Preventing Child Abuse and Neglect Press Conference Transcript
THE NATIONAL PRESS CLUB
WASHINGTON, D.C.
TUESDAY, JANUARY 29, 2008
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TIME FOR REFORM:
PREVENTING CHILD ABUSE AND NEGLECT
WELCOME AND MODERATOR:
JIM HMUROVICH,
PRESIDENT/CEO,
PREVENT CHILD ABUSE AMERICA
SPEAKERS:
MARCI MCCOY-ROTH
PROGRAM OFFICER,
THE PEW CHARITABLE TRUSTS
DAVID SANDERS,
EXECUTIVE VICE PRESIDENT,
CASEY FAMILY PROGRAMS
MARC CHERNA, DIRECTOR,
ALLEGHENY COUNTY DEPARTMENT OF HUMAN SERVICES
JENNIFER GIBSON,
FOSTER CARE ALUMNUS
CHERYL D’APRIX,
PARENT, NEW YORK
JIM HMUROVICH: Well, good morning. Boy, this place got quiet quickly. (Chuckles.) I wish my children would learn how, you know? Anyways, another story, thank you very much for being here. On behalf of Pew Charitable Trusts and Prevent Child Abuse America, it’s really nice to see you all here. Obviously, everyone has seen this to be an important public issue that you wanted to take the time to be part of the discussion so thank you.
As we begin, a couple of housekeeping rules – in respect to our speakers, if everyone could turn their phones and all kinds of electronic devices onto vibrate or silent or something like that. And there will be time for questions and answers hopefully at the end if we stay on track on time. And we just would appreciate holding the questions until all of the presentations are made and the remarks are made. So thank you.
My name is Jim Hmurovich. I’m the CEO of Prevent Child Abuse America and I’ve been very fortunate for the last two years to have that role. It’s a role that’s kind of like the best job I’ve ever had in my life type of thing. And so, I’m very pleased to be here. The mission of Prevent Child Abuse America is very straightforward and simple: to prevent the abuse and neglect of our nation’s children.
You know, at Prevent Child Abuse America and at our chapters in 43 different states, we actually believe that abuse and neglect is preventable. We believe that there’s enough evidence and research that tells us how it happens. It tells us what we can do about it and what are the services and programs that are necessary in order to prevent it. We believe it’s preventable.
We’re going to hear some staggering information here today that’s going to say, “Whoa, this is way too big for us.” It’s not. It’s all of our responsibilities to do something about protecting our next generation. We want to especially say thank you to Marci McCoy-Roth and the Pew staff who have just been fantastic in giving us this opportunity to move this message into a public forum so that we can begin yet again another more innovative debate.
We’re going to have several speakers today. Their bios are in the packet materials, but I’m going to do one of those one- or two- liners on everybody here. So this is my first screw up of the day when I get names wrong and stuff like that. First of all, all the way to my left: David Sanders is an executive vice president at Casey Family Programs. And probably the most important thing he wanted me to say was that Casey Family Programs is very supportive of the efforts of Prevent Child Abuse America, The Pew Charitable Trusts, and that they are dedicated to coming up with better outcome for our nation’s children.
Our second speaker will be Marc Cherna in the middle here. Marc has 30 years of public service, 30 long years where he’s used his education, knowledge, and skills to bring together service systems that are making a difference in people’s lives in Allegheny County, Pennsylvania. Jennifer Gibson, to the left, far left, was in the Utah foster care system for a while. Currently, she’s an actress and an advocate and you’re going to hear some compelling information from her today. And Cheryl D’Aprix is a mother, a wife, and a home visitation worker for the Healthy Families program in New York, a program that I’m sure she’s going to be spending some time talking to you about today.
Let’s get down to the business of today then. I think that the purpose of today, obviously, is to give a presentation and a public distribution of two reports. The first one is a total estimate of cost of child abuse and neglect in the United States. Now, I’m probably going to be calling that the economic impact report because it’s a lot quicker to say. The second report is titled Time for Reform: Investing and Prevention, Keeping Children Safe at Home and that will be presented by Marci in just a few minutes.
I think today there are five takeaways with what we would like to accomplish at this press conference. Number one is that the financial costs of abuse and neglect are, in fact, staggering. However, let’s not get overwhelmed by that. Number two, there is a human cost of abuse and neglect that has long-term effects and impacts on the children who are abused and neglected. Research is very clear that health outcomes, academic outcomes, and even involvement in the juvenile-justice and the criminal-justice systems don’t fare well for children who have been abused or neglected. Three, it doesn’t have to be this way. One of the things we ought to leave here today with is the idea that there is hope: there are things going on throughout our country, pockets of excellence, that we do not have to accept the face that children are abused and neglected.
Number four – that investments in prevention make good, common sense for good, common Americans and it also makes good cents, C-E-N-T-S. So let’s start focusing in on what’s good for kids and, what the heck, it’s good for taxpayers as well. And number five and maybe the most important one is that there ought to be a sense of urgency in everything that we do. You know, the Pew report was so aptly – the original commission was so aptly named: “Kids are Waiting.” Kids are waiting and the children who are just born and six months and a year old, let’s not make them wait to have safe, loving, and healthy environments.
