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Jan 17, 4:56 PM EST

Child death review recommends treatment for addicted mothers



HELENA, Mont. (AP) -- Montana could help prevent child deaths by offering more treatment services for pregnant women and new mothers who are battling drug and alcohol addiction, a Department of Justice review recommended.

The Office of the Child and Family Ombudsman reviewed the deaths last year of 14 children whose cases had been reported to the Division of Child and Family Services within a year of their deaths. Ten of the children were younger than 12 months old.

Three of four accidental deaths involved an infant sleeping in the same bed with their mother, who was using drugs, while two other deaths were due to medical complications where the mother's drug use may have been a factor, the report found.

The Department of Health and Human Services last week announced it was expanding a home visiting program for expectant mothers and young families by adding five workers who would provide education and services to families already involved with Child and Family Services.

The agency hopes to have the five workers in place within the next few weeks. If the pilot program is successful, the state plans to keep those five home visitors and add 10 more in other areas, said Laura Smith, deputy director of the health department.

Montana also has a shortage of drug treatment for parenting mothers and fathers, said Dana Toole, chief of the Children's Justice Bureau within the Department of Justice. Such programs allow the parents to be in a residence with their children while receiving addiction and other treatment to allow them to regain custody or prevent losing custody of their children.

Increasing access to those types of programs would reduce the numbers of children in foster care, Toole said Wednesday. Montana has such treatment homes in Billings, Helena and Missoula, but a revenue shortfall led the state to eliminate nearly $1.2 million in funding for those homes through June 2019.

Montana has 3,925 children in foster care - up from 3,300 in December 2016. About two-thirds of the foster care placements are due to parental drug use, said Jon Ebelt, spokesman for the Department of Public Health and Human Services.

Drug or alcohol use, or both, was a factor in nine of the 14 deaths reviewed by the ombudsman's office.

Five deaths were homicides, one was a suicide and the cause of two other deaths is unknown or still under investigation, the report said. One of the homicides was not due to child abuse or neglect, but was reviewed because there had been a report on the child within a year of the death, Toole said.

Wednesday's report is the second by the Child and Family Ombudsman seeking to find commonalities in the child deaths and offer recommendations to help prevent them.

In its December 2016 report, the ombudsman's review found a list of red flags where the presence of two or more should lead to a more urgent investigation. Those red flags were drug and alcohol use, prior history with the Division of Child and Family Services with the children or with the parent when they were a child, domestic violence along with housing instability and other financial insecurities.

However, this year's review found that supervisors reduced the urgency of two complaints made to the child abuse hotline in which at least two of the red flags were present and the child died. The case files did not include an adequate explanation for the reduced urgency, Toole said.

This year's review also recommends that caseworkers:

- make better and more consistent use of a tool to asses a family's immediate and future safety risk

- require drug testing in every case where drug use is alleged, especially if the child is under the age of 5 or developmentally unable to be interviewed

- and increase contact with law enforcement, medical personnel or other family or friends that might be able to provide more information on a case

In some cases, "there were (others) that could have provided critical information if they had been interviewed," Toole said, while noting that other family and friends don't have to be interviewed and aren't required to provide information.

Montana's reviews of child deaths are expected to be more thorough now that the Legislature created a Child Abuse and Neglect Review Commission. Members were appointed in August and are scheduled to hold their first meeting on Feb. 5, Toole said. The commission will be able to gather information from law enforcement and medical personnel in addition to caseworkers to get a more complete picture.

The ombudsman's report also is scheduled to be discussed by the Children, Families, Health, and Human Services Interim Committee on Thursday.

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