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PREVENTING CHILD ABUSE AND IMPROVING 

RESPONSES TO FAMILIES IN CRISIS 

HEARING 

BEFORE THE

SUBCOMMITTEE ON HEALTHY 

FAMILIES AND COMMUNITIES 

COMMITTEE ON 

EDUCATION AND LABOR 

U.S. HOUSE OF REPRESENTATIVES

ONE HUNDRED ELEVENTH CONGRESS 

FIRST SESSION 

HEARING HELD IN WASHINGTON, DC, NOVEMBER 5, 2009 

Serial No. 111–38 

Printed for the use of the Committee on Education and Labor 

( 

Available on the Internet: 

http://www.gpoaccess.gov/congress/house/education/index.html 
(II) 

COMMITTEE ON EDUCATION AND LABOR 

GEORGE MILLER, California, Chairman 

Dale E. Kildee, Michigan, Vice Chairman 

Donald M. Payne, New Jersey 

Robert E. Andrews, New Jersey 

Robert C. ‘‘Bobby’’ Scott, Virginia 

Lynn C. Woolsey, California 

Rube ́n Hinojosa, Texas 

Carolyn McCarthy, New York 

John F. Tierney, Massachusetts 

Dennis J. Kucinich, Ohio 

David Wu, Oregon 

Rush D. Holt, New Jersey 

Susan A. Davis, California 

Rau ́l M. Grijalva, Arizona 

Timothy H. Bishop, New York 

Joe Sestak, Pennsylvania 

David Loebsack, Iowa 

Mazie Hirono, Hawaii 

Jason Altmire, Pennsylvania 

Phil Hare, Illinois 

Yvette D. Clarke, New York 

Joe Courtney, Connecticut 

Carol Shea-Porter, New Hampshire 

Marcia L. Fudge, Ohio 

Jared Polis, Colorado 

Paul Tonko, New York 

Pedro R. Pierluisi, Puerto Rico 

Gregorio Kilili Camacho Sablan, 

Northern Mariana Islands 

Dina Titus, Nevada 

Judy Chu, California 

John Kline, Minnesota, 

Senior Republican Member 

Thomas E. Petri, Wisconsin 

Howard P. ‘‘Buck’’ McKeon, California 

Peter Hoekstra, Michigan 

Michael N. Castle, Delaware 

Mark E. Souder, Indiana 

Vernon J. Ehlers, Michigan 

Judy Biggert, Illinois 

Todd Russell Platts, Pennsylvania 

Joe Wilson, South Carolina 

Cathy McMorris Rodgers, Washington 

Tom Price, Georgia 

Rob Bishop, Utah 

Brett Guthrie, Kentucky 

Bill Cassidy, Louisiana 

Tom McClintock, California 

Duncan Hunter, California 

David P. Roe, Tennessee 

Glenn Thompson, Pennsylvania 

Mark Zuckerman, Staff Director 

Barrett Karr, Republican Staff Director 

SUBCOMMITTEE ON HEALTHY FAMILIES AND COMMUNITIES 

CAROLYN McCARTHY, New York, Chairwoman 

Yvette D. Clarke, New York 

Robert C. ‘‘Bobby’’ Scott, Virginia 

Carol Shea-Porter, New Hampshire 

Paul Tonko, New York 

Jared Polis, Colorado 

George Miller, California 

Judy Chu, California 

Todd Russell Platts, Pennsylvania, 

Ranking Minority Member 

Howard P. ‘‘Buck’’ McKeon, California 

Brett Guthrie, Kentucky 

David P. Roe, Tennessee 

Glenn Thompson, Pennsylvania 
(III) 

C O N T E N T S 

Page 

Hearing held on November 5, 2009 ........................................................................ 1 

Statement of Members: 

McCarthy, Hon. Carolyn, Chairwoman, Subcommittee on Healthy Families and Communities ................................................................................... 1 

Prepared statement of ............................................................................... 3 

Additional submissions: 

Report from the National Network to End Domestic Violence ...... 51 

Report, ‘‘Meeting Survivors’ Needs: A Multi-State Study of Domestic Violence Shelter Experiences,’’ Internet address to ......... 64 

2007 series of AP articles on child sex abuses ................................. 64 

Cates, Sheryl, chief executive officer, National Domestic Violence 

Hotline, prepared statement of ..................................................... 98 

The Child Welfare League of America (CWLA), prepared statement of ............................................................................................. 98 

The Family Violence Prevention Fund, prepared statement of ..... 103 

The National Association of Public Child Welfare Administrators, 

prepared statement of .................................................................... 108 

The National Network to End Domestic Violence (NNEDV), prepared statement of .......................................................................... 110 

Melmed, Matthew, executive director, Zero to Three, prepared 

statement of .................................................................................... 115 

Platts, Hon. Todd Russell, Senior Republican Member, Subcommittee 

on Healthy Families and Communities ...................................................... 3 

Prepared statement of ............................................................................... 4 

Statement of Witnesses: 

Hammond, Rodney, Ph.D., Director, Division of Violence Prevention, National Center for Injury Prevention & Control, Centers for Disease 

Control & Prevention, U.S. Department of Health and Human Services 6 

Prepared statement of ............................................................................... 8 

Kaplan, Caren, MSW, director of child protection reform, American Humane Association .......................................................................................... 16 

Prepared statement of ............................................................................... 19 

Oliva, Sandra, executive director, Nassau County Coalition Against Domestic Violence .............................................................................................. 23 

Prepared statement of ............................................................................... 25 

Sawyer, Robert Quinn, MSW, LICSW, Olmsted County Child and Family 

Services .......................................................................................................... 35 

Prepared statement of ............................................................................... 37 

Smith, Teresa M., LSW, coordinator executive director, Children’s Advocacy Center .................................................................................................... 32 

Prepared statement of ............................................................................... 34 

Spigner, Carol Wilson, DSW, Kenneth L.M. Pray professor, University 

of Pennsylvania School of Social Policy and Practice ................................ 12 

Prepared statement of ............................................................................... 14 

(1) 

PREVENTING CHILD ABUSE AND IMPROVING 

RESPONSES TO FAMILIES IN CRISIS 

Thursday, November 5, 2009 

U.S. House of Representatives 

Subcommittee on Healthy Families and Communities 

Committee on Education and Labor 

Washington, DC 

The subcommittee met, pursuant to call, at 10:05 a.m., in room 

2175, Rayburn House Office Building, Hon. Carolyn McCarthy 

[chairwoman of the subcommittee] presiding. 

Present: Representatives McCarthy, Tonko, Chu, Platts, Guthrie, 

and Roe. 

Also Present: Representatives Woolsey and Moore. 

Staff Present: Tylease Alli, Hearing Clerk; Calla Brown, Staff Assistant, Education; Adrienne Dunbar, Education Policy Advisor; 

Ruth Friedman, Senior Education Policy Advisor (Early Childhood); 

David Hartzler, Systems Administrator; Fred Jones, Staff Assistant, Education; Joe Novotny, Chief Clerk; Alexandria Ruiz, Administration Assistant to Director of Education Policy; Melissa 

Salmanowitz, Press Secretary; Kim Zarish-Becknell, Policy Advisor, 

Subcommittee on Healthy Families and Communities; Stephanie 

Arras, Minority Legislative Assistant; Alexa Marrero, Minority 

Communications Director; Ryan Murphy, Minority Press Secretary; 

Susan Ross, Minority Director of Education and Human Services 

Policy; Mandy Schaumburg, Minority Education Counsel; and 

Linda Stevens, Minority Chief Clerk/Assistant to the General 

Counsel. 

Chairwoman MCCARTHY. Good morning. I would like to welcome 

our witnesses to this hearing. Today, we are dealing with a very 

difficult and upsetting subject—abuse and neglect—and we know 

sometimes, unfortunately, it results in fatalities. We will hear from 

witnesses on how to improve response for and prevent violence and 

abuse in families in crisis. Abuse, neglect, and fatalities are of significant social concerns in our Nation. 

The official number of children killed from abuse or neglect nationwide in 2007 is 1,760. In 2001, the total was 1,300. Three-quarters of the fatalities are children under four. 

As a nurse for over 30 years, I have seen firsthand the risks and 

illnesses that can result due to abuse and neglect. We know that 

children who experience abuse or neglect and children that witness 

abuse have their sense of security, trust, and safety shaken to the 

core. Studies have shown that young children are more likely to be 
2 

reported as victims. In fact, of all cases, the maltreatment rate for 

infants was 21 percent. For children ages one to three it was 13 

percent. 

The majority of child victims experience neglect. In fact, more 

than 60 percent of the children who come to the attention of child 

welfare authorities are victims of neglect. They are victims of acts 

of omission in terms of their care, in terms of their well-being. 

Sometimes these instances of neglect happen due to the simple fact 

the parents need assistance. These parents are not monsters. Rather, they need to be connected with available services or perhaps 

they need help with basic parental know-how. 

We know from studies that the impact of chronic, 

long-term neglect is devastating to the development of children. 

Victims of abuse and neglect are more likely to have developmental 

delays and impaired language and cognitive skills. They are more 

likely to be arrested for delinquency and violent criminal behavior 

as adults. We also know they have poor health outcomes as adults. 

Over 35 years ago, Congress enacted the Child Abuse Prevention 

and Treatment Act, or CAPTA, with a very simple purpose: Creating a single Federal focus to deal with the front-end issues associated with abuse and neglect. I like to think of CAPTA prevention 

programs as the first line of defense in the child welfare system. 

The CAPTA formula and competitive grants focus on the prevention of child abuse and ensuring continued well-being and safety of 

children. The CAPTA programs consists of two major grant programs, as well as targeted research, data collection, and technical 

assistance to the States. These grant programs provide funding for 

improvements to child protection services, promising prevention efforts, and community-based efforts to prevent abuse and neglect. 

CAPTA provides grants to States for technical assistance and requires States to have laws related to reporting child abuse investigations and procedures and resources for working with affected 

families. In order to receive funds, States must meet a minimal 

definition of child abuse and neglect. 

While CAPTA has brought much-needed attention and change to 

the issues of child maltreatment, this number still remains too 

high. The rates of physical abuse have decreased in recent years, 

but the rates of neglect have remained conservatively consistent, 

and we know that difficult financial times can certainly aggravate 

violence in victims, with fewer personal resources becoming increasingly vulnerable. 

For example, since the economic crisis began, it has been reported that three out of four domestic violence shelters have reported an increase in women seeking assistance from abuse. That 

means we have more work to do, which is why I am holding this 

hearing today. 

I want to thank you all for being here, and I look forward to the 

testimony that we will hear. 

I now recognize the distinguished gentleman from Pennsylvania, 

Ranking Member Platts, for his opening statement. 

[The statement of Mrs. McCarthy follows:] 
3 

Prepared Statement of Hon. Carolyn McCarthy, Chairwoman, 

Subcommittee on Healthy Families and Communities 

I’d like to welcome our witnesses to this hearing. Today are dealing with a very 

difficult and upsetting subject, abuse and neglect, which sometimes result in fatalities. 

We will hear from witnesses on how to improve responses for and prevent violence 

and abuse in families in crisis. 

Abuse, neglect and fatalities are of significant social concerns in our nation. The 

official number of children killed from abuse or neglect nationwide in 2007 is 1,760. 

In 2001, the total was 1,300. 

Three-quarters of the fatalities are children are under four. As a nurse for 30 

years, I have seen firsthand the risks and illnesses that can result due to abuse and 

neglect. 

We know that children who experience abuse or neglect, and children that witness 

abuse have their sense of security, trust and safety shaken to the core. 

Studies show that young children are more likely to be reported as victims. In 

fact, of all cases, the maltreatment rate for infants was twenty one percent and for 

children ages one to three it was 13 percent. 

The majority of child victims experience neglect. In fact, more than 60 percent of 

the children who come to the attention of child welfare authorities are victims of 

neglect. 

They’re victims of acts of omission in terms of their care, in terms of their well 

being. 

Sometimes these instances of neglect happen due to the simple fact that parents 

need assistance. 

These parents are not monsters, rather they need to be connected with available 

services or perhaps they need help with basic parental know-how. 

We know from studies that the impact of chronic, long-term neglect is devastating 

to the development of children. 

Victims of abuse and neglect are more likely to have developmental delays, and 

impaired language or cognitive skills. They are more likely to be arrested for delinquency and violent criminal behavior as adults. 

We also know they have poor health outcomes as adults. 

Over thirty-five years ago Congress enacted the Child Abuse Prevention and 

Treatment Act—or ‘‘CAPTA’’—with a very simple purpose: creating a single federal 

focus to deal with the front end issues associated with child abuse and neglect. 

I like to think of CAPTA prevention programs as the first line of defense in the 

child welfare system. The CAPTA formula and competitive grants focus on the prevention of child abuse and ensuring continued well-being and safety of children. 

The CAPTA programs consist of two major grant programs, as well as targeted 

research, data collection and dissemination and technical assistance to the states. 

These grant programs provide funding for improvements to child protective services, promising prevention efforts and for community-based efforts to prevent abuse 

and neglect. 

CAPTA provides grants to states for ‘‘technical assistance’’ and require states to 

have laws related to reporting child abuse, investigation procedures and procedures 

and resources for working with affected families. 

In order to receive funds, States must meet a minimal definition of child abuse 

and neglect. 

While CAPTA has brought much needed attention and change to the issues of 

child maltreatment, this number remains too high. 

The rates of physical abuse have decreased in recent years, but the rates of neglect have remained disturbingly constant. 

And we know that difficult financial times can certainly aggravate violence and 

victims with fewer personal resources become increasingly vulnerable. 

For example, since the economic crisis began, it has been reported that three out 

of four domestic violence shelters have reported an increase in women seeking assistance from abuse. 

That means we have more work to do, which is why I am holding this hearing 

today. Thank you all for being here and I look forward to the testimony. 

Mr. PLATTS. Thank you, Madam Chair. I first want to thank and 

commend you for your continued leadership and focus on this very 

important issue as we seek to work with partners throughout the 
4 

Nation in protecting our children and helping our Nation’s families 

do right by their children. 

I am going to submit my full statement for the record because, 

as I mentioned, I want to apologize up front to you and to the witnesses. I am against human cloning, but for me, I am supposed to 

be in about four spots right now, so I only have about a half hour 

before I run out, and hopefully I will get back for a later part of 

the hearing this morning. 

I want to very much thank our witnesses for being here to share 

your expertise and your knowledge, but most importantly, I want 

to thank you for day in and day out working to help protect our 

Nation’s children and to serve them and their families so that we 

can all be part of the same team. 

Your work is critically important to the safety of so many children throughout this country. Each day you are making a difference, and I commend you for your efforts. 

With that, I will submit my statement for the record and allow 

us to move forward. 

Thank you, Madam Chair. 

[The statement of Mr. Platts follows:] 

Prepared Statement of Hon. Todd Russell Platts, Ranking Minority 

Member, Subcommittee on Healthy Families and Communities 

Good morning. I would like to welcome you all to our hearing today. 

Today we will examine ways to prevent child abuse and improve responses to 

families in crisis. As we all know, child abuse comes in many different forms. Child 

abuse can be physical, sexual, or emotional in nature, and occurs in all segments 

of our population, crossing ethnic, racial, and even economic lines in some cases. 

According to the American Academy of Pediatrics, each year more than 2.5 million 

cases of child abuse and neglect are reported. Recent studies show that twenty-five 

percent of girls and one in eight boys will be sexually abused before they reach 

eighteen years of age. We know that these children suffer both short and long-term 

physical and emotional damage. Many children become depressed well into adulthood. Others become violent, and even suicidal. Children who are abused are at a 

higher risk of abusing drugs and alcohol. 

Congress has made progress on this issue over the last several decades with the 

Child Abuse Prevention and Treatment Act (CAPTA), first passed in 1974. This legislation provides minimum standards that states must incorporate in their statutory 

definitions of child abuse and neglect. CAPTA defines child abuse and neglect as, 

‘‘any recent act or failure to act on the part of a parent or caretaker, which results 

in death, serious physical or emotional harm, sexual abuse, or exploitation, or an 

act or failure to act which presents an imminent risk of serious harm.’’ The last authorization of CAPTA in 2003 focused on three major goals: preventing child abuse 

and family violence before it occurs; maintaining local projects with demonstrated 

value in eliminating barriers to permanent adoption; and addressing the circumstances that lead to child abandonment. 

We will hear today from several experts on the successful prevention and treatment of child abuse. For example, the Differential Response System has received bipartisan support and demonstrated effectiveness with its approach that allows child 

protective services to respond differently to confirmed reports of child abuse and neglect. Child protective services take into consideration the type and severity of abuse 

reported, number of sources of reports and willingness of the family to participate. 

Results have shown a reduction in investigations, repeated reports of maltreatment, 

court involvement, child in-placements, while at the same time increasing family involvement and the number of children served. 

Despite the considerable work that has been done on this issue at both the federal 

and local level, child abuse is still on the rise. As such, we must continue to explore 

innovative ways to prevent child abuse in our communities. Teresa Smith, Coordinator and Executive Director of the Pinnacle Health Children’s Resource Center in 

Harrisburg, Pennsylvania, has joined with us today. Currently the Co-Chair of the 

Pennsylvania CAPTA Workgroup, I am grateful for her sharing with us the importance of implementing CAPTA in states nationwide, including Pennsylvania. 
5 

I look forward to hearing the testimony from all of our witnesses today. As we 

move toward the reauthorization of CAPTA, we must take into consideration the 

current trends in child abuse and neglect and remain focused on prevention at the 

local level. Thank you, Chairwoman McCarthy. 

Chairwoman MCCARTHY. Thank you. Pursuant to committee rule 

7(c), any member may submit an opening statement in writing at 

this time, which will be made a part of the permanent record. 

Without objection, all members will have 14 days to submit additional materials or questions for the hearing record. 

I would like to briefly introduce our distinguished panel here this 

morning. The complete bios of the witnesses will be inserted into 

the report. 

Today, we will hear from six witnesses, each of whom will focus 

on abuse and neglect prevention and action. I want to thank all of 

you for taking the time out to be here in front of this panel. 

I also ask unanimous consent for a member of the full committee, 

Ms. Woolsey, and a member who is not on a committee, Representative Gwen Moore, to sit on the dais and ask questions. Each of 

these members have been leaders in domestic violence and child 

welfare issues. 

Again, I welcome you to our committee. In the interest of time, 

given the large number of witnesses today, I will keep my formal 

introductions short. 

Our first witness is Dr. Rodney Hammond, the Director of Violence Prevention at the National Center for Injury, Prevention, and 

Control at the CDC. He has held this position since 1996. At the 

CDC, Dr. Hammond is responsible for research and programs to 

prevent homicide, suicide, family, intimate partner and sexual assault, child abuse, and youth violence. Through his professional career, efforts have been focused on youth violence, prevention, and 

it is a public health concern. 

Our next witness is Dr. Wilson Spigner of the University of 

Pennsylvania School of Social Policy and Practice, Philadelphia, 

Pennsylvania. Prior to her arrival at Penn, Dr. Spigner was the Associate Commissioner of the Children’s Bureau at the U.S. Department of Health and Human Services, Administration for Children 

and Families, and was responsible for the administration of Federal child welfare programs. 

Our next witness is Caren Kaplan. She has almost 30 years experience in child welfare and policy and practice. As the Director 

of the Child Protection Reform at the American Humane Association, Caren oversees the National Initiative on Chronic Neglect. 

Caren manages several efforts to examine and refine the assessments of child safety, risk, and comprehensive family functioning 

by child protection agencies. 

Our next witness is Sandra Oliva from Hempstead, New York, 

which is part of my district. Sandra is the Executive Director of the 

Nassau County Coalition Against Domestic Violence. She served in 

that role for nearly 25 years. Under her leadership, the Nassau 

County Coalition Against Domestic Violence has grown into a 

multifaceted, comprehensive domestic violence service organization, 

helping over 3,000 adults and children annually. 
6 

Sandra’s vision, insight, and commitment have encouraged the 

agency to develop individualized and tailored services to meet the 

needs of adults and youth victims in crisis. These services include 

crisis intervention, counseling, advocacy services, safe homes, transitional housing, community education and outreach, legal services, 

and legislation and legal advocacy. 

I now yield to Ranking Member Platts to introduce our next witness, Ms. Smith. 

Mr. PLATTS. Thank you, Madam Chair. I am delighted to have 

the opportunity to introduce a fellow Pennsylvanian, Ms. Teresa 

Smith. Ms. Smith is Executive Director of the PinnacleHealth Children’s Resource Center and has been an employee of 

PinnacleHealth system for 24 years. She 

cofounded the hospital-based Children’s Advocacy Center Program in Harrisburg, Pennsylvania, in 1994, and since that time she 

has been working to ensure that children are safe and well cared 

for. 

The Children’s Advocacy Center in Harrisburg is one of the most 

renowned children advocacy centers in Pennsylvania, and a great 

model program for other centers around the State, and including 

in my congressional district. The Center collaborates with partners 

in the community to prevent, investigate, and treat child abuse. 

Ms. Smith is also a site reviewer for the National Children’s Alliance and the cochair of the Pennsylvania CAPTA Working Group. 

Ms. Smith, we are delighted to have you here. Thanks for your 

work back home and for your testimony here today. 

I yield back. 

Chairwoman MCCARTHY. Finally, I would like to introduce Rob 

Sawyer from Olmsted County Child and Family Services in Minnesota. Welcome. Mr. Sawyer is the former Director of Child and 

Family Services in Minnesota and has spent years working on child 

abuse prevention issues in his State. He brings a wealth of the 

ground experience in our discussion today. And we welcome you. 

Let me explain the lighting system that is in front of you. For 

those of you who have not testified in front of Congress before, everyone, including the members, is limited to 5 minutes of presentation of questions. The green light will illuminate when you start 

speaking. The yellow light will go on when your time is just about 

up. And when you see the red light, you will need to conclude your 

testimony. 

We will be more lenient on allowing members to finish their 

thoughts. So we want to hear all of your testimony. 

Please be certain to turn on your microphones when you start to 

speak to us. 

We will now hear from our first witness. 

Dr. Hammond. 

STATEMENT OF RODNEY HAMMOND, PH.D., DIRECTOR OF DIVISION OF VIOLENCE PREVENTION NATIONAL CENTER FOR 

INJURY PREVENTION AND CONTROL, CENTERS FOR DISEASE CONTROL AND PREVENTION 

Mr. HAMMOND. Thank you and good morning, Chairwoman 

McCarthy, Ranking Member Platts, and other distinguished mem-
7 

bers of the subcommittee. On behalf of CDC, it is an honor to be 

here. 

I serve as the Director of the Division of Violence Prevention at 

CDC’s Injury Center. Today, I will highlight that public health can 

complement child welfare and protective services by bringing proven prevention strategies to scale. 

This involves three key points. First, that public health has an 

important role to play in preventing child 

maltreatment. Second, that we have the opportunity to put in 

place innovations in how we prevent child maltreatment through 

evidence-based strategies. Third, that scaling up these approaches 

necessitates partnerships between public health, social services, 

and child-serving entities to ensure quality. 

We know that child maltreatment has significant short- and 

long-term health consequences. For example, in 2007, an estimated 

1,760 children younger than 18 years old died as a result of maltreatment. We also know that approximately 794,000 children were 

determined by State and local Child Protective Services to be victims of child maltreatment. These numbers, no doubt, are an 

underrepresentation because the data only reflect cases that are reported to the Child Protective Services system. 

But we also know that exposure to child maltreatment has longterm health consequences into adulthood, such as heart disease, 

cancer, drug abuse, and depression. Moreover, studies show that 

exposure to child maltreatment is linked to other forms of violence, 

including youth violence and intimate partner violence. 

There is a wealth of evidence showing the needs of children for 

healthy development. First, we know that children need to be safe 

from physical and psychological harm. Secondly, we know that children need a degree of stability in their environment. And, third, 

they need a nurturing parent or other caregiver that is consistently 

available to meet their needs. 

The way to reduce child maltreatment is to promote child health. 

We can do this by fostering safe, stable, nurturing relationships 

using a public health approach. We are at a critical juncture because we now have prevention programs that work. Now is the 

time to focus on wide-scale implementation of those programs. 

Recent CDC studies show that child maltreatment rates actually 

fall when parents have access to interventions that address problems with child behavior. For example, PPP, a parenting program, 

combines broad social campaigns with targeted parenting support 

services. In addition, early childhood home visitation programs are 

effective. For instance, the nurse-family partnerships focus on firsttime mothers during pregnancy, working to promote positive health 

and interactions between mother and child. 

Although there are promising interventions, there are still some 

opportunities for improvement. We need data that provides a comprehensive understanding of the ideal settings for interventions, 

and we need a better understanding of risk surrounding child maltreatment. 

We need to continually evaluate promising strategies, including 

programs and policies that target at the individual and community 

levels so that we can widely implement. We need to develop public 

health capacity to support prevention programs that complement 
8 

Child Welfare and Child Protective Services. We must work to 

make prevention accessible, especially to parents, without stigma. 

So, in conclusion, public health can lessen the burden on child 

welfare and protective services by bringing prevention strategies to 

scale and ensuring that they are accessible to all families that need 

and want them. Scaling up these approaches necessitates collaboration between public health, social services, and child serving agencies. A partnership between public health and child protection services will allow more people to access programs that strengthen families and help children to live life to their fullest potential. 

I would like to thank the subcommittee for its continued support 

of CDC and its injury and violence programs, and I would be happy 

to answer any questions that you may have. Thank you. 

[The statement of Mr. Hammond follows:] 

Prepared Statement of Rodney Hammond, Ph.D., Director, Division of Violence Prevention, National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, U.S. Department of Health and 

Human Services 

Good morning Chairwoman McCarthy, Ranking Member Platts and distinguished 

Members of the Subcommittee. My name is Dr. Rodney Hammond, and I am the 

Director of the Division of Violence Prevention, a Division of the National Center 

for Injury Prevention & Control (NCIPC) within the Centers for Disease Control & 

Prevention (CDC). Thank you for the opportunity to appear before you on behalf of 

CDC to discuss our Agency’s research and prevention activities addressing child 

maltreatment. At CDC, we work to ensure that all people achieve their optimal lifespan with the best possible quality of health at every stage of life. 

Regardless of gender, race or economic status, injuries are a leading cause of 

death for young Americans. Violence is a particularly serious threat to the health 

and well-being of children and adolescents in the United States. Furthermore, violence such as child maltreatment is preventable. CDC is leading the nation’s efforts 

in reducing premature death, disability, human suffering and the medical costs associated with violence. Working with state and local governments, nonprofit organizations, academic institutions, private entities, other federal agencies and international organizations, CDC continues to document the rates of violence including 

identifying the risk and protective factors for child maltreatment, finding effective 

prevention strategies, and promoting widespread adoption of these solutions. We 

strongly believe that every child deserves to live his or her life to their fullest potential. Preventing child maltreatment is one major step toward that end. 

I will begin my testimony today by giving an overview of child maltreatment and 

explaining CDC’s unique public health role in its prevention. I will share updates 

on promising interventions and gaps within the field, and I will close by highlighting that the widespread adoption of proven interventions is an effective solution 

to preventing a majority of childhood injuries and deaths from maltreatment. 

Child Maltreatment: Definition 

‘‘Child abuse’’ is deliberate and intentional words or overt actions that cause 

harm, potential harm, or threat of harm to a child. ‘‘Child neglect’’ is the failure 

to provide for a child’s basic physical, emotional, or educational needs or to protect 

a child from harm or potential harm.1 CDC defines child maltreatment as any act 

or series of acts of commission or omission by a parent or caregiver that results in 

harm, potential harm, or threat of harm to a child. Much of the child maltreatment 

field divides acts of commission into three broad categories—physical, sexual, or 

emotional abuse. Acts of omission are often referred to as child neglect and divided 

into two categories—failure to provide for a child’s basic needs and failure to protect 

a child. Thus the term ‘‘child maltreatment’’ as used in this testimony applies to a 

broad range of harmful activities including ‘‘child abuse’’ and ‘‘neglect’’. 

The Burden of Child Maltreatment in the U.S. 

The magnitude of child maltreatment in the United States is not easily determined, but it is clearly substantial. In 2007, an estimated 1,760 children younger 

than 18 years old died as a result of maltreatment and approximately 794,000 children were determined by state and local child protective services agencies to be victims of child abuse or neglect.2 It is likely that the actual number of children who 
9 

experience maltreatment each year is even larger, because many cases go unreported or undetected. Survey data provide a more troublesome picture of the problem of child maltreatment. Estimates based on a 2008 national survey of children 

aged 2—17 years indicate that approximately one in ten children reported having 

experienced maltreatment and one in sixteen were victimized sexually.3 Child maltreatment through blunt trauma to the head or violent shaking (also known as abusive head trauma or shaken baby syndrome) is the leading cause of head injury 

among infants and young children. Additionally, homicide was the fourth leading 

cause of death for children ages 1-9 years in 2006. 

In addition to injuries and related health issues during childhood, child maltreatment can increase the risk factors for many of the leading causes of death among 

adults. CDC research shows that children who experience maltreatment are at an 

increased risk for a variety of health problems, including heart disease, cancer, 

chronic lung disease, liver disease, alcoholism, drug abuse, and depression. In addition, child maltreatment is closely linked with other forms of violence in adulthood 

such as intimate partner violence. Furthermore, studies have also shown that witnessing or experiencing abuse as a child can increase the risk factors for becoming 

a victim or perpetrator of violence. Addressing violence issues at an early stage 

would aid in assuring optimal prevention and wellness for individuals throughout 

their lifespan. 

CDC’s Role in Child Maltreatment Prevention: Promoting Safe, Stable, Nurturing 

Relationships 

CDC’s child maltreatment prevention program aims to prevent maltreatment and 

its consequences through data monitoring to understand the problem and its trends 

over time, research and development, capacity building to ensure organizations and 

entities are equipped to engage in prevention efforts, communication, and leadership. CDC’s public health approach emphasizes rigorous science and complements 

other approaches such as those of the child welfare system, criminal justice and 

mental health systems. CDC achieves these primarily through data monitoring and 

sharing; research on possible interventions; community implementation and evaluation of interventions; and widespread adoption of proven interventions. This multipronged effort adds to the knowledge base regarding violence and how to prevent 

it. The long-term goal of CDC’s work in child maltreatment prevention is to achieve 

lasting change in the factors and conditions that place children at risk through making changes at individual, family, community, and societal levels to reduce rates of 

child maltreatment. 

Within this field, there is a great need for primary prevention strategies that stop 

abuse and neglect before it occurs. Developing effective prevention programs is essential. CDC in consultation with national experts has identified safe, stable, and 

nurturing relationships (SSNRs) between caregivers and children as the foundation 

of a unified strategic approach and message to empower parents and caregivers and 

to reduce child maltreatment. This approach is aimed at motivating change in parenting behavior and increasing parents’ skills and knowledge to lower incidents of 

child maltreatment. SSNRs strengthen parenting practices that prevent child maltreatment by focusing on positive caregiving behaviors. Accordingly, promotion of 

SSNRs can have synergistic effects on health problems as well as contribute to development of skills that enhance acquisition of healthy habits and lifestyles throughout the lifespan. It should also be noted that SSNRs are not only about the direct 

relationship parents have with their child but also the environment and context 

within which they parent (e.g., community support such as accessible childcare). 

Rather SSNRs becomes a comprehensive approach that focuses on making changes 

at the individual, family, community, and societal levels to reduce rates of violence 

in populations. 

Promising Interventions 

CDC recognizes a number of promising and effective strategies for the prevention 

of child maltreatment. There is substantial evidence that promoting SSNRs can be 

effective in reducing child maltreatment.4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21 The 

most basic approach to facilitating SSNRs is teaching parents positive child rearing 

and management skills and strategies that are safe and nurturing. There is substantial evidence that parent training programs or behavioral family interventions 

delivered in clinical settings and focused on influencing children’s behavior through 

positive reinforcement are effective at influencing the child rearing practices of families.22,23

In fact, a new CDC-funded study shows that when parents have access to proven 

parenting interventions designed to address problems with child behavior (e.g., tantrums), key measures of child maltreatment fall. For example, Triple P, the Positive 
10 

Parenting Program, uses a multi-level strategy focusing on parenting and family 

support that aims to prevent behavioral, emotional and developmental problems in 

children by enhancing the knowledge, skills and confidence of parents. Triple P incorporates a wide range of support mechanisms for parents including local media, 

brief public seminars, and parent consultation by specially trained providers in clinics, schools, churches, and community centers. Research results showed that implementing Triple P in an area containing 100,000 children could translate annually 

into 688 fewer cases of child maltreatment, 240 fewer out-of-home placements, and 

60 fewer children with injuries requiring hospitalization or emergency room treatment. 

