Two civil rights groups called for a federal investigation into a Jindal administration program that they allege is failing to deliver on promised services to keep at-risk youth with mental health problems out of detention centers and hospitals.
In response, the state health chief acknowledged Wednesday that there are “challenges” in getting providers to meet the specialized needs of the youth and their families, but said the administration remains committed to the program.
The Southern Poverty Law Center and the Advocacy Center complained to the federal Centers for Medicare and Medicaid Services, called CMS, about shortcomings of the program that attorneys claim violate federal law.
Gov. Bobby Jindal launched the Coordinated System of Care amid much fanfare in early 2012 as a way to help children and youth up to age 21 stay out of institutions. The program is supposed to provide short-term respite care, crisis stabilization as well as family and youth support services that allow those at risk to remain in their homes and communities.
The program has been operating in five regions of the state, including the Baton Rouge and New Orleans areas, with the potential for helping 1,200 children and youth. CMS recently approved expansion of the program statewide, which would bring capacity to 2,400.
“It just really hasn’t lived up to the promise,” Advocacy Center lawyer Nell Hahn said Wednesday. “It looks good on paper and people were really excited about it … but there are such serious gaps in failing to give people services in their homes and communities.”
Hahn said the state Department of Health and Hospitals hasn’t developed the provider network necessary to support the program — more than two years since its implementation.
State Department of Health and Hospitals Secretary Kathy Kliebert said the state has struggled to get the providers necessary to deliver the services, which had not been offered in the past.
“We have raised rates,” Kliebert said. And Magellan — the private company coordinating mental health care — has tried to recruit providers, she said.
“But they just don’t feel comfortable at this point taking on new services,” Kliebert said. “We do believe we will eventually get there. We have got the right structure, the right service model and services, but we don’t have the providers to get there. That’s been a big challenge for us.”
Kliebert said the state still has the same goal of keeping the at-risk children and youth out of institutions. “We have a lot more to do to get there,” Kliebert said.
But she said the program is working and “we are seeing success.”
According to the federal complaint, mandated services are not available, and there are waiting lists for others. “These failures place Louisiana’s children at serious risk of institutionalization in direct violation of both the federal Medicaid Act and the Americans With Disabilities Act,” the groups’ lawyers wrote to CMS Director Cindy Mann.
Mann is asked to investigate why the services are unavailable and “take all necessary action” to ensure that program failings are corrected.
Kliebert said she did not see how Louisiana could be out of compliance with federal law because it is “expanding services to these kids” where they live.
The Coordinated System of Care is a special federally approved program for children and youth who have complex behavioral health needs that make them high-risk for placement in a juvenile detention facility, psychiatric hospital, residential treatment facilities, foster care or alternative schools.
The administration initiative pooled funding from a variety of agencies that interface with the population, including the state departments of Health and Hospitals, Children and Family Services, Education and Juvenile Justice. The idea was to reduce the state’s cost of providing services by leveraging Medicaid and other funding sources.
Follow Marsha Shuler on Twitter, @MarshaShulerCNB. For more coverage of the State Capitol, follow Louisiana Politics at http://blogs.theadvocate.com/politicsblog.