Local child services program promises intervention during crisis

Funded by Medicaid, home and community-based services (HCBS) allow for in-home treatment

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Sadly, there is no denying that tragedy has struck our community with multiple youth suicides, the latest victim to succumb an elementary-school child.

Handling mental health issues is encompassing enough as an individual, but as a parent or guardian, the responsibility for proper access can be daunting and intimidating.

Lodestar Children’s Services, a company established in 2016 to provide at-home deployment of coping skills, was started by James Regan after an epiphany moment at his current job that served youth in need.

“It was a moment of clarity for me; I knew care management programs were in need of a transformation,” said Regan. “I would spend the rest of my career regretting not making this leap into my own company because even if I fell flat, it would be on my own terms.”

Lodestar, named after the guiding star of navigation, is a home and community-based service (HCBS), which provides opportunities for Medicaid beneficiaries to receive services in their own home or community rather than institutions or other isolated settings. According to the Medicaid website, “These programs serve a variety of targeted populations groups, such as people with intellectual or developmental disabilities, physical disabilities, and/or mental illnesses.”

In 2014, 53 percent of all Medicaid long-term care spending was on HCBS, with $80.6 billion going towards HCBS and $71.2 billion on other services.

In New York, the Office for People with Developmental Disabilities (OPWDD) and HCBS waiver is a program of supports and services that enables adults and children with developmental disabilities to live in the community as an alternative to intermediate care facilities (ICFs).

Lodestar works with children and families through the NYS Office of Mental Health HCBS waiver program and Children & Family Treatment Supports & Services (CFTSS) array.

Lodestar services are provided in Suffolk, Nassau, and Queens counties, with the bulk of recipients in Suffolk.

According to Regan, one of the most distinguishing factors of Lodestar is “a culture that is zealously anti-bureaucratic. For waiver services to succeed and be meaningful, programs must start with a lean structure that allows for the most funds to go to services. This is an imperative, given the current rate structure.”

Currently, Lodestar has a team of 60 per diem staff that is due to expand, since Lodestar was recently approved to be a mental health counseling provider.

Asked how he recruits and retains his staff, Regan said, “We pay higher wages, as well as use its existing network to identify and recruit high-caliber staff. These costs are offset by lower costs in other areas, such as administrative and bricks-and-mortar costs. Lodestar also teaches and encourages people to maximize their time through development of engagement skills and emphasis on the importance of sustained and consistent intervention. All of these emphases not only result in better service, but in higher employee satisfaction than the field.”

To provide real-time support to clients, Lodestar holds evening and weekend visits at home.

“We recognize and honor the truism that more intensive services are needed in the beginning of an episode and meet this need through focused discussion with families and partner agencies towards careful tailoring of budgets, and through seeking to begin services as soon as possible, independent of enrollment dates,” said Regan.

Another important aspect of providing services for youth in crisis is having the proper demographic of staff.

“The current waiver system on Long Island does not show a true commitment to family preference. The most glaring example can be found in the lack of males performing this work (estimated at less than 10 percent), despite that the vast majority of waiver clients being male (estimated at around 67 percent) and having a preference for male workers,” said Regan.

A collective effort to intentionally focus services on accomplishing goals is achieved through the honoring of family autonomy—especially families whose kids qualify for residential facilities but who have determined a different path.

“We recognize that they need to be empowered to make their own decisions with us serving as ‘consultants,’ not ‘bosses.’ However, the recommendation for structure and intentionality should be strong and persuasive,” said Regan.

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