Insider’s Guide: How to Pay for Therapeutic Boarding School (2017 UPDATE)

Before we dive into understanding the options for paying for a Therapeutic Boarding School, let’s quickly review what they are.

The Rise of Therapeutic Boarding Schools

Image result for boarding schoolAs public schools across the country have slowly been pruned back by state legislatures, funding for behavioral, emotional and academic support within schools have nearly dried up while public money is increasingly being used for private charter schools. Therefore, it’s not surprising private institutions that offer therapeutic (or quasi-therapeutic) environments like boarding schools and private schools have exploded. One of the fastest growing kinds of boarding schools is what’s called a Therapeutic Boarding School. Therapeutic boarding schools maintain the advantages of traditional boarding schools such as intimate class sizes, individual attention, great academics, developing student self-reliance, and the fun of living with peers in a completely “child-friendly” environment.

Some therapeutic boarding schools specialize in helping teens overcome certain psychological problems such as Attention Deficit Disorder, Bipolar, Asperger’s and even Depression. Others have programs for overcoming substance abuse problems or achieving weight loss. Some specialize in helping students who lack motivation get a fresh start in a nurturing environment. Most have some sort of family or parent involvement piece to ensure a team approach (ie. Weekly family therapy via phone or Skype).

While this all may sound great, there are definitely some risks and downsides (beyond the financial cost) of sending a kiddo off to therapeutic boarding school. I address those issues in great detail in another blog post. For now, let’s revisit the financial aspects…

Expense or Investment?

Parents often find themselves in a desperate situation with a troubled teenager. Their daughter runs away from home again, gets caught with the dealer down the street, crashes another car, and has yet another arrest. Parents become afraid for their teen’s lives as their teen’s risk-taking and lifestyle keeps becoming more extreme as the parents’ ability to set boundaries and expectations seemingly erodes.

It’s hard to think clearly and find solutions at times like this. Therapeutic boarding schools and therapeutic wilderness programs can provide answers, but they come at a price, with some programs running upwards of $50,000 a year.

But cost doesn’t have to be an insurmountable obstacle in getting your teen the help they need. We have helped countless parents in similar situations come up with creative ways to finance therapeutic boarding school, knowing that their child desperately needs an intervention. Therapeutic boarding schools are no longer exclusively the domain of the wealthy.

Top 10 Ways to Pay for Therapeutic Boarding School

Image result for therapeutic boarding school

Here are 10 ways families just like yours found to finance their teen’s therapeutic program:

1.   Hire a Consultant: Say what? More money? Yes, but trust me, this really will have super high ROI. Also referred to as case managers, therapeutic placement consultants or educational consultants, a good one is worth their weight in gold (a bad one is expensive and makes bad treatment recommendations). Make sure they are UNAFFILIATED with any program and have the clinical expertise to help advise and guide your family through the whole process. Some clinical educational consultants that specialize are able to handle this. A great case manager will be able to create a treatment plan, explain the process for getting a comprehensive psychological evaluation, walk with you through the intake process, support you while your teen is in the therapeutic boarding school, and coordinate discharge planning to ensure a seamless transition back to home or college. The last piece is essential – making sure your teen has everything they need to succeed after they return. Great case managers also know how to secure reimbursement from insurance providers for teens that attend therapeutic boarding schools. There are definitely some tricks (eg. Hire a case manager that’s also a licensed professional counselor and much of their work could be paid for by insurance) and inside knowledge necessary to make this happen.

Typical cost: $95 – 350/hr (some charge a flat fee of several thousand). 

2. Find the Program’s Financial Aid Officer: The private school or wilderness program should have a financial aid officer who can advise you about how to finance your child’s education. You should ask this person what programs, loans, discounts, or financial aid the school offers. Find out exactly what is included in the tuition and board bills, and if there are additional expenses such as buying uniforms or paying special fees for sports.

Typical Cost: Nothing – programs provide this to try to entice you into signing up. Beware of anything that sounds too good to be true – verify any claims they make about coverage from insurance, student grants/scholarships or loans. 

3.  Public School Funding: You may qualify for a loan through a kindergarten through 12th grade educational loan program. These loans work the same way as college loans, in that you pay what you can while your child is enrolled in the private school, and pay the rest off later. The terms of some loans let you spread out payments over 10 or 20 years. Your credit history will be a factor in securing a loan. Your school’s financial aid officer should be able to help you find such a loan.

