Personal reflections about the work of the U.S. Advisory Board on Child Abuse and Neglect.

Child Abuse & Neglect 41 (2015) 3–18

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Child Abuse & Neglect

Research article

Personal reflections about the work of the U.S. Advisory Board on Child Abuse and Neglect Byron D. Metrikin-Gold 1 4 Hasharon Street, Apartment 8, Kfar Saba 44269, Israel

a r t i c l e

i n f o

Article history: Available online 18 February 2015

Keywords: Ben Zoma Child protection policy Christopher Dodd Cultural change Expert panels National Center on Child Abuse and Neglect National Child Abuse Coalition U.S. Advisory Board on Child Abuse and Neglect U.S. Department of Health and Human Services

a b s t r a c t Created by amendments in 1988 to the Child Abuse Treatment and Prevention Act of 1974 and first convened in 1989, the U.S. Advisory Board on Child Abuse and Neglect issued a series of passion- and research-laden reports that articulated a new neighborhood-based strategy for child protection in the United States. In so doing, the Board went far beyond the vision of its congressional creators, the most relevant federal agencies, and the field itself. The dedication, daring, collegiality, and public spirit of the drafters and ultimately the moral and intellectual power of the reports themselves were awe-inspiring, as was the level of public attention given to the Board’s initial declaration of a national emergency. However, the specific effects on policy were quite limited. Possible reasons for the enormous gap between the strength of the Board’s vision and the weakness of its implementation are reviewed. In the end, the history of the Board may be a case study of a single but notable step in a long process toward redemptive cultural change in the status and safety of children. © 2015 Elsevier Ltd. All rights reserved.

A Few Personal Reflections About the History of the U.S. Advisory Board on Child Abuse and Neglect The life of the 15-member U.S. Advisory Board on Child Abuse and Neglect was brief but sweet. The Board’s output—five reports during the 7 years of its existence (in chronological order: U.S. Advisory Board, 1990, 1991, 1993b, 1993a, 1995)—was small but momentous. From December 1988 until my retirement from federal service in June 1994, I had the extraordinary privilege of serving as the first executive director of the Board. In September 1993, the Board published its keystone report, Neighbors Helping Neighbors: A New National Strategy for the Protection of Children (U.S. Advisory Board, 1993a), which contained its landmark recommendation of a new approach to American child protection efforts. Twenty years after the publication of that remarkable document seems a useful occasion for me both to recount the history of the Board as I experienced it and to consider the lessons that this history may hold for similar efforts in the future. A few caveats at the outset. First, as I set about preparing this document, I realized that the memories I wished to describe were fading. Heightening that problem was the reality that I was working some 6,000 miles from Washington, DC, in a suburb of Tel Aviv, where I have resided since leaving my position with the Board. Unable to confirm the memories that I

E-mail address: [email protected] The author served as the executive director of the U.S. Advisory Board on Child Abuse and Neglect during most of its existence. The opinions expressed are his own. 1

http://dx.doi.org/10.1016/j.chiabu.2015.01.009 0145-2134/© 2015 Elsevier Ltd. All rights reserved.

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B.D. Metrikin-Gold / Child Abuse & Neglect 41 (2015) 3–18

do have, I was without access to whatever records of the Board still exist. Over the years, I have also lost contact with other former employees of the U.S. Department of Health and Human Services (DHHS) who probably have key memories. All of that said, although some of the details that follow may be inexact, I believe that the substance is correct. Second, during the 7 years of its existence (May 1989–October 1996), the membership of the Board changed completely. However, the ideas that drove the creation of the five reports for which the Board is justly known were set in motion early in its history by its original members. Therefore, without any intent to demean the contributions of the individuals who replaced the original 15 members, this article focuses on the experiences I shared with the original members. Third, this article is not an analysis of the overall efforts of the United States government to address the problem of child maltreatment. Others are far more qualified by virtue of expertise and experience to take on that task. Rather, this article is the product of personal and somewhat incomplete musings by a central actor in an interesting and crucial moment. That limitation aside, I hope that the article will illuminate the possibilities and pitfalls of structures and processes intended to enhance external experts’ engagement in making and administering child protection policy. How the Board Came To Be The Board was established by statute in 1988 in amendments to the Child Abuse Prevention and Treatment Act of 1974, commonly known as CAPTA, which created the National Center on Child Abuse and Neglect (NCCAN) within the U.S. Department of Health, Education, and Welfare (now DHHS) and which set the initial agenda for federal action in the field of child protection in the United States. The principal functions of NCCAN were to administer grant programs, support research and demonstration projects, and serve as the focal point for federal child protection efforts. The law also provided modest funding for child protection programs in state governments, in return for action, which all states had already taken, to enact laws for mandated reporting and investigation of suspected child maltreatment. (For an account of the enactment of CAPTA and related early activities in making federal child protection policy, see Nelson, 1984.) Prior to the initial enactment of CAPTA, the emerging coalition of organizations concerned with child protection proposed the creation of a council to advise NCCAN and to consist of officials of other federal agencies. (Howard Davidson, a future chair of the U.S. Advisory Board and the long-time staff leader of the American Bar Association’s activities related to children, recalls having attended the coalition meeting in 1974 when the idea was first discussed.) The relevant provision was indeed included in the statute as enacted. The adoption of CAPTA energized the National Child Abuse Coalition, which became increasingly important in reauthorizations of the legislation. By 1987, dissatisfaction of the Coalition and the Congress with the federal executive branch’s performance in child protection reached a sufficiently high point that a major overhaul of CAPTA was enacted in 1988 (Pub. L. 100-294, Section 3 of which created the Board). The source of the idea for an ongoing, comprehensive, external review of federal child protection policy is not clear. In 1987, the pertinent report of the House Committee on Education and Labor stated: The current structure of the Advisory Board [the committee of federal agency officials created in 1974 to advise NCCAN]. . .is a major reason why it has failed to provide the technical assistance and guidance for the Secretary envisioned in the Statute. In response to this situation, the Committee has recommended the establishment of two entities—a 15 member, majority non-Federal Advisory Board and an Inter-Agency Task Force. Thus, the former Advisory Board was to be reconstituted as an Inter-Agency Task Force to facilitate coordination of child protection policies and programs. However, the advisory role was to be fulfilled by a new U.S. Advisory Board that was comprised primarily of experts representing pertinent constituencies outside the federal government. The legislative history does not indicate how the Reagan Administration reacted to the creation of the U.S. Advisory Board. However, the reauthorization included a number of elements (the Board being only one) that indicated congressional skepticism about the Administration’s seriousness in regard to child protection, an assessment that must have been sobering to the Administration. An illustration of this distrust was the statutory reporting line for the Board, which was directed to both the appointing officer (the Cabinet-level secretary of Health and Human Services) and the Congress, a duality that is unusual in a government that is famously grounded in the separation of powers. Bringing the Board into Being Whatever the reason, the Reagan Administration (specifically the Office of Human Development Services [OHDS] in DHHS; later known as the Administration for Children and Families [ACF]) was slow to begin to fulfill its mandate to bring the Board into reality. Such steps occurred 7 months after the legislation had been enacted. It was at that point that I came to the Board. In early 1988, I returned from a 3-year inter-governmental transfer to the State of Israel to find that my 22-year position in the Administration on Aging, the part of OHDS/ACF responsible for social policy on old age, had been abolished. Temporarily assigned to the staff of the President’s Committee on Mental Retardation while the powers that be decided what to do with me, I was surprised in late 1988 when outgoing Reagan Administration OHDS/ACF officials offered me the opportunity to establish and then staff the Board. As a seasoned bureaucrat, I immediately recognized the raft of problems inherent in such a body. However, two factors caused me to accept the challenge. First, without a permanent assignment at the time of the


