Following InvestigateWest report, Idaho approves funding for teen’s long-awaited care — but now there’s nowhere for him to go

For nearly a year, Brandon Wheeler has pleaded with Idaho’s Medicaid department to pay for expensive, life-saving care that doctors say his teenage son needs.

Two days after InvestigateWest reported on Idaho’s refusal to fund that care, the state agreed to pay.

But Wheeler’s 15-year-old son, Austin, who is being referred to by his middle name, is still without treatment.

In August, when doctors first asked the state to fund the highest level of psychiatric treatment for Austin, Idaho didn’t have a facility that could provide that care. So Wheeler scoured the country and found that Yellowstone Boys and Girls Ranch in Montana was willing to help if Idaho was willing to pay. It wasn’t at that time.

Wheeler was relieved when the state approved the funding last week. But his anxiety quickly returned when he learned that the bed in Montana was filled and Austin had nowhere to go.

“It seemed like an open and shut case,” Brandon Wheeler said. “I never thought they’d deny us when we had so many people saying, ‘This is what he needs.’ Now, we’re back to square one on finding a place for him to go.”

Each year doctors ask the state to pay for psychiatric residential treatment for about 350 Idaho youth, according to five years of state data. Fewer than one-third of those are approved, leaving 1,357 kids with the highest needs without that care since 2019, the data shows.

Juliet Charron, deputy director of Idaho Medicaid and Behavioral Health, said she did not know why Austin’s application was approved last week. Magellan Health, a Texas-based company that took over these applications on July 1 and approved Austin’s care, did not respond to questions about his treatment or about how it will assess the applications in the future.

Kim Hokanson has children with social emotional disorders, advises state leaders on how to get care to families like hers and assists other parents seeking treatment for their kids. Last year, she joined Wheeler in the fight for Austin’s care.

Hokanson credits several factors for the sudden reversal on Austin’s application: InvestigateWest’s article, a conversation she had with the Magellan’s CEO and a recent meeting where parents complained to state employees about the lack of help for kids in crisis, which all took place last week.

“This isn’t what the process should be. It shouldn’t be about who you know,” said Hokanson, who lives near Idaho Falls. “Unfortunately, I do think the public pressure being brought in (Austin’s) case made a difference. Most other families would have given up by now and then those kids go without treatment. It’s not right.”

Austin’s doctors wrote to the state last summer recommending he be placed in a facility with 24-hour psychiatric care after four visits to the emergency room in four months for violence against his family, his teachers, his counselors and himself.

“He absolutely is a threat to himself and others,” one of Austin’s mental health clinicians wrote to the state.

The state rejected the application to fund Austin’s care after a child psychiatrist who reviewed some of his medical records but never treated or spoke to Austin said it was unnecessary. The psychiatrist worked for Magellan’s predecessor, Telligen, who was contracted by the state to review those applications and make recommendations.

Charron said the state is willing to pay for necessary care, but removing children from their homes is a last resort.

Magellan took over all behavioral health services and approvals on July 1. State employees will no longer review applications like Austin’s, leaving those decisions to Magellan. A team of Magellan clinicians will review doctors’ notes and consult with the child’s clinicians to determine which requests to fund, Charron said. The state will take a compliance role and step in only if abnormalities or complaints are raised, she said.

On July 2, the day after InvestigateWest’s report was published, Wheeler reapplied for psychiatric residential treatment funding for his son. It was approved the following day.

“Nothing has changed,” Wheeler said. “We’re still dealing with the same issues as before. We’ve just spent all this time trying to get him the care he needs when he could have already been there.”

Idaho’s first psychiatric residential treatment facility, Idaho Youth Ranch, received its licensing and Medicaid certification last month and is now admitting kids. But it may not be equipped to care for Austin, Charron said. A team of state and Magellan employees and clinicians are looking into it, she said.

In addition to several behavioral health diagnoses, Austin suffers from severe childhood abuse and developmental disabilities that many treatment centers are not equipped to handle. The facility in Montana that was willing to take Austin last year is set up and staffed to care for kids like him.

Two days after Austin’s application was approved, he was kicked out of an Idaho residential facility that houses kids in the corrections system. Austin broke several chairs and attempted to punch and kick staff. It was the only facility in the state willing to take him after his most recent visit to the emergency room in May. With no other options, Wheeler brought Austin home to wait while he searches for another psychiatric residential treatment facility willing to admit his son.

Fewer than 24 hours after Austin returned home, he had assaulted Wheeler, threatened his siblings and said he was going to hurt himself.

“It’s not safe for him or for the other kids,” Wheeler said. “But what else can I do at this point?”