Testimony submitted to the House Subcommittee on Select Education of the Committee on Education and the Workforce for the hearing on CAPTA: Successes and Failures at Preventing Child Abuse
August 2, 2001
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The Child Welfare League of America (CWLA) welcomes this opportunity to submit testimony to the Education and Workforce Select Education Subcommittee for the hearing on the reauthorization of the Child Abuse Prevention and Treatment Act (CAPTA).
CWLA is an 81-year-old national association of over 1,100 public and private voluntary agencies that serve more than two million abused and neglected children and their families. CWLA member agencies provide a wide array of services necessary to protect and care for abused and neglected children, including child protective services, family preservation, family foster care, treatment foster care, residential group care, adolescent pregnancy prevention, child day care, emergency shelter care, independent living, youth development, and adoption.
CWLA fully supports reauthorization of this important and historic Act dedicated to the prevention, intervention, and treatment of child abuse and neglect. As part of the National Child Abuse Coalition we concur with the testimony submitted by the Coalition and support the recommendations made in that testimony. We want to take this opportunity to supplement that testimony with our own comments.
Funding for CAPTA falls short
CAPTA has played a critical role in addressing the challenge of child protection by requiring states to implement a number of standards and eligibility criteria that have as their ultimate goal the creation and maintenance of a strong child protection system. CAPTA state grant funds are the main source of federal funding offered to help states develop a comprehensive child protection infrastructure. Unfortunately, the federal funding provided through CAPTA has fallen far short of what is needed. FY 2001 funding for CAPTA state grants is $21 million.
In 1990, the U.S. Advisory Board on Child Abuse and Neglect concluded that child abuse and neglect in the U.S. represents a "national emergency." This emergency has not yet been adequately addressed. According to the most recent data available from the U.S. Department of Health and Human Services (HHS), there were just under three million reports of suspected child abuse and neglect in 1999. Of this total, nearly 1.8 million of these cases were screened for further assessment and investigation. As a result, over 825,000 children were found to be substantiated victims of abuse and neglect.
The consequences of not addressing child abuse and neglect are clear. An abused and neglected child experiences poor academic performance at school, compromised physical and mental health, and increased risk for negative behavior. These harmful impacts do not necessarily end with childhood, but can be long lasting and have a devastating impact into adulthood. Childhood maltreatment can result in life long struggles that include increased risk of becoming an abusive parent. According to the National Research Council, one-third of the individuals who were abused or neglected as children will abuse their own children. A 1991 study (Hamberger and Hastings) indicated that men who have experienced physical abuse are more likely to act violently against their female partners. An abused or neglected child is 1.8 times more likely to be arrested as a juvenile, 1.5 times more likely to be arrested as an adult and 1.35 times more likely to be arrested for a violent crime (Widom and Maxfield, 1996). Abuse in childhood is the also the single largest risk factor for an adult woman's abuse of alcohol and drugs. These are just some of the indelible imprints that can mar the adult lives of child victims of maltreatment.
What is needed is an increased federal effort to support states in the challenges they face in addressing child abuse and neglect. The National Child Abuse Coalition estimates that the annual cost of child protective services is $5.2 billion. Actual national, state and local spending however fall far short, amounting to only $2.6 billion, a funding gap of over two and a half billion dollars.
Every year we have at least as many new cases of child abuse and neglect in this country as we have new cases of cancer in the entire U.S. population. The incidence rate of child abuse and neglect in this country is about ten times as high (40 children per thousand children per year) as the incidence rate for all forms of cancer (3.9 individuals per thousand individuals per year). Yet the federal fiscal year 2001 budget for the National Cancer Institute is $3.74 billion, while funding for CAPTA state grants, CAPTA discretionary grants, and CAPTA Community Based Grants combined totals only $72 million. We as a nation need to confront the substantial societal costs and devastating consequences with the same vigor as we tackle other national emergencies.
Successful outcomes for children and families who are involved with the child welfare system depend heavily on the quality of services received. The quality of these services, however, depends on the workforce that delivers them. Child welfare agencies nationwide, however, are facing a workforce crisis on many fronts. Attracting, training and retraining qualified staff at all levels has become an increasingly serious challenge. Staff shortages and high turnover have grown with the increased demands that are placed on these workers.
