional development that occur in a young
child need to be addressed using approaches that focus on the child's
interaction with the caregiver. Neurons to Neighborhoods cites programs
such as the Family Development Service Program in Los Angeles, where
researchers ``documented that a relationship-based intervention can
have a significant impact on parent-child interaction and on the
infant's security of attachment.'' Another program cited is the Infant-
Parent Psychotherapy Program in San Francisco that emphasizes
intergenerational patterns of attachments and helps the mother cope
with life issues outside the family.\15\
prevention policy recommendations
Create a Broad and Comprehensive Policy that Supports Vulnerable
Children and Families
I encourage the Subcommittee to consider building an integrated
approach to addressing the needs of very young children and their
families that would encompass outreach and support for parents, high
quality early care and education, and supports for the professionals
who serve them. In addition, we need the ability to better employ the
tools that can identify children at-risk for problems that are more
difficult to spot at a young age, but where early intervention can save
both heartache and dollars at a later age. Some specific steps include:
1. Providing increased access to high quality family support
programs by:
a. Expanding funding for Early Head Start, a program proven
effective in reaching families with infants and toddlers and in
promoting good parenting practices and healthy child development.
Comprehensive early childhood programs, such as Early Head Start, that
combine early learning experiences, parent support, home visitation,
and access to medical, mental health and early intervention services
can provide the specialized services that very young children in the
child welfare system need. Results from the Congressionally-mandated
Early Head Start Research and Evaluation Project--a rigorous, large-
scale, random-assignment evaluation--concluded that parents who
participated in Early Head Start had more positive interactions with
their children than control group parents--they showed greater warmth
and supportiveness, less detachment, more parent-child play
interactions, more stimulating home environments, and less spanking by
both mothers and fathers.\16\
While the American Recovery and Reinvestment Act provided
additional funds for Early Head Start, even with that infusion of
funding, we still will only reach six percent of eligible infants and
toddlers. Increased funding to quadruple the size of Early Head Start,
as the President pledged, will ensure that we reach the most at-risk
infants and toddlers early in life when we have the best opportunity to
reverse the trajectory of poor development that can occur in the
absence of such supports. It will also help us ensure that parents have
the supports they need to sufficiently nurture the healthy development
of their infants and toddlers. Although it is the role of the
appropriators to increase funding for Early Head Start, this
Subcommittee can work to ensure that the authorizers and appropriators
understand the importance of programs such as Early Head Start in
reaching the most at-risk infants and toddlers.
b. Expanding funding to support other comprehensive approaches that
reach out to families with young children. Some communities use
programs that deliver parent support and early childhood services
through home-based models. These home visiting programs offer
information, guidance, and support directly to families in their home
environments, eliminating many of the scheduling, employment, and
transportation barriers that might otherwise prevent families from
taking advantage of necessary services. While home visiting programs,
such as Healthy Families America, the Nurse-Family Partnership, the
Parent-Child Home Program, and Parents as Teachers, share similar
overall goals of enhancing child well-being and family health, they
vary in their program structure, specific intended outcomes, content of
services, and target populations. Program models also vary in the
intensity of services delivered, with the duration and frequency of
services varying based on the child's/family's needs and risks.
A growing body of research demonstrates that home visiting programs
that serve infants and toddlers, can be an effective method of
delivering family support and child development services, particularly
when services are part of a comprehensive and coordinated system of
high quality, affordable early care and education, health and mental
health, and family support services for families prenatally through
pre-kindergarten. Research has shown that high quality home visiting
programs serving infants and toddlers can increase children's school
readiness, improve child health and development, reduce child abuse and
neglect, and enhance parents' abilities to support their children's
overall development.\17\ The benefits of home visiting, however, vary
across families and programs. What works for some families and in some
program models will not necessarily achieve the same success for other
families and other program models.
Expanding access to evidence-based home visiting programs is one
strategy in the prenatal to pre-kindergarten continuum which can help
prevent long-term costs associated with remediating the effects of
maltreatment while promoting healthy social and emotional development
in later years. However, it is important to connect home visiting
efforts with other child and family services, particularly those
focused on children's well-being and healthy development, to help
ensure that young children and their families have the supports they
need to promote healthy outcomes.
