TennCare is now targeting children with mental health problems, hoping to cover less of their medical bills. TennCare thinks bad parents and bad doctors are costing the state too much money. I can’t tell anyone else’s story but I can tell mine.
As an infant Tommy only slept in the battery swing or while I rocked him. People told me he was just colicky. Tommy was a human cyclone as a toddler. Never still, never quiet, never satisfied. He was 3 before he spoke at all. By this point I was complaining to anyone who would listen that something was wrong with Tommy. I was referred to multiple parenting classes by the pediatrician. Classes that told me to lock him in his room whenever he was upset and out of control. Classes that told me to count to three and then give consequence. Class after expensive class saying that I wasn’t parenting him correctly. Family, friends and strangers all had advice but nobody wanted to do anything but criticize. At four I enrolled him in a preschool desperately hoping for three hours twice a week of calm. The third day I went to pick him up they said “Don’t ever bring him back. There’s something wrong with him.” I had him evaluated by the local public school system. They put him in their speech therapy program and told me to get an appointment with someone who would give him Ritalin. I went to a psychiatrist who told me after several weeks of extensive, time consuming and expensive appointments that Tommy was Autistic and would never read or function like other children. He looked at my infant daughter and said “You may want to consider finding a group home that can help him.”
I cried a million tears that night but I never went back to that doctor. I could accept that my child was different but nobody would tell me what he couldn’t do. I found a new doctor and we started trying medications. In Kindergarten he was put immediately in a “we dunno” class with the other children who didn’t fit anywhere. The teacher’s aide told me that “We just babysit the children who can’t be taught." I volunteered for the PTA until I just couldn’t stand listening to another parent complain about the money wasted on “those kids”. Tommy never made it into a regular classroom until 7th grade. In the meantime he went entire years without a single textbook or academic lesson. When he did get lessons it was worksheets which he hates. Tommy has been in and out of nearly every hospital in this state. He’s been diagnosed with Autism, Schizophrenia, Bipolar, ADHD, Tourette's, OCD, ODD, Depression and finally Asperger's. We have the right diagnosis and he has doctors who care. It is frightening to think of someone so intelligent, loving and wonderful not being a participant in life. Tommy deserves the best and nobody is sure how to help him find his way. We have daily interactions with teachers and bus drivers. Tommy is driven to weekly psychologist and therapy appointments and monthly psychiatrist appointments. It is time-consuming and expensive but we would do anything to help Tommy. TennCare wants to make this process more difficult.
ugh… the tenncare thing is a huge mess, isn’t it..
Cathy … the way I read it is that they are going after pediatricians and family doctors that are prescribing Ritalin, Adderall, Seroquel, etc to kids. They should not be doing this. ALL insurance companies should be keeping an eye on this. It looks like they are going to try to get more child psychiatrists to accept TennCare so that these kids can get proper care … not just a bewildered and frustrated pediatrician throwing whatever pills at the problem, hoping for something better. Mental and behavioral issues need the care of specialists. One would not have their internist treat their cardiac problems or cancer, would they?
I have my own TennCare rant … a year ago, when they were saying they were going to take away Justin’s coverage, no more appeals, no more pleading with Gov Bredesen … I said to them that it would end up costing the state a lot more to take him off TennCare and deprive him of the care he needs than to just pay for it.
I was right. He is now at Peninsula for a 30 day court ordered evaluation. He may spend the following month in detention … could be up to a year (19th birthday). Why? Because he had been off his meds since they ran out last April, and he finally had a most impressive bipolar manic rage. The Knox Co deputies were impressed too.
So they saved a couple hundred bucks each month not covering him … what does a month in Peninsula run? A month in juvenile detention? Yeah … nice work, Guv. And nevermind the misery he is experiencing. No one cares about that, outside of his family.
In rural communities the child’s pede is often the only person available. In cities, the wait for specialists is huge, regardless of a psychiatric crisis. This is about making it harder to get meds for children to save money.
Peninsula – been there, done that 4 times
All Tennessee foster children are on TennCare, and I’ve witnessed first hand unqualified physicians prescribing medications to foster children like candy. However, the problem is, as Cathy aptly describes, that diagnosing mental disorders in children is very difficult even for professionals, and there seem to be three patent solutions: 1) blame it on the (foster)parents, 2) diagnose with ADHD and when that doesn’t work 3) drug the kid into a zombie. We’ve got a 4-year old adopted son (through TN foster care) who’s at various times been diagnosed with ADHD, ODD, PDD, bipolar and RAD. It took a year and numerous experiments and therapy to find the right kind and level of treatment for him, and we still don’t have a definite diagnosis. Ironically, had he been our biological child, we’d be bankrupt with medical bills by now.
TN doctors used to tell parents who were using up their insurance and savings that they should relinquish custody to the state to assure medical care for the child.
Wow Cathy, that must have been very difficult for you. I hope it all works out.
Insurance companies across the board are now trying to cut costs wherever they can, and that is really hurting everyone’s budget. Mental health care is extremely expensive and I hope it still continues to get coverage.
Diagnosing ‘mental disorders’ is NOT an exact science. That’s what makes it dangerous sometimes. I worked with ‘autistic’ kids in a hospital setting, and the ‘Psychiatrist’ had intense psychotropic ordered for ‘acting out behaviors.’ WBR LeoP