review proposals to improve child protective services










May 23, 2006

SERIAL 109-73

Printed for the use of the Committee on Ways and Means


BILL THOMAS, California, Chairman

E. CLAY SHAW, JR., Florida
NANCY L. JOHNSON, Connecticut
WALLY HERGER, California
JIM MCCRERY, Louisiana
DAVE CAMP, Michigan
JIM RAMSTAD, Minnesota
PHIL ENGLISH, Pennsylvania
J.D. HAYWORTH, Arizona
RON LEWIS, Kentucky
PAUL RYAN, Wisconsin
MELISSA A. HART, Pennsylvania
DEVIN NUNES, California
RICHARD E. NEAL, Massachusetts
JOHN S. TANNER, Tennessee
EARL POMEROY, North Dakota
JOHN B. LARSON, Connecticut

Allison H. Giles, Chief of Staff
Janice Mays, Minority Chief Counsel

WALLY HERGER, California, Chairman

NANCY L. JOHNSON, Connecticut
MELISSA A. HART, Pennsylvania
JIM MCCRERY, Louisiana
DAVE CAMP, Michigan
PHIL ENGLISH, Pennsylvania
DEVIN NUNES, California

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Ways and Means are also, published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined.


Advisory of May 12, 2006, announcing the hearing


U.S. Government Accountability Office, Cornelia Ashby

Zero to Three, Hon. Constance Cohen, Associate Juvenile Judge, Fifth Judicial District of Iowa, Des Moines, Iowa

Child Welfare League of America, Linda Spears

National Indian Child Welfare Association, Terry Cross, Portland, Oregon

American Academy of Pediatrics, Kent Hymel, M.D., Falls Church, Virginia 

National Council for Adoption, Thomas Atwood, Alexandria, Virginia

American Public Human Services Association, Hon. Cari DeSantis, Wilmington, Delaware

University of Baltimore School of Law, Daniel Hatcher, Baltimore, Maryland

Casey Family Programs, William Bell, Seattle, Washington

National Coalition for Child Protection Reform, Richard Wexler, Alexandria, Virginia

National Association of Social Workers, Ikeita Cantu Hinojosa 

American Family Rights Association, William Tower, Fair Oaks, California

Coalition for Residential Education, Heidi Goldsmith, Silver Spring, Maryland


Children’s Defense Fund, Mary Lee Allen, statement

American Federation of State, County and Municipal Employees, statement

Brown, Tim, Waco, TX, letter

Bryan, Barbara, Davidson, NC, letter

Butts, Donna, Generations United, statement

Citizens Commission on Human Rights New England, Boston, MA, letter

Sutter County Sheriff's Department, Jim Denney, Yuba City, CA, statement

Gladwell, Lisa, River Edge, NJ, letter

Groh, Alicia, Voice for Adoption, statement

Haymon, Gail, Columbus, OH, letter

Holder, Helen, Walton, KY, letter

Kroll, Joe, North American Council on Adoptable Children, St. Paul, MN, statement

Mecca, Frank J., County Welfare Directors Association of California, Sacramento, CA, statement

National Indian Child Welfare Association, Portland, OR, letter

Prevent Child Abuse America, Chicago, IL, statement

Shipman, C. Edward, Happy Hill Farm Academy, Granbury, TX, letter  

review proposals to improve child protective services

Tuesday, May 23, 2006

U.S. House of Representatives,
Committee on Ways and Means,
Subcommittee on Human Resources,
Washington, DC.

The Subcommittee met, pursuant to notice, at 10:04 a.m., in room B-318, Rayburn House Office Building, Hon. Wally Herger, (Chairman of the Subcommittee), presiding.

[The advisory announcing the hearing follows:]

Chairman HERGER.  Good afternoon, and welcome to today's hearing.  The purpose of this hearing is to review State and community‑based efforts to assist at‑risk families, protect children from abuse and neglect, and prevent the unnecessary separation of children from their parents.  Those services are supported by Federal funding from two major programs, both under this subcommittee's jurisdiction.  The first, known as Child Welfare Services (CWS), was created in the 1930s.  The second, called the Promoting Safe and Stable Families Program (PSSF), was added in the 1990's.  Together, these two programs provide States about $700 million per year for services intended to ensure the safety, permanency and well‑being of children.  Combined, these programs are considered the largest source of targeted Federal funding in the child protection system used for prevention.  That is for services to ensure that children are not abused or neglected and when possible, to ensure these children can remain safely with their families.

We know the costs in children's lives and well‑being are far greater when prevention efforts fail.  We also know the costs to Federal taxpayers increase if prevention efforts fail.  The Congressional Budget Office projects that Federal taxpayers will spend almost $35 billion over the next 5 years to support children in foster and adoptive homes and otherwise support State administration of these programs.  In addition to society's obvious interest of protecting children and strengthening families, Federal and State taxpayers all have an interest in ensuring the prevention dollars work to keep kids safely with their own parents, if at all possible.  All of which begs several questions, which are the focus of today's hearing.  What services are States funding through the CWS and promoting safe and stable programs?  How effective are these services at preventing child abuse and neglect and assisting at‑risk families?  And what more can Congress do to encourage States to invest in proven outcome‑based services that protect children and support families at risk of abuse and neglect?  The PSSF expires at the end of fiscal year 2006, requiring congressional action this year.  If we reauthorize this program and the CWS programs, for 5 years, as has been our custom, we will make available more than $3.5 billion in Federal funds for States to ensure that children are protected whether they live with their parents or in foster or adoptive homes.  That includes a $200 million increase in funding provided under the Deficit Reduction Act (P.L. 109-171), which the President signed in February.

I am pleased that we have before us today a wide range of individuals to help us better understand the effectiveness of these programs and what more needs to be done.  They will provide useful context about the services currently provided and what changes Congress should consider to better protect children.  I have shared with the witnesses draft legislation developed in a bipartisan manner with our colleagues.  I look forward to hearing from all of our witnesses today about ways to better ensure these programs promote the safety, permanency and well‑being of all children.  Without objection, each Member will have the opportunity to submit a written statement and have it included in the record.  At this point, Mr. McDermott, would you care to make a statement? 

Mr. MCDERMOTT.  Thank you, Mr. Chairman.  Good morning ‑‑ or good afternoon, I guess it is.  Good day to make a difference in the lives of vulnerable children.  I welcome the opportunity for us to work together, as we have on this bill, as concerned leaders, not as political adversaries.  Sometimes we are a little adversarial in here.  The Members on this dais and the familiar faces I see in the audience share a common goal, helping America's vulnerable kids by strengthening America's lifeline of hope, the Nation's CWS.  Now, it is up to us to find some common ground.  There is a lot we don't know, and we need to learn when we consider ways to improve the CWS and the reauthorization of the PSSF.  What we do know is troubling, 40 percent of kids who have been abused or neglected never receive follow‑up care, 40 percent.  We also know that this Act needs more than a well‑intentioned title.  It needs to be strengthened through its reauthorization ‑‑ that means money.  Now, right now, this bill is the single largest source of money for preventing child abuse and neglect.  Yet it is barely one‑tenth the size of the programs that fund foster care.  Once a family ‑‑ a child is removed from a home. 

The witnesses here today can both educate us and advocate for the real‑world solutions that we can incorporate into this reauthorization.  In some ways, this is draft legislation so you can give us some ideas before we actually put it in print.  We have before us a draft ‑‑ and it really is for your comment today.  There remain questions that needs to be answered and concerns that need to be addressed, but the draft is a good starting point.  The chairman has directed his staff to work with my staff, and they have been working for some time to discuss the challenges that face the CWS and ways we can improve it for vulnerable kids.  I am pleased that we have been able to generally agree on the need to invest more in the people who implement child welfare policy.  People make all the difference.  It really is a people business.  We can do more to help child ‑‑ State child welfare agencies attract and retain quality staff.  As we discuss the reauthorization, that is the money, we all recognize the need for much more comprehensive reform of Federal welfare financing.  We discussed this at least for 6 years without making any progress, and it is time we do.  I am pleased that we are here today.  Administration and some of my colleagues across the aisle support blocked grants.  In fact, the administration's gone so far as to block the extension of the title IV‑B ‑‑ IV‑E waiver authority to put added pressure on States to support a block grant as the only option for fiscal and programmatic flexibility.  We can do better than that in my view.  We know from history that block grants are a favorite target for budget cuts.  Once you got it all blocked together, it is easy to whack off ten percent.  We are seeing it today with the administration's effort to cut the social service block grant.  The system is significantly under‑funded and yet a concerted effort is under way to make matters worse.  In reading the prepared testimony of the panelists, I was pleased to see a strong plea for Congress to maintain the title IV‑E entitlement.  If we are to improve the lives of vulnerable kids, we need to partner with the States to create the meaningful reforms we want.  As the panelists comment on the proposal to reauthorize this bill, I hope they will help us understand the larger context of child welfare financing and the changes required to ensure that we are adequately caring for our Nation's most vulnerable kids.  The draft proposal, in my view, is the first step and it is in the right direction.  I hope that Mr. Herger and I can make a second step after this hearing.  Our common goal should be a bipartisan reauthorization of this Act that meets the real‑world needs of the system.  We can find common ground if we try, and I am glad we are here to begin.  Thank you. 

Chairman HERGER.  Thank you, Mr. McDermott.  Before we move on to our testimony, I want to remind our witnesses to limit their oral statement to 5 minutes.  However, without objection, all the written testimony will be made a part of the permanent record.  Our first panel today we will be hearing from Cornelia Ashby, Director of Education, Workforce and Income Security Issues at the U.S. Government Accountability Office; the Honorable Constance Cohen, Associate Juvenile Judge in the Fifth Judicial District of Iowa on behalf of the Zero to Three; Linda Spears, Vice President of Corporate Communications and Development of the Child Welfare League of America; Terry Cross, Executive Director of the National Indian Child Welfare Association; Dr. Kent Hymel on behalf of the American Academy of Pediatrics; and Thomas Atwood, President and Chief Executive Officer for the National Council For Adoption.  Ms. Ashby, please proceed with your testimony.


Ms. ASHBY.  Mr. Chairman and Members of the Subcommittee, I am pleased to be here today to present information from our 2003 report on States' use of title IV‑B funds.  Specifically, my comments will focus on:  One, how States use IV‑B dollars to serve families; two, the extent the Federal oversight ensured State compliance with spending requirements under subpart one; and three, what research said about the effectiveness of services States have provided to families using IV‑B funds.  While overlap exists and it is difficult to clearly differentiate among the various service categories and populations served, States reported using subpart one funds primarily to staff and administer child welfare programs and serve families in the foster care system and subpart two funds primarily for prevention and support services for families at risk of child abuse and neglect.  Use of subpart one funds is limited in that the total of subpart one funds used for foster care maintenance, adoption assistance, and child care cannot exceed a State's total 1979 subpart one expenditures for all types of services.  However, the range of services allowed under subpart two is more limited than under subpart one.  Generally, as you know, States must spend at least 20 percent of their subpart two funds on each of four service categories.  States can spend no more than ten percent of subpart two funds on administrative costs and under subpart two, family reunification services can only be provided during a child's first 15 months in foster care.  State child welfare directors responding to our survey reported that flexibility was important to meet the needs of their child welfare systems.  Therefore, they generally preferred the financing structure of subpart one over subpart two. 

Despite the statutory limitation on State expenditures for Federal funds under subpart one for foster care maintenance, adoption assistance, and child care, U.S. Department of Health and Human Services (HHS) provided relatively little oversight of State use of Federal funds under subpart one; and therefore, could not ensure State compliance with the subpart one spending requirements.  HHS does not collect data on subpart one expenditures, relying instead on cursory reviews of plans submitted by States that discuss how they intend to use their subpart one funds in the coming year.  We found that HHS regional offices have paid little attention to statutory limits in reviewing States' planned use of subpart one funds.  In response to our survey, ten State child welfare directors reported actual 2002 subpart one expenditures that exceeded the spending limits by over $15 million in total.  Furthermore, at the time we conducted our study, research had provided little information on the effectiveness of services provided in the subpart one, and HHS evaluations of services funded under subpart two had generally shown no or little effect on children's outcomes. 

In our survey, 22 States reported providing services other than maintenance payments, staff salaries or administration under subpart one.  However, none of these States had evaluated the outcomes of these services.  Similarly, our literature review showed that few evaluations had been conducted, and evaluations that had been conducted produced mixed results.  In conclusion, I would like to summarize the recommendations we made in our 2003 report and HHS's response to them.  We recommended that the Secretary of HHS:  One, provide the necessary guidance to ensure compliance with statutory restrictions on the use of subpart one funds.  Two, consider the feasibility of collecting and using data on States' use of these funds to facilitate program oversight and analysis of how States' spending patterns correlate with child outcomes.  Three, use the information gained through enhanced oversight of subpart one expenditures as well as any available information on States' use of subpart two funds to inform the design of an alternative financing option that would give States more flexibility in spending child welfare funds.  Well, HHS agreed with the first recommendation and provided guidance to States, reminding them of the statutory requirements for subpart one spending.  However, HHS disagreed that it should collect data on States' use of subpart one funds and stated that its level of oversight was commensurate with the scope and intent of subpart one.  Also, HHS did not comment on the merits of having enhanced oversight and information to inform the design of an alternative financing option.  Mr. Chairman, this completes my prepared statement.  I would be happy to answer any questions you or other Members of the Subcommittee may have. 

[The prepared statement of Ms. Ashby follows:]

Chairman HERGER.  Thank you.  Thank you, Ms. Ashby.  The Honorable Cohen to testify.


Ms. COHEN.  Thank you very much, Mr. Chairman and Members of the Subcommittee.  My name is Constance Cohen.  I have been on the Juvenile Court bench in Des Moines, Iowa for the past 12 years.  My jurisdiction includes dependency termination, parental rights, child welfare, and adoption rights.  I appreciate the opportunity to speak to you today on behalf of the Zero to Three Foundation.  I commend you, Mr. Chairman, for taking the time to hold this hearing to address the challenges of improving child protection programs, and I also would like to thank Congressman Melissa Hart, who I know is a Member of your Committee, for her recent support of Court Teams and bringing the project to Allegheny County.  Like so many of my colleagues on the bench, my judicial and legal training did little to prepare me to make the best decisions for maltreated children and their families.  I was a teacher before I entered law school.  For 12 years I taught, and so I had some child development training, and I was also a pig farmer.  I didn't come to pig farming because my parents were pig farmers.  I didn't know a darn thing about pig farming.  I was a suburb girl from St. Louis, Missouri.  Pig farming, like any other profession, requires practical and scientific expertise.  Not everyone has that expertise.  Do you know the gestational period for pigs?  Do you know how to pick up a baby pig?  I see you are nodding your head.  It would be irresponsible to get into a business like that if you didn't know that information.  I was fortunate because I was mentored by people who knew that, and I was a fairly successful pig farmer.  I needed to know those things before I committed precious resources and time to this project.  Most people would never consider investing at that level in a venture which required skills that they didn't possess, but that is exactly what most legally trained judges and lawyers do when it comes to child development and mental health issues for children in the system.  They need a child development or mental health expert to provide them with the training and consultation that I was able to benefit from my neighbors.

