Which States Support Parenting Mentally Ill Children?

I’ve been digging into this issue of home-based services and support for families who want to keep their mentally ill children at home, or get services within their community. This issue is inescapably linked to the issue of relinquishing a child to the state so he/she can receive mental health services.

Now, let me explain that I don’t believe for one second that all children with mental illnesses should be left within their homes – there is definitely a need for out-of-home placements, hospitalizations and residential treatment centers (RTCs). But we have to understand that from a policy standpoint, our government is treating families of children with mental illness much different than those with physical disabilities (or even developmental disabilities, for that matter).

I blogged recently on the Katie Beckett waivers. These waivers are designed to allow children who are deemed disabled by the federal government’s definition to have access to Medicaid regardless of their parents’ income. These waivers have allowed thousands of children to stay home and receive services in their community instead of being institutionalized. There are however “catches” to getting children with mental illnesses qualified for these waivers.

The first catch is the federal government’s definition of mentally impaired requires more documentation of the child’s disabilities. See this earlier blog.
The more insidious problem is that the disabled child must need care that is comparable to what would be received in a medical institution. However, residential treatment centers are explicated excluded. So, what has happened is that even states who have set up waiver programs, have not set them up for children with mental or emotional disorders, because of the federal rule that excludes children who are at risk of being admitted to an RTC. Hmmm….

(This report from Bazelon Center for Mental Health Law does an awesome job of explaining all the intricate problems with waivers for mentally ill children.)

Anyway, the info I really wanted, and wanted to share with you, is which states have waivers. The answer wasn’t that straight-forward, as I discovered there are two kinds of waivers. The TEFRA (Katie Beckett) kind and the Home-Based/Community-Based kind. The Bazelon report advocates for more use of the HB/CB kind, because it allows states the flexibility to go beyond traditional Medicaid services and include “wraparound” services like respite and independent living counseling. While 49 states have embraced these types of waivers for children who qualify as developmentally disabled, only three have HB/CB waivers for those with mental/emotional disabilities: Kansas, Vermont and New York.

There are 20 states that have traditional TEFRA (Katie Beckett) waivers. Out of these 20, only 10 offer the waivers to those qualifying with mental impairments (as opposed to physical impairments or developmental disabilities). Below are the 20 states and those with asterisks are the 10 who DO provide waivers to mentally impaired children:

*Alaska
*Arkansas
Connecticut
*Delaware
Georgia
Idaho
*Maine
Massachusetts
Michigan
*Minnesota
*Mississippi
Nebraska
Nevada
*New Hampshire
Rhode Island
South Carolina
*Vermont
*West Virginia
*Wisconsin

Photo Credit

You can leave a response, or trackback from your own site.