PRESIDENT CLINTON'S BUDGET PROPOSAL FOR NEW FUNDING
    FOR CHILD WELFARE SERVICES TARGETED FOR FAMILY SUP-
    PORT AND PRESERVATION SERVICES.

    HEARING
    BEFORE THE
    SUBCOMMITTEE ON HUMAN RESOURCES
    OF THE
    COMMITTEE ON WAYS AND MEANS

    HOUSE OF REPRESENTATIVES
    ONE HUNDRED THIRD CONGRESS
    FIRST EDITION

    APRIL 21, 1993



    STATEMENT OF DEBORAH DARO, DIRECTOR, CENTER ON
    CHILD ABUSE PREVENTION RESEARCH, AND RESEARCH DI-
    RECTOR, NATIONAL COMMIITTEE FOR PREVENTION OF
    CHILD ABUSE

    Ms. DARO. Thank you, Mr. Chairman.

    You know, efforts to prevent child abuse and to support children
    in this country are not new; they are not limited to small areas.
    There are literally thousands of programs around the country that
    have had success in reducing a child's risk for physical abuse, ne-
    glect, emotional maltreatment, and sexual assault.

    As a field, child abuse prevention has accomplished a great deal.
    We have a very aware public. We have parents increasingly willing
    to reach out and ask for assistance before they harm their children.
    We have an increasing array of programs which they can reach out
    to.

    We have a widespread willingness on the part of people to get
    involved, to do something to prevent child abuse. The fact is that
    in this country, every year one in four of the general public, one
    in three parents, do something to prevent child abuse. What do
    they do? They help their neighbors, they help their friends get the
    services they need. They volunteer in parent support groups. They
    do parenting education classes. They give money to organizations
    that help prevent child abuse.

    And we have seen a change, I think, in the normative standards
    of parenting in this country. We do repeated public opinion polls,
    and since 1988, we have seen 11 percent fewer parents reporting
    the use of insulting and swearing at their children; 12 percent
    fewer report the use of spanking. Now, maybe they are lying to us
    and they didn't lie to us m 1988; but even if they are lying, it rep-
    resents a change in the normative standard, that people are under-
    standing there are different ways to relate to your children other
    than using physical force.

    Despite these gains and encouragement, the prevention field has
    failed a large number of families, and these are the families that
    swell our protective service caseloads; these are the families that
    are showing up in foster care, and the children that are showing
    up as suicides, runaway youth, teen pregnancies, and a host of
    other problems that plague our children.

    I think the reason for this is twofold. As you have heard from
    many witnesses, the current child welfare system is simply under-
    funded, overwhelmed, and cannot get the job done. It is a system
    that can't even begin to think about being preventive or protective
    of children.

    Second, the prevention field has failed. We have been too frag-
    mented, too disorganized. We haven't provided services in enough
    venues, in enough different settings, in order to reach those fami-
    lies that are truly at risk.

    I think President Clinton's initiative goes a long way toward pro-
    viding the leadership and the resources we need to make preven-
    tion work for all families and to bring child protective services on
    as full partners for prevention.

    Let me talk a little bit about the child protective service system
    as we see it, and then talk about an initiative we have at the na-
    tional committee called Healthy Families America. It is an initia-
    tive that we hope will bring universal home visitation services to
    all new parents eventually, but in the short run at least to those
    parents that are in the moat difficult circumstances.

    With respect to the child welfare system, things are not good,
    and you have heard it from a number of speakers. Every year we
    do an annual survey of child welfare administrators, and in 1992
    the data were the same that we have seen for years. Overall, al-
    most 3 million children were reported as suspected victims of mal-
    treatment, 8 percent more than were reported in 1991, 50 percent
    more than the number reported in 1985. Most tragically, for the
    fifth consecutive year, three children a day have died as a result
    of child abuse.

    The case that Congressman Reynolds was talking about is not
    that unusual. We would like to think it is unusual. But three chil-
    dren a day die as a result of parental maltreatment.

