As many as half of the 1,500 mentally ill and emotionally disturbed children in Colorado residential treatment centers risk being turned out as the state scrambles to meet strict Medicaid guidelines, facility operators say.
The children will go back to foster families, correctional facilities or parents as the homes face a federal funds cutoff that may come as soon as Oct. 1.
Federal officials warned Colorado in August that for more than a decade it had improperly billed Medicaid, a government health program for the poor and disabled.
Treatment centers in Colorado’s youth rehabilitation program do not meet guidelines such as requiring medical doctors and registered nurses on site and accreditation, federal officials said.
The centers house children who stay from a few days to more than a year and receive counseling and other therapies.
“The Bush administration has, without a doubt, laser-focused on making sure that Medicaid is only paying for Medicaid-certified services,” said Mary Khan, a spokeswoman for the Centers for Medicare and Medicaid Services in Washington, D.C.
Colorado, for example, was billing Medicaid for counseling provided to youths in the juvenile justice system who are wards of the state, Khan said.
State officials have asked the federal government to extend the deadline.
“This is going to be a collaborative process with the federal government, the providers and the state to reach a solution,” said Rhonda Bentz, spokeswoman for the state Department of Health Care Policy and Financing.
Colorado spent $68.2 million, half of which was federal money, on the programs last year.While over the course of a year as many as 3,000 youths spend time in Colorado’s 44 treatment centers, at any one time there are about 1,500 residents, state officials estimate.
Only 18 of the residential treatment centers meet current federal Medicaid requirements, according to state Medicaid Director Barbara Prehmus.
The rest of the homes, many of which are rural and house fewer than 20 children, say they are looking for ways to survive.
Some plan to expand special day schools and mental health visits to children at home.
Others are working with county social service agencies to find private funding sources. A few will have to close their doors, industry experts said.
“For us, it means a much smaller scope of services,” said Cyndi Dodds, director of Namaqua Center in Loveland. “We’re going to have to do fundraising, look for donations, grants,” she said.
Namaqua houses 20 children age 3 to age 12. The center has a school and provides counseling.
Some of the children have been removed from unsafe homes, and others come because severe behavior problems threaten their own safety, Dodds said.
If Medicaid funding is lost, Namaqua expects to cut by half the number of children in its residential program and does not have the resources to meet new federal rules, Dodds said.
The home, for example, is not accredited – a process that can cost as much as $10,000 and take up to a year to complete.
Larger, institutional facilities, particularly those that draw their residents from several states, are most likely to meet the Medicaid requirements, state officials said.
These homes will need to make only minimal changes such as adding psychiatrists and nurses, operators say.
“It will have little impact on us,” said Bentley Smith, executive director of Devereux Cleo Wallace Center in Westminster. The facility is part of a nationwide chain of residential mental health facilities treating troubled youths.
Excelsior Youth Center for girls in Aurora operates a similar facility that will also qualify.
Still, Excelsior associate director Arnold Goldstein criticized the direction federal officials are pushing Colorado’s mental health system.
“It’s not going to enhance the program one bit,” Goldstein said. “It’s all about cutting Medicaid dollars. It’s a way to ratchet down costs to the state and local level. And, as you know, there is no extra money in Colorado.”
Staff writer Marsha Austin can be reached at 303-820-1242 or maustin@denverpost.com.
