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Congressman Stark introduced a bill dealing with this problem. And that has led to the cooperation with him and Congressman Stuckey and their staffs in looking at this question.
As they looked at the problem of inadequate reporting, it became clear that there were other deficiencies in the way in which the District is dealing with child abuse and child neglect.
We joined in introducing H.R. 15779. And then, I introduced a separate bill H.R. 15918. And I would like to touch upon the differences between the two bills.
First, let me say I think both bills are good. The reason for our introducing a second bill is to add some ideas that may facilitate the exploration of this problem.
First, in our bill, we would center the responsibility for initiating and coordinating investigations in all cases of child abuse with the Director of the Child Abuse Center, rather than with the Metropolitan Police Force, as is the present situation and presumably would continue under H.R. 15779.
Second under H.R. 15918, the decision as to whether or not a petition should be filed with respect to a child rests with the Director of the Center and the multi-disciplinary child abuse team.
Now, H.R. 15779 does not change the existing situation in which the decision is apparently made by Corporation Counsel after reference to the Counsel, either by the police or by the Department of Human Resources or by doctors or some other agency.
EXAMINATIONS OF CUSTODIAN
Third, our bill provides that there may be an examination of the person having custody of the abused child by a physician, by psychologists or psychiatrists; while the other bill makes no special provisions.
My statement goes on to discuss each of these three differences at greater length. And since we are inserting the statement in the record, I won't detail more.
FEDERAL CHILD ABUSE PREVENTION AND TREATMENT ACT
Let me stress, however, that enactment of either of these bills, if the committee should decide to move forward, would facilitate the flow into the District of Columbia of Federal funds provided for in the Federal Child Abuse Prevention and Treatment Act.
I think it is also worth noting that child abuse and child neglect are tied together in that Federal law.
There has been some question raised as to whether it is wise to tie these two responsibilities into one center.
But the problem is that the Federal law apparently ties these two concerns together.
Our general view is that there is a need to coordinate these cases. Someone must act as the traffic director so that cases are not sorted out at random by whatever agency happens to be first asked, or whichever agency happens to respond.
We, in our approach, lay great stress on the multi-disciplinary team, which includes pediatrician, psychologist or psychiatrist, social worker, and attorney, and whenever useful, teacher, police officer, nurse, and so on.
Mr. Chairman this is an effort to just open up some of the issues. I wanted to point out the differences, the three principal differences,
between the two bills.
But I think both bills represent a good start.
Mr. MAZZOLI. I thank my colleague for his explanation this morning and also for taking the lead with the other members of our committee on this important problem.
At this time, I would like to yield to my colleague and distinguished member of our subcommittee, Congressman Stark of California, for any statements that he might wish to make today.
STATEMENT OF HON. FORTNEY H. STARK
Mr. STARK. Thank you, Mr. Chairman.
I would like to thank you and our distinguished colleague from Minnesota for their willingness to work so well over the past few months to get into focus the various interests in the District; further, to say thank you, Mr. Chairman in particular for calling this hearing and creating this forum.
One of the frustrations of being a freshman Congressman is that it is so difficult to get things done. I wish all of the committees in the House were as willing as this subcommittee to investigate and move ahead on important legislative areas sometimes, maybe it isn't going to lead to a pen from the White House-or perhaps in view of that, it is indeed refreshing that the process can go ahead.
And I would say that your willingness to investigate coupled with a willingness to relinquish the reins, which is so uncommon around this institution, has been a great benefit to the District of Columbia and to the members of this committee.
I, too, have prepared testimony that I would like to submit for inclusion in the record at this point.
Mr. MAZZOLI. Without objection, that will be included in the record. [The full statement follows:]
OPENING STATEMENT BY CONGRESSMAN FORTNEY H. STARK, JR.
It has been only in the past decade that the problems of child abuse and neglect have received the serious medical investigation and legislative consideration that they deserve. A conservative estimate reveals that 60,000 children are victims of some form of child abuse or neglect each year of that number over 700 cases result in death. And it is becoming increasingly apparent that those numbers, tragic as they are, do not completely represent the depth of the problem we face.
Child battering is the most common cause of death in children today outnumbering those caused by any of the infectious diseases, leukemia and automobile accidents. As a social problem it is not confined to the poorer segments of our society. Abuse and neglect are not relegated by socio-economic class or color. It is a sickness which can strike the affluent or the poor, the white family or the black, the highly educated or the illiterate.
More people must realize that child abuse is a medical and social disease that is reaching epidemic proportions. It is incumbent then on this and other legislative bodies to respond to the problem and propose solutions.
In dealing with a problem of such human proportions, it is not enough to enact child abuse laws providing solely punitive answers. Retribution as a major
philosophy in criminal law has become, thankfully, outdated. Instead, a positive rehabilitative approach towards both the parents and the child can lead to an elimination of the causes of abuse.
Children hold little representative or lobbying power. We are responsible for providing for their protection and treatment, and we must embrace that responsibility with sincere dedication and creative initiatives.
