State Sen. Sara Gelser Blouin wants to expand the availability of care for Oregon children with severe mental and behavioral health needs.
Gelser Blouin, chair of the Oregon Senate Human Services Committee, is working on a bill for next year’s session that would make it easier for children with complex behavioral health needs and their families to access treatment and support, including caregivers who visit children in their homes.
The goal is to equip children and their families with the support they need and prevent them from needing more intensive services like placement in a residential facility, said Gelser Blouin, D-Corvallis. To accomplish the goal, she wants to make children with behavioral health needs eligible for Medicaid, regardless of their family’s income. This would reduce obstacles families face when they try to find care and services available through their private insurers.
“It opens up this entire array of services that will be available to kids in their homes and in their foster homes,” Gelser Blouin said Thursday in her committee meeting. “What they need is a higher level of structure and support and supervision that’s very difficult for their family that’s in crisis to provide.”
Her work comes at a tumultuous time for Oregon’s children. The Oregon Department of Human Services is under a federal court order to improve its foster care system, which still routinely houses children in temporary hotels because of a lack of housing.
And families of children with complex needs like autism and post-traumatic stress disorder, or a combination of conditions, struggle to access services and navigate a cumbersome system. Some children act aggressively because of their conditions, and parents worry about whether they can care for their children. In those cases, direct service providers can work with children and parents as they learn to address crises as they arise.
Parents and Oregon child welfare officials spoke before the Senate committee.
Eugene resident Amy Fellows told lawmakers she struggled to find mental health care for her autistic 14-year-old. Her family also endured a two-week hospitalization after the child’s new medication triggered a seven-hour manic aggressive behavior episode.
With more support offered at their home, Fellows said, “we could have avoided a traumatizing hospital stay that severely impacted our attachment and connection.”
In an interview, Gelser Blouin said the bill and change to drop the income requirement could help several hundred children in Oregon.
A precise figure – and the cost – wasn’t immediately available. But the Medicaid funding would provide a 67% match, keeping the state’s costs down and setting up children for long-term success, Gelser Blouin said. Another potential benefit: opening up more beds in youth residential facilities because families can receive support, she said.
As a result, Gelser Blouin said she hopes the state can prevent worse problems in the long-term: trips to the emergency room, homelessness and foster children housed in hotels.
Foster children in hotel rooms
Lodging children in temporary housing – usually hotels – is a last resort. About 30% of Oregon foster children who are in temporary lodging have safe parents, said Aprille Flint-Gerner, child welfare director at the Oregon Department of Human Services.
“What it tells me is that parents are really lacking support,” she told lawmakers. “Families are lacking the clinical supports and the behavioral health supports that they need.”
A federal judge in July ordered the appointment of a special master, essentially an outside expert, to recommend ways for the court to end the practice. After a 2016 lawsuit from child advocates and former foster children, the agency entered into a settlement agreement in 2018.
But the agency fell out of compliance and didn’t bring the number of children in hotels down within the terms of the agreement. By July 2020, the agency was to have no more than 12 children during any six-month period, down from a limit of 120 children during the last half of 2018.
Since then, the agency has blamed staffing shortages from the pandemic and fewer providers for its struggles. As of Tuesday, the agency had 16 children in temporary lodging, out of 4,694 foster children total in the system, said Jake Sunderland, a spokesman for the agency.
Flint-Gerner said the agency appreciates the input of the special master, Marty Beyer, an Oregon psychologist and child welfare expert.
Beyer will make recommendations to the federal court by the end of 2023.
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