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offer and well aware of the uncertainties that would inevitably arise as the Reagan Administration gave way to the George H. W. Bush Administration, any port in a storm was attractive. Second and more importantly, the task seemed genuinely significant. Although I knew almost nothing at the time about federal efforts to address the problem of child maltreatment, in retrospect one could say that from the beginning of my career a higher power had intended me to occupy my new position with the Board. The very first job I had held upon leaving my graduate studies in English literature in 1961 was a minor administrative post in the legendary U.S. Children’s Bureau. Sometime in the next few years, I heard the Bureau’s professional staff discuss a paper by a Dr. Kempe (Kempe, Silverman, Steele, Droegemueller, & Silver, 1962) that they all seemed to believe was groundbreaking. As my career advanced during the years that followed, I began to accumulate knowledge about and develop expertise in two related phenomena: the use by government of outside expert opinion and the attempts by government to increase the involvement of ordinary citizens in policy making. Among the organizations that I had the opportunity to observe at close range were both expert and citizen advisory bodies in the field of aging, the 1971 and 1981 White House Conferences on Aging, the Council of the National Institute on Aging, and the President’s Committee on Mental Retardation. I now understand that all the insights I was storing during those years were just waiting to be put to use when the Board was established. In the old days, when offered a new position, an experienced bureaucrat would immediately examine the position’s statutory basis. My review suggested that Congress continued to see NCCAN as the centerpiece of the federal child protection effort. The legislation reflected the view of Congress, probably encouraged by the child protection establishment, that if DHHS would take its child protection responsibilities (as embodied in CAPTA) seriously, then all would be well. In this context, the Board was perceived by Congress as a tool for reforming the administration of NCCAN’s programs. To understand the significance of the different path that the Board took as soon as it convened, one must appreciate the overriding congressional intent to use the 1988 amendments to improve NCCAN. When I turned to Section 3, I found that what the statute had set forward as the Board’s mission was bureaucratically straightforward. The pertinent language in the amendments follows: (f) Duties. The board shall (1) annually submit to the Secretary and the appropriate committees of Congress a report containing (A) recommendations on coordinating Federal child abuse and neglect activities to prevent duplication and ensure efficient allocations of resources and program effectiveness; and (B) recommendations as to carrying out the purposes of this Act [CAPTA]; 2) annually submit to the Secretary and the Director (of NCCAN) a report containing long-term and short-term recommendations on (A) programs; (B) research; (C) grant and contract needs; (D) areas of unmet needs; and (E) areas to which the Secretary should provide grant and contract priorities under sections 6 and 7; and (3) annually review the budget of the Center and submit to the Director a report concerning such review. My experienced eyes did not detect a hint in the statutory charge of what was to come. The only reasonable expectation that one could have for the Board was that its products would be recommendations for improvements in the operation of NCCAN. The statute further specified that the Board would consist of 15 members. Two members were to be officials of the federal government, and 13 members were to be drawn from the public, all to be appointed by the secretary of Health and Human Services. The 13 non-federal members were to be “individuals knowledgeable in child abuse and neglect prevention, intervention, treatment, or research,” who would be selected with “due consideration to representation of ethnic or racial minorities and diverse geographic areas,” and were to represent 11 constituencies or categories of expertise (e.g., medicine; law; parent self-help groups; psychology) Moving my office to the NCCAN facilities, I found that the 13 public members had already been selected by the outgoing Reagan Administration’s leaders in OHDS/ACF. The statute required that nominations for all candidates for the 13 slots were to be publicly solicited. I cannot recall whether I ever knew if such a solicitation had taken place and, assuming that it had, the extent to which the individuals ultimately selected had been nominated. I do know that Susan Weber, the NCCAN director, drawing on her deep knowledge of the field, had assembled a list of possible candidates. Working from that list, the OHDS/ACF leaders had settled on the final group of 13. From the information I was shown about them, I could see that their titles suggested that several were quite distinguished and that the other selection criteria had been met. Looking at the list, there was not one name I recognized. In December 1988, the most pressing task at hand—getting the 13 public selectees officially appointed so the Board could be convened—was caught in the transition between administrations. The Board appointments required the concurrence of ranking OHDS/ACF officials in the incoming G. H. W. Bush administration. Those officials, when finally named, would need to undergo Senate confirmation, an attenuated process even under the best of circumstances. The inauguration of the new President would not take place until January 20, 1989, after which months would pass before the new OHDS/ACF hierarchy (the new assistant secretary for human development services and the other political appointees, especially the commissioner for children, youth, and families, who reported to her) would be in place. So I knew that quick accomplishment of appointments would be a challenge. Selecting the two officials of the federal government who would also serve as members of the Board presented another unexpected problem. In some measure, that selection required determination of the relationship between the Inter-Agency Task Force on Child Abuse and Neglect, the other new body created by the statute (to consist entirely of federal officials), and

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Table 1 Original members of the U.S. Advisory Board on Child Abuse and Neglect. • Frank D. Barry* (organizations providing services to adolescents), senior extension associate, Family Life Development Center, Cornell University • Betsy Brand (federal administration), assistant secretary for vocational and adult education, U.S. Department of Education • Yvonne M. Chase* (social services), assistant secretary for children, youth, and family services, Washington State Department of Social and Health Services • Howard A. Davidson* (law), director, ABA Center on Children and the Law • Earl L. Dunlap (state and local government), director of juvenile correctional services, Department for Human Services, Jefferson County, KY • Deanne Tilton Durfee* (at large), executive director, Los Angeles County, CA, Inter-agency Council on Child Abuse and Neglect • H. Gordon Evans (parents’ groups), director, National Foster Parents Association • Judith C. Frick (voluntary groups), vice-president, Kansas Action for Children, Inc. • Donna N. Givens (federal administration), deputy assistant secretary for human development services, U.S. Department of Health and Human Services • Richard D. Krugman* (medicine), acting dean of medicine, professor of pediatrics, and director, C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado • Joyce London-Mohamoud (parent self-help organizations), executive director of the State Resource Office, Parents Anonymous of New Jersey • Gary B. Melton* (psychology), Carl Adolph Happold professor of psychology and law, and director, Center on Children, Families, and the Law, University of Nebraska-Lincoln • Jeanne D’Agostino Rodriguez (at large), director of community relations, Laurel Oaks Hospital, and member, Orange County, FL, Citizens Commission for Children • Deborah M. Walsh (teachers), associate director, Educational Issues Department, American Federation of Teachers • Diane J. Willis (organizations providing services to disabled persons), director of psychological services, Child Study Center, Department of Pediatrics, University of Oklahoma Health Sciences Center Editor’s note: The positions and affiliations listed are those that the members held during their first term on the Board. As might be expected after 20 years, only three of the members (Davidson, Tilton-Durfee, and Krugman) still have the same professional affiliation, and Krugman has just retired from his administrative posts. Members whose names are starred served as members of the executive committee of the Board at least during its first four years. Krugman was the initial chair, and Davidson was the initial vice-chair. The parentheticals indicate the statutorily designated seat that each member held. Author’s note. In late 1991, resignations came from Walsh, who was leaving Washington, DC, for career reasons, and Brand, who was leaving federal service. In 1992, the terms of Dunlap, Evans, Frick, and Rodriguez came to an end. In 1993, Givens resigned because she was leaving federal service. Also in 1993, just after the completion of the fourth report, the terms of Barry, Davidson, Krugman, London-Mohamoud, and Willis ended. In late 1993, Melton, who had been re-appointed (along with Chase and Tilton-Durfee) in 1991, resigned because of his need to care for a chronically seriously ill family member. I do not recall the Board having set terms of office for the chair and vice-chair before the initial elections took place. However, I assume that such a decision was made. The first election, held in 1989, resulted in the election of Krugman and Davidson, who served for two years. The second, held in 1991, resulted in the election of Davidson as chair and Tilton-Durfee and Melton as co-vice-chairs. The third, held in 1993, resulted in the election of Tilton-Durfee as chair and Chase as vice-chair. In accordance with the pattern established in the three elections that I observed, I assume that another was held in 1995 after I completed my service to the Board.

the Board before either body had been convened or even appointed. The statute specified that both of the federal members were to be drawn from the membership of the Task Force, an overlap intended to enhance coordination that for a variety of reasons never actually occurred. At the time of the statute’s enactment, the perception within the OHDS/ACF hierarchy apparently was that the Task Force’s activities would be considerably more valuable than the reports of the Board. So before the Task Force was established, the leaders of OHDS/ACF selected two political appointees in the new Bush administration as the federal officials to be appointed to the Board and subsequently also to the Task Force. One came from the OHDS/ACF hierarchy itself—a selection that suggested that she would advocate the long-standing and deeply held perception that the federal child protection effort meant NCCAN. The other was an assistant secretary in the U.S. Department of Education who had neither background in the child protection field nor responsibilities obviously related to it. As expected, the official appointments of the public members were long delayed. Until mid-spring 1989, I was not able to invite those selected to serve. Finally, the first meeting of the body was scheduled for May 30–June 1, 1989. The OHDS/ACF hierarchy’s assumption that the Board’s mission was limited to rendering advice on NCCAN guided its decision making about required resources. Accordingly, for the first several months staff support would consist only of me, joined several months later by an assistant, Eileen Lohr. The bare-bones budget was just enough to cover expenses for members’ compensation and travel for two to three meetings a year. My initial assignment was to staff both the Board and the Task Force. After the Board began its work, it quickly became clear to me that the dual assignment would not work, both because there was an inherent conflict between the two bodies and because the Board required all of my time. The issue of my dual responsibilities became one of many subjects of contention between the Board and the OHDS/ACF hierarchy, resolved by the hierarchy removing me from the Task Force position. I cannot remember the point at which that change took place, but I do recall being very relieved when it happened.


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The First Meeting The 15 members, listed in Table 1, met for the first time in a downtown Washington, DC, hotel. Because they had not yet elected a chairperson and vice-chairperson, I gaveled the meeting to attention and oversaw the drawing of straws among the initial public members to determine whether they would receive 2-, 3-, or 4-year terms.

