The recent closure of the Edmund N. Ervin Pediatric Center in Augusta (described in a May 13 op-ed by Dr. Stephen Meister) represents more than a loss for all of Maine’s children. It is a devastating blow to the most vulnerable among us, the 900 children who each year enter foster care.

The Pediatric Rapid Evaluation Program (PREP) was started at MaineGeneral by Dr. Meister, then brought to Spurwink in Portland by me and to Bangor by Dr. Adrienne Carmack. It offers comprehensive, trauma-informed evaluations for children when they most need support. Its sudden disappearance from central Maine leaves a significant gap in our state’s safety net.

For many years, PREP has served as a lifeline for foster children throughout the state, offering thorough assessments that identify urgent medical, developmental and psychological needs. These evaluations prevent long-term harm, reduce costs and give families and case workers the tools they need to care for traumatized children. As noted in a study by the Muskie School, the program improves outcomes while saving the state thousands of dollars per child, proof that compassionate care and fiscal responsibility are not mutually exclusive.

Maine’s foster children carry a heavy burden. Studies consistently show that children entering foster care are more likely than their peers to suffer from chronic illnesses, developmental delays and behavioral health disorders. More than half have at least one chronic medical condition, and many have more.

Foster youth are diagnosed with ADHD at triple the rate of other children. Nearly a quarter have PTSD, more than double the rate of U.S. war veterans. Without the availability of a comprehensive evaluation like that provided by PREP, these children are often left to fall through the cracks of a fragmented system.

The closure of the Edmund Ervin Center’s PREP program represents a reversal of everything Maine has worked to build in trauma — informed, evidence-based care. More than 900 children entered foster care last year in Maine. The loss of this program means at least a third of these children will receive no evaluation.

This failure is not based on the proven value of the program. It is a failure of funding and of leadership. Medicaid, which pays for the care of children evaluated by PREP, pays below cost. In the current hospital fiscal climate, such losses are difficult to justify. But the tragedy is not just in the financial numbers,  it is in the silence. No public warning or discussion. No plan for transition.

The state of Maine must act immediately to:

1. Mandate timely, trauma-informed assessments for all foster children and adhere to the American Academy of Pediatrics’ standard of comprehensive health assessments with specialized follow-up for behavioral health.

2. Establish a state-supported Pediatric Rapid Evaluation guiding committee. This committee should include state and local political, medical and mental health leaders. The purpose of such a committee would be to guarantee the fiscal viability of existing programs and urgently reestablish services for the children entering foster care each year in central Maine.

3. Increase MaineCare reimbursement rates for high-need pediatric programs to make certain that critical programs are financially viable, particularly those serving Medicaid-dependent children.

Maine has long led the way in caring for its most vulnerable youth. Programs like PREP reflect our best instincts as a community. Let us not allow this closure to become just another budget casualty. Let it be a call to action.

Our foster children deserve more than fragmented care and missed diagnoses. They deserve the commitment and coordination that only a program like PREP could provide. We owe it to them to restore what we have lost.