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The recent media coverage in Florida of the plight of the Bostock family in obtaining mental health services for their adoptive son is not a “new” story. Families all over this country have been relinquishing children into state custody for years in order to obtain long-term mental health treatment. It is a devastating practice and one that most people would agree is just plain WRONG…yet it continues.
Truth is, there’s not much information out there on which states require relinquishment in order for Medicaid to cover long-term mental health treatment or out-of-home placement. The facts are that few private insurances provide adequate coverage in this area. And it seems to be the upper working class and the middle class who are most devastatingly impacted by all this, when insurance runs out (or is non-existent) but the family’s income is high enough that they don’t qualify for Medicaid.
The problem is widespread, but no one knows how widespread. In 2003 the GAO conducted a survey in which 19 states responded that families had indeed placed a total of 12,700 children with mental illnesses in states’ custody in 2001 – either in the child welfare system or the juvenile justice system for the sole purpose of obtaining the needed mental health care. Even more troublesome than a number like 12, 700, is the fact that 31 states did not even bother to respond to the survey, leaving those who study public policy unsure of how much more widespread the problem is.
The Bazelon Center for Mental Health Law has looked at this issue in conjunction with the home-based/community-based waivers and Katie Beckett waivers, because having appropriate waiver programs in place is one way states can reduce the number of children needing to be relinquished.
Eleven states have passed laws prohibiting the relinquishment of a child to the state to obtain mental health care. Those states are Connecticut, Colorado, Idaho, Iowa, Maine, Minnesota, North Dakota, Oregon, Rhode Island, Vermont and Wisconsin. Out of these, seven have passed laws allowing for agreements between parents and child welfare agencies for payment of out-of-home-placements. These states are Colorado, Oregon, North Dakota, Rhode Island, Maine, Connecticut and Idaho.
(Blogger’s Note: I’m caveating this listing of states above, because I could not find a date on this information. I can only hope and pray that more states have passed similar legislation.)
Since 2003 in Congress there is a piece of legislation called the Keeping Families Together Act. In 2007 it was S. 382/HB 687. So far the legislation hasn’t made it out of committee. So the travesty of families forced to choose between getting their child the medical treatment he/she needs and keeping the child in the family continues.
It is appalling to me that in 2007 we can’t understand that mental illness is an ILLNESS. We would never dream of asking parents of children with cancer, or even autism, to relinquish their children to get services. In some states the act of relinquishing the child brings legal abandonment charges on the parents that is not only extra humiliation, but in some cases prevents them from working at professions dealing with children and definitely prevents them from pursuing future adoptions.