The Composition and Characteristics of the Board Here are some of my initial impressions of the group, as I recall them. Group Identity. Although some of the members knew a few of the others, no one in the group knew all of the others, and a significant number knew none of the others. Nonetheless, rather surprisingly to me, the group coalesced almost immediately. Personal Characteristics. Taken as a group, the members seemed unusually intelligent, appropriately serious, and surprisingly funny. Expertise. Eight of the initial members (Frank Barry (representing organizations providing services to adolescents), Yvonne Chase (representing social services), Howard Davidson (representing law), Deanne Tilton-Durfee (member at large), Richard Krugman (representing medicine), Joyce London-Mohamoud (representing parent self-help organizations), Gary Melton (representing psychology), and Diane Willis (representing organizations providing services to people with disabilities) had a significant background in child protection. Through sheer chance, all had drawn terms that allowed five of them to serve 4 years and three to serve 6 years. Two others, Earl Dunlap (representing state and local governments) and Gordon Evans (representing parents’ groups), had a background in areas germane to child protection. Five (Betsy Brand (representing the U.S. Inter-Agency Task Force on Child Abuse and Neglect), Judith Frick (representing voluntary groups), Donna Givens (representing the U.S. Inter-Agency Task Force on Child Abuse and Neglect), Jeanne Rodriguez (at-large), and Deborah Walsh (representing teachers) had no background in child protection or only a marginal connection with the issue. However, the respect with which they were immediately treated by the core eight suggested that they would be able to contribute. Paradoxically, despite the disparities in the backgrounds of the members, the possibility of synergy was evident from the outset. In terms of involvement with child protection, the depth and breadth of the knowledge and experience of the core eight was formidable. Although all of them greatly impressed me, one in particular, a county official, fascinated me, for reasons unrelated to child protection. In the years following the explosion in federal grant making that began in the 1950s, federal officials involved in inter-governmental programs became obsessed with a mythical figure: the state, county, or municipal administrator who would use the tools of information gathering, planning, coordination, etc. to implement the mandates of federal legislation with ease. Here that mythical figure (Tilton-Durfee) was, sitting on the Board. Politics. The public members’ political affiliations were clear to me in only a few instances. This initial impression proved prescient. In the 5 years that I worked with the original 13 public members, I cannot recall any instance in which their individual political preferences had any effect on Board action. Conclusion. From a variety of perspectives, they were truly an amazing group.

The Selection of the Board’s Officers The statute required the members to elect a chair and a vice-chair from among the 13 public members at the first meeting. As I recall, the first substantive item on the agenda was the self-introduction of members. I am not certain whether that item was immediately followed by the election or by a discussion of the status of American child protection efforts (followed then by the election). However, I am reasonably certain that by the first evening, when the formal swearing-in of the Board by Secretary of Health and Human Services Louis Sullivan took place, the election had been held. Krugman was elected as the first chair, and Davidson was elected as the first vice-chair. In retrospect, the choice of these particular individuals seems critical to the events that subsequently unfolded. Both had renowned reputations within the field of child protection, and both had complementary skills. Krugman, a charismatic leader with a sensitive feel for why people within large organizations behaved the way that they did, had been the principal protégé of C. Henry Kempe, the father of modern child protection, and had also been a medical fellow on the staff of a Republican senator. At the time of the Board’s creation, Krugman was director of The Kempe Center at the University of Colorado. Davidson, a Washington child welfare insider and director of a center on children’s law within the American Bar Association, had a deep understanding of the history of federal child protection efforts. They knew and liked each other. As a team, they were to perform brilliantly. Unbeknownst to me at the time, several of the members with a child protection background had quietly gathered for a breakfast discussion prior to the opening session to select their candidates to be the initial officers of the Board. As I was subsequently told, these members shared a strong belief, which was to become manifest quickly, that the Board had the opportunity to fill a near-void in leadership in the field, a void that they believed was particularly egregious in NCCAN and that they further perceived to be at the root of a myriad of gaps in child protection policy and lapses in child protection practices. In their view, the first step in beginning to fill that vacuum was the Board’s election of strong leaders.

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Redefinition of Mission Beginning with the members’ self-introductions and continuing with their initial discussions, the not-so-hidden agendas of individual members were clear. Krugman was interested in having the nature and scope of child protection re-understood as belonging to the sphere of public health, rather than as the province of child welfare in which it had always belonged. Davidson’s focus was on a major restructuring of federal efforts to address child maltreatment. Tilton-Durfee wanted to attack what she perceived was the most acute of all child maltreatment problems, child maltreatment fatalities. Melton was a zealot for prevention. Consistent with her institutional role, Givens wanted the Board to adhere to a narrow reading of the mission set forth in the statute. During the first day and the morning of the second day, certain recurrent themes emerged: a national emergency of enormous proportions existed; the scale of the emergency had overwhelmed previous federal efforts to deal with it; a new approach was necessary; prevention should be at the heart of that new approach. In my view, because this concern with prevention captured the instant and strong support of core members Barry, Chase, London-Mohamoud, and Willis, it became the nucleus around which all the varied interests reflected in the early discussions could co-exist. At some point in the deliberations during the first 2 days, Melton suggested that the Board’s mission should be to propose a new national strategy for preserving the right of children to personal security. Gradually but with growing enthusiasm, the public members embraced the idea. The inevitable question they then directed to me was whether the Board’s statutory base could be interpreted to support such a mission. I immediately understood that, given that the Board was in a very early stage of development, my reaction would be meaningful to the public members. Several years earlier, a large number of DHHS higher-level career executives, including me, had had their ranks lowered as part of a government-wide effort to reduce so-called “grade-creep.” Like all the rest, I burned to get my civil service grade restored. Restoration would mean an increase in salary and pension. Of even greater concern to me, it would repair my injured dignity. Getting my grade back depended on pleasing the OHDS/ACF hierarchy in the newly installed G. W. H. Bush Administration. Thus the Board’s question confronted me with a difficult dilemma. I had no doubt that the expectation of the OHDS/ACF hierarchy was that I would do what I could as executive director to keep a lid on the Board. Allowing them to sail into uncharted waters would not be perceived as keeping a lid on them. In deciding how to respond, I found that being 5 years away from retirement does wonders for clarification of one’s vision. Like all organizations located within DHHS, the Board received legal support from attorneys in the DHHS Office of the General Counsel. The attorney in whose purview the Board fell was Madeline Nesse, whom I had only met for the first time when I took up my new position. A Harvard Law School graduate, a stellar attorney, and coincidentally an attendee with her husband at services of the same synagogue that my wife Rachel and I attended, she and I had instantly clicked. I had insisted that she be present at the first Board meeting. In my early discussions with Nesse to review the statute authorizing the Board’s work, neither of us had considered the possibility that the Board might want to do something other than the tasks expressly stated in the statute. However, I had an intuition about the answer that she would give to the Board’s question. I suggested to Krugman that he call on her. Knowing full well (as did I) what the OHDS/ACF hierarchy’s reaction was likely to be, she reluctantly told the Board that what they wanted to do could be interpreted as falling within their mandate. With Nesse’s opinion in hand, the Board was off and running. The members quickly decided that they would need to hold a series of public hearings to solicit the views of child protection organizations, state and local officials, and various experts. It was then that the body came face to face for the first time with the problem of resources. Obviously, the Board’s decision to hold hearings, coupled with the small amount of resources that the OHDS/ACF hierarchy had made available to support the Board’s operations, meant that the preparation and release of the new strategy would be delayed to some indeterminate point in the future. That conclusion illuminated the immediate problem of dealing with the statutory requirement for annual reports. The solution adopted was that the first report due in 1990 would declare that a national emergency existed, discuss the reasons why the Board was making the declaration, indicate that the ultimate national response needed to be a new approach, and promise that the Board would articulate the details of that approach in an early future report. That hurdle surmounted, the Board appointed an executive committee to oversee the implementation of its decisions and adjourned. As I look back 25 years, it is now clear that by deciding to structure their activities around the development of a new societal approach to the protection of children—essentially, requiring fundamental reform of a whole set of complex social institutions—the Board was going far beyond the view of the problem long embraced by the child protection establishment, the leading federal agencies, and Congress. This decision of the Board was to have many consequences in the years to come.

The First Report In June 1990 during its fourth meeting, the Board released its first report, Child Abuse and Neglect: Critical First Steps in Response to a National Emergency (U.S. Advisory Board, 1990). Re-reading it recently for the first time in many years, I thought of Shakespeare’s description of Cleopatra: “Age cannot wither her, nor custom stale her infinite variety.” I found myself struck by how powerfully the report’s tone of moral outrage still rings.


