Medicaid to cover mental illness care

INDIANAPOLIS -- Some Indiana children with serious emotional problems soon will can get the cross-section of services they and their caregivers need at home instead of only at hospitals.\nIndiana this week became only the fourth state granted a waiver from federal Medicaid rules so these children -- which include about 10 percent of all those between the ages of nine and 17 in Indiana -- can remain in their home communities.\nThe state's program will serve up to 50 people ages 4-21 with so-called serious emotional disturbances over the next 12 months.\nA year from now, it will serve up to 200 patients. That's or more than the 177 children now treated in three state hospitals at Evansville, Indianapolis and Richmond, most of whom are being treated for serious emotional disturbances, Suzanne Clifford, director of state's Division of Mental Health and Addiction, said Tuesday.\nThe Medicaid waiver is important because it will bring to local communities some services that now are provided only in state hospital settings. Those services include family support and mentoring, life skills training for patients, and respite care that gives patients and caregivers a needed break from each other.\nThis is going to jump-start our ability in Indiana to expand services because now there is a way to pay for those services," Clifford said.\nThe pilot program in 10 counties this year will cost the state up to $223,000, with the money coming from the budgets of the Family and Social Services Administration and the correction and education departments. By the third year, Indiana will provide up to $910,000 of a total $2.62 million in state and federal funding.\n"It really is something that is significant for Indiana," said Stephen C. McCaffrey, president of the Mental Health Association in Indiana. "Across the country, we have never prioritized children's mental health services the way they need to be prioritized. As a result, children rarely get the services they need."\nInstitutionalization in hospitals is appropriate in some cases, but in others, caregivers may choose to keep the affected child at home, McCaffrey said. As a result, a child with severe depression or another mental health problem develop behavior that affects their abilities to get along with others.\nAn important service is respite care, in which a hospital or foster home may temporarily relieve the caregiver of responsibility for the child. Parents and other caregivers sometimes need a break from their emotionally disturbed children, said Cathleen Graham, executive director of the Indiana Association of Residential Child Care Agencies.\n"Families get worn out having children with serious emotional disturbances," Graham said.\nIndiana follows New York, Vermont and Kansas in receiving the Medicaid waiver.\nThe 10 counties selected for the pilot program are Daviess, Elkhart, Knox, Lake, Marion, Martin, Pike, Randolph, St. Joseph and Vigo. They were chosen on the basis of how well they have developed "wrap-around" treatment programs for affected children and their interest in expanding them, Clifford said.\nSuch treatment programs allow the people closest to the child, including parents and other relatives, mental health professionals, teachers and probation officers, to work together in treating the child and giving the support needed to lead a more normal life.\nA 1999 Surgeon General's report said about one in every five children has a diagnosable mental, emotional or behavioral disorder. In Indiana, a 1996 study estimated 9 percent to 11 percent of children ages 9-17 have been diagnosed with a serious emotional disturbance, FSSA said.