Sunday, July 09, 2006

Delayed Health Care for Foster Children

Drugging foster children unnecessarily is not good.

Denying foster children medical services due to citizenship concerns is equally disastrous.

Deficit Reduction Act of 2005 Revisited
Due to recent concerns about illegal immigration, the federal government is now implementing a provision of the DRA which requires that all U.S. citizens who apply for, or renew, their eligibility for Medicaid coverage must document their citizenship.

This ruling was effective on July 1, 2006. It is intended to prevent illegal immigrants from receiving benefits through Medicaid, the government program of health care for the poor.

What About Foster Children Receiving Medicaid?
Therein lies the rub. All children who eligible for Title IV-E funds can be enrolled in Medicaid. Up until now, the very fact that they receive federal foster care payments has been accepted as proof of citizenship.

Likewise, low-income children and children with disabilities within the foster care have had access to Medicaid as well.

Well... not anymore.

New regulations are requiring the documentation of citizenship for every child entering foster care. Without the proper documentation, foster children will remain uninsured.

Approximately 300,000 children enter foster care each year. How many of them will be carrying their birth certificates with them? Many of these children are coming from abusive and neglectful homes, and their families might not have (or be willing to relinquish) vital information.

Due to the circumstances surrounding the emergency removal of children from their homes, state agencies frequently use electronic birth records to establish case files. Now, only the original document, or a copy certified by the issuing agency will be considered acceptable.

Will foster parents be given enough information to apply for birth certificates on children's behalf?

What about the waiting period? Obtaining a birth certificate can take weeks or months.

Denying Foster Children Access to Health Care
Upon entry into foster care, a child might be developmentally delayed or underweight. They may never have visited a dentist or lack up-to-date immunizations.

It is for all these reasons that the American Academy of Pediatrics Committee on Early Childhood recommends a comprehensive medical screening upon entry into foster care.

Children who enter foster care are at high medical risk. How long should they wait to receive treatment?

I agree wholeheartedly with this quote from Robert Greenstein, Executive Director of the Center on Budget and Policy Priorities:

"These children are among the most vulnerable members of our society. To deny them health care coverage for beaurocratic reasons that readily could be resolved, and refuse them coverage while their documents are being located is not defensible."

Kudos to Montana for coming up with a creative solution
Montana's Motor Vehicle Division will issue state identification cards to nearly 2000 foster children.

Casey Family Programs contacts the Department of Health and Human Services
The following agencies joined Casey Family Programs in voicing (and documenting) their collective concern over this issue:

Association of Jewish Family & Children's Agencies
Arkansas Center for Health Improvement
Bazelon Center for Mental Health Law
California Mental Health Directors Association
California State Association of Counties
Child Welfare League of America
County Commissioners Association of Pennsylvania
County Welfare Directors Assocaition of California
Familes USA
Foster Care Alumni of America
Illinois Department of Children and Famiyl Services
Jim Casey Youth Opportunties Initiative
National Advocacy Center of the Sisters of the Good Shepherd
National Association of County Human Services Administrators
National Association of Social Workers
National Education Association
NETWORK, a National Catholic Social Justice Lobby
Pennsylvania Children and Youth Administrator's Association
Public Children Services Association of Ohio
Safe Place: Center for Child Protection and Health
Alliance for Children and Families
Arc of the United States
Children's Health Fund
Vermont Department for Children and Families
Voices for America's Children
United Cerebral Palsy
Wisconsin Counties Association

Kids in foster care receive state cards. Montana News Station, Great Falls, MT: July 2006.

National organizations warn HHS that citizenship-verification rules could lead to denial of critical medical services to foster children. Casey Family Programs press release: June 30, 2006.

Redmond, Pat. Children in foster care may have to delay health care because of federal regulations on citizenship requirement. Center on Budget and Policy Priorities: July 7, 2006.

Spillane, Shannon. Changes in Medicaid rules 'commendable,' but further changes needed to precent loss of health coverage by poor children and parents. U. S. Newswire: July 7, 2006.

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Again, I unfortunately have first had information about how the depravation of medical care for foster kids has been going on for years in Los Angeles County. LA contracts with group homes and foster homes in Orange County, but the Medi-Cal program is administered separately from county to county. In other words, a child who is placed in Orange County out of LA County has LA Medi-Cal. Orange County health care providers who contract with the group homes don't (can't) take LA Medi-Cal.

The judges in Los Angeles are well aware of the problem and yet it persists. The end result is a lack of health care and or mental health care for kids.

The new legislation you describe above will onlly make an already horrible bureaucratic mess more cumbersome.
thank you for sharing this information. i am a former foster child and experienced this myself. for years. i would like to send you a link to my blog, somewhere more private.
Dear Anonymous,
Was your comment for Lisa? If so, there are links to her email in her profile. If it was for me I'd be happy to give you my email. I'd love to see your blog.
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