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Consider only the opening of the executive summary of the report: For 25 years the nation has become more aware of the magnitude of child abuse and neglect. The Board has concluded that child abuse and neglect in the United States now represents a national emergency. The Board bases this conclusion on three findings: (1) each year hundreds of thousands of children are being starved and abandoned, burned and severely beaten, raped and sodomized, berated and belittled; (2) the system the nation has devised to respond to child abuse and neglect is failing; and (3) the United States spends billions of dollars on programs that deal with the results of the nation’s failure to prevent and treat child abuse and neglect. The American child maltreatment emergency leads the Board to make the following observations: Not only are child abuse and neglect wrong, but the nation’s lack of an effective response to them is also wrong. Neither can be tolerated. Together they constitute a moral disaster. All Americans share an ethical duty to ensure the safety of children. Protection of children from harm is not just an ethical duty: it is a matter of national survival. . .. The Board believes that the extent of the emergency is so compelling that it dictates an immediate response. The Board has decided, therefore, to devote its first report to alerting the nation to the existence of the emergency and to recommending 31 critical first steps that will provide a framework for a decade of review and reconstruction of policies and programs that have exacerbated the emergency. As important as these 31 critical first steps are, implementing them will only result in controlling the emergency. Once the emergency is brought under control, the Board believes that the nation should commit itself to achieving an equally important goal: the replacement of the existing child protection system with a new, national, child-centered, neighborhood-based child protection strategy. (U.S. Advisory Board, 1990, pp. vii–viii) Government entities do not write in such language. However, the full report is replete with it. The release took place in a large space in the Humphrey Building, the DHHS headquarters building. I never learned what strings Lohr had pulled to give us access to such a grand venue. Vaguely, I recall her asking me whether I thought we could fill the hall. Not having any idea, I decided to gamble. I recall the tension among the 15 members as they assembled to enter together. In an era before cell phones, Lohr, who was in the room and knew what was happening, was unable to give me a heads-up. Imagine then the shock of the members and me, as we came into the hall to discover an enormous crowd, a large number of television cameras arrayed, and the mood patently electric. The surprise of the Board members was heightened, because the relationship with the OHDS/ACF hierarchy during the year leading up to the event had been unremittingly hostile. Whether the issue was increasing the budget to allow the members to attend a field hearing, facilitating the printing of a large number of advance copies of the report, or providing professional assistance in development and distribution of a press release, whatever obstacles could be fashioned to impede successful preparation and release of the report had been fashioned. For example, distribution of the press release was delayed until the last minute because of dithering about the letterhead to be used. Somehow, despite the hostility, the report had been finished, the venue obtained, and the media notified. Now Krugman was completing his opening statement, questions from reporters were beginning, and my amazement about what had been wrought was growing. I remember the moment that I became certain something truly astonishing was underway. I was approached by a celebrated CNN reporter, who timidly asked me if I could find a copy of the report for him, the supply having disappeared. I gave him my personal copy. In an insightful article examining the work of the Board from a member’s vantage point, Melton (2002) observed, “The long row of network cameras at the press conference was a sight unfamiliar to child welfare insiders. Similarly, if there ever had been another day in which virtually every network talk show—McNeil-Lehrer Report, Good Morning America, and the like—had focused on child protection, none of us could remember it” (p. 573). The reaction to the report had a notable impact on the child protection community, on the OHDS/ACF hierarchy, on the Board itself, and on me. By the time of the release of the report, I was nearly certain that the National Child Abuse Coalition (or at least key member organizations) had been responsible for most of the ideas in the 1988 amendments to CAPTA, probably including the establishment of the Board. As the public attention to the Board’s report began to translate into active discussion on Capitol Hill about implementing the reactions, the child protection establishment’s reaction was a mixture of delight at the attention that the issue of child protection was receiving and horror at having created a monster. Melton (2002) acutely described the conflicts of ideologies and interests that underlay the negative side of the ambivalence: [T]aken together, the recommendations [in the first report] were unusual in their breadth. They were directed not only at CPS [Child Protective Services] but also the general public, elected officials at all levels, the media, the courts, the schools, mental health and substance abuse agencies, and voluntary religious, civic, philanthropic, and entrepreneurial

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associations. They coalesced in a recommendation for the development of mechanisms for ongoing planning of child protection policies and programs. Further, the Board promised to develop a new national strategy for neighborhoodbased, child-centered child protection. . .. The significance of this approach became obvious as the Board prepared an intermediate report [its second report, for release in 1991,] on the federal role in child protection. . .. The Board members shared strong beliefs that, to be effective, child protection must become part of everyday life and that, to accomplish such a goal, it must be comprehensive—built into the fabric of every community institution. Such an approach implies the need to reduce not only the burden but also the centrality of the specialty child welfare system in the protection of children. Child protection is not simply or even primarily a job for social service agencies. At the time, this conclusion was actively resisted by the Washington-based organizations that represent public child welfare agencies and their staff or that have historically been closely allied with them. Thus, recommendations that might have been expected to be uncontroversial were perceived as threatening by groups that perceived a diminution of their role in child protection. (p. 573) Within the OHDS/ACF hierarchy and, in particular, the NCCAN leadership, the reaction was unambivalent. The political leaders of social service programs in DHHS during the G. H. W. Bush administration seemed to believe that their worst fears (begging the question of whether such fears should have ever existed) had been realized. The response was simply negative, although that sentiment apparently surfaced mostly in private and semi-public discussions (e.g., individual briefings of key Republican members of Congress and their staff directors; pointed exchanges between some Board members and Administration leaders during subsequent Board meetings), not in truly public discourse (e.g., statements to the media). Nonetheless, from that point on, although the hostility of DHHS to the Board did not diminish, the body was treated with noticeably more cautious respect. The less cavalier response probably emanated from both sides of the relationship. The OHDS/ACF hierarchy learned that the Board did have the capacity, at least in the right context, both to generate and to diffuse a message that would resonate among the public and that would challenge inaction in both the Administration and the Congress. Experience demonstrated a risk from the Administration’s perspective that the Board’s having the attention of leaders in the Congress, the child welfare establishment, and the media could translate into major change. At the same time, some Board members were already outraged by the continuing resistance in the OHDS/ACF, especially over matters that seemed to them to be petty, concocted bureaucratic disputes that were designed to avoid the need to confront the failures in federal child protection policy. Moreover, those Board members’ skepticism began to be supported by other members, whose instinct had been to give the Administration time and to trust the OHDS/ACF leaders ultimately to do the right thing. Key members in the latter group began to conclude that their patience and trust (based in some cases on professional respect and in others on the prestige that goes with presidential appointments to leadership positions in the Administration) had been misplaced. Those members also were emboldened by the enormous interest in the first report. Indeed, the non-federal member who most obviously had a history of political support for Presidents Reagan and G. H. W. Bush and who probably had been appointed in significant part as a reward had become the principal advocate of increasingly strong language in the Board’s reports and its communications with the Administration. As that example illustrates, the greatest impact of the response to the first report was on the Board members themselves. Thinking that they had been writing prose, they suddenly discovered they had been writing poetry. Friendly toward one another before, they now began to develop deep bonds of affection. A coalescing group before, they now fully bonded. Unsure of themselves before, they now were ready to move ahead with confidence. My reaction? I realized that I was on the ride of my life. Whether I would survive it was in my mind an open question.

The Development of the Second, Third, Fourth, and Fifth Reports The Board’s declaration of a national emergency in the child protection field (U.S. Advisory Board, 1990) was followed in the next five years by the release of four more reports. (All but the third report [U.S. Advisory Board, 1993b] have been archived at http://www.ucdenver.edu/academics/colleges/medicalschool/departments/pediatrics/subs/can/ KempeNatlForum/Pages/Reports.aspx.) Each of the second through fifth reports is worth looking at with fresh eyes. Each one in its own way is absorbing. Collectively, they will prove a treasure chest for historians seeking to understand the formulation and implementation of American social policy as the 20th century gave way to the 21st. The second report (U.S. Advisory Board, 1991) addresses structural changes in the response of the federal government required by the national emergency. The entire third report—the only one of the reports that closely followed the original legislative charge—(U.S. Advisory Board, 1993b) is in essence a report of activities, because the Board was in a holding pattern while completing the articulation of its proposed national strategy. (An example is the position of the Board on the U.N. Convention on the Rights of the Child.) The fourth report (U.S. Advisory Board, 1993a) is the Holy Grail on paper—the proposed new national strategy. Paging through it 20 years later, the report’s dazzling brilliance still has the power to move. What strikes me most now is the amount of careful thought that had been devoted to its organization. The fifth report (U.S. Advisory Board, 1995) addresses the issue of maltreatment-related fatalities.


