An Interview with Catherine Strode
The Child Mental Health Treatment Act (CMHTA), enacted by the state in 1999, is celebrated as a victory for the mental health community. The Act allows families to access children’s treatment services without requiring parents to be charged with abuse or neglect. In its current format, the bill faces reauthorization every ten years in the legislature. Mental Health Colorado’s VP of Public Policy Moe Keller says the CMHTA has had to institute a wait list because of increased referrals this year.
In an interview with Catherine Strode, she says in addition to requesting the reauthorization of more funding for the Act this Session, changes are also being proposed.
What is the major significance of the Child Mental Health Treatment Act?
“The Act was created to answer the desperation of parents who were unable to access residential level of care for their child who had a very serious mental illness. The old practice was if parents went to their county Department of Human Services, they would be told, ‘We do not fund anything unless the child is a ward of the state. We will file false charges on you as a parent. We will say you abandoned your child, or you had a dependency and neglect action on your child. We will take the child and make them a ward of the state. Then we will pay for residential.’ The significance of the Child’s Mental Health Treatment Act is that you don’t file false charges on parents and say they committed abuse on their children when they didn’t. You don’t require the child to be out of home and a ward of the state in order to be able to access services on any level. Besides keeping families together, we do things that would not normally be billable under Medicaid or health insurance companies would not cover. We’ve been successful because we individualize the treatment to the child.”
How do you track the Act’s success?
“We have tremendous data. This year we’ve served about 100 kids in the state. Two-thirds of those are actually treated in community; about one third go to residential. We are seeing a success rate of 87 per cent of the youngsters treated through the CMHTA never appear in Human Services. They don’t wind up in foster care. They don’t wind up in the juvenile justice system. They don’t wind up with a parent charge of dependency and neglect. They have been successfully treated and stayed within family. This was the whole point: preserving family; providing families who are desperate for resources; keeping children from being placed in out of home placement. We spend a lot of money when a child goes into foster care per day and per month. We’re saving the system all that money.”
How has the Act changed?
“When the bill first passed, it was for residential only. A lot of the kids really didn’t need that level of care. They hadn’t tried anything in the community first. In the Reenactment in 2008 we added a lot of community resources: day treatment, in home treatment, wrap around. We worked with schools. We did a lot of different options for the family to access before they went to residential. Today we are going to be coming in with the second round of reauthorization. We do have changes we are going to make.”
What changes are being proposed?
“We’re going to get rid of the ten-year reauthorization so it becomes a permanent program. There’s also language in the bill that says ‘subject to available appropriations.’ That limits our ability to get supplemental requests for additional money if our caseload is higher than expected, or our children are more expensive. We’re going to get rid of that so we can get additional funds. We’re going to change a technical requirement that parents apply for Social Security Income to make a child who is in a residential setting Medicaid eligible. We have found that the amount of money we get through that process is so small it’s not worth the aggravation of the parents to have to fill out all the forms. We’re trying to broaden the number of options for parents so they would not have to go exclusively to the mental health centers. We’re going to have other contractors with the state provide mental health services (potentially a pediatrician’s office) for youngsters in a geographic area.”
How much funding is covered and why is more needed?
“It’s $1 million this year. We believe the fiscal need for the continuance of this CMHTA will be more than double that. We will need about $2.5 million for continuation of the Act because two things have happened. We’re getting more referrals now than we used to have because we’re doing a lot more in the community. That group is growing. Right now, what has happened is we had to actually establish a wait list for parents to access the CMHTA because of the finances. Our reallocation of monies was July 1 and we were going to be out of money by December if we didn’t put a wait list on. This year we are also serving a few children with more complex needs. I am hoping in January we can ask for a supplemental to get additional money to carry us through the remainder of the year while this bill is in reauthorization to be passed.”
Catherine Strode is Advocacy Denver’s Communications and Policy Specialist. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes Policy Perspective, featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.