Testimony of Dr. Wade F. Horn, Assistant Secretary for Children and Families, HHS

This is an archive page. The links are no longer being updated.

Statement by

Dr. Wade F. Horn

Assistant Secretary for Children and Families

Department of Health and Human Services

Before the

House Committee on Education and the Work Force

Subcommittee on Select Education

U.S. House of Representatives

August 2, 2001

Mr. Chairman and distinguished members of the Subcommittee, thank you for the opportunity to testify on reauthorization of several programs critical to the safety and well-being of our Nation's children -- the Child Abuse Prevention and Treatment Act (CAPTA), the Adoption Opportunities Act, and the Abandoned Infants Assistance Act. President Bush, Secretary Thompson and I are committed to helping families in crisis and to protecting children from abuse and neglect. We firmly believe that every child deserves to live in a safe, permanent and caring family and greatly appreciate the interest, support and leadership demonstrated by the members of this Committee in protecting children from abuse, neglect or abandonment and in promoting adoption.

As presented in the President's FY 2002 budget, we believe the 1996 reauthorization of these programs established a strong framework for the critical services they provide and we are convinced that major changes to the legislation are not necessary. Consequently, I would like to focus my time today discussing the programs and services authorized under each of the three Acts and the progress we have made since the last reauthorization.

This is not to say that we have solved the issues of abuse, neglect and abandonment. Despite our mutual commitment to protecting and supporting American's families, these issues continue to be a significant problem in the United States and we must work together to focus our energy on sound implementation of these critical programs. However, we cannot stop there -- these issues demand a more comprehensive response.

Overview -- FY 2002 Initiatives to Strengthen Families

Before discussing the specific programs being considered for reauthorization by this subcommittee, I would like to briefly highlight several initiatives in President Bush's FY 2002 budget that will further our efforts in preventing child abuse and assisting troubled families.

This Administration is convinced that a broad-spectrum approach to helping families in crisis is needed. In addition to providing for a five-year reauthorization of CAPTA, President Bush's FY 2002 budget includes four additional proposals to ensure that every child grows up in a safe and stable family.

First, to strengthen States' ability to promote child safety, permanency, and well being, the FY 2002 budget proposes funding the Promoting Safe and Stable Families program at $505 million, a $200 million increase over the current level. These additional resources will help

States provide more preventative services to families in crisis, as well as enable children to be adopted more quickly into loving and committed families when that is the best option -- in both ways, increasing the prospects for children to live in a safe, permanent home. Since these funds can be used to provide a wide range of services, they certainly could support our efforts to reduce child abuse and neglect, underscoring safety in the home environment.

Within the context of the Safe and Stable Families program, the President also is proposing to provide $67 million to fund activities to mentor children of prisoners, to improve social outcomes for children and support positive family reunification. The more we focus on strengthening the family and parenting skills, the better chances we have at reducing the incidence of child abuse and neglect.

Likewise, the President has requested $64 million to invest in strengthening fatherhood and marriage. One of the focuses of grants under this initiative will include promoting successful parenting skills to help fathers learn to better relate to their children and be positive role models.

Similarly, the President's budget provides funding to support parenting education for young mothers, who are unable to live with their own families because of abuse, neglect, or other circumstances. Maternity group homes would be funded at $33 million to ensure these mothers have access to safe and stable environments and would offer child care, education, counseling and advice on parenting skills as part of the President's multi-faceted approach to cultivating a climate that supports strong, stable families.

In addition to these new and expanded initiatives included in the President’s FY 2002 budget request, the CAPTA, Adoptions Opportunities and Abandoned Infants programs play a key role in furthering the goal of this Administration to provide every child with a safe, permanent and caring family. I would now like to discuss each of these programs in more detail.

CAPTA

The Child Abuse Prevention and Treatment Act, in combination with other Federal child welfare statutes, plays an important role in our national efforts to protect children from abuse and neglect. The statute requires that the Federal-State child welfare system:

support and improve the infrastructure of child protective services (CPS);

develop and expand Statewide networks of community-based family support and child abuse prevention programs; and

support research and demonstration projects designed to address the problem of child abuse and determine how best to improve the well being of abused or neglected children.

