Busting Healthcare Myths

If you’ve ever been to college, or summer camp, or really if you have been involved with school general, you have probably heard of the game Two Truths and a Lie. I think games make things more interesting, so today we are going to play the child advocate version: Two Lies and a Truth. Alright, here we go.

  1. Neglect and substance abuse, not physical abuse, are the primary reasons young children (under the age of 5) are placed in foster care
  2. After the zombie apocalypse, Rick Grimes plans to run as the next Governor of Georgia.
  3. Future Governor Grimes also plans to eliminate all existing state Senate and state House seats, because this is a Ricktatorship.

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Welcome to Busting Healthcare Myths, a new Voices for Georgia’s Children series that tries to get to the “why” behind some surprising child health data out there, and ponder possible policy solutions.
If you haven’t figured it out already, the truth is that neglect and substance abuse are the primary reasons young children are placed into foster care. Inadequate housing follows behind in a close third. In fact, those three things alone account for almost 75 percent of why children under five enter care. April was Child Abuse Prevention Month, so it seems a particularly poignant time to take a look at the levers that could explain the why behind these stats, and explore some possible solutions.
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The Why:

As with pretty much any data point, there really isn’t one concrete “why” that ties this up in a neat bow, as much as we would like to. That said, being the savvy policy experts we are (in our own mind), we can form a fairly comprehensive picture simply by walking through what we know.
We know people who are depressed are at risk to self-medicate their symptoms with alcohol and other mood altering substances. We also know parenting –– especially when it’s new –– is stressful, and the financial strains, childcare challenges, work conflicts, and the myriad of other complications that can arise increase the risk of becoming depressed. We also know that new mothers are already predisposed to experience postpartum depression even without all these other factors.
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What We Can Do:

I like to think of myself as a nice person, and it just didn’t seem “nice” to lead with a hopelessly fraught policy issue in our first installment of this series, and fortunately, this quandary has some very tangible solutions.
First things first –– we can safely assume children insured through Medicaid are at-risk for health and developmental challenges, because of the financial circumstances that made their family eligible for Medicaid in the first place. All of these kids who are insured through Medicaid are required to have something called Early Periodic Screening Diagnosis and Treatment (EPSDT). These screening are typically aligned with well-check visits (a.k.a check-ups).
Here’s the important part: federal regulations consider maternal depression screenings a “risk assessment” for children, and that means screenings for it can actually happen during a well-check visit and be billed to Medicaid as part of EPSDT. The kicker? A state has to “turn on” the Medicaid code and providers must use approved standardized tools in order to put it into practice. Georgia has yet to do this, but streamlining the process would go a long way towards ensuring maternal depression concerns are caught and addressed early. Complicated? Yeah a little. Possible? Definitely.
This brings us to part two: helping children get access to consistent, quality child care. Currently, quality child care isn’t an option for many parents, either because it’s not affordable, or because it isn’t available in their area. Right now, there are several different systems in motion trying to address this, the first of which is Quality Rated. An initiative of the Department of Early Care and Learning (DECAL), Quality Rated is a systemic approach to assess, improve and communicate the level of quality in early care and education programs. On the affordability side, the Childcare Assistance Program is working to help families afford quality care. Lastly, at the state official level the Governor’s Early Childhood Education Subcommittee of the Education Reform Commission actually released their recommendations in December.
Now, it’s important to recognize that each of these programs are incomplete on their own. In fact, there are still hundreds of child care centers that are not quality rated, the Childcare Assistance Program only serves a fraction of the families that are eligible, and the recommendations from the Governor’s subcommittee are only recommendations at this point. But more importantly, they provide a starting point, one all of us child advocates can get behind and nurture and grow.