In addition, early childhood home visitation programs show strong evidence of effectiveness in reducing violence against visited children. These programs are designed to decrease the likelihood of child maltreatment by providing parents with 

guidance for and examples of caring and constructive interaction with their young 

children. This approach facilitates the development of parental life skills, strengthens social support for parents, and links families with social services. Nurse-Family 

Partnership, or NFP, is one example of an evidence-based early childhood home visitation program that was developed based on evidence from randomized, controlled 

trials. NFP focuses on first-time mothers during pregnancy and works to promote 

and teach positive health and development behaviors between a mother and her 

baby. Additionally, NFP is delivered by registered nurses over a period of time (typically from the mother’s first trimester to the child’s second birthday), thereby fostering a bond between nurse and mother. 

This early intervention during pregnancy allows for any critical behavioral 

changes needed to improve the health of the mother and child. Several randomized 

controlled trials have found this program to effectively reduce abuse and injury, improve cognitive and socio-emotional outcomes in children and have a very favorable 

benefit-cost ratio. An evaluation of NFP documented a 48 percent decline in rates 

of child abuse and neglect at the time of a 15-year follow-up study. Furthermore, 

studies found reduced rates of crime and antisocial behavior among both children 

and mothers. 

Recognizing the significant benefits of home visiting programs such as the NFP, 

the President has proposed in his 2010 budget, a home visiting program designed 

to support the establishment and expansion of evidence-based programs in states 

and territories. The President’s proposal gives priority to models that have been rigorously evaluated and shown to have positive effects on critical outcomes, such as 

the reduction in child abuse and neglect. This new home visitation program will create long-term positive impacts for children and their families as well as positive impacts for society as a whole. 

Areas for Improvement in the field of Child Maltreatment Prevention 

Although there are promising interventions within the field of child maltreatment 

prevention, there are still some areas for improvement. 

Improved Monitoring 

Routinely collected data for monitoring the rates of fatal and non-fatal child maltreatment are limited. Simply put, better data on child maltreatment will strengthen the ability to measure the true costs of maltreatment; target crucial programs 

and policies to populations or areas most in need to determine if progress is made; 

and help make the best use of limited resources. Improved ability and capacity to 

monitor nonfatal and fatal child maltreatment at the national and state levels, will 

inform efforts to operationalize, measure, and monitor the implementation of SSNR 

activities. CDC is working to address this gap by funding the development and implementation of the National Violent Death Reporting System, which monitors fatal 

child maltreatment across 18 states. 

Development and Evaluation of New Approaches to Prevention 

Caregiving behaviors occur in many different contexts and develop with time. Understanding the development of caregiving behaviors and how the contexts in which 

they occur influence child development is key to understanding which interventions 

and policies promote SSNRs and reduce child maltreatment. To gain a full understanding of the ideal times and settings for intervention strategies, research is needed that examines how SSNRs and negative caregiving behaviors, including child 

maltreatment, develop. Understanding the development of different forms of child 

maltreatment perpetration (i.e., physical abuse, neglect, and sexual abuse) is critical 

because the different forms of child maltreatment might have varying causes and 

thus require different intervention strategies and timing. Moreover, although many 

parenting programs have been evaluated, evaluation research is beneficial to determine if such approaches are effective for the prevention of child maltreatment and 
11 

for the promotion of SSNRs, paying special attention to whether these approaches 

are effective in different settings and with different populations. 

Building Community Capacity 

The concept of a public health approach to child maltreatment prevention is still 

relatively new, and capacity to address prevention in community settings is not yet 

robust. Building community receptivity and capacity for preventing child maltreatment facilitates the implementation of evidence-based prevention strategies. Ensuring community participation requires clarification of barriers to cooperation and outlining key actions to foster a multidisciplinary, collaborative approach to child maltreatment prevention and the promotion of SSNRs. Working with experts within the 

field of child maltreatment, CDC is developing evidence-based strategies needed to 

help communities and their leaders understand the magnitude of the problem and 

the long-term benefits of investments in primary prevention, including tools that 

can be used to apply public health approaches to child maltreatment and the promotion of SSNRs. For example, some tools that CDC is reviewing include strategy 

guidance products that help community planners and practitioners select the appropriate type and mix of SSNR promotion strategies in their community. 

Conclusion 

As you have heard, there is a strong and growing scientific basis for the primary 

prevention of child maltreatment. In looking toward the future, preventing such adverse exposures as maltreatment by ensuring that all children are protected and 

raised in a safe, stable, and nurturing environment is strategic for achieving measurable and lasting impacts on health throughout life. It is critical to develop the evidence for interventions that work and then get these interventions into the hands 

of parents and caregivers who can use them effectively to prevent child maltreatment. CDC is working to improve the gap between research and practice and between discovery and delivery and to continue progress in preventing and controlling 

violence. To save lives, parents, caregivers, and providers need support for adopting 

and maintaining interventions over time. Violence is preventable, and thus should 

not happen. 

I would like to use this opportunity to thank the Subcommittee for its continued 

support of CDC and its injury and violence prevention programs. I would be happy 

to answer any questions that you many have. Thank you. 

ENDNOTES

1Leeb RT, Paulozzi L, Melanson C, Simon T, Arias I. Child Maltreatment Surveillance: Uniform Definitions for Public Health and Recommended Data Elements, Version 1.0. Atlanta (GA): 

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 

2008. 2Department of Health and Human Services, Administration on Children,Youth, and Families. Child Maltreatment 2007 [online]. Washington (DC):Government Printing Office; 2009. 

[cited 2009 Apr 15]. Available from:www.acf.hhs.gov. 3Finkelhor, D., Hammer, H., and Sedlak, A. 2008. Sexually Assaulted Children: National Estimates and Characteristics. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention. 4 National Scientific Council on the Developing Child. Young children develop in an environment of relationships. Working Paper No. 1. [online] 2004. [cited 2006 Aug 10]. Available from 

url: www.developingchild.net/reports.shtml. 5 Board on Children, Youth, and Families, National Research Council and Institute of Medicine. From neurons to neighborhoods: the science of early childhood development. Committee on 

Integrating the Science of Early Childhood Development. In: Shonkoff JP, Phillips DA, editors.Washington, DC: National Academy Press; 2000. 6 Barnard KE, Solchany JE. Mothering. In: Bornstien MH, editor. Handbook of Parenting. Vol. 

3. New Jersey: Lawrence Erlbaum Associates, Publishers; 2002. pp. 3—25. 7 Ainsworth M.Patterns of infant-mother attachments: antecedents and effects on development. Bulletin of the New York Academy of Medicine 1985;61:792—812. 8 Bowlby J. Developmental psychiatry comes of age. American Journal of Psychiatry 

1988;145:1—10. 9 Antonovsky A.How the sense of coherence develops over the lifespan in: unraveling the mystery of health. How people manage stress and stay well. San Francisco: Jossey-Bass; 1987. pp. 

89—127. 10Widom CS, Maxfield M.An update on the ‘‘cycle of violence.’’ National Institute of Justice 

Research Brief. Washington (DC): National Institute of Justice, 2001:1—8. 11Sidebotham P, Heron J.Child maltreatment in the ‘‘children of the nineties’’: a cohort study 

of risk factors. Child Abuse and Neglect 2006;30:497—522. 12Seagull EAW.Social support and child maltreatment: a review of the evidence. Child Abuse 

and Neglect 1987;11:41—2. 13Waters E, Kondo-Ikemura K, Posada G, Richters JE.Learning to love: mechanisms and 

milestones. In: Gunnar M, Sroufe L, editors. Self processes and development. Minnesota Symposium on Child Psychology. Vol. 23. New Jersey: Erlbaum; 1991. pp. 217—55. 
12 

14Shaw DS, Gilliom M, Ingoldsby EM, Nagin DS.Trajectories leading to school age conduct 

problems. Developmental Psychology 2003;39:189—200. 15Dawson G, Asman DB.On the origins of a vulnerability to depression: the influence of the 

early social environment on the development of psychobiological systems related to risk of affective disorder. In: Nelson CA, editor. The effects of early adversity on neurobehavioral development. Minnesota Symposia on Child Psychology 2000. New Jersey: Erlbaum. pp. 245—79. 16Dawson G, Frey K, Panagiotides H, Yamada E, Hessl D, Osterling J.Infants of depressed 

mothers exhibit atypical frontal electrical brain activity during interactions with mother and 

with a familiar nondepressed adult. Child Development 1999;70:1058—66. 17Seeman TE, Singer B, Horwitz R, McEwen BS.The price of adaptation-allostatic load and 

its health consequences: McArthur studies of successful aging. Archives of Internal Medicine 

1997;157:2259—68. 18Widom CS, Maxfield M.An update on the ‘‘cycle of violence.’’ National Institute of Justice 

Research Brief. Washington (DC): National Institute of Justice, 2001:1—8. 19Kotch JB, Browne DC, Ringwalt CL, Dufort V, Ruina E.Stress, social support, and substantiated maltreatment in the second and third years of life. Child Abuse and Neglect 

1997;21(11):1025—37. 20Garbarino J, Kostelny K. Child maltreatment as a community problem. Child Abuse and 

Neglect 1992;16:455—64. 21 Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychological Bulletin 1985;98(2):310—57. 22Taylor TK, Biglan A.Behavioral family interventions for improving child-rearing: a review 

of the literature for clinicians and policy-makers. Clinical Child and Family Psychology Review 

1998;1(1):41—60. 23Lundahl B, Risser HJ, Lovejoy MC.A meta-analysis of parent training: moderators and follow-up effects. Clinical Psychology Review 2006;26:86—104. 

Chairwoman MCCARTHY. Thank you. 

Dr. Spigner. 

STATEMENT OF CAROL WILSON SPIGNER, MSW, DSW, ASSOCIATE PROFESSOR/CLINICIAN EDUCATOR, UNIVERSITY OF 

PENNSYLVANIA SCHOOL OF SOCIAL POLICY AND PRACTICE 

Ms. SPIGNER. Good morning. Chairwoman McCarthy and Ranking Member Platts, it is an honor for me to be back here in this 

forum. I speak based on my experience. I have been working in 

child welfare 40 years, including my service as Associate Commissioner of the Children’s Bureau. Since I left the Children’s Bureau, 

I have been focusing on assisting large child welfare systems attempt to improve their services. 

I want to talk a little bit about the background related to CAPTA 

and then offer four areas that I think would be useful to consider 

in improving Child Protective Services. 

CAPTA was originally enacted in 1974 to assure that all children 

experiencing maltreatment have the protection of the State. 

CAPTA encouraged the development of systems that could receive 

reports of abuse and neglect, evaluate them, and provide protection 

for children. 

CAPTA has facilitated effectively the development of child protective systems across the country, as well as the development of 

knowledge and practice strategies to address this problem. Over 

the years, CAPTA has been modified to include adoption, abandoned infants, and homeless children. It provides funding for prevention, research, and program development. 

We have heard the statistics already on maltreatment today, but 

I want to underscore several ideas. First, that neglect is the largest 

category of child maltreatment. Secondly, I want to underscore that 

the data tells us that the children under four are the most vulnerable. They comprise 75 percent of the children who die. They are 

unable to protect themselves and often invisible to the community 

because of their age. 
13 

For the children at greatest risk, child protection involves using 

the police power of the State to intervene in family life. Through 

a combination of assessment, 

decisionmaking and service, protective service agencies operate 

to help families and children. 

The four areas of concern I would like to speak to briefly are decisionmaking; interstate referrals for abuse and neglect; support for 

workers; and then, finally, the issue of partnership with communities. 

Let me just say that we have made significant progress in terms 

of decisionmaking and developing 

decisionmaking protocols to guide child protective service workers, but we are not where we need to be. We now have the capacity 

through technology and other resources to begin to apply actual 

science to the predictive aspects of child protection. We need an additional focus on decisionmaking to improve the way judgments are 

made. 

Secondly, I want to speak to the question of interstate referrals. 

What we have found—I live and work in an area that involves two 

jurisdictions. If the child, the location of the event, and the perpetrator are not in the same jurisdiction, cases are likely to fall 

through the cracks because one jurisdiction will say, Well, the child 

is not in your jurisdiction; another will say, Well, the event didn’t 

occur here. So in a time of mobility, there is a real problem that 

cases get—reports get lost and potential perpetrators don’t get 

tracked. So that is an area that I would encourage you to look at. 

The third area I would encourage you to look at is really improving the capacity of supervisors to support 

frontline workers. This is very difficult work. Workers are exposed to difficult situations; to child trauma repeatedly. They are 

at risk of burnout, they are at risk of secondary trauma. 

I think the most critical thing that we can do in terms of that 

is strengthen the supervisors’ ability not only to manage work, but 

to support them. 

The next area has to do with partnerships with communities. 

Child protection cannot be done by the child protective service system alone. Communities shape the values and attitudes that we 

have toward children. A number of jurisdictions have been quite effective in sharing information about the conditions of children in 

their neighborhood and organizing the neighborhood to begin to 

create new messages and new structures to protect children and to 

create neighborhood ownership of the responsibility for child protection. 

So one of my recommendations is that you use the discretionary 

resources of CAPTA to promote more focus on neighborhood-based 

strategies to child protection. They will complement prevention 

strategies. They will also complement the work of the child protective agency in attempting to increase the safety of children. 

I want to thank you for the opportunity and look forward to any 

questions you may have. 

[The statement of Ms. Spigner follows:] 
14 

Prepared Statement of Carol Wilson Spigner, DSW, Kenneth L.M. Pray 

Professor, University of Pennsylvania School of Social Policy and Practice 

Chairwoman McCarthy and Ranking Member Platts: I am pleased to have the opportunity to participate in this hearing with its focus on issues that need to be considered in the reauthorization of the Child Abuse Prevention and Treatment Act 

(CAPTA). I speak based on over forty years of experience working with or on behalf 

of children and families in distress. I continue to work with a number of child welfare agencies in their efforts to improve the quality of service to children and families. I wish to thank you both for your leadership on this issue. 

Background 

CAPTA was originally enacted in 1974 to assure that all children experiencing 

maltreatment had the protection of the state. CAPTA initially encouraged the development of systems that could receive and evaluate allegation of abuse and provide 

protection to children. The focus was on identification of children at risk, prevention 

and intervention. CAPTA has facilitated the development of child protection systems 

across this nation and the development of knowledge and practice strategies to address this problem. Over the years the CAPTA has been modified to include a focus 

on adoption, abandoned infants, homeless children and children with disabilities. By 

providing funding for prevention, research, program development, this legislation 

has been a major building block for child protective services. 

CAPTA authorizes in Section 106, the provision of formula grants to states and 

territories to help improve their child protective service (CPS) systems. To receive 

funding States must establish a child protective service system and be able to comply with various requirements related to the intake, screening, reporting, investigation, and treatment of child maltreatment cases. Among the requirements for funding of the basic grant States must define child abuse and neglect, at a minimum, 

to include any ‘‘recent act, or failure to act, on the part of a parent or caretaker, 

which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm.’’ 

States are required to provide ‘‘to the maximum extent practicable’’ annual state 

data reports to the Secretary. Section 106 requires the Secretary to annually compile this State data in a report. 

CAPTA does not direct the specific practices of state child protective agencies but 

rather identifies the essential components of a child protective service system. 

States have considerable discretion in the design of their systems consistent with 

the values of their community and the available resources. As a result all of the 

states have the shared goal of protecting children, but structure their responses differently. 

Maltreatment Today 

Today we continue to struggle to make sure that every child has a safe and stable 

environment in which to grow up. According to Child Maltreatment 2007, during fiscal year 2007 the number of referrals received was nearly 3.2 million and involved 

5.8 million children. 794,000 children were found to be maltreated. The most frequent problem was neglect (59%) followed by physical abuse (10.8%) and sexual 

abuse (7.6%). 

Children of all ages are affected, but young children age of three and under are 

the most vulnerable. Their vulnerability stems from their age, dependency and their 

inability to protect themselves or speak out. Because may of these children are not 

in school or child care setting, they can be hurt without anyone recognizing injury, 

trauma and neglect. There were an estimated 1760 deaths attributed to maltreatment in 2007. Children under the age of one are had the highest rate of maltreatment related deaths and children under the age of 4 comprised 75% of the children 

who died. 

For children at greatest risk, child protection involves using the police power of 

the state to intervene into the privacy of the family. We have an obligation to intervene and should do so with attention to the child’s safety, stability and well being. 

We want to protect them and to do so in a manner that does the least damage. Most 

children are helped by working with their families to improve safety and the quality 

of care they receive. One in five maltreated children was placed in foster care in 

2007. 

Through a combination of assessment, decision making and service, child protective service agencies work to help vulnerable families and children. Staff must assess the safety and risks to children; determine whether it is safe to leave the child 

with the family or if placement is necessary; and decide which services are provided 

to increase safety and reduce risk in families. The work is complex. 
15 

I would like to identify four areas of concern that could be improved if addressed 

in the reauthorization of CAPTA: decision making, responsibility for inter-state allegations, support for frontline workers and partnerships with communities. 

Issue #1: Decision-making 

CAPTA can assist in strengthening the capacity of state child protection programs 

to conduct systematic decision making related to the safety of children and selecting 

service options. 

Several years ago, the City of Philadelphia was plagued by child fatalities. I was 

asked to head a review team to identify needed reforms. In reviewing the operation 

of the Department of Human Services, we learned that the agency was not consistent in its decision making. During investigations some children who were unsafe 

were being not served while other children whose families were struggling with the 

problems which were not related to safety and risk but rather material needs were 

being accepted for protective services. The resources of the agency were not being 

used in a focused way contributing to failure to identify some of the most vulnerable 

children. The criteria being used to screen for safety were not clear. As a result the 

purpose of child protection was not clear and the agency’s ability to protect children 

was compromised. 

Nationally, we have made progress in developing systematic decision making tools 

which identify factors that need to be assessed and the criteria for assessment. The 

tools have been developed for screening referrals and assessing risk and safety. The 

tools guide the worker’s examination of important areas that are thought to be predictive. With some of the newer technology, we now have the ability to apply actuarial science to maltreatment to improve our protocols and decision making and to 

begin to identify which services work for which families. Moving this forward will 

require focused investments. 

Recommendation: Create within CAPTA opportunities to enhance the development of decision making protocols that are empirically based; have the ability to 

predict future abuse; and identify appropriate services. Such tools can allow child 

protective services to focus resources on the families where children are at greatest 

current and future risk and to provide services that foster the outcomes of safety, 

permanency and well being. 

Issue #2: Unclear responsibility for investigation of reports that cross state lines. 

Child maltreatment is no respecter of state lines. Given the mobility of our society, it is not unusual for an incident of maltreatment to occur in a state other than 

the one which the child resides. For example a custodial parent may learn of abuse 

that occurred in an adjacent state during a visit to other members of the family. 

If the parent makes a report in the state where she resides, she may find that the 

state is without jurisdiction because it was not the location of the abuse. On the 

other hand, if the report is made to the state in which the abuse occurred, they may 

indicate that they have no jurisdiction because the child is not currently living in 

their state. 

The result is that neither of the jurisdictions will investigate the allegation and 

the opportunity for protection is lost. Future abuse may continue for this child or 

others. It is difficult to document how often this occurs, but in the absence of a clear 

federal standard or interstate agreements which provide clarity about responsibility, 

children in these situations do not have access to investigations or assessment that 

will evaluate the need for protection. 

Interstate compacts have been developed in other areas of child welfare such as 

foster care and adoption, which clarify responsibilities among the states when a 

child moves beyond the original jurisdiction. 

Recommendation: Using the authority of CAPTA, the federal government work 

with the states to develop clear guidelines that establish responsibility for investigation of allegations of child maltreatment in instances when the location of the abuse, 

the location of the victim and the location of the perpetrator involve more than one 

state. 

Issue #3: Supervisory Support for Frontline Workers 

Frontline workers go out into communities every day and confront families and 

children where sexual and physical abuse and neglect are suspected. We expect 

workers to be fair and engage families who did not invite them into their lives and 

are understandably angry and defensive. Every day workers have to look at the consequences of maltreatment on children including physical injury; sexual trauma; the 

sadness, depression and anger. 

Workers are asked to deal with trauma, conflict and hostility repeatedly in the 

course of their work. The work is stressful and over time can lead to secondary trauma and burnout and reduce effectiveness. In order to be productive and objective, 
16 

frontline workers need to have supervision that focuses not only on the work tasks 

and decision making, but also on the impact of repeated stress on their performance. 

Key to providing this kind of support and guidance are supervisors. Most supervisors are good at managing the flow of work but not as skilled at managing the 

emotional aspects and it impact on performance. 

There is general recognition that the work force needs to be supported and 

strengthened. One way to do this is to assist supervisors in developing the skills 

needed to assess and assist staff in dealing with the emotional impact of their work 

so that they can continue to work effectively. 

Recommendation: Provide training and technical assistance resources that focus 

on the role of the supervisor in managing not only the administrative and practice 

requirement of the work, but also the soci-emotional aspects of the work. 

Issue # 4: Partnership with communities 

Finally, the prevention of child abuse and neglect cannot be done by agencies 

alone. In the communities where children experience the greatest risk, there is a 

need for both agency and community leadership and residents to address the problem. We need to begin to change the cultural attitudes that make it easy to victimize children. This will require partnerships that extend beyond the usual collaborators. We need to develop strategies for child protection that focus on neighborhoods; and include decentralized services and the inclusion of neighbors, community 

institutions, faith-based organization and community leaders in the discussions 

about improving the safety and well being of children. 

In the past, child protective services have operated with little interaction with 

residents. The work has been invisible except when children disappeared from the 

community or a tragedy occurred. We have come to recognize that how children are 

valued and cared for is more influenced by the attitudes of the community than the 

state or local government. When communities are provided data and information on 

the status of children, they mobilize to act and bring about change. In communities 

that have built partnerships with residents, there is a real interest in the conditions 

of children and leadership develops which offers new ideas and underscores the importance of raising children well. Houston, Texas has used this approach to deal 

with child safety and disparities in the child welfare system. We need to continue 

to expand and test this approach. 

Recommendation: Establish demonstration grants to support neighborhood partnerships based on shared responsibility for child protection. These grants will be 

used for the purpose of adapting current approaches to new communities and evaluating the impact in order to better document and understand this approach. 

Madam Chairwoman, Thank you again for the opportunity to address this Committee. 

Chairwoman MCCARTHY. Thank you. 

Ms. Kaplan. 

STATEMENT OF CAREN KAPLAN, MSW, DIRECTOR OF CHILD 

PROTECTION REFORM, AMERICAN HUMANE ASSOCIATION 

Ms. KAPLAN. Good morning. Chairwoman McCarthy, Ranking 

Member Platts and members of the subcommittee, my name is 

Caren Kaplan, Director of Child Protection Reform at American 

Humane. I am honored to provide comments on the reauthorization 

of the Child Abuse Prevention and Treatment Act, and thank the 

chairwoman, ranking member, and subcommittee members for the 

invitation to do so. 

American Humane is a national, nonpartisan membership organization that was founded 132 years ago to protect the welfare of 

children and animals. Our testimony reflects over a century of progressively advocating at the Federal, State, and local levels for 

laws that protect both children and animals from abuse and neglect. 

In 1974, Congress passed what was and still remains the preeminent Federal legislation addressing child 
17 

maltreatment. Throughout the United States, a primary responsibility of child protection agencies is to receive and respond to all 

reports of alleged child abuse and neglect. Historically, there has 

been one response by the Child Protection Agency to accepted reports: An investigation. 

Given that the majority of families who come to the agency’s attention are at low or moderate risk of 

maltreatment and are not experiencing immediate safety issues, 

a trend has emerged since 1993 among child welfare agencies to respond to these families differentially—in a way that is much more 

responsive to the needs they present. 

Differential response—I will also refer to it as DR—is based on 

several foundational tenets. Families are not all the same and the 

severity of the family situation is not identical across families who 

come to the attention of the agency. It is important to be responsive to the specific differences. 

Another foundational tenet of differential response is based on 

the fact that the child welfare data nationally collected annually indicate that many families receive no post-investigation services. 

After being identified and labeled as child abusers, these families 

refuse services and the case is closed. 

A significant proportion of these families will return to the agency, as there is no intervention to the immediate difficulties they 

have. Some will eventually be involved in the court, and they will 

be ordered to comply with court decisions. Thus, our historical approach with these families has been to produce incentives to meet 

an obligation instead of promoting cooperation and motivating families to change, which is the aim of differential response. 

Differential response emphasizes the value of child and family 

assessments without a determination that 

maltreatment has occurred. It allows for access for available resources and services rather than solely investigating the occurrence 

of maltreatment. Services are provided to families without labeling 

a perpetrator, a victim, and without listing anyone in the central 

registry. 

Thirty-eight percent of victims, or over 300,000 children nationwide, received no post-investigative services. This was data from 

2007. In States that have mature differential response practices, 

much like Minnesota—my colleague, Rob Sawyer will speak to 

this—between 60 and 80 percent of the families screened by the 

county child welfare agencies receive this family assessment response. And that is the name used in Minnesota to refer to their 

differential response system. 

Families who come to the attention of the CPS agency because 

the child has poor hygiene is inadequately supervised, harshly disciplined, are examples of families that can receive a non-investigation response. Families who come to the attention of the CPS agency because the child has been sexually abused will receive an investigatory response. 

The likelihood of any criminal activity requiring involvement of 

law enforcement is not considered appropriate for differential response. Families for which there is substance abuse or domestic violence or family violence of any kind may receive one or the other 
18 

response, depending on the specific situation and the characteristics of the family. 

Differential response has been implemented Statewide and in selected jurisdictions in 20 States nationwide. The number continues 

to grow. Although research is in its infancy, random assignment 

design studies, a rigor that is not common in the child welfare system, show the following positive results: Child safety is not compromised. In some instances, safety is achieved sooner. Repeat 

cases of abuse and neglect decrease. There are higher rates of family cooperation and participation. There are lower placement rates 

in foster care. The costs to the system are reduced over time. And 

there is increased satisfaction both by the workforce and the families that are participating in a differential response system. 

On behalf of American Humane, I respectfully request that the 

subcommittee entertain four recommendations: Support the efforts 

of State, local, and tribal child welfare agencies to provide differential responses to individual families who come to the attention of 

the Child Protection Agency. Many families, through no fault of 

their own, lack the personal history, know-how, and resources to 

protect their children from harm or risk of harm. Differential response systems allow for and promote the use of interventions that 

do not alienate nor demonize parents, but rather engage parents in 

addressing the needs so they can successfully and safely parent 

their child. 

Support flexibility to front load the system. The current Federal 

child welfare funding streams provide incentives to place children 

outside their home. The primary way to prevent removal of children from their families’ origin is to invest resources, whether they 

be staff time in an intervention, concrete and therapeutic services, 

and formal and informal supports, at the beginning of families’ involvement with the Child Protection System. 

The identification of service needs in a differential response begins at the first contact with the family, without delaying the availability of service provision until an investigation or any other agency procedures are completed. To the extent possible, encourage 

modifications in the State Automated Child Welfare Information 

System, better known as SACWIS, that allows recapturing the data 

of those children who are part of a differential response. 

With the implementation of differential response, the current 

child welfare data systems require modification in order to collect 

and produce quality data so that we can understand and assess 

what is happening with these families. 

While we understand that appropriated levels of funding do not 

come out of this committee, it is significant to note that, as I said 

previously, 300,000 children identified as victims of maltreatment 

receive no post-investigative services. Therefore, we request your 

support for the increase of allocations. 

American Humane hopes this CAPTA reauthorization serves as 

a foundation and impetus for the reduction of children who experience abuse and neglect and an increase in the number of families 

who have sufficient strengths, capacity, and supports to keep children safe from harm. 

Thank you. 

[The statement of Ms. Kaplan follows:] 
19 

Prepared Statement of Caren Kaplan, MSW, Director of Child Protection 

Reform, American Humane Association 

Chairwoman McCarthy, Ranking Member Platts and Members of the Subcommittee, 

My name is Caren Kaplan and I am the Director of Child Protection Reform at 

American Humane. I am honored to provide comments on the Reauthorization of 

the Child Abuse Prevention and Treatment Act (CAPTA) and thank Chairwoman 

McCarthy, Ranking Member Platts and the members of this Subcommittee for the 

invitation to do so. 

American Humane, a national, nonpartisan membership organization, was founded 132 years ago to protect the welfare of children and animals. Our testimony 

today reflects over a century of history progressively advocating at the federal, state 

and local levels for laws that protect children and animals from abuse and neglect. 

In 1974, Congress passed what was, and still remains, the preeminent federal legislation addressing child abuse and neglect. This landmark legislation sets forth a 

minimum definition of child abuse and neglect and authorizes federal funding to 

states in support of prevention, identification, assessment, investigation, and treatment activities. 

Through its provisions—the Basic State Grants, the Community Based Prevention 

Grants and the Research and Demonstration Grants, CAPTA provides state, local, 

and tribal public child welfare agencies with a foundation for quality child protective 

services, enhancements of the formal and informal preventive, community based 

services, the opportunity for systemic and practice improvements, and expansion of 

our understanding and knowledge that will guide our state statutes, policies, practices and customs. This is the essence of CAPTA and the promise of our nation’s 

ability to keep children safe and families together. 

Improving the child protection system 

The first goal of any child protection system response is to keep children safe from 

harm. In fiscal year 2007, an estimated 3.2 million referrals, involving the alleged 

maltreatment of approximately 5.8 million children, were made to Child Protective 

Services (CPS) agencies [US HHS, 2009]. An estimated 1.86 million children received an investigation or assessment. In 2007, an estimated 792,000 children were 

determined to be victims of abuse or neglect. Of the 792,000 victims, 38% of the victims (300,960 children) received no post investigation services. 

American Humane has dedicated the past several years to the successful launch 

of large-scale initiatives that advance our nation’s child welfare system in order to 

effectively protect children and support families. I would like to detail several of 

these issues and opportunities to be responsive through the reauthorization of 

CAPTA. 

Differential response systems 

American Humane advocates for the implementation of Differential Response Systems in Child Welfare as an effective way to respond to reports of abuse and neglect. Differential response also referred to as ‘‘dual track,’’ ‘‘multiple track,’’ or ‘‘alternative response’’ and ‘‘family assessment’’, encourages families to recognize their 

own needs and seek services to enhance parenting skills, mental health concerns, 

substance abuse issues, work/day care issues and/or other distinct needs of each 

family. Differential response encourages family participation in agency and community based services. By alleviating the concerns raised without a formal determination or substantiation of child abuse and neglect, these ‘alternatives’ to traditional 

child protection investigative response achieve or maintain child safety through family engagement and collaborative partnerships. 

Historically, there has been one response by the child protection agency to accepted reports of alleged maltreatment—an investigation. Given that the majority of 

families that come to the attention of the child protection agency are deemed to 

present low or moderate risk of maltreatment, and are not experiencing immediate 

child safety issues, there has been a developing trend for the past 15 years to respond to these families differentially in a manner that supports families. 

Differential Response is based on several foundational tenets. Families are not all 

the same—and in particular the severity of the family situation is not identical 

across families who come to the attention of the child protection agency and therefore, it is important to be responsive to the differences among the families that come 

to the attention of the child protection agency. Another foundational tenet of Differential Response is based on the notion that over the many years in which we 

have collected data—the 2009 report of the Children’s Bureau on Child Maltreatment that examines 2007 data and is the 18th issuance of this official report—many 

families (38% of victims in 2007) received no post-investigation services. After being 
20 

identified and labeled as ‘child abusers’, these families refuse services and the case 

is closed. A significant proportion of these families will return to the CPS agency 

as there was no intervention to remediate their difficulties. Some will eventually require juvenile or family court involvement and they will be ordered to comply with 

court decisions. Thus, our historical approach with these families has produced incentives to ‘meet an obligation’ and resist anything that resembles comparable interference and enforcement instead of breeding the cooperation and motivation of families to change—which is the aim of Differential Response systems. 

