‘Working with us as a family’: Jefferson mom says insurers should cover behavioral health service for children

Gov. Kelly Ayotte is pushing for more private insurers to cover a state-run behavioral health service for children.

The program, FAST Forward, is covered by Medicaid, but kids on private insurance often don't have the same access to it. The New Hampshire House is voting on a bill Thursday that would change that.

NHPR's Morning Edition host Rick Ganley spoke with Andrea Brochu, a mom in Jefferson who struggled to get her private insurance to cover the program for her son.

Anthem, the largest health insurer in the state, which is opposed to the bill, said in a statement to NHPR that it is committed to ensuring that all children who need it have access to high-quality behavioral healthcare — including wraparound services, and it is committed to working with lawmakers on the issue.

Transcript

I have not heard about FAST Forward before. What is it, and what did it do for your son and your family?

I had not heard of FAST Forward either, and it was a little bit of a fluke that we even heard about it when we were in the trenches with our son. My son, back in 2023, was in a very difficult place in his life due to a lot of outside influences and failures within systems and so on.

And we had to make an incredibly difficult decision at that point in his life and our life, where we had to send him for residential treatment because we almost lost him. We sent him to a state several states away for care. It was the most difficult decision we had ever had to make, and this type of support was never mentioned until there was discussion of my son being discharged from residential care and brought back home.

Ultimately, to just answer your question, what FAST Forward provided for us was a wraparound support network that worked with us as a family. His father and I co-parented so we were no longer together. Our son would go between our homes, and they worked with us as a family. They worked with us to help us determine a vision for our family: what would peace and met needs look like versus living in a continual crisis mode? And when we made that family vision, then our wraparound support team, the FAST Forward team, worked with us, caregivers, other members of the team over almost a two year period.

It sounds to me that it's almost taking existing services and kind of presenting them all to you and telling you all about your options. These aren't necessarily services that you could not have accessed on your own, but you may not have known that existed?

Exactly. So what it did — instead of having all of these fragmented services where I as mom or his father would need to try to coordinate or have talked to each other — our family support specialist was the person who kind of took that off of my shoulders. So I was able to be Mom.

So what happened when you tried to get your son enrolled in the FAST Forward program on your private insurance?

This does not exist as a covered service on private insurance. Both his father and I had, at the time, employer-sponsored health insurance plans, and he was on his father's plan. It wasn't covered. We had to sign up and be approved for New Hampshire Medicaid for him to be able to access this program.

That was difficult. It was quite a cumbersome process. It took months. So again, it was a very difficult thing because we're transitioning our son home. We're doing everything we can to keep him healthy and safe and level at this point. And we still can't access the services we need because we have to jump through more hoops and over more hurdles to get resources that are ultimately life saving.

Medicaid is one of those social safety net programs for those who are marginalized, disadvantaged, have barriers from access to those regular insurance programs. That's where those dollars need to be going as a safety net. We had our own safety net. We were responsible people having insurance, but yet we couldn't have our services paid for by that insurance.

Anthem, one of the largest insurers in the state, told a New Hampshire Senate committee that it is covering children's behavioral health needs, just not this particular state service. Private insurers generally do cover clinical costs. This isn't technically clinical care. How would you respond to that?

Clinical mental health is one thing — to be able to sit in a room with a clinician and talk about what's going on. FAST Forward services are so much greater than that where it's not just clinical. It is working with a family. It's bringing people to the table, and ultimately they're less costly than the services that Anthem per se is covering. They'll cover clinical care.

We were able to have a portion of my son's residential treatment covered through clinical care, but ultimately, if we had been able to have access to FAST Forward before my son's mental health devolved to such a state where we had to place him in residential care, that insurance company would have saved a lot of money. And also I would have saved a lot of money because of what I had to pay out of pocket.

FAST Forward needs to be an upstream service so that youth never get to that point. That is where the private insurer, if you have it, needs to step in and provide a whole ecosystem of mental and behavioral health support.

How is your son doing now since getting these services?

Thank you so much for asking that because his father and I could not be more proud. He is doing so well. He graduated from high school early this past January, just after his 18th birthday, for many reasons — one being that he's a nontraditional learner, and he wants to work. He is just finishing up trade school. He has a conditional offer with New Hampshire [Department of Transportation] upon his completion of his CDL license. He's thriving and we would not be here if it were not for FAST Forward.

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