Following the Newtown shootings, the General Assembly told Department of Children and Families Commissioner Joette Katz in 2013 to come up with plan to eliminate barriers to mental and behavioral health services for all children, regardless of whether they’re under DCF care. But a group of mothers on Thursday expressed concern that Katz may be ignoring their kids.
The basis for their concerns rises out of the lack of mental health care coverage from private insurers. Since the insurance companies either don’t offer behavioral or mental health care coverage, or their policies only cover a limited, “medically necessary” amount, children are often discharged before they’re mentally or emotionally ready and find themselves back in the emergency rooms after new incidents.
With nowhere else to turn, families can ask DCF to provide “voluntary services” for situations where they can’t otherwise gain access to behavioral health care for their children. But the mothers on Thursday said the state is failing to authorize appropriate care for children in crisis, and as a result their emergency room stays are getting longer because they’re not getting into group homes or other institutional settings where their troubled kids can get behavioral services around the clock.
During a joint public hearing of the legislature’s Children’s and Appropriations committees, Katz said 25 percent of the kids stuck in emergency rooms seeking treatment for behavioral issues are already in DCF care. But she said the other 75 percent of the children in the same situation are not under DCF care.
“That’s not the child who would otherwise go into the bed that I’ve since closed,” Katz said Thursday.
Katz was talking about the more than 100 congregate care beds — a.k.a. group home or institutional beds — she’s closed since being appointed commissioner of the child welfare agency in 2011. Katz told the committee she’s been able to reduce the number of children in congregate care from 30 percent to 19 percent. She said she’s also raised the number of children placed with families from 14 percent to 35 percent.
Her goal is to have the number of children in congregate care down to 10 percent, but she admits she has not set a deadline.
Mothers and lawmakers wondered if Katz is striking the right balance for children by pushing them out of institutional or congregate care settings.
Katz told the committee that said she would have no problem placing a child in congregate care if it was appropriate, but she is trying to move the department away from congregate care settings.
“The children in the EDs [emergency departments] that you’re talking about — first of all, three-quarters of them aren’t mine, so I’m happy to help and you know that we are stepping up to work with those families and those children,” Katz said.
Carol Poehnert, a mother who belongs to the Moms’ Mental Health Advisory Group, found Katz’s statement troubling and hurtful.
“Hearing her repeatedly talk about her kids, and that the ones in the ER are not her kids, gave me the impression they weren’t her problem either — and that’s my child,” Poehnert said. “It gave me the perception that the plan she and her colleagues may be formulating will also be geared to her kids [already in DCF care].”
A majority of Connecticut’s children are not under DCF care, Poehnert said.
Nancy Aker, another mother in the group, said the non-DCF kids spending time in ERs because of behavioral issues may require voluntary DCF services when they can’t find help in other places.
In a set of issues and recommendations the mothers gave to the Children’s Committee, they explained that psychiatrists and therapists often do not accept private insurance and private insurance rarely covers mental health services.
“So while she wants to make a clear differentiation that she’s responsible for only 25 percent, in fact when you have families who are in crisis and haven’t gotten the services they need, that blows over and becomes her problem, too,” Aker said.
Mary Jo Andrews, another mother, said she had trouble accessing voluntary DCF services because a social worker at the agency refused to bring her request to Katz. Based on that experience, she said Katz has made cutting down on these types of placements part of her goal, and she said the social worker was afraid that she would be retaliated against if she brought the commissioner a request for this type of placement.
“My daughter should be one of her kids, but she wouldn’t even open a file for us,” Andrews said.
Sen. Beth Bye, D-West Hartford, pointed out that Katz’s policy decisions regarding congregate care placement are having an impact on the system.
“Do we have a way to know this move has improved outcomes for those children?” Bye asked.
Katz said all that information is tracked.
Bye said she sees people in her community suffering because of this policy shift.
Bye said she many of her constituents belong to the Moms’ Mental Health Advocacy Group and have children with significant mental health challenges. They came to DCF for voluntary services and didn’t get them, Bye said, adding that the parents then had to make some tough decisions about how far they were willing to go to get their children the services they needed.
“I continue to have concerns about kids having appropriate settings that are sometimes a step above what foster care can give them at that time,” Bye said. “. . . As representatives we hear human stories that speak sometimes against some of the shifts and make us worry about kids whose parents didn’t mortgage their homes for that special program, cycling in and out of the ER because they’re not making it in another setting.”
With the ongoing shortcomings of private insurance, there’s a lot more that Katz’s department will be expected to do for these children, Bye said.
There already is a well-documented shortage of mental health care professionals in Connecticut. It’s not clear whether DCF or a coalition of state agencies including DCF even have the capacity to provide behavioral health care for all non-DCF children who need it in Connecticut.
Bye encouraged Katz to work with the 36-member advisory panel to up with recommendations by the Oct. 1 deadline.