2. Increasing access to preventive and treatment services for
families affected by substance abuse, including screening of children
for FASD. Millions of children and families are impacted by the growing
epidemic of substance abuse. In fact, an estimated 11 percent of all
children live in families where one or more parents abuse alcohol or
other drugs.\18\ This issue is even more pressing for families in the
child welfare system where up to 80 percent of children are affected by
substance abuse.\19\ Families need access to a community-based,
coordinated system of comprehensive family drug andalcohol treatment.
Prevention and treatment services should include: prevention and early
intervention services for parents at-risk of substance abuse; a range
of comprehensive treatment options including home-based, outpatient,
and family-oriented residential treatment options; aftercare support
for families in recovery; and preventive and early intervention
services for children that address their mental, emotional, and develop
In addition, given the heightened risk of FASD for children in the
child welfare system, we must adopt useful screening strategies for
children who come to the attention of child protective services staff.
Many affected children will be born into families with severe
dysfunction, substance abuse and long histories of parenting failure.
Screening infants and children entering child protective services
caseloads, and especially those in foster care, would link high risk
children with appropriate treatment services. Currently, only children
exposed to illegal substances are screened and referred for services
despite the more devastating effects of legal substances such as
alcohol.
It is also critical to recognize that many parents who maltreat
their children do so as a result of the organic brain dysfunction
caused by FASD. Behavioral deficits include: impulsive behavior, an
inability to plan and remember commitments (e.g. the child's antibiotic
regimen) from one day to the next, and emotional volatility. Some
states recognize FASD as an adult disability and provide case
management and disability payments. With this kind of support, FASD
victims have a much greater likelihood of successfully carrying out the
tasks of daily living, including their parenting responsibilities. The
focus on screening we recommend for young children should include
screening for their parents as well.
3. Increasing access to parent-child therapy by allowing
reimbursement through Medicaid for dyadic/relational therapy for at-
risk families and funding research into promising approaches.
Currently, not all states allow reimbursement through Medicaid for
therapy provided to parents and infants or toddlers together. Such
therapy is often effective, because the mental health of parents and
very young children are so closely interrelated. In a recent study
among mother-child pairs where there was a history of domestic
violence, not only was the therapy effective in improving the parent-
child relationship and the child's behavioral symptoms, but the
intervention had a positive effect on the mother's mental health.\20\
The proposed modification would allow infants and toddlers, who
health practitioners find are at high risk for developing mental health
disorders, to receive a referral for a full diagnostic evaluation. The
referral would be made for both the young child and parents using a
developmentally appropriate diagnostic tool such as the Diagnostic
Classification of Mental Health and Developmental Disorders of Infancy
and Early Childhood Revised (DC:0-3R). Current diagnostic tools such as
the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)
and the International Classification of Diseases (ICD-10) do not
comprehensively cover the mental health issues of infants, toddlers,
and their parents. A comprehensive classification tool such as DC:0-3R
will allow professionals to identify, understand, and treat mental
health problems, relational issues, and developmental disorders of very
young children at an early stage and prevent problems from worsening.
In addition, while some approaches to parent-child therapy have
been tested as noted above, more research and demonstrations are needed
to advance our understanding of how best to improve parenting skills
and repair damage to social and emotional development in infants and
toddlers. The Subcommittee could play a critical role by financing such
research. Too often, parents are simply sent to parenting classes that
may not help them understand and experience how best to interact with
their children and support their healthy development.
Improving Responses to Families Already Touched by Child Maltreatment
I have already noted the highly detrimental effects of maltreatment
on the development of infants and toddlers. We know all too well that
the circumstances that often surround a family where abuse or neglect
has occurred do not bode well for the child's development, and we also
know that the relationships that support this development, once gone
awry, do not heal themselves. Much of the CAPTA statute focuses on the
legal system for dealing with these cases and has indeed led to a great
deal of progress in helping states ensure the physical safety of
children. But we need to pay greater attention to the developmental
needs of the children involved and the needs of their families--in
other words, to the treatment part of the program.
Our Child Protective Services (CPS) system needs to recognize the
critical nature of the early years for child development and have
procedures in place to move quickly to address the damages of
maltreatment and the needs of infants and toddlers and their families.