To fully address what is needed to strengthen the child protection and child welfare system will require that we overcome the challenges of a compromised workforce. Federal supports are needed to develop and sustain an infrastructure that supports a sufficient number of staff who possess the essential knowledge, training, skills and experience to perform the complex and demanding tasks associated with child protection and are compensated at a rate commensurate with the requisite skills and demands of the work. We urge the Subcommittee and the full Committee to look at ways to address these needs. CWLA supports H.R. 1371, the Child Protection Services Improvement Act which begins to address these issues.
Federal leadership is also necessary to craft a national research agenda to inform the political, research, and practice establishments in order to increase our understanding of child maltreatment and better serve this nation's children and families. Data from the most recent national incidence study was collected in 1993 and the results were published in 1996. Clearly it is time to revisit these issues through a comprehensive incidence study.
The CAPTA reauthorization is an opportunity for this Subcommittee to recognize the need for the federal government to send a clear and unmistakable signal that as a nation we must do much more to address the problem of child abuse and neglect. Reauthorize and increase support for CAPTA so that we can address basic child protective services needs, as well as provide trained staff; manageable workloads; adequate supervision; and prevention, intervention and treatment services. In this way, we can implement an effective system of accountability. Addressing core systemic concerns is essential to the delivery of quality child protective services and the achievement of desired outcomes which, above all, includes child and family safety.
CWLA would also like to comment on two other programs that are included in the CAPTA reauthorization-the Abandoned Infants Assistance Act and the Adoption Opportunities Act.
The Abandoned Infants Assistance Act
The Abandoned Infants Assistance (AIA) Act, enacted a little over a decade ago, offered a federal response to the child welfare problems associated with the crack cocaine and AIDS epidemics of the 1980s. These dual epidemics gave rise to a dramatic increase in the number of infants exposed to drugs and HIV/AIDS in utero, and to the staggering numbers of "boarder babies" who languished in hospitals across the United States. CWLA worked closely with the Congress to address this growing national problem.
Boarder babies are infants who remain hospitalized, beyond medical discharge, due to their parents' inability to provide appropriate care coupled with the child welfare system's inability to promptly investigate their circumstances and locate alternative residential placements for them. Although hospitals and child welfare agencies struggled to address systemic barriers, find suitable placements for these children, and develop helpful supports for their families, they often lacked the necessary resources to do so.
In 1988, Congress passed the Abandoned Infants Assistance Act (P.L. 100-505). The AIA Act authorized HHS' Children's Bureau to fund the development of service demonstration programs to respond to the hospital boarder baby crisis. The objectives of these projects included: (1) preventing the abandonment of infants and young children; (2) identifying and addressing the needs of abandoned infants and young children, particularly those with acquired immune deficiency syndrome (AIDS); and (3) assisting infants, particularly those with AIDS, to reside with their natural families or in foster families, as appropriate.
In 1991, Congress reauthorized the AIA Act. The reauthorization (P.L. 102-236) mandated that programs funded through the Act give priority to infants and young children who were perinatally exposed to dangerous drugs, as well as infected with or exposed to HIV. It also promoted the concept of comprehensive service sites that offer health, education, and social services at a single geographical location in close proximity to where abandoned infants reside. Additionally, Congress expanded the focus of the program to prevention, encouraging the provision of services to all family members for any condition that increased the probability of abandonment. In 1996, the AIA Act was reauthorized for an additional four years (P.L. 104-235) under CAPTA, emphasizing expedited permanency for infants. CWLA asks the Subcommittee to reauthorize AIA under CAPTA this year for an additional four years with an authorization and appropriation of $35 million.
There are currently 35 AIA demonstration projects, including a national AIA Resource Center. Twenty-five of them are comprehensive service demonstration projects, six are family support service programs for relative caregivers, and three are recreation programs for children affected by HIV/AIDS. Located in 18 states and the District of Columbia, these diverse programs operate out of hospitals, community-based child and family service agencies, universities, public child welfare agencies, and alcohol and drug treatment centers. They serve families affected by substance abuse, HIV/AIDS, or both. The 25 comprehensive service programs provide a broad set of social and health services which can include case management; child development services; job training assistance; infant development screening and assessment; permanency planning; prenatal care; residential services; recovery support; financial and entitlement assistance; parent skills training; domestic violence services; HIV education, prevention, counseling, and testing; and respite care.