CAPTA supports this framework by providing funding for: a basic State grant program for the prevention, identification, and treatment of child abuse and neglect; the Community-Based Family Resource and Support (CBFRS) program; the Children’s Justice Act grants to States; the National Child Abuse and Neglect Data System (NCANDS); research and demonstration projects on the prevention and treatment of child abuse and neglect; and a National Clearinghouse on Child Abuse and Neglect Information.

While we support the current statutory structure of CAPTA, more progress needs to be made in preventing child abuse and neglect. Tragically, in 1999, the most recent year for which we have complete data, State and local Child Protective Services agencies reported approximately 826,000 substantiated cases of abuse or neglect. While the rate of children who are victims of substantiated or indicated abuse and neglect has been decreasing over the past decade -- from a rate of 15.3 per 1,000 identified as victims of abuse or neglect in 1993 to 11.8 per 1,000 in 1999 -- effective child abuse and neglect prevention and treatment activities must be continued and enhanced if we are to see a continued decline in child abuse and neglect. As Secretary Thompson noted, "We are encouraged by the continuing decline in the number of children who are maltreated, but it is nevertheless unacceptable that so many children are suffering."

It would be helpful to summarize the changes made by the most recent reauthorization and discuss how these changes are leading to reduced rates of maltreatment.

The 1996 reauthorization made three significant changes to CAPTA:

First, it streamlined the Basic State grant program by replacing the annual application with a five-year plan that encourages comprehensive planning for a State's full complement of child protective and child welfare services, from prevention and protection through permanency. The CAPTA Basic State Grant is the chief Federal funding mechanism specifically targeted at improving the infrastructure of State child protective services systems – that is, the systems for receiving, assessing and investigating reports of child abuse and neglect. States may use the funds for a variety of purposes. For example, States can develop, test or implement new tools for assessing the degree of risk involved in a case, so that appropriate interventions are taken to keep children safe. Or they might use funds to provide enhanced training to CPS workers in order to respond better to families experiencing multiple problems, such as domestic violence and child abuse, or substance abuse and child maltreatment.

Another significant development stemming directly from the last reauthorization of CAPTA is the creation of Citizen Review Panels that provide an essential measure of citizen involvement and system accountability. Consistent with the statute, all States receiving the Basic State Grant have established panels to examine CPS agency policies and procedures and to evaluate their effectiveness in protecting children. Several States have gone beyond minimum requirements by implementing citizen review panels in every county recognizing that children and families benefit from third party review. Other States, such as Idaho, Arizona, Texas and Hawaii, report that the panels are working effectively with both their State agencies and legislatures in recommending changes in policies or procedures to improve the protection of children.

Third, the 1996 CAPTA Reauthorization consolidated several programs including the Community-Based Family Grants, the Temporary Child Care for Children with Disabilities and Crisis Nurseries Grants, and the Family Support program into a new Community-Based Family Resource and Support grants program. The purpose of this consolidated approach was to support State efforts through a formula grants program to develop, operate and expand coordinated State networks of community-based, prevention-focused family resource and support programs using a wide variety of existing public and private organizations.

The CBFRS program focuses on primary prevention -- preventing child abuse and neglect from ever happening in the first place -- as well as prevention of the recurrence of abuse and neglect. Each State has used CBFRS funds to create a prevention network model that meets its unique needs. Based on the results of their service inventory and needs’ assessment, States fund services that fill gaps in their Statewide network of prevention services. For example, in Ohio, a regional infrastructure supports public and private community-based prevention efforts in all 88 counties. In Wisconsin, the Children’s Trust Fund is collaborating with the Department of Workforce Development to administer grants to local communities to support fatherhood initiatives. In California, the Office of Child Abuse Prevention encourages counties to blend a variety of State and Federal funding sources, thus maximizing the impact of these prevention funds.

