Parents

Parents

Did You Know?

Serious emotional disturbance (SED) is a legal term and refers to people who have a mental, behavioral or emotional issue that limits their ability to participate in family, school, or community activities.

Idaho’s legal code* uses this definition:
"Serious emotional disturbance" means an emotional or behavioral disorder, or a neuropsychiatric condition which results in a serious disability, and which requires sustained treatment interventions, and causes the child’s functioning to be impaired in thought, perception, affect or behavior. A disorder shall be considered to "result in a serious disability" if it causes substantial impairment of functioning in family, school or community…”

A person is identified as having SED if they have both a DSM diagnosis and a functional impairment as identified by the Child and Adolescent Needs and Strengths (CANS) tool.

* Idaho Code, 16-2403(13)

If your child qualifies for Medicaid, the Idaho Behavioral Health Plan (IBHP), currently operated by Optum Idaho, provides services that can be accessed once a child’s primary care and/or mental health provider determines your child’s treatment needs. You can coordinate your care through your current doctors, or you can contact Optum to discuss additional resources that may be available to you.

If there are resources that your child needs that are determined to be medically necessary but are not available to your child, you can work with your doctors to make a formal request for services through the Early Prevention Screening Diagnostics and Treatment (EPSDT) process.

If your child does not have Medicaid, there are resources available through your local Children’s Mental Health (CMH) office. These resources may be available to your child even if you have private insurance of your own. You can find contact information for your local CMH office here.

YES services and supports will start rolling out in 2018. While each service and support may not be available at the same time in each region initially (often due to the availability of providers), the goal is to provide access to each service and support in every region of the state before the end of 2020.

The Department of Health & Welfare will ensure that services and supports are made available to all YES eligible children and youth. The Idaho Behavioral Health Plan (IBHP) from Medicaid will include many of these new services, however if your child is not eligible for Medicaid other options will be created to provide access. The details of this access have not yet been finalized but will be posted on the YES website when available.

A list of the types of services and supports that will be included in YES by the end of 2020 can be found in Appendix C of the Settlement Agreement that led to the creation of YES. These items represent a home and community-based treatment approach to deliver services and supports in the least restrictive setting possible. They also allow your family to access the specific treatment your child needs based on medical necessity.

Not everyone who has a mental health concern has serious emotional disturbance (SED), but other types of mental health issues can also benefit from treatment. Completing a mental health assessment can help you decide if mental health care could help your child.

As YES develops, there will be multiple ways to start the process of getting a mental health evaluation for your child, including:

  • A checklist tool available from the Idaho Department of Education (coming soon!) that anyone can use
  • A screening tool available for professionals working with your child

Both options can help you decide if your child would benefit from a full mental health assessment.

If your child does not currently have a mental health provider, you may want to speak with your child’s primary care provider to decide if a referral to a mental health provider for a full mental health assessment is appropriate. You can do this even if you have not used the checklist or had a mental health screening.

If you need help locating a mental health care professional for a mental health assessment, please contact your local Children’s Mental Health office, Optum (if your child is currently eligible for Medicaid), or your private insurance company for local resources.

If you would like to know if your child is eligible to receive services from YES, after January 2, 2018 you may request an assessment from an independent assessor. Please call Liberty Healthcare at 1-877-305-3469 to schedule an appointment for an assessment.
The Child and Adolescent Needs and Strengths (CANS) is an assessment tool that looks at different areas of your child’s life, such as:
  • Their past experiences
  • Individual strengths
  • Social and family interactions
  • Their emotional needs
  • Their activities

Your child’s needs (areas that need support) and strengths (areas that will help them during treatment) are identified by the CANS and serve as the foundation for the development of your child’s individualized treatment plan. The output also provides a common language for everyone working with your child to communicate about their treatment goals. The CANS considers the family’s needs and strengths as an important part of developing the treatment plan.

Along with a diagnosis from the current version of the Diagnostic & Statistical Manual of Mental Disorders (DSM), the CANS will help establish whether or not your child has a serious emotional disturbance (SED) and meets the criteria for YES services and supports.

