We're about four weeks and counting to Children's Mental Health Awareness Week, May 3–10, 2009. First Lady, Katie O'Malley is the honorary chair for the campaign and Mrs. Debbie Phelps is a spokesperson for the campaign. Look for some dynamite public service announcements with these two prominent Maryland mothers that will be aired during May. All of the state agencies, along with numerous state and local organizations and providers, have signed onto the campaign. Posters and other materials are being prepared for distribution in the next few weeks.

You can help spread the word about the importance of children's mental health by distributing campaign materials in your community at such locations as schools, libraries, doctors' offices, churches and any other community outlet. You can write a letter to the editor of your local newspaper about the importance of children's mental health in your community. To order campaign materials and for other suggestions to raise awareness in your community, go to the campaign website www.childrensmentalhealthmatters.org. We need to raise our voices together for our children during Children's Mental Health Week.

- Jane A. Walker
Executive Director

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What is a Residential Treatment Center?

Following up on last month's newsletter, in which we provided information about the history of residential treatment, this newsletter contains current information on the state's residential treatment centers.

In Maryland regulation (COMAR 10.07.01.01), a "residential treatment center" is a psychiatric institution that provides campus-based intensive and extensive evaluation and treatment of children and adolescents with severe and chronic emotional disturbances who require a self-contained therapeutic, educational, and recreational program in a residential setting.

Next to inpatient psychiatric hospitalization, a residential treatment center (RTC) is the second-most restrictive and costly treatment for children and adolescents. Approximately 785 children were placed in an RTC in 2008. The average length of stay in an RTC is 9-12 months.

There are 11 RTCs in Maryland licensed by the Department of Health and Mental Hygiene, Office of Health Care Quality. Two of these RTCs are operated by the state's Mental Hygiene Administration, while others are privately run facilities.

RTC/Bed Capacity	Operated by	Contact Information	Population	Location
Potomac Ridge at Anne Arundel 26 Beds	Adventist Healthcare	410.729.2135 www.potomacridge.com	Adolescents with mental health and cognitive disorders	Anne Arundel County
Regional Institute for Children and Adolescents (RICA) Baltimore 45 Beds	Maryland Department of Health and Mental Hygiene	410.368.7800 www.dhmh.state.md.us/rica-balto	Adolescents, ages 12 to 18 years, who are experiencing emotional, behavioral and learning difficulties	Baltimore County
Woodbourne Center 54 Beds	Private non-profit	410. 433.1000  www.woodbourne.org	Adolescent boys, ages 12-18 years. Also a self-contained and diagnostic program for males who have acute symptoms or high-risk behaviors and a program focusing on sexual trauma and sexual aggression or offenses.	Baltimore City
Berkeley & Eleanor Mann Residential Treatment Center 17 Beds	Sheppard Pratt Health Systems	410.938.5152 www.sheppardpratt.org	Adolescents with severe behavior problems	Baltimore County
Chesapeake Treatment Center 26 Beds	Mountain Manor	410.663.8500	Adolescent males, ages 15-21 years, adjudicated for sex offenses	Baltimore County
Good Shepherd Center 105 Beds	Sisters of the Good Shepherd	410. 247.2770 www.goodshepherd center.org	Adolescent girls, ages 13–18 years	Baltimore County
Villa Maria Continuum 86 Beds	Associated Catholic Charities	410.788.9440 http://www.cc-md.org/children/villa-residential-programs.html	Children, ages 5–13 years	Baltimore County
Potomac Ridge Eastern Shore 44 Beds	Adventist Healthcare	410.221.0288 www.potomacridge.com	Adolescents	Dorchester County
The Jefferson School 50 Beds	Sheppard Pratt Health Systems	240.315.0200 www.thejeffersonschool.org	Adolescents	Frederick County
John L. Gildner Regional Institute for Children and Adolescents (RICA) Rockville 80 Beds	Maryland Department of Health and Mental Hygiene	301.251.6800 www.dhmh.state.md.us/ jlgrica	Children and adolescents, ages 11–18 yearswith severe emotional disabilities	Montgomery County
Potomac Ridge Rockville 83 Beds	Adventist Healthcare	301.251.4561 www.potomacridge.com	Adolescents	Montgomery County

The facilities listed in the chart above represent those programs specifically licensed to serve children with serious mental health needs. Other residential facilities in Maryland may be licensed to serve children involved with other state agencies, such as Juvenile Services or Developmental Disabilities. Children do not need to reside in the county in which the RTC is located. Depending on the child's age, specific needs, and bed availability, they may be placed in a facility far from their home.

