By Diane Morris
There are hundreds of children in North Carolina who have complex behavioral health needs—that is, they have a developmental or intellectual disability and a mental illness. Often, their parents or caregivers struggle to get them the support, services, and therapies they need. Sadly, the result is that many of these children end up in emergency rooms, institutions, and even prisons.
Now there will be help for children with complex needs, thanks to a settlement reached by Disability Rights NC and the NC Department of Health and Human Services in October. They will soon have access to better services and supports that will keep them out of institutions and help them live at home.
This settlement will help kids like K.B., who has autism and several mental health disorders. He can be physically aggressive, destroying property and harming himself and others. He’s been cycling in and out of hospitals since the age of nine. Without adequate support and services at home, his life is just one crisis after another.
K.B. receives Medicaid because of the severity of his disabilities. Under federal law, he’s supposed to get the mental health services he needs to diagnose and treat his conditions. And he’s supposed to receive those services in his community—that is, while living at home, in a group home, or in some other place that is not an institution or a hospital.
But North Carolina’s mental health system is severely underfunded, which makes finding trained professionals to help children with complex needs difficult or, in some communities, impossible. In addition, North Carolina’s mental health services and developmental disability services are separate systems, and the children can get lost in the bureaucratic mess.
Disability Rights NC uncovered the problems surrounding services for children with complex behavioral needs several years ago. Two years ago, Disability Rights’ attorneys sent the State of North Carolina a demand letter, which told the stories of K.B. and others and called on the state to address its legal obligations to these children. Then the attorneys entered into negotiations with NC DHHS to develop a plan to provide these kids with the help they need.
The agreement reached by Disability Rights NC and NC DHHS will address gaps in services for children with complex behavioral needs. Under the agreement, NC DHHS commits to the following measures:
- Establish a uniform process for identifying and assessing children with complex needs, so care is consistent across the state
- Ensure these children receive appropriate services
- Authorize case management services to help the children’s parents or guardians in identifying and coordinating services
- Begin operation of one outpatient clinic dedicated to serving children with complex needs, staffed by experienced clinicians, no later than April 1, 2017
In addition, NC DHHS has agreed to seek funding from the NC General Assembly to expand its community crisis support program for children statewide. NC START—Systemic, Therapeutic Assessment, Respite and Treatment—is an essential service for children with complex needs who are in crisis, but it is only available in limited areas in North Carolina.
Of course, this process is far from over. Now Disability Rights NC has to monitor the State to make sure it fulfills its promises. But if this plan is fully implemented, it will mean better lives for children all across North Carolina, including K.B.
If you’re interested in learning more about this settlement or about protecting the rights of people with disabilities, please check out our website at www.disabilityrightsnc.org.
Diane Morris is the communications and events coordinator at Disability Rights NC.