Typical Cost: Your sanity – they will drive you crazy with the bureaucracy and take loads of time during your work day since everything in public school shuts down by 3:30pm. 

4.  Discounts for Upfront Payment: Some schools offer discounts if you pay by the year, instead of by the month. The average student stays at a therapeutic boarding school for less than two years, and wilderness programs are even shorter. A good therapeutic placement consultant/educational consultant will save you thousands of dollars by negotiating these discounts.

Typical Cost: More money upfront but no other associated costs. 

5. Tap 529: Consider using your child’s college fund first. Think of the therapeutic program as a way to get your child back on the right path toward college. Without intervention, she won’t have the grades or motivation to get through college and use her fund.

Typical Cost: Make sure there are no withdrawal penalties for use for therapeutic boarding school. 

6. Put it On Plastic: When you enroll your child in these therapeutic programs, there will be upfront expenses such as processing fees and deposits. Some parents borrow these initial payments from credit cards, especially ones that offer “frequent flier” miles. This way their child is immediately enrolled. They use their free mileage for transportation to and from the school.

Typical Cost: Beware of high interest rates if you don’t pay off your balance in full. 

7. Angel Investing: Some parents borrow the necessary funds from employers or relatives, and pay them back after securing educational loans or home equity loans.

Typical Cost: If you go through a peer-to-peer or crowdfunding site like The Lending Club or Kickstarter, count on a 5% fee for total amount funded. 

8. Health Insurance Reimbursement: Your health insurance policy may cover part of the cost of a therapeutic program as a medical expense. When you hire a case manager, they will be able to tell you how to file the paperwork and what you need from the program to ensure a speedy reimbursement.

Typical Cost: Sanity… totally lost if your insurer are jerks that don’t reimburse when and how they should. You are attempting to pull money from their cold, dead hands. Expect a fight.

9. Consult Your CPA: Some expenses for therapeutic schools and wilderness programs can be deducted from your income tax return as medical expenses. If you own your own business, you likely have WAY more creative options for deducting medical expenses.

Typical Cost: $200/hr for a good CPA to walk you through if and how to deduct from taxes.

10. Tap Home Equity: Parents have taken out second mortgages or home equity loans and then deducted their interest payments on their income tax returns.

Typical Cost: Fees, closing costs total 2-6%. It also bumps the timeframe for paying off that home back several years.

11. Public School Funding: We lied – there turns out to be 11 ways to pay for therapeutic boarding school. Is your child enrolled in public special education classes because of problems like attention deficit disorder and learning disabilities? Does your child have an “Individual Education Plan” at a public school? Do you suspect your child has learning problems that the public school cannot address? In certain cases, public school districts have to reimburse parents for private school tuitions. The Supreme Court ruled on June 22, 2009, that an Oregon school district had to reimburse a family for private school costs because the child in question could not achieve a free and appropriate education within the district. The child had not been enrolled in special education classes but was diagnosed later with attention deficit disorder.

When it comes to what matters most parents are unstoppable in finding ways to get the services and support they need. Don’t let cost be the determining factor. If your teen needs help, speak with a case manager, your trusted CPA as well as a therapeutic boarding school you’re considering and work together to find a way to get your teen back on track.

Getting Insurance to Pay for Residential Treatment

imagesSince paying for therapeutic treatments like residential treatment, intensive outpatient program and therapeutic boarding school with insurance is a big topic we’ve broken this into a few different posts. Today, we’re starting with the basics of the health care act that tightens up the requirements for insurers. Historically, insurance paid for outpatient services and residential treatment was only for more affluent families. But thanks to the mental health parity act, insurers are not more responsible than ever for paying for higher levels of care. 

What’s the Mental Health Parity Act?

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires many insurance plans that cover mental health or substance use disorders to pay for coverage for those services that are no more restrictive than the coverage for medical/surgical conditions. Basically, if they pay for medical stuff, they have to pay for mental health and substance abuse stuff – that’s the ‘parity’ part. 

What Does it Cover?

  • Copays, coinsurance, and out-of-pocket maximums
  • Limitations on services utilization, such as limits on the number of inpatient days or outpatient visits covered
  • Coverage for out-of-network providers
  • Criteria for medical necessity determinations

MHPAEA does not require insurance plans to offer coverage for mental illnesses or substance use disorders in general, or for any specific mental illness or substance use disorder. It also does not require plans to offer coverage for specific treatments or services for mental illness and substance use disorders. However, coverage that insurance plans do offer for mental and substance use disorders must be provided at parity (the same) with coverage for medical/surgical health conditions.

The original MHPAEA was enacted in October of 2008. The main purpose of MHPAEA was to fill the loopholes left by the previous Mental Health Parity Act was legislation signed into law on September 26, 1996 that requires that annual or lifetime dollar limits on mental health benefits be no lower than any such dollar limits for medical benefits offered by a group health plan.

What if My Plan is Not in Compliance?

Before escalating things and contacting state or federal officials, contact Fonthill to see how to ‘encourage’ the insurers to provide appropriate coverage (look for future blog posts on how to communicate and educate your insurers for coverage). If you still have concerns about your plan’s compliance with MHPAEA, you can contact the Feds or your State Department of Insurance. You can contact the Department of Labor at 1-866-444-3272 or http://www.dol.gov/ebsa/contactEBSA/consumerassistance.html. You can also contact the Department of HHS at 1-877-267-2323 ext 61565 or at phig@cms.hhs.gov or your State Department of Insurance at http://naic.org/.

Check back next time when we explore some tricks to getting insurance to pay for treatment – it’s what the insurance companies don’t want you to know. 

 

 

FREE Parent Support Group: Residential Treatment and Higher Levels of Care

If you are a parent who wants to learn more about residential treatment for your teen or young adult child, our Parent Support Group is for you. This group is specially designed for Parents of Teens and Young Adult Children either in residential treatment or in need of residential treatment. Whether you have an acting out teen obsessed with gaming or a daughter exhibiting what seems like an eating disorder, residential treatment may be an option. But how do you choose? How do you know the good ones from the bad? We will walk you through the basics of the therapeutic program world through a discussion format. 

Topics will range from residential and treatment options, how to creatively pay for programs and use insurance, myths vs reality of treatment, parenting advice and skill building, and finally, sharing and venting. This is also an open forum to address any other problems related to acting out teens/adults – you’re not alone. 

WHEN

Mondays 7:00pm Starting September 8

WHERE

Fonthill Counseling Conference Room – 141 Providence Rd Suite 160 Chapel Hill NC 27514

COST

Free

FACILITATOR

Licensed therapist with expertise in residential treatment, counseling and parenting education will lead didactic, interactive and experiential sessions.  

RSVP

Due to limited seating, preregistration is required. Please email us at help@fonthillcounseling for sign-up instructions. 

Treatment 101: Therapeutic Boarding Schools and Residential Treatment Centers

Today we examine some of the basic differences and similarities between therapeutic boarding schools and residential treatment centers (or programs).

 

THERAPEUTIC BOARDING SCHOOLS

Also known as Emotional Growth Boarding School (not used so much any more), is a boarding school based on the therapeutic community model that offers an educational program together with specialized structure and supervision for students with psychological, behavioral, substance abuse, or learning difficulties. Another newer term is Academy which lends some gravitas and impressions of legacy. Basically, it sounds fancier. 

In contrast with Residential Treatment Centers, which are more clinically focused and primarily provide Behavior therapy and treatment for adolescents with serious issues, the focus of a TBS is toward emotional and academic realignment involving clinical and academic oversight for physical, emotional, behavioral, family, social, intellectual and academic development. Therapeutic and educational approaches vary greatly; with the approaches best described as a combination of interventions often based on the founders’ perspective. The typical duration of student enrollment in a TBS range from one to two years with many schools mandating a minimum stay of at least 1 year. Students may receive either high school diplomas or credits for transfer to other secondary schools. Some therapeutic boarding schools hold educational accreditation within their respective states. TBS’s may be for-profit or non-profit entities and might also be owned by a much larger company (eg. Aspen Education Group, Red Cliff Ascent, Universal Health Services to name a few). 

Therapeutic boarding schools are generally middle schools and high schools that have comprehensive therapeutic interventions (medication management, individual/group counseling, life skills) for the students and a program to help them with self-esteem and problem behaviors. Some are more therapeutic than others while some boarding schools are actually therapeutic but will not list themselves in that category to avoid any negative connotation. 

Most of the therapeutic boarding schools do not have a medical plan for bipolar disorder, and do not provide psychiatrists on staff. If you want your child to attend a therapeutic boarding school he or she needs to be stable enough to attend school with therapy support (typically includes individual counseling 1-2x/wk, group counseling 1-2x/wk and 1 weekly phone conference with parents/therapist), while maintaining a relationship with an outside psychiatrist. Additionally, some schools do not wish to administer psychotropic meds. Ask the admissions folks if this is something important for you. 

 

RESIDENTIAL TREATMENT CENTERS

Sometimes the school that best meets the child’s needs just doesn’t exist anywhere near home, or the child may become too unstable to stay at home and attend school. It may become painfully obvious that a change in environment with a twenty-four-hour peer group and non-parental authority figures may help the child grow and mature in a safe environment. Maybe they are a danger to themselves or others and they need to be in a setting that can monitor their illness and behavior, as well as provide them with tools to understand and deal with their illness while not losing ground in school.

Residential Treatment Centers (RTCs) are medical facilities (most of the time). They should have psychiatrists and nurses on staff. They administer medications, make medication adjustments, and provide therapy and schooling. They are required to follow a student’s IEP.

Residential schools can cost anywhere from $56,000 to over $125,00 per year. A school district may pay part or most of the fee of such a placement, but typically only after a due process hearing. This process is not recommended for parents – Definitely bring in professional support for this (yes, a case manager or educational consultant with expertise in IEP/504 process and laws within your state). 

If you have not noticed the theme, here it is – Parents should ask for help from a clinical case manager or educational consultant. While the vetting and application may seem like an easy project for accomplished parents, the timing, financial and clinical complexities can create significant challenges. The case manager should have any professionals working with your child contribute to the discussion on placement strategies and options. Leave this to the professionals. It costs money on the front end but will save you thousands of dollars over months and years and also help you to understand your child, family and the education/psychological process much better. 

Here are some additional resources:

Fonthill Response to Vice Article: AMERICAN TEENS ARE BEING TRAPPED IN ABUSIVE ‘DRUG REHAB CENTRES’

To those outside our field of therapeutic schools and programs, it makes sense that Matt Shea‘s article from May 2013 in Vice titled American Teens are Being Trapped in ‘Abusive Drug Rehab Centres’ is alarming.

To those of us in the field it’s a joke. You can read the whole article here: http://goo.gl/zW43F and judge for yourself. It’s a joke not because it’s inaccurate and not because there are no failures within the industry. It’s a joke because, just like so many other ‘journalists’ he paints a picture with such broad strokes that Mr. Shea fails to really understand the pressures, the people and, as cliche as it may sound, the passion with which so many in this field work. Mr. Shea fails to sort out the fiction from fact.

But how else can a budding journalist get retweeted and get his name out there without this version of quicky-journalism? Had Mr. Shea visited programs like many of us in the mental health and educational consulting world do, he would quickly meet and have experiences  which deepen his 2 dimensional paradigm. He would have been driven out into the remote and hot Utah desert to meet with small groups of teens guided by thoughtful and well-trained staff working on individual enrichment projects. He would leave thankful he never had to endure a Spring or Summer like they do yet, somehow, understands that this programming is providing a level of nurturing and structure significantly lacking in their home lives.

Let’s address the reference and correlation Mr. Shea makes between the therapeutic industry and Josh Shipp of MTV fame. Let’s revisit part of Mr. Shea’s article now…

Shipp is your classic Jerry Springer brand of therapist – no real qualifications, a huge ego and a penchant for money and entertaining TV over science and genuine psychology. “I’m a teen behaviour specialist,” he says in the intro. “My approach is gritty, gutsy and in your face.”

If he had actually spent time with Josh Shipp AND real mental/behavioral health and substance abuse professionals – he would very quickly understand that Mr. Shipp (…Mr. is used loosely here) does not represent the values of folks in this industry, an industry that is run by licensed clinicians and professionals. Mr. Shipp is nothing more than a court jester providing entertainment. He’s a monkey with two cymbals making noise and no signal for his ‘edgy’ reality-TV pushers at MTV (MTV is still around?). Occasionally, I’m sure there are teens and even parents (and maybe the rare delusion clinician) that hear the Shipp-Clown-message and it connects with them – changing their lives forever. But an overwhelming majority spend no more energy than a giggle or slight frown. Mr. Shipp does not have a degree, license or any sort of evidence-based training. He graduated from “Life Experience College” which sounds ‘super cool’ to the teens and teen parents he markets his wares to but there is no depth. He’s a can of soda full of empty calories. The therapeutic industry and Mr. Shipp are as polar-opposite as a Kardashian and Bill Moyers. And yes, we recognize as cold as it may sound, it’s an industry.  Just like cancer treatment, just like teaching, and just like daycare. If it were not an industry and did not have the same oversight as other industries, there would be little oversight. Trust me, you want therapy to be part of an industry. Industrialization provides codes of conduct, ethical guidelines, evidence-based treatment standards, inter-disciplinary work and research. NATSAP is an example of this type of self-imposed quality control.

FYI – Therapeutic wilderness programs are not boot camps. Therapeutic boarding schools are not military schools. There may have been some greedy, old-school meat-heads that sold parents on boot camps decades ago, but in the therapeutic world, those non-clinical programs as a laughable as Josh Shipp which may be why he talks about them in his MTV show. Boot camps and military schools are dying out and, thankfully, being replaced by sophisticated, evidence-based programs with transparency and clinical integrity. Not every program is awesome but, neither is every physician or dentist.

Mr. Shea, I make a challenge to you. Join me on a tour to visit 5 therapeutic programs. Together, you and I will kick the tires, dig through the closets and truly get to the bottom of whether this universe of programs is as detrimental as you propose. We’ll spend 2 days out in the back-country, in storage rooms with gear, and circled up in treatment centers. After that, I challenge you to write the same article blasting this world that has helped so many families. Not likely to happen.

Services: Concierge Service as Compliment to After-Care

In 2012, Fonthill took an unprecedented step beyond the traditional case management, beyond after-care and beyond educational consulting model to meet the complex needs of our client families around the country. After gathering feedback from professionals, clients and colleagues, Fonthill’s launched an exclusive Concierge Service as part of our Case Management package. Here is a list of our updated current offerings which is still a work in progress. We’d love your feedback on what you think is missing and what your experience has been with services like this.

Coordinating Safety/Security Measures: Scheduling and overseeing alarm installation, security company/consultation for home or travel

Obtaining Tickets: Concerts, special events and sporting events

Coordinating Transportation Services: Planning all aspects of travel to and from home, school or work

Travel and Vacation Planning: Planning all aspects of recreational travel and vacation planning

Restaurant Recommendations and Reservations: Providing specific recommendations and reservations

Pet Services: In-home pet care during school, work or anytime support is required

Personalized Shopping and Delivery: Extra set of hands or full pick up and delivery from grocery stores, local mall or delivery center like UPS or USPS

Dry Cleaning Pick-up and Delivery: One item or Ten, we’ll drop off and pick up at the dry cleaner of your choice or ours if requested

Modified House Sitting: Waiting for repair person to show? Waiting for a delivery? We’ll be there when you can not

Gift Pick Up or Return: Finding the perfect gift at the last minute or returning something to the store

Meal Delivery: Hate the idea of some random pizza delivery person? We’ll go and pick up any meal for you

Bill Paying: We will help set up or drop off payments for any bill

Auto Care: We will schedule the maintenance, drop it off and pick it up

Home Organization and Cleaning: No time for cleaning? We will coordinate with dependable cleaning service to keep your place beautiful

Prescription Pick Up: Discrete medication pick-up for both over the counter and prescription

Repair and Service Calls: Not sure who to call when something goes wrong? We’ll set up any home repairs

Sick Care: Any errands that you need while you are sick in bed

Personal Chef: Take-out got you down? No time or interest in cooking? We’ll bring in a personal chef for healthy, quality meals

Landscaping: We will set up landscape services and ensure regular service to keep your yard looking lovely, leaf removal in the Fall, snow/Ice removal in the Winter

Charter a Private Jet, Yachts or Helicopter: Want a special travel experience? We’ll charter a private jet, yacht or helicopter

Fashion and Stylist Consultant: When you need help finding your style we’ll call in the expert stylists for fashion, make-up and professional identity

Tee Time: We’ll set up tee time for you and friends at the local course and make sure everything is set for a great day on the links

Moving Assistance: We’ll pack/unpack your boxes and put it all away before you step foot in your new home

We’ve had fantastic response to these additional services which allow parents to feel confident their adult children stepping down from treatment into a transition program or independent apartment or dorm room is completed supported. From a clinical perspective, our concierge service started some interesting discussions among therapists and counselors about where the lines are and how we define ‘comprehensive care’ within the substance abuse, mental health and behavioral health world.