Smoke-free Foster Care: Tales from the Field June 24, 2014
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Presenters Smoke-free Foster Care in Maryland Kathleen Hoke, Legal Resource Center for Public Health Policy, U of MD School of Law Smoke-free Foster Care in Minnesota: Part 1 -- The Local Story Pat McKone, American Lung Association Jeanne Weigum, Association for Nonsmokers - MN Smoke-free Foster Care in Minnesota: Part 2 – The State Story Molly Moilanen, ClearWay Minnesota
Smoke-free Foster Care in Brief • A Vulnerable Population • Public Health Rationale • Common Arguments • U.S. Landscape
A Uniquely Vulnerable Population • 80% of foster children have at least one chronic medical condition • One quarter have 3 or more chronic problems (e.g., diabetes, HIV, tuberculosis, asthma)
Public Health Rationale • Health risks of secondhand smoke • Health care costs for children exposed to tobacco smoke
Fire Hazard • Each year, 300 children in the U.S. suffer injuries resulting from smoking- caused fires • Half of all U.S. home fires result from children playing with tobacco products
Toxic Litter • Ingesting one cigarette butt can be toxic to a child • Ingesting an entire cigarette can be lethal • 77 percent of children who ingest cigarettes are 6 to 12 months old
Duty to Protect • State is legal guardian. • State has legal obligation – To protect foster children Ensure that they reside in safe and healthy foster care environments.
Why Not Act?
Common Arguments • Privacy and autonomy • Effect on parent retention & recruitment • Monitoring compliance & enforceability
Effect on Foster Parent Recruitment • No decline in number of foster parent applicants or retention • Smoke-free residences becoming a social norm
Compliance & Enforceability • Routine compliance checks • Only rarely do states report violations or complaints about the policy • Limited value of voluntary measures
Smoke-free Foster Care Policies in Effect • 27 states have passed laws or regulations regulating smoking in foster care homes • Three of these policies are in statutes (“clean indoor air acts”) • 24 are in administrative codes or regulations
Public and Professional Support “ Therefore, be it resolved that the National Foster Parent Association supports legislation and other rules that prohibit the use of tobacco in foster or kinship homes and in vehicles while transporting a child in foster or kinship care.” — National Foster Parent Association
Kerry Cork, Staff Attorney kerry.cork@wmitchell.edu (651) 290-7509
Smokefree Foster Homes: The Maryland Experience Kathleen Hoke
Power of the Executive Agency Social Services Administration within the Department of Human Resources: “The Administration shall adopt rules and regulations to carry out the child welfare services and foster care programs under this subtitle.” Maryland Family Law Code Ann. §5-532
Scope of Agency Power • Plain language of the statute indicates broad power in agency; • Existing regulations show how the agency construed this power; • Sometimes case law will help define the scope; • Political appointee head of agency ultimately has control over regulations.
The Politics of 2006 Agency had power to issue regulations protecting foster children from exposure to secondhand smoke but would not take action, despite requests from the public health community and child welfare advocates and despite internal support from agency personnel.
2006 Legislative Effort (Unsuccessful) 2006: House Bill 1353 Bill would have given agency the authority to adopt regulations to: Require local departments of social services to consider SHS exposure when developing a permanency plan for a child in foster care; and Require a foster parent to protect a foster child from exposure to SHS in enclosed.
2007 Legislative Effort House Bill 661 was identical to HB 1353 (2006). Change in administration; Agency testified in favor of the bill, taking the position that they would likely do this by regulation regardless of the outcome of the bill.
DHR Regulations Prior to publishing regulations: Agency conducted informal survey of 175 foster families; overwhelming support from families (virtually no opposition--2 families did not support); Reached out to other states with such a provision to talk about implementation and enforcement.
DHR Regulations In Spring 2008, DHR published proposed regulations, open for public comment. LRC encouraged public health and child advocacy groups to submit comments; LRC submitted comments; No oppositional comments were filed.
Current Regulation COMAR 07.02.25.08(A)(17): A foster parent shall: Provide an environment for foster children free from exposure to secondhand smoke. Agency personnel report that the policy was implemented and is in effect with virtually no opposition or problems.
The End. Kathleen Susan Hoke Director, Legal Resource Center for Public Health Policy University of Maryland Carey School of Law 500 West Baltimore Street Baltimore, Maryland 21201 khoke@law.umaryland.edu; (410)706-1294
Smoke-free Foster Care in Minnesota: The Local Level Pat McKone American Lung Association of the Upper Midwest
Minnesota Foster Care: State-Supervised & County-Administered State – Dept. of Human Services / Division of Licensing County Agencies Private Agencies Includes Local Services Agencies, Human Services Boards, etc. Foster Care Providers Foster Care Providers
American Lu Lung A Associati tion i in MN • Rationale for smoke free foster care • Lung Health • Fire hazard • 3 rd Hand Smoke • Toxic Litter Staff commitment to the issue
Foster er C Care E e Efforts a at the L e Local L Level el • Gathered data • Used the data to inform local decision makers and address concerns • Worked with Public Health Law Center to develop case statement • Provided training to others across the state
Passed local p policies….
Thank you! Pat McKone American Lung Association of the Upper Midwest
Smoke-Free Foster Care Ramsey County Jeanne Weigum President Association for Nonsmokers- MN
Health of Foster Children 90% of children entering child welfare system had physical health problems Source: L.K. Leslie, J. N. Gordon, L. Meneken, K. Premji, K. L. Michelmore, and W. Ganger. “The Physical, Developmental, and Mental Health Needs of Young Children in Child Welfare by Initial Placement Type.” Journal of Developmental & Behavioral Pediatrics , June 2005, v26 i3 p177(9)
25% of Foster Kids have 3 or more chronic medical conditions • Asthma • Anemia • Vision and hearing problems • Failure to thrive • Mal-nutrition • Dental concerns • Skin abnormalities • Manifestations of abuse. Source: L. K. Leslie, M. S. Hurlburt, J. Landsverk, K. Kelleher et al. “Comprehensive Assessments for Children Entering Foster Care: A National Perspective.”Pediatrics, July 2003.
Duty to Protect Foster Kids Children are placed in foster care to escape unhealthy and unsafe environments. The state (foster care system) is responsible for placing children in temporary homes that are safe, nurturing, stable. Ultimate goal is to protect the health and wellbeing of the child.
Minnesota Counties who have adopted Smoke-Free Foster Care Policies: - Redwood County - Cottonwood County - Lake County - St. Louis County *Hennepin has done research.
18 Other States Have Established Smoke Free Foster Care laws • Alaska • Maine • Oregon • Arizona • Maryland • Pennsylvania • Colorado • Montana • Texas • Illinois • New Jersey • Vermont • Iowa • North Dakota • Washington • Kansas • Oklahoma • Wyoming
Commissioner Jim McDonough
Commissioner Rafael Ortega
Commissioner Toni Carter
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