The CBFRS program is relatively new, yet these family support programs are beginning to report positive outcomes in terms of participant recruitment and satisfaction -- important outcomes since participation is voluntary -- as well as changes in knowledge, attitudes, skills and aspiration. In time, these initial changes can lead to changes in behavior. For example, a parent education program for Native American parents living on tribal lands reported that over 85 percent of parents were using new methods to manage their stress as well as teaching their children to understand and manage stress. Managing stress is a critical step toward reducing child maltreatment or behaviors that could lead to maltreatment.

Many states have implemented or are implementing long-term studies and other outcome evaluation procedures with their CBFRS programs, so much more data on intermediate and long-term family support outcomes is expected within the next several years.

Children’s Justice Act

The Children’s Justice Act (CJA) provides grants to States to improve the investigation, prosecution and judicial handling of cases of child abuse and neglect, particularly cases involving child sexual abuse and exploitation. States have been extremely creative in using these funds to support innovative approaches to reducing the negative impacts of child abuse and neglect. Examples of these innovations include: developing curricula and conducting cross-disciplinary training for personnel in law enforcement, child protective services, health and mental health, and the judicial system, resulting in improved communication, collaboration and resolution of cases; and, establishing or enhancing child advocacy centers and other multidisciplinary programs to serve child victims and their families, resulting in less trauma to the victims. With the passage of the Child Abuse Prevention and Enforcement (CAPE) Act in 2000, funding provided to the CJA from the Crime Victims Fund has doubled and will enable States to further these innovative efforts.

The National Child Abuse and Neglect Data System

Much of our knowledge about the number and characteristics of cases of child abuse and neglect comes from the National Child Abuse and Neglect Data System (NCANDS). The NCANDS was established in 1988 as a voluntary data collection system on child abuse and neglect. All 50 states report aggregate and/or case-level data (34 States now report case-level data, while 17 States currently report aggregate data only).

The new data requirements specified in the 1996 amendments have been incorporated into NCANDS and, in 1999, most elements were reported on by more than half of the States. The data from the NCANDS are used by the Children’s Bureau in three major endeavors:

The Child and Family Service Reviews, the Department's new outcome-focused system for monitoring State child protection and child welfare programs, to ensure that they provide for children's safety, permanency and well-being;
The annual report on child welfare outcomes, mandated by the Adoption and Safe Families Act of 1997 (ASFA); and
The Government Performance Results Act.

The Child and Family Services Reviews have impacted the quality and reporting of data. States are finding the process of reviewing and analyzing their child abuse and neglect data through these reviews to be a useful and meaningful activity designed to improve child safety.

Research and Demonstration

Much of our efforts in the area of research and demonstration have been focused on the Longitudinal Studies of Child Abuse and Neglect, a consortium of research studies in five sites. This study, now in its eighth year, looks at abused and neglected children over time. One significant finding of this research, which I believe is important in moving the field forward and improving treatment designs for children, indicates that factors such as the severity and duration of maltreatment affects child outcomes and that the significance of these factors varies by sub-type of maltreatment. For instance, a child who is neglected before age four shows more negative effects after age eight than a child neglected at a later developmental stage. If abuse or neglect is continuous, not episodic, more negative outcomes result. This information may help explain, for example, the severely debilitating effects of chronic neglect and assist States in providing better-targeted, more appropriate services.

We also are learning about promising practices related to the prevention and treatment of child neglect through 12 demonstration grants that have been underway for nearly five years. For example, chronically neglectful families appear to be more stable and stay engaged with support services when they receive a wider array of family services for longer periods of time. The services can taper off in intensity without damage to family functioning as long as they continue to cover a wide variety of issues (e.g., nutrition, housekeeping, bill paying, child-centered play activities, substance abuse and mental health support, social network building) with multiple access points to families.

Additionally, community-based groups for adolescent mothers can be successful in helping these mothers considered at high risk of neglecting their children (ages 0 to 4). These groups guide young mothers to become more stable and reliable in their child-care interactions with their children and engage in pre-school readiness activities (e.g., helping children learn numbers and colors). Along the same lines, parent education classes that focus on school-readiness activities for neglectful mothers have shown outcomes better than expected in school-readiness among the children.

