Legislation filed to renew/expand federal adoption tax credit.

Kudos to Congressman Bruce Braley for introducing legislation to continue and expand the adoption tax credit. Every child deserves a permanent, safe, loving family. As a society, we should support families willing to open their homes and hearts to include a child in their lives….and in the productive future of our society.

Telegraph Herald  April 17, 2012

On the deadline for taxpayers to file their federal income tax returns, Rep. Bruce Braley, D-Iowa, introduced a bill to renew and expand a tax credit for families that choose to adopt children.


What’s right with health care reform……


According to my friend, Joan Alker of the Georgetown Center for Children and Families, one of the least discussed aspects of the Affordable Care Act (dubbed ‘Obamacare’ by dissenters) is one of the most popular:  the expansion of Medicaid to cover low-income adults. The Kaiser Family Foundation published a poll last week reflecting a full 70% of those polled favor this aspect of health care reform. Given all the negative we hear about the ACA, it is useful to have a complete picture that includes those portions either working now (such as access to their parents’ insurance for young adults up to age 26) and those portions proposed that the public supports (such as Medicaid expansion).

Reasons Medicaid remains a popular program to the public-at-large:

  • Medicaid does not discriminate against those with pre-existing conditions.  In fact, those who have been turned down by private insurers due to pre-existing conditions in the past often turned to Medicaid for help.
  • Medicaid is cost-effective and spends less on administrative costs than private health insurance plans.
  • Medicaid provides comprehensive coverage that includes the definitive standard of care recommended by pediatricians known as Early Periodic Screening Diagnosis and Treatment (EPSDT).

Once again, the public seems to be very able to consider what benefits Americans. Let’s not allow political-speak from any ‘talking heads’ to give us only partial information.

Child Well-being in Oklahoma: Oxymoron?

According to the latest publications on child well-being state by state, Oklahoma is not doing so ‘well’:

Oklahoma’s domain rankings were:

  • 43rd in family economic well-being,
  • 41st in health well-being,
  • 47th in safe/risky behavior (levels of crime and use of tobacco, alcohol, and drugs),
  • 38th in educational attainment,
  • 44th in community engagement (working, school engagement, and voting among young adults),
  • 49th in social relationships (percentage of children who have moved recently), and
  • 11th in emotional/spiritual well-being (suicide rate and religious attachment).

The Legislature is now in Session. A top priority is tax cuts which may only add damage to these statistics as services are cut. Oklahomans are a hard working, self-reliant people. We belief in self-responsibility. However, babies and vulnerable children and youth cannot control these factors. State leaders, advocates, and Legislators must step up to provide for a healthy, stable future for our families so that we can thrive in our independence.

Adoption Credit Awareness Day Feb. 13th

Voice For Adoption, the Dave Thomas Foundation and the North American Council on

Adoptable Children are asking organizations to take part in a grassroots Adoption Tax Credit

awareness day for Monday, February 13. Many adoptive families are not aware that this tax

credit exists. The goal is to help adoptive families who are eligible to receive the benefit by

educating them on how to claim the credit. The organizations are asking everyone including

professionals, advocates, state agencies, families, and others to help spread the word next

Monday. To obtain a copy of their flyer go online: http://voice-for- adoption.org/sites/default/files/AdoptionTaxCredit_Awareness%20Day%20Feb13th.pdf 

Congratulations to Oklahoma Health Care Authority

With all the grumblings nationally and within states about the high costs of Medicaid, OHCA has earned a real pat-on-the-back that is likely to be missed. It should be of no surprise to any reader….or voter…that Medicaid roles have swelled in all states during the current recession. What is of surprise is that while Oklahoma’s Medicaid roles have increased during the last 5 years by 6.6% in new ‘members’, the cost of Medicaid services to these working poor, uninsured, foster youth, etc. has only increased 1.2%/per member cost. I don’t know about you, but my personal insurance premium goes up 5-11%/year! GREAT JOB, Health Care Authority!

Foster Kids need Services, not more Prescriptions!

New light has been shed recently on the plight of foster youth and too limited application of individualized, clinically assessed psychosocial treatment protocols for these vulnerable youth. While the national child advocacy community and certain leaders on Capitol Hill have been concerned about the over-prescribing and/or inappropriate prescribing of psychotropic medications for foster youth for some time, this conundrum has now been brought front-and-center.  The December edition of Pediatrics, the professional journal of the American Academy of Pediatrics, published a study of foster youth in one mid-Atlantic state demonstrating the high rate of prescribing of powerful antipsychotic medications for this population. Quickly following, the GAO(Government Accountability Office) published a report with similar utilization rates in five other states. Time Magazine, the New York Times, and most impressively, Diane Sawyer (ABC, 20/20) claimed the public stage to inform America about this crisis among foster youth. In short, foster youth are disproportionately being treated with major antipsychotic drugs instead of the psychosocial, behaviorally tested, evidence -informed clinical treatments that can address and ameliorate their trauma, destructive behaviors, and mental or emotional illnesses. Trauma and behavioral health issues do frequently follow the experiences of abused and neglected youth who are removed from their families for their own protection and well-being.  Ironically, a system that medicates and does not treat the underlying clinical issues might itself be accused of ‘neglect’?

