[Perfect7]

I probably shouldn't jinx myself, but we are sitting around waiting for the APS to give APR (approval) for our son to receive residential treatment. They told me the APS is some agency than budgets medicaid's funds and determines if they pay for residential treatment or not. The psychiatrist told us to expect to hear something in about 5 days (from yesterday) but that he's had 1/3 of the cases denied in the past.
Everyone involved with our son's care agrees he needs RTF, so that's not the issue. We actually even found a facility willing to accept him with an IQ under 70 (though it isn't official until they receive the APR), but now I'm stressing the fact that he may be denied services.
Anybody out there been denied before? If so, is there an appeal process or other options? I'm trying to get a "Plan B" together instead of waiting and then wanting to rip my hair out again.

[Again!]

I guess I was denied. In Texas there is some limited funding through post adopt for RTCs but medicaid does not pay, period. Plan B, I paid cash. Let's just say that makes all other categories of discretionary spending look small!

[Perfect7]

Ouch! In GA, if it's approved by medicaid they pay everything but otherwise it's $4,000/month. I've gotten nowhere with post-adopt here and he has a medicaid waiver.....but they have no funds to do anything so he's "on hold" indefinately.

[aMarylandfamily]

... is if you end up in the ER with him and the state/county becomes involved and takes custody, even temporary, they immediately have a bed and placement for him!

Prayers and hugs!

[Perfect7]

I shouldn't have opened my big mouth. We haven't been denied or approved through medicaid yet (still waiting) but we've been officially denied by three RFT facilities (and another coming shortly via email). Even the one who accepts IQ's under 70 told us today they couldn't help him because of limited verbal skills.
There is another that will accept him (and works with M.R. and autism, down syndrome, etc combined with severe psychiatric issues) but they don't accept Medicaid. They told us they will take him if we can afford $127/day or get post-adoption services to pick up the bill. Our cw that handled the adoption is contacting the individual who handles those funds for the State, but with all of the cutbacks she isn't hopeful they will pay for anything.
There are no specialists who can help him, how do they expect me to? A classic case of the system failing these kiddos.

[Peggy]

I live in the Northeast, and I had to take her to the ER and she had to be assessed there. Facilities seem to take a dim view of parents and their doctors making the determination of what their child needs. We were declared FWSN (family with service needs) by the courts and the facility took physical custody and received her adoption subsidy while she was in the facility.Though I retained parental rights. Even then she did not get a placement until several ER visits had occured. I did get her into PHP's through voluntary services, but it was not easy.

[mommytoEli]

Originally Posted by Perfect7

I shouldn't have opened my big mouth. We haven't been denied or approved through medicaid yet (still waiting) but we've been officially denied by three RFT facilities (and another coming shortly via email). Even the one who accepts IQ's under 70 told us today they couldn't help him because of limited verbal skills.
There is another that will accept him (and works with M.R. and autism, down syndrome, etc combined with severe psychiatric issues) but they don't accept Medicaid. They told us they will take him if we can afford $127/day or get post-adoption services to pick up the bill. Our cw that handled the adoption is contacting the individual who handles those funds for the State, but with all of the cutbacks she isn't hopeful they will pay for anything.
There are no specialists who can help him, how do they expect me to? A classic case of the system failing these kiddos.

i was gonna say, back when my dd needed rtc, we got approval for payment...but no facilities could take her in the area for 6 months. all the other facilities we found we would have had to pay for. one we decided we could afford denied her for being too severe. our only choice was to keep her. we did...and we finally got our insurance to support a placement for her, and on the day of her intake the doctor called in sick and the secretary forgot to cancel our appointment. my dd got a tour of the facility and then dh brought her home, and for whatever reason, she improved her behavior enough for us to not have to send her anywhere. but i remember being in the middle of it and thinking about how hard it is to get kids help!!!!

