Troubled child

A teenager longs for his incarcerated father and struggles with feeling repeatedly rejected after multiple foster home placements and school changes.

He and his mother are enjoying time together, arranged and supported by staff, as his mother continues her journey in sobriety. Years of trauma made trusting staff agonizingly slow, but he has discovered his artistic talent and school success is rewarding for the first time.

This teenager is not on the street using substances to cope with his sadness because of trained staff in a therapeutic residential program. But his remarkable success — and that of so many vulnerable children in Oregon — is threatened by the failure of state agencies to include in their budgets the increased rates for behavioral health services already allocated by the legislature.

During the pandemic, the legislature approved extra funding so nonprofits could pay enough to attract talent and maintain staff levels. Last year, the legislature passed House Bill 4012, instructing the Oregon Health Authority, Oregon Youth Authority and DHS to calculate the true costs of Behavior Rehabilitation Services and make their budget requests with adequate rates to cover mental health care in residential programs and home-based services for children and youth in foster care and the juvenile system.

Oregon Health Authority, Oregon Youth Authority and DHS recommended higher reimbursement rates, but service providers will not receive this increase because state agencies are excluding the Behavior Rehabilitation Services allocations in their budget requests. At the current funding levels, most programs cannot pay staff salaries competitive with an increasingly wide array of other employment sectors. Many programs will be forced to close if the state does not raise reimbursement rates.

According to an Oregon Health & Science University study, Oregon has a shocking 50% service capacity deficiency in residential and behavioral health treatment. That number will grow if residential and foster care programs shrink, leading to unnecessary suffering for already traumatized children and youth. Building the service infrastructure back up in the future would take years and millions of dollars.

The failure of state agencies to include higher reimbursement rates in their budget requests is predictable: devastating placement instability, worsening rates of substance abuse, untreated mental health needs and homelessness among vulnerable children.

As stressors made his family fall apart and the teenager described above was placed in state custody, he had a dedicated foster parent. But a loving home is not enough to manage the ravages of trauma on a developing child, and the lack of therapy and strong supports for caregivers from an underfunded behavioral health system often leads to children moving from foster home to foster home and ultimately into the juvenile justice system and the street.

I have seen communities with exemplary foster care and residential programs funded so children and their caregivers receive mental health services of sufficient intensity and duration to ensure their recovery from adversity. Oregon can — and should — choose to be a leader in behavioral health funding to support children and youth in foster care and the juvenile system.

Contact your legislators to let them know it is intolerable to allow Oregon to fall even further behind in meeting the needs of our most vulnerable children.