Still, I don't know whether it would justify doing away with the criminal provisions. Again, you are only going to examine children that have been reported. The only justification I can see for including a criminal provision is to spur some of those physicians on initially who will make the report. And after the report is made, you have a number of other problems, including the physical examination and getting the physician to appear in court.

Mr. HOGAN. But if I understand the testimony earlier, that one reason doctors weren't reporting, or the principal reason given, is that they were fearful of the time they would have to spend in court, and other problems that were associated with this.

Now, if the district had to provide for a physical examination of the individual within 24 hours, which would presumably preserve most of the marks, abrasions, and x-rays and all that kind of thing, the courts themselves could exercise considerable discretion in subpoenaing the private physician, and in most cases I would suspect that the judges, if they had the testimony of a physician, and he had made a physical examination shortly after it had happened, the number of instances in which the subpoena for a private physician would go out would be very limited.

Mr. BRIAN FRASER. Well, that is correct, but again we are particularly worried about the physician who sees the abused child and just absolutely flatly refuses to turn in any report at all. Now, until they turn in the initial report, you cannot get another physician to examine the child, because they are not aware of the child abuse case. Maybe I am not making this particularly clear, but

Mr. HOGAN. No, you are making it clear. I am just suggesting, you know, if you make the procedures less onerous so that the doctors will comply voluntarily, that you get the same result as you would, perhaps, if you put a criminal sanction in here. And it is troublesome to me to have criminal penalties on the laws of the District of Columbia, or for that matter the federal code, and not have them enforced, and know fully and have the testimony in the committee, which we will have here, from you that there has never been a case brought, to your knowledge.

Mr. BRIAN FRASER. Well, let me equivocate a little bit and say that if you do allocate one physician to make the investigation, do the physical work-up, and appear in court, I think that it probably will spur some reporting on, and again I really don't want to take any definitive-and I know it is an equivocation, walking the fence, but again I am still 50-50 on whether or not we should have a criminal penalty for failure to report.

Mr. HOGAN. Well, going now to the question of whether this committee would act on this measure, I gather probably they wouldn't. If they were to act at all, it seems to me that one of the principal questions that they would have to address is whether they would establish an independent agency, and I suppose they wouldn't want to-and I gather from some of the testimony here there is probably a substantial need for an independent agency to perform this function, because even on the reported cases now that you have in the District, which is some five or six hundred a year, you are not getting the kinds of services that perhaps you should have.

Now, if you expand on the reporting and you don't make some provision for improving on the services that are rendered to the individuals

who are brought in, you know, it seems to me that the committee here wouldn't be doing its proper function.

On the other hand, I suppose they will be reluctant to establish a separate agency, and I imagine the District, on the other hand, would oppose the committee moving on this bill if it were to result in the establishment of a separate agency.

I guess my question is, do you think there should be a separate agency?

Mr. BRIAN FRASER. Are you asking me?

Mr. HOGAN. Well, all of you.

Mr. BRIAN FRASER. Well, I am not really too familiar with the politics that are going on in Washington, D. C., but we very strongly do believe that there should be an independent agency which handles all of these cases. We want to get away from unilateral decision-making, be it on the part of the police or on the Department of Social Services, and we think that the only way that we can accomplish this is to move it out of a bureaucratic system and put it into a new agency.

Mr. HOGAN. Professor Areen, you worked in this area.

Professor AREEN. Well, I am also unsure at the political level of where to locate the agency. What is clear to me is that those services do not now exist in the Department of Human Resources. Now, it is possible that within that agency they can set up a division to provide them.

As I have said before, I do not believe protective services is the answer, since their focus is on the child, and not the family.

The big need is, we are not providing services, particularly psychotherapy, for the families.

Perhaps the answer is to mandate the services and negotiate further with the agencies at the proper placement in the governmental structure of the District of Columbia.