Differential Response Systems is an approach that allows CPS to respond differently to accepted reports of child abuse and neglect. It emphasizes the value of 

the assessment of the child and his/her family without requiring a determination 

that maltreatment has occurred or that the child is at risk of maltreatment [U.S. 

Department of Health and Human Services, 2003]. It allows for access to available 

resources and services rather than solely investigating the occurrence of maltreatment. Services may be provided to families without a formal determination of abuse 

or neglect or labeling someone as a perpetrator and listing them in the state’s central child abuse registry. [CWLA, 2005]. It is accompanied by greater efforts to identify, build, and coordinate formal and informal services and supports that respond 

to the families self-identified needs. 

Differential Response is typically used with reports that do not allege serious and 

imminent harm. Factors such as the type and severity of the alleged maltreatment, 

the number of previous reports, the source of the report, and the willingness of the 

parents to participate in services determine the appropriateness of this response 

and suggest a non-adversarial, cooperative approach to meet each family’s unique 

needs. By providing interventions that correspond to the severity of the concern 

being reported, Differential Response results in appropriate services to resolve the 

family issues thereby easing the cause or likely reoccurrence of the original concern. 

Differential Response has been implemented, either statewide or in selected jurisdictions in almost twenty states and this number is rapidly expanding. As Differential Response systems evolve, child welfare systems are incorporating a third pathway to respond to the families whose reports do not meet the statutory threshold 

of alleged abuse and neglect. 

Although research is in its infancy, random assignment design studies involving 

control and experimental groups have indicated the following positive results: 

• Child safety is not compromised and in some instances attained sooner 

• Fewer repeat cases of abuse and neglect 

• Higher rates of family cooperation and participation 

• Increase and changes in service provision; greater focus on basic needs and economic hardship 

• Lower placement rates of children in foster care 

• Reduced costs over time 

• Increased satisfaction, both by families involved with the child welfare system 

and child welfare workers 

• Community stakeholders preferred the dual-response approach 

Opportunities for the reauthorization of CAPTA 

• Support the efforts of states, local and tribal child welfare agencies to provide 

Differential Responses to individual families who come to the attention of the child 

protection agency. The preponderance of families is not individuals who have committed egregious harm to their children. Many, through no fault of their own, lack 

the personal history, know-how and resources to protect their children from harm 

or the risk of harm. Differential Response systems allow for and promote the use 

of interventions that do not alienate or demonize parents but rather engage the parent in addressing their needs so they can successfully and safely parent their children. 

• To the extent possible, encourage modifications in State Automated Child Welfare Information System in Differential Response jurisdictions that allow for capturing the expanded child protection responses. Recognize that with the implementation of Differential Response, the current child welfare data systems require modifications in order to collect and produce quality data to better understand and assess these reforms. Without essential modifications, workers may be entering case 

data in an automated system and documenting by hand the data of other cases. 

This dual approach is ripe for errors and should be eliminated. 

• Support flexibility to ‘front load’ the system. The current federal child welfare 

funding streams, such as Title IV-E, provide incentives to use of out of home placement. It is important to recognize that the primary way to prevent removal of children from their families of origin is to invest resources—whether they be staff time 

and intervention, concrete and therapeutic services, and/or formal and informal sup-
21 

ports—at the beginning of the families’ involvement with the child protection system. • While we understand the appropriated levels of funding do not come out of this 

committee, it is significant to note when discussing levels of funding with your colleagues, that 300,960 children identified as victims of maltreatment received no 

post-investigative services. Therefore, we request your support for the increase in 

allocations. Greater balance is needed in the investments in child maltreatment prevention, identification and early protective interventions compared to investments 

in interventions after a child has been separated from his/her family. • Title I of CAPTA authorizes grants to states to help improve their child protective service systems. Within the eligibility requirements, there is opportunity to encourage states to develop and implement Differential Response to families who come 

to the attention of the child protection system. • Title II of CAPTA authorizes grants to states to develop community based prevention services including home visitation, parent education, and respite care. Since 

the intent is to develop a continuum of preventive services for children and families 

through State and community-based collaborations and partnerships, statutory language can promote the development of community response pathways—a third response to families—established by State and local public child welfare agencies. • In CAPTA’s Research and Demonstration Activities, there is an opportunity to 

build the knowledge and evidence on the multitude of Differential Response approaches that are currently being planned and/or implemented across the nation. 

Family involvement and leadership 

American Humane strongly advocates for the widespread integration of family involvement and leadership models committed to institutionalizing fair and transparent planning and decision making processes that recognize and build on the protective capacities of the family group and provides them with opportunities to reclaim their roles and responsibilities as decision makers about their children. 

In the past 10 years, public child welfare and community-based organizations 

have been implementing numerous family involvement and leadership models as a 

way to provide inclusive and culturally-respectful processes when critical safety and 

permanency decisions are being made about children. Family group involvement 

and leadership models are based on a commitment to ensuring that children’s rights 

to the resources of their families and communities are honored, respected, and actively cultivated, especially when children and their families are involved with formal systems, in particular child welfare. They recognize the inherent right of children and families to be connected. These models are grounded in the belief that children are best protected within the context of their families and that the family 

group has the right to be active partners in making decisions about their children’s 

safety, permanency and well-being. These models also provide a family perspective 

for understanding and responding to the unique developmental needs of children 

and their family. Family Group Decision Making offers communities an evidencebased approach to reach the goals of positioning families as drivers of services, creating individualized, family-driven service plans, promoting cultural and linguistic 

competence and building partnerships among systems. 

Opportunities for CAPTA reauthorization 

• The State Grant eligibility requirements provide an opportunity to advance the 

involvement and leadership of families as a principle practice of quality child protection. 

Chronic neglect 

American Humane advocates for the building of knowledge, policy, prevention and 

intervention practices that address the unique safety and protection needs of children who are chronically neglected by their families. Through the identification and 

monitoring of specialized child protection practices nationwide, the development of 

best practice guidance, and the creation of strategic alliances with traditional and 

non-traditional partners, comprehensive, community-based approaches can prevent 

neglect and the recurrence of neglect, reduce the risks of chronicity, support and 

strengthen families in which neglect occurs, and facilitate system change that is 

more responsive to, and effective with, families that chronically neglect their children. 

‘‘Chronic child neglect’’ refers to the ongoing, serious pattern of deprivation of a 

child’s basic physical, developmental and/or emotional needs by a parent or caregiver. While definitions of chronic child neglect and the implementation of these 

definitions, vary by state, county and local child welfare systems, several dimensions 

include the duration of neglect, the time period covered by multiple Child Protective 

Services reports, the number of reports (not just substantiations), the referral for 
22 

multiple types of maltreatment, the documentation of non-adherence in medical or 

school records, and the child’s developmental indicators. 

While the lack of definitional clarity and the use of various dimensions to identify 

chronic neglect compromise a shared understanding, the system’s inability to reach 

these families and impact the well-being of their children is a fundamental gap. Prerequisites for success include: Differential assessment; skilled staff; manageable 

workloads; service array; and long term intervention. 

For more than a decade, state reports to the National Child Abuse and Neglect 

Data System have indicated that more than half of all child victims in the United 

States suffered neglect. 

Given the enduring prevalence of neglect in child maltreatment cases, there has 

been a long-standing need to focus on prevention, assessment, treatment and interventions targeting neglect in child welfare. According to the National Incidence 

Study-3 (1996), children from families with incomes less than $15,000/year were 44 

times more likely to be victims of neglect compared to children from families with 

incomes greater than $30,000/year. 

Although a growing body of literature illustrates some evidence-based best practices for decreasing neglect, such limited endeavors fall short of the comprehensive 

and integrated approach that is essential to command the visibility, political will 

and system reform to improve the safety, permanency and well-being of families in 

which neglect occurs. With few notable exceptions, advancements in the specialized 

practice and research of neglect are in their infancy. The magnitude of this need 

increases exponentially when addressing the chronicity of neglect. 

The enormous human toll is compounded by the significant economic toll, as resources are disproportionately devoted to families that chronically neglect their children. Costs associated with these families have been determined to be seven times 

that of other families that neglect their children [Loman & Siegel, 2004]. There is 

an undeniable need for more sustained and broad-ranging approaches to families 

that go beyond immediate safety issues, as well as more relevant literature and research to provide a base of knowledge that informs our practices and policies. 

Opportunities for the reauthorization of CAPTA 

• An increasing number of states are struggling to confront the insidious nature 

of chronic neglect. The federal government can provide leadership and guidance to 

states in the CAPTA reauthorization by providing a clear definition of chronicity or 

chronic neglect. • While there has been a significant amount of work on neglect at the federal 

level, there are insufficient connections between federal efforts and what happens 

on the ground at the state and local levels. There is an opportunity in CAPTA’s Research and Demonstration Activities to enhance the connections between research 

and practice; target the efforts on chronicity; and assure broader dissemination of 

that which is known and that which is a promising practice. 

The link between child and animal maltreatment 

American Humane actively addresses the internationally recognized link between 

animal abuse and family violence. Through its campaigns against violence, American Humane is a leader in raising public awareness, advocating for stronger legislative initiatives, and providing tools for decision makers, social service providers, animal care and control professionals, veterinarians, parents, and other concerned citizens to recognize problems and take appropriate steps to end abuse and protect its 

both human and non-human victims. 

Child and animal protection professionals have recognized this link and cycle of 

violence between the abuse of both children and animals. This Link also expands 

to violence against women by domestic partners and violence to elders in the home. 

One of the first research studies to address the link found that 88% of 57 families 

being treated for incidents of child maltreatment also abused animals in the home. 

(Deviney, Dickhert, and Lockwood, 1983). And a 1997 survey of 50 of the largest 

shelters for battered women in the United States found that 85% of women and 63% 

of children entering shelters discussed incidents of pet abuse in the family. [Ascione, 

F. R. 1997] 

When animals in a home are abused or neglected, it is a warning sign that others 

in the household may not be safe. In addition, children who witness animal abuse 

are three times more likely of becoming aggressive or abusive. (Currie, C.L., 2006,). 

Opportunities for the reauthorization of CAPTA 

• In detailing the comprehensive approach required to address child abuse and 

neglect, Title I should acknowledge the vital partnership between animal welfare 

agencies and child protection agencies. Much like the recognition of the relationships between and among domestic violence, mental illness, substance abuse and 
23 

child maltreatment, CAPTA should include language that supports and enhances 

interagency collaboration between the child protection system and animal welfare 

agencies in identifying child abuse and neglect. 

• In order to diminish both the initial occurrence of maltreatment and subsequent 

recurrence, it is essential to engage families and provide effective, responsive services before their challenges become severe and the risks of maltreatment expand 

and/or escalate. 

Conclusion 

The first goal of any child protection system response is to keep children safe from 

harm. American Humane hopes this CAPTA reauthorization serves as a foundation 

and impetus for the reduction of children who experience abuse and/or neglect and 

an increase in the number of families who have sufficient strengths, capacity, and 

supports to keep their children safe from harm. 

As a longstanding member of the National Child Abuse Coalition (NCAC), an alliance of over 30 organizations committed to strengthening the federal response to the 

protection of children and the prevention child abuse and neglect, American Humane lends its enthusiastic support to NCAC’s recommendations for the reauthorization of CAPTA. NCAC’s testimony has been provided to the Subcommittee in 

writing. 

American Humane appreciates the opportunity to offer our testimony and comments to the Subcommittee in regard to the reauthorization of the Child Abuse Prevention and Treatment Act. Given that CAPTA is the preeminent federal legislation 

addressing child abuse and neglect and expires this year, it is our hope that its reauthorization is given the highest priority and completed before the 111th Congress 

ends. As this legislation progresses, we look forward to a continued dialogue with 

Chairman McCarthy, Ranking Member Platts, Members of the Subcommittee and 

the entire Congress. 

Chairwoman MCCARTHY. Thank you, Ms. Kaplan. 

Sandra. 

STATEMENT OF SANDRA OLIVA, EXECUTIVE DIRECTOR, NASSAU COUNTY COALITION AGAINST DOMESTIC VIOLENCE, 

INC. 

Ms. OLIVA. Thank you, Chairwoman McCarthy and the distinguished members of the committee, for the opportunity to testify 

about the Family Violence Prevention and Services Act, known as 

FVPSA. I am Sandy Oliva. I am the Executive Director of the Nassau County Coalition Against Domestic Violence, a full-service domestic violence and rape crisis agency serving all of Nassau County, New York. 

I have been in that role for 25 years, but I come here today not 

to speak for my agency but to speak on behalf of all of my colleagues across the country and of course all of the survivors whom 

we serve. 

I am testifying to support the FVPSA’s swift reauthorization. It 

expired in 2008. So swiftness is important. 

FVPSA is the only Federal funding dedicated to domestic violence shelters and services, and for 25 years it has been the lifeblood of programs that are at the heart of our Nation’s effort to 

prevent and end domestic violence. With 1.5 million American 

women and some 800,000 men physically abused by their spouses 

or partners, 15.5 million children exposed to that violence annually, 

and an average of three women a day being murdered by former 

or current partners, it is clear that the work is essential. 

While FVPSA-funded domestic violence programs have saved and 

transformed millions of lives, great needs remain. As the economic 

crisis that we are in further widens, the gap between the growing 
24 

demand and available resources, it is more important than it ever 

was before to invest in these cost saving programs so that advocates across the Nation are supporting the FVPSA reauthorization 

bill that will allow us to continue to provide these vital services 

and build upon our strengths to improve and expand services. 

Let me tell you about a couple of the people that we have served 

and their families. First, Anita. My agency helped her. She had 

been in a very long-term abusive, terribly violent marriage, and 

one night her husband told her, It’s time for couples therapy, we 

are going together; put her in the car, but took her to a remote 

area and shot her, left her for dead. Fortunately, she was found 

and rushed to the hospital. The hospital knew to call our 

hotline and one of our advocates went to her side. 

Eventually, she came into our safe home, where she was reunited 

with her terrified young daughter and was able to heal from her 

physical injuries and begin to plan for her future. Now she is living 

in a safe location, one of our transitional homes, and has moved 

from crisis to stability. There is a woman who was left for dead and 

got a new chance at life with her child. 

There are approximately 1,400 FVPSA-funded programs like 

ours across the Nation. In 2007 and 2008, these programs sheltered 

almost 600,000 adults and children. Last year, my agency served 

over 3,000 individuals, adults and children, and answered over 

6,000 hotline calls. 

Domestic violence programs across the country are available 24/ 

7 and respond to both the immediate crisis needs of victims in danger and their longer term needs to become safe and self-sufficient. 

And for almost every story like Anita’s, there is a gut-wrenching 

story of a victim who cannot receive lifesaving services because programs simply don’t have the resources. 

According to Domestic Violence Counts 2008, on just one day in 

2008, while over 60,000 victims were served by DV programs, almost 9,000 requests for services went unmet because programs 

lacked adequate resources to serve them. So I strongly support the 

recommendation to increase the funding authorization level at 

FVPSA to meet the needs of all victims. 

Another one of our clients, I will call her Mary, she came to her 

safe home with her five children after her 2-month old baby was 

released from the hospital with 16 broken bones. The abuser, who 

had been violent with every member of that family for years, 

threatened to kill them all if she ever told anyone about the abuse 

that had been going on. 

She was at the shelter for a while, received individualized counseling, case management, advocacy, legal services from our agency, 

and the children had to have a great deal of therapy as well. But 

now this once victimized, terrified, and tormented family is thriving in a safe environment with the tools they need to rebuild their 

lives. 

Excitingly, I am thrilled to be able to say, especially in this company, that we, our domestic violence agency, is about to collocate 

with the local Coalition Against Child Abuse and Neglect so that 

both of our agencies can work with families like Mary’s in an efficient and effective way. And we are very excited about the colloca-
25 

tion and the collaborative effort, which we hope will be a model 

across the country. 

We support the recommendation to include a funding 

set-aside for specialized services for abused children and their 

parents in the FVPSA reauthorization so that programs have the 

resources to provide age-appropriate services to children in a supportive environment for the nonabusive parent and break the cycle 

of violence. You cannot have safe children if you don’t have safe 

parents. 

To successfully meet the needs of all victims, programs must be 

able to target resources, and the FVPSA statute must be reflective 

of all victims needs. Throughout FVPSA the language should be 

more inclusive of children and youth, as well as victims from underserved populations. 

State plans to distribute FVPSA funding should reflect steps 

taken to meet the needs of all victims, including those who are 

marginalized. Specifically, we recommend that it include appropriate definitions of domestic violence, dating violence, and youth, 

to ensure that victims, regardless of age, can receive vital tailored 

services. We also recommend enhanced and improved targeted resources for culturally specific programs and services so that all victims can be safe. 

Finally, the DELTA grants, prevention grants, are a key component of FVPSA reauthorization. They help communities and States 

make strides toward preventing domestic 

violence, and we think prevention is probably the most important 

thing that can happen. They do this by changing the community 

and personal attitudes about relationships and abuse. Therefore, 

we strongly support the recommendation to enhance and expand 

DELTA. 

To sum up, in the words of one little boy, when asked what he 

liked about the shelter that he and his mom had been in in Maryland, he responded, Well, I can sleep at night now. 

All victims and their children deserve to be able to sleep at night 

and feel safe. To move closer to achieving this goal, we urge the 

committee to prioritize the swift reauthorization of FVPSA, inconclusive of the recommendations with an adequate funding level. 

Thank you very much. 

[The statement of Ms. Oliva follows:] 

Prepared Statement of Sandra Oliva, Executive Director, Nassau County 

Coalition Against Domestic Violence 

Chairwoman McCarthy, Ranking Member Platts, Chairman Miller, Ranking 

Member Kline and distinguished members of the Committee, my name is Sandra 

Oliva and I thank you for the opportunity to appear before the Subcommittee to discuss the importance of swiftly reauthorizing the Family Violence Prevention and 

Services Act (FVPSA). As an advocate for victims of domestic violence, I am honored 

to address Representatives who have demonstrated phenomenal leadership on behalf of victims. I thank Representative McCarthy for inviting me to testify and want 

to report that victims in New York’s 4th district are proud of your brave and tireless 

efforts to enact sensible firearms legislation that is so important to domestic violence victims, who are at extreme risk when perpetrators have and use guns against 

them. 

I am Sandra Oliva, Executive Director of the Nassau County Coalition Against 

Domestic Violence (NCCADV). I have served in the role of director for almost 25 

years. NCCADV, founded in 1977, serves all of Nassau County, which with over 1.3 

million inhabitants, is the most heavily populated suburban area in the country. I 
26 

am a member and former Board Member of the New York State Coalition Against 

Domestic Violence and, in turn, I work in partnership with the National Network 

to End Domestic Violence (NNEDV) and the National Coalition Against Domestic 

Violence (NCADV). Having been a part of the movement to end violence against 

women for almost 30 years, I hope to speak on behalf of my colleagues across the 

country and, of course, on behalf of the survivors that we serve. 

I am testifying to support the swift reauthorization of the Family Violence Prevention and Services Act (FVPSA), which expired in 2008. First authorized in 1984, 

FVPSA is the only federal funding dedicated to domestic violence shelters and services and has been the lifeblood of programs that have been preventing and ending 

domestic violence for 25 years. While FVPSA has helped programs save and transform countless lives, significant needs remain. A FVPSA reauthorization bill should 

build on FVPSA’s successes while improving to meet the complex and diverse needs 

of all victims of domestic violence. FVPSA’s swift reauthorization, with key improvements and adequate funding allocation, will ensure that victims across the country 

have continued access to services that save lives. 

Domestic Violence—Across the nation and in Nassau County 

When I began working in this field, much less was known about domestic violence 

and few resources existed to help victims as they endured life-threatening violence. 

While we now know more about domestic violence and our society has acknowledged 

it as a crime, domestic violence is still widely underreported. The statistics are 

alarming. Annually, approximately 1.5 million American women and 800,000 men 

are physically abused by their spouses or partners1 and 15.5 million children are 

exposed to this violence.2

Estimates based on population reveal that there are likely 100,000 women currently at risk of domestic violence in Nassau County alone.3

Domestic violence is serious, degrading and life-threatening. Domestic violence 

and dating violence includes threats, coercion, and physical and sexual assaults 

against a current or former intimate partner. All too often domestic violence ends 

in death. In 2005 alone, 1,181 women were murdered by an intimate partner in the 

United States4—an average of 3 women a day. In Nassau County, in 2008 and 2009, 

16 adults and children lost their lives in domestic violence homicides. The numbers 

across the country seem to indicate an upward trend of senseless loss of life as a 

result of domestic violence. For example, advocates from STAND! Against Domestic 

Violence in Concord, California, are shocked and appalled by the level of violence 

they have seen this year—domestic violence homicides have claimed the lives of 10 

adults and children in 2009. Last year, in York County Pennsylvania, 10 individuals 

were murdered in domestic violence-related incidents and in Minnesota 35 people 

lost their lives in domestic violence homicides. 

Domestic violence is more than a crime—it is a public health crisis. Such violence 

and trauma have immediate and long-term costs on our communities through lost 

productivity, medical and health related costs and law enforcement and court interventions. The Academy on Violence and Abuse estimates the cost of abuse to the 

healthcare system alone to be between $333 billion and $750 billion.5 Many social 

ills ravaging our country are connected to domestic violence, and as the cycle of violence is perpetuated through children who witness the violence, these costs continue 

to multiply. 

The Legacy of FVPSA—Sustaining lifesaving services 

Although the incidence, prevalence and severity statistics paint a grim picture, 

there is hope for victims and for a world free from domestic violence. For many victims, this hope starts with the help of a trusted advocate from a local domestic violence organization. These vital organizations, which are at the heart of our nation’s 

response to domestic violence, are sustained by the dedication of the staff, volunteers and community and the consistent funding provided by FVPSA. 

NCCADV, along with approximately 1,500 domestic violence shelters and programs across the country, has been sustained by the funding and support provided 

by FVPSA, specifically through the state formula grants. Since FVPSA first passed 

in 1984, it has provided a stable, modest funding source to ensure that our lights 

would be on and that someone was there to answer crisis calls in the middle of the 

night. NCCADV, like most domestic violence programs, provides lifesaving services 

that have evolved to meet both the immediate crisis needs of victims in danger and 

their longer-terms needs to become safe and self-sufficient. We offer comprehensive 

services to help victims rebuild their shattered lives, including emergency safe housing/shelter, 24-hour hotlines, counseling, transitional housing, legal and education 

services, and systems and legislative. Domestic Violence Counts 2008, a 24-hour 

census of domestic violence shelters and services conducted by the National Network 
27 

to End Domestic Violence (NNEDV) across the nation reveals that NCCADV’s services are typical of those provided to victims in almost every community. The consistency and flexibility of FVPSA funding make this modest funding stream far more 

valuable than some of NCCADV’s larger funding sources. Because it is unrestricted 

funding, it is used by many domestic violence agencies to fill gaps in funding and 

sustains agencies that literally save lives. 

The scope of FVPSA-funded services is remarkable. In fiscal years 2007 and 2008, 

FVPSA-funded programs sheltered 593,597 adults and children in crisis in America. 

In Nassau County, we provided 22,836 services to 3,217 adult and child victims of 

domestic violence and answered 6,116 hotline calls. To date, NCCADV has responded to more than 188,000 domestic violence hotline calls and has conducted 

over 23,130 intake interviews with victims. Over 2,740 women and children fleeing 

from violent homes have turned to NCCADV’s shelter, the Safe Home for Abused 

Families (SHAF), since it first opened in 1981. We have provided advocacy in more 

than 20,000 court proceedings. Of course, NCCADV is just one program of 1,500. 

We are heartened to know that millions of lives have been touched by FVPSA-funded services since 1984. 

The number of services provided, however, would have no relevance if we weren’t 

highly confident in their efficacy and their transformative impact on people’s lives. 

Our confidence in our services was affirmed in a recently released multi-state study 

which shows conclusively that the nation’s domestic violence shelters are addressing 

both urgent and long-term needs of victims of violence and are helping victims protect themselves and their children.6

Of course, the strongest testament to our work is in the stories of survivors saved 

by our programs. Recently NCCADV helped ‘‘Anita’’, who was in a violent and abusive marriage. One night, her husband told her he was driving them to marriage 

counseling but instead he drove to a remote area. There, he shot her and left her 

for dead. Fortunately, a jogger found her and she was rushed to the hospital. The 

NCCADV hotline was contacted and one of our hospital advocates was soon by her 

side. Our advocates helped her enter the Safe Home upon her release from the hospital. She was reunited with her terrified young daughter who was picked up by 

relatives. Her husband had disappeared and has still eluded capture. At NCCADV, 

Anita was able to heal from her physical injuries and begin to plan for her future. 

With the help of our counselors, she and her child built their strength. We assisted 

them in relocating to a safe location. NCCADV helped her from crisis to stability— 

a woman who was left for dead, has a new chance at life. Stories like Anita’s happen 

every day at programs all over the country. In fact, according to NNEDV’s national 

Domestic Violence Counts 2008, in one day:7

• Advocates in Pennsylvania helped a woman obtain a 3-year protection order 

after her abuser held her at knifepoint for a day, broke her ribs and blackened her 

eye. 

• A father in Illinois turned to a local program to help him obtain a protection 

order for his daughter who was critically injured by her boyfriend. 

• An Arkansas woman found safety in an emergency shelter after her abuser 

threatened to shoot her in the head and attach her protection order to the hole in 

her head. 

In addition, the benefits of FVPSA expand beyond the local work of agencies 

meeting the immediate and long-term needs of victims. For instance, the New York 

State Domestic Violence Coalition (NYSCADV), along with 55 other state and territorial coalitions across the nation, use FVPSA funding to coordinate statewide efforts to end domestic violence. Through advocacy, technical assistance and training, 

NYSCADV helps NCCADV and all service providers and victims in New York State. 

Millions of lives have been saved and transformed in this country, from Anchorage, AK to Portland, ME and everywhere in between, because of the commitment 

of advocates and the Congressional and Executive leadership that have supported 

FVPSA. Therefore, advocates across the nation support a FVPSA reauthorization 

that will not only allow us to continue to provide these vital services but that will 

also allow us to build upon our strengths to improve and expand services. The recommendations included in this testimony have been developed in consultation with 

advocates and victims across the nation and we urge Congress to pass a FVPSA bill 

reflective of these priorities. The recommendations include, (1) an increased authorization level of $350 million, (2) targeted funding for specialized services for children 

and abused parents, (3) improvements to meet the complex needs of all victims, and 

(4) statutorily defining the DELTA prevention grants. 

(1) Investment in services—Increasing the funding authorization level 

FVPSA-funded programs, frankly, have had a remarkable impact despite a lack 

of adequate resources. Often operating on shoe-string budgets, domestic violence 
28 

programs and shelters use public funding in an efficient way and make the most 

of limited resources. But given the paucity of funding, domestic violence programs 

simply cannot meet the breadth and depth of demand on our services. 

Even programs like NCCADV, which is a well-established, long-standing agency 

with comprehensive services, struggle to meet all of the needs of victims who come 

forward for services. Last year, at least 25 families reached out to us for emergency 

shelter but we couldn’t provide it because the shelter was full. We, like other domestic violence agencies, always work with victims to help them find safe alternatives 

but in some instances it is just not possible. With the life-threatening nature of domestic violence, this is simply not acceptable. Across New York State and across the 

country, however, it is clear that many programs cannot meet the increasing demand for services. According to Domestic Violence Counts 2008, 58% percent of programs in New York State served over 5,300 victims on just one day. On that same 

day, however, over 930 requests for services went unmet as programs lacked the resources or space to meet the need. Nationally, while over 60,000 victims were served 

on the census day, almost 9,000 requests for services went unmet.8 In fiscal years 

2007 and 2008, over 240,000 adults and children requested emergency shelter from 

FVPSA-funded programs and were turned away due to a lack of space. For those 

individuals who were not able to find safety that day, the consequences can be extremely dire including continued exposure to life-threatening violence or homelessness in many cases. It is absolutely unconscionable that victims cannot find safety 

for themselves and their children due to a lack of adequate investment in these 

services. 

The gap between adequate resources and increasing demand widens as the economic situation worsens. A bad economy does not cause domestic violence but financial strain can certainly exacerbate violence and victims with fewer personal resources become increasingly vulnerable. Since the economic crisis began, three out 

of four domestic violence shelters have reported an increase in women seeking assistance from abuse.9 Faced with shrinking budgets and reduced donor funding, domestic violence programs simply cannot meet the needs of all of the victims who 

come forward for help. A frightening trend across the country reveals that many 

programs have had to reduce services, cut staff and, in extreme cases, some have 

had to close their doors. According to the National Center for Victims of Crime, 92% 

of victim service providers have seen an increased demand in the last year, but 84% 

reported that cutbacks in funding were directly affecting their work.10 This fall, advocates watched in horror as state budgets were balanced by cutting funding for domestic violence programs. California was the most extreme of these when the Governor completely eliminated funding for domestic violence programs earlier this 

year. While we are grateful that California State funding has now been reinstated, 

we know that many programs in California have already had to close. 

In rural, remote and impoverished communities, many programs can only provide 

the most basic services. They use their FVPSA funding to keep the lights on and 

their doors open. We cannot underestimate how important this is—victims must 

have a place to flee to when they are escaping life-threatening violence. The fact 

is that countless shelters across the country would not be able to operate without 

FVPSA funding. 

In Nassau County, we know that we could do more with more resources. We estimate that there are 100,000 victims of domestic violence in Nassau County at any 

given time. With more funding for outreach, we know that we would see an increase 

in demand for services. We know that young victims and victims from culturally 

specific communities in Nassau County, and across the nation, are often reluctant 

to come forward for services because the services are not always provided in a way 

that is culturally responsive. Undoubtedly, with more funding, organizations in Nassau County could go a long way toward bridging this gap. Many of the recommendations for FVPSA’s reauthorization will expand the reach both in breadth and depth 

of services to ensure that 1) ALL victims in crisis can receive immediate support 

and 2) that those services are tailored, targeted and comprehensive so that victims 

can rebuild their lives. 

As funding for the criminal justice response to domestic violence receives steady 

increases, more and more victims seek the critical services they need to flee violence 

and rebuild their shattered lives. While such safety net services, available 24 hours 

a day, 7 days a week, are primarily supported by FVPSA, FVPSA funding remains 

relatively stagnant. Without a matched investment in services, too many victims are 

left with nowhere to turn. For the past 25 years, FVPSA funding has allowed millions of victims to find immediate safety and move from crisis to stability. In order 

to ensure that all victims are served when they are in danger and to provide the 

comprehensive services victims need to rebuild their lives after abuse, we need to 

increase our investment in this vital funding stream. 
29 

Therefore, I strongly support the recommendation to increase the funding authorization level of FVPSA to at least double its current authorization of $175 million 

to $350 million. 

(2) Specialized Services for Children—Intervening in the cycle of violence 

‘‘Mary’’ came to the Safe Home with her five children, after her 2 month old baby 

was released from the hospital. Child Protective Services had referred her family 

to NCCADV. The baby had a broken arm and other injuries from the abuser’s violence. All the children had scars and bruises, as did Mary. The abuser threatened 

to kill her, the children and her family if she ever told anyone of the abuse. At 

NCCADV, Mary received individualized counseling, case management and advocacy 

to help her attend to the myriad of issues that arise from abuse. At the same time, 

the children began to heal through play therapy. After leaving shelter, they continued receiving counseling and are now safe as the abuser is in prison. This once victimized and tormented family is now thriving in safe a environment with the tools 

they need to rebuild their lives. 

We know that intergenerational violence is perpetuated as children witness and 

experience violence. In fact, one study found that men exposed to physical abuse, 

sexual abuse and adult domestic violence as children were almost 4 times more likely than other men to have perpetrated domestic violence as adults.11

Children who are exposed to domestic violence are more likely to exhibit behavioral and physical health problems including depression, anxiety and violence towards peers.12 They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, and perpetrate sexual assault.13

One-half to two-thirds of residents of domestic violence shelters are children, and 

FVPSA-funded services have always provided services to the children in shelter. We 

know that the most important service you can give to a child is to provide safety 

for her/his non-abusive parent so that the child and parent can heal together. Children who witness and experience domestic violence need specialized, age-appropriate services in order to fully heal and break the cycle of violence. But these services must be provided in the context of supporting the non-abusive parent and child 

together. By empowering the parent to become safe and stable, we help the child. 