I want to talk to you today about a project that fixes that disconnect, a project called Court Teams For Maltreated Infants and Toddlers.  Knowledge about babies development is crucial in my work.  Every day in the United States, 118 babies leave their homes because their parents cannot take care of them.  Children between birth and three have the highest rates of abuse and neglect victimization.  Their rapidly developing brains mean infants and toddlers in child welfare are at a great risk of compromised development.  Without help, they face life‑long implications.  These implications include school failure and juvenile delinquency.  Too many of the young children I see in my court do not receive appropriate services.  Increasingly in Iowa, these children are primary and secondary victims of the rapid proliferation of methamphetamines.  In Polk County, Iowa, a total of 1,300 children younger than 5 in the CWS and approximately 90 percent of those children have cases that involve methamphetamines.  Our Nation's CWS is not meeting the needs of our most vulnerable children, as confirmed by the Child and Family Services reviews, findings of shortcoming in permanency and stability in capacity.  Like other States, I was struggling to meet the outcome related to physical and mental health services.  In fact, child welfare, substance abuse treatment, and mental health agencies were not even talking to each other.  We know what works.  An array of interrelated factors such as parent‑child visits, case worker consistency and reasonable caseloads and few replacements for children all help lead to permanency more quickly and underscore the need for a stronger, more coordinated system of child and family services.  Child protective services alone cannot achieve these goals for children.  It takes judicial leadership and collaboration.

Permit me to describe this partnership model using a collaborative approach to achieve better family outcomes.  Court Teams For Maltreated Infants and Toddlers is a model, grounded in the innovative approach taken by Judge Cindy Lederman of the Juvenile Court in Miami, Dade County, Florida and Dr. Joy Osofsky of the Louisiana State University Health Sciences Center.  Three years of data in their parent‑child intervention show substantial gains in improving child and parent interaction and prospects for reunification.  Front loading and coordinating early intervention services have resulted in nearly 100 percent safe reunification without reabuse.  Taking a lesson from my farmer days, Court Team starts with training on a baby's developmental needs and building community collaborations to put this knowledge to good use.  Members of my Court Team include other judges, pediatricians, child welfare workers, attorneys, mental health and drug treatment professionals, foster parents, Early Head Start, child care providers and court‑implemented project staff, as well as others.  With support and training from Zero to Three, my Court Team is ensuring that infants and toddlers have expedited access to services by monitoring these cases every month.  Already solid collaborations be among community collaborators are leading to flexible ways to communicate to our children in the very first days after court intervenes.  Court Teams help promote reunification or other permanent arrangements and improve the way juvenile and family courts function by creating more effective collaboration and greater understanding of the needs of children and families, our Court Team is also enhancing our community's capacity for prevention. 

The Court Team's project is in four other communities besides Des Moines, and many other judges would like to participate.  Our roles as leaders of our Court Teams are consistent with our responsibilities as juvenile and family court judges for the well‑being of the children in our courts, and for ensuring they receive the resources and supports that they need as well as to fulfill our mandates under the Adoptions and Safe Families Act of 1997 (P.L. 105-89).  In conclusion, I cannot overstate the developmental importance of the first years of life.  To ignore the science of brain development and attachment needs of infants and toddlers when they come into the CWS is practically to guarantee that they will experience difficulties later on.  Court Teams is not a global solution to the problems of the CWS, Mr. Chairman, but it is a proven concrete approach to addressing a critical need at every local level.  As the Subcommittee looks at ways to improve child welfare systems, I encourage you to expand Court Teams and provide other judges with the opportunities similar to the one I have in my court, to improve the lives of young children.  Thank you so much for your time and for your commitment to our Nation's most vulnerable infants and toddlers.

[The prepared statement of Ms. Cohen follows:]

Chairman HERGER.  Thank you, Ms. Cohen.  Ms. Spears to testify. 


Ms. SPEARS.  Thank you so much.  I am honored to be here today to speak on behalf of the Child Welfare League of America and our nine other member agencies around the country.  I am deeply grateful to the Chairman and Members of the Subcommittee.  We at CWLA believe that the country must affirm our commitment to prevent abuse and neglect and to support the needs of children who are abused and neglected.  We believe that strong partnerships at Federal, State, and local level are an essential tool in getting this accomplished.  As has already been stated, we know that the key indicators of child protection have remained unchanged, with 40 percent of children substantiated cases not receiving the needed follow‑up services.  CPS service systems, responding to these children in the 50 States are funded by a variety of sources, including The Social Services Block Grant (SSBG).  In 2004, 38 States spent $194 million in SSBG funds for CPS.  We highlight this because SSBG, under the jurisdiction of this Committee, is threatened with potential reduction of $500 million in the President's proposed fiscal year 2007 budget.  Such a reduction in funding would be devastating to CPS and other services.  A CPS system that functions well, has a fully staffed and competent workforce.  We cannot emphasize enough the need for a national child welfare workforce strategy.  CWLA's vision for an optimal CWS encompasses a variety of services ranging from prevention and neglect to permanency and stability for children in out‑of‑home care.  Key ingredients include a family‑centered approach that involves an entire family and shows greater effectiveness than those services targeting children or parents alone.  A highly professional and stable workforce that includes a supportive work environment, supervisory mentoring, manageable caseloads, formal social work education, et cetera, that can provide workers with the knowledge and skills they need to assess cases.  Prevention services and related services to help safely maintain children with their families and permanency and stability that nurture children, include kinship placements that are more stable and normalizing than other forms of care.  After care and transitional services can help reduce re‑entry rates with children, which are now at about 25 percent, especially for families where there are multiple complex needs and adoptive families and for youth exiting care. 

In regard to PSSF, the program supports four vital services, including basic support strength that strengthen the families, supports for families being reunified and families that we are trying to preserve and for the adoptive families in need of support.  We believe that these services and families should continue to be the target of PSSF.  CWLA supports the extension of the $40 million in mandatory funding, and we want to work with the Members of Congress to see that PSSF is fully funded at the $505 million level adopted by this Committee in 2001.  To truly reach the goal of safe and stable families, we must provide more support services that PSSF attempts to address.  CWLA recognizes that the Members of Congress may see the $40 million as a way to address other child welfare issues.  If so, we all strongly urge this as the first step in a comprehensive strategy to strengthen the workforce over the next few years.  The draft legislation includes a workforce element tied to case worker visits.  CWLA supports regular and ongoing visitation as a critical part of a broader casework process that cannot work alone.  To reach this visitation goal, each State should be assisted in implementing a long‑term workforce strategy that sets goals around reduced workforce turnover, higher education level, adequate caseloads, initial and ongoing training, adequate supervision and partnerships with educational institutions.  We urge the Committee to ‑‑ the Subcommittee to draft legislation that allows flexible funding and planning that includes working with the States to develop outcomes that track progress towards workforce goals.  It should be recognized that $40 million for 50 States may limit the progress we all seek to advance in achieving these goals.  It will also be difficult to determine how this $40 million will supplement and not supplant current State efforts, since it will overlap with title IV‑E administration, but we do highlight additional resources are needed. 

In your reauthorization, we also suggest that Congress ‑‑ that this Committee include recommendations being proposed by the National Indian Child Welfare Association, the National Congress of American Indians and the Association of American Indian Affairs.  Their joint proposal would set the reserve amount for funding for tribal governments at three percent in both mandatory and discretionary funding.  Consortium of tribal governments could also apply for funding, and we endorse an authorization of a tribal court improvement program.  As a part of the application, States should submit information on how they intend to allocate their PSSF funding.  Information submitted can be collected and included in an annual report by HHS.  We also urge the Subcommittee to consider legislative language directing HHS to work with the States to determine how to best compile an annual report describing how funds are spent and how children and families are served.  Like the SSBG report, this information can provide a stronger picture of why the funding is important.  We commend the Committee for including the reauthorization of the mentoring program for children of prisoners in this legislation.  Currently, there are some 218 Federally funded mentoring sites serving thousands of children.  It would be tragic for these children to have their mentoring disrupted or end prematurely, and we urge the Committee to allow provisions that would allow these efforts to continue.  CWLA appreciates the subcommittee's efforts to better align IV‑B part one, the CWS program, with promoting safe and stable families.  This can add clarity to the understanding of funding sources, although it is unclear to the extent to which IV‑B one funds are spent on adoption and foster care annually.  CWLA appreciates the committee's efforts at updating the State plan, and we suggest including requirements to address overrepresentation of children of color in the CWS.  As the legislation moves forward, we look forward to a continued dialogue with the Members of the Committee and others.  We hope that this serves as a building block for future efforts that can have ‑‑ that can create a comprehensive reform for our children and families.  Thank you very much. 

[The prepared statement of Ms. Spears follows:]

Chairman HERGER.  Thank you, Ms. Spears. Mr. Cross to testify.


Mr. CROSS.  Thank you, Mr. Chairman.  My tame is Terry Cross.  I am the executive director of the National Indian Child Welfare Association.  I am here to testify on behalf of our organization and our membership.  I have submitted formal written testimony, so I just want to make my oral comments to illustrate some key points from my testimony.  First of all, I want to start with some thank you's to this Committee.  First, to invite us here for the tribal viewpoint, for our organization's viewpoint is very much appreciated.  Often no one hears the messages about our children who are left out of these kinds of programs.  Chairman Herger, I want to thank you personally for every piece of legislation concerning child welfare that you have introduced in the last 2 years, that have had tribal provisions.  It is a wonderful step forward.  Very grateful for your leadership in that area.  We want to thank the Committee for its role in helping make sure that the recent budget Deficit Reduction Act, including provisions that required State court improvement programs to consult with the tribes in their States.  Another major improvement.  We want to thank Representative Camp who has sponsored our title IV‑E access bill for tribes.  It hasn't gotten any action, but it ‑‑ once again, a representative from this Committee is paying attention to our children's needs.  Also in the recent Budget Reduction ‑‑ Deficit Reduction Act, the provision for the Tribal TANF‑Child Welfare collaboration was a direct result of Representative Camp's work and this committee's work, and we also thank you.  We commend the Committee for this direction, and we think these things that I have just mentioned here in our thanks to you is part of a trend, a track that this Committee is on that is a very positive track for our children.  In front of you today is a major opportunity to take a major leap forward to help protect our children because this really is about protecting children.

I want to tell you about a family and the possible scenario of that family in three different situations.  Family living in a rural area, depressed mom, five children, abandoned by a father, children ‑‑ 12 years old, the oldest; 18 months, the youngest.  CPS worker is called into a home that can be described nothing less than filthy, unsafe for a child to be in.  The caseworker looks at the situation, calls the family together, immediately conducts family group conference, talks about the need for this to change and says, I am going to find a foster home unless I come back and this situation has changed ‑‑ but in the leaving, the case worker leaves garbage bags, a shovel and broom, 6 gallons of water because the plumbing's not working, and comes back later in the afternoon with a wraparound team.  The house is clean enough for the children to stay.  Can stay ‑‑ that family can stay together because there is a team of professionals who can make that decision and can protect those children in their own homes.  Those children, if they were lucky, would live on the three affiliated tribes at Fort Berthold.  They received this funding because they are large enough under the current formula.  If they lived in the Karuk Tribe in Northern California, there would be no services for them.  They would likely be placed in foster care with all of the ramifications we know about that.  If these children lived in the Seattle area, the small tribes of Western Washington, they would not be able to receive these services.  The consortia are not currently eligible to receive this funding.  That leaves me with the recommendations.  We recommend that the funding levels be increased for tribes from the current one percent for the mandatory and two percent for the discretionary funding to a full three percent.  This would allow tribes across the country to have access to these funding and for children ‑‑ for every child to stay at home with their family, to be able to receive the services.  Part of this important program also could support tribal court improvement projects, like the State court improvement projects, because it is only with a collaboration between the courts and the child welfare program and mental health and substance abuse and all the other programs that these programs can be effected.  The opportunity is here before us today, and I appeal to you for your compassion, for your good thoughts, for your care and concern that you have already demonstrated for our children.  We ask that you devote the resources at this critical time when they have already been appropriated when there is already a chance for our children to be served at the same level as other children.  I thank you for your time. 

[The prepared statement of Mr. Cross follows:]

Chairman HERGER.  Thank you, Mr. Cross. Dr. Hymel to testify.


Dr. HYMEL.  Mr. Chairman, I am grateful for the opportunity to testify at this important hearing in response to abused and neglected children.  My name is Dr. Kent Hymel, and I am proud to speak on behalf of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists of the American Academy of Pediatrics.  Until recently, I sat on the Academy's Committee on child abuse and neglect, and I am president‑elect of a professional society of physicians, specializing in child maltreatment issues.  The Academy has a deep and abiding interest in the health care provided to children at every stage of the CWS.  We have published numerous policy statements, clinical guidelines and research studies regarding child maltreatment.  In 2004, an estimated 3 million children were alleged to have been abused or neglected and received investigations or assessments by child protective services agencies.  Approximately 872,000 of these children were determined to be victims of child maltreatment.  At any given time, approximately 540,000 children are in foster care.  Most were placed there as a result of abuse or neglect at home.  Children in foster care have higher rates of serious emotional and behavioral problems, chronic physical disabilities, birth defects, developmental delays and poor school achievement.  These children warrant special attention in all aspects of their health care.  Some require immediate health attention.  Due to the abuse and neglect, many have never received well child visits or care, such as immunizations.  A growing body of research indicates the majority would benefit from targeted long‑term interventions.  More details may be found in my written testimony about research that shows a startling correlation between levels of childhood trauma and adult health outcomes, including obesity, suicide, heart disease, substance abuse, alcohol abuse and much more.

Pediatricians are uniquely positioned to prevent child maltreatment.  We see children at regular intervals.  However, pediatricians exist on the periphery of the Child Protection System.  The average pediatrician reports cases of suspected abuse or neglect but receives little or no feedback from Child Protection System.  Not only is this situation frustrating, but it fails to provide pediatricians with the information that could be vital to the child's follow‑up care.  Only about 200 pediatricians in this country specialize in child maltreatment cases.  This small cadre of physicians perform exam, serve as expert witnesses, treat patients, conduct research, teach, and on and on.  We serve as a resource to our fellow health care providers and many others.  I can tell you that we are spread very thin, isolated, and we find it difficult to communicate or collaborate.  Over the past 3 years, the American Academy of Pediatrics has devoted time, effort and resources to the development of an initiative to bring the medical profession into full partnership in the prevention, diagnosis and treatment of childhood and neglect.  We propose the establishment of a network, a regional consortia dedicated to the medical aspects of child maltreatment.  To help child abuse, research, education and services or health care's network, would consist of virtual centers that link all of the medical resources on child maltreatment within a given region.  Each consortium would be different, depending on the resources that already exist in that region.  The Academy envisions that these consortia will link all medical providers who deal with maltreatment.  Pediatricians, family practitioners, emergency physicians and others.  The consortia themselves would form a nationwide network.  The network would serve a number of critical roles.  Communication, many practitioners are unaware of the resources that exist in their community, State or region.  As a result, they may not know where it turn when they need to consult or gather information.  Collaboration, those of us who specialize in the field, find it difficult to collaborate and compete effectively for dollars that are already available.  One pediatrician may not see enough examples of a particular type to conduct a scientifically valid study, but three or four to collaborate to successfully assemble such a study.  Education and workforce, at present, there are not enough pediatricians entering the field of child abuse pediatrics to replace those who are approaching retirement. 

Child abuse medicine is about to become the next boarded subspecialty of pediatrics later this year.  This network would facilitate the creation and sharing of educational materials and successful programs as well as expand the field of trained professionals, both specialists and educated generalists.  In summary, the Academy envisions the health care network to serve as a resource of social workers, CPS system, law enforcement, the judiciary and many of the other agencies and professionals who deal with these issues.  The network could play a crucial role in improving children's lives as well as in reducing the massive health, education, governmental and other costs of child maltreatment.  To make this enormous task a little more manageable, the Academy urges Congress to provide $10 million for the Centers for Disease Control and Prevention's National Center For Injury Prevention and Control to begin the health care's network.  Mr. Chairman and Members of the Subcommittee, I deeply appreciate this opportunity to testify on behalf of the American Academy of Pediatrics.  I will be ready to answer your questions when the time arrives.  Thank you. 

[The prepared statement of Dr. Hymel follows:]

Chairman HERGER.  Thank you, Dr. Hymel.  Mr. Atwood to testify.


