LINCOLN — In 2008, desperate parents leaving troubled children at Nebraska hospitals shone a national spotlight on families' struggles to get help.
But hopes that the resulting public attention would lead to better care, more services and easier access remain largely unfulfilled, according to legislative leaders and advocates for children and families.
“It's still happening that families reach crisis stage and don't know what to do,” said Dan Jackson, executive director for the Nebraska Family Support Network, an organization for Omaha-area families.
State Sen. Kathy Campbell of Lincoln, the Legislature's Health and Human Services Committee chairwoman, put it bluntly.
“We're failing some youth,” she said.
But a Nebraska Department of Health and Human Services spokeswoman said the state responded to the safe haven experience by developing new preventive services that have helped thousands of Nebraska families.
“We continue to listen to and involve families as we develop and implement programs and services,” said spokeswoman Kathie Osterman.
Before lawmakers limited the safe haven law to infants in the first month of life, 27 parents and guardians used it over the course of 10 weeks to drop off 36 children.
Most were teenagers or preteens with mental, emotional or behavioral problems.
The following year, state lawmakers passed a package of bills aimed at the desperation of the safe haven parents.
A statewide crisis hotline — the Nebraska Family Helpline — was created, with trained staff who can help callers deal with immediate issues and refer them for more help. The number is 888-866-8660.
A second program hires parents with personal experience dealing with the behavioral health system to work one on one with families trying to navigate the system.
A third program provides case managers to work with adoptive parents and guardians of former state wards.
HHS said more than 10,000 families have made more than 14,470 calls to the hotline since its inception in 2010, with nearly 70 percent reporting that the call helped their family situation. The peer navigator program has worked with more than 400 families, all of whom said they benefited.
Case managers have helped 210 families of 788 former wards. Of those youths, only three have been returned to state care.
The legislative package also expanded mental health services for children, made health coverage available to more children in low-income families and boosted support for training mental health professionals.
But Lavennia Coover, who left her 11-year-old son at a hospital in 2008 to get him help, said her family continues to struggle.
Her son, now 16, is on probation for the latest in a string of juvenile offenses. He has spent time at psychiatric hospitals, foster homes, treatment facilities and the Youth Rehabilitation and Treatment Center in Kearney.
“We have been through hell and back,” she said. “Nothing has changed since the world took notice that there are children and families out there in need of help.”
Campbell said there have been changes that are helping families first encountering the system.
But she said Nebraska still has “a ways to go” in meeting children's needs for behavioral health care.
The state also has a difficult time serving children with complex needs that don't fit neatly into one service category.
Jackson, with the Family Support Network, said parents still face the agonizing choice of making their children state wards to get them services. He and his wife did that with their children when their health insurance ran out.
He said Medicaid, behavioral health and child welfare, the three areas that pay for most services, don't always work well together.
In addition, treatment options are limited, and not enough professionals have the training to help the most troubled children. The shortages are especially acute in rural areas.
Kathy Bigsby Moore, a longtime children's advocate, said the shortages worsened because of the turmoil surrounding Nebraska's experiment in turning over major responsibility for child welfare to private contractors.
Four of the five contractors lost or dropped their contracts over 18 months, leaving many subcontracting providers with unpaid bills.
Melanie Williams-Smotherman, executive director of the Family Advocacy Movement, said families who reach out for help often run into an attitude within HHS of blaming and punishing, rather than working with parents.
But Osterman said the department listened to families when it developed new programs in the wake of the safe haven experience.
She said the department is continuing efforts to better help families and children.
One effort in the planning stages is called “differential response” or “alternative response,” which takes a less adversarial approach when families need help but are not putting children at immediate risk. As such, child welfare workers would partner with families to figure out ways to keep children safe.
HHS also is working on a plan to coordinate multiple programs and services to better serve children with serious mental health challenges and their families.