Conclusion
State officials in Kansas, Vermont and New York illustrate the adage,
“where there’s a will, there’s a way.” The reality
is that, in most other states, children with mental health needs continue
to experience the effects of uncertain political will. All of the barriers
identified by these three states were overcome. For example, when New
York did not have adequate data on the cost of community services under
the new waiver, the state surveyed its providers to get that information.
When the community mental health centers in Kansas were hesitant about
the waiver, the state agency did not require them to contribute any funds
to the state match, carving out an exception to the usual Medicaid arrangement
and creating an incentive to participate. The states made use of opportunities,
such as tobacco settlement money, closing of state hospital beds and other
fortuitous events. Working closely with state legislatures and family
advocates was also helpful.
Currently, only three states have a waiver for children with serious
emotional disorders, while all 17 of the states we surveyed had a waiver
for individuals (including children) with developmental disabilities.
It is time for the mental health community to find the will and thus,
the way to offer the rich array of waiver services to children with serious
emotional disorders in the community.
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