Mr. ATWOOD.  Chairman Herger and Members of the Subcommittee, founded in 1980, the National Council For Adoption, NCFA, is an adoption, research, education and advocacy nonprofit organization.  On behalf of NCFA, I thank you for the opportunity to testify on the vital subject of improving Child Protective Services (CPS).  NCFA applauds the Chairman's and the subcommittee's ongoing attention to America's foster care and CWS.  Your leadership in addressing this issue has helped to make important changes in child welfare policy and to prepare the way for other needed reforms.  We thank you for your efforts to improve judicial processing of permanency decisions for children in foster care by authorizing funding for judicial training and case tracking in the Deficit Reduction Act of 2005, for example.  Mr. Chairman, I have five points I would like to make for your consideration this afternoon:  Point one, advancing the broad financing reform agenda.  This hearing on the reauthorization of the PSSF, PSSF, takes place in the context of an ongoing policy discussion regarding the need for foster care financing reform.  Across the political spectrum, there is a widespread consensus about the need for States to be able to direct their Federal financing more flexibly toward other child welfare strategies besides foster care maintenance.  There have been several recent proposals to increase funding flexibility that would enable States to target resources toward prevention, rehabilitation, parent recruitment and adoption support services.  NCFA encourages the Subcommittee to continue to lead in addressing this broad reform agenda.  Point two, preserving and increasing PSSF's flexible funding.  The widespread consensus on the need for flexibility suggests that when reauthorizing PSSF, Congress should be careful.  It would be inconsistent with this consensus to impose specific directives on how States spend this one small source of flexible funding.  We ask Congress to preserve PSSF's flexibility and increase its discretionary funding, even if possible to full funding, as the Administration has previously advocated.  Other than national security and the rule of law, it is difficult to find a more worthwhile use of the Federal budget than to fund policies that effectively promote safe and stable families for vulnerable children.  Point three, supporting families through post‑adoption services, every family faces challenges but families who open their hearts and homes to children with a history of abuse or neglect often find themselves facing special issues requiring post‑adoption services.  The need for post‑adoption services has increased over the life of PSSF because adoptions out of foster care have increased and because of the increased incentives for older child adoptions, older children often needing ‑‑ being in greater need of post‑adoption services.  The failure to provide post‑adoption services can be a significant disincentive for adoption.  When foster parents and other prospective adoptive parents consider the challenges they may face, they may be less inclined to adopt if they feel they cannot rely on the additional supports they need.  Post‑adoption services promote healthy children and families, and they save taxpayers money by minimizing disillusions and re‑entries into care.  However, there is very little funding for these services.  Greater flexibility for title IV‑E funding and increased PSSF funding would enable many more children and families to benefit from post‑adoption services.  Point four, prevention rehabilitation and concurrent planning.  NCFA agrees with the idea that vulnerable children and at‑risk families would be well served by increased availability of funds for preventive and rehabilitative services in order to support, preserve and reunify families whenever such a goal is realistic and safe.  In promoting more preventive and rehabilitative services, it is prudent to note that an excessive attachment to the idea of family preservation was one of the problems that necessitated the Adoption and Safe Families Act of 1997.  This historical perspective reinforces the importance of concurrent planning.  Concurrent planning makes sure that the child has a timely, healthy permanency option when reunification is isn't possible.  It also advises parents of the seriousness of the their situation and the expectation that they must rehabilitate in order to maintain their parental rights and reunify with the child.  Point five, and my most important point this afternoon, parent recruitment, a crucial neglected strategy.  Adoptive and foster parent recruitment would seem to be a vital part of the adoption promotion that is called for in PSSF's purpose statement.  Yet none of the four objectives contained within that statement address this crucial strategy for promoting safe and stable families.  Parent recruitment is as important to child welfare strategy as prevention, rehabilitation and post‑adoption services and another compelling reason for greater flexibility in foster care financing.  There are enough prospective parents in America to care for this current country's vulnerable children. 

With 55 million married couple households in America, there are more than 450 married couples for each child waiting to be adopted.  The millions of qualified singles who could foster parent or adopt as well.  There are three places of worship for each child waiting to be adopted, and all of America's major faiths exhort their believers to care for children in need of parents.  Parent recruitment is especially urgent and challenging for older children.  We must overcome the attitude of hopelessness that can undermine their prospects.  If child welfare workers believe that adoption or guardianship is impossible for a particular youth, then it will be.  Prospective parents need leadership, encouragement and education.  State agencies need enough staff to recruit parents, process their inquiries and prepare them for their child.  Financing policy must be reformed to allow the resources to flow to these vital responsibilities.  See my written testimony for more detail on recruitment techniques and post‑adoption services.  In conclusion, Chairman Herger and Members of the Subcommittee, NCFA applauds and shares your commitment to ensuring that America's children are raised in safe, loving families.  We look forward to continuing to work with you to promote safe and stable families for America's vulnerable children.  Thank you. 

[The prepared statement of Mr. Atwood follows:]

Chairman HERGER.  Thank you, Mr. Atwood.  Now the gentleman from Colorado, Mr. Beauprez to inquire. 

Mr. BEAUPREZ.  Thank you, Mr. Chairman.  Ms. Ashby, first, if I might, if I am correct, Congress appropriated about $700 million for these two programs last year.  If a State does not utilize all of those funds in a given year, can they roll those to the next year or is it a use‑it‑or‑lose‑it situation? 

Ms. ASHBY.  I don't know the answer to that.  I am sorry.  I don't know if these are no-year funds or not. 

Mr. BEAUPREZ.  Would you get back to us? 

Ms. ASHBY.  I certainly will.  Yes. 

Mr. BEAUPREZ.  Secondly, and maybe more importantly from my perspective, I noted I believe somewhere almost half of the moneys appropriated go to administrative overhead.  I believe it is 44 percent.  Is that normal?  Is a good share of that really case workers' salaries, and it really is achieving the objective of helping children?  Or is this ‑‑ is this maybe because of what we have done in creating so many rules and hoops to jump through, is it just so top heavy and administratively weighted that that is necessary?  Is it helping the kids? 

Ms. ASHBY.  I think the percentage, or I know the percentage depends on how one defines administrative expenses, and we are currently working on a report for the Subcommittee, and we will be issuing that report by the end of June, and it will shed some light on what things are included in administrative expenses, and well, we will say more about that.  Right now, I can just say that the percentage does depend on the definitions used, and it does vary across the States. 

Mr. BEAUPREZ.  Even the States aren't consistent what they report as administrative overhead. 

Ms. ASHBY.  That is correct.

Mr. BEAUPREZ.  I certainly hear the cry for more, more, more, but I want to make sure that more of what we are doing is actually helping kids and not just creating that ever‑growing ‑‑ and a bureaucracy out there.  If there is a way to achieve the former and less of the latter, I would be all for that.  Judge Cohen, you mention methamphetamines and the problems it is creating.  I am seeing that in my State.  I am seeing that across society, but especially in the ramifications it is having for children and our families.  Do you see a way of ‑‑ in Iowa ‑‑ and Colorado's not a whole lot different from Iowa in many ways.  Tragically it is not just our urban areas.  It is all across our State.  Some of our smallest towns and smallest counties, most rural are the ones most affected.  How do we head this off?  It seems to be ever escalating, at least out my way.  Is that what you are seeing in Iowa as well? 

Judge COHEN.  Yes, it is.  It is one of these issues I would first address with my magic wand if I had one.  It is one of those issues I wish I had the magic answer.  I can tell you that last year ‑‑ or a couple of years ago perhaps ‑‑ Iowa, like many States ‑‑ Oklahoma, I believe, was the leader in this ‑‑ locked up its pseudoephedrine products, and what that did was it drastically reduced the number of the mom‑and‑pop methamphetamines labs.  Iowa, in fact, overtook California as the number of meth labs for a while, and now our labs are way down.  This is good for children, of course, because in the backyards and garages and bathrooms of these homes, there were toxic laboratories going on, and you would see the HAZMAT guys come in in their Darth Vader costumes, and you know, picking up all of this toxic material with instruments and at the same time, you would see an 18‑month‑old sitting on the floor, slapping around or sucking on a battery.  It was horrifying, the exposure to these children of these toxic materials, plus we were having labs blow up, and children were getting burned.  Locking up the products was a wonderful step in reducing the lab problem.  However, addicts are going to find their poison, and we have seen now a change in the use.  We are seeing more pure ‑‑ the crystal meth coming into our State.  We are seeing more imports.  We are seeing more IV use.  The addiction is so compelling that the addict is going to have to feed it somehow.  We know the drug court treatment works.  We know treatment courts work.  The Court Teams For Maltreated Infants and Toddlers is a treatment court.  It has to be treatment, treatment, treatment, long‑term, recognizing that relapse is part of treatment and being there with a support system is the thing that is working, but the resources are not there ‑‑

Mr. BEAUPREZ.  If I might beg the indulgence of the chairman for just a minute.  What we are seeing ‑‑ and I will cite one of my counties an example.  In a 4‑year period, a tripling of the number of cases of methamphetamines.  Eighty percent of the children in child custody of one type or another in that county, one of our larger counties, we are talking about 675 kids under the age of 12 are there because of drug and almost exclusively methamphetamines abuse in the home.  It is 80 percent of, the county law enforcement tells me 80 percent of their crime, identity theft, burglary, assault is drug related.  I think until we get ahead of some of the sources of the problem that are driving children into foster care, we are only putting sand on the wound instead of healing the wound, and I think this is a major one.  I think it is law enforcement.  I think border security is a piece of this.  I know that is a word we like to throw around this town right now, but 80 percent, I am told, of the illegal drugs in America today are coming across our southern border.  Sadly, my largest city of Denver is in a direct line of the southern border.  We have become a distribution hub, and that is not the kind of notoriety we are looking for, but I think it is law enforcement.  I think it is education, education, education because you said it, it is an extremely and rapidly addictive.  I do think that therapy has to be a piece of it as well.  It is a major problem, and I think what we are all talking about here today is one of the very sad outgrowths and symptoms of a larger problem in society.  I thank the Chairman and yield back. 

Chairman HERGER.  I thank the gentleman from Colorado.  Gentleman from Washington, Mr. McDermott to inquire. 

Mr. MCDERMOTT.  Thank you Mr. Chairman.  Ms. Spears gave a figure which I find startling, and in some ways troublesome, nearly 900,000 kids were found to be victims of child maltreatment.  Only 40 percent receive follow‑up.  When I hear that figure, I kind of wonder from the judge's point of view and from your point of view and from your point of view, Dr. Hymel and Mr. Cross as well, what is missing that 40 percent of the kids are falling through the cracks, is it simply money?  Or are there not professionals enough to deal with the caseloads?  You folks can start anywhere you want, because you said you have got 28,000 docs retiring, or something like that. 

Dr. HYMEL.  I wish we had 28,000 doctors working on child abuse.  I think a big part of the problem is the disconnect between CWS and the primary health care providers.  I recognize that privacy laws prohibit the reporters of suspected maltreatment, like myself, from getting substantive feedback regarding the outcome of a CPS investigation.  When you limit that information or prohibit me from having that information, I can't arrange or provide the follow‑up care for that family.  Most of the Federal investment in child maltreatment is directed to child welfare or the judicial system, and to be quite honest, the families accused of suspected abuse view those two agencies, or the individuals representing them, as their adversaries at the moment the confrontation occurs. 

Mr. MCDERMOTT.  You, who put them up ‑‑ put them in their hands ‑‑

Dr. HYMEL.  Sometimes we face their wrath as well, but I think the primary care provider, who ultimately is tasked with maximizing the help outcomes of a child who has been abused, if brought into the loop, if informed about the outcomes of those evaluations, if provided an opportunity to have a greater input into the process can be a major untapped resource.  I think that it is time for the health care system to become a bigger part of this response. 

Mr. MCDERMOTT.  Do you have enough mental health professionals? 

Dr. HYMEL.  No, sir.  I am not knowledgeable about the details of that subspecialty and their numbers, and but I can tell you it is hard to find available appointments in a cost‑effective manner for the families who need it. 

Mr. MCDERMOTT.  Judge, take a swing. 

Judge COHEN.  The system has to work together and collaborate.  We can bring people together to the table, and judges need to get off the bench and sit down at the table and convene because one thing we are really good at, when we invite people to come and see us, they usually come, and we need to listen to our community ‑‑ usually.  If they don't, they can be in big trouble, as they can before your body, but we need to sit down and learn from each other, and it can be done. 

Mr. MCDERMOTT.  Is there a way to cover that disconnect between what the doctor who sends them in and then never ever finds out what happened, or is a cop brought in again to begin to pick up the pieces?

Judge COHEN.  Well, in my State, he would be a mandatory reporter.  If there were a contested hearing about the facts of the case, whether or not the abuser or neglect occurred, he would certainly be called as ‑‑ to testify as a witness.  I think it is about half of the States child abuse and neglect cases are open to the public.  My courtroom is open to the public.  Anybody can come and sit and listen to a court proceeding unless I find, after hearing evidence, that the danger of harm to the child outweighs the public's right to know. 

Mr. MCDERMOTT.  The doctor doesn't have time to come sit in the court.  Does the caseworker have any responsibility or whatever to give any ‑‑ I am trying to understand. 

Ms. SPEARS.  Yes.  I think it is complicated by the fact that many of the families, and this 40 percent really may not ‑‑ may need services and may not need services from the child protective agency, although they may need services that are provided in the community.  I think the doctor is a lot right, that these families need support services that are provided in a variety of manners, that may be outside the formal system or outside of the court system.  May require stronger mechanisms for connectedness to community‑based services.  That do exist in some communities, family group conferencing, a variety of family support and family stabilization programs, community‑based child protection programs, create models of services that try to bring the doctor, the mental health professional, the family support worker, the childcare worker to the table to help those families.  I think some of the dollars in this pool, in fact, support some of those services, and I suspect many other dollars do as well. 

Mr. MCDERMOTT.  Where is the best example in the country of it working properly, or working as close to maximally as it can. 

Ms. SPEARS.  There are a variety of places I would say it is working well.  Allegheny County, Pennsylvania, is a place where it works quite well, where there is really good integration between what the formal child protection system does, what the court system does and what the community does to support families at all phases, both in front‑end prevention services, in mental health and in adoption services, all the way through the end of the system to really try to do those things.  They have done that by pulling community leaders together, adoptive families and kinship families and birth families together, and by pulling caseworkers together across all systems.  They really have done it sort of top to bottom, up and down, from leadership all the way to kids in ways that integrate the way that that works; and it is one of the places where I see community‑wide services doing that ‑‑ not the only place though.

Mr. MCDERMOTT.  Could we get Mr. Cross for a moment? 

Mr. CROSS.  Another good example is a tribe in Washington.  They have been able to integrate their services at the tribal preschool, the substance abuse program, the mental health program and the child protection program all into one program that supports families.  They have been able to do that because of their creative approach in turning the system around from a system that intervenes, primarily to a system that pays attention to child well‑being from a public health perspective.  I think that is one of the dilemmas here.  These are very complex issues, and as long as we are confused about the difference between the need to intervene in a particular situation to protect a particular child and the well‑being of all children ‑‑ any child can be abused or neglected, given the circumstances in their life, with poor substance abusing, domestic violence, a history of depression, all of those things coming together and you have a situation ripe for disaster no matter who you are or where you live.  We have to approach this thing from many different directions, in teams, with all of the people who are sitting at this table having a voice for each family. 

Chairman HERGER.  The gentleman's time has expired.  The gentlelady from Connecticut, Mrs. Johnson, to inquire. 

