Better mental health for kids
CHILDREN WITH serious mental illnesses have been waiting for years for the state to honor its responsibilities to them under federal law. Now a modest $7.8 million down payment on that debt needs swift approval from the Legislature. The money will start expanding mental health services for children covered by Medicaid - and keep Massachusetts in compliance with a 2006 federal court ruling.
Filed in 2001, the "Rosie D." lawsuit pointed to glaring holes in state mental health services - so glaring that US District Court Judge Michael Ponsor ruled last year that Massachusetts hadn't complied with federal Medicaid laws. Children with bipolar disease, autism, and other illnesses weren't getting prompt, well-coordinated care, he found. And their illnesses were "often exacerbated by external traumas arising from poverty, family chaos or violence, drug abuse, separation from loved ones, and institutionalization."
Ponsor concluded that Massachusetts could do better. For proof, he pointed to three programs that did provide effective treatment - even as they served only a fraction of the children who needed care.
In February, Ponsor approved a four-step plan to build a greatly improved mental health system for these children. The first step requires the state to have a system in place by Dec. 31 that enables pediatricians to screen Medicaid-covered children for mental illnesses. To set this up, the state needs the $7.8 million to train pediatricians how to do the screenings and pay them for the service.
It will be a big job. There are 460,000 children covered by Medicaid, and the state will be required to offer screenings to all of them, according to the state's Executive Office of Health and Human Services. The program is voluntary: Parents can opt out.
Some parents are worried that if the Legislature doesn't release the funding quickly, the state will fall behind on the rest of the four-step plan. Once the screening program is in place and pediatricians can identify children with problems, the next steps are to create a program that can assess children's illnesses by Nov. 30, 2008; to set up an information-technology system to track their care by the same date; and to build a system that can provide consistent care across the state by June 30, 2009.
A supplemental budget containing the $7.8 million is being considered by the House Ways and Means committee. A spokesman for House Speaker Sal DiMasi says that legislators are aware of the issue and its importance and will act on it in a timely fashion.
They should hurry. Families spend heartbreaking months and years navigating the course of their children's mental illnesses. Massachusetts should ease the way by providing children on Medicaid with comprehensive, first-class care. 