WORTHINGTON, Ohio – As her teenage daughter grew older and stronger, Kelly Meara was effectively housebound. Audrey’s rages spared no one.

“She would not leave and she attacked everyone who came in the house,” Meara said. “I had to wear a helmet.”

Obtaining short-term, residential treatment for older children with severe autism and behavioral problems is often impossible for Ohio families, and Meara struggled for years before she finally found a place for 17-year-old Audrey in August.

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Relief was short-lived.

The new, 14-bed Elijah Glen Center – the only program of its kind in central Ohio – is closing at the end of the month after being open for less than a year.

Not enough families could get the insurance coverage they needed, whether through Medicaid or private plans, to pay for the care, founder Marla Root said last week.

The only option left for some was to relinquish custody in hopes that their county Children Services agency would pay for the residential treatment, Root said.

The Elijah Glen Center, on the suburban-Columbus campus of the autism agency Step by Step Academy, charges an average of $850 a day.

Private insurers generally limit the length of stay at such centers. Medicaid pays for the medical and behavioral components of care, but not the residential part.

Surrendering children to secure treatment is a terrible choice for parents, Root said. “It’s scary. They didn’t understand why that had to happen.”

State and federal legislators know that the need for intensive behavioral-health treatment is devastating many families and triggering unnecessary child-welfare cases.

According to the Public Children Services Association of Ohio, six in 10 children in the custody of county agencies in 2013 were there for reasons other than abuse or neglect.

“I’m pretty down,” Root said. “We have families waiting to get in. How can it be that we’re closing?”

In Ohio, a joint legislative committee on multi-system youth – those who need services through more than one system, such as developmental disabilities and mental health – is to study the systemic problems and make recommendations for improving care.

And at the federal level, advocates say, legislation could soon be introduced in Congress that would allow federal foster-care money to be used to help families who are at risk of relinquishing custody to get treatment for their children.

“Residential treatment for children with behavioral health conditions is important but expensive,” said Mark Mecum, executive director of the Ohio Association of Child Caring Agencies. “The family is often on the hook.”

Root went through the nightmare with her son Elijah, now 19 and the center’s namesake. He is 6-foot-8, has severe autism and went through a period of aggressive behavior.

Because there was no crisis-residential program available, Elijah had to be treated at a state developmental center geared toward adults with developmental disabilities. He now lives in a group home.

Even when insurance coverage does work out, options are scant.

“The need is so great, but there are no places,” Meara said. “There are even fewer who take adolescents who are in this type of crisis.”

Her family’s insurance company stopped paying for Audrey’s residential treatment at the beginning of November. Because the teen, who initially was hospitalized at Nationwide Children’s Hospital, still needed more help, Meara recently made the difficult choice to surrender custody to Franklin County Children Services.

The decision feels more bitter now. The agency has been helpful, Meara said, but has the authority to determine Audrey’s placement – possibly in another county or state – after the Elijah Glen Center closes.

“We had found this help, and it’s being taken away, and it’s just stunning,” said Meara, who lives just 4 miles from the center. “I just don’t know what to say.”

Audrey doesn’t mean to cause anguish for her family and two younger brothers, her mother knows. The girl can’t easily convey her feelings.

“It’s like a very primitive way to express her unhappiness,” Meara said of the outbursts. “I know she’s not doing it on purpose. I know that.”

But that doesn’t make it any easier for the Mearas, and many other families, to manage sometimes-violent teens at home.

“Our boys know, when Audrey gets upset, that they run to their rooms and lock the door,” she said. “So much of the focus goes to her.”

© 2015 The Columbus Dispatch
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