Detailed studies have revealed that prevention and treatment programs can effectively relieve the problems of abuse and neglect. Dr. Henry Kempe, director of the National Center for the Prevention and Treatment of Child Abuse and Neglect in Denver, has dealt extensively in both the investigation and the treatment of abuse and neglect. He has found that parental abusive action is very strongly correlated with their own childhood experiences of abuse or neglect. In addition, studies have indicated that with careful attention to both parent and child, 90% of the abusive parents are "readily treatable". His program includes not only a full center for protection and treatment, but also "Parents Anonymous", a 24-hour crisis nursery, a day care center and lay therapists who act as surrogate parents in supplying missing love.
The success of his work provides conclusive evidence of the necessity and efficacy of such a treatment and prevention center. If we fail to intervene, if we fail to provide the treatment and service we know are needed, the problem will continue to climb to even more tragic and monumental proportions.
Today, the problem of abuse and neglect is both acknowledged and unchallenged. The question is not one of gathering support, but rather of determining the most responsible and effective solution given the resources and the expertise that are currently available.
In response to the insufficient laws that are now in effect in the District of Columbia, I have introduced, along with my good colleagues on this committee Mr. Stuckey and Mr. Fraser, a bill to establish an agency for the prevention of child abuse in the District of Columbia. This bill establishes a center for the prevention of child abuse with a multi-disciplinary staff and a confidential central registry. In addition, the bill expands the reporting requirements for those who become aware of a case of abuse or neglect. Contingent with the report, it provides full immunity from liability, civil and criminal proceedings and excludes all confidential privileges except for that between lawyer and client. Finally, it deals with judicial procedures with the best interests of the child being of primary consideration.
As a vigorous supporter of home rule, I am sensitive to the limited goals we can achieve. The value of these hearings lies in providing an open forum for the exchange of ideas. I am confident that this opportunity for expert testimony will prove invaluable in the development of a program that will best meet the needs of the abused and neglected children in the district. In particular, I feel that our proposal offers a progressive solution to a problem that requires and merits our serious attention and immediate reaction. Its emphasis on positive rehabilitation and stringent regulations underlies this constructive approach. It is my hope, therefore, that the final recommendation along with the complete record of these hearings will both reflect our sincere concern and encourage expeditious review and enactment by the new District of Columbia city council. Basically, there are two social philosophies or approaches to the problems posed by child abuse and neglect. They each stem from different attitudes prevalent in the present criminal law system. The first emphasizes retribution to abusive parents, and the second holds as its main tenet the prevention of further abuse to the child through a comprehensive service program.
Briefly, the first philosophy, by concentrating on retribution to parents, reflects an out-dated preoccupation with punishment and disgust with the alleged "criminal". This attitude focuses on the actions of the abusive parents instead of trying to improve the existing conditions. As a result, negative effects often arise.
First of all, lack of evidence to sustain the legal burden of proof promotes an invasion of domestic privacy. Secondly, it is very likely that the parents will avoid seeking medical aid when the possibility of criminal prosecution is imminent. Third, doctors too may resist reporting suspected cases of child abuse or neglect if they foresee involvement in public, criminal proceedings. Finally, punishment of the abusive parents doesn't attack the core problem. It fails to promote treatment for the parents and child, and consequently no positive rehabilitative solution is procured. In all of the above cases, then, it is the child who suffers, and nothing is gained by publicly slapping the parents' hands.
The treatment and service philosophy, on the other hand, proposes a twopronged approach, an approach which deals with both the parents and the child. By recognizing that in the abusive parents there are deeper emotional problems, this approach provides the basis for a compassionate and instructive program of rehabilitation. The parental program, by concentrating on guidance and counseling, directs the involved parties toward a more mature acceptance of parental responsibility.
To further promote treatment and prevention from future abuse, this plan encourages child protective programs with the following responsibilities: (1) To explore and determine facts of neglect and abuse,
(2) To assess and evaluate damage to the child,
(3) To initiate appropriate social work services to remedy the situation, and (4) To invoke the authority of Juvenile court in those situations where removal from parental custody must be sought in the best interests of the child. It is widely acknowledged that a desperate need exists for programs that will help identify, treat and prevent child abuse and neglect. But in order to develop a workable and effective solution, it is imperative that several critical areas be more closely examined. These aspects include a more precise definition of abuse and neglect, detailed methods of reporting, and provisions for immunity and exclusion of privileges.
Discrepancies in defining abuse and neglect arise over the questions of frequency, the amount of physical and/or emotional bantering, visible effects, and parental remorse. Studies have shown that the first abusive injury a child receives is rarely fatal, but that there is a good indication that a subsequent injury will be fatal or maiming. The task, then, is to learn to recognize the symptoms-the evidence of child abuse. Private citizens, as well as members of the health care professions, must become aware of the gravity of proper identification and immediate action.
Since 1963, every state has passed or updated its laws regarding Reporting of child abuse and neglect. But they have fallen far short of a comprehensive proposal. As the present laws stand, many cases go unreported. One reason is that doctors may be reluctant to approach the subject of child abuse if they know the parents involved. Statistics reveal this hesitancy: In New York City only 8 of 7000 written reports came from private physicians. Another obstacle to effective reporting is inherent in this society's "passive consciousness". Too many people would rather accept a parent's unrealistic explanation than deal with the horror of the crime itself.
