We can only hope that the Tamiyah Audain tragedy will serve as the catalyst and accelerate the dialogue between the Agency for Persons with Disabilities (APD) and the Department of Children & Families (DCF) regarding services for children in foster care with developmental disabilities ( State records show pattern of neglect in death of Lauderhill girl, Oct. 9).
There’s a history of partnership between the agencies, including extraordinary and creative solutions that have been developed to assist these special children, but occasionally — and lately with more frequency — boundaries are drawn and walls quickly erected when the discussion turns to who will pay for these services.
For years APD has dealt with mammoth deficits and enormous wait lists for its services. More than 20,000 Floridians, including children, have been waiting years to access APD Medicaid Waiver services. Historically, only extreme circumstances and emergencies would move a person off the wait list to actually receiving services. Florida law prioritizes children in foster care on the wait list at a lower threshold, and APD can only move these children off the wait list with available funding.
Knowing all we do about the impact foster care has on children, how would these children not meet the definition of an emergency circumstance? These children with complex developmental disabilities require frequent monitoring by specialized professionals. Visits by child welfare case managers shouldn’t be a substitute. By no fault of their own, they become wards of the state and should be cared for by professionals with specialized training. Otherwise, their caregivers should receive training and specialized in-home supports. The arrangement between APD and DCF is bureaucratic and involves high-level reviews and approval from Tallahassee. New proposals consider only children on the APD Medicaid Waiver. It shouldn’t matter if a child is on the APD Medicaid Waiver or wait list or has a qualifying disability and never registered with APD. What matters is that they are children with disabilities.
Last year the governor, with his Florida Families First budget, recommended APD receive an additional $36 million to shrink its wait list. The Legislature approved it. The funding, however, is a fraction of what is needed to eliminate the wait list, but it was the first time in more than eight years that APD received an increase. I recommend statutory changes that would make foster children a higher priority, targeting a percentage of the new funding to assist disabled children in foster care and seeking an additional appropriation, if needed.
It’s time to shred the multipage interagency agreement with its complex cost sharing formulas and try a new approach — any child who enters foster care with a qualifying disability deserves the full array of APD services.
We need to learn from fragile Tamiyah. We owe her a new solution.
CEO, Kids Central, Ocala