It is important to note that RTCs are one small component of the full continuum of care for children. Maryland has been investing in community-based care to keep children with their families and in their communities. Next month's newsletter will provide more information on other parts of the continuum.

What is the Process for Admission to an RTC?

While it is preferable to keep a child with their family and in their community rather than place a child out of home, in some instances it may be necessary. Accessing an RTC can be a lengthy and complicated process. In general, it is necessary to go through the Local Coordinating Council to get approval for an RTC. Every jurisdiction in Maryland is required to have an interagency committee called the Local Coordinating Council or LCC. The purpose of the LCC is to:

• Identify interagency resources to assist children with special needs;
• Develop a plan of care;
• Facilitate the provision of interagency services to children with disabilities; and
• Review requests for state funding of residential placements of children with disabilities.

Members of the LCC include representatives from many different agencies, including the local school system (LSS), Core Service Agency (CSA), Local Management Board (LMB), Department of Social Services (DSS), Health Department, Alcohol and Drug Administration (ADA), Department of Juvenile Services (DJS), Developmental Disabilities Administration (DDA) and the parent of a child with special needs from the community, or parent advocate. In most jurisdictions, one of the member agencies involved in the child's care is considered the "lead agency" and must either refer, or assist in referring, the child to the LCC.

Families with private insurance may have particular difficulty in accessing the LCC because their child may not be involved with any state agencies other than education. In these instances, it may be necessary first to seek a voluntary placement through the Department of Social Services before going to the LCC. Unfortunately, the voluntary placement process is also difficult and lengthy.

Once a child's case is finally brought to the LCC, information about the child is reviewed. Each agency considers the services they may be able to provide. With input from each of the agencies, a plan of care is developed. The plan of care may include in-home services, after-school programs or mentoring to help a family care for their child at home. The services and related plans should be child-centered, family-driven, individualized, community-based and culturally competent. Plans of care are reviewed every six months and may change depending upon the child's progress and availability of funding. Due to recent budget cuts, at this time, funding for residential treatment and community-based services is very limited. Each jurisdiction has an LCC specialist located with the Local Management Board.

Local Management Boards in Maryland

Allegany	301.777.2008	Charles	301.396.5238	Prince George 's	301.265.8446
Anne Arundel	410.222.7423	Dorchester	410.228.0281	Queen Anne's	410.758.6677
Baltimore City	410.662.5500	Frederick	301.600.3534	St. Mary's	301.475.4510
Baltimore Co.	410.887.4254	Garrett	301.334.1189	Somerset	410.623.2906
Calvert	410.414.5997	Harford	410.638.3166	Talbot	410.770.6870
Caroline	410.479.4446	Howard	410.313.1940	Washington	240.313.2090
Carroll	410.386.3600	Kent	410.810.2673	Wicomico	410.546.5400
Cecil	410.620.0762	Montgomery	301.610.0147	Worcester	410.632.3648

The Coalition also is available to answer questions about accessing care for children with mental health needs. Contact us at 410.730.8267 or 1.888.607.3637.

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High School Assessment Waiver Program

The details now are available on how the High School Assessment (HSA) waiver program will work for students in the class of 2009. Some students will be able to receive a high school diploma without passing all four of the HSAs in algebra, American government, biology and language arts.

