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We are happy to see that they would be non-uniformed, because we found this very threatening to families.

Section 102(a). The need for a central registry has been emphasized before.

Several questions arise, however. Why is it necessary to have the consent of persons concerned to transmit data to other jurisdictions? Part (b) of that Section 102. The decision to expunge the record should be made by the Director in conjunction with the police investigation.

Section (d). This section points out that nowhere is it stated exactly what information should be contained in this central registry. Should it be only identifying information? Or a whole file of investigation and evaluation material?

If it is the latter, we do not think that a parent, for example, should have access to his psychiatric evaluation.

Section 102(e). Ninety days after the receipt of the report is often too soon to expunge material, because frequently a trial does not take place within that amount of time.

This is one of the problems within the District of Columbia Court system, in which trials sometimes take months to occur.

Section 201. We are much in favor of the expansion of reporting of child abuse cases to "certain persons in child care," and for the reports to go to either the Director or to the police, and then, each in turn reporting to the other.

We do not think that it is the function of the police in the preliminary investigation to determine "the stability of the parents or persons responsible for the care of the child, the quality of the home environment, the relationship of the child to the parents."

This is the function, it seems, of the multidisciplinary team involved, who have this expertise.

Both police and team are needed once a child has been identified, but they have different roles.

This is provided in H.R. 15918, Section 202, where the Director may request the police to help in the investigation.

We think they should help investigate in all cases, except in cases which voluntarily present themselves to the center.

We favor the ability to have parents receive a psychiatric examination as part of the investigation prior to a trial, and to have siblings examined, as stated in H.R. 15918, Section 202.

Section 301(b) (2) of II.R. 15918 is also a good and necessary addition.

Section 205 of 15779. We are in favor of the penalty for noncompliance regarding reporting. Hopefully, this will serve only as a strong incentive for all required to report to do so.

Section 208 (9)(c). Are not these children dependent children rather than neglected children? The section dealing with children whose parents are hospitalized, or, in the hospital, or incarcerated.

Section 302. We disagree with this section completely. H.R. 15918, Section 302 is much more reasonable. That is, if the District of Columbia Council does not change this act, it should remain valid until new legislation is introduced.

There are some omissions in both Bills which need to be considered. How much, and from where will the funding for the center come? Who will take the cases to court? If the police investigate, they should

present the case in court. If the center alone handles some cases, it should have the right to petition the court, if necessary,

The authority of the center over other public agencies is unclear. Strong and binding interagency agreements would need to be formulated.

Mr. MAZZOLI. Thank you very much.

Dr. Green.

Dr. GREEN. Mr. Chairman, members of this Subcommittee, I am here to testify this morning in my role as the Director of the Office of Child Health Advocacy at Children's Hospital and as a professor of Child Health and Development at George Washington University Medical School.

As has been noted, it is true that, as in many other areas of medicine, there is concurrence on the ultimate objective, but there may be lack of concurrence on the methodology to reach those objectives. And such is the case here.

SUPPORT H.R. 15918

I am here to support such legislation for the District of Columbia as found in H.R. 15918.

APPROVE H.R. 15779

I support this Bill, as opposed to H.R. 15779 for the following


Number one, mandatory reporting. Although both bills mandate reporting by broad segments of the child-serving population, H.R. 15918 does allow discretion in establishing the accountable investigative agency.

Mandatory reporting to the police department is not required.

Such an option seems to allow for a therapeutic approach to parents, rather than a punitive approach.

Because I personally feel that, no matter how well-trained a police investigator, the simple fact that he or she may be part of a law enforcement agency is potentially threatening, and may be counterproductive to the management of some cases.

Number two, the objectives. Recognition is given to the need "to preserve the existing family unit of the child" in both Bills, even though neither Bill gives the emphasis to this major objective of management that it deserves.

For those of us who believe that the ideal place for child-rearing is in the natural home, no matter how humble, with biological parents capable of meeting the child's necessary nurturing needs, I respect fully suggest that this dimension of supportive care to the parents be given greater priority.

Number three, case investigation. The components of a complete investigation are clearly defined in Title II, Section 202 and Section 205 of H.R. 15918.

I particularly like the mandated home visit by a knowledgeable and sensitive member of the management team.


In spite of the fact that I am in general agreement conceptually with most sections of these Bills, I am compelled to identify certain

parts of this legislation that I feel do not serve the best interests of the abused child and his family.

(1) Organization and function of the Center for the Prevention of Child Abuse. It is axiomatic that any agency, no matter what its hierarchical position in Government may be, that is dependent upon coordinating the resources of other agencies, without clearly identified adequate discretionary resources and/or a clearly defined major role in the budgetary considerations of the appropriate agencies on which its mission will be dependent, will have serious difficulty in assuring the adequate allocation of necessary resources or the capability of developing necessary new resources to carry out its assignment.

(2) Team composition. In Title I, Section 101 (d) (2), I regret that the multidisciplinary management team of the Center does not include among its "experts" a competent parent from the community.

It would seem imperative to me that the experts on the team have the benefit of the input of a resident of the community who is familiar with all aspects of life in that community, including the varying culturally determined child-rearing practices.

(3) Mandatory psychological or psychiatric examination. I must protest the mandatory psychological or psychiatric examination "of any member of that home" prior to the adjudication of the case.

It is my opinion that this could lead to a fishing expedition that may be an unwarranted intrusion into the privacy of the family.

I would not have this same objection if such examinations were mandated for the prime suspect.

Post-adjudication, psychological or psychiatric evaluation and treatment under appropriate circumstances would seem desirable.