If you would like to learn more about the CANS, you can visit the Praed Foundation website. You can also learn about implementing the CANS in Idaho by clicking here.

The Child and Family Team (CFT) is part of a future phase of YES. A CFT is a group of family members, professionals and other involved individuals who will develop a treatment plan for your child based on the results of the CANS.

There is no set number of members on a CFT, but at a minimum the CFT will include your child, your family, and your mental health provider. Other involved individuals may be invited by your family to participate on the CFT. Examples of participants include medical health care providers, teachers, siblings, extended family members, friends, family support partners, coaches, representatives from churches, synagogues or mosques, and community resource partners. Other members of the team may include representatives from other service systems like the Department of Juvenile Corrections, county detention services, or Child Welfare Services, as appropriate.

The size of your CFT will be determined by your child’s treatment goals, the needs of your family, and the number of people in your child’s life who need to participate in order to create a meaningful and effective plan. Members of your CFT can be added or removed as your child’s needs change over time.

The services your child currently receives could be impacted by this change in treatment approach. The CFT may determine that new services are more appropriate, or that the existing services need to be modified to better reach the identified goals. Some families will see no change in their treatment plan, while others may see significant changes. The exciting part about the CFT model is that services and supports can be adjusted as progress is made and new needs are identified.

Once a treatment plan has been created by the CFT, it will be reviewed to make sure treatment goals are being addressed with appropriate services and supports. Once the plan has been finalized those services and supports will be available and provided as identified in the plan. It is important to note that all Medicaid services and supports are subject to plan benefits and requirements.

You can read more about the CFT here.

As vital members of the Child and Family Team (CFT), YES will provide parents and caretakers multiple opportunities to learn about CFTs in person, through printed materials, and through on-line resources.

Training will cover all aspects of the CFT including:

  • The purpose of the team
  • How a CFT is intended to operate
  • Who to invite to be on the team
  • Why certain people should be on the team
  • How to address dispute resolution and collaborate to reach the best solutions
  • How and why to monitor and adapt the plan
  • How to include a transition plan

While the Child and Family Team model has not yet been implemented and thus training materials are not yet available, it will be a focus of YES. Please check back for details as they become available.

In 2017 the Idaho Legislature raised the qualifying federal poverty level (FPL) for Medicaid to 300% for children with serious emotional disturbance (SED) beginning January 1, 2018. This means there are higher household income limits for children with SED to qualify for Medicaid coverage.

To see if your family may be eligible under these new limits, please take a look at the current Federal Health and Human Services Poverty Guidelines.

Please note: The information provided on this site represents 100% of the FPL and does not take into account income exceptions. The only way to know if your child will qualify for Medicaid under the YES project is to apply.

Before applying for Medicaid under the 300% FPL, your child will need to complete an assessment with an independent assessor. Please call Liberty Healthcare after January 2, 2018 at 1-877-305-3469 to schedule an appointment for an assessment.

It is anticipated that families whose income is higher than the 300% FPL will be able to access YES through a cost-sharing program. The Department of Health & Welfare currently operates a cost-sharing program for children’s mental health for those families whose income exceeds 150% FPL. It is anticipated that this program will be modified to reflect the new 300% FPL eligibility limits. Details about this option will be posted once they are finalized.

Children and youth who do not meet the criteria for serious emotional disturbance (SED), and thus are not eligible for the higher Medicaid qualifying income limit (300% of federal poverty level (FPL)) or access to the YES system of care, will still be able to access mental health services in other ways.

If you are looking for a counselor or other mental health care provider you can:

Mental health providers around the state, both within the Children’s Mental Health (CMH) offices and in private practice, are in the process of getting trained and certified in the use of the Child and Adolescent Needs and Strengths (CANS) tool, with Medicaid providers preparing for the July 1, 2018 implementation of YES.

Ultimately it is the hope that all children in Idaho with mental health concerns will receive a CANS assessment to create a needs and strengths based treatment plan.