Such procedures must start with training for all involved in the legal
side of the system--CPS workers, Guardians Ad Litem, judges and other
court personnel--about early childhood development. In their
professional training, these key people are not taught about how young
children develop and the importance of acting to keep that development
on track. ZERO TO THREE's experience with its Court Teams for
Maltreated Infants and Toddlers project, which focuses on children in
the foster care system and is discussed in more detail under
Recommendation #1 below, has been instructive in learning how important
such knowledge can be. It can literally change how staff and judges
approach their decisions regarding young children.
The second need is services for children and families and quick
linkage to them when a family comes into the child welfare system. We
know that the levels of services such as mental health and special
education among children in the child welfare system have historically
been low. As with preventive services, workers at the treatment stage
need the ability to connect children and families with a variety of
services. Again, the Court Teams initiative creates a ``team'' of
service providers in the community who ensure that the children and
parents being supported by the local Court Team receive necessary
services. Formation of the teams has brought together providers in
communities, many of whom had not been involved with this population
before. In some instances, forming the teams has revealed services of
which child welfare workers were not aware. For example, the
requirement in the 2003 CAPTA reauthorization that all infants and
toddlers be referred for assessment under Part C of the Individuals
with Disabilities Education Act was a huge step in seeking to meet the
developmental needs of young children. However, states are still
grappling with how to implement and fund this linkage and many child
welfare workers, themselves, are unaware of the Part C early
intervention requirements. I urge the Subcommittee to focus on how to
ensure the connection between these two systems can be made more
feasible.
Third, an increase in mental health services that address the needs
of parents and children together, as discussed under prevention
efforts, is extremely important in the context of treating child abuse
and neglect. The whole area of infant/early childhood mental health is
often overlooked, but addressing the mental health needs of both child
and family is one of the keys to healing families and preventing future
child maltreatment.
Clearly, there is a great deal of overlap in services for at-risk
families to prevent child abuse and neglect and those where abuse and
neglect are known to have occurred. I encourage the Subcommittee to
explore approaches such as differentiated response that seek to connect
families to services no matter what their CPS status.
Finally, the treatment of abuse and neglect continues after
children are removed from home and placed in foster care, although this
part of the child welfare system is generally addressed through the
programs in Part IV of the Social Security Act. Additional policies
must be implemented to ensure adequate services are in place for
children once they enter foster care.
Infants and toddlers are removed from home at higher rates than
older children precisely because they are so vulnerable to the effects
of abuse and neglect. In fact, infants are the largest group of
children entering foster care in the United States, accounting for 1 in
5 admissions.\21\ Once they have been removed from their homes and
placed in foster care, infants and toddlers are more likely than older
children to be abused and neglected and to stay in care longer.\22\ In
addition, half of all babies who enter foster care before age 3 months
spend 31 months or longer in placement.
Coupled with these alarming statistics is the fact that a young
child's removal from his or her home adds additional layers of
complexity to the initial trauma of maltreatment. Separation from a
child's primary caregiver(s) can cause anxiety, distress, and
additional trauma. For these reasons, we must pay particular attention
to ensuring that developmentally appropriate services and family
connections are available during this critical time in a child's life.
treatment policy recommendations
1. Requiring training for child protective services staff and other
personnel involved with children in the child welfare system around the
unique needs of infants and toddlers. There is a wealth of scientific
knowledge available about very early child development which should be
used to make informed decisions about babies in the child welfare
system. However, child welfare workers are overburdened and do not have
the time or means to seek the training that would provide them with
this scientific knowledge base. Congress should provide grants to
states to enable them to develop and provide training for child welfare
workers and other staff (including Guardians Ad Litem, court personnel,
mental health specialists, child care providers, Early Head Start
teachers and early intervention specialists) around the developmental
needs of infants and toddlers who have been abused or neglected and the
steps that need to be taken to address these needs.
In addition, while training is important in providing the initial
exposure to information, ongoing technical assistance is critical if
the training information is to be applied in real life. Like any
bureaucracy, child welfare agencies have developed protocols and
guiding assumptions over the decades. Much of the knowledge of infant/
toddler development is new and challenges prevailing practices in the
field of child welfare (e.g., sibling relationships always trump the
child's relationship with the foster parent, etc.). Changing long held
opinion in bureaucratic settings is extremely difficult. Developing a
mechanism to provide consultation to caseworkers on cases involving
infants and toddlers will allow them to reflect on decisions that may
otherwise be made without grounding in the child's best interests.
