Child Abuse:

Prevention Programs Need Greater Emphasis

HRD-92-99: Published: Aug 3, 1992. Publicly Released: Aug 24, 1992.

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Pursuant to a congressional request, GAO reviewed a variety of child abuse programs, focusing on: (1) the extent to which child abuse prevention strategies have been evaluated and shown to be effective; (2) obstacles inhibiting program implementation and alternative approaches to overcome these obstacles; and (3) the types of programs providing services to prevent child abuse in families, and how those programs are coordinated at the federal and state levels.

GAO found that: (1) studies show that child abuse prevention programs are effective, but future evaluations need to focus on what program works best under what circumstances; (2) prevention programs may pay for themselves by lowering the social costs resulting from child abuse; (3) it could not determine the amount of total federal funding for prevention programs because funds are scattered among many agencies and are not labelled as targeted to child abuse prevention; (4) federal child abuse prevention funding appears relatively low compared to federal expenditures for assistance to victims of abuse; (5) prevention programs have difficulty meeting their funding needs because grants are short-term and come from multiple sources, which increases the programs' administrative costs; (6) efforts toward statewide coordination of prevention programs are hampered by a lack of resources; and (7) only one state has begun implementation of a statewide program, and another has developed plans to do so.

Matters for Congressional Consideration

  1. Status: Closed - Implemented

    Comments: Legislation was passed (P.L. 103-66) in August 1993 that addressed the related recommendation made in a companion report, "Foster Care: Services to Prevent Out-of-Home Placements Are Limited by Funding Barriers," (GAO/HRD-93-76). This legislation amended Title IV-B of the Social Security Act by funding a new program for family preservation and support services. This legislation gives the states, among other things, the ability to fund prevention programs such as those recommended in this report as they relate to family preservation as well as for evaluations.

    Matter: To provide incentives to states to implement and sustain child abuse prevention programs, Congress should amend Title IV of the Social Security Act to give the Secretary of Health and Human Services authority to reimburse states, at foster care matching rates, for the costs of implementing prevention programs. The reimbursements would be provided to states where prevention programs have been demonstrated, through sound evaluations, to pay for themselves through reductions in the incidence of child abuse and the related foster care placements.

  2. Status: Closed - Implemented

    Comments: In 1994, Congress replaced the Challenge Grants program with a broader Community-Based Family Resources Program (CBFRP). CBFRP's purpose is to help states develop systems of family resource services and support a broad range of child abuse and neglect prevention activities. Under CBFRP, states must develop a strategic plan, but there is no requirement for a comprehensive needs assessment. However, the 1993 Family Preservation and Support (FPS) legislation requires each state to develop a 5-year plan; federal rules require that these plans be based on a comprehensive needs assessment. States may use the FPS plan to satisfy the CBFRP plan requirement. According to HHS officials, states have linked their CBFRP and FPS planning efforts. Thus, while Congress did not take action on this recommendation, GAO is closing it because Congress' alternative actions are designed to achieve the same desired result of basing funding and service decisions on child and family needs.

    Matter: To encourage states to develop and implement state prevention plans based on comprehensive needs assessments, Congress should give the Secretary of Health and Human Services the authority to direct any future increases in National Center on Child Abuse and Neglect (NCCAN) Challenge Grants to states that are putting such plans in place.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: Citing two new federal programs with broader implications, HHS did not take action on this recommendation. The CBFRP, enacted in 1994, provides incentive funds for a broad range of child abuse and prevention activities and family resource programs. To receive these funds, states must develop a strategic plan for establishing a network of family resource programs and describe methods for evaluating its implementation. At the same time, the 1993 Family Preservation and Support legislation gives states the flexibility to target new funding where most needed--including prevention activities. In developing their mandated 5-year plans, federal rules require states to conduct a comprehensive needs assessment, set priorities, establish goals, and determine methods--such as rigorous evaluation--for measuring progress in achieving goals.

    Recommendation: The Secretary of Health and Human Services should provide funding incentives, such as through NCCAN, to encourage states to establish and rigorously evaluate programs with the potential for statewide implementation, and promote statewide adoption of strategies that have demonstrated effectiveness and cost benefits.

    Agency Affected: Department of Health and Human Services

 

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