Residential care for children...Q

[Tap]

Things are progressively getting worse with dd9.  We are currently looking at residential care for her for a short period of time (guessing a month or two).  One thing we really want to do, is do a restart on her medications.  We can not take her off meds in our home, so she will have to be inpatient to do so.  It will take time to get her off meds and then restarted.  

 

She has Aspergers and other mental health issues.  She is completely verbal and mobile.  She is about the mental age of a 1st-3rd grade child overall.  She will understand what is happening as well as anyone this age, but it is not like sending a person with full blown Autism, who would potentially not understand at all. 

If you have any experience with this, can you tell me what to research or PM me.  I will be in and out today meeting with her pdocs, so I may not be able to respond right away. 

 

We are on the border of Portland, Oregon and Vancouver, Washington if anyone has experience in this general area.

 

I am so very sad about this, but we (and her doctors) have hit a wall and feel that this is in her best interest in the long run. 

Edited January 14, 2016 by Tap

[Ottakee]

I have only put a foster child inpatient once. Not easy and she was only in my care for 6 hours before I had to admit her.

 

In our area, they would.likely admit her to the mental health hospital and then transition to residential.

 

As tough as it may be, it does sound like a very good idea. I agree in many cases these med changes need to be done inpatient.

[Pink and Green Mom]

I have no advice but I can only imagine how hard this is for you.  I am so sorry.

[Pamela H in Texas]

If you have to do inpatient to do it safely then you have to.

 

My son is being admitted to day treatment to fix meds and give us a few more resources/ideas/tools though the last couple days I've thought I needed to talk doctor into inpatient (short term). I did speak to him letting him know that things have taken a nosedive. 

 

Inpatient can be hard.  But having things wrong is hard too.  And getting things right can make a huge difference.

 

 

[zoobie]

:grouphug: You're a good, caring mom.

[JudoMom]

:grouphug:  :grouphug:  :grouphug:

[Anne]

:grouphug:  :grouphug:  :grouphug:

 

 

[Guest]

I have no advice, but just sending healing and hugs your way. That sounds very hard.

[applethyme]

:grouphug:  :grouphug: :grouphug:  

[Kim in Appalachia]

First,  :grouphug:

 

Second, I have no experience but my first thought was you may want to start by calling your insurance agency and see what order you need to follow and if they had any facility on their list.  

 

and  :grouphug: again.  

[Tap]

First,  :grouphug:

 

Second, I have no experience but my first thought was you may want to start by calling your insurance agency and see what order you need to follow and if they had any facility on their list.  

 

and  :grouphug: again.  

I have.  They are sending me a list of in-network facilities and what my portion will be.  I have a max out of pocket for the year, but it is higher if it is out of network.  

 

The one that my daughters psychiatrist recommeded as top choice, is calling me tomorrow, so we can get some details.  That one is out of network.   My insurance will let me go where ever I want, as long as it is a covered service, but I will pay 60% for OON (80% for In-network).  The percentages don't really matter though, because my max out of pocket will kick in quickly for inpatient care. 

 

$4000 for in-network

$8,000 for out of network

 

She also has state medicaid, but it may or may not pay.  It depends on which state she gets care in.  We are on the border but the majority of close by homes are in the other state.

Edited January 13, 2016 by Tap

[Ausmumof3]

Hugs. That sounds really tough. Hope it goes as smoothly as possible.

[Nan in Mass]

Tap - Many hugs.  I know nothing at all about this, so I can't give you any sort of advice, but I did want to tell you that over the years, I've known a few people who worked (or volunteered) in residential situations and that they were all wonderful, caring people, people that I would trust with my children.  - Nan

[Ottakee]

I would.fight, fight, fight with her adoption worker, state levle person, subsidy, or whoever to get her the best care in whichever state that is. Hard to do though.

[QueenCat]

:grouphug: Tap :grouphug:

[zimom]

I'm sure you probably already know this but the out of network will be $8000 plus the balanced billed between what the insurance allows and what the facility bills.  The facility does not have to accept the rate the insurance would typically allow so that can add up quick.  I second Ottakee and I would fight tooth and nail to have the state medicaid cover the difference.  To me, this is what medicaid should be for.

 

Hugs to you.  I have watched dear friends go through inpatient care with a child numerous times.  