To be eligible for a waiver, a student must:

1. Complete all other graduation requirements, such as getting course credits, meeting attendance requirements, service learning hours and any other requirements;
2. Take (but not pass) all four High School Assessments;
3. Take advantage of all offered interventions, including bridge projects; and
4. Fail one or more of the HSAs and not meet the HSA requirement through the combined score of 1602 or the Bridge Plan.

Also, the student must meet any one of the following circumstances to be eligible for the waiver:

1. A problem with local scheduling decisions;
2. Late arrangement of courses (such as the school scheduling government too late in a student's high school career);
3. A problem with testing decisions;
4. Inadequate intervention opportunities;
5. Special circumstances (such as a recent death in the immediate family or an extended illness); and
6. Arriving in the United States in the junior or senior year and is literate in his or her native language but not in English.

If you and your child have received a letter saying your child may be eligible for the waiver, or if you think your child should be eligible for the waiver, and you have questions or concerns, you may contact any of the following organizations for assistance:

Sara Morgan
Legal Aid Bureau
410.951.7729

Maureen van Stone
Project HEAL at Kennedy Krieger Institute
443.923.4416

Parents' Place of Maryland
410.768.9100

Law Offices of Mark B. Martin, P.A.
410.779.7770

Selene Almazan
Maryland Coalition for Inclusive Education
410.859.5400

Maryland Disability Law Center
410.727.6352

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A Message from the Social Security Administration

On February 17, 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act . This law provides for a one-time economic recovery payment of $250 to people who get certain types of federal benefits.

Who will receive the one-time $250 economic recovery payment? The law provides for a one-time payment for certain individuals who receive Social Security, Supplemental Security Income (SSI), Railroad Retirement and Veterans benefits. If you were eligible for one of these benefits at any time during the months of November 2008, December 2008 or January 2009, you may be eligible for the one-time payment. To receive the payment, your address of record must be in one of the 50 states, the District of Columbia , Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa or the Northern Mariana Islands.

If I am eligible for the one-time payment, when will I receive it? You should receive your one-time payment by the end of May 2009. You don't need to do anything to receive this payment. Social Security does not need to contact you to request information. The Department of the Treasury will be sending payments throughout the month of May.

How will I receive my one-time payment? Your one-time payment will be delivered the same way you currently receive your Social Security or SSI benefit. If you receive your monthly benefit by check, you will receive your one-time payment by check. If you receive your benefits by direct deposit or Direct Express® debit card, you will receive the one-time payment the same way. The one-time economic recovery payment will be sent separately from your Social Security or SSI benefit; it will not be included with your monthly benefit payment.

I receive both Social Security and SSI. Does this mean I'll receive two one-time economic recovery payments? No, you can only get one $250 payment, regardless of how many types of benefits you receive. For example, if you receive any combination of Social Security, SSI, Railroad Retirement or Veterans benefits, you still can get only one payment.

If my spouse and I both receive Social Security or SSI benefits, will we each get a one-time economic recovery payment? Yes, if both you and your spouse are receiving benefits from Social Security or SSI, you each will get the one-time payment.

Are children who receive Social Security benefits eligible for the one-time economic recovery payment? No, children under the age of 18 (19 if still in high school) who receive Social Security benefits are NOT eligible for the one-time payment. However, adult children who receive disability benefits on a parent's record will receive a payment.

Are children who receive SSI benefits eligible for the one-time economic recovery payment? Yes, children receiving SSI are eligible for the one-time payment.

I have a representative payee. Who will receive my one-time economic recovery payment? If you have a representative payee, the one-time payment will be sent to your representative payee. Your representative payee is required by law to use the payment for your personal benefit.

Will ALL Social Security and SSI beneficiaries receive a one-time economic recovery payment of $250? No. In most cases, the following individuals will NOT receive the one-time payment:

• Anyone living outside of the United States or its territories;
• Individuals who no longer are lawfully present in the United States;
• Individuals whose benefits have been suspended under the law for giving false or misleading statements;
• Social Security beneficiaries who are minor children*;
• SSI beneficiaries who receive benefits at a reduced rate of $30 because they live in a medical treatment facility (such as a nursing home or hospital) and Medicaid pays more than 50 percent of the cost of their care;
• Individuals only entitled to Medicare and not to Social Security or SSI benefits; and
• Prisoners, fugitive felons and probation and parole violators.