Sometimes our children need services that aren’t currently available through the Idaho Behavioral Health Plan (IBHP), but may be available through other methods, such as private pay or private insurance. Sometimes these services may only be available in another state. Children and youth with Medicaid who require additional services that are currently unavailable through the Medicaid State Plan can apply for Early Prevention Screening Diagnostics and Treatment (EPSDT) services, which may help the family access the services they need.

Once approved, the EPSDT process not only allows families to access needed services; it also helps the state identify services and supports that are lacking in Idaho. YES is actively working to identify the needed services and supports that are currently unavailable or understaffed in each region of the state so that appropriate resources can be directed towards resolving the shortages. Building a network of providers who can meet the treatment needs for children's mental health is a major component of YES.

Living in a small community can present challenges when it comes to available resources and providers. YES is a statewide system of care and is working toward having service availability even in smaller communities.

To provide services statewide, one focus of YES is the Workforce Development Plan which is being designed by the children’s mental health community in collaboration with parents and providers. This plan recognizes that Idaho currently has a healthcare provider shortage and identifies strategies to provide more families with access to appropriate services and supports.

Current strategies identified by the Workforce Development workgroup include identifying methods to attract new mental health providers to the state and expanding access to telehealth interventions. These topics and many others are being addressed as the Workforce Development workgroup strives to make sure YES reaches all corners of Idaho.

If you have questions regarding the Workforce Development Plan, please check out the updates.

YES acknowledges the struggle parents face to access appropriate mental healthcare and develop meaningful treatment plans. The Child and Family Team (CFT) model is expected to start rolling out in mid-2018 and will change how families identify treatment goals and access services and supports for their children.

The CFT will use the goals identified in the Child and Adolescent Needs and Strengths (CANS) to create a treatment plan. The team will then work together to identify what services and supports are needed to meet your child’s treatment needs. If members of the team do not agree with treatment goals (or the services being suggested to meet those goals), the team will work to resolve any differences so that all members of the team can support the final plan.

If you do not agree with the CFT’s finalized treatment plan or if you have other concerns, YES is currently creating a complaint process that will be finalized in the upcoming months. If you have any questions or concerns about YES, the treatment planning process, or the services and supports offered, please see the Contact US link for your regional Behavioral Health office phone number, or send an email to yes@dbh.idaho.gov. For complaints regarding YES, please call: 1-855-643-7233.

YES will launch a statewide information campaign to help families and youth know what services will be available in their areas and when. Information about the planning and design of YES is currently posted on this website (yes.idaho.gov). Status reports regarding the implementation of YES are posted regularly and new information will continue to be posted as it becomes available.

As YES is rolled out into local communities, the Regional Behavioral Health Boards, and their Children’s Mental Health Subcommittees, will be a good place to get ongoing information about implementation. YES will work closely with the Regional Behavioral Health Boards and their Children’s Mental Health Subcommittees to ensure local community needs are identified and incorporated into planning for the future. Parents and caretakers are welcomed at the board and subcommittee meetings.

While it would be desirable if all the features of the new system of care could be available immediately, YES is still working to gather input from parents, youth, and providers so that the completed project reflects the unique needs of our communities. Updates will be available as they are ready.

The lawsuit began in 1980 when children were co-mingled with adults at State Hospital South (SHS). There was a lack of appropriate treatment and education services at SHS and a lack of community-based mental health services across Idaho. After many hearings over 30 years, the Court encouraged a mediation process to identify solutions. Mediation occurred from September 2013 through December 2014.

Mediation resulted in a Settlement Agreement, which is the result of more than a year of negotiations among key community stakeholders representing parents, advocates and private providers, representatives from DHW, the Department of Juvenile Corrections, the Department of Education and attorneys representing the Class Members.

The settlement agreement requires the State of Idaho to develop a mental health system of care for children with serious emotional disturbance (SED). The new system will be implemented and sustained in a manner that is family driven, community-based, coordinated and comprehensive. The state developed the Idaho Implementation Plan as the framework for building the YES Project Plan.

After the YES project has been fully implemented in May of 2020 there is a period of three (3) years that is identified in the settlement agreement as a period of monitoring for sustainability.

For more information, please visit the Contact Us page on the YES website. If you have additional questions or comments, please use the YES Contact form to email the YES team.