To that end, I am very excited about NCCADV’s unique partnership with the local 

child abuse agency, the Coalition Against Child Abuse and Neglect. This month, we 

are moving to a shared space, where we will offer adult, youth and child victims 

enhanced, seamless services in one central location. At The Safe Place in Bethpage, 

NY, each organization will maintain its independent identity and mission while 

streamlining operations and collaborating on services provided to individuals and 

families. Through joint case management, the entire family’s issues (emergency 

housing, counseling, legal representation, and parenting skills workshops, for instance) can be addressed on an ongoing basis as they work to piece together their 

broken lives and build a safe supportive environment. 

If we had more targeted resources for specialized children’s services, NCCADV 

could easily serve twice as many children as we currently do. Such funding would 

allow programs like NCCADV to sustain and enhance the essential services provided to children and their families and would allow other domestic violence programs to develop this critical work. 

Therefore, we strongly support the recommendation to include a funding set-aside 

(25% of excess funding over appropriations of $130 million) for the Specialized Services for Abused Children and Their Parents in the FVPSA reauthorization. 

(3) Enhancing FVPSA to meet victims’ diverse and complex needs 

To successfully meet the needs of all victims, programs must be able to 

proactively target resources, and FVPSA must be reflective of all victims’ needs. 

Throughout FVPSA, the language should be more inclusive of children and youth 

as well as victims from underserved populations. The state plans that are developed 

to distribute FVPSA funding should reflect steps taken to meet the needs of all victims, including those who are marginalized. The additional recommendations outlined below will help to ensure that all victims can be served by FVSPA-funded programs. 

(A) Teen and Youth Victims 

At NCCADV, we serve victims of intimate partner violence, regardless of age and 

legal relationship to the abuser. We are also committed to reaching out to teens and 

youth, who are often very reluctant to seek services. We have one teen counselor 

and one teen educator but we desperately need additional resources to provide counseling and outreach. 
30 

Recently, NCCADV helped a 17 year-old girl whose boyfriend was extremely controlling and verbally and physically abusive. This young survivor is currently attending our teen dating violence support group, where she has begun to regain her 

strength and finds comfort and validation in the company of her peers. 

At the ACCESS-York domestic violence program in York, Pennsylvania, an 18 

year-old abused, malnourished and pregnant teen received services after being referred by a local health clinic. At ACCESS, she found transitional housing and was 

connected with community health services. With good prenatal care, she gave birth 

to a healthy baby. She completed her high school education and graduated with honors. ACCESS was able to give her the services she needed to start her adult life 

safely. 

By providing early intervention services to youth and teens victims of dating violence, we are able to help them define their relationships boundaries and distinguish between healthy and abusive behavior. NCCADV strongly believes in investing in these services, and we plan to allocate additional resources to teen services. 

It is essential that the FVPSA reauthorization allows us to continue to meet the 

unique needs of youth victims and victims of dating violence, by explicitly referencing youth and dating violence throughout the statute. 

In order to continue to be able to provide services to teen and youth victims, advocates support the recommendation to clarify the definitions of domestic violence, 

dating violence and youth to ensure that all victims, regardless of age, can receive 

vital, tailored services. 

(B) Resources for racial and ethnic minority communities 

In racial and ethnic minority communities, service providers need resources to develop programs and strategies that build upon cultural and community strengths 

and eliminate barriers to information and services. The proposed amendments to 

FVPSA and dedicated funding can help ensure that appropriate services are available to victims in ethnic and minority communities. In Nassau County, our population is becoming increasingly culturally diverse. The Asian population in Nassau 

County has increased to 6.3% of the total population. In 2007, there were 162,564 

Latino/Latina individuals in Nassau County, comprising 12.4% of the estimated 

county population, and Spanish is the language of 42% of the Nassau County families who speak a language other than English in their home. Twenty-three percent 

of clients at NCCADV are Latino/Latina. 

NCCADV provides many of our services in Spanish, provides a language line and 

partners with culturally-specific community-based programs. We know, however, 

that many victims from racial and ethnic minority communities do not seek services 

for fear of becoming isolated from their cultural communities. 

Therefore, we support recommendations to enhance and improve targeted resources for culturally-specific programs and services so that all victims can be safe. 

(C) Resources for Victims from Marginalized Communities 

We know that victims from underserved and marginalized communities, including 

victims with mental and physical disabilities, victims from rural areas, elderly and 

youth victims and those from marginalized religious populations often struggle to 

access services. 

Therefore, we support recommendations to make the FVPSA statute reflective and 

inclusive of such needs and provide targeted resources. 

(D) Resources for Victims and Programs in the U.S. Territories 

Resources are currently available for domestic violence programs and Territorial 

coalitions in the U.S. Territories but the funding formula is not fairly devised to provide adequate resources. Therefore, victims from the U.S. Territories often cannot 

get the services they need to flee violence. 

We support recommendations to alter the current funding formula to fairly distribute funding to services and coalitions in the U.S. Territories of American Samoa, 

Guam, Northern Mariana Islands and the Virgin Islands. 

(4) Prevention—The Need to Stop Violence Before it Starts 

Meeting the urgent needs of victims in crisis is vital in order to save and rebuild 

lives. But we know that in order to end domestic violence for good, we also have 

to invest in prevention work. Therefore, advocates in New York and across the nation strongly support the recommendations to enhance and expand the Demonstration Grants for Community Initiatives/DELTA grants in the FVPSA reauthorization. 

DELTA is authorized through FVPSA but is an independent funding line item. 

These statewide prevention efforts, administered by the Centers for Disease Control 

(CDC) and the National Center for Injury Prevention and Control, have made bold 
31 

strides toward preventing domestic violence by changing community and personal 

attitudes about relationships and abuse. 

In Nassau County, we acknowledge a great need for prevention work. Currently, 

we have a unique education program aimed at changing attitudes about violence in 

primary and secondary school students. However, we certainly do not have adequate 

resources to sustain all of the prevention work that is necessary in our community. 

Fortunately, because the New York State Coalition Against Domestic Violence 

(NYSCADV) is a DELTA grant recipient, NCCADV and programs across the state 

benefit from this statewide initiative. We are highly anticipating the release of a 

state-specific primary prevention tool-kit that NYSCADV will be releasing in spring 

of 2010. The primary prevention tool-kit will contain exercises, activities, information and resources to help individuals and groups think about what would prevent 

domestic violence from happening in our communities. Tools and resources are 

based on lessons learned from the New York State DELTA Project and successes 

from DELTA-funded and non-funded domestic violence programs throughout the 

state. The tool-kit will help organizations to initiate their own process of discovery 

to determine the role they wish to play in changing their communities. With interactive, web-based tools, NCCADV will be able to connect with other advocates to 

share successes and challenges with others across the state and the country. 

Each statewide DELTA project works with a number of local initiatives to develop 

community-specific prevention plans. The local projects learn from one another and 

depend on the guidance of state domestic violence coalitions for support and technical assistance. For instance, the California Partnership Against Domestic Violence 

(CPEDV) and STAND! Against Domestic Violence in Concord, California are involved with a local DELTA project called ‘‘Men Mentoring Boys Into Compassionate 

Men.’’ This project is lead by men to encourage other men to challenge violence 

against women. Their annual ‘‘Men of Merit’’ initiative has been recognized by the 

CDC as a successful prevention strategy because of its positive emphasis on men’s 

ability to reduce the occurrence of intimate partner violence as well as its ability 

to engage multiple partners, agencies and state representatives and community. 

CPEDV’s involvement in the project allows CPEDV to share findings and best practices across the state of California. 

New York and California are two of the fourteen current DELTA grant recipients, 

which includes Alaska, Delaware, Florida, Kansas, Michigan, Montana, North Carolina, North Dakota, Ohio, Rhode Island, Virginia and Wisconsin. A partnership between CDC and the Robert Wood Johnson Foundation is currently supporting additional states in a DELTA ‘‘Prep’’ project that is helping them to devise statewide 

prevention plans. With additional funding, the DELTA Prep states will receive resources they need to implement and execute their statewide plans. Additional resources will also help to extend research findings and tools to support communityspecific prevention efforts to the rest of the country. 

Therefore, advocates support the recommendation that DELTA grants become 

statutorily defined, reflect current best practice and are authorized at $20 million 

annually. 

Building on Strength while Embracing Change 

Our nation depends on FVPSA-funded programs to meet the immediate, urgent 

and long-term needs of victims of domestic violence and their children. Domestic violence organizations, sustained by FVSPA funding, have helped to save and transform countless lives. FVPSA has reduced costs to taxpayers by stopping and preventing costly violence. While we celebrate our successes, we are ever aware that 

victims’ needs are great and we have much to do to end domestic violence in this 

country. In order to move closer to achieving this essential goal, we urge the Committee to prioritize the swift reauthorization of FVPSA, inclusive of the recommendations outlined in the testimony above with an adequate funding authorization level. 

ENDNOTES

1Tjaden, Patricia & Thoennes, Nancy. National Institute of Justice and the Centers of Disease 

Control and Prevention, ‘‘Extent, Nature and Consequences of Intimate Partner Violence: Findings from the National Violence Against Women Survey,’’ 2000. The Centers for Disease Control 

(CDC) (2008). Adverse Health Conditions and Health Risk Behaviors Associated with Intimate 

Partner Violence, United States, 2005. 2McDonald, R., et al. (2006). ‘‘Estimating the Number of American Children Living in Partner-Violence Families.’’ Journal of Family Psychology, 30(1), 137-142. 3 Based on 1 in 5 women experiencing DV in the U.S., Nassau County’s population of 1.3 million and Census data from 2000. 4 Bureau of Justice Statistics, Homicide Trends in the U.S. from 1976-2005. US Department 

of Justice. (2008). 
32 

5Dolezal, T. McCollum D., Callahan, M., Edan Prairie, MN: The Academy on Violence and 

Abuse; 2009. 6Lyon, E., Lane S. (2009). Meeting Survivors’ Needs: A Multi-State Study of Domestic Violence Shelter Experiences. National Resource Center on Domestic Violence and UConn School 

of Social Work. Found at http://www.vawnet.org. 7Domestic Violence Counts 08: A 24-Hour census of domestic violence shelters and services 

across the United States. The National Network to End Domestic Violence. 8Domestic Violence Counts 08: A 24-Hour census of domestic violence shelters and services 

across the United States. The National Network to End Domestic Violence. 9Mary Kay’s Truth About Abuse. Mary Kay Inc. (May 12, 2009). 

10 National Center for Victims of Crime. Crime and the Economy. 2009 11Greendfeld, L. A. (1997). Sex Offences and Offenders: An Analysis of Date on Rape and Sexual Assault. Washington, DC. Bureau of Justice Statistics, US Department of Justice. 12 Jaffe, P. and Sudermann, M., ‘‘Child Witness of Women Abuse: Research and Community 

Responses,’’ in Stith, S. and Straus, M., Understanding Partner Violence: Prevalence, Causes, 

Consequences, and Solutions. Families in Focus Services, Vol. II. Minneapolis, MN: National 

Council on Family Relations, 1995. 13Wolfe, D.A., Wekerle, C., Reitzel, D. and Gough, R., ‘‘Strategies to Address Violence in the 

Lives of High Risk Youth.’’ In Peled, E., Jaffe, P.G. and Edleson, J.L. (eds.), Ending the Cycle 

of Violence: Community Responses to Children of Battered Women. New York: Sage Publications. 1995. 

Chairwoman MCCARTHY. Thank you, Sandra. 

Ms. Smith. 

STATEMENT OF TERESA M. SMITH, LSW, COORDINATOR 

EXECUTIVE DIRECTOR, CHILDREN’S ADVOCACY CENTER 

Ms. SMITH. Chairwoman McCarthy, Ranking Member Platts, and 

all of the subcommittee members, I would like to thank you for the 

opportunity to speak to you today on the Child Abuse Prevention 

and Treatment Act and the impact this funding has had on service 

provision locally, Statewide, and nationally for child victims of 

abuse. 

My experience as a former child welfare caseworker in Pittsburgh, the director of a local children’s advocacy center in Harrisburg, and an accreditation site reviewer for the National Children’s 

Alliance, have helped to shape my commitment to ensure children 

receive what they need to feel safe, cared for, and believed. I have 

also had the privilege of acting as cochair of the CAPTA Work 

Group in Pennsylvania and observing firsthand the teamwork and 

perseverance necessary from State and local government, nonprofit 

agencies, and public-private partnerships to meet the requirements 

necessary to become compliant and eligible under CAPTA. 

Pennsylvania, as the 50th State to do so, submitted its application and State plan for CAPTA in the spring of 2006. Professionals 

from child-serving agencies and disciplines across the State have 

been working diligently to meet the requirements and have selected several areas for improvement to Pennsylvania’s child welfare response. Although our State is early in this process, great 

strides have been made that demonstrate the efforts of those committed to providing quality services to child victims an their nonoffending family members. 

The Pennsylvania CAPTA Work Group has selected several areas 

for improvement. Among them, enhancing the Child Protective 

Services system by developing, improving, and implementing risk 

safety and developmental assessment tools. Skill-based training for 

child welfare workers, State, public, and private agency staff is 

critical to ensure children at risk are identified and appropriate 

strategies and actions take place for their health, safety, and welfare. Developing and facilitating training protocols on mandated re-
33 

porting target audiences with children, such as primary medical 

providers, schools, hospital staff, and first responders. Collaborations among many child-serving agencies and community-based 

programs support comprehensive physical and behavioral health 

needs of children who are reported to be abused. 

These are among just a few of the initiatives in progress as 

Pennsylvania carries out CAPTA requirements for compliance. 

CAPTA funding has allowed Pennsylvania the opportunity to move 

forward with the establishment and training of citizen review panels to provide recommendations for systemic change of the Child 

Protective Services system. 

Training of health care providers to report 

drug-affected infants has increased the opportunities to engage 

families that might have remained ‘‘invisible’’ in the system, thereby improving outcomes for those that are addicted, as well as their 

children. 

I have conducted more than 70 accreditation site visits of children’s advocacy centers across the country over the past 7 years. 

I have met many dedicated professionals, community members, 

and staff members from public and private agencies who are 

charged with providing services to child abuse victims and their 

non-offending family members. Many centers utilize Federal funding for child abuse prevention and treatment programs to reach underserved populations and develop public-private partnerships to 

provide services in creative ways. 

CAPTA compliance has allowed Pennsylvania to examine its current child welfare system and develop improvements for the benefit 

of children and families. In addition to child abuse prevention and 

awareness efforts, CAPTA compliance will also allow Pennsylvania 

to increase its impacts on providing a coordinated response to child 

abuse across the State through access to funding from the Criminal 

Justice Act. 

The Children’s Advocacy Center, or CAC, model is a collaborative 

community response that coordinates 

multidisciplinary partners in the investigative evaluation and 

treatment of child victims of abuse. Thousands of child abuse victims in Pennsylvania have benefited from the collaborative team 

approach for child interviews, medical exams, and mental health 

treatment. 

CJA funding will be a welcome resource to assist those communities in developing effective child abuse multidisciplinary teams. 

The PinnacleHealth Children’s Resource Center, as an accredited 

CAC, has served a geographic region of more than 20 counties for 

many years. In 2008, the Children’s Resource Center evaluated 883 

children for many counties in central Pennsylvania. Approximately 

52 percent are referred for services from Dauphin County, a thirdclass county. The CRC has seen an increase in the numbers of children referred for both sexual and physical abuse and an increase 

in requests to interview siblings of children that have died. 

Dauphin County has seen a 12.8 percent increase in the numbers 

of indicated cases of child abuse thus far this year. In 2008, there 

were four reported deaths in Dauphin County. In the first 10 

months of this year, there have already been 10 child deaths. Prior 

to 2009, Pennsylvania did not keep statistics of child near deaths, 
34 

but has kept them this year in compliance with CAPTA. In Dauphin County alone there have been eight near fatalities of children, 

four of which were indicated cases of abuse. The increase in numbers of reported abuse cases and the severity of this abuse inflicted 

is evident in this community. 

CAPTA and CJA provide support for local programs and is essential to continuing the comprehensive quality services provided to 

child abuse victims in Pennsylvania and throughout the United 

States. Child abuse prevention efforts as well as coordinated interventions are imperative to providing a safe environment for children, families, and the communities in which they live. 

I welcome any questions you may have. 

[The statement of Ms. Smith follows:] 

Prepared Statement of Teresa M. Smith, LSW, Coordinator Executive 

Director, Children’s Advocacy Center 

Thank you for the opportunity to speak with you today on the Child Abuse Prevention and Treatment Act and the impact this funding has on service provision locally, statewide and nationally for child victims of abuse. My experiences as a 

former child welfare caseworker in Pittsburgh, the director of a local Children’s Advocacy Center in Harrisburg, PA and as an accreditation site reviewer for the National Children’s Alliance have helped to shape my commitment to ensuring children 

receive what they need to feel safe, cared for and believed. I have also had the privilege of acting as co-chair of the CAPTA workgroup in Pennsylvania and observing 

firsthand the teamwork and perseverance necessary from state and local government, non-profit agencies and public-private partnerships to meet the requirements 

necessary to become compliant and eligible under CAPTA. 

Pennsylvania, as the 50th state to do so, submitted its application and state plan 

for CAPTA in Spring 2006. Professionals from child-serving agencies and disciplines 

across the state have been working diligently to meet the requirements and have 

selected several areas for improvement to Pennsylvania’s child welfare response. Although our state is early in this process, great strides have been made that demonstrate the efforts of those committed to providing quality services to child abuse 

victims and those children at risk of abuse. 

Pennsylvania CAPTA State Plan 

The Pennsylvania CAPTA workgroup has selected several areas for improvement 

that include: 

Improving legal preparation and representation through the expansion of the 

Court Improvement project statewide including training for Guardians ad Litem in 

juvenile dependency matters. 

Enhancing the child protective services system by developing, improving and implementing risk, safety and developmental assessment tools. Skill-based training for 

child welfare workers, state, public and private agency staff is critical to ensure children at risk are identified and appropriate strategies and actions take place for 

their safety, health and welfare. 

Developing and facilitating training protocols on mandated reporting to target audiences that have regular and ongoing contact with children such as primary medical providers, schools, hospital staff and first responders. 

Supporting and enhancing collaborations among many child-serving agencies and 

community-based programs that include comprehensive physical and behavioral 

health needs of children who are reported to be abused. 

These are among just a few initiatives that are in process as Pennsylvania carries 

out CAPTA requirements for compliance. CAPTA funding has allowed Pennsylvania 

the opportunity to move forward with the establishment and training of Citizen Review Panels to provide recommendations for systemic change of the child protective 

services system. Training of healthcare providers to report drug-affected infants has 

increased opportunities to engage families that might have remained ‘‘invisible’’ in 

the system thereby improving outcomes for those addicted and their children. 

I have had the privilege of conducting more than 70 accreditation site visits for 

the National Children’s Alliance across the United States over the past 7 years. I 

have had the met dedicated professionals, community members and staff members 

from public and private agencies charged with providing services to child abuse victims and their non-offending family members. Many centers utilize federal funding 
35 

for child abuse prevention and treatment programs to reach underserved populations and develop public-private partnerships to provide services in creative ways. 

Children’s Advocacy Center Model: A Community Response to Child Abuse 

CAPTA compliance has allowed Pennsylvania to examine its current child welfare 

system and develop improvements for the benefit of children and families. In addition to child abuse prevention and awareness efforts, CAPTA compliance also allows 

Pennsylvania the opportunity in the future to increase its impact on providing a coordinated response to child abuse across the state through access to funding from 

the Criminal Justice Act (CJA). 

The Children’s Advocacy Center (CAC) model is a collaborative community response that coordinates multidisciplinary partners in the investigation, evaluation 

and treatment of victims of child abuse. Pennsylvania currently has 9 nationally accredited CACs and 10 centers that have achieved Associate member status with the 

National Children’s Alliance. Thousands of child abuse victims in Pennsylvania 

have benefited from the collaborative team approach for interviews, medical exams 

and mental health treatment that CACs provide, yet many more child victims live 

in communities without an established center. CJA funding will be a welcome resource to assist those communities in developing effective child abuse multidisciplinary teams. 

PinnacleHealth Children’s Resource Center (CRC), as an accredited CAC, has 

served a geographic region of more than 20 counties for many years and receives 

limited funding designated through the child protective services needs-based budgets from 8 surrounding counties. In 2008, the CRC evaluated 883 children from 

many counties in Central Pennsylvania. Approximately 52% are referred for services 

from Dauphin County, a 3rd class county. The CRC has seen an increase this year 

in numbers of children referred for both sexual and physical abuse and an increase 

in requests to interview siblings of children that have died. Dauphin County has 

seen a 12.8% increase in numbers of indicated cases of child abuse thus far from 

last year. In 2008, there were 4 reported child deaths in Dauphin County. In the 

first 10 months of this year, there have already been 10 child deaths. Prior to 2009, 

Pennsylvania did not keep statistics of child near deaths, but has kept them this 

year in compliance with CAPTA. In Dauphin County alone, there have been 8 near 

fatalities of children, 4 which were indicated cases of abuse. The increase in numbers of reported abuse cases and severity of the abuse inflicted is evident in this 

community. 

CAPTA and CJA provides support for local programs and is essential to continuing the comprehensive quality services provided to child abuse victims in Pennsylvania and throughout the United States. Child abuse prevention efforts as well 

as coordinated interventions are imperative to providing a safe environment for children, families and the communities in which they live. 

Chairwoman MCCARTHY. Thank you. 

Mr. Sawyer. 

STATEMENT OF ROB SAWYER, MSW, LICSW, DIRECTOR, CHILD 

AND FAMILY SERVICES, OLMSTED COUNTY COMMUNITY 

SERVICES 

Mr. SAWYER. Good morning, Chairwoman McCarthy, Ranking 

Member Platts, and members of the subcommittee. My name is 

Robert Sawyer, former Director of Child and Family Services in 

Olmsted County, Minnesota. I appreciate the opportunity to offer 

comments on the reauthorization of the Child Abuse Prevention 

and Treatment Act, and thank Chairwoman McCarthy, Ranking 

Member Platts, and the members of the subcommittee for the invitation to do so. The comments that I will offer reflect a local perspective on child welfare reform efforts and differential response in 

child protection in particular. 

For more than a decade, the Minnesota Department of Human 

Services in collaboration with 87 counties and 11 tribes has been 

actively engaged in child welfare reform. Minnesota is a State-supervised, county-administered child welfare system generating con-
36 

siderable local control on the provision of services for children and 

families in the child welfare system. 

Minnesota counties fund approximately 48 percent of all child 

welfare services in the State. The State department and counties 

enjoy a positive, constructive working relationship that has facilitated a strong child welfare reform effort. 

The Minnesota Department of Human Services, in cooperation 

with the McKnight Foundation, supported the 4-year pilot project 

in 20 counties from years 2000 to 2004. A rigorous field study was 

conducted by the Institute of Applied Research using control 

groups, participant interviews, and the review of administrative 

data. Significant findings included: Child safety was 

uncompromised, fewer child maltreatment reports, less costly approach in the long run, families liked the approach, social workers 

supported the approach. 

In 2005, Minnesota law was changed, requiring a differential response system in child protection, with the preferred way to approach families being a family assessment for reports not alleging 

substantiation child endangerment. 

What is differential response? A differential response system organizes a child protection agency to respond in a proportional manner to reports about possible child 

maltreatment. At a minimum, an investigative response and a 

family assessment response provides an agency option in how to 

approach a family when there is an accepted report of child maltreatment. An investigative response continues to focus on reports 

alleging substantial child endangerment. 

A family assessment response is a formal response of the agency 

that assesses the needs of the child or family without requiring a 

determination that maltreatment occurred or that the child is at 

risk of maltreatment. 

The majority of families reported for neglect or abuse receive a 

family assessment response where fault finding is set aside and replaced with a safety-focused family assessment and services. In 

Minnesota, high risk reports continue to receive a forensic investigation, but greater attention is now paid to family and community engagement and the recognition of strengths that could be 

used to promote safety and well-being. 

During the 4 years, 2000 to 2004, that this program transitioned 

from pilot to full implementation, out-of-home placements in Minnesota decreased 22 percent. Olmsted County initiated the countywide differential response system in 1999. The differential response 

system is organized to provide an investigative response, a family 

assessment response, and a domestic violence response for those reports where a child is exposed to intimate family violence. 

The implementation of groups of provision, a consultation framework, family involvement strategies, and group decisionmaking for 

major decisions has supported the practice model that strives for 

partnership with families and collaboration with community resources. 

Over the past decade, with the implementation of a differential 

response system, Olmsted County has seen the following positive 

results: Fewer investigations, less repeat child maltreatment, less 
37 

court involvement, less children in placement, more family involvement, and more children served. 

Perhaps the greatest lesson learned through the implementation 

of a differential response system is that it is not what we have to 

do alone that is important, but how we choose to do it that makes 

a difference. We have changed how we see and engage families and 

through that have reached better results. 

The following recommendations are respectfully presented for 

consideration: One, support the efforts of States, counties, and tribal child welfare agencies to establish differential response systems 

and child protection. Two, support the efforts of State, counties, 

and tribal child welfare agencies to front load the system, providing 

supportive interventions for at-risk families screened out of child 

protection. 

Thank you for the work you will do in the reauthorization of 

CAPTA, continuing to enhance safety and well-being for children 

and the strengthening of families to provide a safe, nurturing home 

life. 

[The statement of Mr. Sawyer follows:] 

Prepared Statement of Robert Quinn Sawyer, MSW, LICSW, 

Olmsted County Child and Family Services 

Chairwoman McCarthy, Ranking Member Platts and Members of the Subcommittee, 

My name is Robert Quinn Sawyer, former Director of Child and Family Services 

in Olmsted County, Minnesota. I appreciate the opportunity to offer comments on 

the reauthorization of the Child Abuse Prevention and Treatment Act (CAPTA) and 

thank Chairwoman McCarthy, Ranking Member Platts and the members of this 

Subcommittee for the invitation to do so. 

The comments that I will offer reflect a local perspective on Child Welfare Reform 

efforts and Differential Response in Child Protection in particular. 

For more than a decade the Minnesota Department of Human Services in collaboration with the 87 counties and 11 tribes has been actively engaged in Child Welfare Reform. Minnesota is a state supervised county administered child welfare system generating considerable local control in the provision of services for children 

and families in the child welfare system. Minnesota counties fund approximately 

48% of all child welfare services in the state while the federal government contributes 36% and the state government 14%. The state department and counties enjoy 

a positive constructive working relationship that has facilitated a strong child welfare reform effort. 

The Child Protection System since the 1960’s saw a significant increase in the reporting of child maltreatment as expanding reporting requirements were added in 

an effort to address perceived child safety concerns. The system was limited to an 

investigative response that became an increasingly forensic process with a focus on 

procedure and practices that were developed in response to the most severe forms 

of child abuse and neglect. The Child Protection System had one way of responding 

to all reports accepted for intervention. Nationally and in Minnesota approximately 

one third of accepted reports of child maltreatment were founded. In Minnesota approximately 65 to 70% of all reports were concerned with child neglect. 

In 1997 Minnesota legislation prompted child welfare reform in an effort to improve child welfare outcomes. A pilot project in Olmsted County experimented with 

an Alternative Response to child protection reports of low or moderate levels of risk. 

In 1999 legislation permitted counties to voluntarily engage in Alternative Response 

an early name for Differential Response. The Minnesota Department of Human 

Services in cooperation with the McKnight Foundation supported a four year pilot 

project in 20 counties from 2000—2004. A rigorous field study was conducted by The 

Institute of Applied Research, using control groups, participant interviews and the 

review of administrative data. Significant findings included: 

1. Child Safety was uncompromised 

2. Fewer new child maltreatment reports 

3. Less costly approach in the long run 

4. Families liked the approach 
38 

5. Social Workers supported the approach 

In 2005, Minnesota law was changed requiring a Differential Response System in 

Child Protection with the preferred way to approach families being a Family Assessment for reports not alleging substantial child endangerment. At the time of the 

law, all 87 counties in Minnesota were voluntarily providing a Differential Response 

System. 

What is Differential Response? A Differential Response System organizes a child 

protection agency to respond in a proportional manner to reports of possible child 

maltreatment. At a minimum an Investigative Response and a Family Assessment 

Response provides an agency options in how to approach a family when there is an 

accepted report of child maltreatment. An Investigative Response continues to focus 

on reports alleging substantial child endangerment. A Family Assessment Response 

is a formal response of the agency that assesses the needs of the child or family 

without requiring a determination that maltreatment occurred or that the child is 

at risk of maltreatment. 

Effective social work practice in child protection strives to engage children and 

families in a constructive working relationship that resolves the issues and challenges impacting child safety and well-being. Collaborative working relationships 

with community resources and families build supportive coordinated efforts to enhance safety and well-being. Both an Investigative Response and a Family Assessment Response utilize the same structured decision making tools to provide a frame 

of reference for evaluating child safety and well-being and the identification of family needs. 

Minnesota is a leader in developing a Differential Response System to reports of 

child maltreatment. The majority of Minnesota families reported for neglect or 

abuse receive a Family Assessment Response where fault finding is set aside and 

replaced with a safety focused family assessment and services. High risk reports 

continue to receive a forensic investigation but greater attention is now paid to family and community engagement and the recognition of strengths that could be used 

to promote safety and well-being. During the four years (2000—2004) this program 

transitioned from pilot to full implementation, out of home placements decreased 

22%. 

Olmsted County is one of 87 counties in the state of Minnesota with responsibility 

for administering the child welfare system providing intervention and services for 

children and families where there are child protective concerns. Olmsted County initiated a county wide Differential Response System in 1999. The Differential Response System is organized to provide an Investigative Response, a Family Assessment Response and a Domestic Violence Response for those reports where a child 

is exposed to intimate family violence. The implementation of group supervision, a 

consultation framework, family involvement strategies and group decision making 

for major decisions has supported a practice model that strives for partnership with 

families and collaboration with community resources. 

In recent years the Differential Response System has been enhanced by the development of a Parent Support Out Reach effort to respond to families screened out 

of child protection that may have needs that if addressed now will prevent their future entry into child protection. Targeted early intervention front load the child protection system providing necessary service to families when they need them. 

Over the past decade with the implementation of a Differential Response System 

Olmsted County has seen the following positive results: 

1. Fewer investigations 

2. Less repeat child maltreatment 

3. Less court involvement 

4. Less children in placement 

5. More family involvement 

6. More children served 

Perhaps the greatest lesson learned through the implementation of a Differential 

Response System is it is not what we have to do alone that is important but how 

we choose to do it that makes a difference. We have changed how we see and engage 

families and through that have reached better results. 

The following recommendations are respectfully presented for consideration: 

1. Support the efforts of states, counties and tribal child welfare agencies to establish Differential Response Systems in child protection. 

2. Support efforts of states, counties and tribal child welfare agencies to ‘‘frontload’’ the system providing supportive interventions for at-risk families screened out 

of child protection. 

Thank you for the work you will do in the reauthorization of CAPTA continuing 

to enhance safety and well-being for children and the strengthening of families to 

provide safe, nurturing home life. 
39 

Chairwoman MCCARTHY. Thank you, Mr. Sawyer. 

I thank you all for your testimony. As I said earlier, we knew 

that this was going to be a difficult hearing, basically hearing the 

issues that are facing our families and children in our Nation. Like 

many of you, I believe that we all can do better to protect our children. They are the future of this Nation. I think it is extremely important that we have our work cut out for us, but hopefully work 

with all of you as we go forward on the reauthorization. 

Dr. Spigner, one of the things you had said in your testimony, 

especially talking about when a child abuse case happens over 

State lines, even though they might live in your State and how 

sometimes they are falling through the cracks and the cases are 

not really followed through. 

We also know that, unfortunately, we have seen many stories. In 

fact, I have from the Associated Press a series of reports from 2007 

which discuss the shadow of sex abuse in U.S. schools. Because one 

of the things we have seen, that someone who might be a sex offender goes from one State to another State and works at a school. 

And I have a great concern about that. If you could talk about that 

a little bit on what can be done and how we can improve on that. 