Mrs. JOHNSON.  Thank you.  For a number of years now we have held these hearings and we have seen some development of services locally, and certainly we have grown in our understanding of the importance of integrated services; case management and court teams are really impressive.  We have begun to discuss, how do you foster an integrated, collaborative approach at the community level, because most communities in America are single‑hospital communities, and if you look at where the hospitals are placed and the service areas of those hospitals and the pediatricians around them and the school systems around them and the social service child and family systems around them, it is hard to believe that we should continue to pursue, do we put more money in this service or more money in that service or more money in this team model or that team model.  We have to find a way to incentivize communities to look at themselves.  Now Head Start does some of this, the Free to Grow program that Columbia has developed on top of Head Start has had a profound effect on the Head Start programs because it has helped the human resource agencies, the cap agencies, which are long established but were also isolated.  They talk to themselves, in their own base of people; and Free to Grow is the most recent model I have seen that has forced people beyond their own boundaries.  How do we get ourselves ‑‑ what kind of money do we put in the system to get communities to think collaboratively?  Because a lot of this ‑‑ my husband is a retired obstetrician, and the obstetricians and pediatricians used to say, they know what families are going to have trouble before they deliver the child.  I have heard schools say this too, we know who is going to have trouble.  Why is it we can't bring what we know about parenting education, about early signs of substance abuse, about not looking at the child, looking at abuse problems in the whole family, whether it is substance or violence or behavioral, and begin to focus on who can come to us with an integrated model and can show us how they are thinking together as a community and how they are reaching out, so the number we get in the court means we need very few court teams.  I hate to put the money in to expand the court teams.  One last comment along this line.  For years I have tried to get us to think about the number of kids going into foster care, and it is declining.  There are a lot of reasons why it is declining.  It doesn't necessarily mean that things are getting better.   Your money is declining.  As the number of kids decline, your money declines.  Your money is going to decline, and it is going to get harder to get foster parents.  I know it is a nice thing to do, but lifestyles are working against this.  As that declines, you lose resources.  Yet if we freed up those resources, so that they could be used for prevention, and gradually shifted, we might have a handle on how to move forward.  Now, I appreciate the worry about what happens if there is a surge, but frankly that is kind of a secondary problem if we get better services in place that are more logistic and effective.  We need help in knowing, how do we stop reacting to this one thing.  Medicare, we are looking at the medical home.  We might ‑‑ how does the pediatrician professional stay in the loop, be seen as the parent, as the center of help.  I have tried to get grants for my Head Start programs because they have the trust of the families.  If you could use them as the avenue through which you reach substance abuse or mental health help or something, we could do that.  We are failing to go take what we know to get to where we know we need to be.  Congress can't do this; we are way too far away.  If you help us, we ought to be able to think of at least a few demonstrations and take a look.  I appreciate your testimony.  I appreciate the level of this testimony as to 5 years ago and as to 10 years ago, and we really are making substantial progress in our understanding of family dynamics and intervention, but we are not able to overcome the old divisions, the old turfs, the old organizations; and we are still pouring money into the administrative superstructure of a lot of different groups including ‑‑ public school agencies that are here have a very limited context.  We need to think this through, and we need you to help us come up with some demonstrations that we can really work on.

Chairman HERGER.  I thank the gentlelady.  The gentleman from California, Mr. Stark, to inquire. 

Mr. STARK.  Thank you, Mr. Chairman.  Thank you for holding this hearing on your draft bill.  My understanding is that it is still a work in progress, and I hope that all Members of the Committee can add their two cents worth, maybe even 2 million worth, and that we will do something to assist the witnesses and their agencies in providing better care.  I just wanted to check, and the Chair might care to toss his comment in here, but I just wanted to make sure.  Ms. Ashby, you have seen the bill, the draft bill? 

Ms. ASHBY.  Yes, sir, I have.

Mr. STARK.  It is my hope ‑‑ and with the Chairman's concurrence, I wanted your understanding ‑‑ that there isn't anything in the bill that intends to apply the administrative cap to caseworker salaries.  Mr. Chairman, I don't know.  Was that how you would read it? 

Ms. ASHBY.  I did not interpret it as doing that, no.  It defines administrative costs as being more limited than currently is the practice, but it doesn't include caseworker salaries, I don't believe. 

Mr. STARK.  Mr. Chairman, is that your understanding too?  In the draft bill there is nothing that would limit the caseworker salaries, whatever you spend for that? 

Chairman HERGER.  That is my understanding. 

Mr. STARK.  Okay.  That is great.  I figured that those are the lowest paid of the people that we need on the front lines, and I just wanted to reassure myself at least that was the case.  Ms. Spears, you have published standards.  Do you want to comment on a requirement that mandated monthly visits?  how do those fit into your best practice models, and does that do enough to assure what you guys would like to see as better outcomes? 

Ms. SPEARS.  In an ideal world, no.  I think it does help us.  I think, for me ‑‑

Mr. STARK.  Does it go in the right direction? 

Ms. SPEARS.  It tremendously goes in the right direction.  I believe that worker visitation is an absolutely critical part.  We have seen that it does improve outcomes for kids and families, and we believe it is a sound part of case practice.  For me, having done the direct service work, having been an administrator in programs, et cetera, there a lot of roles that visitation serves and the needs for visitation varies in each and every case.  Visitation is critical all across the casework perspective from the point in time that a family is first identified, where you are doing assessment and service planning and safety planning and risk calculation to keep kids safe, to helping children stabilize at home, to assessing their behavior and determining treatment needs, to looking at long‑term stability for a child.  All of those things, and workers cannot do that without regular contact with the kids and without the skills; they need to know what to do when they have those visits.  This isn't a social call, and it is not just playtime.  It has a meaningful function in the casework delivery process for kids and families.  We are very concerned that workers both don't have time and don't have skills all the time to do this.  I once trained a group of workers probably a zillion years ago, but it was a mantra that has stuck with me, because I have heard it many times, that workers feel like often that the kid visit is the first thing to go when they are busy, because someone else in the family, someone else in the case, may in fact be available to supplement for their role.  That may be true but they sometimes lose track of the importance of their role in visiting kids, or they don't necessarily know what to do with the visit. 

Mr. STARK.  Thank you.  I just wanted to thank Dr. Hymel and the American Academy for endorsing tirelessly and again our MediKids bills, which might provide the universal coverage that was written.  If the Chair will indulge me 1 additional minute to be out of order here, it probably is apparent with everybody except the Chair that the Members of this Committee would be useless if it wasn't for our hardworking and dedicated staff.  Sean McCluskie, who has worked here 7 years, started when Ms. Johnson was chairing this Committee and has worked tirelessly in all the areas of our jurisdiction; he has kept me out of trouble, he has been a valuable asset to, I think, even the majority staff.  He is a knowledgeable guy, both a Ph.D. and a lawyer.  We are losing him to the world of welfare reform and unemployment insurance for a while, but maybe some day we can get him back.  Thanks.  Stand up. 


Thank you, Mr. Chairman.

Chairman HERGER.  You are welcome.  We all join in wishing the best to our colleague.  Mr. Atwood, your testimony on page three points to a significant increase in the number of adoptions from foster care since the late 1990s, rising from 31,000 in 1997 to 50,000 today.  Could you tell us why you feel that has occurred; and what role has the State use of Promoting Safe and Stable Families funds played in facilitating this change? 

Mr. ATWOOD.  I think, first and foremost, you have to give credit to the Adoption of the Safe Families Act, which created the adoption incentives program and also made it ‑‑ authorized the States to forgo family reunification under certain circumstances, aggravated circumstances.  The incentives did much to motivate State agencies to place children for adoption, and I think you have to first look there for credit for that success.  I think the PSSF also contributed to the extent that there has been funding of postadoption services, the provision of which is a comfort to people who are considering adopting, foster parents who are considering adopting and other people who are considering adopting.  It appears to me that the adoption promotion and support services aspect of the PSSF could be more fully served in the implementation of the program.  I cited in my oral testimony, and written, the lack of parent recruitment emphasis throughout the system.  In fact, if you look at the purpose statement, it refers to adoption promotion and support services, yet if you look at the objectives, there is no sign of promotion, adoption promotion in the four objectives of the PSSF statement purpose ‑‑ purpose statement.  Parent recruitment would certainly fit under adoption promotion.  I just bring that to the committee's attention.  I think that it is an underserved strategy throughout the system.  When you look at the arguments that are made for flexibility, you hear prevention and rehabilitation, which are very good arguments and very worthy purposes for more flexibility, but so is parent recruitment and so is postadoption services.  Both promotion aspects of Promoting Safe and Stable Families for adoption does not appear to me to be very well served, very fully served.  The adoption ‑‑ the postadoption services does receive attention, does receive some funding, but there, again, it is nowhere near.  I am sure that is true for prevention and rehabilitation as well.  I think that parent recruitment is ‑‑ receives the least amount of attention on that list. 

Chairman HERGER.  Do you see any other factors that have played a role in this increase in adoption?

Mr. ATWOOD.  Besides the Adoption and Safe Families Act and Promoting Safe and Stable Families, I think there has been a genuine and widespread paradigm shift within the child welfare community that family preservation is not always what is best for the child.  One of the things that necessitated the Adoption and Safe Families Act was pockets in the system ‑‑ was the idea in places in the system, in courts, in State agencies that family preservation must be achieved at almost all costs.  There were horror stories, you will recall, back then about children who, it should have been clear to everyone, should have had their parents' parental rights terminated and been eligible for adoption; and who suffered as a result of this ideology, really, of family preservation.  The Adoption and Safe Families Act addressed that, the CWS responded, and I think it is fair to say that there really has been ‑‑ that has been taken to heart almost everywhere throughout the system.  There are exceptions, but now, thankfully, the best interests of the child are weighted more highly than family preservation.  I think that paradigm shift, if you will, is just simply more of a dedication throughout the system in placing children for adoption.  People have that ‑‑ they recognize adoption is very good for children when their biological parents cannot parent them. 

Chairman HERGER.  Thank you, Mr. Atwood.  Certainly our top priority still remains to try to assist these parents to be able to have healthy families for their children, but we all know that there are circumstances where, when this can't be done, we need to be moving as rapidly as we can to find good homes for these children, not have them go from, as we have seen examples of, 40, 50, 60 different foster care homes.  I appreciate the work that all of you are doing.  I want to thank each of those of you on our panel very much for your testimony.  With that, I would like to ask our next panel to please be seated.  On this panel we will be hearing from the Honorable Cari DeSantis, Secretary of the Delaware Department of Services for Children, Youth and Their Families, on behalf of the American Public Human Services Association; Daniel Hatcher, Assistant Professor of Law at the University of Baltimore School of Law; William Bell, President and Chief Executive Officer of Casey Family Programs; Richard Wexler, Executive Director of the National Coalition for Child Protection Reform; Ikeita Cantu Hinojosa, Associate Counsel for Legislative Affairs at the National Association of Social Workers; William Tower, President and Chief Executive Officer of the American Family Rights Association; and Heidi Goldsmith, Executive Director of the Coalition for Residential Education.  The Honorable Ms. DeSantis to testify, please.


Ms. DESANTIS.  Good afternoon, Chairman Herger, Congressman McDermott, Members of the Subcommittee.  I am Cari DeSantis, the Cabinet Secretary for the Delaware Department of Services for Children, Youth and Their Families.  I am also the Chair of the National Council of State Human Service Administrators.  First, I would like to commend the Committee for working in a bipartisan manner to reauthorize the Title 4B programs, including Promoting Safe and Stable Families.  As you are well aware, the CWS serves some of America's most fragile and troubled citizens, families in crisis and children who have been abused and neglected.  When APHSA recently spoke with our members about the reauthorization of Promoting Safe and Stable Families, they overwhelmingly indicated that Title 4B is their most flexible source of dedicated Federal dollars to provide child welfare services.  States would like to see the funds remain as flexible as possible, while continuing to be directed and meeting the goals of the four categories of Promoting Safe and Stable Families.  This funding has allowed States to implement innovative and effective practices, because it affords States the flexibility to fund the critical services that the Federal entitlement program, title IV‑E, cannot fund.  For example, in Delaware our programs are offered through a network of local community providers that help to support our system‑of‑care approach to child welfare services. 

The community‑based interventions address the four life stressors that may cause child maltreatment.  These are the parental personality characteristics that are related to risk, child development and behavioral characteristics, stress and crisis in the family, and the absence of or inability to access resources and support.  One unique service we have begun to use in Delaware to use IV‑B funds is to provide intense services to youth in our juvenile justice system and their families.  Many of these youth present with complex family issues and personal needs.  Providers assist families of youths exiting our residential rehabilitation programs to establish support systems to help implement a plan that addresses their concerns and assures the safety and well‑being of the youth upon their return home.  We have also recently begun collaborating with faith‑based organizations in Delaware to provide family consultation and support for the families at risk of child maltreatment.  These families are often isolated and experiencing conflict and may be in need of basic support like food, shelter, rent and utilities assistance.  Again, a true system of care fashioned this program and has a faith‑based organization that works with the family to build on their existing strengths, provides consultancy, guidance and community support, as needed, and helps the family resolve their needs before a crisis lands the child in care.  We urge that Congress act quickly on this reauthorization and that they appropriate the additional $40 million in mandatory funding provided in the Deficit Reduction Act.  Additionally, we ask that States be given a full 2 years to spend these additional dollars, as they would have had if they had received them at the beginning of fiscal year 2006.

Mr. Chairman, child welfare professionals courageously work in one of the most challenging professions in our country.  Enormous responsibility is placed in the hands of caseworkers as they are expected to perform multiple interventions and make judgments that have the power to change a child's life.  Their findings can determine whether a child is kept safe and protected or put at risk.  We understand that with the intent of focusing the majority of 4b funds on services to families, the Subcommittee might consider capping administrative costs.  If the decision to restrict the use of funds is made, we respectfully urge the Committee not to include caseworkers, who provide the actual services to children of families under that cap.  In conclusion, States appreciate that title IV‑B is the most flexible source of dedicated Federal child welfare funding.  APHSA supports the reauthorization of the current $545 million in title IV‑B funding.  On a closely related issue, we also urge this Subcommittee to reject the proposed $500 million cut to the SSBG program, a program that States rely upon as a key source of funding for child welfare services.  Simply put, a reduction of $500 million in SSBG would mitigate any of the good that the additional $40 million in additional mandatory funds would produce.  Over the past few years, Federal funding for child welfare has remained flat while State and local governments have increased funding for child welfare.  We believe that a strong Federal‑State partnership is essential to improving outcomes for children and families in the CWS.  To that end, we urge the Subcommittee to consider fundamental reform of child welfare funding, including the reform of title IV‑E.We look forward to continuing to work with the Subcommittee to assure a Federal financing construct that can help the States meet the needs of the most vulnerable children and families that we serve.  I thank you for the opportunity to testify, and I am happy to answer any questions that you may have. 

[The prepared statement of Ms. DeSantis follows:]

Chairman HERGER.  Thank you.  Mr. Hatcher to testify.


Mr. HATCHER.  Thank you for this opportunity.  My name is Daniel Hatcher and I am an assistant professor at the University of Baltimore School of Law and also a former legal aid lawyer from Maryland, where I represented hundreds of children in the abuse and neglect system, as well as adults in virtually all areas of civil poverty law.  My testimony today will focus on an issue from my recent law review article, Foster Children Paying for Foster Care, which addresses how cash‑strapped foster care agencies are converting foster children's Social Security benefits into a source of State funds by taking the children's Social Security benefits and applying them to cover State costs for which the children have no legal obligation.  This use of foster children's Social Security benefits results in an incredible missed opportunity, an opportunity to use the children's own resources as a tool to improve planning for the children's current and future needs, and to encourage coordination of the children's own resources with other child welfare programs and services including IV‑B and IV‑E. Children of foster care can be eligible for two types of Social Security benefits, either SSI benefits because the children themselves are disabled, or old age, AOSDI benefits because their parents are either deceased or disabled themselves. 

