Secretary of Health objects to parenting workshops at hospitals

Secretary of the Puerto Rico Department of Health Víctor Manuel Ramos Otero

By The Star Staff

The Committee on Older Adults and Social Welfare, chaired by Representative Ricardo Rey Ocasio Ramos, has begun reviewing House Bill 654.

The bill proposes the creation of the “Mandatory Responsible Parenting Education Act,” which aims to establish workshops for parents to prevent child abuse and promote safe family environments in line with existing legal frameworks. These workshops are intended to be part of hospital discharge procedures and a requirement for preschool services in the public sector.

The Department of Health (DOH) would be responsible for overseeing hospitals’ compliance in offering these workshops and could impose administrative fines of up to $5,000 for noncompliance.

The legislative bill highlights a troubling trend in child abuse cases in Puerto Rico, with statistics indicating “a social crisis that demands immediate preventive actions.” According to the latest report from the United States Department of Health and Human Services (AFCARS Report, 2023), 4,320 child abuse victims were reported during fiscal year 2022, resulting in a rate of 8.3 per 1,000 minors. Among these cases, 78.9% were instances of neglect, 59.3% were emotional abuse cases, and 22.1% involved physical abuse.

During the hearing, Juan Carlos Malavé Rexach, a specialist in child and sexual abuse, expressed support for this measure, stating that “state investment in early guidance prevents judicial interventions and reduces long-term costs in mental health, social protection, and special education.” He noted that the legislation, authored by Representative Ramos Ocasio, aligns closely with the spirit of the federal Family First legislation, emphasizing prevention rather than interventions after issues arise.

Malavé Rexach added, “The problem with intervening after the fact is that even with excellent intervention programs, we are left to address trauma. It’s much more challenging to deal with trauma, especially regarding sexual abuse, and it is far more costly for the government to rectify such issues than it is to invest in preventative programs. This approach contributes not only to prevention but also fosters responsible citizenship.”

In response to questions from Representative Ramos Ocasio, Malavé Rexach suggested that the topic of sexual abuse prevention should be included in workshops provided before a child’s birth, as a prerequisite for enrollment in programs like Head Start, Early Head Start, and the Department of Education.

Carlos A. Rivera Otero, assistant administrator of the Administration for Families and Children of the Department of Family Affairs (ADFAN), voiced his support for the measure but suggested further examination regarding the mandatory nature of the workshops for enrollment in public education programs. “We are concerned that requiring a workshop for enrolling a child in programs like Head Start and Early Head Start contradicts the spirit of these federal initiatives, which aim to encourage broader participation,” he commented.

Miguel Hernández Vivoni, legal advisor to the Department of Family Affairs, recommended further study on funding the entire framework for offering these workshops. He proposed that health insurance could potentially cover the costs as an alternative.

Marcos Santana Andújar, president and executive director of the Network for the Rights of Children and Youth, supported the proposal while recommending amendments to ensure accessibility for all populations. He emphasized the need for responsible parenting workshops to cater to individuals in remote areas, those with language barriers, disabilities, limited access to technology, or those opting for non-traditional birthing methods such as home births.

On the other hand, Víctor Manuel Ramos Otero, secretary of the Puerto Rico Department of Health (DSPR), did not support the legislation in a brief submitted to the Committee.

He pointed out that the agency already offers a similar course called “Responsible Parenting” at the community level, led by health counselors, covering ages 0 to 5 and 6 to 11. While acknowledging the laudable intent of the measure, he warned that offering the workshop during a hospital stay after birth might lead to information overload for women recovering from childbirth, who already face substantial emotional burdens.

He suggested that the hospital’s role should be limited to referring families seeking services, either through the Department of Family Affairs or the agency he leads.