More than 50 years ago the National Mental Health Association celebrated the first “May is Mental Health Month.” This year marks the inaugural celebration of National Children’s Mental Health Awareness Day on May 8th.
The theme of this celebration is “Thriving in the Community.” Throughout the country activities are being held to build awareness that children’s mental health needs are real and that progress is being made toward developing effective strategies for achieving the vision of a life in the community for everyone.
The next edition of the Coalition’s newsletter will contain details about Maryland’s celebration activities.
—Jane A. Walker
Executive Director
Legislative Wrap-up
Thanks to your efforts, Maryland’s children with mental health needs and their families did well in the recent General Assembly session. Your phone calls, letters, personal visits and testimony in Annapolis let lawmakers know—in no uncertain terms—the needs of the state’s youngest and most vulnerable residents.
Several measures were particularly important for families caring for children with mental health needs:
Senate Bill 748-Psychiatric Residential Treatment Center Waiver Application states that the Maryland Department of Health and Mental Hygiene will apply to the federal Centers for Medicare and Medicaid Services for a “Residential Treatment Center (RTC) Demonstration Waiver” for 150 children.
Currently under federal law, children with significant and complex mental health needs who are not eligible for Medicaid become Medicaid-eligible as a family-of-one 30 days after they enter an RTC (without regard to parental income or private insurance coverage). The only way these children can receive intensive mental health services is in an RTC as a family-of-one. When they are not in an RTC, they are unable to access intensive, community-based mental health services.
The federal government recently approved funding for five years for an RTC demonstration waiver. The waiver would allow children who need an RTC level of care—but whose families wish to care for them at home—to be eligible to receive Medical Assistance in the community. Under the waiver, children will be able to access a wide range of community-based services, such as case management, psychiatric rehabilitation programs, mobile treatment, one-to-one behavioral aides, partial hospitalization and respite services. With these intensive services available in the community, some children will be able to be diverted from expensive RTC placement or to return home more quickly from an RTC.
The first step is that Maryland must apply to the federal Centers for Medicare and Medicaid. If the waiver is approved for Maryland, funding would be available to the state in October. We will keep you posted on this important piece of legislation. If you want to know more about Medicaid waivers, read the article below from the Maryland State Department of Health and Mental Hygiene.
House Bill 549—Private Review Agents–Emergency Inpatient Admission Determination places a number of requirements on insurance companies. The portion of the bill that is most important to children and families states that an insurance company’s private review agent (the person who would authorize or deny an emergency psychiatric inpatient admission) may not deny a hospital admission for up to 72 hours, if:
- The admission is determined to be medically necessary by the child’s treating physician; and
- The hospital immediately notifies the private Review Agent of the admission.
Other important bills that passed:
HB 98—Children’s Psychiatric Rehabilitation Rate Study requires that the Mental Hygiene Administration review its current method of calculating reimbursement to providers of children’s psychiatric services. The current method inadequately compensates most providers and has caused many programs to close.
HB 301/SB 294—Local Management Boards and Local Coordinating Councils Requirements codifies statewide that every county in Maryland will have a local management board and a local coordinating council (which provide access to services for children with mental health needs).
SB 375/HB 1286—Residential Treatment Centers requires that an RTC 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 hospitalization.
HB 1405 Health Insurance - Coverage for Part-time Students with Disabilities requires that HMOs and insurers (subject to COMAR) who provide health benefits to full-time students over the age of 18 may not exclude health benefits for a student over the age of 18 who is enrolled less than full-time, if the student:
* has a documented disability that prevents the student from maintaining a full-time course load and
* is maintaining a course load of at least 7 credit hours per semester
What is a Waiver?
(from the Maryland State Department of Health and Mental Hygiene)
Section 1915(c) of the Social Security Act, Medicaid law authorizes the Secretary of the U.S. Department of Health and Human Services to “waive” certain Medicaid statutory requirements. These waivers enable States to cover a broad array of home and community-based services (HCBS) for targeted populations as an alternative to institutionalization. Waiver services may be optional State Plan services which either are not covered by a particular State or which enhance the State’s coverage. Waivers may also include services not covered through the State Plan such as respite care, environmental modifications, or family training.
To be a waiver participant, an individual must be medically qualified, certified for the waiver’s institutional level of care, choose to enroll in the waiver as an alternative to institutionalization, cost Medicaid no more in the community under the waiver than he or she would have cost Medicaid in an institution, and be financially eligible based on their income and assets.