One example of innovation in this area is ZERO TO THREE's Court
Teams project for children in foster care. Under the leadership of a
juvenile or family court judge, the Court Team model works to increase
awareness among court personnel and community providers about the
negative impact of abuse and neglect on very young children and to
change local systems to improve outcomes and prevent future court
involvement in the lives of very young children in the child welfare
system. Preliminary data and anecdotal evidence suggest that the Court
Teams project is having a positive effect on children and families,
including: reducing the number of times maltreated infants and toddlers
move from one foster home to another, increasing visits between parents
and their young children in foster care, providing critical health and
developmental screenings, increasing placements with relatives,
expediting and enhancing services to parents to facilitate
reunification, and reducing the time to permanency.
2. Ensuring access to early intervention services (Part C of the
Individuals with Disabilities Education Act) for children three and
younger. Amendments to CAPTA in 2003 required states to develop
procedures to ensure that all children 0-3 who are involved in a
substantiated incident of abuse or neglect are referred to Part C early
intervention services. The IDEA amendments of 2004 also required Part C
services for all children who have been maltreated or exposed
prenatally to illegal substances or domestic violence. Under Part C,
all participating states and jurisdictions must provide early
intervention services to any child below 3 who is experiencing
developmental delays or has a diagnosed physical or mental condition
that has a high probability of resulting in a developmental delay. In
addition, states may choose to provide services for babies and toddlers
who are ``at-risk'' for serious developmental problems, defined as
circumstances (including biological or environmental conditions or
both) that will seriously affect the child's development unless
interventions are provided.
Despite the promise it holds for the future, there is wide
variation in the percentage of infants and toddlers enrolled in Part C
programs across states. Currently, states carry a significant burden to
fund Part C programs, in part, because of inadequate federal funding.
The result is that many eligible infants and toddlers do not receive
the early intervention services they desperately need in order to reach
their full potential in school and in life. Congress should provide
incentives and adequate funding for states to increase access to early
intervention screening and Part C services for infants and toddlers in
foster care. Early intervention services under Part C may prevent or
minimize the need for more costly services under Part B of IDEA or even
later in a child's life.
3. Adding infants affected with FASD to the policies and procedures
CAPTA requires states to have in place to identify and address the
needs of infants born with and affected by illegal substance abuse.
Infants and toddlers in the child welfare system have ongoing risk
factors that predispose them to developmental delays. While
developmental delays are often present in young children with FASD,
currently, FASD is not included among the eligibility criteria for Part
C services. It is critical to screen for FASD specifically because it
is a lifelong chronic condition requiring management rather than a
developmental delay that can be corrected. As mentioned earlier, when
children are screened for FASD and determined in need of early
intervention services, those services should be allowable under Part C.
4. Increasing access to parent-child therapy by allowing
reimbursement through Medicaid for dyadic/relational therapy for at-
risk families and funding research into promising approaches. This
approach is discussed under the Prevention section above, but I want to
reiterate its importance for families where maltreatment has occurred.
CAPTA could be an important source of funding to develop and/or
disseminate promising approaches for this type of therapy.
5. Requiring (under Title IV-B of the Social Security Act) that the
Department of Health and Human Services promulgate guidelines for
states for the care of infants and toddlers in the child welfare
system, including:
a. Visitation standards and developmentally appropriate visitation
practices for infants and toddlers in out-of-home care. One of the
major challenges faced by young children in foster care is developing
nurturing relationships with their parents. Standard visitation
practice permits one visit each week. In practice, however, visits
occur less than once a week. Parent-child contact consists of brief
encounters at the child welfare agency. For very young children,
infrequent visits are not enough to establish and maintain a healthy
parent-child relationship. For parents, visits often become yet another
forum where they feel judged and incompetent. Research indicates that
visitation with parents and siblings is not only highly correlated with
better child functioning at discharge from foster care, but also allows
children to leave foster care in much higher numbers and more
quickly.\23\
Parental visitation can and should be looked at strategically.
