A $39.4 million increase in Arkansas’s revenue forecast for the last two months of the fiscal year means the state can fund second-tier annual budget priorities and provide some money for Medicaid.
However, analysts note the positive trend in revenue collections will do little to close a looming $400 million Medicaid shortfall in two years, a deficit of great concern to many organizations that provide health services.
Youth Home, an intensive psychiatric treatment program in Arkansas for young people ages 12 to 18, occupies 55-acres in West Little Rock. Various education, recreation, and administrative facilities are situated throughout the campus. And there are dorms, like Crestview House, a residence for girls who require inpatient therapy.
Kesia Clemons greets me at the front door. She manages the house and has worked with Youth Home since 2006.
“Well we have up to 10 girls, a variety of ages, and back there are the dorm areas,” said Clemons.
Inside the house, there’s a kitchen, a dining area, and space for meeting and lounging, so the girls can do homework, chat, and have group therapy sessions. Most treatment services provided by Youth Home are funded through Medicaid.
“Actually, they just got back home from school. Once they get in here we have to check them to make sure they’re not bringing in any contraband, which could be letters, pencils… we don’t want them to hurt anyone,” said Clemons.
All of the girls living in the house go to school on the Youth Home campus. Some have a regular curriculum, while others with learning challenges take special education courses. In the afternoon when the girls return to Crestview House, they usually talk about their school day and sometimes discuss more serious issues, like family problems.
“We have girls that have sexual abuse issues, physical abuse issues… so you know someone may have hurt them in the past so we have to gain their trust here,” says Clemons as she walks me through the facility.
Former Youth Home patient Michelle Blaney says trusting strangers was difficult when she first arrived on campus in 2006.
“I remember the house that I stayed in, Rose House, I was here for about six months and it does bring back a lot of memories some good and some not so good, but you know that’s with life you have your good and your bad memories,” said Blaney.
Blaney says being separated from family was tough, but classes and counselors at Youth Home helped her focus on educational goals and emotional healing.
“I was always used to being at home with my mom and my younger brother,” said Blaney. Going from being in a public school of over 1,500 people to a school of a very few it’s a different transition, but after awhile I got used to it,” said Blaney.
Just like the young girls who use Youth Home’s services, Boys have similar emotional and behavioral problems that often arise from abuse, neglect, and medical conditions.
Jon Pulliam, a unit manager at Youth Home, has worked with the organization for 17 years. He spends a lot of time counseling the boys on campus.
“One of the biggest things that I tell the kids, it’s perfectly okay and natural to get angry it’s what you choose to do with [anger] that decides whether you’re right or wrong,” said Pulliam. “We can’t force them to make the right choice… if they make the wrong choice, then we just continue to work to them.”
Darren Reeves oversees outpatient and community-based services for Youth Home. His team remains focused on individual services and family therapy for people who are not in residential treatment.
“When I get to see a child and a family take a very stressful situation, like a trauma, a major loss, something where there whole world is turned upside-down; and through therapy we’re able to kind of put the pieces back together and help them reclaim their family… that’s what does it for me every day,” said Reeves.
Back inside Crestview House, it’s evident that at a time when state budget woes mean reductions in Medicaid funding, Youth Home officials have to deal with other obstacles, like not having enough space for residential treatment.
We have 10 girls here. Our youngest is 14 and our oldest is 17. We have one that will be discharging on Friday and then we will have another one coming right in,” said Clemons. “Our waiting list has been pretty active, because as soon as one leaves we have another one coming in.”
Some years ago, the Arkansas Legislature put a moratorium on new beds at treatment facilities in central Arkansas, like Youth Home. The decision was part of an effort to encourage the creation of similar programs in rural parts of the state. However, it has been difficult to get good doctors, nurses, and support staff to move to those areas and start health, wellness, and medical programs.
Currently, the moratorium is intact, so there remains a policy of no new beds in central Arkansas and a gap in support services continues in rural regions.
Kesia Clemons admits possible state funding setbacks for programs that offer comprehensive care can be difficult, but she enjoys playing a part in changing children’s lives.
“Being a part of the Youth Home team really means the world to me,” said Clemons.
Clemons sits behind her desk in the foyer of Crestview house and watches the girls get ready for dinner.
“Yes, it’s challenging, but I feel that the reward of knowing the progress and the achievement that I see them make totally outweighs the bad days,” said Clemons.
Arkansas officials are concerned about possible bad days on the horizon. Governor Mike Beebe has already said the state will probably have to channel more revenue toward Medicaid to pay for a shortfall of up to $400 million in the 2014 fiscal year and service cuts may be necessary to close the funding gap.
Without state funding, finance officials say Arkansas could lose up to $900 million in federal matching funds, creating a potential gap of $1.3 billion for Medicaid. Follow the link below to listen to Part One of Malcolm Glover's report on Arkansas Medicaid funding and the Youth Home organization.