Hi!! I use to post here 9yrs ago

[cathyw1970]

Hi!! My name is Cathy and me and my husband have 4 children. Christian 16, Justin(difficult child) 15, Ollie 10, Cerena 8. I use to post here around 6yrs ago when Justin was 9. It was thru some wonderful people here I got my son rightfully diagnosis'ed and once on the medications he was really good until he was 12. He is bipolar,adhd and odd. From what his psychiatric says he has a severe case of bipolar and adhd. Do to the severity of bipolar the adhd has to remain untreated. He has already been in 2 residential facilities. One was a wilderness program which was not a good program for him at all and another was a level 4 facility. I had to pull him out of the level 4 facility in July due to abuse from a staff member even tho I knew he wasn't ready. He has a case manager and has intensive home therapy which is not working at all. So I asked his case manager to start searching for another level 4 facility in the North Carolina area. However, because he receives SSI and Medicaid, Medicaid is turning down a level 4 placement. Not sure how it is in any other states, but in NC Piedmont Behavorial took charge of the Medicaid. They closed most of the level 4 facilities in NC and the few that remain open it's hard to get approval. They claim that intensive home therapy is better than placement.(hahaha) Justin needs a medication overhaul which can not be done at home. It is too dangerous. The last time we did it at home he set fire to our bathroom. So I went to take him to a local hospital here (only one in our area that has a mental unit for children). They turned us away because Medicaid refused to pay for treatment. In the meantime, Justin is spiralling big time. He's back to talking to himself. Seeing things that aren't there, very defiant and physically aggressive. Not to mention running away for a day or so. He's been suspended for 18 days due to fights and being aggressive with the teachers. I'm really at a loss on what to do. My husband receives disability due to a back problem and I'm the only one who works and supports a family of 6. I honestly can't afford to pay for it myself. Can someone guide me in the direction on where to go next? I've been told that until he hurts himself or someone in the home that Medicaid will continue to reject placement. Do they not understand how dangerous a bipolar child can be not getting the help they need? I'm trying to prevent him on hurting himself or someone so please if anyone has any knowledge please point me in the right direction. Thanks so much,

Cathy

 

[klmno]

Welcome!! It sounds like things weren't too bad for a while- sorry they're not so good now.

I have a question- Do you mean this was an acute hospital that turned him away when he was a danger to self and others? Did you take him directly there or thru the ER? I was under the impression that they pretty much had to take them (even if it's just for a few days) under these circumstances, if they had a bed open.

 

[Wiped Out]

Cathy,
Welcome or actually Welcome back! I'm sorry Justin is spiraling so much right now. My son who is younger is also bipolar and adhd and probably ODD too although never officially diagnosis. We also can't treat his adhd due to his bipolar.

I'm sorry that Medicaid is being so difficult. It doesn't seem right that it should take him hurting himself or others to get him the level of help he needs. Can a psychiatrist advocate for his placement in a hospital-would Medicaid pay then?

It sounds like you are dealing with so much. Are you able to find time to take care of you? It isn't easy to do but is very important.

Gentle hugs.

 

[cathyw1970]

Klmo, It is a medical hospital that has a mental floor for children and you have to take them thru the ER. I took the referral from his psychiatric to the ER for the medication overhaul. They claimed that medicaid said that can be done at home even tho he has a pass history of not doing well with medication change at home. This is the main problem. The hospital I have to take him to is in a different county than his psychiatric. They also told me that the psychiatric they have on staff doesn't accept medicaid anyway. That he technically isn't a staff member of the hospital but comes in to treat the patients. If medicaid would have approved it the hospital stay would have been covered but the psychiatric wouldn't have because at his clinic he is no longer set up to take medicaid because of Piedmont Behavioral's restrictions. It is totally stupid. NOt sure if Jeri is a moderator here but she taught me how to be my son's advocate and I will make them one way or another I just didn't know if someone had any suggestions.

Wiped, since when do us mother warrior's ever have time for ourselves? lol

 

[LittleDudesMom]

Cathy,

Welcome back! I'm glad you felt this was a place to come back to. I'm sorry that I can offer only words of support. I don't really know much about the medicare system and/or how to navigate the psychiatric hospital and Residential Treatment Center (RTC) programs.

I'm glad you are here and I'm sure you find the information you need to get help for Justin.

Sharon

 

[DavidWH]

cathyw1970

I am in the middle of this.. took me three years to get things going... am in Triad ara of NC Son is in Residential Treatment Center (RTC) and paid 100% by NC Medicade.

I would look into having a sit down with your case manager... something does not sound right - this person is the where with all get it done no matter what for you Residential Treatment Center (RTC) demanded I file for SSI for Son, SSI even told me I could get approved for him due to all that we have been through.. But wants tons of info I could not come up with (paper trail from Birth before I knew what problems were.. I never kept records) So I did not continue the SSI..

Point being case manager is the one that CAN get medicade in NC to pay - Makes no sense they would not...

UNLESS - they paid before and he was removed before the Residential Treatment Center (RTC) recommended - I have been told they do not take kind to paying and it ending up being a waste of $.

I know what you mean about the revamp of the NC mental health dept. thanks to that Governer .... what a mess that was!

 

[tammyjh]

Hello and welcome back.