[Perfect7]

Thank you all for understanding. Tomorrow I may start trying to ER route. What do I have to lose? The 14th facility I spoke with today has an "autism program" not paid for by MCD but they also have a "psychiatric program". He mentioned getting him admitted under psychiatric for treatment, and they will have the autism specialists there. Kind of a loop hole? We will know tomorrow but I'm afraid to get my hopes up again. One facility even told me today that he would have been better off left in DCFS custody because he would be eligible for more services then! I'll pray that he makes some miraculous improvement before/if he gets accepted somewhere (he did this same stuff this summer and it lasted for just a month, so then we finalized). I am just so baffled that everyone who reads his reports are telling me how he is a very complicated case and needs intensive therapy but nobody can do it. It's nice to have everyone here who understands. My family/friends are all like, "We told you so" and that isn't helping anything. Maybe I was an idiot for thinking the S on my chest was bigger than what it is, but hind site isn't going to get him the treatment he deserves (and neither would have leaving him in foster care).

[kay]

Originally Posted by Perfect7

Maybe I was an idiot for thinking the S on my chest was bigger than what it is

I love this phrase! And to continue with that analogy, I think your S is plenty big - it's just that you're dealing with idiots hiding behind kryptonite! The fight you're engaged in is so frustrating and so exhausting, and yet so worthwhile. As for your son being "better off in DCFS", well, maybe, in terms of treatment, but definitely not in terms of family and love. Love can't cure everything, but it's still pretty darned valuable!!

[Linny]

I don't know what state you live in, but this is a similar situation we found ourselves in back in 2000. DS was severe RAD (still is)......and harming himself---and others---as well as threatening to do so to others. He'd been admitted into a psych ward 3x's in three months and NOT for simply 1 week, but at least for 2 weeks each time. The psychs suggested RTF...and NOW. Of course, the system didn't want to do a thing. I remember a person in charge of grants for RTF's told me 'You'll never get that child into residential.'

Now one thing *I* have a problem with...is someone telling me 'no', when I know what we're trying to do is right and good. We picked up the phone and started calling every RTF we could hear/read about/were told about. I remember it took days....and FINALLY, we found one place that offered a one year scholarship for children. I pleaded and told them of our plight with DS. They said they'd put him on a waiting list...and there he stayed for around 3months. (Man...did I ever PRAY!)......I called them often to see how long they felt it might be...and maybe THIS is what did the most good, I don't know. But, three months later, they had a bed available.

Within almost 1yr, they asked us to file for state grants as they felt he'd be in RTC for some time. I know I felt like I was putting together a thesis for college....sectioning off everything I had in terms of dx's, therapies we'd tried, counselor reports, psych reports pre and post placement with us, etc........even the local SASS worker was impressed.

Long story short, we were accepted. There was an appeal process availabe had we needed it. My suggestion to you is to phone a congressman and tell him/her about your situation. I suspect you'll get some help. We didn't have to go that far, but it would have been our next step. Funny how the system loves to place these damaged children so quickly, but leaves the same children in the dust when they need services! Sadly, our DS has lived most of his life in residential because of his unpredictability and dangerous choices...NOT what we'd hoped for at all...but reality, plain and simple.

If you're in IL, I can tell you exactly who to talk to; if not, I hope you find the right connection soon.

Sincerely,

Linny

[Perfect7]