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The Board’s Process The second through fourth reports resulted from a process that the members and I invented during the preparation of the first report—a process that constantly evolved during the preparation of subsequent reports. In its most refined form, the process contained the following elements: (a) attempts to formulate preliminary positions through exhausting discussions during a Board meeting; (b) first tries by various members of the executive committee in translating the discussions to written text; (c) efforts by the executive committee (with Davidson frequently playing a somewhat larger role because of his residence and work inside the Washington, DC, Beltway) and me to edit the preliminary text into polished drafts, the editing often refined through conference calls; (d) discussion of the draft during conference calls of all 15 members; (e) creation of new drafts, based on submissions received from the members after the calls; and (f) seemingly endless iterations of these steps through a very large number of drafts. As this process evolved, surely all of the members at one time or another found themselves paraphrasing Professor Higgins’ observation that they’d “prefer a new edition of the Spanish Inquisition” over becoming involved in another advisory board. Nonetheless, pain and suffering aside, the members and I came to believe that the outcome of the process was sheer magic. That said, I understood completely when Melton recently made this salient observation in a personal note: If taken seriously, service on an advisory board or commission about a topic of social importance and public controversy, especially one in which (a) the important intellectual and political work remains to be done and (b) there is ongoing conflict at least with the Administration, takes a considerable psychic toll and accompanying sacrifices in regard to one’s day job and family life. . .. [T]he investment of time was much greater than I anticipated (I was accustomed to writing single publishable drafts; writing by committee was a new and frustrating experience). . ..Certainly the very modest financial considerations are not worth the investment of time and energy! For some, “the game” (political drama) may provide the recompense, but I did not have that experience, and my guess is that most “civilian” participants in politics and relatively high-stakes public administration share that sentiment. Of course, the process was affected by changes in both leadership and membership. New leaders were elected in 1991 and 1993 (see Table 1, author’s note). Until late 1991, the Board’s original membership remained intact. By late 1993, however, only Chase and Tilton-Durfee remained from the original group of 15 (see Table 1, author’s note). The Role of the Federal Members The second report (U.S. Advisory Board, 1991) was the Board’s statement that most focused on the structure and functioning of the federal government. Consequently, that report was bound to provoke a response from the two federal members. Their dissent (the only occasion in the five reports where dissent occurs) can be found on the very last page of the report. From my vantage point 20 years after the fact, Congress appears to have naïvely assumed that adding two federal officials (indeed, presidential appointees) would facilitate the development and implementation of recommendations by a body charged with conducting an external review of public policy. It now seems clear that the chance of anything useful emerging from the inclusion of representatives of the Administration was at best slim. On one hand, what choice would they have except to defend the status quo? That was, after all, their responsibility and, either tacitly or expressly, undoubtedly the instruction provided by their superiors. On the other hand, their presence had a chilling effect on the Board’s work. The federal members exercised particular influence on the three members coming from state and local government. Moreover, most of the public members appeared to believe (undoubtedly mistakenly in many respects) that the professional aspects of the federal members’ positions would trump political considerations in their participation in the Board’s deliberations and public statements. A Missed Opportunity Neither the second, third, nor fourth of the reports achieved the kind of triumphal success that the first one had, although Melton remembers the second (on the federal role in child protection) engendering considerable discussion among the Board’s leaders, key congressional staff, and the child protection network inside the Beltway. Because I had retired prior to the release of the fifth and final report (on child fatalities), I am unable to describe what the response to it was. However, I was in contact with several of the original Board members, and none of them mentioned anything unusual to me about the release. Therefore, I assume that the response was similar to the response to the second, third, and fourth reports. That conclusion is supported by the elimination of the Board in the 1996 CAPTA reauthorization. The failure of the remaining reports to attract the kind of attention that the first report received raises the obvious question why the Board, in view of the reception the first report had received, did not follow it up immediately with the release of its proposed national strategy. There are several possible explanations. First, although the Board had committed to formulating a strategy and had largely reached consensus on the general contours for the strategy, similar agreement on the details would require considerably more interaction. An accelerated meeting schedule was a near-impossibility. Just matching the schedules of 15 exceptionally busy people for a few meetings

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a year was always a challenge. Even if the members were prepared to make the development of the strategy their first priority (in effect, trumping their “day jobs”), the reasonable presumption was that the resources required to make such a schedule possible (e.g., additional funds for members’ travel) would not have been made available. In short, the details of the strategy were not yet prepared, there was not yet a Board consensus about what the details would be, and a highly accelerated timetable was impractical. Second, Melton was the critical member in the development of the strategy. Accordingly, his insistence that all recommendations related to the strategy be knowledge-based would hold great sway. That insistence had a practical consequence. He wanted to commission several social scientists to prepare technical papers, which would be used to support the Board’s conclusions. [Those papers were published in a book edited by Melton and Barry (1994). Twenty-year follow-up reviews can be found in this issue of Child Abuse & Neglect.] The reasonable presumption was that commissioning the papers and guiding the purchase of the authors’ services through the maze of government procurement regulations were going to be time-consuming tasks. Third, the decision to produce a new national strategy did not mean that the competing approaches that had been advocated at the first meeting had been set aside. Davidson’s concern with remodeling the federal response remained very much alive, as was Tilton-Durfee’s concern with child fatalities resulting from abuse or neglect. These concerns were themselves to be the topics of Board reports (i.e., U.S. Advisory Board, 1991, on the federal role; U.S. Advisory Board, 1995, on child fatalities). Those reports, like the others, also responded to specific statutory mandates for attention, for example, to NCCAN research priorities. Finally, both Krugman and I were not able to maintain aggressive leadership in capitalizing on the attention generated by the release of the first report. Around the time of the release of the first report, Krugman became dean (at that time, interim dean) of the University of Colorado School of Medicine, a position from which he has just retired after a remarkable quarter-century of service. The initial appointment was unexpected and intended initially to be temporary. Accordingly, Krugman remained director of the Kempe Center, editor of Child Abuse & Neglect, and president of the International Society for Prevention of Child Abuse and Neglect. With such heavy administrative responsibilities, Krugman was unable, of course, to put most of his time into leadership of a new reform movement! The tenuous design of my own position impeded my filling some of that gap. I was still enmeshed in the tangled thicket of the relations between OHDS/ACF and the Board. Much of my time and energy was invested in trying to maneuver through those relations. Whatever the principal reason was for not seizing the moment, in fact I do not recall the possibility ever being discussed. In view of the considerations that I noted, a more activist approach may simply have seemed impractical. Following the release of the first report, the Board adhered to the decisions it had made during its first meetings on the schedule that would guide its work. Why Were the Board’s Recommendations Ignored? Taken together, the five reports produce a sense of wonder. The means through which the ideas they contain emerged can be described as a gem of American governance. Collectively, the reports include an enormous amount of thought about a social problem that threatens the future of American society. The following gorgeous Lincoln quote used to introduce the Executive Summary of the fourth report captures that threat perfectly: A child is a person who is going to carry on what you have started. He is going to sit where you are sitting, and when you are gone, attend to those things which you think are important. You may adopt all the policies you please, but how they are carried out depends on him. He will assume control of your cities, states and nations. He is going to move in and take over your churches, schools, universities, and corporations. All your books are going to be judged, praised or condemned by him. The fate of humanity is in his hands. Interestingly, the report omits these original words: “All your books are going to be judged, praised or condemned by him.” If the hypothetical historians of the future to whom I referred earlier were coming to the task of judging, praising, or condemning the impact of these reports without knowing what that impact was, they probably would expect to find that the reports had been enormously influential. As we know, the exact opposite was the case, which begs the question, why a body with such distinguished, even monumental accomplishments should see its recommendations, especially its proposed new national strategy for child protection, ignored. I believe that the answer is found in a series of overlapping reasons. Please note that, in offering my take on those reasons, I am not absolving myself of responsibility for any mistakes I attribute to the Board leadership. The Board’s Approach as an Unintended Consequence Earlier in this account, in describing the 1988 enactment that created the Board, I mentioned that the law reflected considerable congressional skepticism about the seriousness with which the executive branch had treated the child protection issue from 1974 until then. Seen from that perspective, the Board was expected to be a means through which the Administration could be kept honest. When the Board went in the direction that it did (irrespective of how morally correct and