Edited January 14, 2016 by zimom

[Tap]

I'm sure you probably already know this but the out of network will be $8000 plus the balanced billed between what the insurance allows and what the facility bills.  The facility does not have to accept the rate the insurance would typically allow so that can add up quick.  I second Ottakee and I would fight tooth and nail to have the state medicaid cover the difference.  To me, this is what medicaid should be for.

 

Hugs to you.  I have watched dear friends go through inpatient care with a child numerous times.  

Yep, I'm aware, but thanks for pointing it out just in case.  That is what I meant by "if it is a covered service", but that could mean many things, so I appreciate you mentioning it.

 

Since she is school age and qualifies for free lunch, I would imagine that part of the funding could come from that (school funds and free lunch/meal funds).  I can imagine that there are lots of little things that insurance may not cover, like toiletries etc. but I would pay for all that anyways, so unless they charge an exorbitant fee, it will likely just be like home.

 

I have to check, but to me, if she is going to be in a residential facility, that means she will 'live' there.  I would assume that would mean she could get Medicaid for that state, and hopefully that means they will cover her copay and the remainder as well. XXXcrosing fingers and toesXXX.

 

Hopefully I will be able to find out more of the money part in the next week or so.

Edited January 14, 2016 by Tap

[Melissa in Australia]

:grouphug:  :grouphug: :grouphug:  :grouphug:  :grouphug:  

 

 

 

[Junie]

:grouphug:

[myfunnybunch]

:grouphug:  :grouphug:  :grouphug:

 

I am sorry you're facing this.

[Reefgazer]

I have no experience or advice to offer, but wanted to say good luck with your decision and I hope things turn out well for your family.

[Guest]

I am so sorry.

 

(((((((((((((((((((((Tap)))))))))))))))))))))))

[Whereneverever]

There are also specific medicaid waivers to cover inpatient psych care for minors. 

[Tap]

I would.fight, fight, fight with her adoption worker, state levle person, subsidy, or whoever to get her the best care in whichever state that is. Hard to do though.

(ETA: Please ignore my random capitalization, I am too exhausted to fix it)

 

She doesn't have a social worker and she doesn't qualify for one through the state.  This is a problem we run into on occasion.  She is a ward of the state of Oregon, but we live in Washington.  We are permanent legal guardians. The guardianship is based in Oregon, and is just as binding as an adoption, (for example, the parents can not contest it).  Washington won't provide any assistance with disability services, because she is a ward of Oregon.  Oregon, says she lives in Washington, and needs to access Washington services. It has to do with the wording in the Laws. One of my tasks tomorrow is to look into the guardianship to see what legal steps, if any, we have to take, if we decide to admit her.  I think we just have to notify them of her new address, but I am not certain.

 

Her issues are considered behavioral, and she is low-normal on IQ, so Disability services can't help us.

 

On top of that, she is Non IV-E eligible which has always caused problems (Ottakee is one of the few who may understand that). This means she is not eligible for federal funds or guardianship assistance (This is due to her parents having jobs the day she went into foster care and her dad is supposed to pay child support to the state, mom got it waived). That can't be changed because it was based on the single day she went into care. 

 

Her psychiatrist and behavior therapist are trying to help me. They have an coworker/family support liaison they think can help me navigate the system and coordinate the insurance.  I am not sure how much Oregon will tie her hands in helping us, but hopefully she can help.  

We don't get money for her care right now (long story). Nor do we get any kind of assistance/subsidy from SSI, DDI, or any other city/state/federal program.  Since she doesn't qualify for services, she doesn't get a case worker. 

 

Please don't take that to mean I am complaining that she doesn't get state services, but just explaining why she doesn't have case workers like most kids in her situation would. No funding/no services....no case to manage. 

 

She has basic state health insurance, special needs daycare, my private insurance and that is it.

Edited January 14, 2016 by Tap

[Nart]

I see below your post she has an IEP. Are things going downhill at school too? Is she getting FAPE at school? Does she need a higher level of service at school? Or is it primarily a home issue and school is going well?

[Tap]

I see below your post she has an IEP. Are things going downhill at school too? Is she getting FAPE at school? Does she need a higher level of service at school? Or is it primarily a home issue and school is going well?

school is ok. She is in a public school/therapeutic day school for kids with behaviors.It is a highly structured environment and she gets an almost one on one education. But it seems like a rubber band,  The better she does at school behaviorally, the worse we have it at home and visa versa.  She has a daily limit of self control and it only covers about half of the day.