By Stephen Smoot
According to the United States Centers for Disease Control and Prevention, slightly more than five percent of children between the ages of four and 17 exhibit serious emotional and/or behavioral difficulties. West Virginia studies have shown that a little less than 1,400 children statewide between three and 21 display identified emotional or behavioral disorders.
As the social foundation of the traditional family continues to break down, more children experience the kind of neglect and trauma that leads to these behaviors. Parents, guardians, or other caregivers can find themselves overwhelmed by behaviors displayed and emotional problems experienced.
In the past, this has often led to placement in a facility like Burlington Children’s Home or others. The State of West Virginia, however, has created a program to prevent placements when support services can help to connect troubled children and their caregivers to the right resources.
The Children with Serious Emotional Disorder Medicaid waiver, according to a West Virginia Department of Health and Human Resources document, “provides additional Medicaid support to children from ages three to 21 with serious mental, behavioral, or emotional health needs.”
Cindy Beane, commissioner of the West Virginia State Bureau of Medical Services, shared that the goal of this program aims to “keep West Virginia kids home and with their parents.”
“The State of West Virginia was confronted with the fact that too many kids were being placed in residential treatment homes,” said Damon Cater, CEO and founder of Home Base Inc. in Charleston. Some of these treatment centers took kids hundreds of miles away, many even to other states.
Cater added that “there was a severe lack of meaningful and effective community based services to work with this population in the child’s home and community.”
Home Base serves as a provider for Pendleton County under the WV CSED program.
According to the West Virginia Department of Education, serious emotional and behavioral problems can have a variety of causes. Family dysfunction serves as a powerful malefactor, whether the cause comes from drug abuse or addiction, the impact and stress of living in poverty, or mental illness in parents, guardians, or others living in the home.
In many cases, however, as Beane explains, taking a child from their home environment, even one that is less than ideal, but not threatening or dangerous “is traumatic for the child.” She adds that “we don’t want them to have disruption in their home life” if services can treat the child where he or she lives and is most comfortable.
Not every child, however, develops these behaviors or emotions in an atmosphere of family breakdown. Some children have hereditary conditions, develop brain disorders, or live under high levels of stress. Children developing such problems, regardless of origin, can face tremendous challenges at home, in school, or with peers.
“We have seen really fantastic results,” shared Cater. He explained that a “sibling group was on the verge of losing an opportunity to be adopted due to the behavioral and emotional dynamics being displayed in the home.” After eight months of treatment and services supported by the CSED waiver, “the adoption was able to proceed successfully and the family is still intact today.”
Cater added “had it not been for CSED, these kids would have been placed back into foster care and probably would have had to endure a multitude of placements and separation over the past few years.”
The program started three years ago when the State of West Virginia requested from the federal Centers for Medicare and Medicaid Services “if we could have an in-home program to provide services,” as Beane stated.
Most children in the program receive “professional counseling for the child and family,” but families may also obtain “respite, supportive counseling, wrap around facilitation, independent living skills, job development, supportive employment services,” and more.
West Virginia residents between three and 21, even those housed in an out-of-state facility, can be eligible. Potential participants must meet eligibility requirements, receive services in the home or community based treatment, sign up with an identified managed care organization, have a professional diagnosis found in the Diagnostic and Statistical Manual, and have a “severe” score on an assessment scale.
The program relies on a partnership connecting the West Virginia Bureau of Medical Services, state providers, and Aetna.
As with seniors, providing in home services usually costs patients and taxpayers much less than relocation to a residential facility. Home based treatment, when appropriate, also helps to keep clients better connected to the world.
Beane described the program as “well-received” by parents and others who struggle with basic child rearing skills. “Often,” Beane said, “parents don’t know what to do,” especially when behaviors and emotional disorders can overwhelm the family unit.
“As families become aware of the program, those who have been struggling to get meaningful services for their kids” increasingly gain access, says Cater. Kids with SED “are able to work with a team of professionals to build a plan to help to stabilize their families and to ensure that the integrity of the family remains intact.”