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empirically justified that direction was), the real purpose for which Congress had created the Board was not being satisfied. Consequently, neither the child protection establishment nor the Congress was enthusiastic. The root problems, I believe, were that, in legislating the Board into existence, congressional staff did not fully analyze what they wanted the Board to accomplish and that they lacked a sufficient grasp of how, in the absence of clear direction, the executive branch would implement the statute. Although the literature of public administration is full of examples of this kind of mismatch between policy formulation and policy implementation in terms of laws authorizing programs, there are far fewer examples of such mismatches in terms of laws creating expert bodies to render advice about policy. It is a subject worthy of more study. Failure of the Board to Persuade Congress About the Merit of Its Ideas Despite valiant and persistent efforts, the Board was unable to get its message across to the Congress, either directly through its own efforts or indirectly through the child protection establishment’s relationship with the Congress. This inability was an obstacle that the Board never effectively overcame. Both Krugman and Davidson devoted considerable energy to meetings with individual legislators and their staffs. Congressional staff frequently attended Board hearings and meetings. Accompanied by the entire Board, Krugman released the Board’s second report during a hearing of the House Select Committee on Children, Youth, and Families. In connection with the 1992 reauthorization of CAPTA, Krugman testified twice before the Senate subcommittee (S. Hrg. 101-1051 and S. Hrg. 102-691) and Davidson before the House committee (H. Hrg. 102-96) responsible for the reauthorization. A review of the Board’s testimony at the four hearings shows considerable appreciation for the Board’s work. An example is this statement by Senator Christopher Dodd, chair of the subcommittee conducting the September 27, 1990, hearing: Senator DODD. . . . You did a remarkable job, and you make me very proud to have authored legislation that allowed for this commission to do its work. The product you did is one of the best ever done, in my view, in my 10 years in the U.S. Senate, on any subject matter. This commission deserves a great deal of credit for what you have done already. If you didn’t do anything else—and I know we have got a lot more ahead of us to do to make it come to life, but nonetheless you have done a tremendous amount. And on behalf of this committee and my colleagues in the Senate, I want to express that gratitude to you and your fellow commissioners who put a lot of time in producing that product. So our hats are off to you. (pp. 51–52) A year later such appreciation continued in the language of the bill report accompanying S. 838, the Senate version of the 1992 reauthorization (S. Report 102-164): The Committee is impressed with the accomplishments of the Board. Their first report is the most comprehensive policy document on the problem of child maltreatment developed in the U.S.; the second report provides the basis for thoughtful reform of the child protection activities of the Federal Government. The Committee concurs with the Board’s view that the response to child maltreatment must be multi-disciplinary and believes that the Board should be supported in its efforts to promote interdepartmental and interagency cooperation. An annual appropriation for Board operations has therefore been authorized. The work of the Board would also be enhanced by further autonomy; the Board should continue to elect its own officers and formally have the authority to establish its own procedures. This matter is important as it relates to the ability of the Board to render independent judgments. Current law is amended in this reauthorization so that all proposed and final regulations, guidelines, program announcements, and operating procedures developed to implement a Federal child maltreatment program may not be promulgated until the board has had 30 calendar days to review the documents in question. That review would include the opportunity to provide written comments on the documents to the promulgating agency. The Committee, moreover, believes that the Board should have the latitude to render advice, even if it is not called upon to do so by a Federal entity. Such advice should be rendered to all relevant branches of government, including Congress and the Departments of Justice, HHS, Education, Housing and Urban Development, and Agriculture. Many important topics related to the protection of children warrant greater attention than can be given in a summary annual report. An example of such a topic is the coverage by health insurers of the treatment of child abuse. The Committee holds that the Board has the responsibility to develop and issue reports on such topics as it deems necessary. The Committee expects the Secretary to continue to appoint the most qualified individuals to the Board, by establishing a vigorous recruitment, nomination, and selection process. In accordance with the bill report, S. 838 (as reported out of committee to the Senate floor) contained extensive language enlarging the responsibilities of the Board and increasing its autonomy. In retrospect, S. Bill Report 102-164, issued on September 27, 1991, was to prove a high-water mark for the Board’s influence. In the Senate passage of S.838 on November 7, 1991, the new language directly concerning the Board was sharply abridged. Subsequently S.838, as passed by the House on April 7, 1992, while changing many aspects of the Senate version,

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left the abridged language concerning the Board unchanged. The final version of S.838 was enacted by both chambers and signed into law by President G. H. W. Bush as Pub. L. 102-295 on May 28, 1992. Interestingly, President Bush in his Signing Statement singled out the provision concerning the Board for objection: The Act, however, contains an objectionable provision—a requirement that the Advisory Board on Child Abuse and Neglect recommend changes in Federal law to implement a national policy on child abuse prevention. I must view this provision as advisory rather than mandatory, in order to avoid conflict with my exclusive authority under the Constitution to decide whether and when the executive branch should propose legislation. My concerns about separation of powers had finally been heeded. Other inaction, however, was far more significant than the lack of expansion of Board authority in Pub. L. 102-295. From June 1990 (when the Board’s first report was released) until October 1996 (when the Board was legislatively abolished), there was not one congressional document that referred to the approach the Board recommended. In that spirit, nowhere in the records of the four hearings at which the Board chairpersons testified concerning the 1992 reauthorization and nowhere in the language of the Senate bill report is there any indication that the recommendations contained in the Board’s first two reports had had the slightest impact on legislative thinking regarding child protection. Like a laser, the congressional focus remained fixed on NCCAN. Similarly, the Board’s oft-repeated cry for the necessity of an interdisciplinary approach to child protection had gone unheeded. An example emerged out of the second report (providing a blueprint for federal action). The report had pointed as a model to the level of collaboration achieved among diverse House and Senate committee chairs in regard to key disability and homelessness legislation that required crossing committee jurisdictions. Despite considerable energy having been devoted to the education of senior congressional staff about the forthcoming plan, any evidence of willingness to undertake such cooperation was totally missing. Looking back, the absence of Board influence on the reauthorization should have been, in the words of Sherlock Holmes, “the dog [that] did not bark” for the Board leadership and me. Clearly, we were doing something wrong in a major way. I think that all of us realized it. Certainly we spent time lamenting the lack of impact of an approach to child protection that was, we believed, far more coherent than its predecessors. By that time, however, we were in so deep that all we could do was soldier on. A corollary failing occurred with the child protection establishment. As a group, Board members had extensive experience in working with or within the key organizations. However, despite those close ties, the Board never devoted sufficient effort to convince the child welfare organizations to buy the Board’s conviction that any measure short of remaking society would adequately ensure a safe childhood for all of America’s children. As discussed supra, guild interests were formidable obstacles to the launch of an effective campaign in that regard. In retrospect, what was clearly needed was a Board staff member experienced in legislative liaison and specifically dedicated to the task of marketing Board recommendations to the Congress. We also needed a Board staff person experienced in media relations and specifically dedicated to marketing Board recommendations to the public. Of course, given the unrelenting hostility of the OHDS/ACF hierarchy, a request from the Board for such resources would have been rejected without serious consideration. Inability to Interest the White House A First Lady decides that drug use among young people is a national problem; it becomes one. A First Lady decides that adult illiteracy is a national problem; it becomes one. A first lady decides that childhood obesity is a national problem; it becomes one. The Board never came close to interesting the White House in its recommendations. The case of First Lady Hillary Clinton is the exception that proves the rule. Given her well-known involvement with the Children’s Defense Fund, it was reasonable to anticipate that the Board’s recommendations would be of great interest to her. There was never a scintilla of such interest from the White House. Need for an Influential Spokesperson Arthur S. Flemming had been a secretary of Health, Education, and Welfare during the Eisenhower Administration, chair of the 1971 White House Conference on Aging, a special assistant on aging for President Nixon, U.S. Commissioner on Aging, and chair of the U.S. Civil Rights Commission. After President Reagan removed him from the Civil Rights Commission because of political differences, he devoted the last 16 years of his life to work as the best known public advocate for Social Security. In retrospect, it seems clear that the Board needed an equally compelling public advocate for the new national policy. It never tried to find one. Inability to Overcome OHDS/ACF Hostility The National Commission on Terrorist Attacks upon the United States, also known as the 9/11 Commission, illustrates how the Board could have functioned had the 1988 legislation created it as an independent entity. Instead, located within