Ms. SPIGNER. One of the critical issues in this whole process of 

evaluating reports of child abuse is attempting to identify the perpetrators. When people cross State lines—and, generally, teachers, 

child care providers, when they go to a new State, they have to go 

through a criminal records clearance and a child abuse records 

clearance. If there has been no identification because a case has 

fallen through the cracks, then when they are reviewed their 

records come back as if there was no problem. 

So that the more we can resolve the interstate conflicts, the more 

we can identify perpetrators that may be moving around, and that 

is true in terms of teachers, child care providers, as well as relatives. If a case is screened out because it didn’t occur in the right 

place or because the child is not in a particular place, we have no 

track record on that. We cannot even predict how many of these 

cases are lost because there is no trail. 

Chairwoman MCCARTHY. Thank you. 

Sandra, you talked about your unique partnership we have in 

Nassau County for the local abuse agencies and the coalition 

against child abuse and neglect. Could you go into it on how basically you came up with the idea and how you became the partners 

and have a little more influence on the family and the child? 

Ms. OLIVA. Yes. I would be happy to. We have actually been 

planning and working on this I would say for 6 years now. Our 

agency has had a long-term State grant, which we actually just had 

doubled, to put domestic violence specialists within the Nassau 

County Department of Social Services Child Protective Services 

Unit. 

So we have seen for a very long time how critical it is to work 

on the issues of domestic violence and child abuse in coordinated 

ways. So very often you have co-occurrence in the same family. And 

if you don’t have safe parents, if the non-abusive parent isn’t feeling safe, she is not going to be able to protect the child. 

So we began to work together with the local child abuse agency, 

which has a child advocacy center, as has been described today, to 
40 

look at ways we could partner and determine what we really need 

to do was not just have projects together but really to work very 

closely to cross-train our staffs so when we had a family come in 

we could identify the issues for the children and the moms. And 

when they had children come into their center who had been sexually assaulted, they could begin to identify where the mothers also 

had been victims and been unable to protect themselves or their 

children and also needed help. 

And so we are really looking—we are calling it the safe place. 

And we are looking at one location where all families will come. 

They will be served for their different specific needs by the two different agencies, because we remain two separate agencies at this 

point. But we would be able to—our staffs will be working back 

and forth, we will be doing programs together. 

We are going to have a training institute about family violence, 

which focuses both on domestic violence and child abuse. We are 

going to be working with parents because the issue of supporting 

families and working with parents and strengthening parenting is 

critical in protecting victims and in giving them—really enabling 

them to tap into their strengths and live independently and live 

self-sufficiently, which is also critical. 

So this idea has been brewing between our two agencies, myself 

and the director of the other agency, now for years and years, trying to figure out the best way to do it. The State is very excited 

about it because this is a model. It is really not done anywhere 

else. 

So we are hoping that we can develop something which other 

agencies across the country will be interested also in developing. 

And of course it is smart business. There is also cost savings involved and there are efficiencies involved. In these days, you need 

to save every penny you can for programs. Why duplicate the cost 

of boardrooms and kitchens and bathrooms and copiers and that 

kind of thing when there are smart ways to do business? 

Chairwoman MCCARTHY. Thank you. 

Mr. Roe. 

Mr. ROE. Thank you Madam Chairwoman for holding this very 

important hearing. And thank every one of you all for being here 

to participate. And I am sorry you have to be here. I am sorry the 

issue is even out here. 

My career and background is an Ob/Gyn physician. And you go 

through a difficult pregnancy to deliver a healthy baby and then 

you put it in an environment where it can’t be healthy and safe. 

I was just—I don’t know about Dr. Hammond. I noticed a CDC 

definition of the threat of harm. I felt that maybe that kept me in 

the straight and narrow. I felt the threat of harm sometimes at 

home to keep me getting my homework and so forth. 

One of the issues, Ms. Oliva, I want to talk to you about which 

I think is extremely important are domestic shelters. At home ours 

is called Safe Passage. And my job before I got here was mayor of 

our city, and we almost passed the hat. I mean, we would get a 

few Federal dollars, a few State dollars, a few local dollars. 

Two weeks ago my wife and I, I guess, attended a fundraiser. We 

were the keynote people at the fundraiser to try to raise a little 

money, because it is a life vest. It is not a boat, it is a life vest, 
41 

because these people are sinking, they have no other place to go. 

And it needs to be open 24/7. And I wholeheartedly support that 

program. 

I mean, we have tremendous volunteers in Johnson City, Tennessee, where I am from, that support this, very needed. And also 

the Children’s Advocacy Center also, great programs. 

Just a comment about the funding, if you would. How, where you 

are, are you able to fund your center? 

Ms. OLIVA. We are able to fund our center primarily through 

TANF funds, because we are reimbursed on a per person, per day 

basis. In New York State it is different from most in that those 

women who go into a shelter, unless they have a lot of money, and 

almost not ever come in with access even to that kind of money, 

they have to go on to TANF, they have to go onto welfare. And so 

we are reimbursed that way. 

That is really a degrading process for so many people, and it is 

shameful. But on the other hand, it has really produced a supply 

of funding for the neighborhood shelters in New York to survive. 

But I will tell you, it is not enough because you can’t have a shelter 

in isolation. And the FPSA money goes to shelters and to programs 

that support it. You have got to have a hotline running 24 hours 

a day. You have got to have advocates able to work with women 

and to advocate for them with all the many systems. You have got 

to be interacting with the criminal justice system on behalf of these 

women; we provide legal services. So especially with growing immigrant populations we need—really we need specialized immigration 

legal services for so many of our clients. So the funding for these 

programs is essential. 

Mr. ROE. And I agree with you. 

Ms. OLIVA. You can’t live on volunteers. You must have paid 

staff, and that is where most of the cost is. 

Mr. ROE. Our problem is we can barely pay the staff. Everywhere 

you are understaffed. And so I hear you loud and clear. 

A couple of just quick questions. A demographic I noted years 

ago, if you are 18 years old when you have your first child, you 

have a high school education and you are married, those three 

things, you almost don’t live in poverty. And those things, I think, 

are missing. So when the children are abused, is it educational 

level, is it drug abuse, is it poverty, is it urban versus rural? I 

know you have got a model to tell us. And anybody can answer this 

question. Someone who is at risk, I guess, is what I am asking. 

Ms. OLIVA. You are asking what puts people at the greatest risk. 

Mr. ROE. Right. 

Ms. OLIVA. Well, in domestic violence it has a great deal to do 

with the way in which people grow up, what they learn, what they 

learn about how to channel their feelings, how to channel their 

anger, how to use the power that they have within their families. 

And so much of abuse is about that. 

But there is no doubt that the economic issues are there. And if 

you—we have so many women who are stuck in relationships. They 

can’t get out of marriages. They can’t get out of the house or the 

apartment that they are living because where are they going to go, 

how are they going take care of their kids? And so the economic 

issues are tremendous. 
42 

We find that being able to provide transitional housing through 

Federal HUD dollars has been the key to helping women not just 

escape on a temporary basis from the immediate danger, but to become self-sustaining and really begin violence-free lives with their 

family. 

Mr. ROE. Dr. Hammond, one quick question. My time is about 

out, but did you all have a demographic of that from an educational 

level, drug abuse, all those factors that we know may play a role? 

Mr. HAMMOND. Well, there is no question that things like substance abuse, level of income, et cetera, are contributors to child 

abuse. But I want to underscore there is no absolute profile of who 

is and is not an abuser. But what we try to do in public health is 

look at the circumstances surrounding families. The pressures of 

everyday parenting can be exacerbated, for example, by economic 

conditions, interpartner conflict in the home. And the more we can 

involve others, and in particular I would suggest the primary 

health care system, as an avenue for the support of parents, the 

more we can provide some system for early intervention on these 

pressures. 

So what we see is that it is possible to recognize some of the very 

subtle risks that create the potential for child abuse and neglect in 

families. But families, and parents particularly, need a safe environment in which to get the help where there is less risk of them, 

in fact, losing their kids. So that is why I have been underscoring 

the need for public health to complement what child protective 

services and child welfare agencies can do. 

Mr. ROE. Thank you. 

Thank you, Madam Chair. 

Chairwoman MCCARTHY. Thank you. 

Representative Chu. 

Ms. CHU. Thank you, Madam Chair. 

Ms. Kaplan and Mr. Sawyer, you made a compelling argument 

for the deferential response system, and you said that 20 States already have this, and it is kind of a no-fault system where there is 

a front load of services in families where there may be abuse or neglect. How do these States pay for it? Does it require funding above 

and beyond the allocation that is there? Can any CAPTA funds be 

utilized for it, or can this be done through reallocation of funds? 

Mr. SAWYER. In Minnesota about approximately half of the funding for all child welfare services is raised through local property 

tax. So the State county commissioners are in a position to levy 

funding that is used. The second source of funding comes from the 

State legislature and the appropriations that it makes. And then 

the third source of funding in Minnesota is the Federal revenue 

that comes into the State. And it really is a stream of funds. 

And I think the request to the Federal Government is that the 

more flexible and the less caps that are put on funding makes it 

easier for the system to access and be able to fund programs at an 

appropriate level. 

Ms. KAPLAN. And I would just add that—I wanted Rob to go first 

because I knew what he was going to say specific to Minnesota. 

CAPTA Title I dollars can be used. CAPTA Title II dollars cannot 

be used because they are targeted to children that are not involved 

with the child protection system. And that is by design so that 
43 

there are monies that are dedicated exclusively for the preventive 

arm. 

But that is not typical. It is very much a patchwork where people 

are taking dollars from the Children’s Justice back, they are taking 

dollars from Safe and Stable Families. There are local and State 

revenue streams, but there is not a dedicated source of dollars. And 

as you know, CAPTA dollars are not aplenty, and so a small 

amount might have the ability to go ahead and be targeted toward 

it. They are able to do it, but there are not a whole lot of dollars 

to do that. 

Ms. CHU. So are you saying that one part of the fund should be 

more flexible, or that there should be targeted funds for this. 

Ms. KAPLAN. I think that, frankly, the States would be very 

pleased to have more flexibility, and that flexibility should allow 

for using the dollars in this way. 

Ms. CHU. Thank you. 

Dr. Hammond, Prevent Child Abuse in California bought to my 

attention a fundamental flaw in the structure of our child protective services. They said that most funds are only available after a 

case is made official; and that is to say when Child Protective Services gets an initial phone call making them aware of possible abuse 

or neglect, Federal funds can’t be used—can’t be used to evaluate 

whether or not that case should be pursued. And considering the 

fact that an average investigation costs $1,200, it could be quite 

costly to the tight budgets of child abuse agencies. 

Can you talk about this? It basically would seem like the incentive would then be to either make a finding of abuse to pay for that 

investigation and evaluation. Shouldn’t there be funds for an initial 

evaluation? 

Mr. HAMMOND. Thank you for the question. 

I am not familiar with the details of the law and how the money 

flows with respect to evaluations, but I can say that everything 

that we can do to invest on the front end with preventive services 

will—in the back end will lessen the cost of families getting enmeshed in the child protective services systems. 

There is no question that the cost of investigations, et cetera, are 

probably very, very high, but what would be very helpful is if we 

had ways to identify support for preventive services, perhaps 

through new ways of doing health care in the primary health care 

system that would prevent the need for the back-end cost that you 

are referring to. But I am happy to refer your question to the Department of Health and Human Services regarding the specifics of 

how costs are related to child abuse investigations and what can 

be done there, and I would be happy to provide that. 

Ms. CHU. Thank you. 

Chairwoman MCCARTHY. Mr. Platts. 

Mr. PLATTS. Thank you, Madam Chair. And, again, my apologies 

for having to run out and come back, but that is one of the benefits 

of written testimony. I do apologize, though, if I ask a question that 

was already addressed and is being repetitive. 

Ms. Smith, I want to start with your testimony. And you talk 

about the numbers, staggering, a 12.8 percent increase in indicated 

cases in Dauphin County, and then from 4 last year deaths and already 10 this year, just a really heart-wrenching statistic. 
44 

Are you able to try to identify, or would you be able to, what you 

think is driving that? Is it added stress because of the economic 

issues? Is it, you know, other, you know, social issues, you know, 

what is really kind of an underlying thing we need to look at? 

Ms. SMITH. Well, I think as Ms. Oliva had mentioned—— 

Chairwoman MCCARTHY. Could you put your mic on? 

Ms. SMITH. As Ms. Oliva had mentioned, she was talking about 

economic stressors really having an impact, I think, on the stress 

that people are feeling. I can’t specifically say in these cases in 

Dauphin County what those things were that brought it to that 

point, but I know that the children that we are seeing more in our 

advocacy center, and we are a hospital-based center so we can provide the medical exams right there, seem to be not only more frequent, but more severe cases, particularly of physical abuse. And 

I believe that some of those deaths were related specifically to 

physical abuse of those children. 

Mr. PLATTS. Is there any change in the age of a child—children 

being abused, any variables in that sense? 

Ms. SMITH. We haven’t done a study recently, but I think the 

majority of the children that we are seeing, the average age is still 

around 6 to 8 years old. We do seem to see a lot of very young children. I know that we have evaluated children as young as just a 

few weeks old. 

Mr. PLATTS. Two weeks. 

Ms. SMITH. A few weeks. I believe one of the child deaths in Dauphin County was of a 5-week-old infant. 

Mr. PLATTS. Just heart-wrenching as a parent and hard to imagine the harm of a parent doing that to their own child. 

In the testimony you also reference the citizen review panels. 

Ms. SMITH. Yes. 

Mr. PLATTS. Could you expand on that and how that kind of 

works, and the type of feedback or the structure? 

Ms. SMITH. Well, we are just in the process of doing that. Actually letters have just gone out. There will be three panels in Pennsylvania in different regions of the State. We are going to be training the citizens in the child welfare system itself and then asking 

for their input in what they see. The citizens were sent letters requesting anybody that was interested. We were hoping to have 

folks from various areas maybe that already had some experience 

in their life of dealing with the child welfare system, and utilizing 

that to help make changes and to really look at the system. 

Mr. PLATTS. So the panel, the goal is how to improve the system 

in how we respond, prevent and respond to child abuse more so 

than helping in the local communities to identify—— 

Ms. SMITH. Well, regionally they will be pulled from those regions. So hopefully we will be able to get some of the information 

from the rural areas as well as from the urban areas of what the 

specific issues are that are being dealt with. 

Mr. PLATTS. Again, about how to respond to, prevent and respond 

to. 

Ms. SMITH. Yes. System improvement. 

Mr. PLATTS. Right. What is working in their area and try to have 

that shared in a broader sense. 
45 

Ms. SMITH. They will be working with State officials from the Department of Public Welfare and sharing that information. And then 

the department will be looking at how to take that and put it into 

action. 

Mr. PLATTS. Somewhat related. Dr. Spigner, in your testimony 

you talked about neighborhood-based strategies. Could you expand, 

one, when you talk about neighborhood, do you mean truly a local 

neighborhood or a local community, and how you anticipate that 

working? 

Ms. SPIGNER. That is a great question. A number of jurisdictions 

have started this process by mapping where the reports come from, 

because reports, sometimes they are dispersed, but sometimes they 

are really aggregated in certain neighborhoods or certain communities. So the first thing an agency would do is to look at where 

the reports are coming from, then to begin to identify those communities with the greatest vulnerability in terms of child abuse and 

neglect. 

Then the agency really recruits neighborhood leaders and residents and shares information about what is happening to the children and families in their community, and begin a process of brainstorming and collaboration to begin to build strategies that the 

neighbors can literally engage in to keep children safe. 

One of the problems we have in child protection is that we have 

held onto this notion of privacy and confidentiality so closely, that 

people really don’t understand how many children are being removed from the neighborhood, what the circumstances are. So 

when data gets presented, it really surprises people, because this 

has been kind of an invisible process. 

And this is not about destroying privacy, but it is about giving 

a picture of what is happening in a community. Then you begin to 

see the community say, wow, we didn’t know what is happening to 

our kids. We need to begin to think together about how we can use 

churches and civic clubs and actually communities to work on this 

issue of safety, to begin to say to a parent in a way we are not willing to do now, don’t you really think—let me offer you another way 

to talk to your child about this, so that you begin to change almost 

the culture of the neighborhood so that children’s safety becomes 

paramount. And it is a capacity-building process. But I think we 

have got to recognize that communities are part of the answer, and 

we need to begin that kind of discourse. 

Mr. PLATTS. And empowering those communities and getting 

that buy-in at the local level to respond, because I can equate it 

to the difference today in growing up. When I was a kid in our 

neighborhood, there was—I mean, the times are different. And so 

if anything happened to anyone in that neighborhood with any of 

us kids, it was immediately known by everybody. Also it was different because moms were more present in the communities because of different times, where now both parents are having to 

work more. With both parents working or more single-parent families, it is harder to have that type of engagement that maybe we 

need to try to return to for the safety of children in all ways, including when it comes to abuse. 

Ms. SPIGNER. Let me just say that there are a number of jurisdictions that have been working on this. In Jacksonville it has been 
46 

really interesting, because as they began to talk to the community, 

the neighborhood, about what kids needed, what was needed, people began to say, well, our kids really don’t have anything to do 

after school. So it kind of raises the challenge of caring, and it puts 

pressure. And so they began to organize within that community 

after-school programs and got some city funding so that kids could 

stay in their neighborhood, but there was someplace for them to go. 

We have seen a similar strategy in Houston, where they looked 

at the area where most of the kids are coming from, and they 

began to talk about what was going on in that neighborhood because of the high rates of entry of African American children in the 

child welfare system. So they began to mobilize the African American community. And now they are beginning to see after a period 

of 3 to 5 years declines in reports and increased safety in kids. 

So we have got to think about new partnerships. 

Mr. PLATTS. Thank you, Madam Chair. 

Chairwoman MCCARTHY. Thank you. And thank you for that line 

of questioning. 

Before I call on the next questioner, I just want to say with the 

testimony that you have all been saying, and Dr. Hammond mentioned public health, primary care and nursing services, and then 

working together, what Sandra was talking about of bringing everything together, until we are able to have—and also, Dr. Spigner, 

what you were talking about, bringing the community together in 

one place so that you can see the child and the family as a whole. 

I happen to think that would certainly help each and every one of 

you in your job. 

Mr. Tonko. 

Mr. TONKO. Thank you, Madam Chair. 

Ms. Oliva, you talked about in your testimony about the importance of providing services to teens as it relates to their being victimized by dating violence. 

Ms. OLIVA. Yes. 

Mr. TONKO. Can you indicate for us where there might be added 

efforts made for those who are victimized by dating violence as opposed to domestic violence? Are there needed professionals, or are 

there approaches that need to be taken to address that population? 

Ms. OLIVA. Well, actually dating violence is a subset of domestic 

violence, it is a form of, because domestic violence has to really be 

seen as something broader than just a husband/wife or two partners who are living together. It also involves intimate partners, 

whether they are related, living together or seeing each other, dating each other and having a relationship. And as we all know, our 

kids are dating earlier and earlier, you know, seem to be getting 

older faster. And this issue of violence within teen relationships is 

growing exponentially. It is the one place where we are really seeing significant increase in the violence is in particularly for young 

women between 16 and 24. This is a very high-risk population in 

high schools and colleges. 

And so we believe that early intervention through prevention 

services, being able to reach young people, teens, and not expect 

them to come to the schools for their help; but to work with the 

schools, to be able to bring the issues, the messages to the schools, 

to let the kids know who is there to help them. But kids are not 
47 

going to go for help to a school counselor because of the stigma or 

the fear of ratting on the guy, or the stigma of being seen by everyone as the young woman who was raped or the young man who is 

being beaten. 

So what we are really talking about is being able to work collaboratively between schools and programs to do the kind of outreach 

so that young people know about and learn about healthy relationships early when they are beginning to have relationships. And I 

am talking about, you know, young boys and girls and working 

with them and giving them a place to come to. 

And that is why the kind of funding we have been talking about 

for domestic violence is so critical, because this outreach and prevention and the ability to provide services. I mean, so many young 

women now, especially with the advent of technology, are being 

stalked. We had one girl who she had to turn her cell phone on 

next to her pillow at night so that he could hear her breathing any 

time he wanted to from his home and she would never be out of 

reach. 

I mean, these kinds of things are happening to our kids, and we 

have to become aware of it. It is so critical to reach them young. 

If you teach people young to be in healthy, respectful, nonviolent 

relationships, then we won’t need these programs generations 

later. Prevention is key. 

Mr. TONKO. So if there is a stigmatization that occurs through 

the school networking, how do you best reach—— 

Ms. OLIVA. Well, we go into the schools. We use some of our 

FPSA money to go into the schools to do programs within, the guidance programs within the social studies curricula. We are working 

within different—depending on where in the school we are invited 

in that we can get, at levels, at junior high school, high school, college levels, and reach the kids and talk with them and have sessions with them. 

But we understand that the kids are not going to come out publicly in front of their friends for the most part. But we do get our 

kids coming up to us saying, my friend, this is happening to her. 

And then we can reach out to the individual through the guidance 

counselors and the social workers in the schools and arrange for 

the children to come and work with us on site or other sites near 

the school, make use of other programs, because you have got to 

have—I mean, absolutely you have got to have communities. This 

has got to be integrated work. You cannot be isolated and have a 

program here and a program there and a school here and a library 

there. You have got to integrate all of the resources of a community 

in order to work so that we can prevent this and we can have 

young people growing up in healthy, safe relationships. And they 

in turn will then provide healthy, safe environments for their children. 

Mr. TONKO. And how early in the networking with children, 

youth? 

Ms. OLIVA. We start very early. We start in first, second grades. 

But we primarily focus—because we know at that age what we are 

really teaching them is things like hands are not for hitting, not 

to be—you know, not to be physically hurtful of each other. 
48 

But really our real focus is around the junior high school, somewhere around the early teens, because kids 12 years old are involved in relationships. At 13 and 14 they are in sexual relationships, and if you don’t reach them then when they are beginning 

to form their ideas—children often replicate what they have 

learned at home, and they also replicate what peers—you know, 

what is the thing to do and how to be. And if they don’t all—if they 

don’t begin to believe that the way to be within relationships is loving and respectful and nonabusive, then we are never going to— 

this issue is going to be perpetuated in parents and children, and 

it is just going to go on and on. So to stop it we have to get to the 

kids. 

Mr. TONKO. And just a question about how perhaps boys, young 

men, relate to the program as opposed to girls and young women. 

Ms. OLIVA. We have been working on different projects over the 

years that are very successful with young men. They are primarily 

the kinds of programs that say, you know, real men don’t hit, real 

men don’t hurt. It is that kind of using men who are good role models for them to be there talking to the kids in the schools. It is very 

effective when young men see men they respect speaking to them 

about how—you know, how real men are loving and kind and don’t 

physically harm and hurt and abuse. 

And, of course, you know this is very complex. Abuse is not always physical. There are an awful lot of other kinds of abuse that 

go on that you don’t see, that don’t come to the attention of the 

criminal justice system or the guidance counselors in the school or 

the social workers and agencies, but people who are in very painful, denigrating relationships. 

So it is very critical to reach the young men and the women, and 

they are both responsive. I do believe that people want to learn and 

want to be happy and healthy, and what they need is a hand. They 

need someone out there to reach them personally. And we find 

what is especially effective at the college level is working with the 

residential assistants, for example, in the dorms, and to have someone there who has been trained and understands, not to be the 

counselor, but to get someone to the right help. So it is reaching 

out, letting people know what is available in your community, 

whom you can go to to help you get the help you need. And that, 

to me, is the way it has to be. 

Mr. TONKO. Thank you. 

Chairwoman MCCARTHY. Ms. Moore. 

Ms. MOORE. Thank you so much, Subcommittee Chair McCarthy, 

for allowing me to participate in this hearing. 

I have so enjoyed working with the National Network to End Domestic Violence, with all the domestic violence coalition partners 

over the past several months to get this desperately needed reauthorization of FPSA. And I certainly look forward to working with 

the subcommittee and the committee in the months ahead to do 

this. 

I want to ask the panel some important questions, but I just 

want to state for the record, Madam Chair, that I do think we need 

to seek to increase, substantially increase, the authorization levels 

for the FPSA program. And I think that this hearing really substantiates and elucidates the reasons. 
49 

We have heard some really chilling testimony here today about 

the kinds of dangers that women and children, and even men, are 

in in domestic violence situations, and with some staggering statistics that Ms. Oliva presented for the Academy on Violence and 

Abuse stating, was it, $333 billion to $700 billion being the cost of 

abuse in our health care system. So it is no wonder that these insurance companies want to treat domestic violence as a preexisting 

condition and not pay for it when you consider a $750 tab for the 

cost of domestic violence. 

Dr. Hammond made a statement in his testimony, in his written 

testimony and in his oral testimony, that these children and families were at greater risk for cancer, heart disease and other sorts 

of diseases you don’t ordinarily associate with domestic violence. 

And so, again, I think prevention, as all of them have mentioned, 

is increasingly important. 

And, of course, Dr. Wilson Spigner talked about the importance 

of getting the communities involved. I remember Billie Holiday’s 

song, you know, if I get beat up by my papa, I ain’t gonna call no 

coppa, and it ain’t nobody’s business if I do. It is our business. Domestic violence is our business. 

I guess in terms of reauthorizing the program, there is increased 

monies for States and territories in a new grant program to reach 

out to underserved communities. So I would ask Ms. Oliva and Mr. 

Sawyer in particular, who has worked with 11 tribes in Minnesota, 

number one, what difference does having cultural competent services make? I notice in the territories there is a higher rate of domestic violence. And then I want Ms. Oliva to tell us what happens 

to these families who they are unable to serve because of the 

dearth of funding? 

Mr. SAWYER. In Minnesota the Department of Human Services 

and a number of the tribes have begun a new collaboration over 

the last 2 or 3 years, and that collaboration is really focused 

around trying to strengthen the tribes themselves, to build capacity 

within the tribal community to provide outreach and services to the 

members of its tribes. 

I think that overall in the system there is a continuing need for 

the personnel who work in the child welfare system to reflect the 

populations that they work with, is probably a good place to start 

in terms of reaching common ground, in terms of understanding of 

each other. But I think it is that basic appreciation that we are all 

different, and we have to be very respectful of those differences and 

find ways to make sure that we are approaching the work in a way 

that decreases issues like—— 

Ms. MOORE. My time may expire, so I want to make sure I push 

you toward answering my question. I mean, is there a consequence 

that we all need to know about in terms of not having culturally 

competent services? 

Ms. OLIVA. You know, this is an issue which creates so much 

shame and stigma and a sense of wanting to keep this private and 

this ‘‘behind closed doors’’ concept. And it is very difficult for people 

to reach out and make known that they—or even to be able to feel 

safe doing so. So it is extremely important that people have the 

ability to reach out in places that they are comfortable. And culture 

competence and culture familiarity and language familiarity cer-
50 

tainly are critical for that, because the important thing is to get 

people to reach you, to reach out to you before the police come to 

the door because the neighbor heard a shot or someone screaming. 

You want people to be able to reach for help. And when they do 

come out for help, or when they are brought for help, you want 

them to feel safe and able to communicate what their needs are 

and what is happening in their homes to themselves and their children. 

Ms. MOORE. With your diligence, could you please answer my 

second question: What happens when there is no room in the shelter? Can you give us some examples? 

Ms. OLIVA. Domestic violence programs never turn somebody— 

never say, sorry, we are busy, call back tomorrow, we don’t have 

room. However, more and more we are seeing shelters, including 

my own, not able to meet the needs. So we need to—we get very 

creative, and in every possible way we use much of our discretionary money on helping people pay for transportation, medicine, 

food, you know, that kind of thing, so that they can be in some kind 

of emergency situation, they can be relieved of it. 

We have used motels for very short-term stays. We try to work 

with everyone to find is there a safe place for you to be. We have 

transported people all over the country. But—sometimes because 

that is the safest thing for them, but also because sometimes we 

just don’t have the resources, and so we have to scrounge and find. 

It is very difficult, it is extremely difficult, and sometimes people 

give up when they don’t get the help they need right away, and it 

just feels easier to just go back. And that is terrible, and we don’t 

want that to happen. That is why these resources are critical. 

Ms. MOORE. I yield back. Thank you, Madam Chair. 

Chairwoman MCCARTHY. Thank you. 

As you probably heard, bells are going off, and beepers are going 

off. We are in the middle of a vote. So we usually have time on this 

panel to actually go for a second round of questions. That is the 

beauty of—I personally think of our subcommittee anyhow. But 

with that, being that we are going to be down there for 45 minutes, 

I want to thank each and every one of you for coming in. It was 

heartbreaking testimony, but it certainly gives us a good roadmap 

on what else it is we need to do as we go forward on the reauthorization. 

We heard the testimony today about the importance of good prevention programs, the need for good decisions to be made by our 

child welfare workers, and the need to consider all appropriate avenues for families that are in crisis. As we move towards reauthorization, we will have our work cut out, but by taking a comprehensive approach to abuse, violence, prevention, children, families and 

communities, we will be a healthier Nation. 

I want to thank again all of our witnesses for being here today. 

Each of you have highlighted the very real concerns with access 

and the issues we need to focus on during the reauthorization process. 

I want to mention that there has been a great deal of interest 

in this hearing, and we have received many requests to submit 

written testimony. I would also like to submit two reports for the 

record, one from the National Network to End Domestic Violence, 
51 

which provides a snapshot of the lifesaving work of domestic violence services and shelters across the country. The second is called 

Meeting Survivors’ Needs: A Multiple State Study of Domestic Violence Shelter Experiences. I would also like to introduce the 2007 

series of AP articles on child sex abuses in our schools. Without objection, so ordered. 

[The information follows:] 
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[The report, ‘‘Meeting Survivors’ Needs: A Multi-State Study of 

Domestic Violence Shelter Experiences,’’ may be accessed at the following Internet address:] 

http://www.ncjrs.gov/pdffiles1/nij/grants/225025.pdf 
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Chairwoman MCCARTHY. I am also expecting several other 

groups will be submitting testimony towards this as we go forward. 

As previously ordered, Members will have 14 days to submit additional materials for the hearing record. Any Member who wishes 

to submit follow-up and questions in writing to the witnesses 

should coordinate with the Majority staff within the requested 

time. 

Without objection, this hearing is adjourned. Thank you again. 

[Additional submissions of Mrs. McCarthy follow:] 
98 

Prepared Statement of Sheryl Cates, Chief Executive Officer, 

National Domestic Violence Hotline 

Dear Members: For over 13 years, victims have obtained 24-hour, confidential and 

anonymous help through the toll-free National Domestic Violence Hotline. Each 

year, highly trained Hotline advocates provide support, information, safety planning, crisis intervention and referrals to agencies for hundreds of thousands of victims and anyone calling on their behalf. Assistance is available in English and 

Spanish with access to more than 170 languages through interpreter services. Help 

is available to callers 24 hours a day, 365 days a year by calling 1-800-799-SAFE 

(7233) or TTY 1-800-787-3224. The Hotline serves as the only domestic violence hotline in the nation with access to a network of more than 5,000 shelters and domestic 

violence programs across the United States, Puerto Rico and the U.S. Virgin Islands. Advocates receive approximately 21,000 calls each month. 

The Hotline provides an essential first response to hundreds of thousands of victims each year by directly connecting them to a life-saving network of providers who 

assist them with a violence-free future. Yet increasing call volume, combined with 

a lack of resources, undermines the Hotline’s capacity to answer each call for help. 

In 2008, while the Hotline received 255,047 calls, there were over 42,500 calls 

(17%) that Hotline advocates were unable to answer due to increased demand. 

There were over 18,140 more callers in 2008 than in 2007 and the Hotline has 

seen a 13% increase in callers needing assistance in languages other than English. 

Without increased resources, current call trends suggest the Hotline will be unable to answer nearly 45,000 calls in 2009. 

The loveisrespect, National Teen Dating Abuse Helpline (NTDAH) managed by 

the Hotline was launched in February 2007 to address the alarming and increasing 

trend of teen dating abuse. NTDAH is a national 24-hour resource that can be 

accessed by phone or the internet and is specifically designed for teens and young 

adults ages 13-18. loveisrespect.org offers real-time, one-on-one support from trained 

Peer Advocates. Peer Advocates are trained to offer support, information and advocacy to those involved in dating abuse relationships as well as concerned parents, 

teachers, clergy, law enforcement, and service providers. 

