State senators heard both sides Friday afternoon to a controversy involving changes to Nebraska policies that have led to much less drug testing of parents and children in child welfare abuse and neglect case investigations.
Sen. Julie Slama of Peru, who introduced the interim study (LR134), said it seemed judges, foster parents, providers and others were not informed of the protocol change by the Department of Health and Human Services, and that the protocols appeared to be changed in secret in 2018.
She hoped to bring the drug-testing policy to the attention of lawmakers who could change it or find a compromise with HHS, she said.
The new protocol limits drug testing of parents and children to tests that are court-ordered. Child advocates have told her the new policy appears to give parents days to prepare for drug tests and visits from HHS case workers, and the means to pass a home inspection and interview.
Slama's concern with the new drug-testing protocol, she said, is that studies show children suffer physically, mentally and emotionally in homes where drug use is present.
That's because the first priority of addicted parents is drugs.
Slama said she also has heard stories from parents who said if they had not been tested and lost their children as a result, they would not have stopped using drugs.
"Their rock bottom was removal of their children," she said.
Lancaster County Juvenile Judge Roger Heideman, the presiding judge of the county's family drug court for seven years, said judges learned of the new policy in the spring of 2018 as case workers began to testify in court about what they could and couldn't do as a result of the new HHS policy. The new practices were in contrast to the HHS' published policy found on its web site, he said.
With drug testing, he said, a court can help ensure adherence to a drug-treatment plan for parents. It allows the court not to remove children if it is safe and appropriate, or to get children back into the home more quickly when drug use is monitored. It also helps to modify treatment for those who continue to struggle.
"That's what's at the heart of this, is how do we help these parents with what's going to be a lifelong issue for them," he said.
The judges later met with HHS officials and told them the new policy wasn't best for the children and not the best practice in these cases, he said.
The new policy went into effect, officially, in October last year.
Judges could still order drug testing for court cases, but tests were not done for voluntary, or noncourt, cases.
Amber Pelan has worked for HHS as a children and family services specialist, trained child welfare workers, and is now a program director for youth services in Saunders County.
She also is the child of a methamphetamine addict and knows the lasting impact drug abuse can have on families. Pelan told senators 35% of 100 to 120 cases introduced in Saunders County are related to substance use.
And home visits and interviews don't always reveal the true impact of drug and alcohol use. Frequently, they don't show what's happening between 2 a.m. and 5 a.m. when a parent is coming down off a drug high.
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"That's what the schools hear about and that's what the workers hear about, and if we're not able to test exposure it just makes it difficult," she said.
The long-term and short-term consequences of youth being exposed to drugs in the home, sometimes their whole lives, are linked to impulsive behavior and delinquency.
In the long run, it costs the state money for mental health treatment for kids and then treatment into adulthood.
She told the Legislature's Health and Human Services committee that Nebraska is the only state that doesn't have a law or policy regarding substance use during pregnancy. Other states have "safe" programs in which they begin working with pregnant women before the birth of their child to get help with getting sober and providing a safe home. They also work with her 60 to 90 days after the birth.
Steve Greene, deputy director of the HHS division of children and families, told senators the shift in the policy was in part to keep families intact whenever possible, with kids remaining safe and parents getting the help they need.
"We're not saying, 'Don't drug test,' and we're not saying that there's not a value to drug testing," he said. "I think that what our policy reflects is that our specialists that go into those homes are assessing for the risk of a child and the safety of a child in that home."
Other states that are changing their drug-testing policies in the same way are Kentucky, Iowa, Arizona and Massachusetts, he said.
Drug testing can be time-consuming and costly and appear punitive, he said.
"And sometimes it can miss the point when the point is child safety and family well-being," he said.
But it is still used when recommended by a treatment provider or a judge, Greene said.
The department believes the new policy is trauma-informed and data-driven, he said, while retaining a focus on child safety and a better understanding of the needs of parents, he said. Before changing it, officials had conversations with the courts and child welfare providers, and consulted with Casey Family Programs, a national foster care and child welfare foundation.
"A drug test alone does not indicate that abuse or maltreatment has occurred," he said. "Nor, importantly, does it indicate the level of substance abuse or addiction or the degree of family function."
A drug test looking for exposure of a child also does not show the whole environment of the child, or where they might have been exposed or how frequently, he said. There are other things that show more accurately what is going on in the home and the entire risk to the child.
Greene said saving money was not what guided the policy change.
The department acknowledged there was more work to do to enhance communications with others in the child welfare field. And it is open to that discussion.
Sen. Matt Williams of Gothenburg said the committee has questioned how the department collaborates with others in the child welfare field.
"And I would suggest that we need to be sure that there is a definition and an understanding of what collaboration is," he said.
Greene said the division, and especially CEO Dannette Smith, shares that desire for "robust collaboration," and is committed to it moving forward.