The effects of adequate mandatory reporting are well documented. After the state of California enacted a mandatory reporting law, over 1600 reports were received in the first five months. Reporting laws have also spurred welfare departments and other agencies to publicize the problems of child abuse and neglect. As a result, symposia, panels, speeches and literature have been em ployed to educate the public.
These facts indicate that reporting laws have had beneficial, though limited, effects, but it is necessary that they be expanded to include full immunity and stricter standards so that the child's best interests are fully considered.
Immunity under the present District of Columbia statutes is granted to all physicians and health professionals employed in a hospital or institution. It is not granted to other professionals in the community, school personnel or neighbors. This exclusion reduces the input of concerned individuals who might otherwise have been influential in bringing the case to the attention of the proper authorities. Without the existence of a more comprehensive immunity clause, the child is placed in a disadvantaged position. If expanded, this immunity would offer protection from liability with respect to the making of "good faith" reports of suspected abuse or neglect.
Finally, the District has no Central Registry on abused children to which the medical profession can refer on cases of suspected abuse or neglect. This local problem is compounded because many suspected abusive parents come from the surrounding Virginia-Maryland metropolitan area. Without a registry parents can too easily avoid discovery by switching doctors or hospitals. These failures in the present laws clearly illustrate that punitive measures are not entirely effective. Most laws do not even require any followup or treatment once a case of abuse has been reported. A multi-disciplinary network of protection needs to be developed to implement the good intention of these child abuse laws.
In response to these inadequate legal avenues, I have proposed, along with my good colleagues on this Committee, Mr. Stuckey and Mr. Fraser, a bill for the establishment of a child abuse Treatment and Prevention Center in the District of Columbia. It is our hope that this proposal will address itself to the needs of the abused children, and will redress many of the deficiencies in the present laws.
SECTION-BY-SECTION ANALYSIS OF H.R. 15779
The Purpose Clause states that abused and neglected children are to be provided with the necessary resources and services to remove the causes of abuse from their home environment. It directs the District of Columbia to establish a Prevention Center with a multi-disciplinary staff, a confidential central registry, and stringent reporting regulations. The aim is to protect the health, safety, and welfare of the child concerned, to prevent further abuse, and whenever possible, to preserve the existing family unit. Responsibility for ensuring these rights lies with the Commissioner of the District of Columbia through the Center for Child Abuse.
Title I.-Section 101 establishes a Center for the Prevention of Child Abuse as an individual agency of the District Government. The full-time Director holds responsibility for administration, coordination of public and prvate resources, and the development and mantainance of a supportive program for families with child abuse or neglect problems. In addition, he is required to establish and maintain a training and informational program to educate his employees and the general public concerning the issue of child abuse prevention. Finally, he must file a yearly by report with the Mayor and City Council of the Center's activities.
The staff of the Center shall include at least one full time multi-disciplinary team of professionals to treat each case of child abuse or neglect. Additional personnel for additional teams can either by hired full time by the Center or may be secured from the appropriate public and private resources.
In addition to cases referred to the Center from reporting agencies and individuals, the Center may treat volunteers, but the Director must take specific action to assure that the individual rights of all persons involved are fully protected. Central Registry.-The Director shall maintain a confidential registry of child abuse cases for use by the Center, the police, Corporation Counsel, hospitals, and the courts. The rights of anyone subjected to a report in the registry are to be protected. The bill emphasizes that data shall not be transmitted without consent of the persons concerned and unless the receiving jurisdiction has comparable safeguards on the use and dissemination of such data. This protection includes sealing of the record in most cases when the child reaches the age of eighteen. Title II.-Reporting of child abuse cases. Medical personnel and child care professionals are mandated to report suspected cases to the center or to a specially designated unit of the Metropolitan Police. In addition, any person who has reason to believe a child is being abused may report the abuse. The Metropolitan Police are directed to investigate the report, and whenever a situation of potential abuse appears high, the Police are instructed to immediately report the case to the Center for further investigation and treatment.
In addition, the bill ensures full immunity from liability, civil or criminal, and for any judicial proceeding. It also waives confidential privileges, except for that between attorney and client, when such waiver would serve the public justice.
To assure public cooperation in this matter, penalties are established for those individuals or agencies who willfully fail to make such a report. These penalties shall include a fine not greater than $1000 or imprisonment for not longer than thirty days, or both.
Definitions of abuse and neglect are worded to include the siblings of abused or neglected children so that the Center can also serve them.
Termination of Parental Rights.—In those cases where the treatment of the Center fails to solve the problems of abuse or neglect, the Courts are instructed to consider the alternative of terminating parental rights. This is done so that the children in these cases can be put up for adoption instead of living in a string of Foster Homes. At all times, the best interests of the child are to be given full consideration. This determination shall consider the preservation of continuity of care for the child, the quality of the interaction and interrelationship of the child with his parent or guardian, the child's own determination of his own best interest, and the mental and physical health of all individuals involved.
The final section states that the provisions of this Act shall be effective only for the first 12 full calendar months following enactment unless extended by the