How do you all pay for residential treatment programs?

[agee]

Hey everyone -
I know I'm a ways off from this (and hopefully we will not ever have to put difficult child in a Residential Treatment Center (RTC), although I can see the writing on the wall...) but I'm wondering how you swing the cost.
The list of what rtcs should and shouldn't do got me thinking about this.
I used to work at a private Residential Treatment Center (RTC) (in a teaching position) which was probably a pretty good one based on that list (which is controversial, I understand) but it also cost a hideous amount of money per year. How do people afford it?
A

 

[DammitJanet]

It all depends really.

My son was placed in his psychiatric residential treatment facility straight out of the state psychiatric hospital and Medicaid picked up the cost. We were told they also did a sliding scale for income and we might have an additional portion to pay but I never received any sort of bill from them.

When my son went to his wilderness camp, his SSI was used to pay for that. We turned over his monthly checks to them. It also was income based and whatever he got in SSI was what his tuition was for the month. I assume they probably also charged Medicaid something.

 

[slsh]

My son's Residential Treatment Center (RTC) was paid for with- a grant thru the state of IL. It is a program that pays for both home-based as well as residential services for severely mentally ill children. It's unfortunately unique to the state of IL. If Residential Treatment Center (RTC) ever becomes a possibility, I would recommend you speak with potential RTCs and ask them where their funding comes from.

I would also direct you to a list of questions to ask RTCs in our archives. I personally take issue with- some of the "warning signs" on the list that was recently posted - again, I think it has to be taken in context of the program as well as the needs of your child. I started out with- a list of questions to ask in it's original form (10 years ago!!) and then added my own questions. Literally printed it out and took it with- me when I went and looked at RTCs.

(I'm awful at hyperlinking or whatever it's called, LOL. If you click on "questions to ask RTCs" in the above sentence, it'll bring up the archived thread.)

 

[DammitJanet]

My gosh Sue...I didnt know it did that!

 

[Betty]

Hi
I am finally posted after many months. I had to put my son in a Boarding School in Nevada, we did not have any other choice. My husband owns a Company including the building, he had to sell the building to be able to pay for the School. My son has been there for more than a year, and he finally is back to the old self, he finished HS in just 7 months, even thought the payments are taking a tool in all our finances, I will do it again, finally we had some peace in our home and I saved my son from a life of crime and drugs. This programs are so helpful to our children that are living with very low selfsteem, now my difficult child looks very secure of himself, he is 17 years old now and he is looking to a bright future for himeself. I know the battle is not over yet, because some of this children can get back to the same garbage, but I know that I am much stronger and he knows that if he keeps making the same mistakes we will not going down the drain with him again, he will go by himself. I will take him out of the program in March and I will be posting how he is doing.
The besto for everybody

 

[dadside]

In some cases, including that of our daughter's attendance, the local school district pays much or all of the tuition. There are a number of factors that influence whether or not a school district will pay. Key elements include the student qualifying for an IEP and the local school being unable to come up with anything else to provide the help the law calls for. I understand this is easier said than achieved, and state of residence is a factor in difficulty of getting an Residential Treatment Center (RTC) paid.

Many parents got second mortgages on their home. I know that would be harder now.

Getting a local school district to pay the cost of an Residential Treatment Center (RTC) won't happen instantly. A case has to be made, and certain time lines observed. Unless you have an already cooperative district, it would probably pay to have the help of an advocate, or even an education attorney.

 

[torycf]

My son is currently in a Residential Treatment Center (RTC) in Nevada. Our insurance (Tricare) will pay for up to 5 months per fiscal year. We do have a co-pay of $40 per day until we meet our catistrophic cap (which should be met after this month). Even with most of the cost paid for by insurance, it is still hard for us financially as husband is unemployed. Totally worth it however...

 

[agee]

Thanks for the answers, everyone.
It looks like it's a mix, depending on why your child is in the Residential Treatment Center (RTC) and his/her diagnosis.
A

 

[CrazyinVA]

I'm a little late, but wanted to say that I entered into a partial custody agreement with my local Dept. of Social Services to pay for residential treatment. Medicaid covered it once that agreement was signed. It took months and months of fighting to get that accomplished, however.

