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I am here this morning to urge the members of this committee, the subcommittee, and your colleagues in the U.S. Senate to significantly increase the Federal funding for education and treatment programs that deal with child sexual abuse and neglect.

Yesterday I had the opportunity to testify before the Senate Labor and Human Resources Committees, Subcommittee on Children, Family Drugs, and Alcoholism. I added my voice to those who urged that committee to reauthorize the Child Abuse Prevention and Treatment Act. After nearly 25 years, the day has arrived for our Federal Government to dramatically expand and increase the scope of that legislation.

How can we afford to ignore the finding of the U.S. advisory board on child abuse and neglect which concluded last year that child abuse and neglect in the United States now represents a national emergency? A national emergency demands an appropriate response. This society spends billions of dollars to deal with the consequences of child sexual abuse. Our prisons, our courts, our social service systems at every level all strain at the seams as a result of the tragic lives that have been damaged by child sexual abuse. For too many years

many years this issue has been ignored and underreported. I am committed to raising the level of public awareness, helping to focus the attention of policymakers and to ultimately breaking the cycle of child sexual abuse that exists in our society.

It has been said that an ounce of prevention is worth a pound of cure. In the area of child sexual abuse, a wise investment of Federal funds now will help us realize savings that cannot be calculated easily both in money saved and in lives protected and enhanced.

I recognize that this subcommittee has difficult choices to make and that our current Federal deficit dictates prudent expenditure of every discretionary dollar this committee has to spend. The national emergency of child abuse justifies an increase in funding for these programs, particularly if we are to begin developing the training models needed to insure the emergency is addressed.

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PREPARED STATEMENT At the Barbara Sinatra Children's Center we are prepared to play a role in addressing the national emergency of child sexual abuse. We look forward to working with the Congress and the administration to see that April 1991, National Child Abuse Awareness Month, is remembered as the month when child sexual abuse became an urgent national priority. Thank you. (The statement follows:)

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STATEMENT OF BARBARA SINATRA
Mr. Chairman, I am Barbara Sinatra, President and Founder of the Barbara Si-
natra Children's Center at Eisenhower in Rancho Mirage, California. I am here this
morning to urge the members of this subcommittee, and your colleagues in the Unit.
ed States Senate, to significantly increase the federal funding for education and
treatment programs that deal with child sexual abuse and neglect.

Yesterday I had the opportunity to testify before the Senate Labor and Human
Resources Committee's Subcommittee on Children, Family, Drugs and Alcoholism.

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I added my voice to those who urged that committee to reauthorize the Child Abuse Prevention and Treatment Act. After nearly twenty years, the day has arrived for our federal government to dramatically expand and increase the scope of that legis. lation. How can we afford to ignore the finding of the U.S. Advisory Board on Child Abuse and Neglect, which concluded last year that child abuse and neglect in the United States now represents a national emergency? A national emergency demands an appropriate response.

This society spends billions of dollars to deal with the consequences of child sex. ual abuse. Our prisons, our courts, our social service systems at every level all strain at the seams as a result of the tragic lives that have been damaged by sexual abuse, For too many years, this issue has been ignored and under-reported. I am committed to raising the level of public awareness, helping to focus the attention of policy makers, and to ultimately breaking the cycle of child sexual abuse that exists in our society:

It has been said that an ounce of prevention is worth a pound of cure. In the area of child sexual abuse, a wise investment of federal funds now will help us realize savings that cannot be calculated easily, both in money saved and in lives protected and enhanced.

I recognize that this subcommittee has difficult choices to make, and that our current federal deficit dictates a prudent expenditure of every discretionary dollar this committee has to spend. The national emergency of child abuse justifies an increase in funding for these programs, particularly if we are to begin developing the training models needed to ensure the emergency is addressed.

At the Barbara Sinatra Children's Center, we are prepared to play a role in addressing the national emergency of child sexual abuse. We look forward to working with the Congress and the Administration to see that April 1991, National Child Abuse Prevention Month, is remembered as the month when child sexual abuse became an urgent national priority. Thank you.

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Senator ADAMS. Thank you very much, Mrs. Sinatra.

I notice that Senator Gorton has joined us. I have only one question, and then in a moment I will turn to Senator Gorton for an opening statement and any questions that he may have.

I understand, and Mr. Shields may want to address this, too, that the administration has frozen the State grants between the 2 years for child abuse at $19.5 million, the challenge grants at $5.4 million, and discretionary activities at $14.6 million. I heard your testimony yesterday because I sit on that other committee also, and we all know that that bill has not yet been reauthorized. A good part of your testimony was directed for training of professionals in this field or giving training to people who may be professionals in the field but do not know the symptoms and the manner of handling child sex abuse.

I would want to question you or Mr. Shields as to whether or not you are going to apply for a challenge grant or for potentially some discretionary activities under the existing law. I state that early on in the committee so others who will be testifying will understand that the committee's allocation is going to be very limited, and we want to be certain that everyone has an opportunity to know the limitations before us and their potential alternatives.

Do you have that type of activity in mind? As I understand it, you are entirely privately funded at this point.

Ms. SINATRA. Yes.
John.

Mr. SHIELDS. Yes; if that is priority in the funding streams to provide child sexual abuse training to professionals, we would certainly be interested in playing a national role in that effort. We have a model community-based, multifunded sexual abuse treat

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ment program that is an excellent center to bring visiting professionals to and let them see and experience firsthand and take back with them a blueprint into their own communities, as well as we have the capabilities of doing teleconferencing through an uplink and convening the best minds and providing training to multiple training sites in children's hospitals and community centers throughout the United States.

