update on son: found hospital/Residential Treatment Center (RTC) but there's a hitch...

[recovering doormat]

Last time I posted our son had agreed to try a wilderness program in the Adirondacks, but my ex and I after much thought have decided that we should stick with our first choice, a hospital diagnostic program that steps down to an Residential Treatment Center (RTC). The judge knew and approved of it, and three kids in our district are currently placed there.

Our son has been accepted into the program but there's a problem, a big one: the facility requires that the insurance carrier precertify the child's stay, and the carrier won't precertify until we show up on their doorstep and they examine our child, then call the carrier's Care Advocate to see if they will precertify on medical necessity.

I'm just sick about this. Today we finally nailed down the school district to take responsibility for the $200/day educational costs that we would otherwise pay out of our own pocket, and now we might not get him in.

Or, we just bite the bullet and sign a responsibility contract and pay for the bulk of it ourselves.

I'm sure my ex is going to hesitate about that part. He is also already fretting that our son won't let us get him in the car to take him to PA when a bed is available (he has told us he won't go and since it's out of our state, the juvenile court can't help us with transport).

I was so happy that we were going to get this resolved, and now it looks like it's unraveling.

Have you ever heard of an insurance company not precertifying ahead of time, with a kids' physician?

 

[bran155]

I have a question. Is your son under the eyes of the Family Court? I ask this because my daughter has been in 3 rtcs, 2 of which were mandated by the Family Court System. Once they took over we automatically got a case worker through Social Services, thereafter everything that the court mandated was paid for by DSS and NY state. I am confused why you have to pay out of pocket for this program. The state in turn sued me for child support which I owe to this day, but they paid for everything up front.

Just thought that might help. Good luck.

 

[bran155]

You said the judge agreed, even if it is a Criminal Court judge, if they mandate him into a program doesn't that make them responsible for the costs of it?

 

[klmno]

That's kind of what I'm thinking- at one point, an out-of-state Residential Treatment Center (RTC) was (barely) considered for my son. It's my understanding that the sending court arranges things with the "receiving" state. So, I would think that they really could transport him, but at least, they could transport him to state line and have a someone from that state transport him from there. Of course, that is not the same as a juvy judge allowing you to take responsibility for providing the treatment that he/she is ordering. That is what we are doing with my son. In that case, they are providing anything to help me.

It sounds like you need someone from the courts (judge or PO) to make sure your son understands- he either goes there with you, or he's going to be in juvy.

 

[recovering doormat]

I think what happened was that the court agreed to support our request that our son go to a rehab/dual diagnosis/Residential Treatment Center (RTC) facility rather than juvenile detention, but they are not taking away our parental authority and ordering it themselves. Our son's attorney said if we wanted the state to pay for it, we would have to give up our parental rights and it could take months for that to happen, and in the meantime he's getting worse.

I'll have to ask my ex about that, he arrange for the attorney and attended the last court hearing. I had to leave to take our oldest to her therapist by the time the judge was ready to see us.

 

[klmno]

My post was meant to say that the courts aren't providing anything. It sounds like your son's court order was similar to mine. It gives us some leeway to provide adequate treatment that we are comfortable with and we keep custody but it is up to us (the parents) to figure out a way to make that happen and fund it. I fought for this too and got it, but I'm not having a lot of success maintaining finances thru it. I don't know the details of your son's situation- why he's in legal trouble, the judges characteristics, etc., but it sounds like maybe you need to provide your son with an eye-opener- either he complies with what you say or it will get back into the courtroom. I don't know- I struggle with every decision I make regarding my son because we are now in this situation.

 

[recovering doormat]

Yeah, we're in a weird limbo-land of having some say in what is done with our son but no assurance that we're going to get any help tomake it happen. If my son refuses to get into the car to go to PA, I have no way of compelling him. We will be allowed one more chance to place him on our own, and if that fails too, he goes back before the judge, they snap on the cuffs, and off he goes to Bridgeport juvenile detention. A lovely place, I'm sure.

 

[susiestar]

I am sorry. It is a tough situation because in many places MOST of the placements must be court ordered.

If at all possible call the resource officer at your child's school and ask if they have a list of placements. It may give you other options - I got a whopping list with over 50 placements our therapist didn't even know about - and she had years and years of experience in this in our area!

If it helps, maybe get DHS involved to say it isn't safe for your daughter to have your son at home? Not sure how well it would work - they told us they didn't "need" to be involved because we had already had our son removed, but if he came home then they would take my other 2 kids??

But I THINK others have gotten help this way.

Whatever happens, I hope and pray you get the approvals you need for the placement your son needs.

Susie

 

[Rotsne]

If the court allows it you can hire a private transport firm. After all we are not talking about that you imprison him just because you want to, it is court ordered. I have a link to a directory of transport firms here. Try to seek some who don't insist on handcuff, transport hood, pepperspray and tasers. They exist but if they based on the history of your insist on mechanical restraints then put them on him yourself. It is stressful enough for him to travel with strangers even if you are in a car behind him all the way.

It believe that the rate is about 1,000 dollars + various expenses.

 

[recovering doormat]

The court probation officer gave us the name of our city police department youth officer whom we could hire to accompany our son to PA if needed. He is a former Marine with a lot of experience with youth and I'd be okay with him -- no cuffs needed, he just has to look at you.

My happiness and relief at getting him admitted and getting the school district's cooperation is mitigated by learning that we are liable for thousands of dollars in court costs, including the home monitoring bracelet rental. I don't object to being responsible for the costs, it's just that no one in the system gave us a head's up that we'd be paying it or how much it would be.

