“1 month, 12 days died suddenly.”
The obituary of Brayden Cummings provided a wake-up call about the most vulnerable and forgotten victims of the heroin and prescription opioid epidemic.
Brayden was born physically dependent on opioids. He suffered through weeks of withdrawal in a Pennsylvania hospital. Upon discharge he was prescribed opioids to treat his Neonatal Abstinence Syndrome (NAS).
A baby diagnosed with NAS can cry excessively, experience tremors or seizures and suffer from a low birth weight that can be further complicated by difficulty eating. Tough as NAS is for a baby to endure, rarely is it fatal.
For weeks Brayden received around-the-clock medical care, supervision and social services. Then this medically fragile infant was discharged home with no plan of safe care or appropriate treatment and support services for his mother who was battling the chronic disease of addiction.
Within days he was dead after his mother co-slept with him. She was then sent to prison.
Tymir Smith was born drug-dependent in Philadelphia. He died on his 86th day of life after nearly half his life was spent receiving around-the-clock hospital-based care. Within weeks of his discharge from the hospital, Tymir was also dead. He was co-sleeping with his mother and post-mortem medical tests revealed unexplained healing fractures of his rib and lower leg.
Similar to Brayden, no risk assessment was completed and no plan of safe care developed.
Babies like Brayden and Tymir are regularly dying across the United States.
These babies are dying in spite of the fact that, since 2003, the federal Child Abuse Prevention and Treatment Act (CAPTA) has required states to have policies in place to develop a plan of safe care for the infant experiencing withdrawal symptoms resulting from prenatal drug exposure.
Brayden and Tymir and other drug-dependent babies – along with their families – are routinely slipping off the radar of rural and urban child-serving systems. These babies have died as the federal government provided no guidance to states about effectively implementing the 2003 law and how to address the complex multi-system needs of these babies and their families.
These tragedies also happened as Congress ignores the growing disconnect between the well-intentioned policy within CAPTA and the lack of resources that exist at the front-end of the child protection system to keep babies safe at home in stable and supported families.
President Obama recently signed the Infant Plan of Safe Care Improvement Act authored by United States Senator Bob Casey (D) from Pennsylvania along with Pennsylvania Congressman Lou Barletta (R).
This legislation smartly recognizes that keeping an infant safe requires effectively assessing and responding to the diverse needs of the infant and his/her family. States will be tasked with finally getting intentional about designing two-generational plans of safe care that build upon the unique resources and expertise of health care, child protection, early intervention, substance abuse treatment, affordable housing, and evidence-based home visiting.
Promising as this new law is, it well may become meaningless if Congress doesn’t act now to remedy the shocking disconnect between smart policy and the inadequate federal dollars invested in the front-end of child protection.
In federal fiscal year 2016, approximately $4.7 billion was available to pay for costs associated with foster care and adoption. Meanwhile, the federal funding stream designed to support and strengthen families received $355 million.
By contrast, CAPTA and its smart policy initiatives, including creating plans of safe care, received only $26 million.
This funding imbalance is unreasonable if, as a country, we meaningfully want to protect our children, strengthen families, and prevent young children from dying as a result of child abuse or neglect.
The Family First Prevention Services legislation, awaiting action in the United States Senate, will give states flexibility and permit the use of federal dollars to pay for prevention and effective, up-front evidence-based interventions that are trauma-informed and that smartly work to address families striving to recover from the chronic disease of addiction. States will also have to work with intention to learn lessons and work to prevent child abuse fatalities.
Congress honored the lives of Brayden and Tymir by unanimously supporting the Infant Plan of Safe Care Improvement Act.
It was an important step forward in protecting children, but it is not enough.
Now Congress must send the Family First Prevention Services Act to the President’s desk, renewing America’s commitment to protect children and strengthen families, in part, by realigning federal child welfare investments.
James Greenwood served in the United States House of Representatives from 1993 to 2005. He authored the original plan of safe care provision in CAPTA. He is president and CEO of the Biotechnology Innovation Organization.
Cathleen Palm is the founder of The Center for Children’s Justice based in Pennsylvania.