 

[Star*]

I think getting INTO an Residential Treatment Center (RTC) is great - with one exception. ACCREDITED schooling.

Dude qualified for Medicaid - and then in SC because he was one of the most severe cases in the state got into a special group through the Governors Office that takes the most severely disabled emotionally disturbed kids. They fund for the caseworkers time etc.

This was all well and good EXCEPT - none of the schools that Dude was in were accredited, he fell behind severely - he's now 19, with about a 9th grade education and no way in the world of EVER catching up or getting even a GED. So my word of caution to you would be make sure the schools your son will attend get him a high school diploma.

My other answer was - How do you pay for Residential Treatment Center (RTC)'s? (Pound of Flesh) about covered it. (Oh what like we're supposed to always be so serious?)

 

[DammitJanet]

LOL Star...there is that pesky little thing about education isnt there? Once they hit 9th grade no one seems to give a rats behind about their education. Im another one with a son with a 9th grade education.

Of course, it really is his fault. I tried my best to get him to care about getting through school. Later he told me he would have tried harder if he had realized there were girls in HS! I could have strangled him.

 

[Marguerite]

Residential Treatment Center (RTC) isn't really an option in Australia. We do have residential treatment facilities but they are for adults, are drug/alcohol rehab mostly. There are the occasional teen drug rehab centres. Otherwise - it's boarding school. Or psychiatric ward in a hospital, and I've not had to deal with that.

I'm not sure about the cost of rehab. I do know of one recent big news story of a church-based place which was a sort of Residential Treatment Center (RTC) (from what I gather). It paid for itself by getting the inmates onto disability and then getting them to sign over their disability in full to the centre, as payment. The treatment was called into question when a number of inmates (various isolated cases) either suicided, attempted to suicide or became much worse. Other questions have been asked about that church organisation but they always manage to find legal loopholes to avoid the scrutiny. At least as a church. the centres have been closed down, I believe, because they didn't pass scrutiny. Or wouldn't.

As for us - we would never consider it for difficult child 3, never would have for the other kids. We don't have access to anything like you people have described. We have been offered respite but chose to refuse, on the grounds that difficult child 3 does a lot better with people he knows, and who know him. It simply would have been too big a problem trying to set it up, not worth the problems - for us. I've happily recommended respite for others, though.

We do have a therapeutic foster system - a kid we know is in there, probably permanently. His mother is the best, most caring, most conscientious. But she can't watch him 24/7 and it was wearing her out. He's a PWS kid who was self-harming badly in his desperation to get food.

For us, boarding school costs big bucks. I think treatment facilities otherwise get paid partly through our health care system and partly through contributions set at a level where the inmates themselves can pay, based on their own welfare payments. They also get public donations.
But if you were coming in from overseas, it would be private fees and probably much the same costs as the US centres.

Marg

 

[Lori4ever]

If your son is a minor in school. you can send a letter in writing to request an IEP be done. My son has spent 3 years in an Residential Treatment Center (RTC) in Texas and comes home in 2 days with his diploma!! I am so excited. It's not easy to get the ball rolling, but it can be done.

 

[SondraO]

Lori4ver~

Saw your post, and I am in the process of trying to find a Residential Treatment Center (RTC) for my difficult child who had Childhood Onset Bipolar Disorder (COBP), ADHD, ODD, and Intermittent Explosive Disorder (IED). Finding it is very difficult since he is not a Juvie or CPS case, and private pay is not something the centers I have contacted really want to talk about. Insurance is thru the State of Texas so I am at a loss here. Any suggestions would be greatly appreciated! I am just clueless at this point.

 

[ebonyqueen209]

Hello, SondraO.
I am moving to Arlington or the Plano area as soon as I school is out. I am hoping that TX will be more helpful than CA. Other than the Residential Treatment Center (RTC) struggle has your county/state and schools been helpful. I am praying that TX can do our family some good.

