Arkansas Medicaid Funding And Youth Home: Part One

May 22, 2012

As Arkansas officials prepare for a Medicaid shortfall of close to $400 million in 2014, many organizations that rely on those funds are battling budgetary constraints to continue providing necessary services that meet the needs of their patients.

On a rainy afternoon in a rural corner of West Little Rock, 20-year old Michelle Blaney from Bryant returns to the campus of Youth Home, the oldest and largest psychiatric treatment facility for adolescents in Arkansas.

Michelle Blaney at the campus of Youth Home.
Credit Malcolm Glover

While walking through the hallways she talks with Youth Home staff members about finishing up final exams at Pulaski Technical College. She feels fairly confident about final grades.

“I’m hoping it went really well. I have my finger crossed,” said Blaney. “I don’t know yet, but hopefully I did really well after studying for three or four hours. I’m hoping that did some good.”

As we leave the confines of Youth Home’s administrative offices and stroll along the grounds of the campus, Blaney is very candid.

“There’s not really a lot that I would consider just too personal, because back when I was here you have to talk with people and be open with them,” said Blaney. “You don’t get too personal in your discussion groups, but you do have to open up to people, staff members, and others. Over the years, I’ve gotten more used to it and just being able to get things off your chest makes you feel a lot better.”

Blaney says life was difficult when she first arrived at the residential treatment facility six years ago when she was almost 14-years old.

“I was very defiant. I wanted to do things my way and I was going to do it whether or not I had the approval and I didn’t care what anybody thought,” said Blaney. “Back then, I didn’t care about any of the consequences, but even if I could go back and change things I wouldn’t, because you learn from your mistakes.”

Blaney says her newfound determination for personal and professional achievement is partially due to Youth Home’s programs. She credits the organization’s therapists, educators, and specialists with helping her learn how to control various emotional and behavioral problems.

“Yeah, I had some troubles in my past, but even with attending here I learned so much from this place. You learn from your mistakes and this was definitely a place that gave me things that I could take with me, like certain coping skills,” said Blaney.

The kinds of skills that curb anger and teach patience.

“If I get mad, instead of trying to curse somebody out, I just sit back and think about what you might do before you do it, because you don’t want your actions to bite you in the butt in the long run for something you said out of rage,” said Blaney.

Brenda Griffin oversees residential programs. She says Youth Home staff members are diverse and have various skills from degrees in psychology and social work to physical education.

“We have people who’ve had experience coaching youngsters or working with youth groups so they bring with them a natural sense of wanting to help others. I think these patients that we get here respond to that,” said Griffin. “We see people turn their lives around and seeing that everyday keeps us all going.”

“We exist to help young people and their families become more productive members of society,” said David Napier, the executive director of Youth Home.

David Napier, the executive director of Youth Home.
Credit Malcolm Glover

Napier has worked with the organization for 20 years. He says there are so many children in the state suffering from abuse and parental neglect.

“[These young people] have developed behaviors in order to survive that prevent them from being able to integrate with society,” said Napier. “There has to be a place where they can work through some of the pain that they have in their lives and learn to respond to the emotions that they have in an appropriate way. If not, they’re going to be institutionalized for the rest of their lives.”

Napier says even though it’s an expensive process to treat and house teens for six months at Youth Home, the cost is minimal compared to the expense of institutionalizing a person for a lifetime simply because they didn’t get proper therapy early. As we walk into his office, Napier says treatment for young people ages 12 through 18 is primarily funded through Medicaid.

“Arkansas has a special program set up so you can get a court order for a teenager and he or she can actually become a family of one under the supervision of their parents. It’s called a FINS petition, Families In Need of Services, and it makes that individual child eligible for Social Security and therefore they can get Medicaid payments from the state,” said Napier.

He admits that rising health care expenses have been problematic and the organization continues battling a business model that isn’t faring well in this economy.

“I understand the position that our governor and our legislature are in. Money is tight and it’s going to get tighter,” Napier says as he sits down near his desk. “The per diem, the amount we’re paid each day to help these children by Medicaid, has been frozen for over a decade now and we all know that expenses have continued to go up. In recent years, we’ve had to labor under the fact that we are not bringing in enough money to meet expenses.”

Youth Home has some savings that help defray rising costs, but Napier says the organization continues to fulfill its mission by relying on support from local businesses and other community groups.

In the meantime, Youth Home continues to take in patients from all corners of the state. At any given time 130 teens are getting support from programs and professionals at Youth Home’s main campus. The organization also has an outpatient clinic in West Little Rock that serves anywhere from 800 to 1,200 people a year.

Young people, like Michelle Blaney, who just graduated this spring with her Associates of Arts degree from Pulaski Tech. She plans on transferring to UALR in the fall and study criminal justice and psychology, partially due to her continuing fascination with the way the human mind works. Blaney ultimately wants to obtain a master’s degree in criminal justice.

“I mean I’m just a regular girl. I have had my hard times, but I’ve learned from my mistakes and I’ve moved forward with what I want to do in life and that’s what I’m doing,” said Blaney. “I want Youth Home’s name to be out there, because it’s a place that’s here to help.

Blaney often speaks to young people about the work of Youth Home to dispel myths about behavioral disorders and combat the shame that some teens feel when they seek psychiatric help.

For 45 years, Youth Home has treated emotionally troubled young people so they could become healthy and productive members of the community. Even in this economic climate with limitations on state Medicaid funding, Youth Home continues to serve its clients with a team of employees who are finding ways to do more with less. Follow the link below to listen to Part Two of Malcolm Glover's report on Arkansas Medicaid funding and the Youth Home organization.