I'm glad I can comehere and vent so that I don't overshare with family (not always simpatico) and don't let my frustration and anger get in the way of helping my son. Part of me wants to throttle him for the huge cost in emotion, energy and yes, cash, that his behavior has brought us.

I still dont' know who stole my jewelry, and I probably never will. But the insurance investigator came to the same conclusion I did, that it was an inside job, either by one of my two older children, or one of their acquaintances that they allowed in my home while I was away.

 

[DDD]

Guess I should forewarn you about the next insurance trick. After your difficult child is approved for coverage and starts the program the insurance company stays in contact with the facility and randomly can deem that your child no longer needs residential services because "he is no longer actively using substances".

Yep! It happens. That's a catche 22 that caught me off guard.

Fingers crossed you don't get that roadblock. I'm rootin' for you. DDD

 

[Ephchap]

RD,

I'm not sure of the ins and outs with the juvenille system involved, because in my son's case, he was considered an adult by the courts (just turned 17), but a juvenille by our health insurance provider - so we were also in limbo.

My son wasn't court ordered, but was arrested while we were waiting for a bed to open up at the Residential Treatment Center (RTC).

My insurance company would not pay for anything that had the word "residential" in it. I still to this day do not understand why, but they wouldn't. They also wouldn't pay for anything out of state.

We were able to go through an agency of our county's MHMR agency, and they helped us file for medicaid for him - since it was based on his income (zilch). Although they did have us fill out financial papers and we were required to pay a monthly fee, it was minimal compared to the total cost. Just a thought - you might try contacting one of the agencies that deal with mental health in your area. Maybe they can help figure out financing.

Hugs to you. I know that feeling when you're so close to thinking something might help, and then a hiccup in the system happens and you worry who will help.

Keep us posted, and I hope it all works out !

Hugs,
Deb

 

[recovering doormat]

Merry Christmas and belated Happy Hanukah to all:

Yep, I'm prepared for any and all insurance "tricks," from not getting a precert to the arbitrary decision that treatmetn is no longer "medically necessary." Our carrier has no limit on days in residential but it is governed by medical necessity, which means the staff at the facility will be calling the carrier about every three days to beg another three days. I expect more stress, but at least we are making a dent in our son's rock-hard cabesa, that we will not tolerate his activities.

One of his "friends" just got placed in juvenile detention for four months for beating and punching another boy so badly that bones were broken -- not a shoving match, a real beating. This boy, the perpetrator, is a year younger than my son and had spent several weeks in a wilderness program over the summer. Apparently it didn't do enough. My son spent a lotof time this past summer with this young man, staying at his dad's house wehre there was little or no supervision.

My son cannot come home immediately after this 45-60 day diagnostic program. He needs a real Residential Treatment Center (RTC) experience away from home to break from kids who drag each other down.

Just gotta stay strong until he goes, whether it's Tuesday or Friday.

I am counting my blessings today, that although my family is messed up, I know where everyone is, and they are safe. I"m praying for those out there who are not so fortunate.

 

[standswithcourage]

I have to count my blessings too. I do know where everyone is also. If you have the chance read the book The Christmas Sweater by Glenn Beck. It is awesome.

 

[bonx4chaps]

Just FYI..this is totally irrelevant to your initial thread but I didnt know this beforehand so I wanted to fore-warn you ...My insurance completely covered my son's Residential Treatment Facility (RTF) treatment but Children and Youth took me and my husband (we still even live together) for two separate hearing/cases for child support. After further review with every agency possible (I even wrote to OBAMA!) I found this is policy anytime the child is placed in Residential Treatment Facility (RTF) the parent relinquishes custody. Between the two of us we pay $800.00 a month plus the arrears- not a penny goes towards my son or the program- it is put into the state welfare system. And this is the amount taken into consideration that we have four OTHER children to take care of at home. So, be prepared because that was a really bad hit for us- (nothing like salt in the wound).

 

[recovering doormat]

Bonx4chaps:

My son has been in the Residential Treatment Facility (RTF) for one full week, and the insurance company only gives certification for three consecutive days at a time. Today he is covered (ins. pays 70%, we are liable for 30%, education expenses are borne by our home district), by MOnday they will have to call again to beg for some more days. At some point the insurance company will just flat-out refuse, and that could be any minute now.

The insurance coordinator at the facility called my ex and I today and suggested two things: they have an application for a "charity" something or other where they would work out an extended payment plan, and shave down some costs (other facilities have done one better and charged us the rate they received from the insurance carrier, perhaps 35% less); and they suggested we contact our state DCF and see if they can help us out financially. Probably not, since we went out of state from CT to PA, and most states are cracking down on sending dollars out of the state. But it can't hurt to ask. Otherwise, it comes down to ex husband doing the right thing and raiding his IRA, and I have no control over that.

 

[tracyf551]

My son also went to Residential Treatment Center (RTC) 2 times during his teen years. I personally called Children services because I was out of ideas, doctors, therapists, etc. Tried them all. I also had to give up parental rights, but I still had a say in his care. I live in PA and I believe even though we give up rights we still have a say in things. He was court ordered to go to Residential Treatment Center (RTC). We had to pay support also while he was there and were in the rears before we knew it. I finally got everything paid off about 5 months after he was home. Just in time for him to quit school and go back to the way he was.
I hope your situation works out much better than mine.