DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTORNEY GENERAL RENO: I think one of the ways you measure it is recognizing violence is down six years in a row now, and suddenly people are beginning to think that it might be feasible, it might be realistic, to assume that you can bring it down some more. You've got to be very careful with your figures, and that's the reason why the national survey is important so that people don't get caught up just in numbers.
But I think one of the keys to its success is a development of an ability collected both nationally and locally so you know what is happening, and that not perfected yet. I would add that to the sixth of your points.
I would like to challenge, and I think it's apparent in what you all are saying, that there is the divisionary stuff, and there's the stuff that needs to be done. I think one of the issues that we've got to address is how do we make a workday and a living day and a month and a week so the people have a balance in their lives, and I think we should give that serious consideration. It was raised yesterday in developing workdays that give parents quality time with their children, both parents. I think that's vital.
How we provide for supervision for our children so that it is as expected as K through 12 and then the nonschool hours, I wasn't quite clear. And I'm interested. I had a chance to talk to Dr. Dickie yesterday about what the AMA is doing in terms of the development of its protocol, and I said, "Well, have you considered what involvement of the criminal justice system on these public health issues?"
"Oh, no. That might be a good idea." Just imagine what it could be if the first time you went to a doctor as they advise you about mammograms that they advise you about violence against women so that it is ingrained in everything that we do, and that one of the measurable goals would be that by the year 2000 or 2001 every doctor went through this protocol with a new patient, every doctor went through this protocol with an 11 year-old girl, every doctor talked to this young man when first in the doctor's office as an adolescent about violence, just make it an ingredient, a factor. I think we would have a tremendous result, and then do the same thing with lawyers.
Now, with lawyers, no professionalization makes a good point. Lawyers providing legal services to people of moderate income people to working poor, and I think you've got to think in terms of the community advocates, a four-year degree, if you will, that knows how to cut through the red tape, where to go.
Sometimes they might be a generalist, and have landlord-tenant situations, child support situations, but we've got to get the bar associations of this country to recognize that they are not delivering the services to people in places where they can't afford it.
One of the keys that's missing as far as -- and I didn't hear it come out too much -- is case management. When you talk about the delivery of services, there are wonderful services being delivered, but you go to Dr. A and then you go to Dr. B and you don't tell Dr. B what you told Dr. A, and you flimflam the whole system and you waltz through the whole system for a long time. With the concept of a case manager who really tracks the person without labeling them, and then you win to bring them up sure and win them to give them a pat on the back. I think that's an essential, and one of the least focused-upon disciplines that I know. Sometimes it cuts across.
And to me, even after six years up here, the most underserved area that I know is how you treat alcoholism. We put so much emphasis on drugs, but when you look at alcohol and what it's causing, both in violence against women and children, I just would like to see us focus on that.
Another category of things we don't ordinarily think about is the young men, 18 to 35, who have been in custody in the criminal justice system and cannot break out of the mold that we have fit them in. They can't get a job, they can't get self-respect, and I think they may be many of the perpetrators. And it all ties in to so many other areas.
Finally, how do we change not in terms of violence, but I am touched at the number of people, and I know Donna has seen the same thing, because I've been with her when people have come up and said, "Thank you for showing me that women can do something." We have got to give young women in America today more self-confidence in their ability to be what they want to be. It is still very, very touching to get letters of people who don't think they can do it. They can't grow up to be a lawyer, a doctor, teacher, Secretary of Health & Human Services.
(Laughter.)
ATTORNEY GENERAL RENO: You sent it to me, and that's what got me thinking about what the pediatricians had done. What Dr. Dickie says, they're now cutting across the American Psychological Association, the family practitioners, and come out with a really effective protocol. And if they brought in the criminal justice system, which leads to a final thing, but the drug court we saw, courts created which refused to and spread too thin so there were adequate resources for the court and in a way be the case manager, and it was court-trained on how to follow drug cases.
If we do the same with what we have always referred to as dependency courts, but we've got to think of another name because nobody understands what dependency means. Model abuse and neglect courts that have sufficient resources to do an up-front negotiation, sufficient resources to follow through to prevent foster care drift, and long foster care routines, we can make a difference. If we do the same thing with gun courts for kids arrested at 12 and 14 and 15 in school with guns and have somebody follow them with both the case management and the public health component automatically thrown in, I think we can make a big difference.
I think America's courts have become overwhelmed so they're becoming more than numbers crunchers. If we can restore them with resources and expertise, I think we can be more effective.
I just see a young woman going to a health clinic. She may be 16 or 15, she has a live-in boyfriend, and the doctor sits down with her, as she first learns that she's pregnant, and he starts talking to her. I don't know how you can measure that, but you've let her come to believe that she doesn't have to accept someone hurting her child, and here is where she can go, and here are some phone numbers she can put up someplace. Just getting into the routine, as we now check for helmets and other things, it can be done. And it can be done because all of you care so much. And thank you very, very much.
SECRETARY SHALALA: Thank you, Madam Attorney General.
(Applause.)