So those are our five takeaways today. Let me just give a brief overview of the economic impact report. First of all, I’ll say it for the third time: That number of $104 billion is staggering, but let’s not get overwhelmed by it. I think we need to understand how that number came about. First of all, as you can see from the packet information, $33 billion of that dollar amount is on direct service costs: hospitalization, foster care, and investigations. Seventy billion is in indirect costs, which is loss of productivity in the workplace, chronic health issues, and the need for special education in some instances. These estimates, however, do not include the cost to families that have experienced the abuse or neglect or to the perpetrators of the abuse and neglect. Those are add-on costs that are not included in this $104 billion.
I think as we look around our economic situation and the fact that we want to remain competitive in the global economy, we can’t just forget what we’ve just heard. That has an impact on our competitiveness in the marketplace. I think also it would be wrong for us to just talk about the numbers. Every number represents a child who has been abused or neglected and has had to carry some type of emotional scar, some hardships throughout their life. We cannot forget the human suffering involved here.
But let me close with this part of the presentation, with the idea that this isn’t really just about the numbers. The numbers are only like a doorway, a gateway, a forum, a platform for us to start talking about what are we going to do about this. The number by itself, out of context, means nothing. It’s an economic number. Let’s put good economics and good health for children in the same discussion. We know what causes abuse and neglect. We know what services and programs work. What are we going to do to engage our policymakers, our neighbors, and ourselves in finding solutions?
The last couple of statements are that I think we also ought to put expectations – let’s manage our expectations about what any report can do, specifically the economic impact report. Marci will be talking about the prevention report in a second. Let’s also understand that there is no silver bullet. I mean, when we take a look at the research and find out what the long-lasting adverse effects of abuse and neglect are, it is staggering to see how many things are affected later in a person’s life.
So does it make any less sense that the way to solve the problem is going to be any less complex? There is going to be no one strategy, no one speech, no one anything that does it all. But that’s what’s so good, in my opinion, about the prevention report and the recommendations that the Kids are Waiting campaign has come up with. It’s another tool on the tool belt for us to use in a specific way for our communities to address the way they feel it ought to be addressed, the issues of abuse and neglect. Any answer has got to be interagency, interdisciplinary, and long term.
So, again, let me say a special thanks to the Pew Charitable Trusts. And I’ve purposely left Marci off of the introduction list because I wanted to introduce her in the most friendliest, cordialest of way. You know, we get to meet a lot of people. Prevent Child Abuse is a national organization and we get to meet a lot of people and have an opportunity to discuss and vet things out. I’ll tell you, it’s been a long, long time since I’ve been able to really get my hands down in the dirt and work on a project with such professionals who are committed to the safety and the health and good outcomes of our nation’s children. So, Marci, thank you very much for being with us.
(Applause.)
MARCI MCCOY-ROTH: Thank you very much, Jim, for that very warm introduction. As you know, and I’ve said to you privately, we have just been delighted to work with Prevent Child Abuse America, similarly, for your compassion and commitment to making a difference in the lives of children and your outstanding staff. So it’s just been a pleasure all the way around.
The Kids are Waiting campaign of The Pew Charitable Trusts is very proud to be issuing its latest report in a series of reports called Time for Reform. This one is Investing in Prevention, Keeping Children Safe at Home, and you all have it in your packets, I think. We are especially grateful for the vital contribution of Madelyn Freundlich, who was the researcher and author of this report, but who can’t be with us here today. So in her stead, I’m going to be sharing a few facts from this report.
For nearly a year, the Kids are Waiting campaign has been advocating for federal financing reform to help prevent the need for foster care and to move children out of foster care more quickly to safe, permanent families through reunification, adoption, or guardianship. Building on the recommendations of the Pew Commission on Children and Foster Care, our campaign joined a growing number of other child welfare organizations calling for federal financing support for the broad continuum of services that children and families need in addition to providing foster care as a safety net. The Kids are Waiting campaign has released seven reports in the past year highlighting problems with the foster care system that could be improved by changes to the child welfare funding formula.
Why our focus on prevention? Simply, like Prevent Child Abuse America, we believe child abuse and neglect can be reduced and we’ve found many innovative programs across the country that have demonstrated this successfully. In addition, taking children away from their families and everything they know and placing them in foster care is a deeply traumatic experience that often stays with these children long after their time in the system is over. We should do more to prevent these removals wherever it’s possible to do so safely.
I’d like to highlight two points that make the case for better investments in preventive services. First, in 2005, we didn’t provide any services or supports to 40 percent of the 900,000 children with confirmed maltreatment; that’s 360,000 children who didn’t receive any kind of public service or support. And of the children leaving foster care in 2005, 54 percent of them, or 124,000 children, returned home to their families. I think this suggests that they may have been better served without the need for foster care in the first place.
