VIRGINIA AND FOSTER CHILDREN

State plan for kids makes things worse

The state of Virginia recently released an unsettling report that received little national attention. The gist of it is, almost one of every four children in Virginia's foster care system is taken away from the birth parents because the child is mentally ill and the parents cannot afford treatment. Once children are embraced by the state's “loving arms” (instead of the parents') the state will cover mental health costs for the child. But not until. Before you read on expecting the wailing of a bleeding-heart suggesting the state should pay willy-nilly for mental health costs of any and all indigent comers, think again. Virginia is far from alone in devising this strikingly odd, apparently self-defeating rule-making philosophy. A low-income child is mentally ill. So, the rule suggests, let's rip her/him out of the home environment, cause the child a lot more stress and emotional pain and then we'll pay for psychiatric care. Makes lots of sense, no? Most states follow the same labyrinthine path.

Last summer, the non-profit Pew Commission on Children in Foster Care estimated more than a half-million children are in foster care nationwide. If Virginia's pattern applies nationally, that means well more than 100,000 of them could be living at home with their birth parents if the states chose to provide mental health services to them outside foster care. I'm not for nationalized health care. Health care is a service one must work to pay for, not a “right,” the way liberty or freedom from discrimination are “rights.” But it does seem just this side of zany to take a child out of her/his home when that child is mentally ill, yet still capable of living at home. Foster care was designed, let's remember, to save children from abusive or severely neglectful parents — for the most part, the kind of parents who were never fit to have children in the first place. But the majority of foster kids taken away so the state can provide mental health services are in a different category. Their parents are neither abusive nor neglectful.

They just don't have the money to cope.

The Washington Post reports many of Virginia's children placed in foster care come from low-income households that simply cannot shoulder the costs of “schizophrenia, severe depression or bipolar disorder. The cost of caring for these disorders is so high that private insurers and HMOs don't fully cover it and in many cases the families make too much money to be eligible for Medicaid.”

Sen. Susan Collins, R-Maine, introduced a bill that has languished in Congress for several years called the Keeping Families Together Act. Its purpose is to prevent birth families from forfeiting custody just so the child can receive mental health care. The bill would pay the states to network state child welfare, juvenile justice and mental health agencies (so they communicate better) and to expand eligibility for Medicaid's “home and community-based services waiver” to children and adolescents in residential treatment facilities (so they can remain in the custody of their parents). That's a good start, but we need to act, too, before tragedy strikes, not after. We need to apply preventive medicine. Why not teach high school students about the financial costs of parenting a seriously mentally ill child? What about preparing tomorrow's parents for the economic consequences of bringing such children into the world and give them the skills to weather this misfortune (purchasing specialized medical insurance, for example) should it befall them? To do otherwise is to use a Band-Aid to fix a burst dam. As a nation we spent $1.7 billion on this year's presidential campaign (for ads, strategists, get-out-the-vote efforts and so on). We're predicted to spend $500 million on cell phone ring tones and graphics next year (a huge sum for a trivial pursuit). We're affluent enough to prevent the financial catastrophe of losing a mentally ill child to foster care when that child could just as easily have received those services while living at home. Now let's act like it.

Bonnie Erbe
8 December 2004

http://seattlepi.nwsource.com/opinion/202717_erbe08.html

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