Across the country the practice is occurring basically throughout the same process.  Children who are eligible for Social Security benefits require payment through a representative payee to manage the funds.  Children who are in foster care are having the State agencies appointed as a representative payee through virtually an automatic process, although the State agencies are the least preferred on the regulatory list of choices.  Once an agency becomes a representative payee, they sidestep their fiduciary responsibilities to the child beneficiaries, again by taking those benefits and applying them to State costs rather than using them for the children's current and future needs.  Some States have even used private contractors as part of this process, in which those private organizations assist the States in screening children for disabilities, applying for Social Security benefits and then taking a cut of the resulting benefits through a contingency fee process.  The process raises legal and constitutional concerns as States are taking property of foster children and foster children are treated unequally.  Essentially those who are disabled or who have dead parents are being forced to pay for their own foster care where other children are not.  The State agency representative payees are also not meeting their legal fiduciary obligations to these children to exercise independent and individualized discretion in determining how the children's resources should be used. 

Also, I have been unable to find evidence that States are using the resources that are taken from the children to actually increase the funds available for child welfare services or whether they are simply taking the funds and adding them to the general State coffers.  This practice is not only legally and constitutionally troublesome and simply unfair, but the practice again results in incredibly missed opportunity.  The proposal I lay out in my written statement adds legislative guidance to stop the current State practice and ensure foster children's Social Security benefits are used as intended to help the foster children.  Again, foster children, as we have heard, are having a tough time, both in care and when they are struggling to age out of foster care.  The numbers don't look good for them.  They need our help with increased funding and improved planning and coordination of child welfare programs and services, and their own Social Security resources used as part of better planning for their future.  Thank you again for this opportunity.

[The prepared statement of Mr. Hatcher follows:]

Chairman HERGER.  Thank you.  Mr. Bell to testify.


Mr. BELL.  Chairman Herger, Ranking Minority Member McDermott and Members of this Subcommittee, thank you for this opportunity to appear before you today in support of reauthorizing the PSSF.  I am William C. Bell, President and CEO of Casey Family Programs, which is the largest operating foundation in the country focused solely on foster care.  In January of 2006, Casey Family Programs began to focus its attention on a strategy that we call 20/20.  20/20 is both a point in time and a benchmark from which this Nation can measure significant changes and progress within our child welfare systems and in our communities.  We see the 20/20 benchmark as a critically important reminder to us of the consequences we face as a Nation if nothing changes over the next 15 years for the children in our care.  Consider the following:  If nothing changes between the year 2006 and 2020, nearly 14 million more children will be confirmed as abused or neglected, nearly 9 million more will experience foster care and approximately 300,000 children will age out of the foster care system into adulthood.  Most troublesome is that approximately 22,500 children will die in this country from child abuse and neglect if nothing changes, and most of them before reaching their fifth birthday.  These potential outcomes are unacceptable, and I know that each of us here today shares a commitment to ensuring that these outcomes never occur. 

The draft bill reauthorizing the PSSF clearly articulates your commitment in this area.  At Casey, our 20/20 strategy targets two key outcomes:  one, significantly reducing the number of children in foster care in the next 15 years; and two, reinvesting the savings to increase the opportunity to improve outcomes for vulnerable children.  By the year 2020 we believe that it is possible to reduce the number of children in foster care to approximately 250,000 through increased reunification, increased adoptions, and prevention of unnecessary placements.  We have seen this occur in States such as Illinois, California and New York, and it can happen across the country.  A first step to achieving this goal is reflected in the increase in the mandatory portion of the PSSF by $40 million.  We support this subcommittee's ‑‑

Chairman HERGER.  Mr. Bell, I apologize.  Would you mind moving the microphone.  Let's try moving that away from you.  They are getting ‑‑ I asked them if they could turn it down but they don't seem to be able to.  I apologize for interrupting. 

Mr. BELL.  Is that better?  Or is that better? 

Chairman HERGER.  That is better. 

Mr. BELL.  We support the subcommittee's recommendation to focus these funds on strengthening the capacity of frontline caseworkers.  During my tenure with New York City's Administration for Children's Services, I had the opportunity to help design a series of reforms that significantly reduced the number of children in foster care and the number of new admissions to foster care.  Two key components in this effort were investing in our frontline workforce to improve the quality of frontline supervision and frontline casework; and secondly, a significant investment in the availability of family support and foster care prevention services in the communities where vulnerable families live.  In addition to the $40 million increase in mandatory funding, I would also urge the Subcommittee to consider two other items:  one, an increase in the target of the remaining discretionary funds in IV‑B and/or looking at an approach to reinvest savings that occur when the foster care system declines.  The amount of appropriations is vitally important; however, money is not the only answer in changing outcomes for vulnerable children in America.  We must also create an environment where staff can be successful in their efforts to keep children safe and help them become stable adults.  There are a number of critical components that I would outline for you that I believe must be in place if we are going to see significant change in our CWS.  One, there must be a commitment of political will necessary to sustain change; and the CWS must have the consistent powerful and focused leadership of the chief politician, whether this is the judge, this is the governor, the board of supervisors, or the mayor. 

In order to keep driving improvements forward, child welfare must be treated with the same level of attention and support as the police department, the fire department and our education departments.  There must be competent executive and frontline leadership in our child welfare agencies.  There must also be a clear plan of action for where we want to go and there must be clearly articulated principles and standards that guide our work in that direction.  There must also be a continuous investment in frontline supervision and frontline casework.  The frontline supervisors and caseworkers must believe that they have the backing of leadership if we are going to be successful, as opposed to being afraid of losing their jobs every time a tragedy occurs.  We must develop and demand strong cross‑systems collaboration and we must create data‑driven accountability.  Finally, we must have time.  Systems don't change overnight.  ACS was created in 1996 and by 1999 things were virtually still the same, but we will all look at what occurred and suggest that significant improvement occurred in New York City, and it can happen around the country.  Improving the lives of children in America is a long‑term process.  That can only be accomplished through the investment of collaboration, both public and private partners, and through government leadership.  This subcommittee's continued focus in this area tells our Nation that the health and well‑being of our most vulnerable children is a priority both today, next week, and well beyond the year 2020.  Thank you for this opportunity and I would be happy to respond any questions.

[The prepared statement of Mr. Bell follows:]

Chairman HERGER.  Thank you.  Mr. Wexler to testify.


Mr. WEXLER.  Mr. Chairman, Members of the Subcommittee, greetings from the family‑values left.  My name is Richard Wexler, and I am Executive Director of the National Coalition for Child Protection and Reform, a nonpartisan, nonprofit child advocacy organization.  Thank you for inviting me to testify today.  With only 5 minutes, I am going on skip the boilerplate about what a wonderful organization we are.  It is all in our written statement and on our Web site.  Since I am about to say something nice about a plan from the Bush administration, I do want you to know this.  I am a lifelong liberal Democrat, noncountercultural‑McGovernick, lapsed‑card‑carrying member of the ACLU.  My board members include a former director of Housing and Homelessness for the Child Welfare League of America and a former legal director of the Children's Defense Fund.  I take great pride in being part of the only organization, besides the sponsors singled out for thanks by Representative Miller in his remarks opening the Child Welfare Summit he helped to open in 2002.  The fact that one of the most important ways Congress can improve child protective services happens to come from the Bush administration is no reason for my fellow liberals to reject it out of hand.  Now that this fine idea has been embraced not only by Governor Jeb Bush of Florida and Governor Schwarzenegger of California, but also by Governor Jennifer Granholm of Michigan, I hope my friends on the left will reconsider and give the Nation's other governors the same opportunity to help children if they choose to seize it. 

I refer to the administration's child welfare program option, the proposal to take billions of dollars now reserved for holding children in substitute care and allow States to use that money for safe, proven alternatives as well.  In 2003, Senator Clinton said the plan deserved careful consideration.  It still does.  One year ago this Subcommittee heard some of the shocking findings from a study of alumni of the Nation's foster care system conducted by Mr. Bell's organization and Harvard Medical School.  Other findings are in his written testimony today.  You didn't hear some of the worst.  One‑third of the alumni reported being abused by a foster parent or another adult in a foster home.  When it came to their overall functioning as young adults, only 20 percent could be said to be doing well.  I cannot fathom why some of my fellow liberals are so wedded to locking away billions of dollars and restricting those dollars to funding a system that churns out walking wounded four times out of five.  Some might say that we can fix foster care if only we spent even more on it, but that alumni study found something else.  Even if we could fix everything wrong with foster care, it would improve those rotten outcomes by 22.2 percent.  The system still would churn out walking wounded three times out of five.  Even so small an improvement is well worth the effort, but the real lesson of that study and 150 years of experience with substitute care is that the only way to fix foster care is to have less of it.  To my friends on the right, if you are thinking orphanages, a century of research says their outcomes are even worse. 

It is a dangerous delusion to think that anything that happens in an institution with an endowment that rivals the gross domestic product of some Third World nations, where children are overwhelmingly sent overwhelmingly often by single parents or foster parents and where 77 percent of the children are not foster children at all, has anything to tell us about the norm, institutions where children are held by force of law with no choice and no parent to turn to when the so‑called "house parents" quit every year or two as the norm or when the whole place goes bad, as so many orphanages do not just in 19th century England, but in 21st century America.  Or has everybody already forgotten about Maryville?  Or perhaps people feel the harm of foster care is tolerable because they assume whatever foster children came from must be worse.  Sometimes that is true.  Far more common than the sadistic brutes who make headlines, the horror stories, are families whose children are torn from everyone loving and familiar because a parent's poverty has been confused with neglect ‑‑ parents like the mother who is desperate to keep her low‑wage, job but can't find day care so she leaves her children alone when the sitter doesn't show; or the home rendered unsafe by Hurricane Wilma and yet they had their children torn from them until they provided, quote, "a stable living environment."  These kinds of cases are a large proportion of that 900,000 figure you heard.  The caseworker who comes to the door may know that the answer is day care or rent subsidy, but often there is no money for day care and no money for rent subsidies.  Thanks to an open spigot of Federal aid that covers a large part of the cost for every eligible child and enormous political pressure from a public that knows the horror stories, there is always money for foster care. 

In 1991, Senator Rockefeller's National Commission on Children found that children often are removed from their families, quote, "prematurely or unnecessarily" because Federal aid formulas give States, quote, "a strong financial incentive" to do so rather than provide services to keep families together.  Of course the Administration plan won't fix all of that but it is a reasonable place to start.  One final point.  This hearing asks what works to protect children.  Intensive family preservation services works.  The very term family preservation was invented for this service.  I single it out now because, contrary to what you may have heard, many studies find that when these programs rigorously follow the model of the first such program, Home Builders, in Washington State, they do indeed safely reduce the need for foster care.  Thank you.  I would be pleased to respond to any questions. 

[The prepared statement of Mr. Wexler follows:]

Chairman HERGER.  Thank you.  Ms. Hinojosa.


Ms. HINOJOSA.  Chairman Herger and other distinguished Members, thank you for the opportunity to be here.  The National Association of Social Workers, or NASW, is the largest membership organization of professional social workers in world, with over 150,000 members.  NASW works to enhance the professional growth and development of its members, to create and maintain standards for the profession, and to advance sound social policies.  The social work profession has a long tradition of involvement with the CWS, and we recognize the importance of reauthorizing the PSSF.  Chairman Herger, we completely agree with your statement that we should do all that we can to help families receive services to prevent child abuse and neglect.  Further, we are pleased about the additional $40 million for the PSSF included in the House draft bill.  The bill allows for use of funds to enhance caseworker visitation with foster care children; we know that increased client contact will yield better outcomes.  However, we do caution that one of the challenges we hear from our social workers is the mounting administrative burden imposed by Government.  Agencies need access to technology to reduce such administrative time.  That is why we are pleased to see that funds can be used to improve caseworker ability to access the benefits of technology.  Child welfare positions are particularly stressful, often resulting in unreasonable caseloads and low pay.  Consequently, it becomes difficult to attract and retain the most qualified employees, those with professional training and experience.  We hope to work with Congress to identify solutions, and we offer the following recommendations: 

First, we recommend that Congress help establish a national caseload size.  The Child Welfare League of America recommends the caseload ratio of 12 to 15 children per caseworker and the Council on Accreditation recommends caseloads not exceed 18 children per caseworker, yet a national survey found that caseloads for individual child welfare social workers ranged from ten to 110, with workers handling on average 24 to 31 children, each double the recommended number.  We ask Congress to consider ways to establish a national caseload size.  Methodologies for calculating average caseload sizes, taking into account State variations could be developed in consultation with NASW and other national organizations.  An example of a benchmark measure could include increased percentages of caseworkers and supervisors with BSW and MSW degrees, and we offer additional benchmark measures in our written testimony.  Second, we recommend that Congress improve education and training opportunities for frontline workers.  Some social workers are able to take advantage of Federal assistance through the title IV‑E and title IV‑B programs, which upgrade the skills and qualifications of child welfare workers.  While these programs serve a useful purpose and must be preserved, we know that these two programs alone cannot support the entire field of workers.  A new national study from NASW assuring the sufficiency of a frontline workforce, a national study of licensed social workers, found that the supply of licensed social workers is insufficient to meet the needs of organizations serving families and communities.  Congress should provide the 3.3 percent in discretionary funding to allow for research, training and evaluation of services in the CWS.  We believe that valuable employment incentives, including pay increases, benefits, student loan forgiveness and promotional opportunities are essential for the development and retention of a highly skilled human services workforce.  Third, we recommend that Congress strengthen the cultural competence of the child welfare workforce.  Nationally and in most States, children of color, especially African American children, are overrepresented in the system.  This disproportionate recommendation continues despite research indicating that there are no differences in the incidence of child abuse and neglect by racial and ethnic groups.  We know from our workforce study that social workers' young clients are more likely to be children of color and to come from environments that are plagued by socioeconomic disadvantages.  At each decision point culturally appropriate action or inaction can profoundly influence the trajectory of a child's life, yet there exists a shortage of both social workers of color and social workers with cross‑cultural communication skills to reflect the communities they serve.  We suggest that each State participating in the title IV‑B and title IV‑E programs include within their federally approved plan guidelines for strengthening the cultural competence of child welfare staff, specific steps to identify the existence of racial disproportionality at key decision‑making points, if any ‑‑ and such points are outlined in our written testimony ‑‑ and increased resources both to enable social workers to enhance the recruitment and retention of potential foster and adoptive families consistent with the Multiethnic Placement Act (P.L. 103-82), and to enable the hiring of culturally and linguistically appropriate staff to meet the needs of the community at competitive salary rates.  As you can see, social workers are an integral part of the CWS, as is the PSSF.  For the system to be improved, adequate supports must be in place and the program must be fully funded to its authorized level.  Also, social workers who care for children and families must receive adequate salaries, appropriate training and manageable case loads.  Further, States must make diligent efforts to reduce the disproportionality of children of color in the CWS.  This concludes my remarks.  Thank you for the opportunity to speak with you today.  I will be glad to answer your questions. 

[The prepared statement of Ms. Hinojosa follows:]

Chairman HERGER.  Thank you.  Mr. Tower to testify.


