The Missouri Independent declares it LINK>Truly A Crisis dated June 20 2023. No idea how many other states have similar issues.
Of the 13,183 foster children in the custody of the Missouri Children’s Division at the end of April, 52 were housed in medical facilities and 258 were housed in mental health facilities. At the end of April 2022, there were 72 foster children in medical facilities and 92 in mental health facilities.
The Department of Mental Health also has difficulty finding residential support providers. It has 704 clients who are developmentally disabled waiting for a residential placement, with the more than three dozen housed in hospitals considered among the most critical for placement.
“Unfortunately, right now, hospitals are a place where both residential facilities and in some cases, therapeutic foster families — or you know, or families in general — will bring their children because they don’t feel adept at caring for the child,” said Michelle Schafer, regional vice president for behavioral health at SSM. “There are usually significant behavioral components to the situation.”
All of Missouri’s hospital systems have served this function at one point or another in the last year, and the number of children in limbo has been growing. Foster children living in hospitals or other temporary locations for long periods isn’t just a Missouri problem. Many states are finding it difficult to recruit foster parents, especially in rural areas, KFF Health News reported this week.
For the Department of Mental Health, one of the biggest issues is community providers are struggling with staffing issues. “We lost about 50% of our residential beds, because we had a workforce shortage, which then sort of turned this cycle into a situation where we had a lot of kids, and we had no place for them to go,” Schafer said.
Senator Elaine Gannon sponsored legislation that passed which directs the Mental Health and Social Services departments to study and report on the impact of hospitalizing foster children and Department of Mental Health clients “without medical justification because appropriate post discharge placement options are unavailable,” and how to end it. “This doesn’t happen,” Gannon recalled thinking. “They don’t leave somebody in a hospital for six months, a year or even a month because they don’t have anywhere to send them. I can’t really believe that. Well, let me tell you, it’s the truth, and it is happening, and it’s happening everywhere.”
“That’s not a good setting either for the child or the young adult who’s in that situation. They need social supports, they need connections to communities, that a hospital just can’t provide.” said Brian Kinkade, vice president of children’s health and Medicaid advocacy at the Missouri Hospital Association. “Hospitals are not designed or staffed to provide housing for foster children and adults with developmental disabilities or behavior issues that do not need treatment for acute conditions,” Kinkade said.
“What we’ve decided to do instead is come together in what is truly a crisis and say, ‘You know, we’re all going to recognize that it is a failed system, that deinstitutionalization is failing right now. And we’re all going to lean in and be committed to doing our part to make it better,’” Schafer said.
Missouri puts children into foster care at nearly twice the national average rate, according to the LINK>National Coalition for Child Protection Reform. And part of the process of rebuilding the division is focusing on preventing removal in the first place. “If you put services on the front end to prevent those things from getting to a place where a child had to be removed, that’s a much better expenditure of money,” Children’s Division Director Darryl Missey said during a January budget hearing. Each child in foster care costs the state around $25,000 per year. Traditional foster families receive a maintenance stipend of $450 to $630 a month.
The point, Mary Chant, chief executive of Missouri Coalition for Children said, is to break down jurisdictional barriers where people disclaim authority, leaving people in limbo. “Those things may be true, but none of those things help us figure anything out,” Chant said. “Our first question has to be: What is it that the child’s family needs? And what do we need to do to get them that?”
With everyone at the table agreeing Missouri’s systems are in crisis, the first step was to get past blame, Schafer said. “Blame has no place in this,” she said. “It is literally all collaboration and partnership as we are committed to do this work, and up to it including having legislative support.”
Thanks to Terry West over at LINK>Indivisible Rural Progressives of the Eighth District and LINK>Jess Piper on TikTok for awareness.