Clearly the need for these life saving services has increased. The Family Violence 

Prevention Services Act (FVPSA) remains the core federal funding stream for this 

life saving aid to victims of intimate partner violence. Your support of this funding 

will ensure victims get the help they so desperately need and additional FVPSA 

funding will enhance the capacity to meet growing demand and serve an increasing 

volume of calls. 

Thank you Chairwoman McCarthy and subcommittee members for this opportunity to highlight the importance of increased Family Violence Prevention and 

Services Act (FVPSA) funding to support the critical services offered by the National 

Domestic Violence Hotline and the National Teen Dating Abuse Helpline, 

loveisrespect.org. 

Sincerely, 

SHERYL CATES, Chief Executive Officer. 

Prepared Statement of the Child Welfare League of America (CWLA) 

The Child Welfare League of America (CWLA) is a ninety year-old non-profit organization representing hundreds of state and local child welfare organizations including both public and private, and faith-based agencies. We are pleased to submit testimony to today’s hearing by the Subcommittee on Healthy Families and Communities 

on the topic of Preventing Child Abuse and Improving Responses to Families in Crisis. 

The U.S. Department of Health and Human Services (HHS) releases the latest 

national data on child abuse and neglect every April. For 2007, the numbers tell 

a familiar story: Nearly 800,000 children were substantiated as abused and or neglected, out of the more than 3.3 million child abuse reports made. Children in the 

birth to age 1 year had the highest rate of victimization at 21.9 per 1,000 children. 

Of the estimated 1,760 child fatalities in 2007, 34.1% were attributed to neglect only 

with physical abuse a major contributor to child fatalities.1

Of the child victims, nearly 8% were sexually abused, and 11% were physically 

abused. One consistent statistic that surprises some is that nearly 60% of the 

800,000 children are victims of neglect.2 In many cases, neglect can be just as serious as sexual or physical abuse. It also tells us we are not doing enough to prevent 

these children from being brought to the attention of child protective services (CPS), 

and thereby being placed into care. 
99 

Another consistent statistic is that of the 800,000 abused and neglected children 

identified, more than 40% did not receive follow up services.3 Reasons for this include the way in which data is collected, how states provide services, and in some 

instances the reluctance on the part of some families to access services. Still, with 

such a high and consistent percentage going without follow-up help, clearly services 

are not being adequately provided at the front end of the child welfare system. For 

some, that may mean they will return to the system. 

In the near future, HHS is expected to release the Fourth National Incidence 

Study of Child Abuse and Neglect (NIS). The Subcommittee may want to review this 

study when it is released for the insight it may provide into the need for greater 

prevention efforts. The last one was published in 1996, and, like that one, this congressionally mandated study is likely to tell us that more children suffer from abuse 

and neglect than the official statistics indicate. The report will survey professionals 

from dozens of U.S. counties, and the analysis will shed some light on the number 

of children harmed by abuse and neglect; characteristics of children, families, and 

perpetrators; report sources; and CPS investigations. 

The NIS includes children who were investigated by CPS agencies, but it also obtains data on children seen by community professionals who were not reported to 

CPS or who were screened out by CPS without investigation. Therefore, NIS estimates provide a more comprehensive measure of the scope of child abuse and neglect known to community professionals, including both abused and neglected children who are in the official statistics and those who are not. 

The NIS follows a nationally representative design, and because all four national 

studies have used comparable methods and definitions, comparisons can be made 

about our progress or lack of progress, and this likely will reinforce the need for 

greater preventive efforts. 

Prevention as part of the child welfare continuum 

Prevention of child abuse and neglect is perhaps the greatest challenge in the continuum of the child welfare system. All too frequently, prevention of abuse and neglect is an add-on service instead of a core component of the range of needed services. The issue of providing or addressing prevention too often is conditioned on 

whether a child welfare agency or state agency can free up appropriations or funds 

by reducing the cost, including what some would describe as back-end services typically foster care. Instead, what is required is an investment in the range of services. 

Child protection can trace its origins to the 19th Century when, in 1875, the Society for the Prevention of Cruelty to Children was established in New York City. 

After publicity surrounding the treatment of a young child captured the public’s attention, the President of the American Society for the Prevention and Cruelty to 

Animals was approached and, as a result of his support, existing state legislation 

to protect children was vigorously enforced for the first time. Other states and jurisdictions would eventually follow by enacting their own laws. In 1899, Illinois became 

the first state to create a juvenile court to address issues of dependence, delinquency, and neglect. By 1907, 26 states had followed with their own juvenile court 

laws.4

The first White House Conference on Children was convened in 1909 and led to 

the creation of a Children’s Bureau at the federal level. Part of the mission of the 

new bureau, at the urging of the White House Conference, was to ‘‘investigate and 

report on all matters relating to the welfare of children and child life among all 

classes of people.’’ 5

Throughout the following decades, other federal and state laws were enacted, but 

in 1960, Dr. C. Henry Kempe’s work on ‘‘battered child syndrome’’ raised the importance of communities in their efforts to protect children and led the medical community to improve methods of identifying and protecting children from abuse. In 1974, 

Congress passed the first Child Abuse Prevention and Treatment Act (CAPTA). This 

landmark law helped establish national standards for specific reporting and response practices for states to include into their child protection laws. 

CAPTA is the only federal legislation exclusively dedicated to preventing, assessing, identifying, and treating child abuse and neglect—the continuum of child maltreatment services and supports. Since 1974, CAPTA has been part of the federal 

government’s effort to help states and communities improve their practices in preventing and treating child abuse and neglect. CAPTA provides grants to states to 

support infrastructure and innovations in state child protective services (CPS). 

CAPTA includes three programs: 

• CAPTA authorizes grants to the states to develop innovative approaches to improve their CPS systems. To qualify for these grants, states must meet eligibility 

requirements, such as having mandatory reporting laws, preserving victim confidentiality, appointing guardian ad litems, and establishing citizen review panels. 
100 

• CAPTA discretionary funds support state efforts to improve their practices in 

preventing and treating child abuse and neglect. These funds support program development, research, training, technical assistance, and the collection and dissemination of data to advance the prevention and treatment of child abuse and neglect. 

These funds also support the National Child Abuse and Neglect Data System, the 

only federal data collection effort to determine the scope of child abuse and neglect. 

These funds support national initiatives, such as the National Office of Child Abuse 

and Neglect, the National Resource Center on Child Maltreatment, and the National 

Clearinghouse on Child Abuse and Neglect. 

• The Community-Based Family Resource and Support Program was created in 

1996. The program provides grants to states to support their efforts to develop, operate, and expand a network of community-based, prevention-focused family resource 

and support programs that coordinate resources among a range of existing public 

and private organizations. Funding is allocated to states by a formula based on the 

number of children in a state’s population. 

While CAPTA is intended to bolster child protection efforts and invests some limited funds into preventing abuse from occurring, it’s funding and appropriations history has been dismal at best. Each reauthorization results in adjustments in policy 

and practice but it has not resulted in increased appropriations or commitment from 

past congresses or administrations. We hope that will change in the 111th Congress 

and with the President’s next budget in February. 

As significant as it is, CAPTA is only one part of the child welfare system and 

ultimately our prevention initiatives. Over the years laws such as Aid to Dependent 

with Dependent Children, (AFDC) followed by Temporary Assistance to Needy Families (TANF), and the Social Services Block Grant (SSBG) provide critical funding 

to child welfare services including services to protect children. Overall, SSBG is a 

major source of federal funding, representing 11% of federal funding for child welfare services that addresses the needs of vulnerable children and youth.6 SSBG frequently serves as a link between government funding and private and charitable 

sources and helps build and fund a network of private agencies. SSBG funds supplement local and charitable efforts by providing federal dollars to fill a gap these charities may not be able to meet. The breadth of services provided by SSBG funds can 

also cover shortfalls left by other federal social services programs. 

Two other important sources of funding also found in the Social Security Act 

along with TANF and SSBG are Title IV-B part 1, Child Welfare Services (CWS), 

and Title IV-B part 2, Promoting Safe and Stable Families (PSSF). Both are flexible 

funding streams that fund a range of services. But even in these instances, with 

CWS funded at $281 million in annual appropriations and PSSF funded at $368 

million in combined mandatory and discretionary appropriations, funds have to be 

shared between programs that might prevent abuse and those that assist families 

and children through adoption and reunification services. It should also be noted 

that both have actually been cut over the past eight years. 

Promising initatives 

There are a number of important efforts taking place across the country and we 

are encouraged that some of the Administration’s new initiatives are building on 

these efforts and we hope much more will be done. 

First and foremost is President Obama’s proposal of $8.6 billion over 10 years for 

a new mandatory program that provides funds to states for evidence-based home 

visitation programs for low-income families. Home visiting is just one of several 

other initiatives around child care and early childhood education, which the Obama 

Administration is proposing to advance their zero to five initiatives. 

To date, Congress has been very supportive of this initiative as well. Included in 

HR 3962, is a provision that would provide much needed grants to states to improve 

the well-being, health, and development of children by enabling the establishment 

and expansion of high quality programs that provide voluntary home visitation for 

families with young children and families expecting children. These grants are intended to target at risk and vulnerable families and communities who are in need 

of services that will not only reduce abuse and neglect but also improve the overall 

health and development of young children. Priority funding will provided for programs that adhere to a model of home visitation with the strongest evidence of effectiveness. 

Funding for this provision is currently set at $750 million over five years which 

is much less than what the Administration initially proposed, and half of what the 

Senate bill’s provision contains. CWLA believes that this proposal and other proposals that place an emphasis on evidence based practices and evidence informed 

innovation can serve as a model for a major prevention initiative. 
101 

CWLA is also pleased that the President has proposed and it appears the Congress will approve a new ‘‘Promise Neighborhoods’’ initiative. This initiative, which 

President Obama raised during the campaign, is based on the Harlem Children’s 

Zone program. The program attacks poverty through a comprehensive school-based 

model that provides wrap around services for the entire family. It places a special 

emphasis on early-learning, elementary and secondary education, and guides children through the entire period of learning. The goal is to spread this model to several communities across the country. The planning grants would go to non-profits 

for one year. Only those grantees that developed proposals that incorporated strong 

partnership and strong plans would be eligible for larger implementation grants the 

following year. 

CWLA is also very supportive of the Administration’s emphasis zero to five initiatives. Some of these efforts include the Early Learning Challenge Grants, which the 

Education and Labor Committee has already acted on, and other initiatives focused 

on pre-K funding as well as next year’s debate on child care. Although some of these 

important initiatives that may not be thought of as child abuse prevention, they are 

all critical components of assistance to the country’s most vulnerable families and 

children. 

At the local level we also see examples that can be built on through greater federal support. Some examples include Baltimore’s Family Connections program, 

which uses a range of funding sources from the public, private, faith-based, foundation, and other community partners to show some significant results. The Family 

Connections program has shown positive results in reducing the instances of abuse 

and neglect by using limited federal funds to better coordinate communities and 

services. As the University of Maryland points out, 

Evaluation results show Family Connections improves protective factors such as 

parenting skills and attitudes, and reduces risk factors such as parent depression, 

caregiver drug use, caregiver stress, and children’s behavioral problems. The program also demonstrated reduced incidents of child abuse and neglect and increased 

child safety and well-being.7

The results were enough to encourage HHS to fund eight additional models with 

initial resources focused on an 11-month community-planning process. 

Differential response is one prevention strategy that holds promise in protecting 

vulnerable children. This form of practice allows for more than one method of response to reports of child abuse and neglect. Also called dual track, multiple track, 

or alternative response, this approach recognizes the variation in the nature of reports and the value of responding differentially. 

Great variation exists in state and county implementation of differential response, 

which generally involves low- and moderate-risk cases that receive a non—investigation assessment response without a formal determination or substantiation of 

child abuse and neglect. Although states are attempting several approaches in this 

area, the basic policy difference is in how complaints of abuse and neglect are dealt 

with and screened into or out of the CPS system. In some instances, responses to 

reports of child abuse and neglect may result in greater family support and services 

to address the underlying causes. 

Initiatives that combine the efforts of the courts and the child welfare community 

also have shown promise. These initiatives, which provide funds to train key personnel—including judges and child welfare workers involved with the courts, such 

as court-appointed state advocates (CASAs) and CPS workers—have yielded positive 

results in keeping families together and addressing the abuse and neglect of infants 

and the very young. 

The Court Teams for Maltreated Infants and Toddlers Project, spearheaded by 

ZERO TO THREE, has shown great promise and results; what it lacks is a steady 

source of dedicated funding that can expand on these efforts. 

Another innovation being implemented in some areas, both in terms of CPS and 

in placement decisions, is Family Group Decision Making (FGDM). FGDM offers an 

approach of working with families and communities involved with the child welfare 

system. Families are engaged and empowered by child welfare agencies to make decisions and develop plans that protect and nurture their children from enduring further abuse and neglect. The FGDM approach recognizes that families are the experts of their own situations and therefore are often able to make well-informed decisions about their circumstances with the support of family members and others 

who have worked with the family. 

The prevention challenge 

Prevention can encompass services as basic as access to child care and it can also 

include a range of other services that can help families reduce the stresses of par-
102 

enting. Providing respite for parents can ensure a child’s well-being when parents 

are working, in school, or caring for other children. 

There is an increasing level of research and work that is being done in terms of 

prevention. The Children’s Bureau highlights common factors that can be found in 

successful prevention initiatives. This research suggests that you must both reduce 

risk factors and promote protective factors to ensure the well-being of children and 

families. This work also shows that protective factors include efforts to strengthen 

all families. This kind of approach when possible can extend support beyond the 

most vulnerable families and reach other families may not meet the criteria for the 

most vulnerable but are families that are dealing with stressors that could lead 

them to abuse or neglect. 

CWLA believes that some of the recent initiatives being advanced by the Administration and some of the research now being developed offers an opportunity to develop a new approach to preventing child abuse. A model that requires and is driven 

by community-based partners, that requires on-going research and that can implement and replicate proven models but allows enough flexibility to invest in innovative and emerging practices and programs. 

Recommendations 

First and foremost we hope Congress will act soon to reauthorize CAPTA. More 

importantly however, is our belief that there needs to be a genuine commitment to 

fund this law. That commitment must be shared by the Administration, the Congress and the advocacy community. It offers limited effectiveness to reauthorize the 

law and to fund the basic state grants at $27 million, which would only provide in 

some states enough to hire one or two social workers to carry out the important 

tasks that can help address child abuse and prevent it in the first place. 

CWLA is encouraged and is hopeful that Congress will complete its work this year 

to make the Administration’s new home visitation program a reality. We feel this 

legislation and the emphasis on outcomes and research offers a way forward for 

other child abuse prevention initiatives. 

CWLA also hopes the Administration will encourage and lead states to fully implement the provisions of the new child welfare legislation, the Fostering Connects 

to Success Act (PL 110-351) passed late last year. Although some of the provisions 

deal with children and families already in contact with child welfare, they still have 

an impact on a larger population. This is especially true of those provisions dealing 

with health care, training for child welfare workers and other personnel, and tribal 

funding. We also believe it will help Congress and the Administration take the next 

step and reform the way we finance child welfare so that we can include funding 

to address preventing child abuse. 

Finally we urge the Committee and the Congress will act soon to pass legislation 

to re-establish a White House Conference on Children and Youth. CWLA recognizes 

that dollars and federal action alone cannot reduce the level of child abuse or the 

number of children in foster care, and therefore this has to be a partnership at the 

federal, state and local levels. It is for that reason that CWLA has called on Congress to act to restore the oldest White House Conference, the White House Conference on Children and Youth and to focus it on the needs of the country’s most 

vulnerable families and children. 

This Conference was once held every ten years but has not been held since President Nixon called it in 1970. Its results have been noteworthy. It was mentioned 

earlier that the first White House Conference on Children and Youth led to the creation of a Children’s Bureau in 1909 and subsequently the Bureau’s mission in regards to child protection. It should also be of interest to this Subcommittee that one 

of the results of the 1970 convening was a recommendation to create a designated 

Senate committee on children’s issues and we are sure the members of this subcommittee recognize their own value over the years since. 

We urge the Subcommittee and the full committee to act on this legislation this 

year. It is bipartisan and bicameral and offers Congress an opportunity to reach beyond the politics of this year. There is a much more significant reason for this White 

House Conference. It represents a vision of how communities can come together all 

across the country to engage in a discussion of not just needed federal support but 

local community action; how systems can coordinate and communicate to prevent 

abuse and neglect wherever possible; and when not possible how to act in the best 

interest of the child so that he or she has a permanent and loving family. 

The Child Welfare League of America thanks the Subcommittee for these hearings 

and its attention and we look forward to working with you on these key issues. 
103 

ENDNOTES

1 Administration on Children, Youth, and Families (ACYF). (2008). Child Maltreatment 2006, 

Summary. Washington, DC: U.S. Department of Health and Human Services (HHS). Online at 

www.acf.hhs.gov/programs/cb/pubs/cm05/summary.htm. 2 Ibid. 

3 ACYF. (2008). Child Maltreatment 2006. (Chapter Six, Services). Washington, DC: HHS. Online at www.acf.hhs.gov/programs/cb/pubs/cm05/summary.htm. 4 Child Welfare League of America (CWLA). (1999). CWLA Standards of Excellence for Services for Abused and Neglected Children and Their Families. Washington, DC: Author. 5 CWLA. (2007). History of the White House Conference. Washington, DC: Author. Online at 

www.cwla.org/advocacy/whitehouseconfhistory.pdf. 6Scarcella-Andrews, B.R.; Zielewski, E.; & Geen, R. (2006). The Cost of Protecting Vulnerable 

Children V: Understanding State Variation in Child Welfare Financing (Assessing the New Federalism Occasional Paper). Washington, DC: Urban Institute. Online at www.urban.org/ 

url.cfm?ID=411115. 7 Ruth H. Young Center for Families and Children. (n.d.) Family Connections—National Program Replication Project Website. Baltimore: University of Maryland. Online at 

www.family.umaryland.edu/ryc—best—practice—services/family—connections—replication.htm. 

Prepared Statement of the Family Violence Prevention Fund 

Chairwoman McCarthy, Ranking Member Platts, and distinguished members of 

the Committee, thank you for the opportunity to submit this testimony regarding 

the importance of reauthorizing the Family Violence Prevention and Services Act 

(FVPSA) and the Child Abuse Prevention and Treatment Act (CAPTA). Your hearing on Preventing Child Abuse and Improving Responses to Families in Crisis could 

not come at a more opportune time. In 2007, 1,760 children died from neglect or 

abuse in the United States.i And on average, more than three women are murdered 

each day in this country at the hands of a current or former husband or boyfriend.ii

Violence against women and children is a serious problem in the United States 

that is compounded by the stressors of today’s economic conditions. At a time when 

we need to escalate our response to the emergencies at hand, we see all around us 

that resources and services are dwindling. 

The Family Violence Prevention Fund is a national non-profit organization based 

in San Francisco, California, that has worked for the last 30 years to end violence 

against women and children. Our focus has been on preventing violence and abuse, 

and promoting the safety and well-being of all family members in homes where violence has occurred. We commend the Committee for its commitment to preventing 

child abuse and improving responses to families in crisis, and thank you for allowing us to submit testimony on these issues. We would like to take this opportunity 

to highlight and expand upon the connection between child abuse and domestic violence, and how imperative it is to use new knowledge and increased resources to 

improve our intervention and prevention strategies. 

Intersection of Child Abuse and Domestic Violence 

Research suggests a 30 to 60 percent overlap of child maltreatment and domestic 

violence.iii Further, when active universal screening for domestic violence is used, 

child protection system case workers identify a history of domestic violence in 45 

percent of families they see.iv These statistics highlight the co-occurrence of domestic violence and child abuse within families, and the large population that is being 

seen by both the child welfare system and domestic violence services programs. 

Often, this co-occurrence refers to both mothers and children being abused by the 

father of the children or the mother’s boyfriend. In other cases, we see mothers unable to adequately care for their children due to the stress of being abused. We also 

see parents struggling to cope and parent within the context of their own past histories of experiencing or witnessing violence. 

In October, 2009, the National Survey on Children Exposed to Violence documented the alarming rates at which children are exposed to domestic violence in the 

United States. One in 10 children was exposed to family violence in the past year 

and by the time children reached age 17, more than a third had witnessed a parent 

being assaulted.v Children who are exposed to domestic violence display a host of 

problematic behaviors at far higher rates than children not exposed to violence. 

These include being more likely to become a perpetrator of such abuse (for boys) 

as well as displaying higher rates of violence, aggression, suicide, school failure and 

mental health problems. At the same time, children’s responses to exposure to domestic violence vary depending on age and circumstances; many children are resilient.vi Importantly, we know that when appropriate services are provided, particularly when in partnership with their non-abusing parent or caretaker, children exposed to domestic violence can go on to live lives full of purpose and free from vio-
104 

lence and many of the adverse outcomes associated with that violence. What seems 

to help these children most is the presence of a supportive and protective adult, 

most often their mother. 

The challenge, therefore, for many within the child welfare system and child 

abuse prevention community is to better understand how domestic violence is impacting children, and the best ways to respond to children and their abused parent(s). However, most child welfare workers do not have standardized training to 

help them understand the dynamics of domestic violence and put this research into 

practice. In addition, when child protection systems do attempt to address domestic 

violence, they often seek to impose blanket policies that apply to all victims, and 

frequently blame the victim rather than the perpetrator of violence. These policies 

are now illegal in some states vii and have been proven impractical and unhelpful 

in others.viii However good practice and policy have emerged in many communities 

and states, and the time to bring them to scale is now. 

At the same time, domestic violence programs have an enormous opportunity to 

reach the most vulnerable children who are witnessing this abuse and help them 

and their abused parent—usually their mother—become safe and begin to recover. 

By identifying and helping these children, while simultaneously serving their mothers, domestic violence agencies may have their best chance of truly breaking the intergenerational cycle of violence. Yet, these agencies need the direction and, importantly, funding, to start integrating in a holistic way services for children into the 

work they already do with their mothers. 

The reauthorizations of the Child Abuse Prevention and Treatment Act (CAPTA) 

and the Family Violence Prevention and Services Act (FVPSA) serve as the perfect 

opportunity to make some of the necessary changes in our nation’s response to child 

abuse and domestic violence. 

Best Practices to Address Co-Occurrence of Domestic Violence and Child Abuse and 

Neglect 

For about eight years the U.S. Departments of Health and Human Services and 

Justice have pooled very limited resources to try and implement best practices 

around the intersections of child welfare, domestic violence and juvenile courts. 

Through a demonstration initiative nicknamed the ‘‘the Greenbook’’ (after the cover 

of the seminal publication outlining recommendations for doing this collaborative 

work), six test sites were funded and an evaluation conducted. This work provided 

new insights about how to best improve outcomes for children and their mothers 

in families experiencing domestic violence.ix While many specific recommendations 

have been further developed and refined based on the experiences of these sites, we 

focus here on three critical practice elements specific to CAPTA: 

• Training and education on domestic violence is critical to help already overburdened child protection systems (CPS) and case workers make good decisions; 

• The needs of abused mothers and their children cannot be separated, despite 

funding streams and services systems that inherently separate their interests; and 

• Child welfare systems and child abuse prevention programs overall must do a 

better job in understanding and addressing the role of men and fathers in the lives 

of families experiencing abuse—whether the father is the primary perpetrator of the 

abuse or a potential support system to the woman and child, or both. 

The Need for Domestic Violence Expertise 

After several years of attempting to find one model that worked for creating the 

information sharing, training and technical assistance needed to better serve these 

families, we have concluded that no one single model is right for every system. But 

we have also learned that it is absolutely ESSENTIAL that child protection systems 

have access to expertise on helping families who are experiencing domestic violence. 

Two common forms this has taken are the co-location of staff—for instance, the 

placement of a domestic violence advocate in a child protection agency (often referred to as a ‘‘domestic violence specialist’’) x—and case consultations where supervisors or technical experts are brought in to consult on particularly challenging 

cases with domestic violence or where they may provide ongoing training and technical assistance to staff that turn over often. 

The need for this additional expertise stems from the fact that families experiencing domestic violence face particularly complex challenges. While violence may 

be linked to other risk factors, such as substance abuse or mental health issues, it 

often presents its own threats. For instance, a caseworker may know that a mother 

is being abused and insist that she not let the child be alone with her abusive partner. The courts, however, may have granted him unsupervised visitation and she 

would be in violation of her custody agreement if she refused to deliver the child 

to him unsupervised. By having a domestic violence expert on hand, the conflicting 
105 

messages can be illuminated and corrected through advocacy and legal guidance. 

The advocate and the caseworker together can help both the mother and the child 

stay safe by integrating their knowledge and skills. What this consultation may look 

like will differ by jurisdiction, but its importance is indisputable. 

Supporting Mothers and Children Together 

At the heart of CAPTA, like all efforts to prevent child abuse and neglect, is the 

simple question: What do children need to be safe? And the simple answer is that 

they need a loving and capable parent or caretaker whenever possible. Unfortunately, child welfare systems have often responded to domestic violence by either 

ignoring its significance or over-reacting and blaming the mother for her own victimization. They will often see the mother as the problem for her ‘‘failure to protect’’ 

the child from her victimization or blame her for putting her child at risk, rather 

than placing the blame at the hands of a violent or abusive partner, who in many 

instances is also the child’s father. This is problematic in that it both punishes the 

mother for being a victim and removes from the child the most important source 

of strength and comfort the child may need while going through a particularly difficult time. Fortunately, recent research has documented both the need to keep 

mothers and children connected when there is domestic violence and successful programs that improve both child outcomes and maternal safety. The needs of children 

and their mothers must be viewed together and efforts to keep children safe must 

begin with efforts to keep their mothers safe. 

Betsy McAllister Groves at Boston Medical Center and Alicia Lieberman at San 

Francisco General Hospital have created two model programs to provide the therapeutic services these children need. While their goal is to serve children, both programs work with mother and children together whenever possible, as doing so provides better outcomes for children, as well as their mothers,xi and creates more longterm stable environments to which the child can return. Evaluations have documented positive results in ameliorating children’s trauma and improving their behavior, as well as improving their mothers’ interactions with their children.xii Both 

programs success is tied to their understanding of how children process trauma and 

their need for connection to their primary caretakers, most often their mothers. 

The Role of Men and Fathers 

For the most part, child welfare systems have been oriented toward mothers. It 

is true that most mothers remain the primary caregivers of their children. But ignoring men is a mistake. By largely dismissing the roles of fathers and men in the 

lives of these children, systems are both missing opportunities to constructively engage men, and punishing battered mothers and children for men’s abusive behavior.xiii

Alternatively, some child welfare systems have been successful at developing new 

fatherhood initiatives and reaching out to men who were once invisible to them. 

While we applaud these efforts, we have learned that it is dangerous to involve fathers without understanding the risk they may pose to mothers and children. Some 

child welfare systems are taking the lead and searching for new ways to engage 

both men and fathers and simultaneously hold them accountable for their violence. 

Through the Greenbook Initiative, several communities developed treatment plans 

for fathers, and hired men who specialize in changing violent behavior to help shift 

thinking in child welfare offices.xiv CAPTA is in a unique position to drive new efforts that support forward-thinking fatherhood initiatives that integrate what we 

know about domestic violence. 

Good Data Collection: NCANDS 

Finally, we would like to address one of the least glamorous, though most necessary, elements of preventing and ultimately ending domestic violence and child 

abuse: data collection. The National Child Abuse and Neglect Data System 

(NCANDS) is the basic vehicle that provides information about children and families who come to the attention of local child welfare agencies. It is increasingly apparent that, among other issues, domestic violence is present in a large percentage 

of these families. While not everything about a family’s circumstances is known at 

the time of the initial report, in many instances the presence of domestic violence 

in a family may come to light during the report and investigation phases, or at decision points related to service provision or placement. Yet to date, NCANDS provides 

little, if any, information in its annual reports about domestic violence, and the context and impact of domestic violence. 

This data has enormous consequences because it is likely we are missing the link 

and making inappropriate and potentially dangerous recommendations to families 

and juvenile and family courts. First, we would want to identify in what percentage 

of reports, substantiations and victimization, and for each different category of mal-
106 

treatment, that domestic violence is a factor. Community experience suggests that 

often, exposure to domestic violence is automatically considered ‘‘failure to protect’’ 

by the mother and categorized as ‘‘neglect.’’ It would help if NCANDS could differentiate whether neglect (or other maltreatment categories, including ‘‘other’’) is being 

used as a ‘‘proxy’’ for a ‘‘failure to protect’’ or similar allegation (not all states use 

the same terms). 

Another reason it is important to distinguish which types of maltreatment cases 

come to child welfare as a result of, or accompanied by, domestic violence is that 

most reports or petitions are filed in the mother’s name, automatically ascribing the 

maltreatment to her and making her the sole subject for compliance with case 

plans. However, in many instances she is not the offender against a child, but instead may be a victim of violence perpetrated by her partner. In these cases, she 

needs support, protection and the ability to keep her child(ren) with her safely. 

Without clearer information that helps identify these distinctions, it is difficult to 

develop or target responses and services appropriately. When this happens, the 

mother may be put into a database of child abusers, which unfairly labels her and 

may prohibit her from seeking any job working with children. 

Finally, as an increasing number of states and counties institute some type of differential response system, it will be important to know if families with co-occurring 

domestic violence are provided that alternative, and also whether they have repeat 

reports of maltreatment after the diversion to alternative services. 

Given these concerns we would strongly recommend that data be collected and 

disseminated on the relationship between domestic violence and categories of maltreatment, including: 

• The relationship between domestic violence and child fatalities; 

• The relationship between domestic violence and repeat maltreatment; 

• The identity of the perpetrator in cases of domestic violence; 

• The nature and extent of co-occurring domestic violence and substance abuse; 

• The nature and extent of the services provided to these families; 

• For families with co-occurring domestic violence who are provided alternative 

response, the nature of the agency(ies) to which they were referred and whether the 

services were utilized; 

• In what percentage of cases domestic violence is a factor in removal, and whether there are other characteristics associated with the domestic violence that lead to 

the decision to place a child outside of his/her home; and 

• The percentage of domestic violence in the neglect category. 

CAPTA Recommendations 

Given what we have learned around the intersections of domestic violence and 

child abuse over the last 15 years, and emerging research on best practices for addressing domestic violence as a means of reducing child abuse and neglect and preventing future domestic and sexual violence, we respectfully recommend that 

CAPTA be amended to include a focus on: 

• Increasing the availability of good data on the overlap of domestic violence and 

child maltreatment, and successful policies, procedures and services that improve 

safety and well-being of children and their non-abusing parents and caretakers; 

• Providing expertise to child protection systems and workers on domestic violence and how to work successfully and safely with families where there is domestic 

violence, including safety and risk assessment, case consultation, co-location of domestic violence staff and safe approaches to family group conferencing and team decision making; 

• Funding for cross-training and collaboration so domestic violence and child welfare systems can better work together to improve safety and well-being of children 

and their mothers; 

• Ensuring that CAPTA funding is available to support services for mothers and 

their children together, when that is most appropriate; and 

• Increasing the awareness of and skills pertinent to addressing the roles fathers 

can safely play in the lives of these children. 

The Family Violence Prevention and Services Act (FVPSA) Recommendations 

The Family Violence Prevention Services Act (FVPSA) is the lifeblood of domestic 

violence organizations in the United States. FVPSA is the largest designated federal 

funding source for emergency services for victims of domestic violence and their children, providing shelters, crisis lines, counseling and victim assistance programs. 

Every year, the demand for these services continues to rise, and shelters and services must turn away families in danger because of a lack of resources. 

As previously discussed, domestic violence programs are an important place to intervene early with children who have been exposed to violence. In a single day in 
107 

2007, 13,485 children were living in a domestic violence shelter or transitional housing facility, and another 5,526 sought services at a non-residential domestic violence 

program.xv

Children who live in domestic violence shelters often have suffered many losses. 

They have most likely left their communities, extended families, friends, schools and 

all things familiar. It is difficult to comprehend the extent of the consequences for 

these children. At a minimum, these children need some individualized attention to 

assess how they are doing and determine whether they require specific care based 

on their needs. Their mothers, who are often under great stress, need parenting 

support to repair any damage to their relationships with their children created by 

the abuser. Without support, the attachment between mothers and children can 

weaken and further complicate their safety and healing. Therefore it is essential 

that domestic violence programs have the dedicated resources to help the children 

in their programs and the training and technical assistance to implement the most 

effective programs. 