Foster care provides a vitally important safety net for some children, but many children enter foster care each year because their families need and don’t receive the services and supports that could help them stay home safely. For example, we’ve been able to see – it’s been demonstrated that the use of foster care can be decreased if families have access to services like mental-health services, drug- and alcohol-treatment services, safe and affordable housing, safe, adequate childcare. When these services and others are not available, the only solution is often the placement into foster care.
The good news is we know of successful programs and practices that can help prevent child abuse and neglect in the first place, can help prevent it from recurring when it does happen, can reduce the placements into foster care, and to help more children leave foster care safely. Unfortunately, the outdated federal child welfare financing system does not support these programs to the same degree that it funds out-of-home placements into foster care.
I’d like to direct your attention to this continuum-of-services figure. And it’s on page 19 of the report for those on this side of the room who I’m sure can’t see it. With this figure, we really wanted to demonstrate the scope of services and supports that can help keep children safe and to strengthen families. You’ll note that out-of-home placement services are in green. I’m going to point here to this section here. And foster care is in that category. As today’s report notes, the majority of federal child welfare resources, nearly 90 percent, may only be used to support children after they enter foster care and have been removed from their families. And approximately 10 percent can be used to fund alternative services along the rest of the continuum.
The Kids are Waiting report highlights an array of programs that have been shown to be effective on the prevention side. Home visitation programs such as the Nurse-Family Partnership program and Healthy Families have decreased the incidence of abuse and neglect. Through increased investment-prevention services, Allegheny County in Pennsylvania was able to help more than 65 percent of children remain at home for the entire time they were served by the child welfare system. We’ll hear more about Allegheny and Healthy Families successes in just a few minutes.
In Wisconsin, Wrap Around Milwaukee decreased the number of children in foster care placement by 60 percent and reduced the cost of care from $5,000 per child to less than $3300 per child. Although pockets of innovation and good practice exist, the funding sources for these programs are not always assured and the structure of the federal financing system largely works against the provision of these preventive services.
The Pew Commission on Children in Foster Care, which issued a report in 2004, recommended that the federal child welfare financing system be reformed so that states can provide the full array of services that children and families need. Specifically, the Kids are Waiting report recommends three things. First, we need a sufficient, flexible, and reliable federal funding resource to help states develop and provide the services children and families need. Second, we should encourage states to safely reduce the number of children in foster care by allowing them to reinvest the savings in their programs and services. And third, all children with confirmed cases of abuse or neglect should be eligible for federal foster care support regardless of income or ethnic background.
We must keep children safe. And, unfortunately, the reality is that we may always need foster care as a safety net. But we can do a much better job of preventing child abuse and neglect and reducing the use of foster care. The real question is how much longer must children and families wait for reforms that will help them stay together safely? Thank you so much for being here today.
(Applause.)
DAVID SANDERS: Thank you. Good morning. I want to thank Kids are Waiting and Pew for a very thorough and comprehensive report and also thank Prevent Child Abuse America for the compelling economic analysis. And within the Kids are Waiting report, I particularly liked the definition of prevention that really looked at preventing abuse or neglect, preventing recurrence of abuse or neglect, preventing placement, and promoting safe and timely reunification. And those four points really will form the context for my brief remarks.
Three points that I want to focus on – one is on the structure of the response within the United States for child abuse and neglect. Second is the effectiveness of prevention and then third is the issue of the federal financial support. So to the first point, the structure of the response – I think all of us would agree that the goal of the child-protection system in the United States is to assure that all children are in safe, permanent, loving homes. However, our response waits until children are harmed. We wait generally until children are abused or neglected and then we pour all of our resources in to attempt to fix the children and families.
It’s an unbalanced response. And while an aggressive response to abuse or neglect is important, it’s ultimately a futile response. The need for a much more balanced approach has been recognized by law enforcement, has been recognized by education. When law enforcement talks about reducing crime in a community, it’s a balanced approach of community policing and an aggressive law-enforcement response. When education talks about raising the educational standards and raising educational achievement, it’s a balanced approach of school readiness and strong K-12 programs.
The same kind of approach is necessary within the child-protection system. Our approach today guarantees that children will be hurt because we wait until they’re hurt before we intervene, and then the response is all too often to disrupt the stability, the only stability that they’ve known.
So let me switch to the effectiveness of prevention because I think it’s been already talked about. It’s absolutely critical to intervene in a way that assures that children are never abused or neglected in the first place, or that when it happens that the likelihood of future abuse is reduced. I think Kids Are Waiting highlights a number of the successful programs, and I’m not going to repeat those, but I think in terms of prevention of initial abuse or neglect in general, families who come to the attention of the child-protection system are known to communities or known to other government systems.
It’s imperative that preventive efforts are community based and cross-system. Some of the examples highlighted in the report, like nurse home visitation, really do meet that criteria. Comprehensive early-childhood programs, programs that address single adolescent teens, all of those are important – single adolescent parents, all of those are really critical. They’re comprehensive; they’re community based.