Mr. TOWER.  Thank you.  Mr. Herger, Members of the board, I would like to thank you for inviting me here today.  I believe that a comprehensive, integrated system of child welfare services that emphasizes prevention, and early intervention, requires a different approach to child protection.  As presently constructed, the child protection system cannot support the values and principles described in the administration of child and family services framework.  This is due in part to the fact that they are not family‑centered.  When we come down to the "waiver program" that Los Angeles, California, has just approved, and several other States have begun to request and been granted, in order to make an assessment of family needs for provision of services while continuing to respond to cases of child abuse ‑‑ and with this it provides in‑home services to the family, services that were not available under the guidelines in the Federal funding as set forth in title IV‑E.  When we come to family support services, the existing system has the same services that the department has recommended to typically every parent.  They are all sent for psychiatric evaluations, counseling, parenting classes, anger management classes.  This is a routine set of services that the parents and children receive.  Frequently, one adult member designated as a potential abuser is forced out of the home as part of the service plan.  What needs to be done is that appropriate and meaningful services need to be put in place, not the same standard that can be used in all cases due to differing issues with each family.  For example, if the children were removed due to unstable housing, then counseling, psychiatric evaluations, parenting classes and anger management classes are not appropriate.  Help with the rent would be a more appropriate approach and maybe funding for some education.  In this manner the parents would be able to make a better living and get back on their feet again.  However, there is no funding in the budgets for this.  There is funding for counseling, psychiatric evaluations, parenting classes, anger management classes, and this money is only there after the children have been removed.  Nothing in the budget exists for preservation.  Even with this there is no real funding for family services.  The funding is earmarked for children services, not family services.  Once again, there is a fault in the funding scheme.  A brief history on reasonable efforts:  In 1980, Congress passed the Adoption Assistance and Child Welfare Act (P.L. 96-272) which in it had a provision for a requirement of reasonable efforts that were required prior to the child being removed.  Federal law requires State agencies to demonstrate that reasonable efforts have been made to provide assistance and services to prevent the unnecessary removal of a child from his or her home and make it possible for a child who has been placed out of home care to be reunified with his or her family. 

Under the Adoption and Safe Families Act of 1997, while reasonable efforts to preserve and reunify the family are still required, the child's health, safety and best interest constitute the paramount concern in determining reasonable efforts to be made.  However, reasonable efforts have been reduced to a boilerplate statement on court orders that are usually typed by the very agency required to perform those services.  This was the checks‑and‑balance system that Congress intended the court to use in certifying that the agency had performed their duties.  However, this failed and there are no protections for the families and no consequences, or minimal consequences, for the agency's failure to fulfill this requirement.  The bureaucracy is forever in a high state of flux.  Caseworkers, attorneys general, commissioners, governors and all employees in between are forever flowing through the system faster than they can adequately move up the effective learning curve.  This learning curve, which has proven to be longer than the average turnover time of most positions, takes on a course of its own contrary to the intent of our Federal and State lawmakers.  The majority of human and financial resources are eaten up with activities that have nothing to do with reasonable efforts for family preservation, but more to do with the daily task of managing chaos and cover‑ups within a highly dysfunctional organization.  I would like to challenge this Congress to set aside the time required to hear from the parents that would be able to make it to Washington and hear from your constituents what the system is really like and how it performs, to see how the system impacts the families it touches and how the funding under this bill works from the families' points of view in order to get a true measure of what is going on here.  Thank you.

[The prepared statement of Mr. Tower follows:]

Chairman HERGER.  Thank you.  Ms. Goldsmith to testify.


Ms. GOLDSMITH.  Mr. Chairman, Members of the Subcommittee, on behalf of the CORE, the Coalition for Residential Education, I want to express our deep appreciation for your openness to considering additional ways to serve children in the CWS and, specifically, for mandating proposed legislation to expand and strengthen the range of existing services to improve child outcomes.  I thank you for that.  These children deserve the best.  They deserve what we want for our own children.  My name is Heidi Goldsmith, and I am Founder and Executive Director of CORE, the Coalition for Residential Education, the national nonprofit organization that promotes residential schools for disadvantaged children and youth.  For 13 years we have been helping communities across the country open new boarding schools for these children and strengthening existing ones, new boarding schools such as San Pasqual Academy in San Diego, which opened in 2001 specifically to serve adolescents in the foster care system.  They just had their graduation last year and of their 23 graduates, 16 went on to college, five went into the military, and the other two got jobs.  Those are the outcomes.  Those are the kind of programs we represent.  The number of developing and existing programs that want to serve children in the foster care system is growing slowly but surely, but it is growing and we need your help.  Approximately 23 percent of the students currently in our program are from the foster care system, another 12 percent of these children were homeless when they entered our programs. 

"Residential education" is an umbrella term; it encompasses boarding schools, residential academies and the newest iteration is residential charter schools.  In these settings the children ‑‑ they are education‑focused settings; they basically serve healthy children from troubled homes ‑‑ the students receive a quality education, live with positive adult role models, take advantage of after‑school activities like sports clubs, the arts, community service, leadership programs and more.  They learn social skills like conflict resolution.  They gain a more positive sense of what their lives can be.  Values and lessons learned are consistent 24 hours a day.  What they learn in the dorms or in the family homes are reinforced in the schools and vice versa.  Siblings in large sibling groups can remain together.  The average length of stay, by design, is longer.  It is 2 years or more, much longer than emergency shelter or group homes, which this option is often frequently mixed in with.  These children see these places as their second home often and not yet one more short‑term program to be rushed in and out of.  As a result, there is a reduced number of placements for children in our programs; they go through fewer foster homes.  Somebody mentioned earlier 40 to 50 homes.  They go through much fewer because they can stay in these programs longer, and therefore their education is much more consistent and that leads to better outcomes in life.  The prevailing philosophy and the proposed legislation contends children are best raised in safe, loving families, and we agree.  The children we are talking about today do not come from such homes.  What they need now is not what looks like a family, they need something that behaves like a safe, loving family, and that doesn't have to be just a regular, traditional, foster care family; it can be a larger setting.  Residential schools:  For instance, two‑thirds of our children in the residential schools live with a married couple who live with six to ten boys or girls.  Others live like they do in New England boarding schools. 

I urge you to add the residential education option as an alternative clearly and specifically available to judges, social workers and other child advocates, who are often desperate to find a good, wholesome placement for their kids.  I contend residential education is a first and effective option which we need to expand.  The effectiveness of residential education has not yet been evaluated, and I urge the evaluation of residential education, but we do have one statistic and that is our graduation rate.  In 2005, we assessed our member programs:  79.5 percent of the 2,000 graduates went on to college, another five percent enlisted in the military.  Pretty impressive.  My second contention is residential education is cost‑effective.  On the surface, residential education is more expensive than traditional foster care.  It is about $35,000 a year; that is for their education and their home living, counseling, after‑school activities, et cetera.  Compare that to where some of the children may end up in the juvenile facilities.  In about half of most juvenile delinquency programs it is a third to a fifth of residential treatment programs where some of these children are often placed, because there are no other good residential placements for them.  Another reason why this is extremely cost‑effective for taxpayers is, a majority of the funding for these programs is private dollars.  Some, like the Milton Hershey School, the Glenwood School in Chicago, they don't even want any funding, any public funding.  We are in favor of a range of options.  We are for family preservation, adoption and traditional foster care, but one size does not fit all.  Parents who live in nice, safe neighborhoods often have the financial means to send their children with pride to residential prep schools.  At‑risk children deserve the same.  If you will permit me one more moment.  There is, however, a group that is trying to preclude these services.  They have brought about consent decrees in Tennessee and Georgia precluding any children in foster care systems from entering our programs.  I ask your assistance in stopping this by adding residential education clearly and specifically for children in the foster care system.  Some cling to an old image of warehouses, orphanages, et cetera.  That is not the case.  I appreciate that the red light is on.  Thank you very much for opening yourselves to this option for children.

[The prepared statement of Ms. Goldsmith follows:]

Chairman HERGER.  I thank each of you for your testimony, and I will turn to the questions.  The gentlelady from Connecticut, Ms. Johnson, to inquire.

Mrs. JOHNSON.  I just thank you all for your input.  It is very impressive, all the things that are going on out there.  Mr. Wexler, I was amused at your testimony.  We are from opposite sides of the aisle, but I have been trying to say what you said so eloquently for a long time and I hope that all of you will take really seriously the downward projectile, downward slope that Federal funding is on by formula.  It is automatic.  It is just going to happen.  If we don't wake up, we can't capture those dollars.  We do need to make some major turns in the system, and we need to find words that don't sound like "block grant."  We can't let this money keep drifting out of the system for all the wrong reasons.  I appreciate some of the concrete suggestions you have given us today and hope we can move forward. 

Mr. WEXLER.  I think that is a very important point.  In Florida where they have just received one of the waivers to do it the way that the flexible funding option would allow, some of the agencies in Florida say we have to give back the money at the end the year because it is only usable for foster care; and if we do a good job and we don't put the children needlessly in foster care, then it just goes back, and we can't use it to build our infrastructure of prevention.  Also, I think the point you make about the decline due to the technology term as eligibility look‑back is very, very important.  People talk about how you can cut a block grant.  Well, if you don't take away a whole bunch more kids ‑‑ and I hope nobody would do that ‑‑ it is automatically being cut now and it is in fact, if one were inclined to cut an entitlement, just as easy to do that.  You just say instead of "X" cents on the dollar for each eligible child, you say "X minus ten."  It is really as easy to cut.  Not only that, ironically one of the complaints about the flexibility plan is that it locks States in for 5 years.  I don't think critics can have it both ways.  You can't say on the one hand, Watch out, you are locked in for 5 years, and then on the other hand say, Your money is going to be cut.  If you are locked in for 5 years that means you are guaranteed the Federal money for 5 years. 

Mrs. JOHNSON.  Part of that is to try to prevent the decline that the declining number of cases will just simply carry with it.  I don't understand why more States haven't taken advantage of the waiver, because they must surely see this and they are desperate for money to increase local services and they can see that those do discourage placement.  I don't understand why once we put the waiver there more of you didn't stand up and do something about it.  The only explanation I can think of is that you are just as tubularly oriented as services at the local level.  It is all about pipelines and not about children. 

Mr. TOWER.  Los Angeles, California, after they were granted that waiver, right to start with, they had a decline of over 5,000 children in L.A. County alone.  That shows you, that is proof in the pudding that the waiver system will work.  I believe that what we need to do is take some of the money that we are saving on that end and put it into an incentive program not for how many children go into adoptive care, but how many children are reunified with their parents.  There ought to be an award there greater than the one over here to adopt them, okay?  It is where we should be spending our money.  Let's put the family together, okay?  Let's not just keep sheltering them so we can continue spending the Federal Government's money through the adoption assistance and the continued funding streams.

Mrs. JOHNSON.  My understanding is if they have a waiver and they put fewer people in foster care, they don't lose the money, right.

Mr. WEXLER.  What Florida and Michigan and counties in California now have is basically roughly something very, very similar to the Bush administration, flexible funding option.  They get the money as a lump sum.  They can keep using it for foster care if they want, but they can also use it for safe proven alternatives.  By the way, that is the other key thing about the Bush plan.  In effect, it is the ultimate waiver because it is purely and strictly voluntary for the States. 

Mrs. JOHNSON.  Are those programs far enough along so we can do evaluations? 

Mr. WEXLER.  No.  We cannot do evaluations of the specific waivers just granted because they have literally been just granted.  However, the experience of the State of Illinois, which swam against the tide and crafted its own system of reversing financial incentives, is striking.  There was a time when Illinois had one of the worst systems in the country, 51,000 children trapped in foster care on any given day.  They changed the financial incentives, and lo and behold, the intractable became tractable, the dysfunctional became functional.  Today there are fewer than 18,000 foster care trapped in foster care in Illinois, and most important, independent court‑appointed monitors have found that the children are safer today, and the person who brought that lawsuit Ben Wolf, Illinois branch of the ACLU, said the linchpin, the key factor ‑‑ not the only factor, but the key one ‑‑ was changing the financial incentives. 

Mrs. JOHNSON.  Thank you. 

Chairman HERGER.  The gentleman from Washington, Mr. McDermott, to inquire. 

Mr. MCDERMOTT.  Thank you, Mr. Chairman.  Mr. Bell, you had some experience in New York City before you came to Casey.  Tell us how it worked and how you ‑‑ what it took to make that program work.  Casey didn't go get you because you were a failure in New York.  They went to get you because you were making it work.  I would like to hear what was going on there in that political system that made it work. 

Mr. BELL.  One of the things I would say is that New York City also saw a significant reduction in a child welfare population, and it occurred, I would say, in spite of the fact that we were operating under a block grant in New York City, in New York State.  I say in spite of the fact because New York City made significant financial contributions of its own resources into the CWS, and I would say that there are a series of reasons why the system changed.  The first and foremost was the chief leader, the chief politician decided that he owned the issues of child welfare and that child welfare was just as important in his administration as the police department, just as important in his administration as the fire department and just as important as the education department, and resources and talent were contributed and invested in that arena.  He also stood and spoke about the amount of time that it actually takes for a system to turn around.  I said in my oral statement that ACS was created in 1996 in New York City and 1998, the system looked pretty much the same because it was that time period that we used to build a foundation for change.  The foundation for change included investing in the frontline case staff. 

Mr. MCDERMOTT.  What way?  Paying higher salaries or sending them back for additional education or what? 

Mr. BELL.  A combination of both of those things and others.  One is we had a system where anyone with a degree in anything could become a child protective, child welfare case worker, and it essentially meant you could have a banking degree, you could have an architectural degree, all wonderful degrees, but they are not human service degrees.  The first thing we did was to pass a regulation that said, you must have a social work degree or a relevant human services discipline in order to become a case worker.  It also then focused on who could ‑‑

Mr. MCDERMOTT.  You supplied money for them to go do that? 

Mr. BELL.  More than $600 million was added to the budget over the course of the first 6 years of reform in New York City. 

Mrs. JOHNSON.  Would the gentleman yield? 


Mrs. JOHNSON.  Do you mean the $600 million was added for kids to go back and get degrees in social work? 

Mr. BELL.  The entire reform package in New York City in which a portion of that was a scholarship program for 200 of our workers.  We instituted a program that said there would be a hundred new applicants entering into the schools of social work in New York City, coming out of child welfare every year, and there would be a hundred continuing social work students coming out of child welfare with degrees that were being paid for by New York City.  They were degrees that cut the gamut, degrees at Hunter College, which ran a couple thousand dollars and degrees at Columbia, which ran significantly more than a Hunter College degree, but the incentive was to get people who were trained in dealing with complex human issues.  We also, in addition to the social work requirements, had requirements for supervision, and we essentially indicated that in order to be supervisor in the agency you needed to have at least 30 credits towards your master's or have a master's.  Because of our union and civil service issues, we could not require a master's in social work to get the supervisory position, but we also changed a reporting process which essentially allowed social ‑‑ supervisors to pass a court team and become a supervisor.  We instituted a process where merit and performance became ‑‑ who became supervisors in the system.  The investment in the frontline in supervision basically changed who was interacting with the families on the frontline.  We implemented ‑‑ as we talked about increased salaries, but there was also a pay scale.  We began to recognize one thing, you have to control how much work an individual has if you expect to get the quality outcomes.  We reduced caseloads from over 30 cases per worker down to about 13 cases per worker.  Just for an example, if you have ten children on your caseload ‑‑ and I applaud your movement to mandate 90 percent in child visits.  I think it should be 100 percent, and I think that every child should automatically expect that if they are in the care of the Government, that the Government is going to see them and make sure that they are okay.  That then requires a commitment of resources to do that.  If I had ten children on my caseload, not only do I have to have child visits, I also have to have parent contacts.  I also have to talk to service providers.  I also have to talk to the collaterals, like the doctor who was saying I don't hear back on what is going on in the cases.  I have to talk to the schools.  I have to go to court on those cases.  I have to have supervision.  I have to have training, and I have to have documentation.  If we just simply looked at a caseload of ten children, that could add up to 80 hours per month in order to meet the needs of those ten children.  If you then doubled that to a caseload of 20, that comes up to 145 hours.  If you get to 30, that takes you over 210 hours.  There are only 160 work hours in a month, and those things that I just listed do not include lunch, do not include sick time, do not include personal family emergencies that might take a person away.  One of the things we had to commit to in the city, we would stand behind workers and give them the opportunity to do a good job.  You cannot expect the kind of outcomes we want for our children by giving someone 40 children to work with.  The challenges in the city went from political will and leadership, competent leadership in the program investment in the frontline staff, data‑driven accountability where we knew what was going on in every case and workers knew we knew what was going on in every case, and then having the time to engage cross systems because child welfare can't do it alone.  You need the courts, you need the education, you need substance abuse, you need medical and having the community engaged.  These children live in communities, and we have to have community residents engaged in the process of protecting their own children, and that is the picture of what we had to employ in New York City in order to be able to get the changes that we saw. 

