The writer is a pediatrician in Omaha and a past president of the American Academy of Pediatrics Nebraska Chapter.
Too often when we hear those words, we have a negative reaction. We think of group homes, broken families, troubled children and hardship.
As a pediatrician in Omaha, I can tell you that there’s so much more to it than that. I had the opportunity to screen the new documentary “Foster” at Film Streams Dundee Theater, which recently premiered on HBO, and follows several children and their families as they navigate the foster care system in Los Angeles County.
I see patients from all walks of life. I can tell you, foster care does not discriminate; many of my families never anticipated entering the system. When it comes to helping families at risk of entering the foster care system, we should do everything we can to keep families together and outside of the system altogether. Yet I know sometimes there may not be an option to do so safely.
Often the parents love their children but are incapable of caring for them due to substance use or mental health challenges. In the best-case scenario, we could make sure a family who is struggling receives the care and treatment they need as soon as possible so they can heal together. In cases where foster care is needed, we must make sure it provides a loving and supportive environment.
For years I have cared for a family with three children who were removed from their home due to neglect and drug use by the parents. I was their pediatrician before that, and I was able to remain their pediatrician after they were placed in foster care. The children had a relationship with me and some sense of consistency as their medical home. I was grateful they found a wonderful foster family who continued the children’s care with me.
The children grew and thrived in the new home. Unfortunately, despite repeated efforts, it was not possible to reunite the children with their parents. The biological parents were still struggling with substance use disorders and were unable to make consistent, positive visits with the children. After several years, the children were eligible for adoption. I was happy to see the foster family adopt all of the children, where they have been able to grow up happy and healthy.
This story had a happy ending, but that’s not always the case. Sometimes children are taken from the home and not kept together or sent to a foster home when a family member was available to care for them. In many situations, had a medical home provider been contacted, they could have provided a history that would assist in the children’s placement or prevent their removal from the home.
Everything I’ve seen from my patients and the stories in “Foster” illustrate the need for big picture policies that are most supportive of vulnerable families. The Family First Prevention Services Act is one example that was signed into law last year. This law shifts the focus of the child welfare system on prevention and keeps families together when possible, so they can heal together. When children are removed from a family, it ensures that children are in a family setting, unless they need quality residential care to effectively address their treatment needs.
Family First exemplifies everything we know about what children need to thrive. It is critical that we shift the nature of the child welfare system from punitive to preventative. We may not be able to stop all out-of-home placements, particularly if the safety of the child is at risk, but have we exhausted all our options first? If we are to do what is best for children, we must make sure we answer that question.