 

[ebonyqueen209]

Lori can you give me some more information with the iep. I live in CA also but moving to tx when school is out. I am in the process of calling an IEP, but need some direction.

 

[totoro]

We are still holding our breathe that a bill never shows up!

When K was in the psychiatric hospital for 5 weeks the psychiatric hospital called our insurance for pre-approval. psychiatric hospital told us everything was good to go and that they would not let her in unless it was approved.
She was supposed to go in Full time but they let her go sleep in a hotel with me at night because she was 5.
I double checked with everyone... fine. I had called insurance 2 weeks prior to let them know the psychiatric hospital was calling.

The psychiatric hospital was supposed to call 24 hours after first call to insurance for an approval number or some BS!

We never received a letter ever until 2 years later from our insurance company saying they were taking the Hospital to court.

Hospital lost the case after 2 appeals. According to insurance they tried to work a deal with Hospital.

Bottom line insurance told us off the record that Hospital messed up and that a lot of times they will wash their hands of the whole thing...
But in the mean time we just sit and wait. We were told not to let the psychiatric hospital know we know anything.
almost 3 years and the psychiatric hospital has never contacted us... I think the bill is over 35,000.00$

SO make sure even when you think you know!!! Triple check, and then check again! LOL

 

[trinityroyal]

I think in many cases there is funding available to help pay for part or all of the cost of an Residential Treatment Center (RTC).

In my family's case, we work and work and work and work and work, and do without luxuries, and sometimes do without necessities. We clip coupons, buy in bulk, shop at thrift and discount stores, make do with less, and are thankful that we've been able to scrape together the funds we need. The cost is prohibitive. But I think back to what life was like when difficult child was living at home. Honestly, every last sacrifice is worth it.

 

[DadFirst]

A couple of things I haven't seen mentioned yet...

The Federal Trade Commission has drafted a fact sheet on Residential Treatment Center (RTC) that contains a list of questions to ask. The website is here: http://www.consumer.ftc.gov/articles/0185-residential-treatment-programs-teens

The National Association of Therapeutic Schools and Programs (NATSAP) also has a list of questions.

Finally, for those who are self paying through loans, selling the farm, grandparents, etc... Although insurance may not cover the cost of the program, often they will cover the cost of the therapy, psychiatrist etc. IF the program will bill separately for these services. I have heard (but don't know) this can sometimes be as much as 30% of the costs.

 

[Marguerite]

Totoro, your story reminded me of something. easy child, when she arrived at our place last night, was also talking about the same thing - the companies behind private hospitals. I used to work for a journal that was distributed through the health care industry and I got to talk to a lot of people who were writing articles on various topics. The boss of te organisation I worked for was a very wealthy man who owned interests in a great many nursing homes and private hospitals. I got to see how he conducted his business. easy child, talking about her most recent employer, said much the same thing - it is a money-making enterprise. Sick people are the commodity. There will always be sick people. There will always be old people. So if an enterprising business provides the services, they will make money if they set it up the right way to do so.

That means, that when it all comes down to it, these places are not in it for their health (or yours, or your children's). They are in it to make money. Insurance companies make it easier because they are the cushion between h health institution and the individual client. A hospital doesn't like to have to chase individuals for money they owe. It is more tedious to do so. It is far easier to link in with an insurance company and let THEM worry about who is covered and who isn't; if it means Person A can't come in because their insurance is insufficient, then from the institution's point of view that is not a problem, because there will always be Person B (and the rest of the alphabet) who wants the place.

If you are an individual with no insurance but you want a place - they will want to see the colour of your money first.

A hospital might go after an insurance company, they will do it far more readily tan they will go after an individual who owes them. Especially after a number of years. I suggest you quietly find out if there is a statute of limitations on them coming after you for any money. In the same way that a cheque written on a certain date will expire after a certain period of time elapses, surely creditors have a time limit in which they need to at least notify you of the amount owing.

It costs money to chase money owing. Sometimes it is in an institution's best interest (for many reasons, PR is just one more) to waive the problem.

But never forget - they are in it for the money. Every single one of them.

Marg