Bill May End Painful Choice Of Custody or Care

A bipartisan group of congressional legislators reintroduced the Keeping Families Together Act (HR 832/S 380) last month in the House and Senate.

APA supports the legislation, which would provide parents of children with mental or emotional disorders an alternative to relinquishing child custody to the state as a way to ensure that their child receives necessary mental health services.

Moderate-income families in particular are struggling with the lack of affordable mental health services. “These middle-class parents find themselves trapped between not having the resources to pay private mental health care and making too much money to be eligible for Medicaid,” according to a press release from the office of Rep. Patrick Kennedy (D-R.I.).

Kennedy, a cosponsor of the legislation, commented, “When parents in America are forced to surrender their children to a bureaucracy to receive care, we have nothing short of a mental health crisis in our nation.”

A General Accountability Office (GAO) report released in 2001 found that 12,700 children from 19 states were placed in the juvenile justice system to receive mental health treatment (Psychiatric News, September 19, 2003).

The GAO report caught the attention of Reps. Kennedy and Fortney (Pete) Stark (D-Calif.) and Sens. Susan Collins (R-Maine) and Mark Pryor (D-Ark.). They sponsored the 2003 Keeping Families Together Act in the House and Senate. The legislation did not make it out of committee in either congressional chamber. The original cosponsors reintroduced identical legislation in February along with Reps. Nancy Johnson (R-Conn.) and Jim Ramstad (R-Minn.).

The need for the legislation has only increased since 2003. Collins, who chairs the Senate Governmental Affairs Committee, held a hearing last July on the issue of youth who were incarcerated while waiting for community mental health services. Collins and Rep. Henry Waxman (D-Calif.), ranking minority member of the House Committee on Government Reform, announced at the hearing the results of a national survey they had commissioned on youth with psychiatric disorders held in juvenile detention facilities.

The results in the report, “Incarceration of Youth Who Are Waiting for Community Mental Health Services in the United States,” found that two-thirds of juvenile detention facilities lock up mentally ill youth, including children as young as 7 years old, because there is no place else for them to go. The report also emphasized that nearly 15,000 incarcerated youth were waiting for community mental health services during the six-month period from January 1, 2003, to July 1, 2003.

More than 500 administrators of juvenile detention facilities in 49 states responded to the national survey, which was a response rate of more than 75 percent, the report noted.

To improve families' access to affordable state mental health and family-support services, the Keeping Families Together Act would allocate $55 million for competing grants over six years.

States would be eligible for the grants if they are willing to end the practice of allowing child-custody relinquishment for the purpose of obtaining mental health care and if they create alternative avenues to mental health care that keep children with their families, according to the legislation.

Existing Medicaid home- and community-based waivers would be reformed under the bill to allow states to move children out of inpatient psychiatric hospitals and into less-restrictive home- and community-based care.

The 2005 Keeping Families Together Act (HR 832/S380) should be posted soon at<http://thomas.loc.gov>. The House Committee on Government Reform report, “Incarceration of Youth Who Are Waiting for Community Mental Health Services in the United States,” is posted at<http://democrats.reform.house.gov/Documents/20040817121901-25170.pdf>.▪