Hundreds of Minnesota children who have suffered the trauma of being removed from their birth parents, and are now living in foster care, could soon receive state-funded intensive psychotherapy services to give them safer, more stable lives.
Minnesota officials hope the mental health services, rolled out at a time of soaring foster care caseloads, will cut the persistently high number of children who cycle in and out of foster care placements without finding safe and permanent homes.
Until now, many of these children have gone years without receiving psychiatric treatment for their emotional problems, and end up in publicly funded group homes and treatment centers that cost the state Medicaid program millions of dollars, officials said.
Statewide, nearly one in five foster children in Minnesota bounce back to care within a year of being placed with families — among the highest so-called “re-entry” rates in the nation.
Last year, Minnesota’s rate of re-entry, a key measure of stability in foster care placements, was more than twice the federal benchmark of 8.3 percent, according to recent state data.
At least 600 Minnesota children in foster care should benefit from the new service, which will cost the state-federal Medicaid program about $1.2 million in its first year, state officials estimate.
“This [program] should help prevent future disruptions” in a child’s life, said Claire Wilson, assistant commissioner of community supports at the Minnesota Department of Human Services, which oversees the foster care system. “Certainly, the hope is that with an intensive intervention, kids are going to stay well and families will stay well enough to maintain a placement, and provide the groundwork for reunification.”
The new benefit comes as the state and counties wrestle with swelling numbers of children being removed from their biological families and placed in foster care.
Caseloads are soaring
Since 2010, the number of Minnesota children in out-of-home care has soared by 46 percent, and they are staying in foster care for longer periods of time. State officials say the increase has been driven, in large part, by the prescription drug epidemic. Last year, nearly 2,000 Minnesota children, double the number from 2010, were removed from their parents because of parental drug abuse, state records show.
As a result, the demand for more intensive therapy has grown rapidly. More than one-quarter of children in Minnesota’s foster care system have an emotional disturbance, according to a 2015 legislative report.
“The system is being taxed mightily,” said James Koppel, DHS assistant commissioner for child and family services, in a recent interview.
For the past decade, limited psychotherapy and life skills training has been available to foster care families through a Medicaid-funded program known as Children’s Therapeutic Services and Supports, or CTSS. But the services offered in CTSS are largely provided through unlicensed practitioners, and foster parents say they are often inadequate for children with severe trauma and diagnosed mental illnesses.
The new service will make care available in a child’s home, enabling therapists to better identify potential disruptions in the home and possible solutions, officials said. Children who qualify for the benefit will receive at least six hours of face-to-face treatment each week from agencies certified by the state.
Marsha Van Denburgh of Oak Grove said she wished the program had been in place four years ago, when she became the foster parent of an emotionally troubled 5-year-old with a history of abuse.
‘We have nowhere to turn’
Over the years, the boy’s outbursts had become more frequent and more violent, forcing Van Denburgh to call 911 on several occasions simply to protect the family. The child was finally removed from the home two weeks ago after a string of outbursts that culminated when he pelted police officers with rocks, she said.
“All too often, foster parents like us have nowhere to turn except to call 911,” Van Denburgh said. “There has to be something more.”
Studies in other states, such as Oregon, have found that foster children who receive intensive therapy have far fewer failed placements and show fewer problem behaviors than children in regular foster care. Foster parents of children receiving such one-on-one therapy are also less likely to drop out of the system, researchers have found.
“This is a well-thought-out, hugely important benefit for a population of kids who are most at-risk of emotional and behavioral problems,” said George Realmuto, a professor of child psychiatry at the University of Minnesota.
Kory and Alicia LaCroix of north Minneapolis said they discovered the importance of psychotherapy soon after becoming foster parents last year to a 16-year-old girl.
The girl was deeply scarred from early childhood trauma and had trouble forming personal attachments, Kory LaCroix said. At times, she would “shut down and explode,” and the family was unsure of how to react. Psychotherapy helped the girl work through conflicts and form relationships again, Kory LaCroix said.
“We’ve heard too many stories of young people who are moved from family to family to family to family, and every time it’s another traumatic event,” LaCroix said. “To have no support for those young people does our society a huge disservice and only adds to the trauma.”