Laz
03-05-2006, 06:59 PM
Posted on Sun, Mar. 05, 2006
Advocates contend that Medicaid cuts are threatening treatment
Children forced from group homes
By FINN BULLERS
The Kansas City Star
Efforts to curb Medicaid spending are coming at the expense of some of Kansas’ most troubled children, who, critics say, are being placed in foster homes too soon to succeed.
Child-welfare advocates say that privately run group homes in Kansas are being forced to discharge mentally and physically challenged children before they are ready to live in home settings.
All told, the funding tangle affects an estimated 500 children statewide, said Rep. Bob Bethell, an Alden Republican who is leading hearings beginning Monday to address the problem.
“It’s not a large number of kids unless you’re one of those kids,” Bethell said Friday. “But these kids are some of most needy kids that must have stability in their lives. These are kids who may have been abused. They may be mentally ill. They may be mentally disabled. They may be aggressive.
“We really think this is a serious problem, and we’re trying to find a solution.”
The difficulty arose from a recent federal ruling that Kansas does not comply with its own Medicaid plan, which restricts stays in group homes to between 140 and 180 days.
But for the last decade, Kansas ignored the plan and caregivers forgot about it.
In December, the federal Center for Medicare and Medicaid Services told officials at the Kansas Department of Social and Rehabilitation Services that in order to retain Medicaid funds, they must stop submitting bills for children who have been in the system too long.
If Kansas decides to leave those children in group homes, federal regulators said, the state will have to pick up the entire tab for their care.
The result has been a “chaotic rush” to discharge children before the funding runs out, said Bill Craig, president and CEO of Lakemary Center in Paola, a school and residential center for children with severe mental disabilities.
Bad decisions are being made with the lives of vulnerable children, he said.
As of Wednesday, Craig said, 22 children at his group home will be moved by the end of the month. Eight are already gone.
Two-thirds of the children at his center have been physically or sexually abused, Craig said. And when dealing with a child who’s also developmentally disabled, treatment takes a long time — well past the allowed 140-day to 180-day limit.
The average stay at Lakemary is 650 days, he said.
State officials have agreed to intervene and slow this process down where they can. So far those efforts have produced “marginal gains,” Craig said.
In recent months, federal officials have been reviewing state plans in an effort to find ways to cut or curb Medicaid spending.
Without federal funding, the state would be left to pick up all the costs, rather than the usual 40 percent. That could add up to $3 million a year, SRS Secretary Gary Daniels said Friday.
Until a long-term solution can be found, Daniels said, the state is committed to finding a funding solution for those children who fall through the cracks. For now, the state will provide enough money — roughly $750,000 — to pay for the group-home stays through June 30, the end of the state’s fiscal year.
Records show that the state has about 100 children who have been in group homes 140 days and are not ready to transition to a foster home.
Children who fail with foster care guardians can return to group homes for another five-month cycle. But critics say that is not in the best interest of children who desperately need a stable home life.
Foster care contractors also feel pinched.
If Medicaid won’t pay, they can’t afford to leave children in group homes. And there aren’t enough foster parents to handle children coming out of group homes.
Ideally, both sides of the debate want children out of institutions and into homes. But critics say the rush to integrate troubled children threatens the success of the effort.
“All I want is for us to pay close attention to each child for whom we — the state — are the parents,” said Tom Laing, a Topeka advocate for the disabled.
“We won’t succeed in every instance, but better parenting usually produces better lives for children.”
Advocates contend that Medicaid cuts are threatening treatment
Children forced from group homes
By FINN BULLERS
The Kansas City Star
Efforts to curb Medicaid spending are coming at the expense of some of Kansas’ most troubled children, who, critics say, are being placed in foster homes too soon to succeed.
Child-welfare advocates say that privately run group homes in Kansas are being forced to discharge mentally and physically challenged children before they are ready to live in home settings.
All told, the funding tangle affects an estimated 500 children statewide, said Rep. Bob Bethell, an Alden Republican who is leading hearings beginning Monday to address the problem.
“It’s not a large number of kids unless you’re one of those kids,” Bethell said Friday. “But these kids are some of most needy kids that must have stability in their lives. These are kids who may have been abused. They may be mentally ill. They may be mentally disabled. They may be aggressive.
“We really think this is a serious problem, and we’re trying to find a solution.”
The difficulty arose from a recent federal ruling that Kansas does not comply with its own Medicaid plan, which restricts stays in group homes to between 140 and 180 days.
But for the last decade, Kansas ignored the plan and caregivers forgot about it.
In December, the federal Center for Medicare and Medicaid Services told officials at the Kansas Department of Social and Rehabilitation Services that in order to retain Medicaid funds, they must stop submitting bills for children who have been in the system too long.
If Kansas decides to leave those children in group homes, federal regulators said, the state will have to pick up the entire tab for their care.
The result has been a “chaotic rush” to discharge children before the funding runs out, said Bill Craig, president and CEO of Lakemary Center in Paola, a school and residential center for children with severe mental disabilities.
Bad decisions are being made with the lives of vulnerable children, he said.
As of Wednesday, Craig said, 22 children at his group home will be moved by the end of the month. Eight are already gone.
Two-thirds of the children at his center have been physically or sexually abused, Craig said. And when dealing with a child who’s also developmentally disabled, treatment takes a long time — well past the allowed 140-day to 180-day limit.
The average stay at Lakemary is 650 days, he said.
State officials have agreed to intervene and slow this process down where they can. So far those efforts have produced “marginal gains,” Craig said.
In recent months, federal officials have been reviewing state plans in an effort to find ways to cut or curb Medicaid spending.
Without federal funding, the state would be left to pick up all the costs, rather than the usual 40 percent. That could add up to $3 million a year, SRS Secretary Gary Daniels said Friday.
Until a long-term solution can be found, Daniels said, the state is committed to finding a funding solution for those children who fall through the cracks. For now, the state will provide enough money — roughly $750,000 — to pay for the group-home stays through June 30, the end of the state’s fiscal year.
Records show that the state has about 100 children who have been in group homes 140 days and are not ready to transition to a foster home.
Children who fail with foster care guardians can return to group homes for another five-month cycle. But critics say that is not in the best interest of children who desperately need a stable home life.
Foster care contractors also feel pinched.
If Medicaid won’t pay, they can’t afford to leave children in group homes. And there aren’t enough foster parents to handle children coming out of group homes.
Ideally, both sides of the debate want children out of institutions and into homes. But critics say the rush to integrate troubled children threatens the success of the effort.
“All I want is for us to pay close attention to each child for whom we — the state — are the parents,” said Tom Laing, a Topeka advocate for the disabled.
“We won’t succeed in every instance, but better parenting usually produces better lives for children.”