Sick kids come last - Charlotte Observer Editorial

EDITORIALS

North Carolina doesn't care about its mentally ill kids. That's the only logical conclusion to draw from the way the state Department of Health and Human Services handled the decision to outsource approval for treating sick children on Medicaid.

Mistakes were made, and kids have been hurt. Gov. Mike Easley should ask for a full accounting from HHS Secretary Carmen Hooker Odom. This isn't the first major HHS foul-up that has put vulnerable children at risk. If Ms. Hooker Odom can't fix the mess, and fix it now, Gov. Easley should replace her.

In March, Ms. Hooker Odom suddenly decided to pay a private company to review requests for treatment for the state's mentally ill Medicaid recipients. The idea behind that change was sound: to save taxpayers millions of dollars a year and get requests approved faster than local public health agencies could work.

Yet reforms began with children's services, and secretary's decision only gave the company two months to prepare. HHS ignored warnings that requests could balloon, and swamp the company.

The result? Thousands of treatment requests for mentally ill children flooded into the company. Long delays left children who needed help waiting and suffering, or getting worse.

Here a few of the things the Charlotte Observer's investigation uncovered.

• One mentally ill boy ran away while waiting for approval to go into a group home.

• A girl in Charlotte attempted suicide while waiting for her treatment to be approved.

• Kids charged with crimes waited in detention centers -- or getting into more trouble while they waited.

Gov. Easley should ask for an investigation of what went wrong. Of particular concern:

• Why did HHS move so quickly to implement a major reform?

• Why didn't mental health providers receive thorough training in how this change would work?

• Why did Ms. Hooker Odom not realize that a combination of new treatment services and new approval rules would produce as many requests as it did?

In 2001, another critical leadership failure at HHS put emotionally ill children in group homes at risk. Slack rules, lucrative reimbursements to private contractors and scant state oversight surfaced after a girl in a Charlotte group home suffocated while a worker without proper training restrained her.

Administering mental health services is complicated, but we'll say it again: The only logical conclusion is that the people in charge in North Carolina don't care about mentally ill kids, particular poor ones. That's not acceptable.

Government can't be expected do everything, but it can and should be an advocate for vulnerable children who cannot speak up for themselves.