Mr. MCDERMOTT.  Thank you.  Thank you, Mr. Chairman. 

Chairman HERGER.  Thank you very much.  The gentleman from California, Mr. Stark, to inquire. 

Mr. STARK.  Thank you, Mr. Chairman, and I would like to thank the panel for their work in preparing this for us, and I would like to engage Professor Hatcher in a couple of questions here because we have ‑‑ we are trying to draft some legislation which perhaps would move toward solving some of the problems that you present in your testimony.  Some of the things I would like to get your comment on, and this is the concept that maybe somehow these kids who got either Social Security benefits or SSI are rich kids.  No way they are going to have the funds to get into Ms. Goldsmith's program at $35,000 bucks a year.  They are going to get a couple hundred, $600 maybe tops. 

Mr. HATCHER.  That is right. 

Mr. STARK.  Yet we are dealing in a system where we deal here on this Committee, for instance, in the question of qualifying under Medicare, we don't deal in this Committee but we deal in the Congress under Medicaid, so if you are old and my kids want to shove me in a nursing home, they have got to figure out how to get rid of my savings account or I am going to qualify for Medicaid.  We have a standard.  You have to impoverish yourself to participate, and I want you to tell me if I am on the right track.  I don't think that should apply to kids, and once I get into the nursing home and croak, the kids could ‑‑ I don't need it anymore.  Once the kids graduate from ‑‑ mature out of a foster program, as you point out, they maybe have needs for a car, a start to buy some clothes to go to work, to go get vocational training, what are they, 18, probably denied some of the support that you get out of living in a home with your parents and maybe needing some extra help.  If a child went into the foster system say, and it had received a life insurance policy, benefits because their parents had some kind of small life insurance policy, wouldn't the courts set up a custodian or a trustee or conservator to manage that?  Would the foster service be able to get ahold of those funds? 

Mr. HATCHER.  Well, generally, yes.  In most States there would be a guardianship, a guardian to set the property of the child. 

Mr. STARK.  Would the guardians automatically have to turn that money over to the foster care system? 

Mr. HATCHER.  No.  In fact, if anybody else was the representative payee of the Social Security benefits, they cannot ‑‑ and the Supreme Court has indicated this ‑‑ they cannot be forced to pay over those Social Security benefits. 

Mr. STARK.  I have to fill that out for my kids.  The thing each Social Security ‑‑ they want to know what I did with the money. 

Mr. HATCHER.  Essentially, we are talking about children who are either ‑‑ they are poor and disabled or they have parents who are now dead or disabled themselves, those parents worked enough quarters to pay into the system to earn Social Security benefits. 

Mr. STARK.  Might also be old, I hate to tell you, but that doesn't happen all that often.  At any rate, I guess what ‑‑ and I would ask Ms. DeSantis, what did you do in Delaware under Governor Castle?  Did he stop this practice of letting the State of Delaware take Social Security payments? 

Ms. DESANTIS.  Yes.  To my knowledge, that practice has been stopped in the State of Delaware. 

Mr. STARK.  You are not suffering from it? 

Ms. DESANTIS.  No, sir.  We have a Governor who is very committed to supporting our children. 

Mr. STARK.  I just want to establish here, these are not rich kids.  Now, if every child who went into the system would have some kind of savings account to be added to through SSI or Social Security, I think that would be wonderful, but I don't know if we should penalize those children who are either unfortunate enough through disability to need it, certainly in that case we shouldn't take it away from them because obviously they need assistance to mature into an adult life.  Let us just say the children who are fortunate enough for one reason or another to get SSA payments, as the illustration in your testimony, which I would commend to my colleagues, I am trying to establish that we should allow them to maintain that it isn't ‑‑ not going to get rich on it, but it may help them to mature into a useful adult life.  I hope that ‑‑ are there any of you here who have run into this in other States where this is done?  My time has expired, Mr. Chairman, but are there any witnesses who think we ought not to let the child hang onto their SSI or SSA payment?  I dare you.  See, Mr. Chairman, they all want ‑‑ how do you like that?  That is unanimous.  If you and I can get together like that, we would have a hell of a bill, wouldn't we?  Thank you.  Thank you, Professor Hatcher, for taking the time to come here and explain this problem, and hopefully we can make a step to solve it. 

Chairman HERGER.  Thank you very much.  The gentleman's time has expired.  Mr. Wexler, I think your testimony can be summarized on this one line from page four.  Your testimony quotes, "Safely reducing foster care should be an end in itself, and it is a noble end, for it will spare thousands and thousands of children the emotional torment of separation from everyone they know and love."  For anyone on the panel who would care to respond to this statement and how States are working to reach this goal.  Yes, Ms. DeSantis. 

Ms. DESANTIS.  Thank you, Mr. Chairman.  In the State of Delaware, we agree that the best place for children is in a loving family.  That is not always the case, as we all can acknowledge.  In our State ‑‑ we are one of the handful of States that are lucky enough to have child mental health services in the same department under the cabinet level department with child welfare, and one of the things that we are doing, we have been doing over the past several years, is to work very closely with our child mental health experts to provide behavior and mental health assessments for every child that comes into foster care.  This is a great step forward for the children who we know have been traumatized in some way or another.  We are also working very closely with our colleagues in the communities with our faith‑based organizations and what is called the 21st Century Service Delivery Approach or a System of Care, which is an emerging practice that is ‑‑ a lot of research has been done by Sheila Pry and folks at Georgetown University.  It is a demonstration project that has been done around the country.  We are doing very well with that, and we believe that engaging the entire community and raising our children in helping support the families and the children in care, these methods will go a long way toward reducing the number of children who need to be in out‑of‑home care.  We have to keep in mind that it is not necessarily the number of children in care, but that it is the appropriate children that are in out‑of‑home care because we found ‑‑ we also have in our department level ‑‑ the juvenile justice children were also in my department, and we found that juvenile justice children who were dependent were treated differently than children in child welfare.  By having that knowledge and being able to bring the child welfare expertise to the children coming out of the juvenile justice system, it has actually increased the number of children under the traditional child welfare numbers, but it has enabled us to embrace those children, provide most appropriate placements for them, and better placements and better services around that child and the family to a greater extent, and so I would keep in mind that we just not count heads but that we count outcomes when we are talking about children that need foster care or any kind of family care. 

Chairman HERGER.  Anyone else wish ‑‑ Mr. Tower? 

Mr. TOWER.  Yes, Congressman Herger.  Basically the removal of the children ‑‑ okay, the way that the departments are doing it is they are traumatizing the children right from day one.  They will storm a house with two case workers and a half a dozen police officers.  They go in, they grab the children.  I have seen and heard of cases where they maced an 8‑year‑old girl and handcuffed her and handcuffed her ankles because she was kicking and screaming, she didn't want to be taken away from her mother.  Okay.  The little girl went to the hospital with mace burns around her eyes.  This is how ‑‑ and this is what they are doing in some of these cases.  This boils down to they are going in and using a bomb when a bullet would have done the job.  Okay.  If they went and talked with the parents a lot of times, the necessary ‑‑ it wouldn't be necessary to remove the children.  The parents would be willing to work with them, but the way that it works now is people are absolutely petrified to even let the department in the door of their house because they have gained the reputation that they storm in, they grab the children, and they run.  From there on out, it is ‑‑ someone made the analogy ‑‑ I was sitting on a hearing Saturday in San Jose for CCHR, and someone made the analogy that this goes back to ‑‑ it is kind of like the movie where the little kid got sucked into the TV screen, the name of that movie was Poltergeist, and it was a fight forever more to get that little girl back out of that screen.  You know?  It covers how the system has been operating in a lot of cases. 

Chairman HERGER.  Thank you.  Mr. Bell. 

Mr. BELL.  Chairman, a number of focus has been on looking at where the decision gets made to bring children into care, and so a lot of the reform has focused on what is happening with child protective investigators and how are they making the decisions that children should come into care and how are we equipping them to make better decisions.  I think the first step that this is rooted in a community‑based approach to care where we are targeting particular communities.  In New York City we found that 18 of the 59 community districts produced 60 percent of the kids who came into foster care, and we targeted our efforts on looking in those 18 community districts to determine what was happening with families.  We aligned our staff in those communities, same staff working in the communities.  We contracted with a not‑for‑profit agency and assigned them solely to those communities so the communities had an opportunity to get to know the providers in that community and our child protective staff had to become accountable to the families that they were actually removing children from.  We then equipped them with decision‑making tools, like family group decision making, which is a model that brings families in to sit down and talk with workers.  We set up two approaches, one which was a pre‑removal conference which said, I feel like something is going on in this family.  What are my options?  We said to the worker, your first option and only option doesn't have to be placement.  Bring the family in, bring community supports with their family.  Sit down with facilitators and social workers and determine how best to build on family strength, as opposed to children coming into foster care.  We also set up a counterconference to that, which was a post‑removal conference, and we said in every situation where you have made this critical decision that a family had to be separated, within 72 hours of making that decision you needed to have the family sitting at a table with you and others to examine why that decision had to be made and what the alternatives might be in terms of getting those children back home quickly.  We looked at data that suggested that we had children who were coming into care and 25 percent of them were going home in the first 90 days.  So from our perspective, that may have suggested that those children didn't have to come into care in the first place.  One major piece is looking at the decision makers and really supporting them and encrypting them with tools to maker better decisions.  One of the things that we did I think was essential, we created what we call a Quality Case Practice Guide for Child Protection, which essentially defined what a quality child protective investigation looked like for everybody.  There was one standard, and we didn't have different workers creating different standards when they were going into homes.  We held everybody accountable to the same standards, and I think that has made a significant difference in reducing the number of kids coming into foster care. 

Chairman HERGER.  Thank you. Mr. Wexler. 

Mr. WEXLER.  We have an item on our website, 10 Ways To Do Child Welfare Right, which is a brief interview with contacts, and I also have a hard copy here that indicates the model programs that have been successful and also the model systems that have helped to make the dramatic transformations.  I mentioned Illinois.  New York City is on that list, thanks to the outstanding work of Commissioner Bell and those who proceeded and followed him.  Another has already been mentioned here, Pittsburgh, Allegheny County, Pennsylvania.  In fact, I don't know what the logistics are of moving an entire Subcommittee, but if you held a hearing there and brought together all the people who have made Pittsburgh a success, I think you would find all sorts of fascinating things about what really works.  Drug treatment is crucial to success, particularly treatment programs in which parents are allowed to stay with their children.  That is what we ought to do with the orphanages, make them residential drug treatment campuses where parents can live with their young children.  That kind of treatment has the best record of success, and every day we are getting more and more indications that methamphetamine addiction is just as treatable as any other.  Also, strengthening due process protections for families.  An institutional provider of legal counsel for birth parents, which has been crucial to some of the other reforms in New York City, such as the outstanding bridge builders projects in the hybrid section of the Bronx, that kind of institutional provider would go a long way.  You can see these things make a difference when you look at the extraordinary differences in how many children are taken away from State to State.  There is no logical reason why Iowa should be taking away children at a rate seven times higher than neighboring Illinois, and yet that is what happens.  There are vast disparities within counties in individual States.  The one thing the successful programs have in common is that they emphasize safe proven programs to keep families together.  The places that emphasize the take‑the‑child‑and‑run approach fail time after time after time.  Finally, since you quoted that section from my written testimony, I should explain why I felt compelled even to say that.  Unfortunately, one of the groups that is leading the opposition to the flexibility plan, one of their leaders, an outstanding child advocate, someone who has been one of my heroes over the years but whom I strongly disagree with on this point actually said to the trade journal Youth Today that reducing the number of children in foster care shouldn't be an end in itself.  I couldn't disagree more. 

Chairman HERGER.  Mr. Tower. 

Mr. TOWER.  Basically most of the problems in the Child Protection System could be summed up with a very simple phrase, the Department needs to do a proper, and the key here word here is "proper," proper investigation prior to the removal of the children, and at that point reasonable efforts should come in.  Okay, Congress never gave the States a definition of what constitutes reasonable efforts, and it is a flaw in the system because everybody has got their own little ways, and like California, you know, 58 counties, they interpret it 58 different ways.  Reasonable efforts should be mandatory, okay, that that finding be made before ‑‑ because that is how they get the Federal funding.  That statement has to be made.  It is a judge's signature on a piece of paper, basically. 

Chairman HERGER.  Right.  Thank you.  Gentlelady. 

Mrs. JOHNSON.  We have a very ‑‑ a modest piece of legislation before us that is at least bipartisan, but when I hear what you have done and what programs are out there and how successful they are, you know, if the waiver is too much for States to take on, you know, what is the next step?  What else is it we could do?  What changes could we make in this law or a combination of laws to open a window for States to think this way or to set different criteria?  If we meet these criteria, we waive all of these other requirements in the law.  You know, it seems to me over and over again, we have had ‑‑ we have had a hearing here, I think about 2 years ago, that showed that none of the States were doing all the stuff we are asking them to do anyway.  I think five States were doing everything we were asking.  Maybe it was three.  We have States putting in an enormous amount of effort into complying with stuff that doesn't seem to matter much anyhow and then we have other States doing remarkable things, paying for it themselves outside the system.  Now, you all know the laws better than I will ever know them.  You know the money flows better than I will ever know them.  The best I can do is just waive the whole thing and do the ‑‑ you know, and we will keep your money whole, but you know that didn't work.  We need for you to think about ‑‑ at least I need for you to think about what else could we do?  What is the criteria we could set?  You meet this, you do this, and, you know, we will let your money cut, but also we will relieve you from all of this other stuff.  See, I don't know the system well enough to make those trade‑offs.  Even when you know the system well enough, as I do in Medicare, it is still mighty hard to get the motion moving.  I really invite you to pursue this.  It has been a very excellent hearing, Mr. Chairman.  I thank you and the staff on both sides of the aisle for getting two very good panels together.  It is an issue we have kind of let lie fallow for a few years, and I see that you have really accomplished a lot.  You know a lot more than we used to know, and I appreciate your expertise and your dedication.  Thanks. 

Chairman HERGER.  I thank the gentlelady, and I would like to thank each of our witnesses for taking the time to appear before us today.  I would like to point out that Subcommittee Members may follow up with additional questions, and I would ask that you please reply to these questions forwarded to you in writing so that they may be included in the hearing record.  I appreciate your help and comments on this issue.  I look forward to working with all of you to improve our Nation's child protection programs.  We know that finances are a challenge here in Washington, as they are in each of the States.  Therefore, any ideas we have that we can work within the funding that we have to make the system work better certainly would be appreciated.  With that, the Committee stands adjourned. 

[Whereupon, at 4:33 p.m., the hearing was adjourned.]
[Questions submitted from Chairman Herger to Ms. Ashby, Judge Cohen, and Ms. DeSantis, and their responses follow:]

Questions from Chairman Wally Herger to Ms. Cornelia Ashby

Question: The 2003 GAO report notes on page 2 that states reported using Child Welfare Services funds primarily to staff and administer child welfare programs and serve families in the foster care system, whiles states reported using Promoting Safe and Stable Families funds primarily for prevention and support services for families at risk of child abuse and neglect. What accounts for the difference in how states use these funds? Does federal policy drive state decision-making? If so, how?