Visits can play an important role in concurrent planning (pursuing two
permanency options simultaneously--reunification and adoption) and can
be used to assess the parent-child relationship and how the family is
progressing. The frequency and success of visits between children and
parents can provide a caseworker with evidence for either movement to
an alternative plan for the child or movement for early reunification.
Visits should occur frequently, in a safe setting that is comfortable
for both parent and child, and should last long enough for a positive
relationship to develop and strengthen. CAPTA can provide a framework
for enhancing the visitation experience by providing support and
coaching to improve future visits for all involved. Standard practice
must shift from a CPS worker sitting in the corner observing to an
engaged and supportive visit coach who helps the parent plan the time
with his/her child(ren), handle the actual visit, and reflect afterward
on how well the visit went.
b. Minimizing multiple placements while in out-of-home care. In the
first year of life, babies need to have the opportunity to develop a
close, trusting relationship or attachment with one special person. The
ability to attach to a significant caretaker is one of the most
important emotional milestones a baby needs to achieve in order to
become a child who is trusting, confident, and able to regulate his or
her own stress and distress. For babies in foster care, forming this
secure attachment is difficult. Multiple foster care placements present
a host of traumas for very young children. When a baby faces a change
in placement, fragile new relationships with foster parents are
severed, reinforcing feelings of abandonment and distrust. Even very
young babies grieve when their relationships are disrupted and this
sadness adversely effects their development. All placement decisions
should focus on promoting security and continuity for infants and
toddlers in out-of-home care.
Guidelines should be developed for states on how to minimize
multiple placements for infants and toddlers in out-of-home care. For
example, a state may decide to develop foster-adopt homes for infants
who come into the child welfare system so that if the birth parents
cannot successfully regain custody of the child, the child will not be
moved again. States should have a system for tracking the number of
moves an infant makes while in foster care. When a change in placement
is necessary, child welfare workers and foster parents should receive
training on how to handle transitions with infants and toddlers so the
children have the opportunity to get to know their new caregivers
before leaving the security they have gained in the care of their
current caregiver.
c. Promoting timely permanent placements for infants and toddlers
in foster care.
During the earliest years of a child's life--a time when growth and
development occur at a pace far exceeding that of any other period of
life--time goes by quickly. Babies can drift for years in foster care.
They need stable loving parents as soon as possible. Standard child
welfare practice is to seek reunification over the course of months or
years, and only when it is clear that the birth parents are not able to
regain custody of their children, is an alternative permanency
arrangement sought. In the meantime, the babies have grown up in a
series of foster homes and have suffered developmental damage they will
carry with them throughout their lives. All members of the family's
team need to understand concurrent planning right from the start as the
legal way to make sure that a child is in a permanent home as quickly
as possible.
6. Requiring state child welfare agencies to include in their state
plans a description of their approach to addressing the specific needs
of infants and toddlers. Infants and toddlers in foster care have needs
that are very different from older children. They also move through the
child welfare system in ways that are very different from older
children--they stay in care longer, they are less likely to be
reunified with their parents and they are more likely to be abused and
neglected while in foster care. State child welfare agencies should
address the unique needs of infants and toddlers in their state plans,
with a detailed description of their approach to dealing with issues
for babies in foster care such as reducing multiple foster care
placements, assuring regular visitation with biological parents,
ensuring that all infants and toddlers have access to early childhood
and family mental health services, addressing the effects of trauma and
separation on infants and toddlers, and promoting interventions that
support their healthy development across all domains.
Conclusion
We must ensure that infants and toddlers are healthy and safe.
During the first years of life, children rapidly develop foundational
capabilities--cognitive, social and emotional--on which subsequent
development builds. The amazing growth that takes place in the first
three years of life creates vulnerability and promise for all children.
These years are even more important for maltreated infants and
toddlers. We know from the science of early childhood development what
infants and toddlers need for healthy social, emotional and cognitive
development. We also know that maltreated infants and toddlers are at
great risk for poor outcomes. We must continue to seek support for
services and programs that ensure that our nation's youngest and most
vulnerable children are safe, and that promote and improve their
emotional, social, cognitive and physical health and development.
Policies and funding must be directed to preventing harm to all
children and reducing further harm to maltreated children. I urge the
Subcommittee to make the investment to support and protect our nation's
most vulnerable children and their families.
