Adopted children in Colorado do not get mental health screenings on time

Many adopted children in Colorado are not being screened for mental health problems as quickly as they should be, according to data recently reviewed by state lawmakers, who said they were concerned about this delay in care and other issues raised in a Colorado Sun investigation into disrupted adoption. .

A recent report from the state’s Medicaid system reinforces the Sun’s findings that 13% of foster child adoptions in this state have failed in the past decade in part due to a lack of behavioral health services that can help children recover from trauma.

Less than one-third of children in foster care across Colorado receive a behavioral health exam within a month of enrolling in the state’s medical insurance program, according to 2020-21 numbers from the Colorado Department of Health Care Policy and Financing. This is despite well-documented concerns about the prevalence of trauma and mental health problems among foster children and those adopted from the foster care system—issues that, in many cases, can follow former foster children for years.

The data shows that only 15.4% of foster children in Adams, Arapahoe, Douglas, and Elbert counties received a behavioral health evaluation within 30 days of enrolling in a state health insurance program. Just over 16% of the kids on the western slope did so. Foster children in southern Colorado counties, including Las Animas, Mineral and Alamosa, fared better. Thirty-three percent of children there received a behavioral health evaluation on time in 2020 and 2021.

Previous foster children are eligible for Medicaid until they turn 26, regardless of their income. Children adopted from Colorado’s foster care system can remain on Medicaid, regardless of the adoptive family’s income.

Lawmakers on the powerful committee that writes the state budget raised concerns about low ratings in the Nov. 18 session.

State Senator Rachel Zinzinger linked the data to the findings of the Sun investigation, which found that former foster children and their adoptive parents were failed by state and county systems ill-equipped to care for severely traumatized children.

“Some of those stats… I worry about that,” said Zinzinger, a Democrat from Arvada and chairman of the Joint Budget Committee.

She said behavioral health checks are important because of the trauma children experience, which can include abuse, being with multiple foster families, or being adopted and abandoned by the foster care system.

Left unaddressed, mental health problems can “wreak havoc” and lead to other problems later on.

“High rates of substance abuse, high rates of violence, high rates of homelessness, and an inability to pursue education,” she said. “It just has such an impact on your ability to be successful that if you don’t address it, you’re going to hurt them.”

Zinzinger, who sponsored previous foster child support legislation in Colorado, said she wasn’t surprised by the low ratings. She intends to find out what actions the legislature can take to address the loopholes in the system.

“It’s really important that we follow through on this,” she added. “We want to make sure that all children who are in the child care system have access to these types of essential – what I consider – types of support.”

It also plans to work with the governor’s office on a bill that would create a voucher program for former foster children to help them find housing.

“With my pride in the work we’ve done,” she said, “it seems like there’s still a lot to do.”

Sybil Komin, a behavioral health therapist in Arvada who handles foster children, said child protection workers are often so overwhelmed with their caseload that there are delays in communicating with therapists.

As children move to new foster homes, they may also shift to a different area in Colorado’s Medicaid system, which includes seven regional entities that license mental health and substance abuse therapists in their area. This means that children may have to find a new therapist if they change homes.

On top of all that, there is “a significant shortage of child service providers in general and fewer who specialize in handling cases of child abuse, neglect and sexual assault,” says Kamen, who runs Arvada Therapy Solutions.

Treating foster children often means more work for therapists, not only because their mental health needs are more intense, but because therapists have access to caseworkers, court-appointed guardians, adoptive parents, and biological parents, she said.

Lauren Ferguson, a coniferous therapist who has worked with about 25 foster children in the past five years, said finding therapists who take Medicaid and don’t have long waiting lists is more difficult in rural areas. The schedule is crucial, she said, because children who have experienced a “significant and traumatic life-altering event” often need someone to help them process it.

“The sooner they can get immediate support for their emotional and mental needs, the better,” she said.

Over the past decade, nearly 1,100 children adopted from foster care in Colorado have ended up in the system—an outcome that can be traumatic for parents and adoptive children. Child welfare officials say behavioral problems are the main reason why adoptions fail. And the parents, who often feel like monsters, say they nullified the adoption after failing to get help.

“I’m screaming for anyone who will listen. Teachers. Therapists. Someone help me. Someone help my child, my family,” said one mother.

Some children adopted from the foster care system are diagnosed with reactive attachment disorder, which can manifest in behaviors including stealing, lying, manipulation, and resisting parental affection while interacting with strangers. Parents told The Sun that a lack of therapists able to treat the disorder may be contributing to the adoption breakdown.

Michelle Schuldt cuddles Nico, 5, as Wesley, 7, watches Sunburst Park in Aurora. Scholdt and her husband have six adopted children in addition to two biological children. “I think there should be an offshoot at every post-adoption agency—helping adoptive parents find support groups, therapy, or marriage counseling,” Schuldt said. (Olivia Sun, Colorado Sun via Report for America)

More broadly, the lack of healthcare providers who accept Medicaid is a common complaint for adoptive families, who have sometimes resorted to driving hours to get their children to appointments. As of this fall, the Joint Budget Committee heard persistent concerns about the “inadequacy” of the Medicaid Provider Network.

Stephanie Holsinger, program director for Montrose County Child and Adult Protective Services, said earlier this month that access to health care providers is “a huge problem, in rural areas especially.”

Caregivers who accept Medicaid frequently complain about the high administrative burden of participating in the government program, and the low rates at which they are compensated for providing care.

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