Child advocates and the head of the state's child protection unit are urging lawmakers to spend more money on drug treatment for parents of children who are abused and neglected.
The request comes just days after a judge released thousands of previously secret documents related to the state's protective oversight of a teen mother and her 20-month-old son.
Kayden Branham died after drinking drain cleaner in May 2009 that was allegedly used in the manufacturing of methamphetamine. His mother, Alisha Branham, was 14 at the time of her son's death.
The documents detailing social services' involvement with the girl and her baby show a family struggling with addiction and a social service network with too few resources and money to treat them.
Patricia Wilson, the commissioner for Community Based Services, told a legislative committee last week that if there was one area of child protection that needed more funding "it would be in the treatment of substance abuse."
"There aren't enough of these programs," Wilson told the Interim Committee on Health and Welfare on Wednesday. "We have no way to offer them treatment."
The Cabinet for Health and Family Services, which oversees child protection in Kentucky, has two substance abuse programs to treat parents who have been accused of abuse and neglect, but they only operate in 11 of 120 counties. And there is little money to help poor parents pay for drug testing, which is often mandated by the cabinet or a family court judge for parents suspected of abuse and neglect.
Parents with drug problems are overwhelming the system, according to cabinet statistics. Nearly 60 percent of substantiated cases of abuse and neglect in Kentucky involved caretakers with substance abuse problems.
Last week, a Franklin Circuit judge released thousands of records related to the state's oversight of Alisha and Kayden Branham's case. The records were released after the Herald-Leader and The Courier Journal of Louisville successfully sued the cabinet earlier this year.
Alisha Branham was removed from her parents' custody in May 2007 after social services discovered she had become pregnant at age 12. When her parents, Larry and Melissa Branham, completed parenting classes, Alisha Branham was released to her mother's custody in November 2007. Larry and Melissa Branham are divorced.
Over the next 18 months, Melissa Branham was asked more than two dozen times to take voluntary drug tests by social workers and failed to do so, records in the case show.
Melissa Branham told social workers she didn't have the money to pay for the voluntary drug tests, the records show.
Social workers told Melissa Branham in 2009 the state would pay for three drug screens, but she still didn't come in as requested on several different occasions.
Twice in 2008, when she did show up for tests, her urine sample was diluted — a potential indication of an attempt to tamper with them. Two months before Kayden died, Branham tested positive for an anti-anxiety drug but couldn't immediately prove she had a prescription for it, according to the file.
Melissa Branham later sought intensive drug treatment after Kayden's death, the records show.
If the cabinet had pushed harder for drug tests, it's possible Alisha and Kayden would have been removed from her parents' custody, said child advocates.
David Richart, executive director of the National Institute for Children, Youth and Families, a think tank in Louisville, said he and others have raised concerns about the lack of funding for drug testing in the past.
Richart questioned why the cabinet did not do more to require Melissa Branham to take the drug screens. Her reluctance to do so should have triggered "alarm bells" to social workers that Alisha and Kayden were living with someone who likely could not take care of them.
"The system itself put an impediment to good child protection by asking clients to pay for their own drug tests," Richart said.
Relatives of the dead boy also fault social workers for not taking Alisha and Kayden out of Melissa Branham's house despite suspicion of drug abuse.
"If they'd done their job, that baby would've been taken out of that home," said Clarence Jones, Melissa Branham's father.
Vikki Franklin, a spokeswoman for the Cabinet for Health and Family Services, said the cabinet is occasionally ordered to pay for drug testing in some child protection cases. But it has few resources to cover those costs. The state has had eight rounds of budget cuts over the past three years because of declining state revenues.
"The department has not been appropriated funds to pay for court-ordered drug screens for parents," Franklin said. "In some situations, the department has paid for drug screens as a last resort. However, based on the current budget, it has become increasingly difficult to absorb those costs."
Franklin said a parent's willingness to pay for and take drug screenings can tell the cabinet how serious a parent is about keeping the child with them.
"In general, the department believes a parent's willingness to assume responsibility for undergoing and paying for a drug screen can be viewed as a barometer of his/her commitment to his/her child," Franklin said.
The cabinet has declined to answer specific questions about its supervision of Kayden and Alisha Branham.
The records show Melissa Branham had told social workers she suspected her former husband, Larry Branham, was involved with drugs shortly before Kayden's death.
Larry Branham admitted to social workers he had once been addicted to pain killers but said he sought treatment and no longer had a problem.
There is no indication in the records that social workers investigated Melissa Branham's concerns about drugs at Larry Branham's home, where Alisha said she moved shortly before Kayden's death because her mother had no electricity.
Social workers have fewer and fewer options for parents who want drug treatment and can't pay for it, said Wilson, the commissioner for Community Based Services. Medicaid, the state and federal health care program for the poor, pays only for drug treatment for pregnant women.
The cabinet has only two programs for addicted parents. One program called Solutions, which is available in six Eastern Kentucky counties, is an intensive treatment program that works with women who have addictions and have had substantiated cases of abuse and neglect.
A second program, called START, or Sobriety, Treatment and Recovery Teams, operates in four counties: Jefferson, Kenton, Martin and Boyd.
The programs have shown some success.
Of 81 START cases tracked by the cabinet, a little less than 4 percent were referred to the cabinet again after completion of the program. Only 2.5 percent of those cases resulted in a child entering state custody.
Wilson said those programs are paid for through a combination of state and federal grant money.
"A rigorous and extensive program evaluation is underway," Wilson said of the costs of expanding the programs. "Although we don't yet have exact numbers, we do know that more money for substance abuse treatment services is desperately needed in Kentucky, particularly for the population served through this substance abuse initiative."
Rep. Tom Burch, who chairs the House Health and Welfare Committee, said he plans to pursue the issue of expanding payments for drug testing and treatment during this year's legislative session.
"If we're going to mandate it, we have to pay for it" said Burch, of the drug testing. "It's our responsibility."
But Burch acknowledges getting funding for more drug treatment for adults will be an uphill battle. The current political mood is for greater fiscal restraint, Burch said.
"I know the Tea Party doesn't want us to pay for it, but they also think that the Holy Spirit rains money on us all the time," Burch said.