The Need for Technical Assistance to Continue 

Technical assistance and resource centers are also necessary to help victims of domestic violence who may not access targeted domestic violence agencies. Most victims of domestic violence never go to a domestic violence shelter, and often call law 

enforcement only when it has become a life or death situation. But they do go to 

the doctor, either for themselves or their children. Reaching out to victims 

proactively before they may reach out to domestic violence services is another important prevention and early intervention strategy, and health care providers play 

a critical role. The Family Violence Prevention Fund’s National Health Resource 

Center on Domestic Violence (HRC), is a model for providing technical assistance 

and training across systems on family violence. The HRC works to improve health 

and public health responses to victims of family violence, and seeks to directly impact individual, local, state and national health care practice and policy as it relates 

to violence prevention and intervention. The HRC provides technical assistance to 

thousands of providers and advocates each year, as well as patient and provider resources, including culturally relevant safety cards, educational posters, quality assurance tools, national consensus guidelines on domestic violence, and a national 

conference. We must maintain support for these types of resource centers that provide cutting-edge technical assistance, training and information to victims and those 

who assist them, including health care providers and domestic violence service providers. 

FVPSA Recommendations 

Specifically, we recommend that the Family Violence Prevention and Services Act 

reauthorization: 

• Increase overall authorization to meet increasing needs for services; 

• Include a specific funding stream dedicated to children’s services within domestic violence programs; 

• Maintain support for existing technical assistance resource centers and culturally specific institutes to help identify victims earlier and meet their needs in culturally and linguistically appropriate ways. 

Thank you for the opportunity to comment on these critical pieces of legislation. 

For additional information, please go to www.endabuse.org; or contact our Washington, D.C. office at 202-682-1212. 

ENDNOTES

i U.S. Department of Health and Human Services, Administration on Children, Youth and 

Families. Child Maltreatment 2007 (Washington, DC: U.S. Government Printing Office, 2009). 

Available at: http://www.acf.hhs.gov/programs/cb/stats—research/index.htm#can. ii Catalano, S. 2007. Intimate Partner Violence in the United States. U.S. Department of Justice, Bureau of Justice Statistics. Available at http://www.ojp.usdoj.gov/bjs/intimate/ipv.htm. iii Edleson, J. Interventions and Issues in the Co-Occurrence of Child Abuse and Domestic Violence, 4 CHILD MALTREAT. 91-182 (1999). See also Anne E. Appel & George W. Holden, The 

Co-Occurrence of Spouse and Physical Child Abuse: A Review and Appraisal, 12 J. FAM. 

PSYCHOL. 578-599 (1998). iv Active screening at intake for domestic violence in the child welfare system includes the use 

of formal policies, procedures, and screening tools. See The Greenbook National Evaluation 

Team, THE GREENBOOK DEMONSTRATION INITIATIVE, INTERIM EVALUATION REPORT 33 (2004). vFinkelhor D., Turner H., Ormrod R., & Hamby S. 2009. Violence, Abuse, and Crime Exposure in a National Sample of Children and Youth, Pediatrics, Volume 12, Number 5. vi Edleson, J. L. (1999). The overlap between child maltreatment and woman battering. Violence Against Women, 5(2), pp. 134 to 154. 
108 

viiSee especially Nicholson v. Scoppetta 181 F Supp2d (EDNY 2002); Nicholson v. Scoppetta 

3 NY3d 357, 366 (2004). viii Edleson, J., et al. Defining Child Exposure to Domestic Violence as Neglect: Minnesota’s 

Difficult Experience. Social Work, Volume 51, Number 2, April 2006. ixKnown as the Greenbook Initiative, these recommendations were initially developed and 

published by the National Council of Juvenile and Family Court Judges (NCJFCJ) in 1999, in 

Effective Interventions in Domestic Violence and Child Maltreatment Cases: Guidelines for Policy and Practice. For the most up-to-date research and analysis from the demonstration sites, 

go to www.thegreenbook.info. x Rosewater, Ann for the National Council of Juvenile and Family Court Judges and the Family Violence Prevention Fund (2008), Building Capacity in Child Welfare Systems: Domestic Violence Specialists. See also, Taggart, Shellie and Litton, Lauren for the National Council of Juvenile and Family Court Judges and the Family Violence Prevention Fund, Reflections from the 

Field: Considerations for Domestic Violence Specialists (in press). xi Ibid. p. 37. xiiLieberman, A.F. Van Horn, P.J. and Ghosh Ippen, C., Toward Evidence-based Treatment: 

Child-Parent Psychotherapy and Symptom Improvement in Preschoolers Exposed to Domestic 

Violence,’’ Annual Meeting of the International Association of Traumatic Stress Studies, New 

Orleans, 2004. xiii Rosewater, A. and Goodmark, L., p. 38. xiv Ibid. See also, www.thegreenbook.info. xvDomestic Violence Counts 07: A 24-hour census of domestic violence shelters and services 

across the United States. 2008. National Network to End Domestic Violence. Available at 

http://nnedv.org/docs/Census/DVCounts2007/DVCounts07—Report—Color.pdf. 

Prepared Statement of the National Association of Public Child Welfare 

Administrators 

On behalf of the American Public Human Services Association and its affiliate, 

the National Association of Public Child Welfare Administrators, we applaud the 

committee’s interest in preventing child maltreatment and improving responses to 

families in crisis. We respectfully submit the following for your consideration. 

APHSA is a nonprofit, bipartisan organization representing state and local human 

service professionals for more than 79 years. NAPCWA, created as an affiliate in 

1983, works to enhance and improve public policy and administration of services for 

children, youth and families. As the only organization solely devoted to representing 

administrators of state and local public child welfare agencies, NAPCWA brings an 

informed view of the problems today’s at-risk children and families face. 

More Resources Needed for Prevention and Protection 

NAPCWA represents state public child welfare administrators implementing child 

safety and protection programs. Our members depend on a patchwork of federal 

funding streams, including CAPTA, to meet families’ needs. However, most prevention and protection services are supported by state and local dollars. Child protection and safety services include, but are not limited to, child abuse and neglect hotlines and investigations, family intervention, differential response, parent training, 

mentoring and coaching, and residential substance abuse treatment centers, among 

others. Each public child welfare agency works to reduce child abuse and neglect 

by supporting and responding to families either not known to the system (primary 

prevention); families known, but with no open case (secondary prevention) and families already part of the system (tertiary prevention). 

Federal resources for prevention and protection are scarce and support children 

placed in out-of-home settings such as foster care and adoption. Ninety percent of 

all federal dollars are used for foster care and adoption, while only the remaining 

10 percent supports prevention. This imbalance indicates the need for a stronger 

federal role in providing resources for preventing and treating child abuse and neglect, including an increase in funding for CAPTA. 

Child Welfare’s Role 

Difficult economic times impact at-risk children and families the most. Child welfare has witnessed first-hand how the economic downturn negatively affects the entire family unit. Families struggle with job security, mental and physical health as 

well as substance abuse issues. States and localities are amplifying their efforts to 

expand child protection programs and focus on better serving these vulnerable populations. 

In addition to supporting parents and other caregivers, the state child welfare 

agency’s primary responsibility is the safety, permanency and well-being of children. 

Through referrals from the child abuse hotlines as well as tips from mandated reporters such as teachers, physicians and nurses, child protection workers investigate 

and assess family situations and determine the child’s imminent risk of serious 
109 

harm. It is the role of child welfare professionals to balance the rights, roles and 

responsibilities of parents and the safety and well-being of children. 

Public agencies cannot ensure child safety alone. Therefore, child welfare agencies 

collaborate with communities, nonprofit and private agencies, and faith-based organizations to help support children and families. Together, they provide a wide array 

of prevention and protection activities such as public awareness campaigns, skillsbased courses, parent education and support groups, home visitation, family resource centers and respite and crisis care programs. 

State, local, federal and private resources help sustain these programs to better 

serve children and families involved or at-risk of becoming involved in the child welfare system. Below are best practices and promising innovations states are using to 

keep families stable and healthy, especially during difficult financial times. 

Engaging Community Partners to Reduce Child Maltreatment 

Los Angeles County Department of Children and Family Services partnered with 

local community-based organizations to establish the Prevention Initiative Demonstration Project. The partnership between the DCFS and community-based organizations extends beyond traditional parameters and contractual agreements. It 

builds a unique relationship between committed entities to help strengthen families 

during times of crisis. In 2003, the DCFS established agency-wide goals to reduce 

reliance on foster care, and support children and families at home. These partnerships were essential to expedite this mission. Through the county’s IV-E waiver, the 

PIDP receives $5 million a year to serve low-income, at-risk families. The PIDP is 

known for its work using parent advocates, cultural brokers and family visitation 

centers to assist families in need. 

The PIDP’s basic principles to reduce child abuse and neglect include increasing 

families’ accessibility to adequate resources and support; creating economically stable environments for families to raise children in their own homes; and developing 

integrative activities and resources to improve communities and build healthier 

families. Los Angeles County’s effort to engage private, public and nonprofit organizations to collaboratively serve a common purpose is one example of how states and 

localities are expanding their resources to prevent child maltreatment. 

Enhancing Child Protective Services by Implementing Differential Response Models 

Minnesota established differential response to transform its approach to address 

child maltreatment reports by implementing a strength-based, community-focused 

mechanism to effectively improve child safety and well-being. This approach serves 

to identify families’ needs so children can safely remain in their homes. 

Due to increased child maltreatment reports, Minnesota launched a four-year differential response pilot project in 20 counties from 2000 to 2004. The pilot began 

in Olmstead County and provided family assessments and parent support intervention services to families determined to be at-risk. The Institute of Applied Research 

conducted a rigorous field study on the effectiveness of this pilot program using control groups, participant interviews and a review of administrative data. The findings 

show that child safety was uncompromised; there were fewer child maltreatment reports and minimal uses of costly approaches; and families and social workers supported the model. Many states are using similar models to reduce child protection 

reports by providing early intervention. 

Investing in Local Evidence-Based Initiatives to Enhance Child Welfare Prevention 

and Child-Well Being 

Ohio widely invests in evidence-based, multi-pronged initiatives serving vulnerable children and families. The state has launched various countywide child welfare 

reform efforts focusing on front-end services to increase support for families in need. 

One of these efforts includes the Ohio Children’s Trust Fund, which supports local 

and statewide prevention services to help empower families using positive family 

engagement activities and promote an alternative response to child maltreatment 

reports. The Incredible Years is an exemplary evidence-based model that provides 

parent, teacher and child social skills training and has proven to be effective in 

Ohio’s counties. This community-based model seeks to develop comprehensive treatment programs for young children with early onset behavioral issues and works to 

prevent juvenile delinquency, drug abuse and violence. The program has been rigorously tested using randomized control evaluations and produced evidence of high 

ratings and effectiveness. Local, federal and state dollars assist the program’s sustainability during tough economic times. 

Another protection and prevention aspect in Ohio is the Darkness to Light program. This outcome-based program provides sexual abuse prevention and intervention services to vulnerable communities. The program raises awareness about preventing child sexual abuse by educating adults about the prevalence and con-
110 

sequences of child victimization. Darkness to Light offers online support group services that focus on aiding current and past child abuse and domestic violence victims. 

Outreach efforts include a sexual abuse hotline to serve victims and media campaign to spread awareness. These local innovations offer universal preventive approaches offering cost-effective, multi-layered strategies to improve child well-being. 

Preventing Child Abuse and Neglect Through Home Visitation Models 

The New York State Office of Children and Family Services operates a researchbased, comprehensive home visitation model serving more than 20,000 low-income 

families since 1995. Healthy Families New York is dedicated to provide child abuse 

and prevention services to expectant parents and parents with infants from zero to 

three months of age. These children and families are considered to be at-risk of 

abuse or neglect and live in vulnerable communities with high poverty rates, infant 

mortality and teen pregnancy. The HFNY’s home visitors provide families with support, education and linkages to community services designed to address the following needs: (1) to prevent child abuse and neglect; (2) to enhance parenting skills 

and parent-child interactions; (3) to ensure optimal prenatal care and child health 

and development; and (4) to increase parents’ self-sufficiency. 

The HFNY is rigorously evaluated and shows positive outcomes in childbirth, 

child abuse and neglect, parenting practices and access to health care. This nationally acclaimed program was featured in a January 2009 issue of The American Journal of Preventive Medicine showing that all mothers enrolled in the HFNY before 

their 31st week of pregnancy were half as likely to have low-birth weight babies 

compared to mothers in an unassigned control group. Another study published in 

the March 2008 issue of Child Abuse and Neglect indicates that the HFNY has seen 

a decrease in incidences of abuse and neglect during children’s first two years of life 

and reduced use of aggressive parenting practices particularly involving first-time 

teen mothers. The OCFS’s home visitation model has proven to be successful in lowincome communities. New York is one state out of many that operate these programs. 

NAPCWA Guidance on Prevention & Protection 

NAPCWA recently released national child safety guidance known as Framework 

for Safety in Child Welfare. This manual provides tools for states to define, assess 

and respond effectively to child abuse and neglect. We believe that this guidance 

will assist states in reducing the likelihood of child fatalities and instances of child 

maltreatment. Child safety is paramount from the time children come to the attention of state child protection agencies through case closure. However, everyone is responsible for ensuring children’s safety, regardless if they are employed by the public or private sector. 

Public child welfare agencies work diligently to ensure the safety and well-being 

of children and families. These agencies respond to more than a million reports of 

abuse and neglect each year. However, there are minimal federal resources to support child protection and prevention programs. Therefore, we encourage Congress to 

increase CAPTA funding and restructure the child welfare financing system to better support children and families. Thank you for your leadership and commitment 

to child safety and family preservation. 

Prepared Statement of the National Network to End Domestic Violence 

(NNEDV) 

Chairwoman McCarthy, Ranking Member Platts, Chairman Miller, Ranking 

Member Kline, and distinguished members of the committee, thank you for the opportunity to submit testimony for this hearing on the reauthorization of the Family 

Violence Prevention and Services Act (FVPSA). We are grateful for the subcommittee’s leadership on behalf of domestic violence victims and their families. The National Network to End Domestic Violence (NNEDV) is a membership and advocacy 

organization representing the 56 state and U.S. territory domestic violence coalitions. NNEDV is the voice of these coalitions, their more than 2,000 local domestic 

violence member programs, and the millions of domestic violence survivors, advocates and professionals that our member programs represent. 

In order to ensure the safety of domestic violence survivors, we urge the Subcommittee to act swiftly to reauthorize FVPSA with improvements to better serve 

victims’ needs. FVPSA is the only federal funding dedicated to domestic violence 

shelters and services and has been the lifeblood of programs that have been preventing and ending domestic violence for 25 years. Its reauthorization is urgently 

needed to provide stable funding to address victims’ needs. To that end, advocates 

across the country praise the leadership of Representative Gwen Moore (D-WI) who 
111 

is leading the effort to draft a FVPSA bill, likely to be introduced by the end of the 

month, reflective of priorities outlined below. We urge the Committee to prioritize 

FVPSA reauthorization this year. Reauthorizing FVPSA presents an exciting opportunity to meet the needs of underserved communities while continuing proven, successful strategies. FVPSA’s swift reauthorization, with key improvements and adequate funding allocation, will ensure that victims across the country have continued 

access to services that save lives. 

FVPSA: Keeping Families and Children Safe 

Thanks to the leadership of Committee, FVPSA was enacted by Congress in 1984 

in order to address public awareness and prevention of family violence, provide services for victims and their dependents, and provide training and resources to local 

agencies and nonprofit organizations working to address domestic violence. FVPSA 

is administered by the Department of Health and Human Services (HHS) Administration on Children and Families, and for over two decades it has been the lifeblood 

of core domestic violence programs, including shelters and outreach programs, in 

communities nationwide. FVPSA includes three central programs: Formula Grants 

for Shelter and Services; Community Initiatives to Prevent Abuse, which is frequently referred to as Domestic Violence Prevention Enhancement and Leadership 

Through Alliances (DELTA) Grants; and the National Domestic Violence Hotline. 

Working together, these FVPSA programs have made significant progress toward 

ending domestic violence and keeping families and communities safe. However, 

there are steps that should be taken to build on the success of FVPSA and improve 

services for victims. 

The Need for FVPSA-Funded Services for Families 

Since its passage in 1984 as the first national legislation to address domestic violence, FVPSA has remained the only funding directly for shelter programs. Despite 

the progress and success brought by FVPSA, a strong need remains for FVPSAfunded services for victims. Research has shown that one in every four women will 

experience domestic violence during her lifetime.1 Annually, approximately 1.5 million American women and 800,000 men are physically abused by their spouses or 

partners2 and 15.5 million children are exposed to this violence.3 This violence and 

abuse is devastating, costly and can be deadly. Each day in this country an average 

of three women are killed by a current or former intimate partner. 

Domestic violence is more than a crime—it is a public health issue. To address 

this issue, there are approximately over 2,000 community-based domestic violence 

programs for victims and their children (approximately 1,500 of which are FVPSAfunded). These programs offer services such as emergency shelter, counseling, legal 

assistance, and preventative education to millions of women, men and children annually.4

Domestic Violence Counts 2008, a 24-hour census of domestic violence shelters 

and services, found that in one 24-hour time period domestic violence programs 

across the nation served over 60,000 women, men and children. Unfortunately, due 

to a lack of resources, almost 9,000 requests for services were unmet during that 

same day.5 For those individuals who were not able to find safety that day, the consequences can be extremely dire including continued exposure to life-threatening violence or homelessness in many cases. It is absolutely unconscionable that victims 

cannot find safety for themselves and their children due to a lack of adequate investment in these services. 

The gap between adequate resources and increasing demand widens as the economic situation worsens. A bad economy does not cause domestic violence but financial strain can certainly exacerbate violence and victims with fewer personal resources become increasingly vulnerable. Since the economic crisis began, three out 

of four domestic violence shelters have reported an increase in women seeking assistance from abuse.6 Many programs across the country use their FVPSA funding 

to keep the lights on and their doors open. We cannot underestimate how important 

this is—victims must have a place to flee to when they are escaping life-threatening 

violence. The fact is that countless shelters across the country would not be able 

to operate without FVPSA funding. 

By swiftly passing a FVPSA reauthorization inclusive of the recommendations 

below and with an adequate authorization level, Congress can work to ensure that 

victims can find safety and stability after fleeing abuse. 

Key Programs Authorized in FVPSA 

FVPSA State Formula Grants Administered through the Department of Health 

and Human Services, the FVPSA State Formula Grants provide funding to States, 

Territories and Tribes to support domestic violence services in their communities 

using a population-based formula. FVPSA Formula Grants enable communities to 
112 

respond with lifesaving emergency assistance when victims of domestic violence and 

their families reach out for help. Over the past 30 years, shelters and local programs have evolved to provide a wide spectrum of residential and nonresidential 

services, which can include shelter or transitional housing, safety planning, counseling, legal services, child care and services for children, career planning, life skills 

training, community education and public awareness, and other necessities such as 

clothing, food, and transportation. In addition, the FVPSA Formula Grants support 

essential resource centers, institutes, and state, territorial and tribal coalitions that 

help local programs and grantees better meet community needs. Despite receiving 

only a small share of FVPSA funds, these programs ensure a coordinated response 

to domestic violence, address emerging issues, provide technical assistance to 

FVPSA grantees, train community members, and meet the needs of underserved 

communities. 

The impact of FVPSA State Formula grants is phenomenal. The flexible, consistent funding provided by FVPSA has helped millions of victims find safety for 

themselves and their children. In fiscal years 2007 and 2008 almost 600,000 adults 

and children found safety in FVPSA shelters. Research shows that shelter programs 

are among the most effective resources for victims with abusive partners7 and that 

staying at a shelter or working with a domestic violence advocate significantly reduced the likelihood that a victim would be abused again and improved the victim’s 

quality of life.8 These programs keep children and their non-abusive parents safe 

and allow families to rebuild their lives after crisis. A recently released multi-state 

study which shows conclusively that the nation’s domestic violence shelters are addressing both urgent and long-term needs of victims of violence and are helping victims protect themselves and their children.9

DELTA Grants In addition to supporting emergency services through local programs and shelters, FVPSA includes Demonstration Grants for Community Initiatives (also known as DELTA grants, administered by the Centers for Disease Control and Prevention) to expand community-based primary prevention that address 

the underlying causes of domestic violence in order to stop abuse before it starts. 

DELTA is one of the few funding sources for primary prevention work. Domestic violence carries a high price tag, with costs exceeding $5.8 billion each year,10 making 

it all the more important to stop the cycle of violence before it starts. 

DELTA programs are guided by the principles of preventing violence through evidence-based programs that are evaluated to inform future program planning. They 

use innovative strategies including peer education programs for men about family 

and relationships, community change initiatives focused on engaging men in prevention efforts, school-based education to prevent youth bullying that often carries into 

adulthood, and youth-led initiatives to prevent dating violence and promote healthy 

relationships. 

National Domestic Violence Hotline FVPSA also includes the National Domestic 

Violence Hotline, a 24-hour, confidential, toll-free hotline. Using a multifaceted telecommunications system, Hotline advocates immediately connect the caller to a service provider in his or her area. Highly trained Hotline advocates provide support, 

information, referrals, safety planning, and crisis intervention to hundreds of thousands of domestic violence victims and perpetrators. Through a national database, 

advocates can link callers to more than 5,000 local shelters and other service providers across the country that offer a wide range of services to support and respond 

to victims’ needs. For many callers, their call to the Hotline is the first time they 

open up about the abusive relationship. One recent caller described how her abuser 

had forced her to quit her job and monitored all of her phone calls and conversations, saying ‘‘He forced me to give up all my relationships aside from him. I’m completely and utterly alone. Now it’s too late to go back to my friends and family. It’s 

been 15 years.’’ The advocate was able to assure her that she was not alone and 

refer her to a local shelter in the area. The Hotline also provides a helpline for teens 

who are experience dating abuse. 

Since opening in 1996, the National Domestic Violence Hotline has received over 

2 million calls from individuals in need of support and assistance and it now provides services in more than 170 languages. While the National Domestic Violence 

Hotline answers an average of 21,000 calls a month, ever-increasing demand and 

dwindling resources left 42,500 calls unanswered in 2008. 

Priorities for Reauthorization 

Immediate Congressional action is needed to reauthorize this critical legislation 

and continue the progress we have made toward ending domestic violence and protecting the lives of thousands of victims and their children who come forward each 

day for help. Our nation depends on FVPSA-funded programs to meet the immediate, urgent and long-term needs of victims of domestic violence and their children. 
113 

We urge the Committee to prioritize the swift reauthorization of FVPSA, inclusive 

of the recommendations outlined and with an adequate funding authorization level. 

Our priorities for reauthorization include: 

1. Maintain the successful response to victims of domestic violence FVPSA has 

been intervening in and preventing domestic violence since it was first authorized 

in 1984. It funds essential services that are at the core of our nation’s work to end 

domestic violence: emergency shelters, hotlines, counseling and advocacy, primary 

and secondary prevention—immediate crisis response and the comprehensive support to help victims put their lives back together. The reauthorization of FVPSA 

must continue to support this successful approach to meeting the needs of victims 

and their families. 

2. Address the unique needs of underserved and marginalized communities Victims from marginalized racial, ethnic and religious populations may not feel safe 

reaching out for help beyond their communities. To meet the needs of victims from 

underserved populations and Communities of Color, FVPSA reauthorization should: 

• Dedicate 2.5% of funding from the formula grants to meet the needs of victims 

from Communities of Color, through a program entitled Grants to Enhance Culturally and Linguistically Appropriate Services For Racial and Ethnic Approaches 

to Change, and include language throughout that supports community-based and 

faith based organizations; and 

• Include a pilot project, entitled the Grants for Underserved Populations and Racial and Ethnic Approaches for Change, which is designed to build community capacity to provide both services and prevention for underserved communities. 

3. Set-aside funding for specialized services for abused parents and their children 

One-half to two-thirds of the residents of domestic violence shelters are children, 

and approximately 15.5 million children are exposed to domestic violence each year. 

FVPSA currently includes a set-aside for services for children, but it is largely undefined. FVPSA reauthorization should strengthen and clarify funding for services to 

children and youth, including clarification of how such funds will be distributed. Domestic violence programs provide safety and support for children, but many struggle 

to meet the demand for children’s services. They see the needs of children who are 

recovering from the trauma of witnessing or experiencing abuse and they are eager 

to implement new and expanded children’s programming. 

4. Protect the confidentiality of victims It is absolutely essential that victims’ privacy and confidentiality is addressed in the FVPSA reauthorization. We have recommended that the FVPSA confidentiality is primarily based on VAWA confidentiality provisions to ensure consistent administration among grantees, which often 

access both funding sources for distinct projects. 

5. Fairly distribute funding to the U.S. Territories The U.S. Territories of the U.S. 

Virgin Islands, American Samoa, Guam, and the Northern Mariana Islands are eligible for FVPSA funds but the distribution formula does not provide adequate resources for Territories or Territorial Coalitions. This inequality should be rectified 

by amending the relevant funding formulas. 

6. Enhance the state planning process The distribution of FVPSA funding should 

be tied to a state planning process that adequately addressing the unique needs of 

domestic violence victims, including those who are underserved. The state planning 

should be made more responsive and accountable to grantees, advocates and legislators alike. 

7. Strengthen the provision of technical assistance to help meet community needs 

FVPSA currently funds several national resource centers, culturally specific institutes, state coalitions, and Tribes to ensure a coordinated response to domestic violence and rapid response to emerging issues. As FVPSA makes continued progress 

addressing domestic violence, grantees and communities face new challenges and 

need access to training and technical assistance on the most up-to-date resources, 

models and research. To continue this and improve the provision of technical assistance, the language authorizing the institutes and resource centers should be restructured and combined with dedicated funds. 

8. Define the service population FVPSA must include distinct definitions for Dating Violence and Youth to ensure that all victims in danger can access services. In 

some states the definition of Domestic Violence does not include those who are in 

‘‘dating’’ relationships or youth victims—yet we know that women between the ages 

of 16-24 experience the highest rate of intimate partner victimization. The FVPSA 

reauthorization must ensure that technical definitions do not exclude those in need. 

9. Streamline and clarify FVPSA provisions The FVPSA code has been significantly amended 6 times over the last 25 years and is now difficult to interpret; language in some parts is antiquated. To reflect current and emerging best practice, 

enhance consistent implementation and monitoring by HHS and Congress, and 
114 

make provisions consistent with those of the Violence Against Women Act (VAWA) 

2005, we recommend streamlining the FVPSA statute. 

10. Expand the emphasis on prevention DELTA grants have made bold strides to 

prevent domestic violence from ever happening by changing community and personal attitudes about relationships and abuse. Community collaborations funded by 

DELTA have produced innovative models that can be adapted and replicated to 

strengthen domestic violence prevention efforts. In order to leverage the successes 

and lessons learned thus far, the DELTA grants should be statutorily defined and 

expanded to include a secondary-prevention component and appropriations increased to continue expansion of these valuable programs. DELTA grants should be 

authorized at $20 million. 

11. Maintain the Hotline and leverage its strengths to address teen dating violence When victims of domestic violence have courageously chosen to pick up the 

phone and seek help, having someone on the other end to answer the call and connect her resources is critical in keeping her and her family safe. The National Domestic Violence Hotline should be maintained in order to respond to the growing 

number of victims who are coming forward for help. In addition, funding should be 

available to develop and deliver specialized services to teen victims through the use 

of innovative technology. The National Domestic Violence Hotline should be authorized at $7 million. 

Conclusion 

As a coalition of domestic violence advocates and service providers, we recognize 

the critical need to address domestic violence in order to keep families and communities safe. Without effective intervention, this violence will continue to repeat itself 

and impact successive generations. The reauthorization of FVPSA provides an important opportunity to continue the progress that has made toward meeting the 

needs of domestic violence victims and breaking the cycle of violence affecting our 

children, families and communities. We look forward to working with the Subcommittee to reauthorize this critical legislation and continue progress toward ending domestic violence. 

ENDNOTES

1Tjaden, Patricia & Thoennes, Nancy. National Institute of Justice and the Centers for Disease Control and Prevention, ‘‘Extent, Nature and Consequences of Intimate Partner Violence: 

Findings from the National Violence Against Women Survey.’’ 2000. 2Tjaden, Patricia & Thoennes, Nancy. National Institute of Justice and the Centers of Disease 

Control and Prevention, ‘‘Extent, Nature and Consequences of Intimate Partner Violence: Findings from the National Violence Against Women Survey,’’ 2000. The Centers for Disease Control 

(CDC) (2008). Adverse Health Conditions and Health Risk Behaviors Associated with Intimate 

Partner Violence, United States, 2005. 3McDonald, R., et al. (2006). ‘‘Estimating the Number of American Children Living in Partner-Violence Families.’’ Journal of Family Psychology, 30(1), 137-142. 4 National Coalition Against Domestic Violence, Detailed Shelter Surveys (2001). 

5Domestic Violence Counts 08: A 24-hour census of domestic violence shelters and services 

across the United States. The National Network to End Domestic Violence. (Jan. 2009). 6Mary Kay’s Truth About Abuse. Mary Kay Inc. (May 12, 2009). 

7See: Bennett, L., Riger, S., Schewe, P., Howard, A., & Wasco, S. (2004). Effectiveness of hotline, advocacy, counseling and shelter services for victims of domestic violence: A statewide evaluation. Journal of Interpersonal Violence, 19(7), 815-829; Bowker, L. H., & Maurer, L. (1985). 

The importance of sheltering in the lives of battered women. Response to the Victimization of 

Women and Children, 8, 2-8; Gordon, J. S. (1996). ‘‘Community services for abused women: A 

review of perceived usefulness and efficacy.’’ Journal of Family Violence 11(4): 315-329; Sedlak, 

A. J. (1988). Prevention of wife abuse. In V. B. Van Hasselt, R. L. Morrison, A. S. Bellack, & 

M. Hersen (Eds.), Handbook of Family Violence (pp. 319-358). NY: Plenum Press; Straus, M. 

A., Gelles, R. J., & Steinmetz, S. K. (1980). Behind closed doors: Violence in the American family. NY: Anchor Press; Tutty, L. M., Weaver, G., & Rothery, M. (1999). Residents’ views of the 

efficacy of shelter services for assaulted women. Violence Against Women, 5(8), 898-925. 8See: Berk, R. A., Newton, P. J., & Berk, S. F. (1986). What a difference a day makes: An 

empirical study of the impact of shelters for battered women. Journal of Marriage and the Family, 48, 481-490; Bybee, D.I., & Sullivan, C.M. (2002). The process through which a strengthsbased intervention resulted in positive change for battered women over time. American Journal 

of Community Psychology, 30(1), 103-132; Constantino, R., Kim, Y., & Crane, P.A. (2005). Effects of a social support intervention on health outcomes in residents of a domestic violence shelter: A pilot study. Issues in Mental Health Nursing, 26, 575-590; Goodkind, J., Sullivan, C.M., 

& Bybee, D.I. (2004). A contextual analysis of battered women’s safety planning. Violence 

Against Women, 10(5), 514-533; Sullivan, C.M. (2000). A model for effectively advocating for 

women with abusive partners. In J.P. Vincent & E.N. Jouriles (Eds.), Domestic violence: Guidelines for research-informed practice (pp. 126-143). London: Jessica Kingsley Publishers; Sullivan, 

C.M., & Bybee, D.I. (1999). Reducing violence using community-based advocacy for women with 

abusive partners. Journal of Consulting and Clinical Psychology, 67(1), 43-53. 
115 

9Lyon, E., Lane S. (2009). Meeting Survivors’ Needs: A Multi-State Study of Domestic Violence Shelter Experiences. National Resource Center on Domestic Violence and UConn School 

of Social Work. Found at http://www.vawnet.org. 10 Costs of Intimate Partner Violence Against Women in the United States. (2003). Centers 

for Disease Control and Prevention, National Centers for Injury Prevention and Control. Atlanta, GA. 

