“What a horrible message to a kid. You already have a mental illness, and then you think, ‘I’m so bad, my parents don’t want me anymore.’”
– Renee Dvorsky, who was forced to give custody of her 16-year-old son to the state.

ISSUE: Each year, thousands of parents are forced to relinquish their custody rights to the state in order to obtain mental health care for their seriously ill children. Services to treat severe mental disorders in children are extremely expensive and private insurance tends to run out after a few months, leaving parents unable to afford the cost. Yet affected children often remain ineligible for Medicaid because their parents’ income and assets keep them from qualifying for assistance. With no other way to get their kids treatment, parents are forced to choose between custody or care. The GAO reported in April 2001 that parents in 19 states placed 12,700 children in state welfare or juvenile justice agencies to obtain mental health services for them. That estimate is considered low, because 31 states did not respond to the survey.

THE SOLUTION: The Keeping Families Together Act would keep these children with their families through three main components:

• Grants to states to build new state-level infrastructure to more efficiently serve these children while keeping them in their families;
• Establishment of a federal interagency task force to examine mental health issues in the child welfare and juvenile justice systems; and
• Inclusion of eligibility of children and adolescents in residential treatment facilities for Medicaid home or community-based services waivers.

Competitive grants to states are conditioned on the existence of state laws or policies in effect to ensure that children receive appropriate mental health services so that parents do not have to relinquish custody of such children. The Family Support Grants will:

• Keep children with their families by helping states establish interagency systems of care as an alternative to custody relinquishment;
• Allow states, which already spend significant money serving children in state custody, to use resources more efficiently by delivering care to children while allowing them to remain with their families;
• Facilitate the design of a state plan through a collaborative process involving state child-serving agencies, parents, providers, and other stakeholders;
• Only fund activities which benefit children and youth who are in the custody of the state or who are at risk of entering into the custody of the state solely for the purpose of receiving mental health services; and
• Require states to provide matching funds over the 6-year period of the program, ultimately equaling not less than $2 for each $1 of federal funds provided in the grant.

COST: Grants to states authorized at $4.5 million for fiscal year 2007, $6.5 million for fiscal year 2008, and $11 million for each of fiscal years 2009-2012. Grants to establish the task force authorized at $1 million for each fiscal years 2007 through 2012.

AACAP POSITION: AACAP urges you to support H.R. 687/S. 382, The Keeping Families Together Act, in the 110th Congress.