The Child Welfare League of America (CWLA) welcomes this opportunity to submit testimony. We commend the subcommittee for its efforts to examine the links between substance abuse and child abuse and neglect. Our comments focus on substance abuse as a factor in the placement of children into foster care, and highlight the need for and examples of interventions that keep children safe and help families recover.
CWLA’s 900-member public and private agencies across the country work everyday to improve conditions for children and families at risk and in crisis. Serving over 2.5 million children and their families each year, CWLA member agencies provide a wide array of services including child protective services, family preservation, family support, adoption, family foster care, treatment foster care, residential group care, adolescent pregnancy prevention, child day care, emergency shelter care, substance abuse treatment, independent living, and youth development.
NEED FOR PROTECTION AND CARE INCREASES
- In 1996, an estimated 3,126,000 children were reported to child protective services agencies as alleged victims of child maltreatment.1 From 1987 to 1996, the total number of children reported abused or neglected increased 45%.2 The number of reports substantiated has increased by approximately 14% over the same period.
- In 1996, nearly one million children were confirmed victims of child maltreatment.3
- Last year, an estimated 1,046 children, or three children per day, died as a result of child abuse and neglect; 82% of the victims are under the age of five, and 42% are less than one year old at the time of their death.4
- When child protective services determines that a child cannot be safely cared for at home the child is removed to a safer place. Preliminary estimates indicate that 502,000 children in the U.S. lived in out-of-home care — family foster care, kinship care, or residential care — at the end of 1996.5
SUBSTANCE ABUSE HIGHLY INVOLVED IN ABUSE AND NEGLECT REPORTS
The use of drugs and abuse of alcohol among families is a pervasive and disturbing trend that continues to have a devastating impact on the safety and well-being of children. Although it is difficult to quantify a causal relationship between alcohol and other drug (AOD) use and child maltreatment, experts agree there is a high correlation between parental chemical dependency and child abuse and neglect.
- Nearly eighty percent of states report that parental substance abuse is one of the top two problems exhibited by families reported for maltreatment.6
- Drug testing of families with abused and neglected children in the District of Columbia Family Court in 1995 revealed that two in three parents tested positive for cocaine and one in seven tested positive for heroin and other opiates.7
Identifying family members who are chemically involved and assessing how AOD use affects their ability to provide a safe, nurturing living environment are critical steps in determining risk of maltreatment for children. Once substance abusing caregivers are identified, child welfare professionals struggle to find and provide appropriate treatment. Even if treatment services are available, the timeframes for effective treatment may exceed timeframes to achieve permanency for children. A wait for residential AOD treatment for women with children may be close to 10 months in some parts of the country.
CWLA’S 1997 AOD SURVEY REVEALS GREAT NEED, FEW RESOURCES
In 1997, CWLA surveyed state public child welfare agencies in order to obtain a baseline measure of the types of policies, programs and data collection efforts in place to support chemically involved families, with a special emphasis on children and youths in out-of-home care. Survey respondents estimated that:
- 67% of parents involved with the child welfare system need AOD treatment;
- Child welfare agencies could only provide services for 31% of those parents in need;
- Less than half of all states report that training on recognizing and dealing with AOD problems is available for foster parents;
- Only 9 states (of 47 states responding) provide similar training for kinship care providers yet 30 percent of all children currently in out-of-home care are in kinship care living with a relative;
- 83% could not provide the number of youth in out-of-home care whose parents are chemically dependent;
- Only 11% believe that children and parents with AOD problems can be treated in a timely manner (less than 1 month);
- 42% rely on school-based education drug prevention programs as the only form of prevention services available for youth in out-of-home care;
- 94% could not provide the number of youth in out-of-home care known to abuse AOD themselves.
EFFECTIVE TREATMENT EXISTS; SUPPLY AND ACCESS REMAIN VERY LIMITED
Treatment is a cost-effective strategy for intervening to stop the cycle of destruction and despair that substance abuse inflicts on children and families. Programs providing comprehensive services and attending to the continuing treatment needs of women are most beneficial. The U.S. Department of Health and Human Services’ Center for Substance Abuse Treatment recently reported on women’s outcomes for their grantees providing comprehensive programs targeted to post-partum women and their infants.8
Of the women in treatment:
- 95% reported uncomplicated, drug-free births;
- 81% were referred by the criminal justice system and had no new charges following treatment;
- 75% who successfully completed treatment remained drug-free; and
- 40% eliminated or reduced their dependence on welfare.
Of their children:
- 65% were returned from foster care; and
- 84% who participated in treatment with their mothers improved their school performance.
As noted earlier, such interventions are in short supply. In general, traditional substance abuse treatment services have been tailored to male addicts not to women. Very few substance abuse treatment programs provide child care or adequate alternatives for women who seek treatment, creating a significant barrier for women who need help. A 1993 survey of drug treatment programs in five cities found that most accept pregnant women (83% of outpatient and 70% of residential programs), but only 20% both accept pregnant women and provide child care. In three of the five cities surveyed, no residential programs accepted pregnant women and provided child care.9
The most effective and responsive solution to the chemical dependency/child abuse dynamic is preventing the problem in the first place. We must educate the public on the devastating health consequences of AOD abuse and the emotional and physical hazards of growing up in a chemically involved household. We must develop better means to identify and provide a continuum of treatment and support services to chemically involved families. Without additional prevention and treatment resources, the child welfare system will continue to wage a war against substance abuse that it cannot win.
We again applaud the efforts of this subcommittee to investigate the difficult and complex links between substance abuse and child abuse and neglect. We look forward to continuing to work with you to help children stay safe.
(1) National Committee for the Prevention of Child Abuse (NCPCA). Current Trends in Child Abuse Reporting and Fatalities: NCPCA’s 1996 Annual Fifty State Survey, Chicago, IL: NCPCA Publications.
(2) NCPCA, 1996.
(3) NCPCA, 1996.
(4) NCPCA, 1996.
(5) Tatara, T., American Public Welfare Association. Research Notes. (1997, March).
(6) NCPCA, 1996.
(7) Newmark, L. (November 15, 1995).”Parental drug testing in child abuse and neglect cases: Major findings.” Presented at the 46th Annual Meeting of the American Society of Criminology. Washington, DC: The Urban Institute.
(8) U.S. Department of Health and Human Services, Center for Substance Abuse Treatment. (1995). Study of grantees administered by the Women’s and Children’s Branch. Rockville, MD: author.
(9) Breitbart, V, Chavkin, W, and Wise, PH (1994). Accessibility of drug treatment for pregnant women: A survey of programs in five cities. American Journal of Public Health, 84(10), 1658-1661.