I think family love has definately made a big difference for our son. A lot of his issues have surfaced since he's been here, and I think that's because he's feeling safe enough to "let it all out". He was living in his head completely before he came here and coming back to reality has got to be tough. It's not easy for any of us, but healing is a hard and painful process.
Linny, I've already found our governor's contact info for here in GA, and he is also an adoptive father so I think that will go a long way. I'm holding out until that last door closes before we move to a plan B,and that may be tomorrow. The facility that accepted kiddos with lower IQ's and denied us today faxed his info on to their sister facility, and they seem like they want to get him accepted. We shall see. Our cw is also trying hard on her end to get post adoption services to pay in case this doesn't work. I've crossed off a list of about 30 facilities that won't take him, and now we're down to two: one that accepts medicaid and the other that is $4000 a month.
We're also doing lots of praying here and tonight my son was the best I've seen him in awhile. No hallucinations all night and very affectionate and engaging. It tends to cycle for him, so I'm really thinking PTSD with triggers we don't yet understand but that's for the professionals to figure out.
I'll spend some time seeing if there are grants available, too, and his teachers/psychologist/psychiatrists will also be more than willing to help out.
I'm sorry things haven't turned out as well as you hoped for with your son. That's one of my biggest fears.
A friend of mine (who has also adopted) was talking about "wrap around services" and I was clueless. I thought wrap around services was my wrapping my arms around a telephone trying to figure out what was available to help our son post-adoption. It's really a joke, but when this is said and done I'm going to do something about it. I've resolved to do something, anything that will educate adopted parents in our area about what's what so they aren't left in this situation. Our cw said she's never dealt with these issues before, and I can imagine she hasn't. Our son has multiple issues going on that make him a big puzzle to everyone....but I always loved puzzles. God put him here for a reason, though some days I throw my hands to the air and ask why me?
Probably because otherwise he'd still be sitting in the group home not potty trained and drooling in front of a television all day. I would have loved to have met him much sooner when more probably could have been done, but it all happens when it's supposed to.
Thank you all so much for everything, and I now have lots of good ideas for a plan B.

[lucky_13]

Go to this link: http://www.apshealthcare.com/site/fi...h_criteria.pdf

See page 10 - this is the APS criteria for RTC. I would make sure you have everything on this list and petition directly with APS/Medicaid with this documentation.

Hope this is helpful. You may also try Google and search for CASSP or CRCG in your State and/or County. This would be the "wraparound" your friend mentioned. Meetings to "staff" child or family is usually open to families within the community and it's a panel of local agencies and providers that can help you find resources within your community for respite care, specialized education services, social programs, etc. Might not be a long term solution but might help in the interim. Best of luck. Hope your son receives the help he needs.

[Perfect7]

Thank you, I will visit that link. The core provider said we should hear about ASP approval or denial by Friday and they plan to appeal if he's denied. I guess it doesn't really matter, though....
The facility we were waiting on for approval called and said they could only admit him into the autism program and not psychiatric since he carries the dx, even though the primary issue is psychosis (????) That's good, but they don't contract with MCD for this (nobody pays for autism) and the cost is $1,300/day. WOW! Our cw called and the "set aside funds" by the State to pay for services above MCD are bankrupt, sent back to the government for the State's deficit. So APS, I guess, is totally irrelevant. Nobody will take him. Also, I was advised that our State refuses to send children out-of-state, even though there is a facility in FL that will take him and possibly contract with MCD for a "single case agreement".
One facility suggested we take him to an ER (like someone here suggested) but said even then, they may not be able to find a facility that will take him because of the autism label. They said most likely we would sit there for several hours, and then be given a referral to a core provider to get a referral to RTF and we spin the circle once again.
We live in a small, rural community with no services. It's so pathetic that our local DCFS doesn't even do homestudies for adoptions through foster care and referred us (and everyone) to private agencies. There are no foster parents in our county (so I've been told). They ship the kiddos off to other counties where they've contracted with private foster care agencies. Respite care consists of us finding someone to watch him (ie..friend or family member) and then the State will reimburse us at $7 an hour some months down the road. They don't understand that nobody wants to babysit while our son is hallucinating all day.
We were told we'd have more services to address his issues after we finalized because he'd qualify for post-adoption services and the MCD waiver. Yep, he does. But they also have frozen funds. The people from the office that does the MCD waiver (dept of mental retardation and developmental disabilities, or some such title) told us funding may be available when he is in high school and he isn't high priority because he had a family to assist with his needs. I guess that was just a sucker punch to get us to finalize after the psychosis issues came to light.
I am totally appalled and disgusted. Time to move to plan "B" and write to our governor. All of the doors have slammed shut.
I have accumulated a nice stack of email denials and lack of funding from State sources. Unbelievable.

[shy_bear]

I would also write to your congressman. Their office staff can be very helpful!

[Perfect7]

Miracles do happen! One of the facilities that previously denied our son called today and said they had reviewed his case again. If MCD gives approval, the are going to accept him into their program! I can't tell you the weight that has fallen off of my shoulders and my son will finally get the help he's needed all of these years. Thank you all for your support.