Smoke-free Foster Care: Tales from the Field June 24, 2014 Tobacco - - PowerPoint PPT Presentation

Smoke-free Foster Care: Tales from the Field

June 24, 2014

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Tobacco Control Legal Consortium

A national network of legal centers and attorneys supporting tobacco control policy change.

www.publichealthlawcenter.org

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
• f 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

• pposition 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

Includes Local Services Agencies, Human Services Boards, etc.

Foster Care Providers Private Agencies Foster Care Providers

American Lu Lung A Associati tion i in MN

• Rationale for smoke free foster care
• Lung Health
• Fire hazard
• 3rd 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)

• Asthma
• Vision and hearing problems
• Mal-nutrition
• Skin abnormalities
• Anemia
• Failure to thrive
• Dental concerns
• 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.

25% of Foster Kids have 3 or more chronic medical conditions

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
• Arizona
• Colorado
• Illinois
• Iowa
• Kansas
• Maine
• Maryland
• Montana
• New Jersey
• North Dakota
• Oklahoma
• Oregon
• Pennsylvania
• Texas
• Vermont
• Washington
• Wyoming

Commissioner Jim McDonough

Commissioner Rafael Ortega

Commissioner Toni Carter

Media

Letter to the Editor

Media

Mshale Article

African Community Newspaper

Media

Pioneer Press

Smoke-free Foster Care in Minnesota

Molly Moilanen ClearWay Minnesota

Sarah’s Story

“I am writing…to bring attention to a

matter of grave injustice, a public health concern and an unnecessary burden on the Minnesota tax payer... Minnesota requires foster homes to be free of dirt, rubbish, peeling paint and rodents…but makes no provision about keeping the air free from the 4,000+ chemicals found in cigarette smoke!”

• Rep. Liebling

Rochester

Stakeholder Meetings

Association of Minnesota Counties Assn of County Social Service Admins Local Public Health Association Department of Human Services Private Placing Agencies Child Advocacy Groups

Bill Summary

• Provide a “safe, healthy, smoke-free home

environment”

• Home
• Enclosed space connected to the home

– Garage, Porch, Deck

• Vehicle
• Outdoor areas when a foster child is present

and exposed

Bill Summary

• Smoking is permitted in outdoor areas when

the child is not present/exposed

• Exemptions

– Family Placement – Emergency Placement – Native American Ceremonies

2014 Session

Challenges

• 1. Short Session
• 2. Chair of Early Childhood Committee
• 3. Floor Amendments

We Won!

Top 10 List

• 1. Legislative Champion
• 2. Effective Coalition
• 3. Support from Key Stakeholders
• 4. Local Policies and Local Action
• 5. Strong Public Support
• 6. Grassroots
• 7. Powerful Testimony
• 8. Earned Media
• 9. Messaging and Materials

10.Sarah’s Story

• 1. Champion

• 2. The Coalition
• 3. Key Stakeholders

• 4. Local Action
• Beltrami
• Cottonwood
• Dakota
• Jackson
• Lake
• Ramsey
• Redwood
• Steele
• St. Louis
• Bois Forte

Resolutions of Support

61

• Lake County
• Otter Tail County
• Beltrami County
• Pipestone County
• Redwood County
• St. Louis County
• Southwest Health and Human

Services

• HHS for Cottonwood and

Jackson Counties

• 5. Strong Public Support

6% 1%

• 6. Grassroots

63

• 7. Powerful Testimony

64

• 8. Earned Media

Fargo Forum: Editorial: Again, Big Tobacco is wrong Minneapolis Star Tribune: Letter: Smoking around kids is simply bad news Duluth News Tribune: Opinion: Lawmaker’s view: Smoke-free foster care will help youths grow

• 9. Messaging and Materials

• 10. Sarah’s Story!

Thank You

Molly Moilanen, M.P.P. ClearWay MinnesotaSM mmoilanen@clearwaymn.org 952-767-1400

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