HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Monday, December 13, 2004

Mental Health and Foster Care: Virginia Report

A report commissioned by the Virginia General Assembly contends that one in four children in foster care in that state are there because foster care is the only setting in which the children can get needed mental health care, according to a report in the Nov. 29 Washington Post:

The study -- the result of a months-long examination of the state's foster care and mental health services -- chronicles the difficult decisions that thousands of Virginia parents have made to relinquish custody of their children to the foster care system so they can get mental health services that are otherwise unavailable or unaffordable.

Many of these parents have children who suffer from schizophrenia, severe depression or bipolar disorder. The cost of caring for these severe conditions 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.

But because children can get those services if they are in foster care or in special education programs, parents turn to the child welfare system, which can provide day treatment, residential care and other expensive services.

"The main problem is that there is inadequate access to mental health treatment . . . and it tends to be extremely expensive if parents are able to receive it," said Raymond R. Ratke, deputy commissioner of the state's Department of Mental Health, Mental Retardation and Substance Abuse Services, who led the work group that published the report.

A syndicated column (courtesy of the Seattle Post-Intelligencer) by Bonnie Erbe appeared this week and focused attention on this largely-overlooked report.  She concluded:

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). . . .

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.

The report, "The Relinquishment of Custody for the Purpose of Accessing Behavioral Health Treatment (House Document 34)" is here (PDF).

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