In terms of preventing subsequent abuse or neglect, most families who come to the attention of the child protection want to care for their children. It’s really a small percentage that’s not interested in caring for their children; most parents do want to care for their children. However, what the child protection offers, and you heard it from Marci, is really in general just an investigation. And so, the question of did you abuse or neglect your kids is really foremost, and not looking at can we bring supports to actually assure that your children are safe.
There’s an approach that’s been used in a number of states called alternative response, differential response; it’s called by different names. But really what it does is bring comprehensive supports to families rather than just bringing in investigation. We used it both in Minnesota and in California, where I was a child welfare administrator, and really found that bringing supports like housing, respite care, access to substance-abuse treatment to families, to ensure that further abuse and neglect didn’t occur, was successful and that both the likelihood of future abuse as well as the severity of future abuse was decreased.
The third area, in terms of prevention of placement: As you’ve heard already, most children are referred to child-protection agencies due to neglect. It’s really critical to engage families and communities to assure that children’s needs are met. Families, most families, again, care for their children. And families who care for their children need support. They don’t need their families torn apart. And the notion of assuring that children are able to stay safely with their families through engaging families is not just an abstract, kind of do-gooder notion, but really it is because it’s less costly to children and families and it’s less costly to taxpayers.
Finally, the notion of promoting safe and timely reunification – and I think Marci talked about it in the general approach, but within the child welfare system, within child protection – it’s absolutely critical to approach timely and safe reunification with a sense of urgency, that when children go into foster care it’s an absolute crisis. Their life has been disrupted and the whole community needs to wrap around families to make sure that there’s a sense of urgency to safely reunify children with their families. In Los Angeles, where I was responsible for the child-protection services from 2003 to 2006 using these and other strategies, we reduced the foster care population in the country from 30,000 to approximately 21,000 and, as importantly, improved safety in all measures for the children that were served by the system.
However, that brings me to the third point, which is the federal financial support. During that period of time, Los Angeles County lost tens of millions of dollars in federal support although we were better at the goal of the system, which was to assure that children were in safe, permanent homes. The federal government financial structure waits for children to be hurt, then supports breaking up families as a primary intervention. In California, we were able to have a waiver that was approved by the federal government, which allows for some of the funding flexibility that Marci talked about.
However, the federal waiver authority no longer exists, as Congress decided not to continue the waiver authority. So there’s not today a federal mechanism that allows for the kind of reinvestment of savings or the funding flexibility that could actually assure prevention of abuse or neglect, or prevention of subsequent abuse or neglect. The federal government needs to support the kind of outcomes that the entire system is working towards and that the public expects.
So just in summary – we have a system that’s structured to wait until children are hurt, but we know that there are effective prevention strategies that can reduce abuse or neglect across the country and that, most importantly, we need a federal financial structure that actually supports the kind of outcomes that we’re looking for.
So thank you.
(Applause.)
MARC CHERNA: Good morning. I’d like to thank Prevent Child Abuse America and The Pew Charitable Trusts for giving me the opportunity to speak about the benefits of prevention and keeping children safe with their families. I think we’ve demonstrated that in Allegheny County – and that’s what I’m really going to talk about as well as some of the federal financing problems that we have.
Allegheny County has about 1.3 million people, so it’s a fairly large-sized county. And when I came to Allegheny County 12 years ago, it was viewed as a national disgrace. We had eight child-abuse deaths under supervision; we had 3318 children in foster care, which was growing every month.
So what we did is a considerable public process of really getting a lot of input from the community in terms of what they felt we should be doing, and how we should be doing things differently, and we adopted the following philosophy. We decided we were going to invest in prevention and do everything we can to prevent folks from having to come into our system, to give them the supports they need before they got here and if they did, we were going to do everything we can to preserve families, to provide services so we did not have to remove children from their homes, to minimize risk so they can safely live in their homes. And if we did have to place, we were going to place at relatives first and foremost because removal is so traumatic to children, so at least if you have to remove, if you can remove and put them with people they know who love them and they trust, it’s less traumatic, as well as placing siblings together at all times.
And we’ve demonstrated over the years that this philosophy shows that children can live safely in their homes. For example, over the last five-plus years we have not had a single child-abuse death under supervision in our county. A few years back – (applause) – you know, to some degree I – you know, knock on wood each time because you could have one today – but it’s been a pretty good run and I think a lot of it is because we have the prevention supports and community taking ownership in protecting children, which is really what’s critical.
We went for over 30 months without a single child-abuse death in the whole county, whether they were known to us or not a few years back, which I think was pretty remarkable. We only had 131 substantiated abuse and neglect cases last year, in the last 12 months. Now, 131 is 131 more than we would like to have, but for a county of 1.3 million people, the reality is most places have an awful lot more than that. We didn’t have a single case of re-abuse, where children returned home and then were re-abused, in the last 12 months.
We’re down to about 2200 children in care; of that, over 80 percent are with family foster homes, and of that, over 60 percent are with relatives. Over 90 percent of the siblings are placed together, and our average length of stay is about 14 months right now. And we made this transition in spite of the federal financing restrictions, which primarily reimbursed placement. You’ve heard that a number of times before; you know, just need to repeat that.
