The Status Woe

Rising above mediocrity one mishap at a time

Getting Treatment, The Abridged Version

on January 15, 2013

I just wanted to update everyone who has followed our journey so far.

You may remember that Issy is terribly aggressive and has caused some awful injuries to me (her mom). Read more here.

I’ve been trying like crazy over the last few years to find a behaviorist who will take our case.  I’ve called all over the state of MI and the Midwest.  Trying to find ANY help for her behaviors.

I found a place!  And only a few hours away!!  It’s a residential treatment facility in Kalamazoo called ‘The Great Lakes Center for Autism Treatment and Research‘.  So they treat her and she can come home when she is better!! *squee*

But our insurance won’t pay and neither will our local mental health agency (community mental health or CMH)

We have been using our local CMH to manage our waiver.

Let me explain the waiver in .02 seconds:

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Michigan Children’s Waiver 101

Because Matt has a good job with benefits; we would not qualify for any help from our local mental health agency.

NONE.

BUT, years ago when the government started closing down state institutions they set aside funds to give to parents who’s children would be living in an institution if they still existed.

The waiver is for people who wouldn’t normally qualify for benefits but have an extreme need.

******************************************

Our CMH files the paperwork with the state so we get the waiver.  They also bill the waiver program for services they provide (so they get money from the waiver).  The waiver allows us to have staff with Issy almost all of her waking hours.  It is the ONLY thing that gives us a life.  However, it’s been getting harder and harder to keep staff because of Issy’s aggression. Currently we have not had help for 3 months.  A child who destroys property, knocks me unconscious, and rampages almost every waking moment, is hard to work for.

So I finally found this AMAZING place in Kalamazoo and I can’t get anyone to cover the cost (around $17 thousand dollars/month for treatment; I can’t come up with it. Neither will community spaghetti dinners.  It is a crazy amount of money).

If you need MORE help we're going to take away the help we already give you!

If you need MORE help we’re going to take away the help we already give you!

Not only that, but our CMH threatened that we would LOSE THE WAIVER if she went into residential treatment and there was no guarantee we would get it back. Sooooo we would be punished if our daughter went into treatment!!!!  This threat worked!  Even after treatment, she will need to be constantly monitored and worked with.  An impossible task for me to do myself.

In fact, treatment in the Kalamazoo facility is recommended 3-15 months with discharge not happening until the family is fully supported and able to bring the child home.  How great is that?!  They won’t even send the child home unless they can ensure success!  I knew I liked this place!  So a family would have to have a waiver or something like it to even have the child back at home!

*Except*

The Kalamazoo facility a has come up with a NEW 30 day program.  This program is an assessment followed by outpatient services.  Even if your child is a hot mess, they will discharge.  Even if they recommend to your insurance company or CMH, that the child SHOULD stay in the facility, it doesn’t matter.  They will send the child home once the funding source has stopped.

Issy is the first child to do this 30 day program.  There is no “best practices” involved in this decision.  It comes down to money.  The waiver will pay for her visit to the Kalamazoo facility, but that’s it.  The 30 day stay also makes it so we keep the waiver.  It also makes it so she doesn’t have to change school districts.

So in a nutshell, we have 30 days instead of full treatment.   The abridged version of treatment.

I was told I needed to compromise.

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God help us, but I think 30 days is better than nothing.  Forgive me Issy…..

The people making decisions about what she needs are not doctors and they have NEVER seen her.  It’s only about money.

Seriously, I wish captain obvious would visit the people working for the state, CMH, and Blue Cross and Blue Shield.

Well, we get 30 days and we are going to make the best of it.  We are going to get her past these behaviors and give her a

images (9)

Oh, and the evil villains in this story?

images (8)

1. Our Local CMH has a general fund balance of over 3 million dollars.

2. Blue Cross and Blue Shield of MI reported a profit of 40 million dollars in 2011.

 

I love you baby girl.  I won’t fail you

hands

 

Thanks for reading!

Kelli-Stapleton,the-status-woe

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