Improving State Systems
TEFRA and the home- and community-based waiver are underused resources
for helping families of children with mental disorders avoid having to
relinquish custody or place their children in institutions far from home.
State officials contacted for the Bazelon Center study confirm the importance
of TEFRA. Officials in seven of the 10 states where children with mental
or emotional disorders qualify for TEFRA said that availability of the
option has reduced the number of parents relinquishing custody to the
state. The experience in Vermont shows the potential: More than half of
TEFRA children in Vermont are children with mental or emotional disorders.
Advocates for families of children with mental or emotional disorders
should therefore review their state’s policies with respect to TEFRA
and the home- and community-based waiver. State policymakers should be
urged to make the changes needed to help families keep their child with
a mental disability at home. Table 1, which can be found on page 20, shows
details of state policies on TEFRA and the home- and community-based waiver
for children with mental disorders. Using data in that table, advocates
should:
- Urge adoption of either the TEFRA option or the home- and community-based
waiver in the 29 states that have adopted neither of these approaches.
- In the 10 states that have the TEFRA option but where no children
with a primary diagnosis of mental disorder are qualifying, urge changes
to state TEFRA rules and criteria and greater effort to publicize the
option to potentially eligible families.
- In states with the TEFRA option that do include children with a primary
diagnosis of mental disorder, check the number of these children currently
qualifying. If it seems low, urge state officials to make greater efforts
to publicize the option to potentially eligible families.
- In states without the home- and community-based waiver, urge policymakers
to review the practicality of this waiver for children with mental and
emotional disorders.
If the state already has the TEFRA option for children with mental or
emotional disorders, advocates may wish to find ways to get the word out
to families. In addition to developing appropriate parent materials, it
is important to give this information wide circulation. Both the state
and parent groups should work to ensure that families are aware of their
options.
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