Valuing Children

Can we really put a dollar value on the psychological well-being of children? The State of Indiana evidently thinks so, if the reported reaction to a recent decision in a lawsuit brought by the ICLU is any indication.

Can we really put a dollar value on the psychological well-being of children? The State of Indiana evidently thinks so, if the reported reaction to a recent decision in a lawsuit brought by the ICLU is any indication. (In the interests of full disclosure, I should add that the lawyer who won the suit is my daughter-in-law.)

There is no dispute over the facts: for years, if an Indiana family on Medicaid had a child who was so severely mentally disturbed as to require hospitalization, the only way to get treatment for that child was to relinquish their parental rights and give custody of the child to the State. Only when the child was a ward of the State would the county of residence pay for residential  treatment. This was not a “pro forma” or paper transfer, either—once the parent had surrendered custody, s/he had no further legal right to make medical, educational or other decisions for that child.

Parents faced this Hobson’s choice because the State of Indiana refused to follow federal law governing how Medicaid funds are to be applied. We were happy enough to take the money, but unwilling to abide by the rules that came with it. In effect, the State paid for other programs with funds meant for mentally ill poor children—a constituency without power or voice. And to add insult to injury, in response to lobbying from the counties (who were being stuck with the bills that the State wouldn’t pay), the Indiana Legislature recently amended the Children in Need of Services (“CHINS”) statute to take away even the cruel option of custody surrender. After the amendment, there was simply no way for poor people to get psychiatric help for their children. Not from the State, not from the County, not anywhere.

Now that a federal judge has ruled that the State can no longer flout federal law, no longer deny children needed treatment, what has been the response of State officials?  Have there been expressions of sympathy for the families that were torn apart? Expressions of regret that children entitled to treatment were denied access to care?  Hardly. The State says it intends to appeal. Bureaucrats involved in administering Medicaid are bemoaning the money that will now have to be spent treating mentally ill poor children. The headlines reflected their attitudes perfectly; “Ruling to Cost State Millions” was typical.

Also typical was the plaintiff’s situation: In northern Indiana, a five-year-old boy named Brandon lived with his grandparents, who wanted so desperately to help him that they exhausted their meager resources in the process. His father, a policeman, had been killed in action when Brandon was two months old. Brandon needed residential care, but Indiana doesn’t invest in such facilities, so he became a ward of the court, and was placed in a facility too far for visits from his grandparents and cousins and friends.  He was scared and lonely.

There are others like Brandon. Taking money meant for desperately ill children and then refusing to treat those children is not even debatable. It is despicable. 

is not even debatable. It is despicable.