May is Mental Health Awareness Month. This observation comes at a time when many of us are working to acclimate to our new norm and discover coping habits for the era of COVID-19. As difficult as this time has been, we should be mindful that these circumstances and compounding distress can have much bigger consequences for those we serve.
Here’s the reality: Every child in foster care has experienced trauma, and right now, the added stress and isolation that comes with COVID-19 means they need mental health support more than ever.
CASA volunteers can make a difference in the lives of the kids they advocate for by helping to make their mental health a priority. So, how do we go about making sure that kids are getting the professional mental health care they may need, from counseling to psychiatry?
First things first: make sure you’re familiar with STAR Health and the mental health services it covers.
In order to support access for children to the care they need and deserve, CASA volunteers should get to know STAR Health —Texas’ Medicaid program for children in foster care.
Texas administers its state Medicaid program through a managed care system, meaning the state contracts with private health insurance companies to provide services. The company Superior HealthPlan manages healthcare for the STAR Health program.
STAR Health’s services and provider network are specifically designed to support the behavioral health needs of children in foster care. All children enrolled are entitled to any medically necessary service and remain covered until their 21st birthday. It’s important to note that STAR Health only covers children in temporary, joint and permanent managing conservatorship of the state.
Here’s a high-level list of services covered under the STAR Health Medicaid managed care program:
- Medications for mental health and substance use care
- Psychotherapy and counseling services
- Psychiatry services
- Outpatient therapy
- Initial substance use screening and assessment
- Non-hospital and inpatient residential detoxification and rehabilitation
- Lab testing
- Targeted case management
- Substance use counseling treatment
- Medication assisted therapy
- Texas Child & Adolescent Needs & Strengths (CANS) Assessment
- Psychological evaluations
That’s not all! More services may be covered in individual cases.
Review a child’s medical records in order to make the most-informed advocacy decisions.
Talk with the child’s family and foster family to learn what kind of mental health services the child may already have experienced or benefited from, if any. If the youth is a teen, talk with them about their mental and emotional well-being, too.
CASA volunteers are authorized to view copies of a child’s medical history. STAR Health maintains patient medical records through a web-based tool called the Health Passport. This tool serves as a community health record for both health professionals and child advocates to view prescribed treatments and any diagnoses for children in foster care.
Ask your CASA supervisor how to access the Health Passport, and review the Health Passport for each child, when possible. Review diagnoses, treatment and medications, if any. Work with caregivers and caseworkers to discuss any concerns in a child’s Health Passport.
Know who the child’s medical consenter is (who makes the big decisions) and talk with them to ensure the mental health care needs of the child are being met.
The medical consenter is the person in charge of making decisions regarding medical, psychiatric, psychological, dental and surgical treatment for a child. By default, the medical consenter is typically the foster parent or kinship caregiver. However, if the child is in a congregate care facility, their caseworker serves as the medical consenter.
CASA volunteers can support the caregiver or caseworker in a variety of ways. Talk with them about the kind of therapy or counseling that might work best for the child. See if they need help with locating a specific mental health provider. Refer to the STAR Health network directory to find mental health practitioners in the child’s area who are in-network and who offer therapies your CASA child might benefit from. Find out what kind of services the practitioners offer, and if they have openings for new patients. Offer the caregiver information and support with setting up appointments, if they wish.
Know how to access services, and what services look like during physical distancing.
Many therapists and doctors are operating online through telemedicine now, which may make accessing services easier, as it does not require transportation. Earlier in March, Governor Greg Abbott ordered state-regulated health plans, including STAR Health, to temporarily expand telemedicine and allow online patient-doctor visits to be billed the same as an office visit.
The expansion allows doctors and mental health providers in the STAR Health network to cast a wider net for service delivery, particularly for children in rural areas.
CASA volunteers can go online to help caregivers locate a provider in the STAR Health network. However, it is important to know that not all providers listed in the STAR Health network directory might be taking new Medicaid patients or have appointments immediately available. If this happens to you, it might be best for the caregiver or medical consenter to contact STAR Health directly. Caregivers can call an in-network doctor using the online provider directory, or get help by calling Superior HealthPlan at 1-866-912-6283.
Ensure the provider you are working with is trauma informed.
Doctors and mental health providers in the STAR Health network are specially trained to work with children who have experienced abuse or neglect. However, not all providers are trauma informed.
To find a trauma-informed provider, caregivers and other medical consenters can call STAR Health directly or use the Provider Search Engine on the website and type “Trauma-Informed Care” under certifications.
As a CASA volunteer, your mental health advocacy depends on building a bond with the child or youth, asking questions, listening and building collaborative relationships with everyone involved on a case. By familiarizing yourself with the services available and communicating with the caregiver and caseworker about mental health concerns and options, you can ensure the full spectrum of a child’s needs are being met.
For more information about STAR Health, please visit the Superior Healthplan website, and keep an eye out for Texas CASA’s Health Advocacy Guide to be released later this year.
Thank you stepping up for the most vulnerable children and families in your community!