Texas Must Take Advantage of Federal Funds to Keep Kids Out of Foster Care

This week, I met a beautiful baby girl named Avery. She has brown eyes, a head full of wild brown hair and rosy pink cheeks. When she was born, she weighed just under 5 pounds despite being full term. Her mother had used cocaine while pregnant, and Avery now found herself in my pediatric office for a check-up after being placed into foster care at just 6 weeks old. She has eight brothers and sisters who all live in four additional foster homes, spread across East Texas because their parents' substance abuse disorders have rendered them unable to care for their children.To see firsthand the results of our state's child welfare crisis, look no further than my pediatric practice. The children I care for experience extensive trauma, which affects their health, development and well-being. Babies like Avery will struggle to grow and develop normally. Other older children will struggle in school, having higher instances of anxiety and chronic illness.In 2016, almost 20,000 children in Texas entered foster care, and more than one-fifth of them were infants. That's more than 4,000 Texas infants each year. Parental substance abuse was a contributing factor in the decision to remove a child from his or her home for over 60 percent of children entering foster care in our state, which was true for Avery. I also have several teenage patients who are in foster care for the second or third time because their parents are battling substance abuse disorders. These teens are frequently moved from one placement to another, often in group homes, while their parents complete rehabilitation. Each time they re-enter the system, their sense of security, routine and safety is disrupted as they are once again separated from their parents with no real sense of how their families are doing or when they might be reunited.I know we can do better for my patients.During the 2017 legislative session, our Texas lawmakers took steps to address our state's child welfare crisis by passing legislation to reform the system, including improving payment and retention of caseworkers and increasing access to medical care for children in foster care. While these policy changes are important first steps to strengthen families, we now have a major opportunity to bring in federal resources to help even more Texas families under a new federal law, the Family First Prevention Services Act, which I urge our state to take up without delay.In the text of the law and woven into its core policies is one word that carries a lot of importance for our state: prevention Enacted as part of the bipartisan budget agreement Congress passed earlier this year, the Family First Prevention Services Act would, for the first time, enable states to use funds previously used to place children in foster care to instead support evidence-based services to prevent the need for foster care in the first place. These services, available for both the children and their parents or caregivers, include substance use disorder treatment, mental health care, and in-home parenting skills training. States can also use these funds to keep children together with their parents in specialized treatment facilities that can meet a family's needs. This means that Avery's mother could have received treatment during her pregnancy and postpartum, allowing Avery to stay safely with her mother instead of entering foster care. This means that my teenage patients could continue living with their parents as they sought treatment, rather than being uprooted from their homes again and again.This understanding of what children and families need to thrive is why this legislation had the support of the American Academy of Pediatrics and its Texas chapter, the Texas Pediatric Society. Texas's own Rep. Kevin Brady helped lead the way on this bipartisan effort. His commitment to getting this legislation enacted is a testament to the promise it offers for Texas.But the promises of Family First are not guaranteed; Texas will have to affirmatively elect to use federal resources to address our current crisis. I urge our state policymakers to take up this opportunity. For children like Avery, there's no time to waste.Dr. Valerie Borum Smith is a pediatrician at St. Paul Children's Clinic in Tyler and a member of the Texas Pediatric Society and the American Academy of Pediatrics. She wrote this column for The Dallas Morning News. What's your view?Got an opinion about this issue? Send a letter to the editor, and you just might get published.  Continue reading...

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