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OHDS/ACF, it constantly fought an uphill battle to obtain the resources to carry out a mandate that the OHDS/ACF hierarchy did not want it to carry out. The issue of why the hostility never abated is a matter of speculation, like so many aspects of the Board’s history. Despite my frequent abrasive contact with the OHDS/ACF hierarchy during my stint with the Board, I never came close to understanding the source of the hostility. Melton’s (2002) conclusion is plausible, however: The nature of the first Bush administration’s opposition to implementation of the Board’s vision was less clear. At root, however, it appeared to be related to a general aversion to growth of government and a general preference for the status quo. Although the Board did argue that the federal mission in child protection ought to be to strengthen communities’ capacity to protect their children (thus potentially limiting strong central control of child protection), we also contended that this mission extended to many agencies that had not perceived any such role for themselves. . .. Frankly, child protection was simply not a high enough priority to elicit that kind of government-wide attention. At least implicitly, piecemeal attention by a small, low-level agency in the social services side of HHS was enough for both the administration and some of the relevant professional guilds. (p. 574) Whatever the explanation, the impact is unquestionable. Consider that on September 27, 1991, the Senate Committee on Labor and Human Resources reported out a bill substantially expanding the Board’s authority, but 6 weeks later the full Senate passed a bill that gutted those provisions. Clearly something happened, although what it was remains unknown. We can only assume that the lack of Administration support altogether and the equivocal support from some child welfare organizations were sufficient to deter the action intended by the committee. The Problem of Timing The Board was cursed with bad timing. Although the law creating it was enacted in the spring of 1988, serious efforts to activate it did not begin until the winter of 1988–1989. The Board did not meet until the late spring of 1989. At that meeting, it made decisions from which, thereafter, it never varied. Those decisions resulted in the release of the centerpiece of its efforts, a new national strategy, only several years later in 1993. By delaying the release of the strategy until 1993, the Board had ignored the possibility that the release might not come until a new administration had taken power. Moreover, it had foregone the possibility of being able to take advantage of the election as a means of leveraging the issue of child protection. As we all know, a new administration did take power in 1993, following an election in which the issue of child protection did not surface. All of this is to say that, had the first meeting taken place in 1988, the release of the new national strategy might well have occurred in 1992. The fate of the fourth report might have been somewhat different. The Nature of the Fourth Report One of my first supervisors in the government hammered into me the principle of face validity. He argued that, because most government reports were only scanned and hardly ever read in their entirety, it behooved the author(s) to provide the target audience with the opportunity early on in the document to grasp the principle that the authors knew what they were talking about and that, therefore, they could be trusted. Although the fourth report is one of the most intellectually acute government documents in my experience, it failed this test. It is too dense, it is too heavy with social science, and it lacks the requisite number of quotable zingers. Surely there have been few reports of governmental advisory bodies that were more complex and better reasoned than was the articulation of the Board’s proposal for a new national child protection strategy. In my view, however, that dense complexity was the reason for the reaction it engendered: a monumental thud along the lines of that sophomoric question that we all grappled with. If a tree falls in the desert, does it make a sound? Despite efforts to humanize it, the report’s utter awesomeness made it unreadable except by academicians and unactionable by what should have been its primary audience, Congressional staff. The Ignominious End In October 1996, Pub. L. 104-235 amended CAPTA to eliminate NCCAN, the Board, and the Task Force. Pub. L. 104-235 was based on Senate Bill 919, described in Senate Bill Report 104-117, which was issued in July 1995. That Bill Report is the only expression of legislative intent that I could find for this set of amendments. S. 919 proposed the abolition of the Board by removing the requirement for the secretary of Health and Human Services to appoint such a body. In place of the requirement, the bill grants the secretary permission to appoint such a body but makes such action discretionary. The language in the proposed bill remained unchanged in the law as it was enacted. The Bill Report offers no explanation of any kind for abolishing the Board. Ironically, however, it cites Board findings at several points for other actions proposed in S. 919, including the elimination of NCCAN and the Task Force. By the time that S. 919 was introduced, the fifth report had been completed and published. Theoretically, the appointments of Chase and Tilton-Durfee, the only remaining original members, had come to an end. I had not only retired but had left Washington for my new home in Israel. With none of the original Board leadership actively involved in the 1995–1996

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legislative process and with such skimpy legislative history to work with 18 years after the fact, I can only speculate about the reasons for the abolition. One possible explanation may lie in the results of the 1994 congressional elections in which Republicans regained control of both houses of Congress for the first time in 40 years. I recall someone telling me at the time that the abolition was related to a House decision to eliminate the House Select Committees on Children, Youth, and Families and on Aging, both bodies deeply identified with the Democrats. According to that source, the Republican majority in the House killed the two select committees on cost-cutting grounds, and the Board was tossed into the pot for good measure. That story may be true, but there is no official legislative history to support it. Also, note that the locus of the abolition was the Senate and not the House. Another possible explanation that connects to the 1994 election results may have to do with the intense animosity that some members of the Bush Administration’s OHDS/ACF hierarchy expressed toward the Board. Having left office after the Clinton Administration was installed in 1993, these individuals may have perceived the 1994 change of congressional control as an opportunity for payback. They may have followed up with newly empowered congressional allies to fulfill that desire. Again, such a possibility is purely speculative. As I began working on this article, I asked Davidson for his views on why the Board had been abolished. He responded that he thought that “there were some congressional supporters who wanted a Board to do what we did, but after we did it (four times), there were other members who didn’t care much for having a Board like ours.” Whatever the explanation, it is worth noting that Donna Shalala, the only secretary of Health and Human Services during the Clinton Administration and a well-known liberal (now president of the University of Miami), did not choose to take advantage of the 1996 CAPTA amendments and appoint a new Board. The same was true for all of Shalala’s successors in the G. W. Bush and Obama administrations. Shalala’s inaction was not wholly the product of a lack of knowledge. The niece of a close personal friend of the secretary served as an intern with the Board for several months in 1993. The intern was very positive about the internship. I recall her reporting that on occasion, when she and her aunt were with Shalala socially, the topic of the Board and its reports was discussed. By way of a coda, consider the following. In 2015, the plague of child maltreatment with its terrible sequelae endures substantially untamed with the same failed national efforts that the Board described in its first report still largely not working. The Board’s proposed new strategy remains off the national agenda, still unconsidered. (The rays of hope in that regard are the several trials of Strong Communities under Melton’s leadership, as discussed elsewhere in this issue.) In faraway Israel, I was overcome with sadness on learning that Congress (with support of the Obama Administration) had created a new national commission to examine child maltreatment-related fatalities. That commission recently met for the first time. At the conclusion of the meeting, the commission announced that it would need several years to make recommendations. That report will be presented more than 20 years after the fifth report of the Board (U.S. Advisory Board, 1995) was released. Conclusions The years that I spent working with the Board were enormously rewarding. In a 33-year career of public service studded with interesting assignments and major accomplishments, the Board experience was clearly the high point. Here are some of the reasons why. First, the Board developed a unique personality of its own. The group had incredible esprit, its mix of personalities clicking in just the right ways, thereby producing unexpected synergies. At the same time, as individuals, not only the Board members who were “stars” shined. To cite only one of the members only briefly mentioned so far in this account, there was Gordon Evans, a foster parent and a retired business executive (now deceased), active in national foster parent organizations. The fervor with which he constantly reminded his Board colleagues of the documented inadequacies of foster care, a major child protection solution, contributed greatly to the tone of the reports. Evans was an example of the way that each of the 13 public members brought important experience to the table. Second, the contributions made by all six of the Board leaders were very special. The six gave of themselves unsparingly. During my career, I had seen impressive contributions in the policy arena by non-governmental experts, but the extent to which those six people contributed was without parallel. Gilding the lily of the contributions by the six leaders was the critical role played by Melton. His angry passion, animated by analytic vigor, was the engine that drove the Board. Fourth, working with the Board, I was able to learn so much. Of all that I learned, the surprisingly weak role played by classroom teachers in child protection stands out for reasons I cannot explain. On the day I accepted the assignment to establish the Board, I clearly remember naïvely assuming that one of the benefits would be the opportunity to do some work with the Department of Education, because teachers were obviously central to child protection efforts. My disappointing discovery of the reality caused me to relearn a truth I had learned long before: often the obvious is more apparent than real. Fifth, during my pre-Board career, I had been able to make contributions to the development of policy in the field of old age, even though I did not have specialized education in gerontology. The experience that I was also able to contribute to the field of child protection without education specifically focused on child welfare validated my cherished belief in the immense value of the kind of liberal education that I received at the University of Michigan in the mid-1950s. I was further


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convinced as a result of my professional experiences that the skills involved in analysis and development of social policy are generic. Sixth, there are the happy memories. From the myriad, three are representative. One was teaching the Board members the meaning of the phrase, “we need to go back,” which was best savored when the Board had just completed its deliberations on a particularly difficult passage in the draft of a report. Another was Krugman’s tutoring me on the psychology of the child abuser, an education that occurred on a circuitous trip to a meeting on Capitol Hill, as we avoided a heavy rainstorm by traversing the network of tunnels that connect the DHHS complex to the Capitol. The third occurred one night when Rachel volunteered to come to the Board offices to help Lohr and me collate the draft of a report that needed to be express-mailed the next morning to the members. Unable to find a sitter for our 3year-old (now adult) son, she brought him with her. When she discovered that there was no place for him to sleep in the copying room, she decided to put him to sleep on the couch in my office, a distance from the copying room. One can only imagine what security guards would have made of the following scene, had they come across it: a young child asleep on a couch in the office of the executive director of the U.S. Advisory Board on Child Abuse and Neglect, covered by a flip-board sheet containing the warning that this child belongs to Byron Metrikin-Gold, who can be found in the copying room.

