Tag Archives: General Accounting Office

GAO report: Better oversight is needed in program for homeless children

27 Aug

Moi wrote in 3rd world America: Money changes everything: The increased rate of poverty has profound implications if this society believes that ALL children have the right to a good basic education. Moi blogs about education issues so the reader could be perplexed sometimes because moi often writes about other things like nutrition, families, and personal responsibility issues. Why? The reader might ask? Because children will have the most success in school if they are ready to learn. Ready to learn includes proper nutrition for a healthy body and the optimum situation for children is a healthy family. Many of societies’ problems would be lessened if the goal was a healthy child in a healthy family. There is a lot of economic stress in the country now because of unemployment and underemployment. Children feel the stress of their parents and they worry about how stable their family and living situation is.

This government, both parties, has failed to promote the kind of economic development AND policy which creates livable wage jobs. That is why Mc Donalds is popular for more than its dollar menu. They are hiring people.
This economy must focus on job creation and job retention and yes, hope. Both for those racing through college and those who have paid their education and training dues. “You deserve a break today at Mc Donalds,” the only employer who seems to be hiring. https://drwilda.com/2011/11/22/3rd-world-america-the-economy-affects-the-society-of-the-future/

Lauren Camera reported in the Education Week article, Better Oversight Needed of Federal Program for Homeless Students, GAO Says:

The U.S. Department of Education needs to provide better oversight of a federal program aimed at ensuring that homeless students have access to the public education system, a new Government Accountability Office report found.
The authors of the report, obtained by Education Week, listed several challenges to the Education for Homeless Children and Youth program, which provides students with transportation to and from school as well as wraparound services such as health care, counseling, and food assistance. The biggest of those include limited staff and resources, the high cost of transportation, student stigma associated with homelessness, and responding to students made homeless by natural disasters.
And while the department has protocols for monitoring the program, the report notes, it doesn’t have a plan to ensure adequate oversight in every state. In fact, it the department assessed the program in just 28 states from fiscal year 2010 to 2013, and in only three states since then….. http://blogs.edweek.org/edweek/campaign-k-12/2014/08/gao_report_ed_department_needs.html

Here are the highlights of the GAO report:

Contact:
Kay Brown
(202) 512-7215
brownke@gao.gov
Office of Public Affairs
(202) 512-4800
youngc1@gao.gov
What GAO Found
To identify and serve homeless students under the Education for Homeless Children and Youth (EHCY) program, officials in the 20 school districts where GAO conducted interviews reported conducting a range of activities to support homeless youth, but cited several challenges. With regard to GAO’s interviews, 13 of the 20 districts identified homeless students through housing surveys at enrollment, while all 20 relied on referrals from schools or service providers. However, officials in 8 of the 20 districts noted that the under-identification of homeless students was a problem. Districts GAO reviewed provided eligible students with transportation to and from school, educational services, and referrals to other service providers for support such as health care or food assistance. Among the challenges that officials in the 20 districts cited were limited staff and resources to provide services, the cost of transportation, student stigma associated with homelessness, and responding to students made homeless by natural disasters. Nationally, school districts surveyed most recently in school year 2010-11 by the Department of Education (Education) reported providing many services while facing similar challenges.
Education’s EHCY program manager and state program coordinators have collaborated with other government agencies and with private organizations by sharing information, participating in interagency councils on homelessness, and providing technical assistance to relevant staff. In addition, state EHCY program coordinators have provided training to school districts and helped connect local programs to ensure homeless students receive various services. However, federal and state officials frequently cited limited resources and differing federal definitions of homelessness as constraints to greater collaboration.
Education has protocols for monitoring state EHCY programs, but no plan to ensure adequate oversight of all states, though monitoring is a key management tool for assessing the quality of performance over time and resolving problems promptly. Prior to fiscal year 2010, it had been Education’s policy to monitor 50 states and 3 area programs at least once during a 3-year period, and it did so for fiscal years 2007 to 2009. Subsequently, the department adopted a risk-based approach in fiscal year 2010 and monitored 28 states over the next 3 years. In fiscal year 2013, Education again changed its approach to EHCY program monitoring and has monitored 3 state programs since then. Department officials cited other priorities and a lack of staff capacity as reasons for the decrease in oversight. As a result, Education lacks assurance that states are complying with program requirements. GAO found gaps in state monitoring of districts that could weaken program performance, reinforcing the importance of effective federal monitoring of states.
Declining Frequency of Federal Monitoring for EHCY Compliance since Fiscal Year 2007
Why GAO Did This Study
The McKinney-Vento Homeless Assistance Act established a grant program to help the nation’s homeless students—more than one million in school year 2011-12—have access to public education. Under the Education for Homeless Children and Youth grant program, states and their school districts are required to identify homeless children and provide them with needed services and support. In fiscal year 2014, Education received about $65 million to administer this program. Education provided formula grants to states, which competitively awarded funds to school districts to help meet program requirements. GAO was asked to review program implementation and oversight.
GAO examined (1) how districts identify and serve homeless students and challenges they face (2) how Education and states collaborate with other service providers to address student needs and any barriers, and (3) the extent to which Education monitors program compliance. GAO reviewed relevant federal laws, guidance, and reports, and analyzed Education’s state and school district survey data from school year 2010-11. GAO also interviewed federal officials, and state and local officials in 20 school districts—representing a mix of urban, suburban, and rural districts and grant status—in four states, selected for geographic diversity and other characteristics, such as experience with natural disasters.
What GAO Recommends
GAO recommends that Education develop a plan to ensure adequate oversight of the EHCY program. Education concurred with our recommendation.
For more information, contact Kay Brown at (202) 512-7215 or brownke@gao.gov.
Status Legend:

• Review Pending
• Open
• Closed – implemented
• Closed – not implemented
Recommendation for Executive Action
Recommendation: To help ensure state compliance with the McKinney-Vento Act, Education should develop a monitoring plan to ensure adequate oversight of the EHCY program. This plan could, for example, determine a schedule of states to be monitored and incorporate procedures to assess whether states need to update their state plans.
Agency Affected: Department of Education
Status: Open
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Education of Homeless Students:
Improved Program Oversight Needed
GAO-14-465: Published: Jul 31, 2014. Publicly Released: Aug 22, 2014.
• Highlights http://www.gao.gov/assets/670/665184.pdf
View Report (PDF, 65 pages)

Click to access 665185.pdf

Additional Materials:
• Podcast:
o http://www.gao.gov/multimedia/podcasts/665378

Many educators have long recognized that the impact of social class affects both education achievement and life chances after completion of education. There are two impacts from diversity, one is to broaden the life experience of the privileged and to raise the expectations of the disadvantaged. Social class matters in not only other societies, but this one as well.

A few years back, the New York Times did a series about social class in America. That series is still relevant. Janny Scott and David Leonhardt’s overview, Shadowy Lines That Still Divide http://www.nytimes.com/2005/05/15/national/class/OVERVIEW-FINAL.html?pagewanted=all&_r=0 describes the challenges faced by schools trying to overcome the disparity in education. The complete series can be found at Social Class http://www.nytimes.com/pages/national/class/

There is no magic bullet or “Holy Grail” in education. There is only what works to produce academic achievement in each population of children. That is why school choice is so important.

Related:

Hard times are disrupting families https://drwilda.com/2011/12/11/hard-times-are-disrupting-families/

3rd world America: The link between poverty and education https://drwilda.com/2011/11/20/3rd-world-america-the-link-between-poverty-and-education/

3rd world America: Money changes everything
https://drwilda.com/2012/02/11/3rd-world-america-money-changes-everything/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

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University of California, San Francisco study identifies most common reasons for children’s mental health hospitalizations

23 Mar

Moi wrote about troubled children in Schools have to deal with depressed and troubled children: Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8.
Schools are developing strategies to deal with troubled kids…. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?

According to Mary H. Sarafolean, PhD in the article, Depression In School Age Children and Adolescents

In general, depression affects a person’s physical, cognitive, emotional/affective, and motivational well-being, no matter their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.
Prevalence and Risk Factors
While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:
* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression http://www.healthyplace.com/depression/children/recognizing-symptoms-of-depression-in-teens-and-children/

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression.

How to Recognize Depression In Your Child?

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.
Signs and symptoms of depression in children include:

* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
treatment
* Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide
Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol,
especially if they are over the age of 12. http://www.onhealth.com/depression_in_children/article.htm

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Science Daily reported in the article, Study identifies most common, costly reasons for mental health hospitalizations for kids:

Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 14 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases — Kids’ Inpatient Database and Pediatric Health Information System — the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals…. http://www.sciencedaily.com/releases/2014/03/140317084531.htm

Citation:

Study identifies most common, costly reasons for mental health hospitalization

Date: March 17, 2014

Source: University of California, San Francisco

Summary:
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis. The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
Journal Reference:
1.Naomi S. Bardach, Tumaini R. Coker, Bonnie T. Zima, J. Michael Murphy, Penelope Knapp, Laura P. Richardson, Glenace Edwall, and Rita Mangione-Smith. Common and Costly Hospitalizations for Pediatric Mental Health Disorders. Pediatrics, March 2014 DOI: 10.1542/peds.2013-3165

Here is the press release from the University of San Francisco:

Study Identifies Most Common, Costly Reasons for Mental Health Hospitalizations for Kids
By Juliana Bunim on March 13, 2014
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 4 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases – Kids’ Inpatient Database and Pediatric Health Information System – the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals.
At both kinds of hospitals, the most common mental health diagnoses were similar (depression, bipolar disorder, and psychosis), which the researchers say supports the creation of diagnosis-specific quality measures for all hospitals that admit children.
Depression accounted for 44.1 percent of all pediatric primary mental health admissions, with charges of $1.33 billion dollars, based on the billing databases used in the study. Bipolar was the second most common diagnosis accounting for 18.1 percent and $702 million, followed by psychosis at 12.1 percent and $540 million.
“These are costly hospitalizations, and being hospitalized is a heavy burden for families and patients. Prevention and wellness is a huge part of the Affordable Care Act, along with controlling costs by delivering great care,” said Bardach. “This study helps us understand that mental health is a key priority. The long term goal is not only to improve hospital care for these kids, but also to understand how to effectively optimize mental health resources in the outpatient world.”
Co-authors include Tumaini Coker, MD, MBA and Bonnie Zima, MD, MPH, both of UCLA; J. Michael Murphy, EdD, Massachusetts General Hospital Boston; Penelope Knapp, MD, UC Davis; Laura Richardson, MD, MPH and Rita Mangione-Smith, MD, MPH, both of the University of Washington School of Medicine, Seattle; and Glenace Edwall, PsyD, PhD, MPP, Minnesota State Health Access Data Assistance Center.
The study was supported by the Agency for Healthcare Research and Quality and the National Institute for Children’s Health and Human Development.
UCSF Benioff Children’s Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital.

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

GAO report: Children’s mental health services are lacking
https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

Schools have to deal with depressed and troubled children:
https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

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GAO report: Children’s mental health services are lacking

12 Jan

Moi wrote about troubled children in Schools have to deal with depressed and troubled children:

Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.

As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids….

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?      

According to Mary H. Sarafolean, PhD in the article, Depression In School Age Children and Adolescents

In general, depression affects a person’s physical,  cognitive, emotional/affective, and motivational well-being, no matter  their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.

Prevalence and Risk Factors

While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk  of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:

* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression    

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression. 

How to Recognize Depression In Your Child?     

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.

Signs and symptoms of depression in children include:       

* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
treatment
* Reduced  ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or  interests

* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide        

Not all children have all of these symptoms. In fact, most will  display different symptoms at different times and in different settings.  Although some children may continue to function reasonably well in  structured environments, most kids with significant depression will  suffer a noticeable change in social activities, loss of interest in  school and poor academic performance, or a change in appearance.  Children may also begin using drugs or alcohol,
especially if they are  over the age of 12.

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Joy Resmovits reported in the article, Mental Health Care For Kids Severely Lacking, Says GAO which was posted at Huffington Post:

“Most children whose emotions or behavior, as reported by their parent or guardian, indicated a potential need for a mental health service did not receive any services within the same year,” the GAO wrote.

The report comes after Sen. Tom Harkin (D-Iowa), Rep. Rosa DeLauro (Conn.), and Rep. Lucille Roybal-Allard (Calif.) requested that the GAO look into how psychotropic drugs affect the long-term development of kids who grow up in foster care. While the report is very specific in its scope, it’s sure to be a relevant piece of evidence as the Obama administration formulates policy to deal with the ramifications of the Newtown, Conn. elementary school shooting. The shooting has sparked a nationwide debate on gun control, but it has also directed America’s attention to the state of its mental health care system.

Here are some findings:

  • On average, 6.2 percent of noninstitutionalized children in Medicaid and 4.8 percent of privately insured kids received psychotropic medications.

  • 30 percent of foster children who might have required mental health care didn’t receive them over the last year.

  • Most kids outside the foster care system whose behavior displayed red flags didn’t receive mental care services.

  • Many kids who got psychotropic medication didn’t get counseling or therapy to complete the care.

  • While the National Institutes of Health spent1.2 billion on children’s mental health care research between 2008 and 2011, most of the funding focused on research studying therapy, rather than the effects of such medication. http://www.huffingtonpost.com/joy-resmovits/mental-health-care-for-ki_b_2449205.html?utm_hp_ref=education

Here is the GAO press release:

What GAO Found

An annual average of 6.2 percent of noninstitutionalized children in Medicaid nationwide and 4.8 percent of privately insured children took one or more psychotropic medications, according to GAO’s analysis of 2007-2009 data from the Department of Health and Human Services’ (HHS) Medical Expenditure Panel Survey (MEPS). MEPS data also showed that children in Medicaid took antipsychotic medications (a type of psychotropic medication that can help some children but has a risk of serious side effects) at a relatively low rate–1.3 percent of children–but that the rate for children in Medicaid was over twice the rate for privately insured children, which was 0.5 percent. In addition, MEPS data showed that most children whose emotions or behavior, as reported by their parent or guardian, indicated a potential need for a mental health service did not receive any services within the same year. The Centers for Medicare & Medicaid Services (CMS) and many states have initiatives under way to help ensure that children receive appropriate mental health treatments. However, CMS’s ability to monitor children’s receipt of mental health services is limited because CMS does not collect information from states on whether children in Medicaid have received services for which they were referred. GAO recommended in 2011 that CMS identify options for collecting such data from state Medicaid programs. Findings in this report underscore the continued importance of CMS’s monitoring of children’s receipt of mental health services.

HHS’s Administration for Children and Families (ACF) reported that 18 percent of foster children were taking psychotropic medications at the time they were surveyed, although utilization varied widely by the child’s living arrangement. ACF also reported that 30 percent of foster children who may have needed mental health services did not receive them in the previous 12 months. HHS agencies are taking steps to promote appropriate mental health treatments for foster children, such as by sending information to states on psychotropic medication oversight practices.

HHS’s National Institutes of Health spent an estimated $1.2 billion on over 1,200 children’s mental health research projects during fiscal years 2008 through 2011. Most of the funding–$956 million–was awarded by the National Institute of Mental Health, with more research projects studying psychosocial therapies than psychotropic medications. Other HHS agencies spent about $16 million combined on children’s mental health research during this period.

HHS reviewed a draft of this report and provided technical comments, which GAO incorporated as appropriate.

Why GAO Did This Study

Experts have concerns that children with mental health conditions do not always receive appropriate treatment, including concerns about appropriate use of psychotropic medications (which affect mood, thought, or behavior) and about access to psychosocial therapies (sessions with a mental health provider). These concerns may be compounded for low-income children in Medicaid and children in foster care (most of whom are covered by Medicaid)–populations who may be at higher risk of mental health conditions. Within HHS, CMS oversees Medicaid, and ACF supports state child welfare agencies that coordinate health care for foster children.

GAO was asked to provide information on children’s mental health. This report examines (1) the use of psychotropic medications and other mental health services for children in Medicaid nationwide, and related CMS initiatives; (2) HHS information on the use of psychotropic medications and other mental health services for children in foster care nationwide, and related HHS initiatives; and (3) the amount HHS has invested in research on children’s mental health.

GAO analyzed data from HHS’s MEPS –a national household survey on use of medical services–from 2007 through 2009 for children covered by Medicaid and private insurance. GAO reviewed two recent ACF foster care reports with data from a national survey conducted during 2008 through 2011. GAO analyzed data from HHS agencies that conduct or fund research and interviewed HHS officials and children’s mental health providers, researchers, and advocates.

For more information, contact Katherine Iritani at (202) 512-7114 or iritanik@gao.gov.

Concerns Remain about Appropriate Services for Children in Medicaid and Foster Care GAO-13-15, Dec 10, 2012

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Resources:

Counselors, School Support Staff Toil Amid Scant Resources http://www.edweek.org/ew/articles/2013/01/10/16staffing.h32.html?tkn=VPLFw6EYbOz23lTzoeSKlVNGV4SNwasebCry&cmp=clp-edweek&intc=EW-QC13-EWH

About.Com’s Depression In Young Children

  1. Psych Central’s Depression In Young Children
  2. Psychiatric News’ Study Helps Pinpoint Children With Depression
  3. Family Doctor’s What Is Depression?
  4. WebMD’s Depression In Children
  5. Healthline’s Is Your Child Depressed?
  6. Medicine.Net’s Depression In Children
Where information leads to Hope. ©                 Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©                         http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©                                               http://drwildareviews.wordpress.com/

Dr. Wilda ©                                                                                    https://drwilda.com/

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GAO report: Too few families investing in ‘529 college savings plans’

15 Dec

Many families start “529 Plans” to help with college expenses. A General Accounting Office (GAO) report finds that many families are not taking advantage of “529 Plans.” Saving for College.com has some great information about “529 Plans.”

What is a 529 plan?

529 plan history

A 529 Plan is an education savings plan operated by a state or educational institution designed to help families set aside funds for future college costs. It is named after Section 529 of the Internal Revenue Code which created these types of savings plans in 1996.

State plans are OK for out of state colleges

529 Plans can be used to meet costs of qualified colleges nationwide. In most plans, your choice of school is not affected by the state your 529 savings plan is from. You can be a CA resident, invest in a VT plan and send your student to college in NC. Check to see if your institution is eligible under 529 rules.

Which states offer 529 plans?

Nearly every state now has at least one 529 plan available. It’s up to each state to decide whether it will offer a 529 plan (possibly more than one) and what it will look like, meaning 529 plans can differ from state to state. You should research the features and benefits of your plan before you invest, research state 529 plans and even compare between plans.

Tax Benefits

As long as the plan satisfies a few basic requirements, the federal tax law provides special tax benefits to you, the plan participant. See the top 7 benefits of 529 plans.

Some states (but not all) offer tax incentives to investors as well. Research your state’s tax treatment.

More on Tax Benefits

Watch Savingforcollege.com’s Chris Stack in video below (airing date March 31, 2011).

Types of 529 plans

529 plans are usually categorized as either prepaid or savings plans.

Savings Plans work much like a 401K or IRA by investing your contributions in mutual funds or similar investments. The plan will offer you several investment options from which to choose. Your account will go up or down in value based on the performance of the particular option you select.

Prepaid Plans let you pre-pay all or part of the costs of an in-state public college education. They may also be converted for use at private and out-of-state colleges. The Private College 529 Plan is a separate prepaid plan for private colleges.

Educational institutions can offer a 529 prepaid plan but not a 529 savings plan (the Private College 529 Plan is the only institution-sponsored 529 plan thus far).

Enrolling in a 529 plan

There are two ways to invest in a 529 plan.

  1. Directly with the 529 Plan manager. See a list of 529 plans.
  2. Through a financial advisor. Find an advisor in our Pro Directory. \

    Common questions

http://www.savingforcollege.com/intro_to_529s/what-is-a-529-plan.php

See, Where 529 Plans Are Failing http://online.wsj.com/article/SB10001424127887324296604578175260466428712.html

There are some good articles about whether a prepaid college plan is a good idea for your family

1. Baby Center’s Saving for College: Prepaid College Plans

2. Saving for Your Child’s Education

3. Is Your Prepaid College Plan Safe?

4. How to Use a 529 Plan to Improve College Savings

See, GAO Report: Too Few Families in U.S. Invest in 529 Plans http://www.educationnews.org/parenting/gao-report-too-few-families-in-u-s-invest-in-529-plans/

Here is the GAO summary:

What GAO Found

A small percentage of U.S. families saved in 529 plans in 2010, and those who did tended to be wealthier than others. According to the Survey of Consumer Finances (SCF), less than 3 percent of families saved in a 529 plan or Coverdell Education Savings Account (Coverdell)–a similar but less often used college savings vehicle also included in the SCF. While the economic downturn may have reduced income available for education savings, even among those families who considered saving for education a priority, fewer than 1 in 10 had a 529 plan (or Coverdell). Families with these accounts had about 25 times the median financial assets of those without. They also had about 3 times the median income and the percentage who had college degrees was about twice as high as for families without 529 plans (or Coverdells).

States offer consumers a variety of 529 plan features that, along with several other factors, can affect participation. Some of the most important features families consider when choosing a 529 plan are tax benefits, fees, and investment options, according to experts and state officials GAO interviewed. These features can vary across the state plans. For example, in July 2012, total annual asset-based fees ranged from 0 to 2.78 percent depending on the type of plan. 529 plan officials and experts GAO interviewed said participation is also affected by families’ ability to save, their awareness of 529 plans as a savings option, and the difficulty in choosing a plan given the amount of variation between plans. Selected states, however, have taken steps to address these barriers. For example, to address families’ ability to save, particularly for low-income families, some states have adopted plans that include less risky investments, have low minimum contributions, and match families’ contributions.

Savings in 529 plans affect financial aid similarly to a family’s other assets. For federal aid, a family’s assets affect how much it is expected to contribute to the cost of college. If the amount of those assets exceeds a certain threshold, then a percentage is expected to be used for college costs. For example, for students who are dependent on their parents, the percentage of parental assets, including savings in 529 plans, that the family may be expected to contribute ranges from 2.64 to 5.64 percent. Many states and selected institutions also treat 529 plan savings the same as other family assets. However, a few states provide them with special treatment, such as exempting those funds from their financial aid calculation.

Why GAO Did This Study

Paying for college is becoming more challenging, partly because of rising tuition rates. A college savings plan can be an option to help meet these costs. To encourage families to save for college, earnings from 529 plans–named after section 529 of the Internal Revenue Code–grow tax-deferred and are exempt from federal income tax when they are used for qualified higher education expenses. In fiscal year 2011, the Department of the Treasury estimated these plans represented $1.6 billion in forgone federal revenue. Managed by states, over one hundred 529 plan options were available to families nationwide as of July 2012. The number of 529 plan accounts and the amount invested in them has grown during the past decade. GAO was asked to describe (1) the percentage and characteristics of families enrolling in 529 plans, (2) plan features and other factors that affect participation in 529 plans, and (3) the extent to which savings in 529 plans affect financial aid awards. GAO analyzed government data, including the SCF. This survey’s 529 plan data are combined with Coverdells, so the SCF estimates used in the report include both 529 and Coverdell data. GAO also analyzed National Postsecondary Student Aid Study data; conducted interviews with federal and state officials, industry and academic experts, and state and institutional higher education officials; reviewed 529 plan and Department of Education documents; conducted a literature review; and reviewed relevant federal laws, regulations, and guidance.

What GAO Recommends

GAO is not making any recommendations in this report.

For more information, contact Michelle Sager, (202) 512-6806, sagerm@gao.gov .

Highlights (PDF, 1 page)

Jenny L. Phipps of Bankrate.com offers additional suggestions in Cutting the Cost of College Incidentals:

18 ways to cut the cost of college incidentals

 

1.

 Read the bill carefully.

2.

 Don’t get caught in a feeing frenzy.

3.

 Beware too much health care.

4.

 Go on a dorm-dining diet.

5.

 Pay on time.

6.

 Know the financial aid bottom line.

7.

 Vet the class schedule.

8.

 Look for ways to get ahead.

9.

 Consider cheaper alternatives.
10. Transfer advance-placement credits.
11. Buy smart.
12. Decorate creatively.
13. Forget the phone.
14. Eat at home.
15. Buy used books.
16. Look for cheap travel.
17. Devise a money delivery system.
18. Be sure the price is worth it.

http://www.bankrate.com/brm/news/college/cfguide/misc-costs1.asp

Congratulations on your acceptance into college. Now the real work begins.

Related:

Five Ways to Cut the Cost of College                                     http://www.cnbc.com/id/41626500/Five_Ways_to_Cut_the_Cost_of_College

Secrets to paying for college                                          http://money.cnn.com/2012/03/27/pf/college/tuition-costs.moneymag/index.htm

Where information leads to Hope. ©                     Dr. Wilda.com

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For-profit colleges: Money buys government, not quality for students

12 Dec

For-profit education institutions are problematic. There is an inherent possible conflict. The goal of an education institution should be to provide a quality education for those who attend. The goal of a for-profit institution is to provide a return to its shareholders or owners. The conflict is when the profit motive is supreme to providing a quality education. The General Accounting Office (GAO) has a report which details just how far from bargains some for-profit schools are. According to the article, GAO: 15 For-profit Colleges Used Deceptive Recruiting Tactics written by Daniel de Vise and Paul Kane some for-profit schools used deceptive practices to recruit students.

The GAO summarized their findings:

Undercover tests at 15 for-profit colleges found that 4 colleges encouraged fraudulent practices and that all 15 made deceptive or otherwise questionable statements to GAO’s  undercover applicants. Four undercover applicants were encouraged by college personnel to falsify their financial aid forms to qualify for federal aid–for example, one admissions representative told an applicant to fraudulently remove $250,000 in savings. Other college representatives exaggerated undercover applicants’ potential salary after graduation and failed to provide clear information about the college’s program duration, costs, or graduation rate despite federal regulations requiring them to do so. For example, staff commonly told GAO’s applicants they would attend classes for 12 months a year, but stated the annual cost of attendance for 9 months of classes, misleading applicants about the total cost of tuition. Admissions staff used other deceptive practices, such as pressuring applicants to sign a contract for enrollment before allowing them to speak to a financial advisor about program cost and financing options. However, in some instances, undercover applicants were provided accurate and helpful information by college personnel, such as not to borrow more money than necessary. In addition, GAO’s four fictitious prospective students received numerous, repetitive calls from for-profit colleges attempting to recruit the students when they registered with Web sites designed to link for-profit colleges with prospective students. Once registered, GAO’s  prospective students began receiving calls within 5 minutes. One fictitious prospective student received more than 180 phone calls in a month. Calls were received at all hours of the day, as late as 11 p.m. To see video clips of undercover applications and to hear voicemail messages from for-profit college recruiters, see http://www.gao.gov/products/GAO-10-948T. Programs at the for-profit colleges GAO tested cost substantially more for associate’s degrees and certificates than comparable degrees and certificates at public colleges nearby. A student interested in a massage therapy certificate costing $14,000 at a for-profit college was told that the program was a good value. However the same certificate from a local community college cost $520. Costs at private nonprofit colleges were more comparable when similar degrees were offered.

http://www.gao.gov/products/GAO-10-948T

Eric Lichtblau’s New York Times article, With Lobbying Blitz, For-Profit Colleges Diluted New Rules  is yet another example of we have the government money has bought, not the best government money could buy.

Last year, the Obama administration vowed to stop for-profit colleges from luring students with false promises. In an opening volley that shook the $30 billion industry, officials proposed new restrictions to cut off the huge flow of federal aid to unfit programs.

But after a ferocious response that administration officials called one of the most intense they had seen, the Education Department produced a much-weakened final plan that almost certainly will have far less impact as it goes into effect next year.

The story of how the for-profit colleges survived the threat of a major federal crackdown offers a case study in Washington power brokering. Rattled by the administration’s tough talk, the colleges spent more than $16 million on an all-star list of prominent figures, particularly Democrats with close ties to the White House, to plot strategy, mend their battered image and plead their case.

Anita Dunn, a close friend of President Obama and his former White House communications director, worked with Kaplan University, one of the embattled school networks. Jamie Rubin, a major fund-raising bundler for the president’s re-election campaign, met with administration officials about ATI, a college network based in Dallas, in which Mr. Rubin’s private-equity firm has a stake.

A who’s who of Democratic lobbyists — including Richard A. Gephardt, the former House majority leader; John Breaux, the former Louisiana senator; and Tony Podesta, whose brother, John, ran Mr. Obama’s transition team — were hired to buttonhole officials.

And politically well-connected investors, including Donald E. Graham, chief executive of the Washington Post Company, which owns Kaplan, and John Sperling, founder of the University of Phoenix and a longtime friend of the House minority leader, Nancy Pelosi, made impassioned appeals.

In all, industry advocates met more than two dozen times with White House and Education Department officials, including senior officials like Education Secretary Arne Duncan, records show, even as Mr. Obama has vowed to reduce the “outsize” influence of lobbyists and special interests in Washington.

http://www.nytimes.com/2011/12/10/us/politics/for-profit-college-rules-scaled-back-after-lobbying.html?emc=eta1

SHAME on the weasels who caved.  The reasons for the attempt to regulate for-profit colleges were detailed by Tamar Lewin in the New York Times article, For-Profit College Group Is Sued As U.S. Lays Out Wide Fraud

Before signing-up for any course of study, people must investigate the claims of the institution of higher learning regarding graduation rates and placement after completion of the degree. The U.S. Department of Education has an accreditation database and you can always check with the department of education for your state. Back to College has a good explanation of College Accreditation: Frequently Asked Questions

Too bad, we have the government which money has bought, not the best government money could buy.

Citation:

For-Profit Colleges: Undercover Testing Finds Colleges Encouraged Fraud and Engaged in Deceptive and Questionable Marketing Practices

GAO-10-948T August 4, 2010

Highlights Page (PDF)   Full Report (PDF, 30 pages)   Accessible Text   Video

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