As we saved our state and county dollars, that’s what we reinvested, and we invested that in things like family support centers, of which we have 33 in our county; after school and summer programs in high-need areas, such as all our public housing communities; youth places, we have about 16 of them; many parent support programs. A lot of home visiting, a lot of provision of tangible goods because a lot of folks end up neglecting their kids because of parental stressors and they’re single parents and things, so to really give tangible goods to help people around poverty-related issues. And we’ve also used our other Department of Human Services’ services to help families get the help they need so the risk to their child could be minimized. So we provide, you know, drug treatment and mental-health care and housing supports, and all those kind of things instead of removing children right away.
Our current funding of $227 million, a little less than 20 percent now is Title IV-E, which is the reimbursement for placement; it’s about $47 million. For Title IV-B, which is the money which you can use for in-home services and prevention and supports, we get $929,000, less than $1 million out of a $227 million budget. So you can see the difference between the federal priorities of $47 million for placement, less than $1 million for keeping kids in their homes.
Our federal dollars are going down each year because as we reduce placements, we get less of that reimbursement, but their requirements get more and more onerous and they dictate everything. It’s a broken system that really has to be overhauled to be consistent with the adoption of the Safe Families Act, with the Children and Family Services Reviews, of which not a single state has passed, and the federal response to that was to raise the bar even higher to ensure that they don’t pass again, and then they’re taking money away from the states.
When that happens, who gets hurt? It’s certainly not the people who are running the operation; it’s the children and the families. There’s less money for services, so how do you ever improve if there’s that punitive way of doing business?
A lot of us have talked about, you know, what to do about this for quite a few years, and the Pew report was a really good one around that, but there seems to be four key principles that need to be done. One is flexible funding to pay for all services, and to really incentivize the pay for keeping children in their homes and up-front services. Two is fairness to allow all maltreated children to be eligible for federal financing; the way it is now, that you have to do a look-back, then you have to be TANF eligible as of I think July 3rd, 1996, to be eligible for the federal money. Why do poor kids get federal funds and kids who are not, who have been abused, are not eligible for that? And the money it requires to go through all of that, the millions we waste in going through that process that means nothing, could be used for services if it was looked at differently.
There needs to be more options for permanency. Adoption is a good thing if children cannot be reunited, but also subsidized legal custodianship, legal guardianship. If relatives have their kin, they may not want to terminate parental rights, they may not want to actually adopt their grandchild or niece or nephew, but they are committed to them and will stay there and there’s no – a lot of us, our states, have adopted this. In Pennsylvania we have, but we pay with all state money; there’s no federal financing for that option for permanency.
And the last thing is really to incentivize performance rather than punish for lack of performance. If states are not meeting requirements, why can’t they use that money to improve performance, and why can’t people be rewarded for doing a good job as opposed to the other way around? I don’t think it was the legislative intent to just punish the states and take money back; it really doesn’t help anything in terms of these laws.
But in Allegheny County, we’ve shown that prevention and family stabilization works. It keeps children safer, it improves well-being and it saves taxpayers a lot of money. We must align the federal financing to provide incentives so states can move in this direction.
Thank you.
(Applause.)
JENNIFER GIBSON: Good morning. As he said earlier, my name is Jennifer Gibson and I am the youth voice today.
When I was eight years old, my sisters and I were removed from our home and placed in foster care in the Utah state system. Our home environment was unsafe and unstable. The idea was that we would spend temporary time in care until my mother could be named suitable. There were three of us.
My time in care was a brief one, but I remember fully the impact it had on my life. The three of us girls were separated when removed from my mother’s house, two of us placed in foster care, the third in a children’s center alone because my foster mother could not care for all three of us.
I was very fortunate to be placed in a loving young family while my mother jumped through the hoops to regain her parental rights. I was able to experience normality, a real normal for the first time in my life. I had clean clothes, new toys, and after-school snacks. I remember being helped with school work and playing in the backyard pool.
During the separation, my mother became pregnant with her fourth child. In turn, she was back on track for a bit. She got a job, began dating a good man, and rented a house on a quiet suburban street. We bought a dog; his name was Morgan. He was very cute. Things were great during the honeymoon period, as we call it. We all got along; we went to daycare and spent time in the kitchen together. After being reunited, I don’t remember ever seeing a caseworker or social worker, and all of the counseling that we had went through ended as soon as we exited care.
The happy, healthy suburban life didn’t last long. Eventually, we were back to only eating at school, nothing in the refrigerator. My mother was back to using drugs and we’d moved to three schools in one year. I remember many nights waiting for my mom to come home, many times wondering if she would come home and pack us up so we could move again. Her cycle of drug use and rotten boyfriends had come back full swing, and it seemed the only thing that changed for us was that now there were four of us girls.
The PTA mom had again become a party girl. I know that the same resources that could have kept us out of foster care in the first place could have saved us after being reunified. My mother needed addiction treatment, parental classes, and job-skills training. We all needed family counseling. My story could have ended with a new dog on a quiet suburban street; it didn’t have to end the same way it began. My story is just one of thousands like it: children removed from unsafe homes, separated from each other and placed in care, handed back with hopes of impossible promises of how it will be different this time.