We are in a key position to really cost effectively move reliable information to these people and see a real need there and are certainly willing to play a role in that effort.

Senator ADAMS. I might just mention to you and then you may deal with this as you see fit. We started last year the STAŘ school's program or at least implemented it, and there is in existence in the West at the present time a system for teleconferencing. Now one of the problems, of course, is that most places do not have an uplink, but most schools in that area do have the capacity from the satellite to do teleconferencing.

So I would hope that with your technical capacity you might be in contact with the other groups throughout the United States, particularly in the areas that have this technical capacity, so that you could give instruction.

I was appalled by the testimony yesterday, not just yours but of those from Harvard and elsewhere, of the basic lack of knowledge and understanding that many of those in the field dealing with foster children and with those who are abused children have in recognizing both symptoms and being able to give the necessary treatment to the child so that the child can move from basically a paralyzed position into being a functioning member of society because they do not talk to them.

So I am hopeful that you might consider that.

Senator Gorton, I would be pleased to recognize you for an opening statement and any questions you might have.

Senator GORTON. I have no opening statement, just one or two questions of Mrs. Sinatra.

I am told that Secretary Sullivan is in the process of putting together an administration initiative on child abuse prevention. Do you know anything about that? Do you have any insight as to what might come out of that recommendation, whether or not there might be a national training center proposal included in it?

Ms. SINATRA. We certainly hope that there will be. I plan to visit him today after this meeting. We hope to be a part of it, and we would like to help in any way we can.

Senator GORTON. That leads to the second question. If the national training center is included in the proposal, do you believe that, although you are now totally privately funded, you could either be that national training center or play some role in the way in which it is created?

Ms. SINATRA. Yes.
John, would you like to address this?

Mr. SHIELDS. Yes, I think that we are in an excellent position to fulfill that role, certainly, and we would be happy to be a national training center

Specifically on child sexual abuse treatment, I really see a need in that area. We have seen a lot of good training in the field in the

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last 10 years on diagnosing and on doing interviews and determining, whether or not an alleged victim is abused and the system's 1 early response, and we have a real treasure of a national resource : with the program in Huntsville, AL.

Our special focus is child sexual abuse treatment, and we really 1 believe that we can meet the bill there.

Senator GORTON. Thank you both. Thank you, Mr. Chairman. Senator ADAMS. Thank you both for being with us this morning. i We wish you well in your visits to the administration. I have no further questions. If Senator Gorton does not, we have welcomed you here this morning and wish you well for the rest of the day. :)

Ms. SINATRA. Thank you very much.

Mr. SHIELDS. Thank you, Senator. . STATEMENT OF DR. THOMAS S. EDGINGTON, PRESIDENT, FED

ERATION OF AMERICAN SOCIETIES FOR EXPERIMENTAL BIOL

OGY Senator ADAMS. Our next witness is Dr. Thomas S. Edgington, president of the Federation of American Societies for Experimental Biology.

Dr. Edgington, welcome to the committee. We will be very i pleased to hear your testimony.

Dr. EDGINGTON. Thank you very much, Mr. Chairman, Senator Gorton. You have the testimony, and I would like to just summarize the key points.

Senator ADAMS. Without objection, the entire statement will appear in the record as though given.

Dr. EDGINGTON. I wish to compliment the subcommittee on the longstanding commitment to the national effort in biomedical sciences. I wish to address the 1992 budget for NIH and also, in parallel, for ADAMHA.

Biomedical research is one of the most human, cost-effective, and growth-oriented programs fostered by the Federal Government. It returns the investment many times over, and this return is important because it is more expensive not to solve health problems than to go on paying the health care costs. The opportunities for progress at this time can lead to definitive solutions to our health care problems. The opportunities are greater today than ever before. We believe that there must be a national research program equal to the challenge and the opportunity for definitive solutions.

The FASEB consensus conference was held this February and concluded that we are significantly underinvesting in biomedical research at a time of unprecedented opportunity, and we are leaving unmet needs for the solution of disease. Based on our GNP, the United States has dropped to last of the five major nations in the world on R&D investment.

FASEB has been concerned as well about the precipitous decline in the number of new and competing grants and the underfunding of noncompeting continuation grants which seriously hinder progress and effective solution to health care delivery problems, solutions that are cost effective. This profoundly limits the ability to capture the science that is necessary for progress.

This consensus conference met over a period of 2 days and has recommended that NIH should capture and should fund 30 percent

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of eligible applications. We favor considerably more. We feel this is the most prudent and minimal number that will capture sufficient science to meet the needs of this Nation and have laid out a 5-year plan which has been submitted to this committee.

This plan provides a modest increase only over the congressional stability plan. It calls for in the 1992 year support for 6,143 new and competing grants. By 1996 this would grow modestly based on national growth to 6,502 grants, at that time supporting 25,470 grants in toto for the NIH portfolio. We would recommend a parallel increase for ADAMHA.

Support for the number of postdoctoral and predoctoral fellows should be increased by the recommendations of the National Academy of Sciences. Other elements of the NIH budget should be increased at least by the current biomedical inflation index.

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PREPARED STATEMENT
In summary, FASEB plan will restore viability, vitality, and the
appropriate opportunity to the NIH program to maintain U.S. lead-
ership in life science research, in its impact which is major in the
economic fabric of this Nation through the spawning and growth of
the biotechnology industry, in which we are a fragile leader, and,
finally, bring the real solutions to the population of this Nation
through effective and definitive health care solution which does re-
turn, as NIH has provided this year in a handout the cost effective-
ness of the return of biomedical research which returns many,
many fold annually the investment.

Thank you, Mr. Chairman.
(The statement follows:)

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