A therapists has advised using the safe haven law to drop her son off at the hospital so he can get the care he needs, and she knows the state law has been used that way, but she won't do it.
JoANNE YOUNG / Lincoln Journal Star | Posted: Saturday, October 11, 2008 7:00 pm
The mother hears she has options for her son. Resources.
She has tried one thing after another. But as he gets older, his behavior intensifies. It’s getting harder to handle his explosive outbursts.
He needs a structured setting, she believes, beyond home and school. But his Medicaid insurer won’t agree.
One of her son’s therapists has advised using the safe haven law to drop him off at the hospital so he can get the care he needs — as a state ward.
She knows Nebraska’s new law has been used by people like her — nine families who were so at the end of their ropes they couldn’t see any other answers for their children and families than to force the state to help. Even if it meant losing their rights to make decisions for their kids.
She understands. But she won’t do that.
The morning of Sept. 4, Angie would have bet her bank account her son was going to have a good day. As he left for middle school before 8, she told him she loved him and wished him that good day — a hope, never a given.
At 8:15 the phone rang — the vice principal told her to get to Scott Middle School as soon as a possible.
She found Alex in handcuffs, kicking at an officer and her police car. He had arrived at school in a rage, they told her, swinging his backpack wildly and then, unprovoked, hitting another student with his fists.
He had run across Pine Lake Road during morning traffic, then back and into the school, darting door-to-door, swearing.
Alex’s day — and hers — was collapsing. And the 12-year-old was just getting started.
Angie knew something was different about Alex from the beginning.
He hit milestones early: crawled at 4 months, walked at 7½ months.
But he was kicked out of his day care at age 2 and needed weekly therapy when he turned 3. At age 5, doctors diagnosed bipolar disorder, a rapid cycle between manic and depressive moods producing chronic irritability.
“When he’s manic not a lot makes sense to him,” she said. “You can see it in his eyes, the way he holds his body. He doesn’t hear what you say. It can come on in a matter of seconds. But it takes hours for him to calm down.”
Even as she describes Alex’s hard edges, the mother’s words soften. He’s a good kid, smart, loves music. His little brother worships his “Bobo.”
She longs for a school picture. He hasn’t had one taken since second grade. She aches for him to be invited to a birthday party.
Angie battled her son’s illness seven years as a single mom. His dad lives in Colorado, but they parent together, she says.
She has a partner now, and another son, a 2-year-old. But the battle continues.
All of her vacation, her sick leave have gone to Alex. And much of her money.
It took three years to get Social Security disability insurance for him so he could qualify for Medicaid. As a state employee, Angie has good health insurance, but it doesn’t cover mental health, she says.
Medicaid approved residential care for Alex last year, at the I Believe In Me Ranch near Kearney. But after a year of treatment, Medicaid stopped paying, saying he wasn’t improving.
He wasn’t ready to come home, his mother said.
Since then, the family has tried to get Alex back into residential treatment. The insurer has resisted, even though his psychiatrist, Dr. Rafael Tatay, wrote a letter to the state Department of Health and Human Services, recommending a residential treatment center or enhanced treatment home.
“It is our opinion that there is still potential for rehabilitation if he were to be in a structural setting for a prolonged period of time,” Tatay said.
The decision to stop paying for Alex’s treatment was made by Magellan, the Medicaid-managed care provider. Marla Augustine, an HHS spokeswoman, wouldn’t talk specifically about Alex’s case, but said Magellan makes it decisions based on medical necessity, and that there is an appeal process.
Angie did appeal. The company turned her down again.
Doctors and his mother have tried everything, including “practically every available mode of medication we have,” with no significant improvement in his condition, Tatay said.
He has been hospitalized 26 times since he was 5. The BryanLGH Medical Center West program that offers children and adolescents urgent mental health treatment — known by many as CAPS — has been a godsend, the mother says.
His most recent admission was this week, after a violent outburst over a short homework assignment at his grandparents’ house.
He gets in-home therapy four times a week and attends Lincoln Public Schools’ behavioral skills program.
“We try and hope and pray we’re able to sustain without Alex becoming aggressive and violent,” his mother said. “The fact is he’s a very sick kid.”
The school resource officer ticketed Alex the morning of Sept. 4 for disturbing the peace. School administrators suspended him.
His mother knew he needed to go to the hospital. But the officer, although sympathetic, said Lincoln Police Department policy wouldn’t allow her to take the boy to the hospital. The department believes schools should have resources and action plans for students who pose a risk to themselves and others.
The officer put Alex — still raging — in the front seat of Angie’s car, took off his handcuffs and shut the door.
The mother held her breath. They lived close — less than a mile — but she had no idea what might happen on the way home.
At 5-foot-6 and 150 pounds, Alex is two inches taller and 15 pounds heavier than her.
At home, she got Alex out of the car, but in the house, he continued to fume, kick and throw his younger brother’s toys. She hoped he might go to sleep, exhausted, as he sometimes did. Not that day.
The mother tripped as she walked across the living room, and her son jumped from his chair and began kicking her as she lay on the floor and covered her face. She struggled to get up, and he grabbed her hair and pulled her down.
She got away, locked herself in the bathroom and called 911as he beat on the door.
“It was something I never expected to see, especially from my own child,” she said. “He’d never crossed that line with me, or anyone.”
In spite of his increasing violence, Angie resists what some have called the easy way out, to make him a state ward using the safe haven law.
Were she to do that, he likely would quickly go into residential care. He would be protected. Her family and those they encounter everyday would be, too.
But that would mean abandoning her beloved boy. She wants his family to be able to choose, along with his doctors, what is best for him.
“We’ll do what we’re faced with because we love him,” she said. “No one has ever given up on Alex.”
Reach JoAnne Young at 473-7228 or jyoung@journalstar.com.