Mr. HOGAN. Well, if the services are mandated, this committee. wouldn't-they are just saying, you know, that the services are there, and the answer could be, well, they are in the Department of Human Resources. It wouldn't separate out a particular agency.

Normally, when you want to concentrate services, when the Congress feels that a function is being performed inadequately, either in one particular department or there is inadequate coordination between a number of departments on the executive side, they form a special agency to address a special problem.

And I think one of the problems here is, will this committee-will the District oppose segregating out a special agency, and I gather, if I gather your testimony, you feel that there is a need for perhaps this kind of treatment of this problem, there should be a special agency, perhaps, to do this?

Professor AREEN. Yes, perhaps the answer is to establish it on a demonstration basis.

Mr. HOGAN. Thank you, Mr. Chairman.

Mr. MAZZOLI. Because of the bells, I have to go again, and we will take another 5-minute recess. Congressman Stark is coming back. Actually, this is all I would have for this panel, so you are free to go, and we will have the final panel come in after the 5-minute recess. [Recess.]

Mr. STARK [presiding]. If we could call this hearing to order, I would start by apologizing to the next panel for the pace at which we are running, but the House is in session, and the Chairman has asked me to convene.

The final panel, the community panel, is Ms. Anne Riley, of the Metropolitan Washington Chapter of the National Association of Social Workers, Ms. Janet Hutchinson, President, Council on Adoptable Children, and Ms. Martha Galdi, who is a representative of the Community Task Force on Child Welfare Reform.

If they are here, we would like to welcome them to the witness table in whatever way they are comfortable.

Again, I will apologize, when the Chairman returns I shall have to depart, and so I will have to thank you in advance for waiting patiently and foregoing your lunch and being with us here today.

If you have written statement, you may feel free to read them or you may present them to us and we will make them part of the record and you may supplement them with comments, or proceed in any other fashion that suits you.

I understand Ms. Hutchinson has had to leave. Her testimony will be included in the record.

STATEMENT OF MS. E. ANNE RILEY, PRESIDENT, METROPOLITAN WASHINGTON CHAPTER, NATIONAL ASSOCIATION OF SOCIAL WORKERS; MS. MARTHA GALDI, REPRESENTATIVE, COMMUNITY TASK FORCE ON CHILD WELFARE REFORM; AND MS. MARY ANN STEIN, ATTORNEY, FOR LOVE OF CHILDREN, INC.

Ms. RILEY. Mr. Chairman, I am Anne Riley, and I am President of the Metropolitan Washington Chapter of the National Association of Social Workers. I am also a Master of Social Work.

Mr. Chairman, on behalf of our chapter, which represents nearly 2,000 social workers from this area, I would like to express our appreciation to this subcommitte for inviting us to participate in this crucial

matter.

In addition, we would like to thank Mr. Stark, who in conjunction with Mr. Stuckey and Mr. Fraser, made this hearing possible.

In order to clarify my professional involvement in this subject, I would like to indicate to the subcommittee that, as far as I know, I am the only professional involved to any great extent in giving psychotherapy to battering parents in the District of Columbia.

I am a psychiatric social worker employed at the Forensic Psychiatry Office of the Mental Health Administration of the D. C. Department of Human Resources.

I have treated 20 battering parents in an out-patient therapy group for one and a half years, and this group continues to date.

In addition, I have treated several such patients in individual treatment sessions.

I also co-led a seven-week Family Life Education group for some of these same parents.

Prior to this position, I was a D.C. policewoman for 6 years, during which time my specialty was the investigation of hundreds of battered child complaints.

CHILD ABUSE IN WASHINGTON

As professional social workers, we feel that we can support many aspects of this bill, which covers several areas of need which are long overdue in the District of Columbia.

Children have died in this city as a result of physical abuse. They might have been saved if some of the provisions of this bill were in effect.

Indeed, a child may be dying at this very minute as we sit here talking, for it is estimated that battering is the major killer of children under five years of age.

