A bipartisan bright spot we can’t afford to pass up: child welfare reform

Though it does not make media headlines, a team of children’s advocates, congressional staff, and members of Congress from both sides of the aisle have been quietly working over the past two years toward an ambitious goal of reforming our child welfare system to better serve vulnerable children and their families. Big, bipartisan bills with buy-in from both chambers are rare these days, even rarer in election years. But the hard work of champions and members of Congress alike who recognize the need for this kind of effort have led us to an important precipice: a bill, the Family First Prevention Services Act of 2016 (H.R. 5456/S. 3065), that’s passed the House and one that’s soon to advance in the Senate. As President of the American Academy of Pediatrics (AAP) and a pediatrician who works with vulnerable children, including those at-risk for entering and currently involved in the child welfare system, I understand the impact this kind of legislation will have if it passes.

Because of histories of abuse, neglect, and other trauma, some children in the child welfare system have extensive behavioral health needs, which are best met in a residential facility. Current federal standards do not outline requirements for the treatment provided in these facilities, leading many children to languish in overly restrictive settings that fail to meet their needs. This bill would create a new category: Qualified Residential Treatment Programs. These programs are specifically designed to serve the needs of the most vulnerable children and help them heal. The AAP strongly supports this new category, and a dozen medical and advocacy organizations representing health professionals, foster parents, adoption organizations, children’s advocates, and foster youth, agree. The bill is right to require that specially trained clinical and nursing staff are located in congregate care sites where children live. The staff would be physically present onsite during business hours, and available 24-7 to address children’s health needs. Without this requirement, the bill would put already vulnerable children at unnecessary risk, prioritizing the wellbeing of companies providing congregate care over the children who need these services. 

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