My mother is not a bad woman. She’s just another young mother that needs support, wants change, and doesn’t have the resources to do it.
I thank you all for being here and supporting everything that these people are trying to do today. Thank you.
(Applause.)
CHERYL D’APRIX: Good morning. My name is Cheryl D’Aprix and I’m very happy to be here today.
In 1993, my husband Jeff, our 3-year-old daughter and I were presented with a life-changing experience. I received the news that we would be expecting another baby and could welcome him into our world in about seven-and-a-half months. I very gently broke the news to my husband and, together, we sat in silence, each struggling with our own fears and thoughts. Jeff had his mind on the insufficient funds barely coming into the home, not to mention the fact that we were now going to have to replace all the baby furniture we had just given away because we were convinced we were not having any more children. I was busy thinking about having to go through post-partum depression with another baby. I had suffered with post-partum depression for more than year after the birth of our daughter. I made it through that year with the support of my husband and my family, but now I was petrified of it worsening with a new baby. I prayed and hoped that I could remain well enough to take care of our children and hold things together.
Over coffee with a friend, I expressed some of my concerns and she recommended that I check into a home-visiting program that was available through our community and the community-action program. This program was called Starting Together, which is part of Healthy Families America, New York. The program partners with families who have children, prenatal to three to five years of age. After much thought, I reluctantly gave this agency a call. I have to say that it was petrifying and it was scary and it was unnatural to invite someone into my home that I didn’t know. It was very scary, but after minutes of meeting my home visitor I knew that we had made the right decision for our family.
During my pregnancy she listened to me, shared information with me, and gave me the support I needed to feel confident in talking with my physician about my post-partum depression. I was afraid that whichever doctor happened to be on call that day would either just dismiss my concerns or tell me I was an incapable mother. With the help of medication and strong shoulders, I was on my way to a healthier existence and a more secure attachment with my son.
My home visitor brought us curriculum on the stages of development, books and videos on basic care and information on the resources that helped our family stay afloat. Throughout the course of three years, we spent time together doing activities with the kids, setting attainable goals for my family and spending countless hours of talking about my favorite subject, my kids. We also spent time talking about my life and what it was like growing up. She gave me the opportunity to tell my life story and I came to see that I, too, was worth listening to. She laughed with me on the good days; she let me cry on the bad days that were too overwhelming, and there were plenty of those. One of the greatest gifts she ever gave me was the belief in myself. She knew the importance of nurturing the parent as well as the child.
When my son turned three, my family graduated out of the program. Jeff was working hard, our daughter was bossing around her baby brother, and I was going to work. Just before we last saw our family support worker, she encouraged me to apply for a position at Starting Together. It didn’t take me time to think it over; I jumped at the chance. After all she had taught me, and with all the ways my family benefited from the program, I applied for the job. I was excited to start lending a hand and a supportive ear to other parents who needed it.
So here I am seven years later, 2,016 home visits later, and I am still learning about the benefits of preventive programs and my passion to partner with families is stronger than ever. I have visited with low-income families, no-income families, and middle-class families, all who have multitudes of issues, and some who just long for another adult to talk to. Each have a story worth listening to, each craving the opportunity to learn and grow, each deserving the opportunity to be nurtured. Thank you for inviting me here today to tell my story. I’ve seen both sides of what a child abuse prevention program can accomplish. It truly is a life-changing experience. Thank you.
(Applause.)
MR. HMUROVICH: Great. Great stories and great information, thank you to everyone. We have 15 minutes for questions. Now, I’ve taught class for 13 years, so guess what’s going to happen? No – (chuckles). Yes, ma’am?
Q: Could you give us some background on how work is being done on Capitol Hill to get that flexibility that several made reference to?
MR. HMUROVICH: Sure, Bridget can help us and who else would you recommend?
MS. MCCOY-ROTH: I’ll go ahead and start.
MR. HMUROVICH: Great.
MS. MCCOY-ROTH: I’m – can you hear me? Okay, there we go, you can hear me now.
The Pew commission issued its report in 2004, and since then Pew has been supporting a variety of projects to really raise awareness about what reforms are needed. Last year we launched the Kids Are Waiting campaign to really elevate the issue even further. We’ve had over 300 meetings on Capitol Hill with different policymakers in the past year. We have 100 scheduled in the next two days. I think that’s the right count, Courteney’s back – (chuckles) – Courteney’s in charge of that.
We’re working really hard to share information of successes and innovations to show that these recommendations make sense. There’s lots of different opinions about sort of the final package of what the reform should look like, but there’s some fundamentals as folks here have talked about. So we’re pushing pretty hard. I don’t know, Hope or Bridget, would you like to add anything to that?
MS. HOPE COOPER, THE PEW CHARITABLE TRUSTS: That’s great, I would just say that there are a number of proposals pending. There are a lot of champions on Capitol Hill for these children and for families who need help. So there are efforts. There has no been no action taken really that we can point to, but there are a lot of advocates working together and, as Marci said, the Kids Are Waiting campaign is reaching out to many people to work together on this.
