Children with differing disabilities are being treated differently in Virginia’s Behavioral Health and Education system when it comes to residential placements in Psychiatric Residential Facilities.
A child with a severe Developmental Disability or Intellectual Disability(DD/ID) in need of a residential placement is ensured a Free and Public Education (known as FAPE) under the Federal Individuals with Disabilities Education Act (IDEA) laws. Because Developmental Disabilities like these historically tend to be considered effecting the education of the children because of their special needs they are covered under the IDEA Standards. These laws mandate a child receive a free and public education paid for by the public education system. Based upon this standard when a child cannot be educated in the public schools system their education is funded in the setting to which they are referred. The state of Virginia Children’s Services Act (CSA) offices and Department of Education (DOE) has a system related to this need that ensures the student and their parents have a say in this process through the Individualized Education Planning (IEP) meetings. This process also ensures funding for the Education through that IEP process.
The same cannot be said about a child with a Severe Emotional Disturbance (SED) Psychiatric need. The system has a funding “hole” when it comes to serving this population. IDEA has not been interpreted to cover this population because the psychiatric symptoms of the child may not interfere with the daily education of the child although the issues certainly affect the safety and health of the child and their family. Because of this FAPE does not always cover these children meaning they do not qualify for payment of their education services. This leaves the burden of payment for the education services upon the parent. Some may be able to secure “home bound” payment from the public school but this amount is normally less than 50% of the daily fees a residential provider must charge to simply cover the cost of the education services. And for many families seeking services the child simply cannot wait to go through the IEP process to secure even that level of funding.
Both Virginia DOE and Department of Behavioral Health and Disability Services (DBHDS) regulations mandate a child must receive educational services while placed in a licensed residential facility but this mandate does not come with the necessary funding to ensure the proper education of the child in crisis.
In essence, the message to families of a child with an SED is you are on your own when it comes to funding their State mandated education. At a time when a family is in its highest need the system is not there to support them. In essence, the system is saying your child’s disability is not a disability while at the same time other children qualifying for the same level of residential need do have their needs funded. This shifts a very large financial burden to a parent of a child with a psychiatric SED diagnosis that a parent of a child with a DD/ID diagnosis does not face. In addition, a family of a child with an DD/ID diagnosis has likely had to navigate the state system of departments and available state services the entire life of the child. This means the child is in the system and has less time to achieve the needed funding and that the parents are better prepared to know how to seek help from the system. Due to the nature of SED/ Psychotic breaks it is entirely possible the child has never needed this level of care in their past leaving a more immediate need for the child and parents ill equipped to deal with the morass of state system processes needed to ensure proper care and funding for their child’s needs.
Further, the provider networks have responded to this, and the declining referrals for residential treatment by engaging in a “race to the bottom”, but offering scholarships (that they often cannot afford) to families. They offset the expense of the educational service, and as a result, offset their own sustainability.
When is a disability not a disability? The answer is when a child has a psychiatric need that rises to residential level of care but does not meet Virginia DOE and CSA criteria for education funding. This is a burden put on at risk families the system needs to address before a child cannot receive proper services due to lack of funding.