Presently Maryland has three Waiver Programs for children with special needs.
The Home and Community-Based Services Waiver for Mentally Retarded/Developmentally Disabled Individuals, began in February of 1984, to provide services for developmentally disabled individuals, who meet an Intermediate Care Facility for the Mentally Retarded (ICF-MR) level of care, as an alternative to institutionalization in an ICF-MR. Covered services under the waiver include day habilitation, residential option services, respite care, services coordination, environmental modifications, assistive technology and adaptive equipment. This waiver is administered by the Developmental Disabilities Administration of the Maryland Department of Health and Mental Hygiene
The Model Waiver began January of 1985. This waiver targets medically fragile individuals including technology dependent individuals who, before the age of 22, would otherwise be hospitalized and are certified as needing hospital or nursing home level of care. Through the waiver, services are provided to enable medically fragile children to live and be cared for at home rather than in a hospital. Model Waiver services includes case management, private duty nursing, shift home health aide assistance, physician participation in the Plan of Care development, and durable medical equipment and supplies. Individuals that would like to apply for Model Waiver Services must contact the Coordinating Center for Home and Community Care, Inc., a case management organization.
The Autism Waiver began in July 1, 2001 through the Maryland State Department of Education, and targets children ages 1 through the end of the semester that the child turns 21. As a part of determining eligibility, a child must be diagnosed with Autism Spectrum Disorder, meet an Intermediate Care Facility for the Mentally Retarded Level of Care, not be enrolled in any other waiver, and have an Individualized Educational Program (IEP) or Individualized Family Service Plan (IFSP) and receive at least 15 hours of special education and related services per week. The services provided under the Autism Waiver are respite care, family training, environmental accessibility adaptations, supported employment, day habilitation, residential habilitation, and targeted case management.
The waiver referred to in the recently passed Maryland Senate Bill 748 would create a waiver specifically for children with mental health needs who require a residential treatment level of care.
Maryland Coalition Transition Focus Groups
The Maryland Coalition of Families is conducting a series of focus groups for families with a transition age youth (17-24 years) with mental health needs. The Coalition wants to listen and learn about the experiences and needs of those youth who have or will be entering the adult mental health system. Youth and young adults are encouraged to attend with their families!
All groups will be held from 6:30 PM – 8:30 PM
May 4
Southern Maryland
Alternatives for Youth
30049 Business Center Dr., Charlotte Hall, MD
June 1
Eastern Shore
Easton Welcome & Resource Center
11 S. Harrison St., Easton, MD
June 14 Montgomery County Family Services Agency
610 East Diamond Avenue, Ste. 100, Gaithersburg, MD
Co-sponsored by Montgomery County Federation of Families for Children’s Mental Health and NAMI Montgomery County
June 27 Baltimore City new
MD Coalition of Families for Children’s Mental Health
2300 N. Charles St., Baltimore MD 21218
Each participating family and youth
will receive a $20 stipend for attending.
Registration is required.
For more information and to register,
contact the Coalition at 410.730.8267 or 1.888.607.3637
or e-mail info@mdcoalition.org.
Upcoming Events
- Family Leadership Institute Class of 2006 Graduation—May 6, 11 a.m., Villa Maria, Timonium.
- Children’s Mental Health Conference, Nurturing Resiliency in Youth, sponsored by the Mental Hygiene Administration—May 25 at Temple Oheb Shalom in Baltimore. The Coalition has a limited number of scholarships for families to attend the conference. Contact the Coalition office at 410-730-8267 to request a scholarship.
- Self-injurious Behavior Workshop for Families – June 6, 6:30-8:30pm at MD Coalition of Families Columbia Office.
- 2006 Youth Leadership Weekend—July 28–30.
- Kennedy Krieger Institute Adolescent Transition Lecture Series (Sponsored by the Maryland Department of Health and Mental Hygiene, Office of Genetics and Children with Special Health Care Needs)
May 17
Part I: Advocacy 101
Part II: New IDEA
Maureen Van Stone, Equal Justice Works Fellow,
Maryland Volunteer Lawyers Service
June 7
Life Care, Financial and Estate Planning
Nancy Bond, Coordinating Center for Home Community Care
David N. Pessin, Esquire
RSVP or address questions to Resource Network Coordinator Jenny Jones at 443-923-2790 or 800-390-3372.
