One of the most-challenging decisions I see firsthand in my work as a pediatrician is the decision to remove children from their family and place them in foster care. The stakes are high in Arizona: In 2016, over 11,000 Arizona children entered foster care, more than double the national rate. Most children are best-served by keeping their families safely intact, but many families require intensive services and support to do so. Thatβs why I am excited that a new federal law offers our state the opportunity to access needed resources and supports to help these vulnerable families.
A young mother in my practice struggled to provide care for her newborn daughter, Emma. Emmaβs mom had a debilitating illness and a history of drug use. She had previously completed treatment for substance-use disorder, but recently became depressed over her illness and relapsed.
To get the residential services to help her heal, she needed care for Emma. Emmaβs grandmother was willing to help, but had limited resources and worried she would not be able to provide adequate care. As a result, Emma entered foster care. Families throughout Arizona are struggling with similarly complex challenges and choices.
The bipartisan Family First Prevention Services Act, signed into law in February, represents a major improvement to federal child-welfare policy. Emmaβs family is one of many in my practice who could benefit under the law.
For the first time ever, Family First will enable states to use funds previously restricted to foster-care placements for services to prevent the need for foster care. Over 80 percent of Arizona children placed in foster care have been removed from their home due to neglect, often associated with parental substance use and mental illness. Nearly 30 percent of the Arizona children entering foster care in 2016 did so at least in part due to parental substance use. Providing these families with mental-health and substance-use disorder treatment, as well as in-home parenting skills training, could allow a child to safely remain with their parents or other relatives while they heal together.
Arizona initiatives such as the Substance Exposed Newborn Safe Environment Program are already demonstrating that it is possible to keep children with their parents during treatment in an environment where they can heal, using the same philosophy that underpins Family First. Family First also emphasizes the importance of children growing up in families and helps ensure children are placed in the least-restrictive, most family-like setting appropriate when foster care is needed.
The Arizona Chapter of the American Academy of Pediatrics supports Family First. We thank Congress, and especially the Arizona congressional delegation, for taking this major step . However, the work is not done. States will need to affirmatively decide to participate in Family Firstβs prevention-services program. Now it is time for our state to take advantage of this opportunity and utilize these funds to support programs that can help children at risk of entering foster care stay safely with their family with appropriate services, interventions, and oversight. We urge our state policymakers to take up this opportunity immediately; vulnerable children like Emma canβt afford to wait.
