Ron Wyden: Home Visitation Next on Child Welfare Agenda (And Maybe Psych Meds, Too)

In a marathon session before Senators made their way out of town to campaign, a bill to restructure adoption incentives and long-term foster care sailed through the chamber, and will likely be signed by President Obama this week.

Some federal programs at the back end of the child welfare system have been updated. The middle, foster care and family services funding is a much bigger fish to fry, and could be a few more years in the offing. But look for the Senate Finance Committee to take on a growing strategy on the prevention side in the short term.

Senate Finance Committee Chairman Ron Wyden (D-Ore.) told Youth Services Insider he wants to keep the momentum going on child welfare with legislation on home visitation, a strategy that generally involves health professionals helping young or first-time mothers before and/or immediately after birth.

Wyden said he has a “particular interest in home visiting. The evidence we’ve seen is that for at-risk moms, it’s something that works. That, to me, is something we ought to build around and expand.”

Home visitation is hardly a new strategy in the field, but it got an enormous financial boost with the passage of the Affordable Care Act (ACA) in 2009. There was a $13 million carve-out to the Maternal and Child Health Block Grant program for home visitation in 2009.

ACA established a Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, with the following guaranteed money for five years:

  • 2010: $100 million
  • 2011: $250 million
  • 2012: $350 million
  • 2013: $400 million
  • 2014: $400 million

But the ACA-assured spending ended in fiscal 2014. Congress approved an extension into March of 2015, and then the program will need some Congressional love to survive.

Links to the home visitation models approved for funding under the ACA:

Youth Services Insider thought the committee might have psychotropic medication use next on its list of child welfare priorities. It appears that the looming MIECHV deadline has moved that up the list.

In May, Wyden and Sen. Tom Carper (D-Del) vowed to “play offense” on the overuse of what Carper called “mind-bending” drugs for foster youths. That press conference doubled as the release of a Government Accountability Office (GAO) report that identified some flaws in the documentation and monitoring of mental health drugs for foster youths.

“When you have one of these kids who is the victim of intense trauma, you’re not going to have the challenges just prescribed away,” said Wyden, speaking at the May press conference. “You need services where the youngster gets personal attention. The reality is we have programs that get that right, we just don’t have enough of them.”

The issue appeared primed for Congressional action after the House Ways and Means Committee hosted a powerful hearing on psychotropics in foster care, which will always be remembered as the day that Dr. Phil emerged as a critical voice on the subject.

We still anticipate Carper and Wyden eventually pushing something similar to President Obama’s $750 million plan for combating over-prescription, which you can read all about here and here. House Ways and Means will likely move on this issue too, but will likely seek something with a far lower price tag than Obama’s plan.

Youth Services Insider is written mostly by Chronicle Editor John Kelly.

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