Prepared Statement of Matthew Melmed, Executive Director, Zero to Three 

Madam Chairwoman and Members of the Subcommittee: I am pleased to submit 

the following testimony on best practices for the prevention of child abuse and neglect as well as strengthening responses for those families already touched by child 

maltreatment. My name is Matthew Melmed. For the last 14 years I have been the 

Executive Director of ZERO TO THREE, a national non-profit organization that has 

worked for over 30 years to advance the healthy development of America’s babies 

and toddlers. I would like to start by thanking the Subcommittee for all of its work 

to ensure that our nation’s infants and toddlers are safe. I commend you and the 

Subcommittee for tackling this difficult, yet extremely important issue. 

I would like to start by addressing the effects of abuse and neglect on infants and 

toddlers and offer two sets of recommendations (prevention and treatment) for your 

consideration as you look at systemic changes to the way in which child abuse is 

addressed by this nation. 

Vulnerability of Infants and Toddlers to Abuse and Neglect 

Unfortunately, children between birth and three years of age have the highest 

rates of abuse and neglect in the United States.1 Specifically, although infants only 

account for 5.6% of the child population, they represent double that percent of all 

child maltreatment victims.2 In fact, infants are over four times more likely to enter 

foster care than children of all other ages. Infants and toddlers are particularly at 

risk, not only because they are physically vulnerable, but also because of the important brain development occurring during this period of life. 

We know from the science of early childhood development that infancy and 

toddlerhood are times of intense intellectual engagement.3 A child’s first years set 

the stage for all that follows. During this time the brain undergoes its most dramatic development, and children acquire the ability to think, speak, learn, and reason. Future development in key domains—social, emotional, and cognitive—is based 

on the experiences and relationships formed during these critical years. 

Contrary to the once-held belief that very young children do not remember, and 

therefore experience no lasting effects from maltreatment, infants and toddlers are 

extremely vulnerable to its long-lasting consequences. Research shows that young 

children who have experienced physical abuse have deficits in IQ scores, language 

ability, and school performance, even when the effects of social class are controlled.4

Furthermore, physical abuse extracts a substantial toll on young children’s social 

adjustment, as seen in elevated levels of aggression that are apparent even in toddlers.5 The effects of maltreatment are not just seen in children who are abused, 

however. Neglected children may also exhibit a variety of emotional and behavioral 

problems as well, including: poor coping skills, high levels of dependence, self-abusive behaviors, unresponsiveness to affection, lethargy, low academic achievement, 

fewer interactions with peers, and unusual sleeping and eating patterns.6 Long-term 

negative outcomes of abuse and neglect include school failure, juvenile delinquency, 

substance abuse, and the continuation of the cycle of maltreatment into new generations. In fact, one third of the individuals who are abused and neglected as children 

can be expected to abuse their own children.7

The effects of abuse and neglect are not just a bad memory, but affect the developing brain architecture in the young child—effects that we can actually see in Figure 1. This figure compares the PET scan of the brain of a healthy child (left) with 

that of an abused and neglected child in a Romanian orphanage (right). The brain 

of the healthy child shows high activity (depicted in red) in the temporal lobes. In 

contrast, the scan of the Romanian orphan shows very little activity in these areas 

which are responsible for regulating emotions and receiving input from the senses. 

Furthermore, the abused and neglected brain has smaller brain volume, larger fluidfilled cavities, and smaller areas of connection. 
116 

Figure 1.—Image reproduced with permission. Harry Chugani, M.D., Children’s Hospital of Michigan. 

Although the developmental impact of child abuse and neglect is greatest among 

the very young, research confirms that the early years present an unparalleled window of opportunity to effectively intervene with at-risk children. Intervening in the 

early years can lead to positive outcomes (e.g., secure attachments, healthy relationships, school success, etc.) and significant cost savings over time through reductions 

in child abuse and neglect, criminal behavior, welfare dependence, and substance 

abuse. It is critical that child well-being be the first priority in all child abuse and 

neglect cases. 

The Effects of Fetal Alcohol Spectrum Disorders 

I particularly want to call the Subcommittee’s attention to a condition that is a 

perennial problem, but often overlooked. Experts estimate that one out of every one 

hundred US citizens is a victim of Fetal Alcohol Spectrum Disorders (FASD), an 

array of physical disabilities that is 95% under-diagnosed.8,9 Although very little research has been done to document the prevalence of FASD among children in the 

child welfare and juvenile justice systems, one study suggests that almost one in 

four children in the juvenile justice system is a victim of it.10

The brain damage caused by prenatal exposure to alcohol results in poor judgment, impulsivity, difficulty learning from experience and an inability to foresee the 

consequences of one’s behavior. Furthermore, children born with FASD are frequently premature and low birth weight, both of which are risk factors for healthy 

development.11 Infants and toddlers in particular can be delayed in reaching developmental milestones, hyperactive, easily over-stimulated,12 and victims of failure to 

thrive.13 Consequently, academic failure and social impairments are common in 

childhood. 

While policies often focus on illegal substance use and abuse, very little attention 

is given to legal substances such as alcohol and its effects on the healthy development of infants and toddlers. As with child abuse and neglect, intervening early can 

and does make a difference, both in terms of child development and in economic 

costs to society. In fact, children who are diagnosed before the age of six are much 

more likely to succeed in school, careers, and personal relationships.14 In order to 

prevent developmental delays resulting from FASD down the road, we must look beyond the limited focus on illegal substances and include screening to detect FASD 

in infants. 

Preventing Child Abuse and Neglect 

In thinking about approaches to preventing child abuse and neglect, we must recognize that efforts to reach this goal often will not be labeled as child abuse prevention and, in fact, lie largely outside the formal child welfare system. Prevention 

means reaching out to families with risk factors and their accompanying stressors 

to connect them with comprehensive services that work to reduce the stress and promote the healthy early development of their young children. Except for a few narrowly targeted initiatives, there is no such thing as a separate program to prevent 

child abuse, another to promote cognitive development, another to help parents be 

better parents, and yet another to address social and emotional needs. For the very 
117 

young child, especially, all aspects of development are inextricably intertwined and 

must be addressed as such. 

I want to note that child maltreatment, in particular, does not occur only in lowincome families. All parents need support in nurturing their children, just as all babies need supportive relationships to promote healthy development. But some families and their children are more at-risk because of poverty, substance abuse, precarious housing or nutritional situations, or lack of education, just to name a few hazards. We need to ensure that families who face multiple risk factors are connected 

to appropriate services in the community before abuse and neglect occur. In other 

words, there is not a separate category of families in which abuse and neglect occurs. These are the same families to whom we direct other early childhood interventions. So I encourage you to think broadly about expanding comprehensive solutions 

for early childhood development and family support in which preventing abuse and 

neglect will be a natural byproduct of connecting families to an array of resources. 

While the bulk of funds to provide such services will not come from the Child 

Abuse Prevention and Treatment Act (CAPTA) or other child welfare funding 

streams, the limited funds available through Title II of CAPTA can be instrumental 

in developing mechanisms and promoting systems change to integrate services outside the child welfare system to meet the needs of at-risk children and families, provide outreach to those families, and help in accessing services. 

I also want to emphasize the importance of social and emotional development in 

young children, which forms the foundation for later learning, and the mental 

health problems that can occur even when no abuse or neglect is pinpointed. Early 

social and emotional development is vulnerable to such factors as repeated exposure 

to violence, persistent fear and stress, abuse and neglect, severe chronic maternal 

depression, biological factors such as genetic prematurity and low birth weight, poverty, and conditions associated with prenatal substance abuse. 

Healthy development occurs within the context of the family. Supportive early relationships can protect against the effects of stress and biological hazards beginning 

even prenatally. Therefore, problems with social and emotional development that 

occur in a young child need to be addressed using approaches that focus on the 

child’s interaction with the caregiver. Neurons to Neighborhoods cites programs 

such as the Family Development Service Program in Los Angeles, where researchers 

‘‘documented that a relationship-based intervention can have a significant impact on 

parent-child interaction and on the infant’s security of attachment.’’ Another program cited is the Infant-Parent Psychotherapy Program in San Francisco that emphasizes intergenerational patterns of attachments and helps the mother cope with 

life issues outside the family.15

PREVENTION POLICY RECOMMENDATIONS

Create a Broad and Comprehensive Policy that Supports Vulnerable Children and 

Families 

I encourage the Subcommittee to consider building an integrated approach to addressing the needs of very young children and their families that would encompass 

outreach and support for parents, high quality early care and education, and supports for the professionals who serve them. In addition, we need the ability to better 

employ the tools that can identify children at-risk for problems that are more difficult to spot at a young age, but where early intervention can save both heartache 

and dollars at a later age. Some specific steps include: 

1. Providing increased access to high quality family support programs by: 

a. Expanding funding for Early Head Start, a program proven effective in reaching families with infants and toddlers and in promoting good parenting practices 

and healthy child development. Comprehensive early childhood programs, such as 

Early Head Start, that combine early learning experiences, parent support, home 

visitation, and access to medical, mental health and early intervention services can 

provide the specialized services that very young children in the child welfare system 

need. Results from the Congressionally-mandated Early Head Start Research and 

Evaluation Project—a rigorous, large-scale, random-assignment evaluation—concluded that parents who participated in Early Head Start had more positive interactions with their children than control group parents—they showed greater 

warmth and supportiveness, less detachment, more parent-child play interactions, 

more stimulating home environments, and less spanking by both mothers and fathers.16

While the American Recovery and Reinvestment Act provided additional funds for 

Early Head Start, even with that infusion of funding, we still will only reach six 

percent of eligible infants and toddlers. Increased funding to quadruple the size of 

Early Head Start, as the President pledged, will ensure that we reach the most atrisk infants and toddlers early in life when we have the best opportunity to reverse 
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the trajectory of poor development that can occur in the absence of such supports. 

It will also help us ensure that parents have the supports they need to sufficiently 

nurture the healthy development of their infants and toddlers. Although it is the 

role of the appropriators to increase funding for Early Head Start, this Subcommittee can work to ensure that the authorizers and appropriators understand 

the importance of programs such as Early Head Start in reaching the most at-risk 

infants and toddlers. 

b. Expanding funding to support other comprehensive approaches that reach out 

to families with young children. Some communities use programs that deliver parent support and early childhood services through home-based models. These home 

visiting programs offer information, guidance, and support directly to families in 

their home environments, eliminating many of the scheduling, employment, and 

transportation barriers that might otherwise prevent families from taking advantage of necessary services. While home visiting programs, such as Healthy Families 

America, the Nurse-Family Partnership, the Parent-Child Home Program, and Parents as Teachers, share similar overall goals of enhancing child well-being and family health, they vary in their program structure, specific intended outcomes, content 

of services, and target populations. Program models also vary in the intensity of 

services delivered, with the duration and frequency of services varying based on the 

child’s/family’s needs and risks. 

A growing body of research demonstrates that home visiting programs that serve 

infants and toddlers, can be an effective method of delivering family support and 

child development services, particularly when services are part of a comprehensive 

and coordinated system of high quality, affordable early care and education, health 

and mental health, and family support services for families prenatally through prekindergarten. Research has shown that high quality home visiting programs serving 

infants and toddlers can increase children’s school readiness, improve child health 

and development, reduce child abuse and neglect, and enhance parents’ abilities to 

support their children’s overall development.17 The benefits of home visiting, however, vary across families and programs. What works for some families and in some 

program models will not necessarily achieve the same success for other families and 

other program models. 

Expanding access to evidence-based home visiting programs is one strategy in the 

prenatal to pre-kindergarten continuum which can help prevent long-term costs associated with remediating the effects of maltreatment while promoting healthy social and emotional development in later years. However, it is important to connect 

home visiting efforts with other child and family services, particularly those focused 

on children’s well-being and healthy development, to help ensure that young children and their families have the supports they need to promote healthy outcomes. 

2. Increasing access to preventive and treatment services for families affected by 

substance abuse, including screening of children for FASD. Millions of children and 

families are impacted by the growing epidemic of substance abuse. In fact, an estimated 11 percent of all children live in families where one or more parents abuse 

alcohol or other drugs.18 This issue is even more pressing for families in the child 

welfare system where up to 80 percent of children are affected by substance abuse.19

Families need access to a community-based, coordinated system of comprehensive 

family drug andalcohol treatment. Prevention and treatment services should include: prevention and early intervention services for parents at-risk of substance 

abuse; a range of comprehensive treatment options including home-based, outpatient, and family-oriented residential treatment options; aftercare support for 

families in recovery; and preventive and early intervention services for children that 

address their mental, emotional, and develop 

In addition, given the heightened risk of FASD for children in the child welfare 

system, we must adopt useful screening strategies for children who come to the attention of child protective services staff. Many affected children will be born into 

families with severe dysfunction, substance abuse and long histories of parenting 

failure. Screening infants and children entering child protective services caseloads, 

and especially those in foster care, would link high risk children with appropriate 

treatment services. Currently, only children exposed to illegal substances are 

screened and referred for services despite the more devastating effects of legal substances such as alcohol. 

It is also critical to recognize that many parents who maltreat their children do 

so as a result of the organic brain dysfunction caused by FASD. Behavioral deficits 

include: impulsive behavior, an inability to plan and remember commitments (e.g. 

the child’s antibiotic regimen) from one day to the next, and emotional volatility. 

Some states recognize FASD as an adult disability and provide case management 

and disability payments. With this kind of support, FASD victims have a much 

greater likelihood of successfully carrying out the tasks of daily living, including 
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their parenting responsibilities. The focus on screening we recommend for young 

children should include screening for their parents as well. 

3. Increasing access to parent-child therapy by allowing reimbursement through 

Medicaid for dyadic/relational therapy for at-risk families and funding research into 

promising approaches. Currently, not all states allow reimbursement through Medicaid for therapy provided to parents and infants or toddlers together. Such therapy 

is often effective, because the mental health of parents and very young children are 

so closely interrelated. In a recent study among mother-child pairs where there was 

a history of domestic violence, not only was the therapy effective in improving the 

parent-child relationship and the child’s behavioral symptoms, but the intervention 

had a positive effect on the mother’s mental health.20

The proposed modification would allow infants and toddlers, who health practitioners find are at high risk for developing mental health disorders, to receive a referral for a full diagnostic evaluation. The referral would be made for both the 

young child and parents using a developmentally appropriate diagnostic tool such 

as the Diagnostic Classification of Mental Health and Developmental Disorders of 

Infancy and Early Childhood Revised (DC:0-3R). Current diagnostic tools such as 

the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the 

International Classification of Diseases (ICD-10) do not comprehensively cover the 

mental health issues of infants, toddlers, and their parents. A comprehensive classification tool such as DC:0-3R will allow professionals to identify, understand, and 

treat mental health problems, relational issues, and developmental disorders of very 

young children at an early stage and prevent problems from worsening. 

In addition, while some approaches to parent-child therapy have been tested as 

noted above, more research and demonstrations are needed to advance our understanding of how best to improve parenting skills and repair damage to social and 

emotional development in infants and toddlers. The Subcommittee could play a critical role by financing such research. Too often, parents are simply sent to parenting 

classes that may not help them understand and experience how best to interact with 

their children and support their healthy development. 

Improving Responses to Families Already Touched by Child Maltreatment 

I have already noted the highly detrimental effects of maltreatment on the development of infants and toddlers. We know all too well that the circumstances that 

often surround a family where abuse or neglect has occurred do not bode well for 

the child’s development, and we also know that the relationships that support this 

development, once gone awry, do not heal themselves. Much of the CAPTA statute 

focuses on the legal system for dealing with these cases and has indeed led to a 

great deal of progress in helping states ensure the physical safety of children. But 

we need to pay greater attention to the developmental needs of the children involved and the needs of their families—in other words, to the treatment part of the 

program. 

Our Child Protective Services (CPS) system needs to recognize the critical nature 

of the early years for child development and have procedures in place to move quickly to address the damages of maltreatment and the needs of infants and toddlers 

and their families. Such procedures must start with training for all involved in the 

legal side of the system—CPS workers, Guardians Ad Litem, judges and other court 

personnel—about early childhood development. In their professional training, these 

key people are not taught about how young children develop and the importance of 

acting to keep that development on track. ZERO TO THREE’s experience with its 

Court Teams for Maltreated Infants and Toddlers project, which focuses on children 

in the foster care system and is discussed in more detail under Recommendation #1 

below, has been instructive in learning how important such knowledge can be. It 

can literally change how staff and judges approach their decisions regarding young 

children. 

The second need is services for children and families and quick linkage to them 

when a family comes into the child welfare system. We know that the levels of services such as mental health and special education among children in the child welfare system have historically been low. As with preventive services, workers at the 

treatment stage need the ability to connect children and families with a variety of 

services. Again, the Court Teams initiative creates a ‘‘team’’ of service providers in 

the community who ensure that the children and parents being supported by the 

local Court Team receive necessary services. Formation of the teams has brought 

together providers in communities, many of whom had not been involved with this 

population before. In some instances, forming the teams has revealed services of 

which child welfare workers were not aware. For example, the requirement in the 

2003 CAPTA reauthorization that all infants and toddlers be referred for assessment under Part C of the Individuals with Disabilities Education Act was a huge 
120 

step in seeking to meet the developmental needs of young children. However, states 

are still grappling with how to implement and fund this linkage and many child 

welfare workers, themselves, are unaware of the Part C early intervention requirements. I urge the Subcommittee to focus on how to ensure the connection between 

these two systems can be made more feasible. 

Third, an increase in mental health services that address the needs of parents 

and children together, as discussed under prevention efforts, is extremely important 

in the context of treating child abuse and neglect. The whole area of infant/early 

childhood mental health is often overlooked, but addressing the mental health needs 

of both child and family is one of the keys to healing families and preventing future 

child maltreatment. 

Clearly, there is a great deal of overlap in services for at-risk families to prevent 

child abuse and neglect and those where abuse and neglect are known to have occurred. I encourage the Subcommittee to explore approaches such as differentiated 

response that seek to connect families to services no matter what their CPS status. 

Finally, the treatment of abuse and neglect continues after children are removed 

from home and placed in foster care, although this part of the child welfare system 

is generally addressed through the programs in Part IV of the Social Security Act. 

Additional policies must be implemented to ensure adequate services are in place 

for children once they enter foster care. 

Infants and toddlers are removed from home at higher rates than older children 

precisely because they are so vulnerable to the effects of abuse and neglect. In fact, 

infants are the largest group of children entering foster care in the United States, 

accounting for 1 in 5 admissions.21 Once they have been removed from their homes 

and placed in foster care, infants and toddlers are more likely than older children 

to be abused and neglected and to stay in care longer.22 In addition, half of all babies who enter foster care before age 3 months spend 31 months or longer in placement. 

Coupled with these alarming statistics is the fact that a young child’s removal 

from his or her home adds additional layers of complexity to the initial trauma of 

maltreatment. Separation from a child’s primary caregiver(s) can cause anxiety, distress, and additional trauma. For these reasons, we must pay particular attention 

to ensuring that developmentally appropriate services and family connections are 

available during this critical time in a child’s life. 

TREATMENT POLICY RECOMMENDATIONS

1. Requiring training for child protective services staff and other personnel involved with children in the child welfare system around the unique needs of infants 

and toddlers. There is a wealth of scientific knowledge available about very early 

child development which should be used to make informed decisions about babies 

in the child welfare system. However, child welfare workers are overburdened and 

do not have the time or means to seek the training that would provide them with 

this scientific knowledge base. Congress should provide grants to states to enable 

them to develop and provide training for child welfare workers and other staff (including Guardians Ad Litem, court personnel, mental health specialists, child care 

providers, Early Head Start teachers and early intervention specialists) around the 

developmental needs of infants and toddlers who have been abused or neglected and 

the steps that need to be taken to address these needs. 

In addition, while training is important in providing the initial exposure to information, ongoing technical assistance is critical if the training information is to be 

applied in real life. Like any bureaucracy, child welfare agencies have developed 

protocols and guiding assumptions over the decades. Much of the knowledge of infant/toddler development is new and challenges prevailing practices in the field of 

child welfare (e.g., sibling relationships always trump the child’s relationship with 

the foster parent, etc.). Changing long held opinion in bureaucratic settings is extremely difficult. Developing a mechanism to provide consultation to caseworkers on 

cases involving infants and toddlers will allow them to reflect on decisions that may 

otherwise be made without grounding in the child’s best interests. 

One example of innovation in this area is ZERO TO THREE’s Court Teams 

project for children in foster care. Under the leadership of a juvenile or family court 

judge, the Court Team model works to increase awareness among court personnel 

and community providers about the negative impact of abuse and neglect on very 

young children and to change local systems to improve outcomes and prevent future 

court involvement in the lives of very young children in the child welfare system. 

Preliminary data and anecdotal evidence suggest that the Court Teams project is 

having a positive effect on children and families, including: reducing the number of 

times maltreated infants and toddlers move from one foster home to another, in-
121 

creasing visits between parents and their young children in foster care, providing 

critical health and developmental screenings, increasing placements with relatives, 

expediting and enhancing services to parents to facilitate reunification, and reducing the time to permanency. 

2. Ensuring access to early intervention services (Part C of the Individuals with 

Disabilities Education Act) for children three and younger. Amendments to CAPTA 

in 2003 required states to develop procedures to ensure that all children 0-3 who 

are involved in a substantiated incident of abuse or neglect are referred to Part C 

early intervention services. The IDEA amendments of 2004 also required Part C 

services for all children who have been maltreated or exposed prenatally to illegal 

substances or domestic violence. Under Part C, all participating states and jurisdictions must provide early intervention services to any child below 3 who is experiencing developmental delays or has a diagnosed physical or mental condition that 

has a high probability of resulting in a developmental delay. In addition, states may 

choose to provide services for babies and toddlers who are ‘‘at-risk’’ for serious developmental problems, defined as circumstances (including biological or environmental 

conditions or both) that will seriously affect the child’s development unless interventions are provided. 

Despite the promise it holds for the future, there is wide variation in the percentage of infants and toddlers enrolled in Part C programs across states. Currently, 

states carry a significant burden to fund Part C programs, in part, because of inadequate federal funding. The result is that many eligible infants and toddlers do not 

receive the early intervention services they desperately need in order to reach their 

full potential in school and in life. Congress should provide incentives and adequate 

funding for states to increase access to early intervention screening and Part C services for infants and toddlers in foster care. Early intervention services under Part 

C may prevent or minimize the need for more costly services under Part B of IDEA 

or even later in a child’s life. 

3. Adding infants affected with FASD to the policies and procedures CAPTA requires states to have in place to identify and address the needs of infants born with 

and affected by illegal substance abuse. Infants and toddlers in the child welfare 

system have ongoing risk factors that predispose them to developmental delays. 

While developmental delays are often present in young children with FASD, currently, FASD is not included among the eligibility criteria for Part C services. It is 

critical to screen for FASD specifically because it is a lifelong chronic condition requiring management rather than a developmental delay that can be corrected. As 

mentioned earlier, when children are screened for FASD and determined in need of 

early intervention services, those services should be allowable under Part C. 

4. Increasing access to parent-child therapy by allowing reimbursement through 

Medicaid for dyadic/relational therapy for at-risk families and funding research into 

promising approaches. This approach is discussed under the Prevention section 

above, but I want to reiterate its importance for families where maltreatment has 

occurred. CAPTA could be an important source of funding to develop and/or disseminate promising approaches for this type of therapy. 

5. Requiring (under Title IV-B of the Social Security Act) that the Department of 

Health and Human Services promulgate guidelines for states for the care of infants 

and toddlers in the child welfare system, including: 

a. Visitation standards and developmentally appropriate visitation practices for 

infants and toddlers in out-of-home care. One of the major challenges faced by 

young children in foster care is developing nurturing relationships with their parents. Standard visitation practice permits one visit each week. In practice, however, 

visits occur less than once a week. Parent-child contact consists of brief encounters 

at the child welfare agency. For very young children, infrequent visits are not 

enough to establish and maintain a healthy parent-child relationship. For parents, 

visits often become yet another forum where they feel judged and incompetent. Research indicates that visitation with parents and siblings is not only highly correlated with better child functioning at discharge from foster care, but also allows 

children to leave foster care in much higher numbers and more quickly.23

Parental visitation can and should be looked at strategically. Visits can play an 

important role in concurrent planning (pursuing two permanency options simultaneously—reunification and adoption) and can be used to assess the parent-child relationship and how the family is progressing. The frequency and success of visits 

between children and parents can provide a caseworker with evidence for either 

movement to an alternative plan for the child or movement for early reunification. 

Visits should occur frequently, in a safe setting that is comfortable for both parent 

and child, and should last long enough for a positive relationship to develop and 

strengthen. CAPTA can provide a framework for enhancing the visitation experience 

by providing support and coaching to improve future visits for all involved. Standard 
122 

practice must shift from a CPS worker sitting in the corner observing to an engaged 

and supportive visit coach who helps the parent plan the time with his/her 

child(ren), handle the actual visit, and reflect afterward on how well the visit went. 

b. Minimizing multiple placements while in out-of-home care. In the first year of 

life, babies need to have the opportunity to develop a close, trusting relationship or 

attachment with one special person. The ability to attach to a significant caretaker 

is one of the most important emotional milestones a baby needs to achieve in order 

to become a child who is trusting, confident, and able to regulate his or her own 

stress and distress. For babies in foster care, forming this secure attachment is difficult. Multiple foster care placements present a host of traumas for very young children. When a baby faces a change in placement, fragile new relationships with foster parents are severed, reinforcing feelings of abandonment and distrust. Even very 

young babies grieve when their relationships are disrupted and this sadness adversely effects their development. All placement decisions should focus on promoting 

security and continuity for infants and toddlers in out-of-home care. 

Guidelines should be developed for states on how to minimize multiple placements 

for infants and toddlers in out-of-home care. For example, a state may decide to develop foster-adopt homes for infants who come into the child welfare system so that 

if the birth parents cannot successfully regain custody of the child, the child will 

not be moved again. States should have a system for tracking the number of moves 

an infant makes while in foster care. When a change in placement is necessary, 

child welfare workers and foster parents should receive training on how to handle 

transitions with infants and toddlers so the children have the opportunity to get to 

know their new caregivers before leaving the security they have gained in the care 

of their current caregiver. 

c. Promoting timely permanent placements for infants and toddlers in foster care. 

During the earliest years of a child’s life—a time when growth and development 

occur at a pace far exceeding that of any other period of life—time goes by quickly. 

Babies can drift for years in foster care. They need stable loving parents as soon 

as possible. Standard child welfare practice is to seek reunification over the course 

of months or years, and only when it is clear that the birth parents are not able 

to regain custody of their children, is an alternative permanency arrangement 

sought. In the meantime, the babies have grown up in a series of foster homes and 

have suffered developmental damage they will carry with them throughout their 

lives. All members of the family’s team need to understand concurrent planning 

right from the start as the legal way to make sure that a child is in a permanent 

home as quickly as possible. 

6. Requiring state child welfare agencies to include in their state plans a description of their approach to addressing the specific needs of infants and toddlers. Infants and toddlers in foster care have needs that are very different from older children. They also move through the child welfare system in ways that are very different from older children—they stay in care longer, they are less likely to be reunified with their parents and they are more likely to be abused and neglected while 

in foster care. State child welfare agencies should address the unique needs of infants and toddlers in their state plans, with a detailed description of their approach 

to dealing with issues for babies in foster care such as reducing multiple foster care 

placements, assuring regular visitation with biological parents, ensuring that all infants and toddlers have access to early childhood and family mental health services, 

addressing the effects of trauma and separation on infants and toddlers, and promoting interventions that support their healthy development across all domains. 

Conclusion 

We must ensure that infants and toddlers are healthy and safe. During the first 

years of life, children rapidly develop foundational capabilities—cognitive, social and 

emotional—on which subsequent development builds. The amazing growth that 

takes place in the first three years of life creates vulnerability and promise for all 

children. These years are even more important for maltreated infants and toddlers. 

We know from the science of early childhood development what infants and toddlers 

need for healthy social, emotional and cognitive development. We also know that 

maltreated infants and toddlers are at great risk for poor outcomes. We must continue to seek support for services and programs that ensure that our nation’s youngest and most vulnerable children are safe, and that promote and improve their emotional, social, cognitive and physical health and development. 

Policies and funding must be directed to preventing harm to all children and reducing further harm to maltreated children. I urge the Subcommittee to make the 

investment to support and protect our nation’s most vulnerable children and their 

families. 
123 

Thank you for your time and for your commitment to our nation’s at-risk infants 

and toddlers. 

ENDNOTES

1 U.S. Department of Health and Human Services, Administration on Children, Youth and 

Families. (2009) Child Maltreatment 2007, Washington, DC: U.S. Government Printing Office, 

Table 3-6. 2 Ibid. 

3Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to neighborhoods: The science of 

early childhood development. Washington, DC: National Academy Press. 4 Ibid. 

5George, C., and Main, M. (1995). ‘‘Social interactions of young abused children: Approach, 

avoidance, and aggression.’’ Child Development, (50)2, pp. 306-318. 6 Children’s Bureau. (2006) Child Neglect: A guide for prevention, assessment and intervention. Child Welfare Information Gateway. http://www.childwelfare.gov/can/impact/types/neglect.cfm (accessed June 30, 2008). 7 National Research Council. (1993). Understanding child abuse and neglect. p. 223. 

8Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to neighborhoods: The science of 

early childhood development. 9Kelly, K. (2005). The importance of early identification of Fetal Alcohol Spectrum Disorder 

(FASD). The Judges’ Page Newsletter. National CASA/National Council of Juvenile and Family 

Court Judges. http://www.nationalcasa.org/download/Judges—Page/0502—parental—substance—abuse—issue—0036.pdf (accessed March 12, 2007). 10Fast, D.K., Conrey, J., Loock, C.A. (1999). ‘‘Brief reports: Identifying Fetal Alcohol Syndrome among youth in the criminal justice system.’’ Developmental and Behavioral Pediatrics 

(20)5. 11 Jernell, J., Wanninger, M., Brodsky, L., Atherly, E., Caros, L., Chang, P., Coder, S., et al. 

(1999). Guidelines of care for children with special health care needs: Fetal Alcohol Syndrome 

and fetal alcohol effects. St. Paul, MN: Minnesota Department of Health. 12Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to neighborhoods: The science of 

early childhood development. 13 Jernell, J., Wanninger, M., Brodsky, L., Atherly, E., Caros, L., Chang, P., Coder, S., et al. 

(1999). Guidelines of care for children with special health care needs: Fetal Alcohol Syndrome 

and fetal alcohol effects. 14Kelly, K. (2005). The importance of early identification of Fetal Alcohol Spectrum Disorder 

(FASD). The Judges’ Page Newsletter. National CASA/National Council of Juvenile and Family 

Court Judges. http://www.nationalcasa.org/download/Judges—Page/0502—parental—substance—abuse—issue—0036.pdf (accessed March 12, 2007). 15Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to neighborhoods: The science of 

early childhood development. 16 U.S. Department of Health and Human Services, Administration for Children and Families. 

2002. Making a difference in the lives of infants and toddlers and their families: The impacts 

of Early Head Start. http://www.acf.hhs.gov/programs/opre/ehs/ehs—resrch/reports/impacts—exesum/impacts—execsum.pdf (accessed October 23, 2006). 17 Elizabeth DiLauro, Reaching Families Where They Live: Supporting Parents and Child Development through Home Visiting. Washington, DC: ZERO TO THREE, 2009. 18 Child Welfare League of America. 2004 Children’s legislative agenda. Substance abuse, families and recovery. www.cwla.org/advocacy/2004legagenda14.htm (accessed December 14, 2004). 19 Ibid. 20Lieberman, A.F., Briscoe-Smith, A., Ippen, C.G., Van Horn, P. (2006). Violence in infancy 

and early childhood: Relationship-based treatment and evaluation. In A.F. Lieberman & R. 

DeMartino (Eds). Interventions for Children Exposed to Violence. New Brunswick, NJ: Johnson 

& Johnson Pediatric Institute. 21Dicker, S., Gordon, E., Knitzer, J. (2001) Improving the odds for the healthy development 

of young children in foster care. New York: National Center for Children in Poverty. 22Wulczyn, F. & Hislop, K. (2002). Babies in foster care: The numbers call for attention. 

ZERO TO THREE Journal, (22) 4, 14-15. 23 Hess, P. & Proch, K. (1993). Visiting: The heart of reunification. In B. Pine, R. Warsh, & 

A. Maluccio (Eds). Together again: Family reunification in foster care. Washington, DC: Child 

Welfare League of America. 

[Whereupon, at 11:40 a.m., the subcommittee was adjourned.] 

Æ