Every situation is different, and there may be exceptions to these rules.

*Note: Disabled adult children receiving Social Security or children receiving SSI payments will receive the one-time payment.

Will I receive the one-time economic recovery payment if I have a delinquent federal or state debt? The law requires the Department of the Treasury to deduct delinquent child support and debts owed to state and federal agencies from the one-time payment. The one-time payment will not be used to collect Social Security or SSI benefit overpayments.

Will the one-time economic recovery payment count as income or resources when determining eligibility for SSI? The one-time payment will not count as income for SSI. In addition, it will not count as a resource in the month you receive it or the following nine months. For example, if you receive the one-time payment in May 2009, it will not count as a resource from May 2009 through February 2010. If you still have this money in March 2010, it will count as a resource starting that month and may affect your eligibility for SSI.

Will the one-time economic recovery payment count as earnings when determining eligibility for Social Security disability benefits? No. The one-time economic recovery payment will not count as income or earnings for Social Security disability benefits.

If I don't receive my one-time economic recovery payment by June 4, what should I do? After June 4, 2009, you can call 1.800.772.1213 (TTY 1.800.325.0778 ) or contact your local Social Security office. Please wait until then to ask about your payment because the Department of the Treasury will be sending payments until the end of May.

What should I do if someone calls or e-mails me asking for personal information to process my payment? Do not provide your personal information to anyone requesting it to process your payment. If you are unsure about the identity of someone claiming to be a Social Security employee, call 1.800.772.1213 (TTY 1.800.325.0778 ) to verify the call. You may report suspicious activity involving Social Security programs and operations to the Social Security Fraud Hotline at www.socialsecurity.gov/oig/hotline or call 1.800.269.0271 (TTY 1.866.501.2101 ).

How can I get more information about the one-time economic recovery payment? If you are a Social Security or SSI beneficiary, visit www.socialsecurity.gov . If you are not a Social Security or SSI beneficiary and receive only Railroad Retirement or Veterans benefits:

You can visit the U.S. Railroad Retirement Board (RRB) at www.rrb.gov or call 1.877.772.5772 ( 1.877.RRB.5RRB ; TTY 1.312.751.4701 ) for more information. NOTE: You will receive your one-time payment from RRB. You do not have to do anything in order to receive your payment.

You can visit the Department of Veterans Affairs (VA) at www.va.gov or contact your local VA facility for more information. NOTE: You will receive your one-time payment from the VA. You do not have to do anything in order to receive your payment.

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New Ways to Protect Your Child's Mental Health

Early intervention offers great promise for protecting children's mental health, according to a new report from the Institute of Medicine . The report, “ Preventing Mental, Emotional, and Behavioral Disorders Among Young People ,” outlines options to head off—or at least mitigate—episodes of mental illness and their potentially devastating, adverse consequences.

Various studies have put the number of children suffering from a mental health issue at 14 percent to 20 percent—at great cost in lost opportunities and personal suffering for both the child and his or her family. The IOM report notes that early intervention, such as Early Head Start programs for 3-year-olds, and long-term programs throughout the school years designed to address aggressive and disruptive behaviors, can have lasting, positive effects on youth.

The study noted some particularly effective programs:

• A Good Behavior Game, in which elementary students earn such rewards as extra free time by acting appropriately in class, that significantly reduced aggressive behavior in 1st graders. Students who participated were less likely to smoke or be aggressive in middle school and less likely to abuse drugs or alcohol as young adults.
• Positive parenting programs , in which parents learn to use praise and rewards to encourage good behavior and rely less on harsh punishments, led to children who displayed fewer aggressive behaviors. Preschoolers and 1st graders whose teachers used the method were rated more socially competent and had fewer behavior problems.
• The Clarke Cognitive-Behavioral Prevention Intervention, which focuses on helping teenagers at risk for depression learn to cope with stress, reduced episodes of major depression.
• The Promoting Alternative Thinking Strategies (PATHS) program, which teaches elementary and preschool children about emotion, self-control and problem solving, significantly reduced conflict and depression.