Additionally, AIA programs work in collaboration with other community agencies to offer a range of supplementary services, such as housing and rental assistance; HIV treatment; pediatric health care; and residential drug treatment. The comprehensive and collaborative design of the AIA programs addresses the complex and multidimensional needs of the families, which reduces costly duplication of services.
The AIA demonstration program was developed to counteract the abandonment of babies in hospitals and the havoc that substance abuse and HIV/AIDS perpetrates on families, communities, and service systems. Initially, both the problem and intervention were focused upon the needs of the abandoned child, but through the reauthorization process Congress directed the program to take on a more preventative and family-focused approach. In response, the AIA program developed unique models of care that provide for coordinated, child-centered, and family-focused services. The goal is to promote the safety, well-being, and permanence of children from families struggling with substance abuse and HIV/AIDS.
The boarder baby problem has not gone away - but then neither has substance addiction or HIV/AIDS. Many point out that the problem has only intensified, with an increase in the number of boarder babies and a wider distribution of the problem. However, the overall decrease in the median length of hospitalization of boarder babies indicates that progress is being made. Furthermore, in communities where AIA programs exist, there has been considerable success in preventing and addressing the underlying problems and improving the lives of children and families. While challenges in serving these families persist, AIA programs have demonstrated effective ways to address these needs by collaborating across systems, providing support services to all family members, and developing innovative programs to assist those living the substance addiction and HIV/AIDS.
As we move forward in the 21st Century, AIA programs continue to provide an important opportunity to prevent and minimize the damage from perinatal substance abuse, HIV/AIDS, and abandonment. The Committee's commitment to this program over the years is well known. CWLA applauds the your continuing support of AIA and its efforts to address the complex problems associated with this population. Reauthorizing the Abandoned Infants Assistance program for another four years will ensure that resources are dedicated to this important program and that these successful strategies will be replicated to reach more children and families in more communities throughout this country.
Adoption Opportunities Program
CWLA also urges the reauthorization the Adoption Opportunities Program (Section 205 of CAPTA) this year and ask for an authorization and appropriation of $50 million. It is the only federal program created specifically for promoting the adoption of U.S. children waiting adoption. This program funds grants for demonstration projects that eliminate barriers to adoption and provide permanent loving homes for children who would benefit from adoption, particularly children with special needs.
Funds are used for innovative demonstration projects that are available to all 50 states through a competitive process and can be replicated after successful outcomes. From 1997 to 2000, the number of children in the public foster care system with the goal of adoption grew from 100,000 to 127,000, a 27 percent increase. Through efforts like those funded through the Adoption Opportunities Act, the number of adoptions has increased.
Of the 127,000 children with a goal of adoption, the vast majority have special needs. These children often have emotional and behavioral difficulties as a result of their experiences. The average age of the children is 7.9 years old; many are in their teens and soon will leave the foster care system with no families to call their own. Many children have physical and developmental disabilities and/or are from sibling groups who need to be adopted together. Children of color are disproportionately represented in the foster care system. Fifty-nine percent of children in out-of-home care are minority children.
The Adoption Opportunities Program funds the National Adoption Exchange, a National Resource Center on Special Needs Adoptions, and the National Adoption Information Clearinghouse (NAIC).
The National Adoption Exchange recruits homes for waiting U.S. children and last year 52,000 families received information on how to proceed with adoption. The National Resource Center on Special Needs Adoption provides training on current issues in special needs adoption such as compliance with federal laws and regulations, permanency planning, and cultural competence. The Center provides technical assistance to states, tribes, and other child welfare organizations. Nearly 65,000 individuals in all fifty states, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam have received special needs adoption training. The National Adoption Information Clearinghouse (NAIC) responded to 10,603 requests for information on adoption and disseminated information to more than 127,000 families and individuals in 1999.
CWLA stands ready to work with this Subcommittee to ensure that the Child Abuse Prevention and Treatment Act, the Abandoned Infants Assistance Act and the Adoption Opportunities Act are reauthorized this year.
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