Over the last year, people sadly familiar with the lack of services available in most areas of Kansas for children with serious emotional disturbance have been working on a plan of change.

The change involves the expansion of services for these children and their families. The reason expansion is needed not only involves an attempt to alleviate anxiety and pain for families and children. It also is a story of spending money now to cut tremendous costs later, both human and financial. Often, children with severe emotional disturbance who do not get help end up as school dropouts or in out-of-home placements ranging from foster care to state mental hospital to jail.

The availability of services for families with children facing emotional and behavior problems presently is hit or miss across Kansas, with availability dependent on where you live and if resources such as federal grant funds are available to local agencies.

In scores of focus groups followed by regional and statewide conferences, those who work with families in this situation came together to lay a foundation for a much-needed expansion of services. The Kansas Department of Social and Rehabilitation Services' Commission on Mental Health and Developmental Disabilities (MHDD) convened stakeholders representing families and youth along with specialists from education, mental health, and court services.

Together, they created a blueprint for change called the Children's Initiative, which comes in response to the fact that the development of services in the Kansas mental health system for children has lagged far behind the development of services for adults. This has left many families in the state vulnerable. It is estimated that as many of 17,000 Kansas children under the age of 18 meet the criteria for severe emotional disturbance. Many receive few or no services.

SRS Secretary Rochelle Chronister talked about the importance of creating such a system of support. She said bringing advocates and stakeholders to the table to help determine a plan was critical. And she said the support of Governor Bill Graves and the Kansas Legislature to put funding in place to begin the Children's Initiative was essential.

"For the first time in a long time, we have guidance," she said. "The blueprint created for the Children's Initiative is our plan. We must expand services and supports for thousands of children and adolescents with severe emotional disturbance and their families who are currently under served or unserved in the community."

A main feature about the Children's Initiative is the recognition that families need to participate in all levels of planning, implementation, and delivery of mental health services for children. The other overriding factor in the plan is that supports should be home and community-based whenever possible.

The initiative identifies four levels of service intensity: early intervention, short term intervention services, home and community based supportive services and home and community based intensive care.

"These four levels comprise a wide range of interventions, from early supports needed to reduce the overall incidence of severe emotional disturbance to intensive services to avoid psychiatric hospitalization," said MHDD Commissioner Hugh Sage.

Although no single list of services can answer all needs for all children, some services included in the Children's Initiative are screening and evaluation, case management, wraparound facilitation, crisis intervention, home-based therapy, support services such as respite care, and residential treatment. An often-stated request from people involved in the mental health system has been that services for children with the most severe emotional disturbances be made more available in their homes and communities. To help fund these services, SRS, as part of the Children's Initiative, has applied for a waiver from the federal government that would allow children with severe emotional disturbance to be covered for services in the community by Medicaid, the state and federal health care program for low-income or disabled persons. Under the waiver, children determined to need the most intense level of services would be eligible for Medicaid funding for all medically needed and currently existing services along with several new services. Without home and community based services, the children would need hospitalization.

Sage said that outcomes for children involved in services provided by the Children's Initiative would be closely monitored.

"Funding allocations will be determined in part on how well service providers help children and families achieve positive outcomes," he said.

Jim Rast, a principal investigator with KanFocus, a federally-funded five year grant program that provides mental health services to children in Southeast Kansas, was a member of a committee that worked on the Children's Initiative. He said providing supports for families with children with severe emotional disturbance is "one of the greatest challenges to Kansas as a whole.

"The Children's Initiative is a very good next step to develop the state support families need to allow children to grow up as healthy and included members of the community," he said. "We provide support for children with physical and intellectual problems, but kids with emotional or behavior problems have not had that kind of support."

Other members of the committee that worked on the Children's Initiative acknowledged the project blueprint is one step toward creation of a much-needed array of services for children.

"The system is fragmented," said Shelley Duncan, director of children's services for ComCare, the Community Mental Health Center in Wichita. ComCare also received a federal grant to provide services for children, but like KanFocus in Southeast Kansas, the grant runs out within two years.

Duncan said with Mental Health Reform, which was put in place in 1990, funding was put in place to provide community care for adults with mental illness. But, she said, "kids were an afterthought."

She indicated the Children's Initiative was a big step in the right direction.

"I think the plan is good," she said. "It focuses on developing a community-based system of care for kids with severe emotional disturbance. The state has recognized that this sort of system is where they should be moving, and for that I'm very grateful. They have gone to the stakeholders and listened to us about the need for a comprehensive, community-based system of care."

Rose Mary Mohr, president and CEO of the Mental Health Association of South Central Kansas, said people in the state have come to realize that something has to be done to help these families. She talked about families she has known that are forced to give up custody of their children with severe emotional problems because the only way the children can get help is through state hospitalization.

"If we want children with severe disabilities to stay in the home, we have to support and involve families."

Page Last Updated: May 29, 2001