Beyond the moral question of providing known, effective clinical response to foster youth, there is also a matter of cost and prudent investment of Medicaid dollars and other taxpayer monies.  The most frequently prescribed psychotropic medications are Resperdal, Seroquel, and Zyprexa. Responsible medical practitioners know that these drugs are for 1- adults and 2- for treatment of schizophrenia and bi-polar disorders, both of which are rare in the child/adolescent population. What has not been sufficiently stated in this debate thus far is the additional fact that these drugs are among the most expensive of all drugs for mental health treatment. They are expensive, they are not appropriate for the child population, and they do not address the causes of the emotional and development disabilities of foster youth to whom they are prescribed.

The Foster Family-based Treatment Association (the only national association of providers of TFC in North America) is actively engaged in solutions to better serve high-needs foster youth through treatment services. Treatment or Therapeutic Foster Care (TFC) is specialized foster care consisting of intensive behavioral health services delivered in foster homes by licensed mental health clinicians and supported 24/7 by the active participation of highly trained foster parents in the overall clinical plan for high-needs foster youth. TFC is proven to be an effective treatment for children with complex emotional, mental, and physical problems and emphasizes the delivery of clinical services.

FFTA and a broad coalition of 55 child advocacy organizations are urging CMS to publish official guidance promptly to State Medicaid Directors clearly identifying the services integral to TFC and to which custody youth are entitled under EPSDT.  The variations across states in their lack of understanding about TFC covered services too often denies foster youth access to services and forces well-meaning physicians to rely on their other ‘tool’, ie. Medication.

If utilized appropriately by state child welfare entities and state Medicaid administering bodies, TFC is a successfully demonstrated service for addressing the unique and complex trauma and behavior health challenges of foster youth who are otherwise unfortunately medicated with expensive and inappropriate psychotropic drugs.

A Child is Born….

At this most precious time of year for families everywhere and for Christians in particular, we are grateful and celebratory of the birth of the Christ-child.

Ironically, First Focus (Washington, D.C.) released a new publication today on the status of children in our country as impacted by the recession we are enduring. The report finds:

  • 2.7 million more children lived with an unemployed parent during a typical month in 2011, compared to 2007 (an increase of 71%), bringing the 2011 total to 6.5 million children;
  • 3 million (47% of those living with an unemployed parent) lived, during a typical 2011 month, with a parent unemployed six months or longer;
  • 8 million more additional children relied upon SNAP for food in 2011, compared to 2007, bringing the total number of children receiving SNAP to 21 million (one in four) nationwide;
  • 16 million children (more than one in five) currently live in poverty
  • At least 8 additional states became high child poverty states (where more than one-in-five children live in poverty) during the recession, pushing the total number of high child poverty states to 22

As we are mindful of that Babe born on Christmas Day in minimal physical conditions for thriving, let us be mindful also of the children of America and our duty to care for them.

Merry Christmas, Happy Holidays,


Work to do for Child Advocates in Home States

I have been encouraging child advocate leaders in each state to monitor and become involved in the work of their own state’s development of the new “health care exchanges”, which  the Affordable Care Act requires of all states beginning 2014. Simultaneously, my work nationally with the Foster Family-based Treatment Association has included my participation as part of a national child advocacy coalition working with the Center for Medicare and Medicaid Services (CMS) as they study development of an Essential Benefits Package (EBP). We have advocated strongly for needs of foster youth to be addressed by CMS in the benefits package, including both biomedical health needs and behavioral health. 

Friday Dec. 16, HHS published ‘guidance’ announcing a framework of benchmarks each state will be allowed to consider in developing their own EBP. This does not give the federal protections we were seeking with our efforts. Instead, it requires that child advocates must actively engage with legislative, state insurance department personnel, and Medicaid administering bodies with the focus of bringing representation for impoverished and/or custody youth into the discussions.

We will continue our work nationally. You are encouraged to identify those leaders in your state who have responsibility for establishing your state exchange and developing the Essential Benefits Package. That work is well underway now. Your investment of time and energy early in the New Year is encouraged.