The study noted the biggest challenge isn't necessarily to formulate effective, evidence-based programs, but to make them accessible to schoolchildren and their families across the nation.

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ABLE Act of 2009

Recently introduced federal legislation would authorize the establishment of tax-exempt accounts to pay for disability-related expenses. These would supplement, rather than replace, benefits provided by other sources, such as Medicaid and private health insurance.

The Achieving a Better Life Experience Act of 2009 (ABLE Act), S. 493/H.R. 1205, was introduced Feb. 26, 2009, by Sens. Bob Casey (D-Pa.), Richard Burr (R-N.C.), Edward Kennedy (D-Mass.) and Sam Brownback (R-Kan.) and Reps. Ander Crenshaw (R-Fla.), Patrick Kennedy (D-R.I.), Cathy McMorris Rodgers (R-Wash.) and Kendrick Meek (D-Fla.).

ABLE accounts would be similar to individual retirement accounts (IRAs) and 529 college savings plans. As such, individual taxpayers would be allowed a tax deduction for contributions of up to $2,000 a year to such accounts. ABLE accounts would not be a factor in determining eligibility for Medicaid benefits and other means-tested federal programs.

Similar legislation has been introduced in prior sessions of Congress. The measure currently is under consideration in the Senate Finance Committee and the House Ways and Means and Energy and Commerce committees.

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Upcoming Events

Psycho-educational Testing Webinar—April 2, 12 noon–1 p.m. Maryland Coalition online workshop presented by T. Andrew Zabel, Ph.D., ABPP-CN, of the Kennedy Krieger Institute. Limited to 20 participants; pre-registration is required. E-mail callenza@mdcoalition.org.

Social Security Workshop—April 16, 6–7:30 p.m. Part of the Howard County Schools Adolescent Transition Series 2009 for adolescents and young adults with disabilities ages 14 and older, parents/caregivers, educators and community providers. Faulkner Ridge Center , 10598 Marble Faun Court , Columbia. For more information, contact Dawson Robertson at 410.313.5640.

Firsthand Information about Transition—April 22, 7–8:30 p.m. Part of the Adolescent Transition Lecture Series sponsored by the Maryland Department of Health and Mental Hygiene, Office for Genetics and Children with Special Health Care Needs and the Maryland Center for Developmental Disabilities at Kennedy Krieger Institute, a panel of four transitioning youth and their parents will share their experiences; KKI Greenspring Campus, 3825 Greenspring Ave., Baltimore, Bowles Building, 4th Floor Boardroom. Contact Jenny Jones to register at 443.923.2790 or resourcefinder@kennedykrieger.org.

Maryland School Psychologists' Association Spring Conference—April 24, 8 a.m.–4 p.m. Conference will focus on safe schools and solutions to school violence. Martin's Crosswinds, 7400 Greenway Center Drive, Greenbelt. Click here to see the conference brochure and registration form; registrations must be postmarked by April 15. For more information, contact Dave Holdefer at dholdefer@verizon.net or Laura Shriver at leshriv@k12.carr.org.

Children's Mental Health Awareness Week- May 3–10. Visit www.childrensmentalhealthmatters.org for details and materials.

Mental Hygiene Administration Annual Conference- May 5-6. "Mind, Body and Spirit: Promoting Health and Wellness over the Lifespan" conference, Martin's West, 6817 Dogwood Road, Baltimore. For more information, contact Carole Frank at 410.402.8469 or Wendy Baysmore at 410.646.7758, or visit http://trainingcenter.umaryland.edu. Registration begins first week in April.

Addressing Behavioral Management in School Webinar- May 7, 12 noon–1 p.m. Maryland Coalition online workshop presented by Peter Leone, Ph.D., of the University of Maryland. Limited to 20 participants; pre-registration is required. E-mail callenza@mdcoalition.org.