[Congressional Record (Bound Edition), Volume 148 (2002), Part 15]
[Extensions of Remarks]
[Pages 21189-21190]
[From the U.S. Government Publishing Office, www.gpo.gov]




             KEEPING CHILDREN AND FAMILIES SAFE ACT OF 2002

                                 ______
                                 

                               speech of

                           HON. GEORGE MILLER

                             of california

                    in the house of representatives

                       Thursday, October 10, 2002

  Mr. GEORGE MILLER of California. Mr. Speaker, the Child Abuse 
Protection and Treatment Act (CAPTA) is the only federal law that 
focuses on the prevention of child abuse and neglect and the 
improvement of child protective services to better address the critical 
needs of children who have been reported as abused and neglected. I am 
pleased that we have been able to reauthorize this vital program with 
several key new features that will help facilitate better prevention 
and treatment efforts.
  There are approximately 3 million reports of child abuse every year. 
Of these 3 million, nearly 1 million are substantiated. In 1999, an 
estimated 1,137 children died as a result of abuse and neglect. 
Children who are abused and neglected are more likely to suffer mental 
health problems, such as depression, delinquency, and suicide. Child 
abuse is also likely to lead to school failure in adolescence and 
economic instability as adults. With such serious and life-long 
consequences from child abuse and neglect, clearly greater attention 
must be given to effective prevention and intervention services.
  Our nation's current system of protecting children is heavily 
weighted toward protecting children who have been so seriously 
maltreated they are no longer safe at home and must be placed in foster 
care or adoptive homes. These are children whose safety is in danger; 
they demand our immediate attention. Unfortunately, far less attention 
is directed at preventing harm to these children from happening in the 
first place, or providing the appropriate services and treatment needed 
by families and children victimized by abuse or neglect.
  CAPTA plays an important role in the federal response to protecting 
children and preventing child maltreatment. CAPTA provides resources 
for strengthening child protective services systems, so that children 
and families can be better protected and served. It provides resources 
for state grants that provide for prevention and treatment services for 
abused children and children at risk of abuse.
  I strongly support Congress' on-going efforts to reauthorize this 
important legislation to better meet the needs of children, families 
and communities.
  I am especially pleased that in this reauthorization significant 
improvements have been made to CAPTA overall and that important 
provisions have been added to Title 1 that that encourage and support 
new linkages between child protective services, and health, mental 
health and developmental services. These linkages will prove critical 
to ensuring that the youngest, most vulnerable children receive the 
help they need before problems escalate to tragedy. I would urge 
grantees in implementing these critical linkages to look to the Early 
and Periodic Screening, Diagnosis and Treatment (EPSDT) protocol in the 
Medicaid Program to help ensure that comprehensive services are being 
delivered.
  I also support modifications to Title II of the Act to strengthen 
state support for community-based child abuse and neglect prevention 
activities. I am disappointed, however, that while the H.R. 5601 
includes respite and home visiting in its definition of community-based 
child abuse and neglect programs and activities, the modifications do 
eliminate some of the references to respite care and home visiting. 
Children with disabilities, whose families rely on respite for support, 
are nearly four times more likely than children without disabilities to 
be abused or neglected.
  I would also like to register my disagreement with language in the 
Senate report accompanying the CAPTA bill approved by the Senate HELP 
committee that singled out respite care by saying that it is too 
expensive and that states should rely on other funding sources to 
support it. The Senate report cited no data or information to support 
this misconception.
  In fact, there is ample evidence to suggest that respite is a proven, 
cost-effective approach to child abuse and neglect prevention. Research 
overwhelmingly demonstrates that respite and crisis nurseries are 
directly linked to reductions in abuse and neglect and in avoiding much 
more costly out-of-home institutional or foster care placements.
  One Iowa crisis program found a 13% decrease in the reported 
incidence of child abuse and neglect in the initial four pilot counties 
after the program's implementation (Cowen, Perle Slavik, 1992).
  In a recent evaluation study of families of children at risk of abuse 
or neglect who utilized Family Support Services of the Bay Area's 
Respite Care Program in northern California, over 90% of the families 
using the service reported reduced stress (93%), improved family 
relationships (90%), improved positive attitudes toward child (93%), 
and other significant benefits that can help reduce the risk of abuse 
(Owens, Sandra, et al, School of Social Welfare, Berkeley, California, 
1999).
  In April, 1999, the Minnesota Dept. of Human Services, Family and 
Children's Services Division, reported that crisis nursery clients in 
15 crisis nursery programs serving 18 counties showed a 67% reduction 
in child protection involvement after using nursery services. The 
Hennepin County Children and Family Services Department's evaluation of 
the Greater Minneapolis Crisis Nursery found that families with no 
prior child protection involvement had a 0% risk of subsequent child 
protection involvement six months after using the Nursery's services. 
Families with prior child protection involvement who used the Nursery 
had only an 8% risk compared with an 84% risk for families who did not 
use the Nursery.
  The Relief Nursery in Eugene, Oregon, reports that in 1997-98, 91.3% 
of children attending the Nursery were free of any reports of abuse, 
and 89% had no involvement with foster care. This is remarkable, 
because two-thirds of the families had more than ten risk factors, and 
95% had five or more. A family with five risk factors is deemed to be 
at extremely high risk for abuse and neglect.
  An evaluation of the Iowa Respite Child Care Project for families 
parenting a child with