Answer: Federal policy accounts for differences in how states use Title IV-B funds in that the law requires states to spend a “significant portion” of their Promoting Safe and Stable Families (PSSF) funds on the four service categories related to family preservation services, family support services, time-limited family reunification services, and adoption promotion and support services, while states do not have these restrictions on Child Welfare Services (CWS) funds. In fiscal year 2002, states reported spending more than 80 percent of PSSF funds for family services in these four categories. States chose to also use over 14 percent of CWS funds on family services; however, nearly 45 percent were used to help pay for the cost of administering state child welfare programs, including caseworker salaries. One HHS regional official noted that CWS gives states the flexibility to address unexpected circumstances, while other regional officials noted that spending requirements under PSSF helped ensure states used some funds for family support and prevention needed to preserve families and keep children from entering foster care.

Question: What do we know about the effectiveness of the services provided under the Child Welfare Services and Promoting Safe and Stable Families programs? Do they have an established track record of better protecting children or otherwise improving child wellbeing?

Answer: Research on the effectiveness of services provided under CWS was limited, and HHS evaluations of two PSSF services showed no or little effect on children’s outcomes. Our survey of states in 2002 showed that none had evaluated the outcomes of their CWS services. Similarly, our literature review showed that few evaluations had been conducted, and evaluations that had been conducted produced mixed results. HHS evaluations of family preservation and family support services under PSSF showed no or little effect in reducing out-of-home placement, maltreatment recurrence, or improved family functioning beyond what normal casework services achieved. No similar large-scale evaluations of time-limited reunification services or of adoption promotion and support services have been made.

Question: Last year, we provided states approximately $700 million in funding under these two programs. What happens to Child Welfare Services and Promoting Safe and Stable Families funds if states don’t spend the money each year? Can states “save” funds from one year to the next? If states were allowed to carry over these funds for longer periods of time, is there any reason to believe we could expect better spending decisions?

Answer: States may spend funds allocated to them under CWS and PSSF until the end of the fiscal year immediately following the fiscal year of appropriation, and HHS may reallocate any unspent funds to other states for spending in that same fiscal year before returning them to the Treasury. A cognizant HHS Deputy Assistant Commissioner said that during the last fiscal year, three states did not spend their entire CWS and PSSF allotments because they could not come up with the required state match or faced other state budget issues. This HHS official added that because the states did not release these funds in time to be reallocated and spent by other states within the fiscal year, the unspent funds were returned to the Treasury.

Question: The intent of these funds is to support services that assist at-risk families, protect children from abuse and neglect, and prevent the unnecessary separation of children from their families. The GAO report found with regards to the Child Welfare Services program, nearly half the grant—44% of the funds were for program operations rather than for direct services to prevent abuse and neglect. Do you have any estimate as to what percentage of these administrative expenses are for caseworker salaries to provide supportive services versus other administrative costs that may not be applicable to the true intent of this program?

Answer: States reported that about 40 percent of administrative expenses under CWS in fiscal year 2002 were for staff salaries supporting caseworker positions either in child protective services (29 percent), or other offices (11 percent). The remaining 60 percent of administrative expenses were for administration and management (38 percent) and salaries supporting other staff (22 percent) including those providing supervision of caseworkers and legal services.

Questions from Chairman Wally Herger to Judge Constance Cohen

Question: You mentioned that there has been widespread interest in communities outside of Des Moines, Iowa. Do you know if any States are currently using either Child Welfare Services funds or Promoting Safe and Stable Families funds to support Court teams?

Answer: There certainly has been widespread interest among juvenile and family court judges in starting a Court Teams project for maltreated infants and toddlers; however, I know of no other states that are presently utilizing Child Welfare Services funds or Promoting Safe and Stable Families funds to support Court Teams. One Court Team in Texas received a small amount of support from the Court Improvement Project to attend a national judicial conference to learn about the needs of maltreated young children. Our Iowa Court Improvement Project will support attendance at the National Council of Juvenile and Family Court Judges Annual Conference for four judges. Our Court Improvement Project also provided funding for Iowa judges to attend a statewide interdisciplinary conference on May 17, 2006, in Des Moines. The event was a day-long training focused on issues involving maltreated infants and toddlers. Speakers included the founders of the original Court Team: Judge Cindy Lederman and Dr. Joy Osofsky. Judge Douglas Johnson, from Omaha NE, a current fellow with ZeroToThree, has received state funding for a project similar to Court Teams. The Nebraska State Patrol has funded his infant-toddler family drug treatment court. The model for the Court Teams approach in Judge Cindy Lederman’s court in Miami-Dade has received funding from the Department of Justice, but not from the state child welfare agency. From my work with the National Council of Juvenile and Family Court Judges, I can assure you that the concept of using a collaborative approach with a judge as the catalyst enjoys widespread support among judges. Increasingly, we are realizing the critical need to focus on ensuring the well-being of our youngest children in the system, who often carry the negative effects of abuse and neglect throughout their lives. Effective early intervention can forge a new path of positive outcomes for these children. Judges are ill equipped to understand and meet the needs of very young children without the ability to tap into the expertise of child development experts. I am aware of other judges who have been laying the groundwork in their states and are poised to utilize any funds made available to replicate the successful Court Teams project in their jurisdictions. They include Judge Douglas Johnson, Omaha, NE; Judge Peggy Walker, Douglas County, GA; Judge Richard Barron, Coos County, OR; Judge Brutinel, Yavapai County, AZ, and Judge Lou Trosch, Raleigh, NC, among others. The lead judges of the Victim’s Act Model Courts are also a natural venue for expansion, as they have existing collaborations with the stakeholders in their respective communities.

Question: Is there anything - other than competition among scarce resources - that keeps States from using more Federal fuds for this sort of coordination?

Answer: 2. Competition among scarce resources, as you suggest, is the principle impediment to expanding the number of Court Teams. Each year we seem to be asked to do more with less. Caseloads continue to rise well beyond national standards. Everyone is concentrating on “putting out fires”, and strategic planning often takes a back seat. For example, Iowa recently had to de-link child welfare and rehabilitative services for children so that they are separate services in order to comply with Medicare and Medicaid requirements. People are scrambling to meet deadlines to fix a system that was not really broken, taking time away from other responsibilities and opportunities to improve the system. I would surmise that the one of the primary reason states do not explore use of more federal funds for coordinating Court Teams begins with a lack of awareness of the need. Exposure to the issue is the first step. Once a judge sees Dr. Osofsky’s video of a depressed six-month old baby, or a one-year old whose face evidences sheer terror when his abusive mother walks in the room, that judge will begin to understand the critical need for information beyond the traditional training for the bench necessary to make decisions. Hence, the Court Teams model, with its track record of successful reunification, needs adequate financial backing to increase awareness among the judiciary. Our current project is committed to creating curricula for joint trainings and developing a clearinghouse of information. The Court Teams initiative is a judicial response based on our perception of how to most effectively carry out our responsibility to ensure the wellbeing of children. Community providers and joint stakeholders are generally responsive to calls for collaboration when they originate with a judge. Judges must be prepared to take a leadership role in system improvement. In many states, such as Iowa, judges are ethically restricted from fundraising and/or publicly promoting programming. Individual Iowa judges cannot pursue grants. Designating funding in the manner that supported the creation of Court Teams in Iowa, Mississippi, and Texas, is an effective way of growing this opportunity. In our case, ZeroToThree was the grantee for funds Congress designated to the Office of Juvenile Justice and Delinquency Prevention. Expansion of this funding would enable more states to become involved. In conclusion, effective, meaningful. and far-reaching improvements cannot occur if judges are not educated and empowered to collaborate. Model Courts and/or Court Improvement Projects could be invited to apply for competitive grants to expand the Court Teams across the country. And, if there were a portion of the Promoting Safe and Stable Families appropriation, or other appropriation, designated for expanding the number of Court Teams, preferably in jurisdictions with a record of collaborative success, such as the Model Courts, that money would be well spent.

Questions from Chairman Wally Herger to Mr. Dennis Fecci

Question: What have some of the States identified as effective and proven strategies to reduce the reliance on out-of-home care and prevent child abuse and neglect?

Answer: The child welfare system provides different levels of assistance to families and children in crisis, based on their needs. Removing a child from home is an option only when necessary to protect a child's safety. Prevention, family support or early intervention to avoid removal %om home are the optimal means of assisting families and children in need of help. The child welfare system can provide intensive in-home services to f W e s whose situation does not require removal of the child; out-of-home services when a child must temporarily be removed from home to ensure safety; and continued services as needed to prevent re-entry into the system after the child has been reunified, adopted, or placed with a guardian. According to the latest available Adoption and Foster Care Analysis and Reporting System (AFCARS) data, during fiscal year 2003, more than half (55 percent) of the children exiting foster care were reunified with parents or primary caretakers. In order to provide services to prevent removing a child from home or to expedite their return as soon as it's deemed to be safe, states have wed Title IV-B dollars to the extent allowable and we appreciate that this is the most flexible source of dedicated federal child welfare funding. When Title N-B dollars are not sufficient, states have invested their own funds and used other strategies to continue providing these critical services to improve the lives of children and families.

In Delaware, a number of strategies have been implemented. We believe that one of the most effective strategies in reducing unnecessary out-of-home placements and maintaining a child safely in the home is to have an adequate number of well-trained, fully functional case workers. To achieve the goal of a trained, motivated workforce, the Delaware Department of Services for Children, Youth and Their Families implemented several states. The State authorized the hiring of additional workers and mandated maximum caseload standards. The Department also established a trainee program that provides a rolling pool of trained workers ready to step into caseworker positions as they become vacant. The Department also increased training and provided pay incentives to Encourage workers to stay in the Investigation units. These measures have resulted in a reduction of staff turnover from some 48 percent in 1997 to about 16 percent over the past three years, and trending toward 12 percent to end FY06. 

At the same time, Delaware instituted timeliness of contact standards; increased funding for parent training; expanded services for low risk families; and strengthened outcomes-based prevention services. In addition, Delaware instituted a joint program with the Department of Education to place Family Crisis Treatment specialists (child welfare workers) in K-3 schools throughout the stale to identify and work with at-risk children and their families to prevent child abuse and neglect. This K-3 program is a proven effective early intervention.

Question: Which States are investing their Child Welfare Services funds and Promoting Safe and Stable Families funds in services proven to reduce reliance on out-of-home care and prevent child abuse and neglect?

Answer: Research in the field of child welfare is only beginning to provide information on which services meet the proven threshold. Additional federal resources are needed to fully assess effectiveness of the variety of programs and services state and local agencies utilize to meet the greatly varying needs of the children and families they serve. As you're aware, Title IV-E waiver demonstration projects include a research component to assess the effectiveness of the services provided. However, waiver authority has expired and states will no longer haw the ability to test innovative ways to provide services. Waivers that have allowed states to use federal h d s for subsidized guardianship, enhanced training, post-permanency services, and others have shown some effectiveness in improving outcomes for the children and families. Delaware uses Child Welfare Services IV-B, subpart 1 funds to help enhance the Department's child protective service continuum in contracted services in the areas of case management, legal services, patent aide and home-based services. Wrap-around services provided include the System of Care principles of child centered and family focused, strength-based and community based, culturally respectful and seamless integration. Child welfare funding also targets child abuse and neglect prevention messages to engage the public in keeping children safe through early intervention methods. Title IV-B, subpart 2 Promoting Safe and Stable Families funds provide statewide early intervention community-based contractual support to deliver family preservation and family support services, agency staffing that provides time limited reunification services to families with children in placement, adoption promotion and support services.

Question: Do you know of States with performance assessments in place to track whether the services they provide are achieving their intended goals as identified by the State?

Answer: We are aware that states are assessing services based on outcome measures that are linked to state goals, PIP goals as well as goals outlined in the Child and Family Service Plan. The Delaware Department of Services for Children, Youth and Their Families (DSCYF) uses the Malcolm Baldrige performance excellence criteria to monitor its performance and improve service to our customers. We developed a Balanced Scorecard to measure performance in four perspectives: Financial Management, Customer Service, Process Management, and Employee Relations. The customer and Process measures are as follows:

1. Percentage of Eligible Children with Integrated Service Plans

2. Percentage of Children with 6 months of Community-based Services requiring more than 5 days in Out-of-Home Care in the following 12 months.

3. Percentage of Children Returned to DSCYF Services within 12 months of Case Closure

4. Percentage of Children in DSCYP Out-of-Home Care Additional measures at the agency level include timeliness of investigation and treatment contacts and the percent of safety reviews that meet criteria.

Question: Do you have any data by State about how much of the Promoting Safe and Stable Families and Child Welfare Services funds are spent on administration, which would include administrative costs such as payroll management, computers, rent, pens, and so on?

Answer: States do track and monitor administrative expenditures within federally approved cost allocation plans. PSSF funds are also reported on standardized forms submitted to ACF. For PSSF, Delaware is to receive $763,292 federal funding in FY 2006, with a required state match of $254,431. The state match is provided by coding a portion of the service contracts to State funds. Administrative costs of $29,052 include non-salary costs of program administration, supplies and materials to support program advertisement, communication, education training and program management. Delaware is to receive $783,705 FFP in IV-B. subpart, for FY 2006. The required state match is $261,235. The match is provided using non-IV-E foster care payments to match the grant. $21 7,025 is used for administrative cost to include personnel charges and indirect costs, etc.

Question: Is there any detailed documentation of how much States spend on child welfare programs using State funds? For example, do you know what States use for matching and drawing down Federal funds, and where those State funds come from? Has the State contribution to these programs, again using their own funds, been changing in recent years? How?

Answer: States have been providing information on state level funding on child welfare programs to the Urban Institute for The Cost of Protecting Vulnerable Children report. The latest edition of that report, version V, indicates that the increase in total spending through FY 2004 was driven by increases in state and local spending rather than federal spending. Detailed state-by-state data can be found in the appendices of the report which can be accessed at In the case of Delaware, state funding for child welfare has grown significantly over the past six years, both in absolute and in relative terms. In State Fiscal Year 2001, total child welfare spending, excluding salaries, was $1 5,094,800, of which 71.1 percent or $10,726,000 were State dollars; federal support accounted for less than 29 percent. The State's dollars come from Delaware's General Fund appropriations and the Children's Department's cost recovery efforts. For the upcoming State Fiscal Year 2007, estimated expenditures for child welfare services are $24,231,900 (up $9,137,100 or 61 percent from State Fiscal Year 2001). State appropriations for child welfare services will constitute $18,633,900 or 76.9 percent of the total; the federal share will be less than 22 percent, which results in a decline of 23 percent in the federal proportional share of child welfare expenditures in Delaware. As costs continue to rise to meet the needs of more children, with more challenging and complex issues coming into the child welfare system in Delaware, an increasingly larger proportion of the burden of meeting these needs is falling to the state. In light of the timeframe given to respond, it was not possible to gather more detailed data from all states. However, I am confident that the Delaware information I have been able to provide will give the Subcommittee insight into how states utilize Title IV-B funds in addition to their own state funds.

[Submissions for the record follow.]


Children’s Defense Fund, Mary Lee Allen, statement

American Federation of State, County and Municipal Employees, statement

Brown, Tim, Waco, TX, letter

Bryan, Barbara, Davidson, NC, letter

Butts, Donna, Generations United, statement

Citizens Commission on Human Rights New England, Boston, MA, letter

Sutter County Sheriff's Department, Jim Denney, Yuba City, CA, statement

Gladwell, Lisa, River Edge, NJ, letter

Groh, Alicia, Voice for Adoption, statement

Haymon, Gail, Columbus, OH, letter

Holder, Helen, Walton, KY, letter

Kroll, Joe, North American Council on Adoptable Children, St. Paul, MN, statement

Mecca, Frank J., County Welfare Directors Association of California, Sacramento, CA, statement

National Indian Child Welfare Association, Portland, OR, letter

Prevent Child Abuse America, Chicago, IL, statement

Shipman, C. Edward, Happy Hill Farm Academy, Granbury, TX, letter