I am writing in response to the show on the Ohio couple. Thousands of adoptive parents across the United States are facing the same problems.
Over and over you asked-what should parents do? Most of them are already getting counseling and other services and despite intensive in-home and community based interventions, the child continues to escalate to an unsafe level of behavior, risking the lives of siblings and parents.
These are the children of trauma--children who have been severely neglected or abused, often as toddlers or infants and it affects their brain development at a crucial stage. In particular, it effects the child's social and emotional development.
It is generally when a child needs residential care that families are unable to access treatment. In the case of domestic adoptions, children are given Medicaid as part of the adoption subsidy under the Adoption & Safe Families Act (ASFA). As such, they are legally entitled to medically necessary treatment under federal law; however, states are failing to implement treatment for these children at the state level. In effect, the federal government is awarding them permanency, but the states are taking their permanency away when they force an involuntary relinquishment after failing to implement federal law. The federal govt. gives and the states take away.
When families reach the limits to provide safe and appropriate care, the state encourages placing them into foster care as a financial convenience. It allows them to draw down federal funds for treatment. Thus, as an adoptive child, he cannot access funding, but as a foster child he can.
Now, here are the solutions you asked for. The federal government needs to force states to comply with the EPSDT provision of Medicaid (Early, Periodic, Screening, Diagnostic, and Treatment) which is an automatic entitlement from the Medicaid awarded to them as part of the adoption to help preserve their permanency.
Second, "money follows the child." If a state can draw down federal funds for a foster child, they should be able to draw down federal funds for the same child as an adoptive child. This would provide treatment while preserving the child's permanency and keep everyone safe as well. These are the laws that could have helped your caller, Sage, or my family, or thousands of others. They may have saved the Ohio family. These are the laws we need passed.