[[Page 21190]]

developmental disabilities found that respite care results in a 
statistically significant decrease in foster care placement (Cowen, 
Perle Slavik, 1996).
  A study of Vermont's respite care program for families of children or 
adolescents with serious emotional disturbance found that participating 
families experience fewer out-of-home placements than nonusers and were 
more optimistic about their future ability to care for their children 
(Bruns, Eric, November, 15, 1999).
  Preliminary data from the ARCH National Resource Center Outcome 
Evaluation project in which seventeen respite and crisis care programs 
nationwide participated, show that over 80% of caregivers using crisis 
respite services for their children reported that the crisis care they 
received helped protect their child from danger. Nearly half of those 
caring for children said without respite they would have had to leave 
their child in unsafe or inappropriate care or requested foster care.
  Contrary to the Senate report, respite care can be very cost 
effective. According to the ARCH National Resource Center on Respite 
and Crisis Care, an average monthly cost of planned respite care can be 
estimated by multiplying the average number of hours a family receives 
respite per month (12), by the average cost of respite per hour 
($10.02). This model suggests an average cost of $120.24 to provide 
respite to one individual per month or $1,442.88 per year. The Child 
Welfare League of America reports that the average monthly cost of 
foster care for children up to age 16 with special needs is $971.00 per 
month or $11,651 per year.
  The average cost of crisis respite for families at risk of abuse or 
neglect is $8.71 per hour. While the average number of hours a family 
receives crisis nursery or crisis respite services per month is not 
available, it can be assumed that it is significantly less than the 
average number of hours a family might receive planned respite, since 
crisis respite is used only in extreme emergencies when the family is 
at imminent risk of abuse or neglect. As a result, it can be estimated 
that the annual cost per family using crisis nursery or crisis respite 
services would be significantly lower than $1,400.
  The Senate Committee Report also suggests CAPTA Title II resources 
are better spent on services other than crisis respite, but like all 
important prevention and treatment services for at-risk families, 
crisis respite lacks sufficient resources to meet community need. ARCH 
reports that 63% of surveyed crisis respite programs and 48% of 
surveyed planned respite programs had to turn families away in a given 
year. Nationally, this represents a conservative estimate of 258,000 
families who were on waiting lists for planned respite care last year 
alone, and 840,000 families who were turned away.
  I would urge the Department of Health and Human Services to consider 
this evidence when it writes the program instructions for Title II of 
CAPTA and urge State and local community-based programs to consider it 
as well in implementing these services.
  With this reauthorization we have made some important changes to 
these laws that should lead to better prevention and treatment services 
for children and families who need our help. We must do a better job 
preventing child abuse and neglect and providing services to children 
and families in need. Failure to help these children and families 
cannot be tolerated.

                          ____________________