The 1996 Amendments also authorized the Secretary to award grants for projects which provide educational identification, prevention and treatment services in cooperation with pre-school, elementary and secondary schools. The demonstrations were intended to provide information about effective strategies for: (1) collaborating with schools; (2) reaching teachers, children and parents and enhancing their knowledge and skills pertaining to child maltreatment related issues; (3) enlisting school staff as active participants in efforts to prevent child maltreatment; and, (4) intervening in situations in which children are at risk for, or are victims of, maltreatment in ways that improve outcomes for these children. While the results from these 3-year demonstrations are not finalized yet, we expect to complete a report detailing the findings in the near future.

The National Clearinghouse on Child Abuse and Neglect Information

The National Clearinghouse on Child Abuse and Neglect Information was first established in 1974 to collect, organize and disseminate information on all aspects of child maltreatment in order to build the capacity of professionals in the field. Clearinghouse services are designed to be responsive to the changing needs of the field, and to meet the cross-disciplinary needs of professionals working in child abuse and neglect, child welfare and adoption. The Clearinghouse maintains extensive document collections and provides information and referrals, technical assistance, and other products and services to meet the specific needs of users. It offers numerous materials and resources both in printed format and on-line.

Adoption Opportunities Program

I would now like to turn attention to another program the Administration is proposing to reauthorize -- the Adoption Opportunities program. With the increased attention given to adoption by the Congress, the States and private organizations, the number of adoptions has increased significantly over the past few years.

This Administration is deeply committed to promoting the timely adoption of children in foster care who are unable to return home. The Adoption Opportunities program furthers this goal by providing grants to public and private nonprofit agencies and organizations, including religious organizations. These grants are used to test new models of service delivery to address and eliminate barriers to adoption and to help find permanent families for children who would benefit by adoption, particularly children with special needs. The most recent funding initiative stressed the importance of evaluation and directed applicants to assess outcomes related to safety, permanency and well-being, whenever possible. Recent findings from two previously funded grants include the following:

When agencies make an effort to find relatives/kin and promote kinship adoption, families can be located and responded positively. Relative adoptions can occur at greater rates than many workers believe they can be achieved.
When these families of children to be adopted receive the kinds of support services they need or request, services available to non-kin foster families, such as respite care, the placements are more stable and families report less conflict.
Parent-support groups are very effective in making parents feel that they have expanded resource networks and access to services and result in parents seeking out and using more community resources. Parents also report that they are better able to support and parent their children who may have special needs.

Through the Adoption Opportunities program, we will continue to stimulate innovations in recruiting and supporting adoptive families, and we will disseminate information on what works to States and organizations.

Abandoned Infants Assistance Act

The Administration also supports the extension of the Abandoned Infants Assistance Act. This program provides grants to public and community-based entities for projects to prevent the abandonment of infants and young children exposed to HIV/AIDS and drugs, and to provide services to these children and their families. 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 drug and alcohol treatment centers.

There are currently 25 comprehensive service demonstration projects providing a broad array of social and health services, including 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. Two-thirds of the programs provide in-home support services, which enhance client assessment and service provision by yielding a fuller picture of the client’s circumstances and addressing accessibility barriers. Transportation and child care may also be offered to assist the clients in accessing center-based services.

CONCLUSION

Addressing the needs of our Nation's most vulnerable children and families requires national leadership, comprehensive and coordinated efforts at the State and Federal level, and compassionate, caring responses from community-based organizations, including religious organizations, able to meet the specific needs of individual children and families. The Child Abuse Prevention and Treatment Act, the Abandoned Infants Assistance Act and the Adoption Opportunities Program all make important contributions to these efforts. The President's initiatives for strengthening families in the FY 2002 budget that I have highlighted will strongly enhance our work as well.

I look forward to working with the Congress to pass legislation reauthorizing these statutes and funding the President’s new initiatives, so that we may further efforts to prevent child abuse and neglect and respond to it effectively when it occurs; prevent the abandonment of children affected by HIV or substance abuse; and promote the adoption of children in foster care who need loving permanent families.

Last revised: September 14, 2001