(4) Evaluation, particularly photographs of abused child. All children physically abused and neglected to the point of having externally demonstrable signs should be seen in a health facility.

Since a major purpose of the photograph is to give baseline data against which future healing of such injuries are to be compared, I would feel it appropriate that all photographs be taken only in health facilities, and not to be the responsibility of any institution or individual legally mandated to report.

(5) Religious exemptions. I recognize that Title II, Section 208 exempts injured children "under treatment solely by spiritual means through prayer in accordance with the tenets and practices of a recognized church or religious denomination by a duly accredited practitioner," is both politically wise and expedient.

But I suggest to you that this is not necessarily in the best interests of the child. I suggest that a ruptured abdominal organ or a fractured skull may have a lethal outcome if appropriate medical intervention is withheld.

Therefore, I feel that such injured children should be given the benefit of the best medical care available, and the law should not be a part of withholding such treatment.

(6) The labeling of informally adopted children as neglected. To classify a-1 informally adopted children as being neglected will place a substantial number of such children and their "adoptive" parents at risk to the penalties of this Act.

Although I recognize that such children are not protected in a number of ways, we must understand that many of these children remain

in this status because of the lack of financial resources, ignorance, or inaccessibility to legal counsel by such surrogate parents.

To me, it would seem more appropriate for Government to assure the availability and accessibility of such resources and services to complete the appropriate adoption procedures.

Adjudicating such children neglected and possibly arbitrarily removing them from their psychological parents may be more destructive than constructive for all concerned.

(7) Implementation. I can foresee monumental difficulties in implementing this Act if the Director and the agency team become involved in individual case management, rather than the more appropriate policy formulation, program planning, and technical assistance to the various child abuse teams in health facilities in this community.

It would seem more appropriate to me for such an agency to serve the advocacy function of addressing the collective needs of abused and neglected children and their families.

(8) Continuity of care. The critical need for continuity of parental care for the abused child, particularly in the case of a child over 7 years of age, as noted in Title III, Section 301 of this bill, is not well served.

Although recognition is properly given to the differing critical ageddependent time intervals that may seriously impair the bonding process between a child and his psychological parent, the very fact that it is possible for a child of 7 years to be legally kept in a temporary foster care status, with all of its disadvantages, over a 2-year period, is far too long.

It would seem that, for the welfare of this child, this interval could be markedly shortened.

(9) Performance evaluation. I can find nothing in this bill that mandates ongoing review and evaluation of the reporting procedures to be developed and implemented by the Director of this agency.

I would feel that such ongoing monitoring is essential.

Although the above comments do not exhaust my concerns, I am hopeful that, when the guidelines for this legislation are developed, they may be made available for public comment and debate.

Thank you, Mr. Chairman, and members of the Subcommittee, for giving me this opportunity. I will be happy to cooperate in any further way possible.

Mr. MAZZOLI. Thank you very much, the panel, for some very excellent testimony. It has opened some new vistas here in areas that concern you who actually work with these laws.

Let me make mention for the record that Congressman Gude, our colleague from Maryland, is with us, who has shown quite a bit of interest in these bills.

And if we could maybe go a little bit out of order, if the Congressman has any remarks he wishes to make now for the record.

Mr. GUDE. Not at this time. I do have some questions.

Mr. MAZZOLI. Very good. I would just like to ask the panel a couple of questions, and then yield to my colleagues.


Dr. Green, have you been concerned about applying a criminal sanction to the reporting requirements?

Dr. GREEN. If the reporting requirements include that very grave area of neglect which is ill-defined, emotional abuse or psychological abuse, I have very serious reservations in applying criminal sanctions for the lack of reporting.

Under those circumstances, I think it could lead to very serious abuse.


Mr. MAZZOLI. Doctor, one further follow-up. In your experience, is the evidence, the physical evidence, marked enough for the average person who works with the children-and by that, I mean the average thoughtful teacher, the average thoughtful child day care workeris the physical evidence usually clear enough that you would apply criminal sanctions to those persons for failure to respond and to report?

Dr. GREEN. In most instances, the physical abuse of children, the evidence is quite obvious.

The problem of neglect is another thing. A child may not show the physical evidence, but may be abandoned, for example, and that child is at the far end of the spectrum of severe neglect.

And I feel that, under those circumstances, criminal sanctions should be applied for someone who fails to report an abandoned child. But it is not always the physical appearance that may be the key. Mr. MAZZOLI. All right, thank you.


Dr. Heiser, would you perhaps address your comments to the same questions I have asked Dr. Green? And that is, the criminal penalties that would be attached to failure to report where you have physical injuries as well as, maybe, other kinds of neglect. And what is your general feeling on that?

Dr. HEISER. I agree with Dr. Green concerning the neglect, because I believe that that is an area where it is going to be very hard to prove that someone actually knew that this child was neglected.


I would tend to disagree a little bit about physical abuse as being easy to always recognize.

Also, I think that doctors should be able to recognize physical abuse. Even then, it is hard in some cases.

For example, a child that has a broken arm. He could have gotten a broken arm from falling out of a tree. But there might be other things on the child, like a bruise or some old fractures, that would indicate that this was not an accident probably. That it was a direct threat, a direct abuse to him.

And thus, there are going to be cases, even of physical abuse, that would be hard to prove that someone actually knew this was an abused child, and then prosecute because of that.

And I think it is going to take medical testimony, which is going to be hard to obtain.

But I am in favor of this being left in as just an encouragement to people to report. I think it is going to be hard to enforce it, actually.

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