As a pediatrician, I see the ongoing crisis in our state’s child welfare system firsthand.
Two siblings I cared for in my clinic lived with foster parents in Kansas City, 2 1/2 hours away from their biological family. They entered foster care because their birth mother is struggling with a substance use disorder and can’t safely care for them without treatment. Their foster parents are dedicated and loving people, but did not have proper support from our state’s underfunded child welfare system. Unfortunately, this disconnect meant a lack of medical history and prescription information that I needed to help these children, which further fragmented their care.
A recent article in Governing underscored what I already know from working with vulnerable children and families; the programs that serve them are so underfunded that children are at risk. The stakes are incredibly high. In 2016, the most recent year for which we have data, 3,879 children in Kansas entered foster care. In 40 percent of those cases, parental substance use was part of why that child could no longer safely remain with their parents. The siblings I saw are emblematic of this tragedy. Like many families, they likely could have safely remained with their mother if she had access to treatment and other support services. Thankfully, a new federal law gives us reason for hope.
Buried in the budget deal that passed at the beginning of the year is a groundbreaking new law that creates a shift in the way our nation treats its most vulnerable children. The Family First Prevention Services Act could have a profound impact for children and families in our state, and offers Kansas the opportunity to access the federal resources it needs to modernize our approach to child welfare.
For the first time, Family First will enable states to use federal funds previously restricted to foster care placements for time-limited, evidence-based services to prevent the need for foster care in the first place. These services, available for the child and the parent or caregiver, include mental health, substance use disorder treatment and in-home parenting skills training.
Family First passed with bipartisan support and the endorsement of a wide spectrum of respected child advocacy organizations, including the American Academy of Pediatrics and its Kansas chapter. At the heart of the law is an underlying “ounce of prevention” philosophy: By funding therapeutic services for at-risk families, states can reduce the number of children who must be removed from their homes in the first place. And new rules to prioritize placing children with families will ensure that a child does not end up in an institutional setting, known as congregate care, unless that setting meets quality standards and will serve that child’s treatment needs.
But for that impact to translate to real improvement for our state, Kansas must act. States may begin receiving new federal funding for this work on October 1, 2019, but they must elect to do so, and allocate resources to meet the law’s 50 percent state-matching requirement. I urge our state to take this opportunity and participate in the prevention services program that Family First has created without delay.
Family First offers Kansas an opportunity to fix a system riddled with abuse and inefficiencies that has children sleeping in offices and facing further trauma. Our state needs these resources and policy reforms to begin to address the longstanding challenges it faces in serving vulnerable children and families. As a pediatrician, I know that prevention is critical to lifelong health and well being. Failure is not an option.
Pam Shaw, MD, FAAP, is a pediatrician in Kansas and a member of the American Academy of Pediatrics Board of Directors.