MS. BRIDGET GAVAGHAN, PREVENT CHILD ABUSE AMERICA: I mean, I would just add, Jim mentioned that there’s no silver bullet and there’s no one piece of legislation that’s going to get this done, so we’re looking at a suite of options. We’re excited about the reports today. We feel like that’s going to generate some interest on Capitol Hill and the 100 meetings certainly will – some exhaustion on our end, but some interest on Capitol Hill so –
MR. HMUROVICH: Next question? You know, we’re staying here until 10:30. (Laughter.) Yes, sir?
Q: I have a question. Who is opposed to the readjusting of financing principles – (off mike)?
MR. HMUROVICH: Marci, did you want to?
MS. MCCOY-ROTH: No. (Laughter.)
MR. HMUROVICH: Do we have to name names, or – (laughter). Yeah, Hope, did you want to?
MR. CHERNA: I can talk about that a little bit I think. I mean, it sounds like a simple thing and it sounds – you know, everybody seems to subscribe to the philosophy we’re talking about, but when you’re in an environment where there’s not a lot of money and there’s finite dollars, and that’s what we’ll hear from, you know, our federal legislators and the federal government is there’s less and less money to go around. And if you’re going to change, then something’s got to be reduced if you’re going to increase something else. And getting consensus on how to do that is always an issue.
When you look at the federal claiming, it’s all over the lot. Certain states have been aggressive and have claimed a lot of money; other states have not. So states who are late to the game say, we want our chance to get our money up. You know, other states who have already reduced placements say, we don’t want to be capped in a way because things may slip back a little bit.
So getting a way to meet everybody’s needs is easier said than done, and that’s part of a dilemma, you know; it gets complex. I mean, David talked about a waiver, and waivers seem to be a good way to go because then states can decide what is the way that they need to make it happen. But the federal government cut waivers of – so at a minimum, if they let states have that option of getting waivers again, that would be a real positive thing to go forward. But, as of now, that hasn’t happened.
MR. HMUROVICH: One other thing, as folks are making the Capitol Hill visits, some other folks are going to be visiting our federal agencies to determine what, if anything, can be done right now to work on improving the outcomes for children. So it’s going to be a bifurcated approach to the executive and legislative branch of governments. Another question? Yes, sir.
NATHAN MONELL, FOSTER CARE ALUMNI OF AMERICA: Nathan Monell from Foster Care Alumni of America. This morning I heard on the radio on the way in that due to the tragic deaths in D.C. a couple weeks ago that there are reports for investigative on services have gone up 400 percent, calls coming in reporting suspected abuse and neglect. Marc, I just wonder how, as in your county, you balance that kind of constant fear of the media wanting to exploit cases that kind of drives versus one way or the other, and how can you recommend that we keep balance in it, keeping children’s safety in the forefront without it becoming something that overwhelms investigative services?
MR. CHERNA: Yeah, that’s a very good question. It’s a very difficult thing that everybody struggles with. I mean, the – hurting a child, you know, and a child being abused and neglected or killed, you know, is the worst kind of thing. And the public gets so irate and they want to blame somebody. Somebody needs to pay for that and the tendency, unfortunately, is to look at government to blame as opposed to the perpetrator. The government didn’t actually kill the child; someone else did, but it always seems to be that it’s government that’s at fault for letting this happen.
What we try to do is be very open about cases, about what happens. We are far from perfect. There are things that are going to go wrong, but protecting children is really, it’s a community responsibility and it’s a system. It’s not just the child welfare agency alone that does this. There’s the court systems. There’s child advocates who represent the child. There’s parent advocates who represent the parents. There’s all these different factors that come into play and they’ve got to be looked at as a system. And what you need to do is try to learn from things that happen so you minimize the chances of it happening again.
Certainly, if there’s malfeasance, if workers have really messed up, but it’s not workers on their own necessarily, it’s usually supervisors and there’s other folks. One thing we do is we conference everything so workers don’t make their own decisions; they’re making decisions in a group so there’s kind of strength in numbers, and then there’s more – there’s less likelihood that they’re going to be worried about, well, if something goes wrong on my case load, I’m going to be fired.
That’s the worse thing I think you can do is look to make examples, which too often elected officials do that. They’re too quick to look to blame and to get the weight off of them as opposed to really looking at what happened and how can you fix it to do better on this thing. And, unfortunately, a lot of reporters look to – for the headlines – they look for the sensationalism. They don’t do their homework in terms of what really transpired, the deadlines they’ve got to meet. So what we try to do is be very open with reporters. We try to bring them in, we try to educate them, and we try to work with them on that. But that being said, it always is that danger of that public sentiment, and it’s a tough one.
MR. HMUROVICH: David?