A Reconsideration after 20 Years Upon reading a preliminary version of this article, particularly the section about why the Board’s recommendations were ignored, Melton posed a number of questions. On the one hand, he asked, did I truly think that the Board possessed “magic?” If so, what was it and how had it originated, when the relevant authorities were not seeking it? Was it simply good luck in relation to the particular personalities, something about the time, and/or something about the structure and process? On the other hand, he asked, if the group was so magical, why had their impact on policy been so limited? As I thought about the two sets of questions, it seemed to me that the answers were intrinsically related. Here was a group with not only a large amount of expertise but also an even larger amount of passion. Indeed, chemistry played a part, allowing renowned scientists and practitioners to work comfortably with concerned laypeople. Moreover, the group was blessed with staff assistance from a battered official who longed to sing one last song before retiring. Amazingly, given the barriers to achievement that were erected against the body, both the members of the group and the staff were willing to engage in Sisyphean efforts. As in all groups, however, there was a measure of ineptitude. An example was the choice, even if only by inaction, not to do appropriate presentation or follow-up of its reports. Even if the presentation had been more effective, the Board’s message of urgent need for dramatic change in child protection policy was pitted against the objections of political appointees in the Administration and their Congressional allies, abetted by the child welfare establishment. In that regard, it is useful to re-read the February 27, 1992, testimony before the House by the staff leader of the National Child Abuse Coalition. His testimony seems quite intentionally to avoid any mention of any Board recommendation. One can read that testimony and not have an inkling that there was a countervailing approach to the major social problem being explored. All of that said, there remains another possibility worth considering. This truly extraordinary body was doomed to suffer the fate of Ignatius Semmelweis, driven to a premature death because he had discovered an unpalatable scientific truth. Seen from that perspective, the Board correctly understood the nature of the problem and devised the correct solution, only to confront a society unable and unready to accept either the analysis or the solution. If that analysis is correct, it carries with it two powerful implications. First, the rejection by important agents of society—not only legislators and their staffs but also leaders of the child protection community—is understandable. If the resolution of all major social problems is a complex endeavor, the resolution of child maltreatment is arguably among the most complex. One only need look at the five Board reports and the records of the congressional hearings concerned with the 1992 CAPTA reauthorization to grasp the almost breathtakingly complex array of issues that come together in the problem of child maltreatment. Thus, it is no wonder that the agents of society choose bromides like fixing NCCAN rather than doing the heavy lifting that embracing the far-reaching recommendations of the Board would have required. The second implication has to do with the need to wait for history, to recognize that the important contribution of the Board was to serve as an early catalyst for change. In December 2013, when Melton invited members of the original executive committee of the Board to a meeting to review where the concepts embodied in the Board’s fourth report (U.S. Advisory Board, 1993b) stand 20 years after the issuance of the report, he observed: . . .Big changes in society require some very early adopters quixotically and often quietly tilting at windmills frequently enough (and being insufficiently deterred by repeated apparent failure) that the conversation changes. With dogged persistence, after a generation or two, a tipping point is passed. Soon thereafter, almost everyone accepts ideas and practices that had been too radical to take seriously but that were nonetheless morally and logically consonant with core cultural values. That history can be seen in our lifetimes in racial desegregation in the United States, the end of apartheid in South Africa, the Prague Spring in Eastern Europe, most recently in the recognition of gay rights, etc.—even in more mundane change (e.g., the stigma now attached to smoking; the enormous changes in family structure). Although full implementation (change in hearts and minds) is still a struggle (as my examples also illustrate), the

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fundamental change in cultural norms generally happens “overnight” (within a range of a few years), although the change process takes generations. . .. I’m not sure where we stand on that timeline in relation to child protection, and I’m not sure what it will take to bring us to a tipping point at which the nature of child protection is transformed and the situation for children changes in fundamental ways. . .. Shortly after receiving that communication, I began helping Dov Elbaum, an Israeli educator who is a major contemporary religious thinker, to prepare for a North American tour to promote a book recently published in English (Elbaum, 2013). Elbaum decided that, because the book tour would fall near the observance of Passover, he would use the tour to lecture on an issue that had long occupied him: why, when the answer seems so obvious, does the Haggadah, the book read at the Seder, the Passover meal, raise the question of whether one should tell the story of the Exodus at nighttime. As Elbaum asks early in the lecture, “Is there any other time to tell it than Seder night?” The lecture becomes a breathtaking Talmudic exegesis on the thinking of a minor second-century sage, Ben Zoma, mentioned only flittingly in the Haggadah. Working with Elbaum as he developed the lecture, I began to understand the extraordinary relevance of the lecture’s thesis to the meeting of the Board’s leaders that I would soon be attending. For that reason, with Elbaum’s permission, I conclude this article with an extended quote from the lecture: Ben Zoma’s disagreement with most other sages concerns the question whether nighttime and darkness can be understood as the beginning point of renewal and redemption. Is this world under the heavy grip of evil? Is there nothing we can do about this fact other than wait for the Messianic era, when the distance between the creating God and created reality will be eliminated? Or is it possible to narrow the distance between God and life on earth, starting anew in spite of it all? The majority of sages of the post-Second Temple era were of the opinion that all we can do is wait for divine redemption. Ben Zoma, however, thinks that night is part of the redemptive process; hence, liberty and redemption must be discussed from the very beginning to the very end of the process: from the dark of night into the light of day. He believes that one must find the light of the redemptive future, even when one is in the deepest night of this world. Ben Zoma’s claim. . .was that redemption begins in the heart of darkness. To him, the somber atmosphere of Seder night was meant to demonstrate how this process of growth and regeneration already has begun in the most trying and dark moments. Perhaps he is arguing that, sometimes, we need to realize that we are actually in the deep of a dark “night,” in order to start searching for our way out of it. References Child Abuse Prevention and Treatment Act of 1974, Pub. L. 93-247, 88 Stat. 4. Elbaum, D. (2013). Into the fullness of the void: A spiritual autobiography (A. Yadin, Trans.). Woodstock, VT: Jewish Lights. Kempe, C. H., Silverman, F. N., Steele, B. F., Droegemueller, W., & Silver, H. K. (1962). The battered-child syndrome. Journal of the American Medical Association, 181, 17–24. Melton, G. B. (2002). Chronic neglect of family violence: More than a decade of reports to guide U.S. policy. Child Abuse & Neglect, 26, 569–586. Melton, G. B., & Barry, F. D. (Eds.). (1994). Protecting children from abuse and neglect: Foundations for a new national strategy. New York, NY: Guilford. Nelson, B. J. (1984). Making an issue of child abuse: Political agenda setting for social problems. Chicago, IL: University of Chicago Press. U.S. Advisory Board on Child Abuse and Neglect. (1990). Child abuse and neglect: Critical first steps in response to a national emergency. Washington, DC: U.S. Government Printing Office. U.S. Advisory Board on Child Abuse and Neglect. (1991). Creating caring communities: Blueprint for an effective federal policy on child abuse and neglect. Washington, DC: U.S. Government Printing Office. U.S. Advisory Board on Child Abuse and Neglect. (1993a). Neighbors helping neighbors: A new national strategy for the protection of children. Washington, DC: U.S. Government Printing Office. U.S. Advisory Board on Child Abuse and Neglect. (1993b). The continuing child protection emergency: A challenge to the nation. Washington, DC: U.S. Government Printing Office. U.S. Advisory Board on Child Abuse and Neglect. (1995). A nation’s shame: Fatal child abuse and neglect in the United States. Washington, DC: U.S. Government Printing Office.

Causes of child abuse and neglect.

Child abuse and neglect: the myth of classlessness.

Child abuse and neglect: effect on Bayley Scale scores.

The Independent Payment Advisory Board.

Fatal and non-fatal child maltreatment in the US: an analysis of child, caregiver, and service utilization with the National Child Abuse and Neglect Data Set.

Oral and dental signs of child abuse and neglect.

Improving work with fathers to prevent child maltreatment: fathers should be engaged as allies in child abuse and neglect prevention.

More Than Poverty: The Effect of Child Abuse and Neglect on Teen Pregnancy Risk.

Substantiation of reported child abuse or neglect: predictors and implications.

KNOWLEDGE AND ATTITUDES REGARDING CHILD ABUSE AND NEGLECT.

Child abuse and neglect: physicians' knowledge, attitudes, and experiences.

Illegitimacy, child abuse and neglect, and cognitive development.

University-based interdisciplinary training in child abuse and neglect.

Dilemmas for international mobilization around child abuse and neglect.

Current pediatric roles in child abuse and neglect.

Service on the Maryland board: reflections and comments.

Child and adolescent abuse and neglect in the city of Curitiba, Brazil.

Correlates of joint child protection and police child sexual abuse investigations: results from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008.

Long-term effects of child abuse and neglect on emotion processing in adulthood.

The Canadian Incidence Study of Reported Child Abuse and Neglect: a partnership.

Exploring policies for the reduction of child physical abuse and neglect.

Why it matters to know the relationship between child abuse and neglect and sexual offending.

Data research on child abuse and neglect without informed consent? Balancing interests under Dutch law.

Child abuse and neglect. A priority problem for the private physician.