On the final day before retiring, a Howard County Circuit Court master yesterday rebuked the state Department of Juvenile Services for allowing a youth to be dropped from a substance-abuse program because, he alleged, an insurance company wouldn't pay for further treatment after three weeks.
Master in Chancery Bernard A. Raum accused the state of shirking its responsibility by permitting an insurance company to dictate the treatment of a 17-year-old Columbia boy who had pleaded guilty to first-degree burglary.
Raum yesterday ordered that the youth, who is at home recovering from an auto accident, be remanded to the department for placement.
Raum said the department's "total abdication of responsibility and authority" should be reviewed.
"The legislature absolutely must investigate this," he said.
LaWanda Edwards, a juvenile services spokeswoman, would not comment on the case, but she said the department does not consult with insurance companies on such matters. The agency takes direction from counselors treating the children, she said.
"It is the department's policy that we go by the recommendations of the vendors, the doctors, the care staff of the child," she said.
Raum alleged that the department had lied to him at a May hearing about the youth, claiming that it was in the child's best interest to leave the program when an insurance company actually made the decision. He said he wonders if the department misled him in other cases.
"The insurance company is determining the best interest of the child, and the department is following them," Raum said. " ... I am unwittingly being deceived by the department."
Said Edwards: "It is certainly not in the interest of this agency to lie to any judge or any master."
The youth - whom The Sun is not identifying because he is a juvenile - pleaded guilty to first-degree burglary in 2002, and Raum ordered him to a group home. After he ran away from the home, Raum in March ordered that he be detained at the Alfred D. Noyes Children's Center in Rockville while the state found a suitable placement for him. The state then sent the youth to Mountain Manor Treatment Center, a residential drug treatment facility in Baltimore.
He stayed at Mountain Manor from April 12 to May 5, until the managed-care provider, Virginia-based Amerigroup Corp., determined that the treatment was unnecessary, Raum said.
Amerigroup spokesman Kent Jenkins Jr. would not comment on the specifics of the case but said the company follows criteria set by the American Society of Addiction Medicine. If there is any question about treatment, he said, the company consults the treating physician and an outside physician. If the independent review determines that there is inappropriate treatment, Amerigroup authorizes the type of treatment recommended by these experts, he said.
"Any suggestion that Amerigroup as an organization is seeking to not provide appropriate care is simply mistaken," he said.
As the youth was being discharged from Mountain Manor on May 5, Raum ordered that he be placed in the Maryland Youth Resident Center, a shelter program from which he ran away a few days later, said Avery B. Berdit, the youth's lawyer.
Then, about two weeks ago, the youth was detained after being involved in a head-on car collision in Columbia while driving a stolen car, Raum said.
Dr. Laura Estupinan-Kane, a psychologist who had examined the youth in March, told the court yesterday that the boy had abused alcohol and marijuana and in a case like this should have stayed a minimum of 30 days. He stayed 24 days.
But Ronnie Drake, a counselor at Mountain Manor, said the youth was not responsive to the inpatient treatment and could have started receiving outpatient treatment, with supervision by his mother. Drake said the May 5 discharge date was determined by Amerigroup when the boy was first admitted.
"So the insurance company determines how long the kid stays there?" Raum asked Drake.
"Unfortunately, yes," Drake said.
However, both Raum and prosecutor Cindy Johnson said they had talked to Drake in early May, when he recommended that the youth should receive further inpatient treatment.
"Mr. Drake, you're getting real close to perjury," Raum said. " ... Your testimony is completely inconsistent with your conversations with both of us."
Drake said he did not recall the specific details of his conversations with Raum and Johnson, and said, "I'm feeling like a scapegoat."
Transferred to Hickey
Berdit said the Juvenile Services department will now determine where the youth is placed, and it is unclear whether he will receive inpatient or outpatient care.
Raum yesterday ordered that the youth be transferred to the Charles H. Hickey Jr. School in Baltimore County until the state determines where he should go.
The department had previously recommended that the boy be released to his mother on community detention and enrolled in an outpatient substance-abuse program.
A master since 1981, Raum said one of the reasons he is retiring is his frustration with the juvenile justice system and its lack of responsibility to children and the public. He told the lawyers in this case he can no longer influence what happens to the youth.
"The rest of you in this room can make it work," he said. "And I rely on you to do it."