MR. SANDERS: I would just also add, I think that it’s critical to think about the policy, broad policy, and to not have broad policy driven by single situations. And that doesn’t mean that there isn’t a lot to be learned ensuring that deaths are prevented, and I think that’s certainly the attempt in Washington, D.C., but the broad policy, which is – which needs to be a much more balanced approach with much more focus on prevention, isn’t in any way – doesn’t get shifted because of individual incidents, and I think that that piece is critical.
One of the things that I had always talked about when I was in Los Angeles is that we did 160,000 investigations a year. That meant that 160,000 children were really at risk of having been harmed in some way. The number of child deaths was very small for that 160,000 and one needed to think about the approach from as broad a perspective as possible in making sure there’s excellence in every investigation, but not setting policy based on a handful of cases. And I think that’s one of the real challenges, and that the right policy is one that’s balanced, that assures an aggressive response, but at the same time really looks at prevention and what can be done to make sure that children aren’t abused or neglected in the first place.
MR. HMUROVICH: Great question. Follow-up questions? Sania?
SANIA METZGER, CASEY FAMILY SERVICES: Several of our speakers made reference to the fact that – thank you – Sania Metzger from Casey Family Services. Several of the speakers made reference to the fact that poverty plays a role in the removal of children. And I’m wondering specifically what kinds of services, particularly under the differential response system and others, are you able to provide up front in order to address what often is mislabeled as neglect and what is very often the manifestation of very basic needs on the parts of families?
MR. HMUROVICH: Who wants that?
MR. SANDERS: I can certainly start. I think that the point raised about the correlation between poverty and entry into the child-protection system, I think, is a really critical one to kind of stay focused on, in that the majority of children coming into the system come in because of neglect and that there is an ability to provide supports that families need.
And as you were asking the question, I was kind of thinking about, okay, well what are some of the specific things? But I think what’s actually most important is to really build it around what the family identifies and what the family needs. I think that the examples raised earlier today by both of the speakers that really talk about situations that are individual. How do you tailor the supports individually to make sure that the right resources are in place? It means a different kind of flexibility than has generally been in place.
Usually what happens is there’s a determination that there’s a set of three services that might address poverty and those are the three things that are going to be put in place. And I think the focus of alternative response is to step back and to say, what does the family need, what are they identifying, and how can resources be brought to make sure that those needs are met? And I think what we found, certainly in the systems that I was responsible for, was that, generally, the needs were the kind of things that the system might not think were important, but that were important to families in really changing their life: being able to spend time with their kid outside of the stressful kind of day-to-day activities that many families are involved with. They’re being able to spend time away from their kids. I mean, there are a variety of things that I think are really helpful to families, but it’s important for families to identify what those things are.
MR. CHERNA: I’d also add that the demand always so far outweighs the supply, and one of the real problems in our system because of categorical funding is that child welfare agency doesn’t often have access to mental-health services, drug and alcohol services, housing, and all those supports. In Allegheny County, we have that all in one shop of – run all of human services, so I can mandate pretty much that if somebody needs drug treatment, they will get it. They’re not going to be put on a waiting list, and that’s an exception rather than a rule. And unless we look at how we organize in that way to meet people’s needs holistically, that’s one of the real issues, too.
MR. HMUROVICH: Jennifer, did you have any thoughts on this?
MS. GIBSON: Nothing really to add, but I do know that, in my case, the poverty level was very high as far as the neglect issues. But we also needed the drug rehabilitation, so that when the money was there, when we had the food stamps coming in, it was sold, and that those resources were used to fill the drug need and the drug fix. So just handing the money so that there’s food in the fridge doesn’t always help. You’ve got to have those other resources as well.
MR. HMUROVICH: Last question.
KIMBERLY HARDING, BABY STEPS: Did you guys ever think of getting – thank you – I’m Kimberly Harding, I’m part of the Baby Steps program in New York. And I never knew about the program before, so maybe it should be more widely known to get out there – the word to get out because if I knew before for my older son, I would have been better off of knowing certain things of his learning capabilities and certain things that I’m getting from the program now.
So maybe if like more counselors knew from school or – so that, because yes, I’m in a poverty area, whatever, and poverty level, but still it doesn’t seem like it’s more widely known as of out there because the way how I got to this program is because I had the baby and the Department of Health came, a nursing visitor came just to check the home and make sure everything is correct in the home, and they referred me to the program. But if that had never happened, I never would have been in the program because I would have never known about it. So that’s – my question is that, have you guys ever thought about to get the word out more?
MR. HMUROVICH: Great. Cheryl, why don’t you give a thought on that? You’re closest to –
MS. D’APRIX: Being from a very small county, a very rural county, we do have an easier time getting the word out there. The way that we do that is talking to physicians, talking to hospitals. I know that they’re out there; if there’s someone that they can talk to within the schools, they’re doing that. I know that there are certain people within the agency who are specified to go out there and educate the community on what the programs do need to offer. So I’m just glad you heard about it.
MR. HMUROVICH: Well, thank you. You’ve been a great audience. Thank you for your questions. Thank you to our panelists who have given us information. (Applause.) And let’s leave with the idea that if this is an end of a discussion, none of us, any of us, have done our job today. Thank you.
(END)