Arrgghh...its all about $$ isn't it? We're told we have to jump through the in home support hoops too. daughter was approved for a residential program but the program wasn't one that would help her or us much so we turned it down. It was two hours away and we were told that husband, the other 3 kids, and myself would need to be there 2 or 3 times a week for counseling sessions, which we are not oppposed to, but it just wouldn't work for husband to miss the better part of 2 or 3 work days and 2 of my other kids missing that many hours of school...but thats the only program the state would approve at this time :rolleyes: We've had to fight crisis to present her for beds and fight hospitals to keep her and evaluate her more intensely but it all comes back to the $$. I hope that you can find a good place for your son and agree that a good case manager would be helpful in finding something.
Good luck!

 

[DDD]

Welcome back. I don't "quite" remember you from "back in the day" but sorry you have moved back into the frustrating world of
having to advocate actively for your difficult child. It's exhanusting and
stressful......mainly because the systems make no sense!

I have no knowledge that would be of help to you. Have you contacted the MH Dept. for the State? Is you son healthy enough
where you could try to obtain a CHINs petition or a temporary placement in an appropriately equipped foster home without it
causing new problems for him? My thought on that concept is that
perhaps by suggesting out of home placement is required (which would cost them more money in the long run) they might opt to find a slot for him for his medication stabilization.

I'm no fan of most parts of "the system" because a couple of ignorant or poorly motivated links can do real damage to our children. on the other hand, these are the only advocacy options I can think
of this morning. DDD
'

 

[DammitJanet]

Ok...I may be the boards leading expert on NC and its mental health system since it appears that OTE doesnt post here much anymore. I dealt with it for 14 years for my son and I still deal with it somewhat for myself.

I agree that the way they "passed the buck" down to the local agencies was a huge fiasco. The theory was that it was going to save medicaid dollars but it hasnt. It has created tons of little for profit agencies that take medicaid, medicare, access state funds for the indigent, and also take normal insurance. Sounds like a windfall for those agencies if you have ever seen what medicaid pays for things like Techs. It was around $30 bucks an hour back in 1999 so I am sure it is more now.

I had problems accessing out of home placements that were adequate for my sons needs too. They wanted to keep sending him to group homes and he needed a locked placement.

I dont know if calling the head of Children and Family's will still help or not. That is where I finally called and got action. I kept a parent report going and I gave it out like candy every place we went. You have to be persistent with these people and not take no for an answer. There is a website online where you can get all the info on how he qualifies for what and where the places are.

I will try and track all this down for you later. I also have an appointment later today with my therapist who works for one of these little offshoot agencies. I will pick her brain.

 

[DammitJanet]

Ok...had a sit down with some people who handle kids like your son in my county and got the following advice.

Your Piedmont Behavioral is one of these agencies that was branched off when local mental health went defunct. I go to one of these same type of places for my therapy. Had to use them for almost two years when I had no insurance so I had to figure out how they work.

Your agency has a ton of brochures on their website that you can download for information. I am attempting to see if any of them have valuable info pertaining to what you need.

Basically what I was told was that if your son was in a Level 4 and the only reason he was removed was because of abuse by staff and not because he was ready to be moved down to a lower level...which would mean level 3 and then on to the in home interventions...well then they should have found another level 4 placement. It sounds like Value Options (medicaid) is messing around and not doing their job. You can go over their heads and appeal their ruling.

Have you tried simply taking him to Umstead and refusing to take him home? Or Butner? Or take him to the local ER...dont worry if they have a child ward there, they can hold him at his age until they can get him transferred to the state hospital. This was what did with my son when he was 15. I refused to take him home from my local ER and they dont have a child unit anywhere close to me. They threatened me with sending him to the state hospital and I jumped at it. Best move we made.

Be adamant with these people. Tell them to show you in writing where it says that they cant do something. If you feel he needs to be in a hospital or a placement and they wont do it, tell them to show you in writing that medicaid wont pay for it and then tell them that you want THEIR names signed to it, head of Children and Family services name signed to it and Gov. Easley to sign it so that when your son hurts himself or someone else you have a record of who refused to give you help. That should make them take notice. If they refuse to do any of that...get their names and email and snail mail the head of children and family, DHHS, and the governor. SOMEONE will call you! They did me.

 

[cathyw1970]

Sorry it took so long for me to respond back. I work weekends so I usually don't even bother getting online. Janet thanks for your input. I will get on that first thing in the morning. I talked to the case manager's supervisor today and let her know that I felt the case manager wasn't doing her job. That she even agreed that difficult child needs level 4 placement. She directed me to a site to look at. The place is called Old Vineyard, have you ever heard of them? They are in Raliegh. She also told me what the hang up was with Medicaid is that I pulled him out of the place I had him (not sure I can legally say their name but they are located in Charlotte) because of the staff abuse. However, I felt my son wasn't getting the necessary treatment he needed there and it was becoming a saftey issue. She said she will get hold of someone and explain the situation and maybe that will make them change their mind. His psychiatric also faxed a letter of recommendation to her to also send to them. So as with everything else I will continue trying. I guess that is why God gave me difficult child because I'm downright stubborn and refuse to take no for an answer. lol But thanks for the info you gave me other avenues to try.