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18 <br />MENTAL HEALTH TASK FORCE REPORT <br />^ Exceptional Children's services for who have qualified for an IEP (Schools pay for special education <br />services from age 3 to 21 yrs; prior to three years CDSA/public health fund services for d~ildren with <br />developmental delays) <br />Funding for Support of MH/SA/DD Programs <br />^ Smart Start 0-5 year olds <br />^ Some IPRS funds (with approval from the Division) <br />^ Towns of Chapel Hill and Carrboro <br />^ Orange County <br />^ Schools <br />^ Local Foundations <br />^ Grants <br />Major Challenge <br />If over 16, a young person is handled in the adult criminal system, but is still wnsidered a child in the service <br />(care) system. <br />i8-21 AGE GROUP <br />Observations <br />There are two groups of particular concern: <br />1) Young people who have been served in the child mental health system <br />2) Young people who start to experience psychiatric symptoms in their transition years (first break of <br />psychosis, emergence of substance abuse) <br />Both of these groups may have similar development life issues that lead to ambivalence for continuing or <br />seeking treatment. These young people may be living away from home for the first time and associating with <br />peers involved with drug/alcohol abuse/use which may mask their symptoms for some time before a crisis <br />propels their entry into the system. So when these young people enter or reenter the system, their level of <br />need is quite high. Homelessness is often hidden with this group. If they are homeless, they are often <br />'couch surfing" with friends and not using homeless shelters. <br />Oasis' (http://www.psychiatry.unc.edu/oasis) experience is that those seen with first psychotic breaks are <br />70% male and 30% female. They have not been served in the public child system and very few have gone <br />through OPC to access adult services. Many have private insurance. Young people and their families are <br />trying to simultaneously understand this new potentially devastating illness at the same time they are trying <br />to work through what insurance will wver. The insured in this age group are also vulnerable to losing private <br />insurance if they leave school. <br />Challenges -Young People <br />^ Young people who have been served in the child system may disappear from the service system for some <br />time before reemerging on their own or through mandate by involvement with court system. <br />^ If a young person loses Medicaid after turning 18 yrs, the criteria for eligibility for adult IPRS services is <br />much stricter and some young people will not qualify for services. <br />^ If a young person moves beyond DSS foster care age, (s)he can maintain their Medicaid until age 21. <br />Young people aging out of foster care also have supports for higher education and some limited LINKS funds <br />to support their transition to adulthood. <br />^ Youth previously covered under parents' private insurance may become uninsurable when no longer in <br />school. <br />^ A particular challenge in the system is that if a young person has Medicaid and a service is medically <br />necessary, the mental health provider should be able to request authorization from Value Options to provide <br />16 <br />