    The situation in Waco, TX, was awful. Twenty-four children died
    in one fell swoop. But during those 52 days, when the Federal
    troops surrounded that compound, over 150 children across the
    country were killed by their parents. These are generally young
    children; over 80 percent of them are under 5; almost 50 percent
    of them are under the age of 1.

    As reports go up and the deaths go up, we would like to think
    that funding goes up. But this is not the case. There are only 13
    States that had increases in resources allocated to protective serv-
    ices last year, and the balance of States had stable or decreasing
    funding.

    Federal allocations to child welfare have gone up, but they have
    gone up primarily for foster care. In 1985, for every dollar the Fed-
    eral Government spent on services, $3 was spent on foster care.
    Today that ratio is 1 to 10.

    Clearly, we need to move to a system where there are additional
    resources to provide services for child welfare. Last year we esti-
    mate that over a half a million children, confirmed cases of child
    abuse, received no therapeutic or supportive interventions. We are
    very good at identifying children, investigating children, labeling
    children, and then we seem to forget about them.

    This imbalance between the demand and supply has created a
    system that can only respond to crisis and extreme cases of mal-
    treatment. It is a system unable to offer families any significant as-
    sistance until they harm their children.

    Now, certainly greater resources are needed, but beyond that, we
    also need to be thinking more broadly about how to reach these
    families in crisis.

    Let me spend the remainder of my time talking about our initia-
    tive at NCPCA. Healthy Families America represents a public-pri-
    vate partnership and a new way of thinking about prevention. It
    is a new way to deliver our services. Our goal, as I said earlier, is
    to bring home visitation services to all new parents, particularly
    those parents in difficult circumstances.

    This is a recommendation that was raised certainly by the U.S.
    Advisory Board on Child Abuse and Neglect a few years ago, and
    it is one that they came to based on their renew of the empirical
    evidence. We know that home visitation can work. As Dr. Barnard
    was saying, this isn't an unusual finding. Research has repeatedly
    found that early intervention to high-risk parents, even parents in
    general, can enhance parent-child interactions, result in less phys-
    ical punishment and a greater use of alternative disciplines, de-
    velop greater understanding about how children develop and what
    children need, develop a more effective use of formal and informal
    supports.

    One of the wonderful byproducts of home visitation is it teaches
    parents to be good consumers. It doesn't help to have a market and
    a wonderful array of services if parents don't know how to access
    them and use them.

    We see among families that get these services fewer subsequent
    pregnancies, better spacing between children, and in many fami-
    lies, higher employment rates, less welfare dependency.

    Prevention can save enormous money, not just in terms of its
    saving to child protective services, but to the other health and edu-
    cational systems that are certainly overburdened.

    The program that we are basing our efforts on is located in Ha-
    waii, As Dr. Barnard said, it is called the Healthy Start program.
    The State of Hawaii today is screening 52 percent of all births.
    Ideally, they would love to provide home visitation services to all
    new parents. They can't afford to. So what they do is identify those
    families that are most in need, and they will provide services up
    to a 5-year period.

    The evaluations of these programs have been very promising,
    and we expect that if this system is put in place nationwide, we
    can see a tremendous decrease in the number of cases coming to
    protective service caseloads.

    When we talk about Healthy Families America, we are not talk-
    ing about another home visitation program. We are really talking
    about a system, a system that will systematically assess families,
    determine those families at greatest need, and reach out and pro-
    vide services to them. Protecting children and preventing child
    abuse is an enormous challenge, and no one has the magic answer.

    It is a big job, and no one funding stream is big enough, no one
    agency, be it a Federal agency or a State agency, to get the job
    done. No public, no private agency can do it. It really is a joint
    partnership, a venture that everyone needs to be on board with.

    We welcome the initiative as the President has put it in this leg-
    islation. We think it will go a long way toward building this kind
    of cooperation, bringing child protective services into full partner-
    ship with prevention. Until prevention becomes a primary objective
    of this system, child abuse reports will continue to swamp a system
    that is ill designed to deal with it, children will be unnecessarily
    harmed, and as a society we will pay dearly for our lack of vision.

    Thank you.