Funding Program: Out -of -State Education Advances

South Carolina children need immediate psychiatric care around the clock scheduled for days – even weeks – waiting for help, only to be sent hundreds of miles from home for treatment. care.

When psychiatric beds are not available in South Carolina, some children in the Southeast will have to go to workplaces in Florida, Georgia, North Carolina, Virginia, Tennessee, Alabama, or Kentucky – anywhere they can be found. and on a bed.

The problem in South Carolina is not a shortage of residential psychiatric beds, state department officials said, but the state’s total of 518 licensed beds filled by patients from other states. Lastly, according to the state Department of Health and Human Services, about half of the children placed in a psychiatric care setting in South Carolina were not South Carolinians.

The reason goes down the bottom line of employers, led by state wage payments, while Medicaid often covers patient care. The South Carolina average of about $ 330 a day is one of the lowest for these services in the country, said Deborah McKelvey, director of Windwood Family Services in rural Charleston County. North Carolina’s Medicaid is more than $ 500 a day, he said, and other states are paying $ 800.

“It’s like a business,” said McKelvey, who owns a nonprofit residential psychiatric hospital with a mission to care for patients in South Carolina. His factory was built on a loss, and part of it was secured to raise money.

The state’s other psychiatric clinics for children are operated as a financial institution. Three are owned by Broadstep, a subsidiary of the independent company Bain Capital. Some health care researchers say that making money is more important than health care.

“More than in any other area of ​​the health care industry, the social equity is pouring money into health care,” said Eileen O’Grady, a researcher for the watchdog Private Equity. Stakeholder Project. “We don’t know how much money they’re making. They don’t have to show anything to the public.”

The company released a report in February called “The Kids Are Not Alright” outlining some of the actions that health care providers have taken by private businesses to increase their revenues in recent years. , reducing staffing and delaying home maintenance.

“While the conditions are alarming for some young health professionals, their private stakeholders have sometimes found significant benefits,” O’Grady wrote.

Officials from Bain Capital and Broadstep did not agree to comment on the story and did not respond to written questions.

These investments helped shape the arm racing. South Carolina Medicaid increased its salary on April 1 to $ 500 per child per day in a way to entice agencies to get money to accommodate the state’s children. The change is expected to pay the Medicaid company $ 14 million annually, on top of the $ 20 million previously spent on residential psychiatric care for children. The money is needed to free up a bed, said SC Health and Human Services Director Robbie Kerr. But it won’t be enough in the long run.

“We already knew our states were ready to increase their salaries when I worked,” Kerr told a panel of lawyers in January. “It’s going to be an inflationary spiral.”

It is not uncommon for U.S. children who need critical psychiatric care to travel to a foreign state for care. KHN also reported that about 90 Montana children covered by Medicaid are enrolled in psychiatric clinics across 10 states. Similar events took place in Arizona, Minnesota, and Oregon. Many states have a shortage of psychiatric beds.

However, psychologists and experts believe that the well -being of children is more successful than children who receive this care close to home. This makes it easier because patients can easily maintain contact with their parents, caregivers, and the community during their stay that can average weeks or months. .

Medicaid documents show some of the companies in South Carolina have admitted children from as far away as Alaska and Vermont. Currently, South Carolina ranks 50th among all states and DC – with only North Carolina having the lowest mortality rate – for the proportion of children who have the most depression and do not receive care because of it. that is, according to the Mental Health America support group.

Some children, left untreated, become involved in abuse and murder as a result of requiring care in a psychiatric hospital or nursing home. They may have anxiety, depression, or post-traumatic stress disorder, or a drug-using disorder. In many cases, the disease has exacerbated their mental illness. A psychiatric bed was much smaller.

In New Hope Carolinas, a nursing home for 12-21-year-old patients in Rock Hill, South Carolina, 133 of 150 psychiatric beds filled with patients covered by out-of-state Medicaid plans are available. last summer, according to a report filed by the house with the South Carolina Department of Health and Human Services. At Springbrook Behavioral Health in Greenville, a psychiatric hospital that specializes in children with severe autism, is just one of 40 Medicaid patients from South Carolina. At a home in Simpsonville called Excalibur-Venice, 41 Medicaid patients came from North Carolina and only 10 from South Carolina.

Excalibur-Venice is one of three factories in South Carolina to fall under the auspices of Broadstep, a Raleigh, North Carolina company sponsored by private equity firm Bain Capital’s Double Impact Fund. Broadstep’s footprint covers a variety of psychiatric events in seven states, according to its website, and Bain Capital is a far cry from the only private equity player to invest in health care.

In its 2022 “Global Healthcare Private Equity and M&A Report,” Bain & Company – a consulting firm separate from the private sector but founded by the same industry – highlighted the opportunities to invest in health care.

“With a reduction in the stigma for mental health services, combined with more expensive and paid services,” the report said, “the mental health market will expand over the years. is coming. “

However, in the Carolinas, the need for psychiatric beds is much higher. In mid -March, Bailey Pennington, a spokeswoman for the North Carolina Department of Health and Human Services, confirmed that 21 children from that state were in custody, waiting for a mattress to be found. a house in North Carolina or any other state. . Nearly 250 North Carolina children covered by Medicaid will be sent to an out -of -state psychiatric facility between 2019 and mid -2021, he said. And North Carolina, while it has twice the population and a higher Medicaid score, has fewer psychiatric beds for children than South Carolina.

“I have five or 10 young people now who could benefit from this level of care that jumps from setting to setting,” said Michael Leach, director of the South Carolina Department of Social Services. .

In some cases, parents have abandoned their children because they can no longer maintain their mental health needs, he said. Sometimes, law enforcement is involved, but parents refuse to take their children. Children sleep in county wards or hospital emergency rooms, he said, unless psychiatric beds are available.

Often, beds are available in South Carolina, but psychiatric clinics are unable to provide staff to care for patients. That’s when the kids are sent out of state, Leach said. Nineteen South Carolina children in the state prison are receiving psychiatric care outside the state, Leach said in mid -March.

“I need more [beds] now before I have it, “said Leach.” It’s real. “

KHN (Kaiser Health News) is a government news agency that publishes in -depth news coverage on health issues. KHN is one of three major projects at KFF (Kaiser Family Foundation). KFF is a non -profit organization that provides information on health issues in the nation.

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