Thank you for your time and for your commitment to our nation's at-
risk infants and toddlers.
endnotes
\1\ U.S. Department of Health and Human Services, Administration on
Children, Youth and Families. (2009) Child Maltreatment 2007,
Washington, DC: U.S. Government Printing Office, Table 3-6.
\2\ Ibid.
\3\ Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development. Washington,
DC: National Academy Press.
\4\ Ibid.
\5\ George, C., and Main, M. (1995). ``Social interactions of young
abused children: Approach, avoidance, and aggression.'' Child
Development, (50)2, pp. 306-318.
\6\ Children's Bureau. (2006) Child Neglect: A guide for
prevention, assessment and intervention. Child Welfare Information
Gateway. http://www.childwelfare.gov/can/impact/types/neglect.cfm
(accessed June 30, 2008).
\7\ National Research Council. (1993). Understanding child abuse
and neglect. p. 223.
\8\ Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development.
\9\ Kelly, K. (2005). The importance of early identification of
Fetal Alcohol Spectrum Disorder (FASD). The Judges' Page Newsletter.
National CASA/National Council of Juvenile and Family Court Judges.
http://www.nationalcasa.org/download/Judges--Page/0502--parental--
substance--abuse--issue--0036.pdf (accessed March 12, 2007).
\10\ Fast, D.K., Conrey, J., Loock, C.A. (1999). ``Brief reports:
Identifying Fetal Alcohol Syndrome among youth in the criminal justice
system.'' Developmental and Behavioral Pediatrics (20)5.
\11\ Jernell, J., Wanninger, M., Brodsky, L., Atherly, E., Caros,
L., Chang, P., Coder, S., et al. (1999). Guidelines of care for
children with special health care needs: Fetal Alcohol Syndrome and
fetal alcohol effects. St. Paul, MN: Minnesota Department of Health.
\12\ Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development.
\13\ Jernell, J., Wanninger, M., Brodsky, L., Atherly, E., Caros,
L., Chang, P., Coder, S., et al. (1999). Guidelines of care for
children with special health care needs: Fetal Alcohol Syndrome and
fetal alcohol effects.
\14\ Kelly, K. (2005). The importance of early identification of
Fetal Alcohol Spectrum Disorder (FASD). The Judges' Page Newsletter.
National CASA/National Council of Juvenile and Family Court Judges.
http://www.nationalcasa.org/download/Judges--Page/0502--parental--
substance--abuse--issue--0036.pdf (accessed March 12, 2007).
\15\ Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development.
\16\ U.S. Department of Health and Human Services, Administration
for Children and Families. 2002. Making a difference in the lives of
infants and toddlers and their families: The impacts of Early Head
Start. http://www.acf.hhs.gov/programs/opre/ehs/ehs--resrch/reports/
impacts--exesum/impacts--execsum.pdf (accessed October 23, 2006).
\17\ Elizabeth DiLauro, Reaching Families Where They Live:
Supporting Parents and Child Development through Home Visiting.
Washington, DC: ZERO TO THREE, 2009.
\18\ Child Welfare League of America. 2004 Children's legislative
agenda. Substance abuse, families and recovery. www.cwla.org/advocacy/
2004legagenda14.htm (accessed December 14, 2004).
\19\ Ibid.
\20\ Lieberman, A.F., Briscoe-Smith, A., Ippen, C.G., Van Horn, P.
(2006). Violence in infancy and early childhood: Relationship-based
treatment and evaluation. In A.F. Lieberman & R. DeMartino (Eds).
Interventions for Children Exposed to Violence. New Brunswick, NJ:
Johnson & Johnson Pediatric Institute.
\21\ Dicker, S., Gordon, E., Knitzer, J. (2001) Improving the odds
for the healthy development of young children in foster care. New York:
National Center for Children in Poverty.
\22\ Wulczyn, F. & Hislop, K. (2002). Babies in foster care: The
numbers call for attention. ZERO TO THREE Journal, (22) 4, 14-15.
\23\ Hess, P. & Proch, K. (1993). Visiting: The heart of
reunification. In B. Pine, R. Warsh, & A. Maluccio (Eds). Together
again: Family reunification in foster care. Washington, DC: Child
Welfare League of America.
______
[Whereupon, at 11:40 a.m., the subcommittee was adjourned.]