A trickle of COVID relief money is helping fill gaps in mental health services for rural children

The Mary Hill Youth and Family Center building has long stood at the crossroads overlooking this rural Appalachian town, but its purpose has evolved.

For 65 years, residents of Nelsonville and the rolling hills of southeastern Ohio have traveled to a hilltop hospital in search of care. Then, in 2014, the 15-bed hospital, which was often without patients, was closed.

Later, the three-story building was reopened as a health service center. With the help of several funding sources, Integrated Services for Behavioral Health, a nonprofit social services agency, has transformed the building into a site for mental health treatment, primary care, dental care, and access to the food pantry.

In June, the organization opened a 16-bed mental health treatment program on the top floor of the former hospital. The program serves children in rural areas of Southeast Ohio and gives families an option beyond sending their children away — sometimes out of state — for residential care.

For a long time, we’ve been trying to figure out ‘How do we support local service delivery more? “Because when you have the programs here, the work you can do with families is more successful, and the health outcomes are better.”

Efforts to provide residential mental health services at Mary Hill Center, and in other rural Ohio towns, have been boosted, in part, by a small share of Ohio’s $5.4 billion appropriation from the American Rescue Plan Act, a federal coronavirus relief law passed in 2021. .

Congress gave $350 billion to state, local and tribal governments as part of the ARPA, allowing states to decide how the money is used. To date, dozens of states have devoted a relatively small portion to improving mental health resources. Ohio is one of a small group of states that has further divided its allocation to spend a portion on mental health care for children.

Experts said using ARPA funds is just one way for states to support children’s behavioral health during what health professionals have called a “national child and adolescent mental health emergency,” which has been exacerbated by the pandemic. In an effort led by the American Academy of Pediatrics, several organizations wrote to the Biden administration in October, urging it to declare a federal national emergency on children’s mental health.

“At the time ARPA came along, we were really trying to understand, as a country, how mental health and behavioral health systems can be strengthened, because, in my opinion, the systems are really broken,” said Isha Weerasinghe, senior policy analyst at the Center for Law and Social Policy, a group A nonpartisan patriot advocating for policies that help low-income people. “And what ARPA has been able to do is provide some seed dollars to help strengthen the systems.”

The center said ARPA’s funding provisions are “insufficient to address deep systemic and historical disparities” in mental health care. Still, Weerasinghe said there is an opportunity for the money to have a long-term impact on children’s mental health care if it is applied to organizations that have demonstrated a commitment to preserving the well-being of children in their communities.

Countries have until 2024 to allocate their ARPA funding and until 2026 to use it. According to the latest quarterly analysis by the Center on Budget and Policy Priorities, a left-leaning think tank in Washington, D.C., most states have either completed or are close to completing their appropriations. Among states, the average allocation to support mental health services is about 0.5%, based on CBPP data. For states in the Midwest region, the average is about 3%.

CBPP figures showed that by August, mental health provisions varied widely in mostly rural states where suicide rates frequently exceeded the national average by double or more. In some of those countries, including Montana, South Dakota and Wyoming, officials allocated less than the national average. Meanwhile, Colorado lawmakers have directed nearly 11% of the state’s money toward mental health.

Of the $84 million from Ohio officials earmarked for children’s behavioral health facilities, $10 million will go to rural counties in the state’s Southeast. That is less than half a percent of the state’s $5.4 billion appropriation. But doctors hope it will help fill gaps in child mental health services in Appalachian Ohio.

In recent studies, the Ohio Public Children’s Services Association, a nonprofit advocacy group, found that because of gaps in services, some children with behavioral health needs were placed in out-of-state Ohio or in a remote county for care. The association surveyed public children’s services agencies in 19 counties and found that for most of their cases in 2021, the agencies made many calls before finding a place in a residential treatment facility for a child.

In April, Ohio Governor Mike DeWine signed an executive order providing $4.5 million for residential treatment facilities for youth to increase their capacity.

In Nelsonville and the country and hills that surround it, ARPA funds have played a minor role in expanding services.

Mary Hill Center’s new residential treatment facility, which serves children ages 10 to 17, is designed to accommodate 16 beds. But as of September, due to a staff shortage, the facility was operating at a limited capacity and has served a maximum of five children at one time.

Non-ARPA money paid for most of the renovations needed to open the floor, Shafer said, but about $1 million from ARPA will help upgrade the elevators and bathrooms.

Her organization will use an additional $7 million to build another residential treatment facility — whose program is modeled after the Mary Hill Center — in Chillicothe, a city 55 miles west of Nelsonville. This facility will have a capacity of 30 beds, but will start with a ceiling of 15 beds. Construction is scheduled to begin in January.

Services at the residential facility in Chillicothe will be primarily reimbursed under a new Medicaid program called OhioRISE, which will pay for behavioral health treatment at youth psychiatric facilities. But the facility will also treat children who are not enrolled in Medicaid.

Before Rural Ohio projects were approved for ARPA funding, they were reviewed by Randy Leite, executive director of the Appalachian Children’s Alliance, a nonprofit organization that advocates for children’s health. Decide any ARPA-funded project proposals from the Appalachian region that have been submitted to the Ohio Department of Mental Health and Addiction Services.

“I told the people in Columbus that I could give them $300 million worth of ideas to spend money on, but a lot of that wasn’t practical and doable,” Letty said. Instead, focus on ideas that were “shovel-ready”—so that they could be completed within ARPA’s spending time frame—and sustainable.

“A lot of sustainability is related to services that can be compensated,” he said.

Light and the coalition provided Ohio officials with about $30 million in ARPA investment recommendations, including a project aimed at expanding telehealth capacity in schools. State officials only approved about a third of the total requested. The money went to Integrated Services for Behavioral Health Facilities and Hopewell Health Centers, which is a federally qualified health center and received about $1.5 million. These funds will pay for renovations to a 16-bed pediatric crisis stabilization unit in Galea County, south of Nelsonville; expansion of the daily treatment program; and enhancements to school mental health programs – including one in the Nelsonville School District.

“For students to learn, they must be in good physical and mental health,” said Sherry Champlin, chief strategy officer at Hopewell Health Centers. “This support is really needed for children so that they can make good use of their educational opportunities.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and surveying, KHN is one of the three main drivers of the KFF (Kaiser Family Foundation). KFF is a non-profit organization that provides information on health issues to the nation.

Leave a Reply

%d bloggers like this: