Officials at the Department of Children and Families suspect the state is unjustifiably picking up the tab to provide mental and developmental health services for hundreds of children that should be covered by their health insurance or their higher-income parents.
Currently, DCF doesn’t consider the income of a child’s guardians or if the child seeking benefits has health insurance coverage for these needs. Commissioner Joette Katz is seeking to change that, and thinks vetting applications and requiring contributions from capable guardians could save her agency millions.
“The problem is that a lot of parents just don’t even want to fill out the insurance paperwork. That’s unacceptable,” Katz told the DCF advisory panel Monday when revealing the recommendation.
“Some families that are using this service are quite wealthy and are paying nothing,” echoed Deputy Commissioner Janice Gruendel. “In some cases, families are in a position to help out.”
On any given day the state is paying for the care of 650 children with emotional, mental or behavioral problems who, without care, are at risk of entering state custody or of being shunted into an institution, jail or emergency room in crisis. The cost tops $16 million a year, and the DCF proposal says the state could cut that bill in half if fees were put in place for families that earn more than $30,000 a year.
“The state should be the payer of last resort,” said State Childcare Advocate Jeanne Milstein, who supports this change. “The state should not be funding services someone else should be paying for, whether it’s someone whose parents are independently wealthy or their insurance should be covering it.”
This is not the first time this service has been targeted for drastic cuts. Former Gov. M. Jodi Rell tried to shutter the program to close a budget deficit in 2009. The agency is under federal court requirements following a class-action lawsuit in1989 alleging that the state was failing too many abused and neglected children. The judge overseeing the case reversed Rell’s budget cuts, and the services were saved.
Katz recommended to Gov. Dannel P. Malloy’s budget office in October that a $30,000 annual benefits limit per child be used to stave off costs. That proposal was likely to face strong opposition.
“For some of these children, $30,000 in coverage barely scratches the surface for what they need,” said Sen. Beth Bye, D-West Hartford, who has a long career in early childhood education. Cindy Butterfield, DCF’s budget chief, said for the 650 children currently receiving services, the average cost is about $30,000.
This most recent attempt to reduce costs seems to have some support among those whose clients could be affected by the change. Only a few concerns were raised in a roomful of child advocates and providers Monday, most relating to how the changes would be carried out.
Abby Anderson, the leader of the Connecticut Juvenile Justice Alliance, said just because a child is eligible for services through their insurance doesn’t always mean they will be covered.
“It may not be the family” holding things up, she said.
DCF officials agreed. They said they are investigating with the attorney general’s office, the Department of Developmental Services and Milstein to determine if insurance companies are denying services that should be covered.
“Are they cost-shifting those expenses to the state that they should reasonably be paying?” asked Fernando Muniz, an official with DCF. The answer, he said, will likely be completed in the next few months.
Milstein said her office started an investigation into this a few years ago but never completed it because of budget restraints.
“We believe this is something that is going on and it needs to stop,” she said.
While state officials try to determine who will pay the bill, Millstein said she hopes this income and insurance assessment doesn’t mean children will be stuck waiting for appropriate care.
A recent report evaluating the state’s mental health system called it a system “in crisis,” pointing out that one in five children in the nation have a mental disorder and that 75 percent to 80 percent receive no treatment.
The state up until this year was under court oversight for another class-action lawsuit regarding how DCF was handling the mental health needs of children in the state.
As the agency moves forward with making these assessments a reality — pending legislative approval — DCF officials said this week that children will have access to the services they need.
But advocates and providers still worry about bureaucratic obstacles.
“Some people might say the $10 or $30 a week (that a family might have to contribute) might be too much,” said Terry Edelstein, president of Connecticut’s Community Providers Association, which represents health providers that serve this population.
“I am concerned because DCF keeps cutting back on access,” said Jan VanTassel, executive director of Connecticut Legal Rights Project, which advocates for those with mental health needs.
“I worry about what may happen to those families,” she said, “because people aren’t going to DCF for help unless they’re already desperate.”