Children’s Mental Health Matters! That’s the title of the Coalition’s annual fact sheet on children’s mental health released last week. The fact sheet is one way that the Coalition uses to convey the large numbers of children with mental health needs in Maryland. The numbers are overwhelming.
- More than 49,400 children and youth were served in Maryland’s public mental health system last year
- More than 9,350 children in special education were identified with “emotional disturbance” (ED)
- Tragically, 86 youth and young adults under age 25 committed suicide last year
- More than 16,300 children and youth went to the Emergency Department last year for psychiatric treatment
- Almost 1,000 children were placed in residential treatment centers last year.
While these numbers are staggering, it is the face and life of one child – the child that you may be caring for that matters most. That is why the Coalition works one-to-one with families to provide information, support and advocacy and also works at the policy level to improve services for children and families.
Contact us at info@mdcoalition.org or 410.730.8267 to request a copy of the fact sheet.
—Jane A. Walker
Executive Director
Legislative Update
From the opening gavel in January this legislative session has been running at full speed. With elections looming in the fall, lawmakers have much to do before going home to face constituents.
One easy way to keep up with legislative measures concerning mental health is through the Mental Health Association of Maryland’s legislative network postings on the Web. Visit http://www.mhamd.org/policy/weeklyupdate.html to check out the latest news.
Here’s a look at some of the legislation that specifically pertains to children’s mental health.
HB 98—Children’s Psychiatric Rehabilitation (PRP) Rate Study This bill requires the Mental Hygiene Administration to review several things: the utilization of PRP services; the impact of the shift in reimbursement to providers of children’s PRP services; and to recalculate the rate of reimbursement based on utilization. Many PRP services closed as a result of the change in reimbursement and this bill looks at the impact of the changes and how adjust reimbursement rates accordingly.
HB 301/SB 294—Local Management Boards and Local Coordinating Councils Requirements This measure codifies statewide that every jurisdiction in Maryland has a local management board and a local coordinating council (which provide access to services for children with mental health needs). It also codifies there will be a state coordinating council with oversight of the decisions of local coordinating councils.
HB 549—Emergency Inpatient Admission Determinations This is a very important bill for families with a child in an acute psychiatric crisis. It requires the employee of an insurance company who authorizes or denies an emergency psychiatric admission do so within two hours of the request. If the request is denied, HB 549 requires an insurer to immediately allow an opportunity to appeal the decision by the child’s health care provider. Finally, HB 549 requires that if certain basic criteria are met, an insurer approve an emergency admission and a 72-hour inpatient stay.
HB 771—Rate Adequacy Study This requires the Department of Health and Mental Hygiene (DHMH) to study the adequacy of rates paid to providers of care for children in need of therapeutic behavioral services, and that they evaluate the impact of current rates on access and quality of care.
SB 146—Task Force on School Safety This measure establishes a task force that will evaluate and make recommendations regarding the growing incidents of student violence in public schools.
SB 375—Residential Treatment Centers This bill requires that Residential Treatment Centers contact the parent or guardian of a child when significant changes in the child’s status or health occur. This would include (among other things) changes in medication, placement in restraints, an injury or illness that requires medical intervention or a hospital admission.
SB 447/HB 843—Provider Cost-of-Living Adjustment This bill requires that fees paid by DHMH to a community mental health provider be adjusted annually for inflation by a recommended update factor.
SB 748—Psychiatric Residential Treatment Waiver This bill requires the Department of Health and Mental Hygiene to apply to the federal government for a psychiatric residential treatment demonstration waiver. If the waiver is approved by the Centers for Medicare and Medicaid Services, some non-Medicaid children at risk of residential level of treatment would qualify for intensive community-based services.
Transitioning to Adulthood: Private Insurance
Worried about how your child will be able to purchase medications and go to doctors as he/she grows up?
As your child approaches adulthood, it is important to look into options for continuing health insurance. It is imperative to plan for your child’s coverage since policies have cut-off ages whereby your child may no longer be eligible under the family policy. Generally, 19 is the cut-off age for eligibility unless:
- The child attends a college or university carrying at least 12 credits a semester; or,
- The child attends graduate school carrying at least 9 credits a semester.
If your child remains a full-time student at a college, university or graduate school, there is often a maximum cut-off age of 23–25 years, depending on the policy.
The other exception to “aging out” of the family’s policy can occur when the child, having reached 19 years of age, is mentally or physically incapacitated. Maryland state law requires insurers to continue coverage if the child is proven to be “incapable of self-support.”
For children who have reached age 19 and do not fall into any of the categories above, the purchase of health insurance may be an alternative. Provisions of the COBRA and HIPAA federal laws may apply. If at all possible, do not allow any time to elapse between the expiration of your child’s coverage under the family policy and purchase of continuing or new coverage. Information on COBRA may be found by visiting http://www.dol.gov/dol/topic/health-plans/cobra.htm. HIPAA information may be found by visiting http://www.hhs.gov/ocr/hipaa/.
When your child reaches 18, they may become eligible for Supplemental Security Income (SSI) if they meet the following criteria:
• Their income and assets meet Social Security guidelines; and
• Their disability interferes with employability.
If your child qualifies for SSI, they also will qualify for Medicaid. SSI information may be found by visiting http://www.ssa.gov/notices/supplemental-security-income/. A list of Maryland Social Security offices may be found at http://www.ssa.gov/phila/states/maryland.htm.
Children and Medication
There has been a lot of news coverage recently regarding the potential side effects of various medications taken by children. In reading these stories, it’s important to understand the situation of your child could be vastly different.
The Food and Drug Administration (FDA) provides a review process to ensure medical products are safe and effective. The review process can be assisted by an Advisory Committee comprised of outside experts in the field. Advice from Advisory Committees is thoroughly reviewed by the FDA scientific staff, and decisions and votes of the Advisory Committees are not binding on the agency.
The FDA uses “Black Box Warnings” as a way to increase public understanding of medications being taken by the public and the risks involved with taking those medications. The “Black Box” is located at the top of the medication insert which is provided by your pharmacist. It is a box entitled “Contraindications and Warnings” and will detail any of the following regarding the medication:
- Known Side Effects
- Preventable Adverse Events
- Possibility of Injury or Death
- Unexpected Side Effects
- Unstudied Uses
- Unstudied Populations
-Center for Drug Evaluation and Research
For more information or answers, contact the FDA at 1-888-INFO-FDA (1-888-463-6332) or on the web at www.fda.gov.
Upcoming Events
- National Federation of Families for Children’s Mental Health “office warming” celebrating its new location in Montgomery County—March 13.
- Children’s Mental Health Conference sponsored by the Mental Hygiene Administration—May 25.
Here are the latest resources for summer camps and programs:
