Legislator chides state for ignoring U.S. aid for emotionally ill children Delegate seeks to force state to try to get funds

December 31, 1997|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

A key state legislator is taking the state health department to task for failing to get federal Medicaid dollars that could have paid for community services for more than 300 emotionally disturbed children.

Del. John Adams Hurson, Maryland's House majority leader, plans to propose a bill in the General Assembly that would force the state Department of Health and Mental Hygiene to apply to the federal government for two waivers. The exemptions would lead to federal money for services for autistic children and for chronically mentally ill children.

"As far as I'm concerned, there are federal dollars potentially available, and we should be going after every one of them," said Hurson, a Montgomery County Democrat, who put his complaints in a letter to Martin P. Wasserman, state health secretary.

Wasserman says his department was busy designing and gaining approval for a much larger, $1 billion waiver moving 330,000 poor people into managed care.

"We were doing the most for the most," said Wasserman, who said it was strange that he hadn't been notified of the issue earlier, though it dates back 2 1/2 years.

He also noted the complexity of the waiver for chronically mentally ill children, which involves other areas of the administration and might have originated in another agency.

To get the federal dollars, the state must put up its share, a consideration when Medicaid budgets are soaring. "You have to weigh and balance the cost of these new programs," Wasserman said.

It is unclear how much money is involved. Hurson estimated that the state might have gotten anywhere from $2 million to $20 million in federal money. He has written to the state's Office of Legislative Audits, asking it to come up with figures.

Advocates say the children who would benefit from the funding are in extreme circumstances. With conditions ranging from serious emotional problems to stress-related trauma and hyperactivity, they are living at home with their families, in hospitals or in residential centers for as long as a year. Few other options exist. Roughly 600 children and teen-agers are in residential treatment centers across the state.

"Maryland has historically never been attentive to children's mental health," said Jim McCombs, executive director of the Maryland Association of Resources for Families and Youth. Even before Gov. Parris N. Glendening was elected in 1994, McCombs said, his group and others were pushing for services.

In late 1994 or early 1995, the health department submitted an application to the U.S. Health Care Financing Administration (HCFA) for a Medicaid waiver that would allow them to move the sick children from institutions to community settings and be reimbursed with federal dollars for aid that might include day treatment, family training and respite care.

HCFA officials replied in the spring of 1995 with a seven-page letter detailing questions and changes state officials needed to make. The state did not respond.

But Wasserman said now that the managed care changeover is complete, his staff has begun to look at waivers for particular populations, including the one for chronically mentally ill children. He said they will take up the issue next week. State officials have received federal permission for other specialty waivers, including one for diabetes care.

Pub Date: 12/31/97

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