Many more, as you know, suffer permanent mental retardation as well as emotional and physical crippling due to the treatment they receive at the hands of their disturbed caretakers.

We believe, as social workers, that some of this can be prevented and some changes will take place if these families can receive mental health treatment.

My clinic, for instance, can only take patients who have come through the court system. We are legislated that way. We can only receive referrals through the court system.

There is very little, if anything, available for the voluntary selfreferral which you will provide for in this bill.

Now, several statements have made reference to self referral today, and I think it is important that we point out that there really is very little. We have the people in suicide prevention who get numerous phone calls from people on this very subject, who are afraid of losing control and have impulses to kill their children. These people have no real place to take their problems on a voluntary basis.

[Mr. Mazzoli presiding.]

There are approximately 100 battering cases a year which come. to the attention of the major pediatric hospital in the District of Columbia alone.

There are approximately 1,000 neglect cases yearly which are known to the Department of Human Resources. They may never come to the attention of the court.

Both kinds of abuse are serious, but battering is more frequently critical. Both families need help badly, but the battering parent is in need of psychotherapy, which will help him and in turn help his child, and may prevent his victim, the child, from also becoming a battering parent.

We all know about the problem where this goes on in cycles, and can go on for several generations.

It is my estimate that one multidisciplinary team could only successfuly treat approximately 20 to 35 battering families over a period of a year. Therefore, before the end of the first year, there would have to be a minimum of three teams to handle those cases from only one hospital, and we are talking now only about battering cases, not neglect cases.

The need would increase in the second year with voluntary admissions, with the necessary publicity that would have to be done to make it known to the parents who would be potential users of the team services that this did exist, and to encourage them to voluntarily bring

themselves forward. Also, there would be holdovers from the previous year, because this is not a quicky kind of treatment. It is something that may go on for a year and a half or two years.

With this amount of necessary professional staff, which will be very costly, not even one classical neglecting parent could be treated, much less hundreds.

AMENDMENTS PROPOSED

Therefore, I would recommend that the scope of this center be limited to child battering cases only, unless unlimited funds can be found, which is highly unlikely. Admittedly, it is difficult to leave out another very needy group, such as neglecting parents. But hard decisions are necessary without an adequate budget.

This brings up the question of ensuring funding for this center if this bill is passed. Also, protective services does now and can serve these neglecting parents. It is not necessary to bring them under this particular center.

Turning our attention to some of the specifics of this bill, we would recommend some changes in the make-up of the team which we feel are crucial.

The pediatrician and attorney need only be involved on a part-time consultant basis. Now, in my own agency. Forensic Psychiatry, we do have a part-time attorney who is on call, but mainly only comes to staff meetings once a week, and this proves quite sufficient. There is not enough need to really be able to justify a full-time attorney on such a team. A pediatrician would mainly serve as a consultant, because I don't think you need to duplicate the services that are available in the hospitals and the various medical facilities in the city. Possibly a registered nurse might be considered as an additional team member.

On page 4, line 16 (B), it should be changed to read "two psychiatrists (one adult and one child psychiatrist)."

As you know, there is almost nothing existent in the District for mental health treatment for children, and we would need to have the child examined in many cases, too, because in most cases they are quite severely emotionally disturbed. So that there would need to be two psychiatrists on the team.

Also, there must be a clinical psychologist involved. That psychologist would be testing as well as treatment.

Furthermore, a coordinator, a liaison person, should be added to this team, and I consider this most important. This person should only be responsible for assisting in the attempt to coordinate the activities of the numerous public and private agencies involved with each of these families assigned to the team, and again we have in our agency such a coordinator who does this kind of job and can pull together the necessary aspects of the varied functions that are performed by all of the various agencies in the city.

We are very concerned about the term "investigate," and on page 5, line 1, this is referred to. We feel that term should be deleted, as treatment would be doubly difficult if the center carries conflicting roles. I think this is very important.