New Report Uncovers “Alarming” Rate of Child Hospitalization Due to Abuse

The March 2012 issue of Pediatrics will contain the first quantified findings detailing the hospitalization rates of children due to serious physical abuse in the United States. The report, released by the Yale School of Medicine, uncovered 4,569 instances of children being hospitalized due to serious abuse in 2006, with approximately 300 cases in which the children died as a result of serious injuries. According to the findings, children were at their highest likelihood for serious injury within the first 12 months of life, with a projected 58.2 per 100,000 children within the age group being hospitalized for abuse. Researchers at Yale-New Haven Children’s Hospital used data from the Kids’ Inpatient Database (KID) to estimate the number of incidences in which children younger than 18-years-old were hospitalized due to serious physical abuse in 2006. The Kids’ Inpatient Database was prepared by the Healthcare Cost and Utilization Project, under the Agency for Healthcare Research and Quality.

New Study Finds Georgia Foster Kids are Over-Medicated

Georgia’s foster children are being over-medicated, often to sedate them or control their behavior rather than treat a medical condition, a new study confirms.

The question is: What should Georgia do about it? One solution being considered by state legislators calls for oversight of medications given to adjust the mood or behavior of thousands of foster children in Georgia. The bill calls for written standards for the dosages and combinations of psychotropic drugs given to those children, as well as an independent clinical review to assess all such medications and related treatments twice a year. But some child psychiatrists, worrying about second-guessing and lengthy delays in treatment, told state lawmakers last week that they object to a provision that would require the state’s pre-authorization for certain medications or unusual doses. They also cautioned about the consequences of language that would require the informed consent of children 14 and older before taking a new psychotropic drug.

Enrollment in Kids’ Health Insurance Programs Grow Under Medicaid Bonus Program

Last month, the Centers for Medicare & Medicaid Services awarded 23 states approximately $296 million in bonuses for increasing the number of children enrolled in health insurance programs.
The bonuses, funded by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), came a week after the Centers for Disease Control and Prevention released a report stating that about 1.2 million more children have health insurance in the United States than three years prior. According to the most recent estimates, approximately 93 percent of the nation’s children now have some form of health insurance coverage, a 2 percent increase from federal levels around 2008. When the Children’s Health Insurance Program was initially created in 1997, the national statistics hovered around 86 percent. In addition to providing performance bonuses for states that simplify and increase coverage for children, CHIRPA provisions allow states to enroll children using information culled from other public programs, as well as automatic eligibility for babies whose mothers are already covered by Medicaid or CHIP programs.

Cindy Mann, deputy administrator of the Centers for Medicare & Medicaid Services, said that although the nation faces “serious fiscal challenges,” she still believes that children’s health should remain “a top priority” for states. “Not only have more states qualified for performance bonuses in the past,” she said, “but many have continued to improve the efficiency of their programs.”

In 2010, the Centers for Medicare & Medicaid Services awarded more than $217 million in CHIPRA Performance Bonuses to 16 states, all of which qualified for performance bonuses again in 2011.

California Foster Care, Mental Health Reforms

Under a new agreement, California will begin providing intensive mental health services, both home- and community-based, for children in foster care or at risk of entering the foster care system as part of the early periodic screening, diagnosis and treatment (EPSDT) requirements mandated by federal law.

The new services will be available to a class of children covered under Medicaid, a requirement virtually all foster kids and those at risk of entering foster care meet, according to advocates.

The agreement is the result of a settlement reached after nearly two years of negotiations in a class action suite, Katie A. v. Bonta, aimed at statewide child welfare and health reform. The case, first filed more than nine years ago, charges county and state agencies with neglecting to provide federally-mandated mental health services to children in the state’s foster care system.

The California suit is just one of many that is in the process of or has already been filed across the country seeking to force states to comply with federal Medicaid requirements concerning the well-being of children.

Selena Teji On California’s Broken Juvenile Detention System

In 1858, the San Francisco Industrial School, California’s first large juvenile facility opened its doors and ushered in a new era of large dormitory-style institutions that would plague California to the present day.  Rife with scandal, abuse, violence and a significant deficit of programming, congregate care institutions have proven a failed model since the 19th century. While Missouri and Washington have abandoned this broken system and rebuilt their juvenile justice systems anew, focusing on smaller therapeutic regional facilities; California continues to fixate on an archaic system with large training schools that cannot be repaired. Currently, California operates a dual system of juvenile justice — probation, group homes, ranches and camps are provided by its 58 counties, while the state provides youth prisons reserved for adolescents who have committed a serious or violent offense as defined in the state’s Welfare and Institutions Code. All parole and reentry services are provided by the counties.