Tag Archives: Medicaid

Is Family Disruption Necessary in ND in Order for Children to Receive Long Term Residential Mental Health Care?

Say that I wanted to analyze the propensity of ND Medicaid to refuse funding beyond 365 days for PRTF/RTC level care. A component of this could include the psychiatrists telling parents that the best way to get the care a child needs is give up custody of their child.  In part because in the psychiatrists experience the only way children receive the care required is through the voluntary disruption of parental custody.

So question: Do children in state custody receive more than 365 days of inpatient mental health care paid for by ND Medicaid?

Now given that this is a vulnerable population,how do I go about obtaining the data that I need?

Follow-up questions could include:

  • How many children in state custody for treatment of mental health issues ultimately end up in prison?
  • Is the cost of care per child lower while the child is in custody of the state than it is if ND Medicaid funds the care while parents maintain custody?
  • Is the rate of out of state placement higher for children in parental custody than it is for children in state custody?
  • What is the rate of Special Needs Adoption family placement that is disrupted through this process?

Hypothesis include

  • Children in state custody are more likely to receive 365 days or more days of PRTF/RTC level care than children in parental custody.
  • Family disruption is the only way that children receive adequate PRTF/RTC level care that their mental health needs require.

If any of the hypothesis were proven, it would show a trend in ND Medicaid that would be alarming. Wouldn’t you think?

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Our experience has shown that facilities are hesitant to accept children where the payee is ND Medicaid. Denials from ND facilities are high when children are in the custody of the parent.

Does it pay to complain?

In a word, some times, yes it does pay to complain. Just got off the phone with the hospital, David’s medicine just received authorization from the insurance company. This is so awesome.  I can’t begin to tell you. Now we can stabilize his moods again. Eventually, the roller coaster rise will change.  For now, I… Continue Reading

Insurance preauthorization update part 2

So, the insurance company contacted me because I posted a message on their facebook wall. Amazing how social media messages get a faster response than a phone call. The request made for the medicine on Tuesday was marked non-urgent. A second request was made today and it was marked urgent.  This request came in half… Continue Reading

Insurance Preauthorization Still Not In

We are finishing week 1 of the wait for pre-authorization for David’s meds. How frustrating it is that we can be held by hostage by an insurance company and/or medicaid decision. Of course, the doctor is never around when I need to talk to her. Time to annoy some people to no end so that… Continue Reading

I now pronounce sentence. 72 hours and a prayer

The appeal to Medicaid to further fund services has been denied. As a result, I will be picking up David from the facility on Monday.  We then come home to begin a new chapter in our lives as a family. We had an IEP meeting for him this morning. Short term he will be homebound… Continue Reading

Happy One Year Placement Anniversary David

Ironically, the day after we receive notice of denial of coverage of services for our son, is the anniversary of his placement at the current facility.  It has been one year since we placed David in a facility 500 miles from home. Today, I am struggling with the stress of not knowing where we are… Continue Reading

a new year, more medicaid frustration

So what else is new?  right? Received this notice from the facility where our son resides. I am sure you will be receiving a hard copy in the mail, but I wanted to notify you that as of 1/10/2015, David’s  Medicaid has denied coverage for residential care and we were notified of this yesterday. (See… Continue Reading

Annual Christmas Letter and Appeal

Greetings friends and readers. It is with all the joy in my heart that I wish each of you a joyful holiday.  One filled with acceptance of the differences we see in others.  One where our children know how much love we feel in our hearts for them. It is tradition in our home to… Continue Reading