By Michelle Sanborn, Children’s Alliance

The landmark bipartisan Family First Prevention Services Act of 2018 was, in my opinion, the most significant reform to federal child welfare policy in decades. Family First includes policy improvements to help keep children safely with their families and avoid the traumatic experience of entering foster care. It helps ensure children are placed in the least restrictive, most family-like setting appropriate to their needs, when foster care is needed. Family First calls on States to radically rethink their approach to child protection and family services, and full implementation of the law is set for October 1, 2021.

As part of Family First, there are new requirements for children with serious emotional and behavioral health needs to be placed in specific residential treatment programs called Qualified Residential Treatment Programs (QRTPs). Unfortunately, there is an unintended consequence, due to this new language, that would put children and youth in foster care at risk of losing their Medicaid coverage which covers the cost of their medical, dental, and mental health care needs.

You see, back in the early 1900s, states often placed people with mental illness in large, locked institutions and left them there for the rest of their lives. So, in 1965, in an effort to de-institutionalize thousands of individuals with mental health conditions, Congress passed a law prohibiting Medicaid funding for people living in any institution that has more than 16 beds, which they called “Institutions for Mental Disease” (IMD).  Regrettably, today, these two federal laws are colliding.

Thankfully, U.S. Senators Richard Burr (R-N.C.) and Dianne Feinstein (D-Calif.) introduced the Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 (S. 2689). This bipartisan legislation would ensure that children in foster care who are placed in QRTPs with more than 16 beds also qualify for Medicaid.

Our foster children should not lose their Medicaid coverage because they are placed in a setting that best meets their severe emotional and behavioral health care needs. Ultimately, without this exemption for QRTPs, thousands of children in foster care who are vulnerable will be pushed into more restrictive placements, non-therapeutic or unstable settings, or they will bounce from placement to placement without addressing their true needs – which is the opposite of the intent of Family First.

Please contact your Congressional leaders and let them know to pass S. 2689, and if any organization has not signed on and would like to demonstrate support, they can sign on to the support letter with over 600 state and national organizations HERE.

Children's Alliance

Michelle Sanborn is the President of the Children’s Alliance in Frankfort, KY. She has more than 25 years’ experience in serving and advocating for at-risk children and families in Kentucky.