photo courtesy veronica flanders

Thirteen-year-old José Flanders has been hospitalized 40 times since he was 8. High Meadows is the only place his mother says she’s seen him improve.

Thirteen-year-old José Flanders has problems. He has autism, mild retardation, developmental disabilities, psychosis and a thyroid problem caused by his many medications.

Since turning 8, he's been hospitalized nearly 40 times.

For nearly a year, José has lived at High Meadows, a state-run residential treatment facility in Hamden for boys whose medical, psychological and behavioral needs are so complex other private facilities refuse to take them.

His mother, Veronica Flanders, says it's the only place she's seen him improve.

Now the state wants it closed.

After José and his twin brother were born, his mother noticed José was different. At three months, he didn't respond to loud noises, and Flanders worried her son was deaf. He didn't talk until he was 4. Things like holiday decorations frightened him. During school, his teachers would call to say he's hiding under the sink or crying in a closet.

José was hospitalized a dozen times at Yale-New Haven Hospital's child psychiatric unit and more than a dozen times at Saint Raphael's Hospital, says his mom.

He's been to private treatment centers across the state. Twice he was admitted to Riverview, the state psychiatric children's hospital in Middletown.

José's illnesses, doctor's appointments and constant calls from school have cost his mother jobs.

High Meadows, she thought, was the answer.

Then came Gov. M. Jodi Rell's February budget proposal. It eliminated funding for High Meadows. The facility closed admissions and started pushing kids out. The center has beds for 43 boys. Only 12 are left.

After the longest budget battle in state history, Democrats restored funding last month for High Meadows. Even so, Rell and Susan Hamilton, head of the Department of Children and Families, are moving to shut down High Meadows. (Attorney General Richard Blumenthal is investigating the legality of such a move.)

The attempt might be seen as a Republican governor bulldozing a Democratic-led legislature. It might also be seen as evidence of mismanagement by DCF.

Either way, one thing's for sure. Those who must live with the effects of political wrangling and bureaucratic gamesmanship are not politicians or bureaucrats.

They're sick kids.

How hard is life for José?

Consider this event during a recent visit home to see his mother: They were out and about when a man made an offensive remark about José. José became so distraught that he laid down, sobbing, in the middle of the street.

"He was so upset I took him to the ER," Flanders says.

Back at High Meadows, the staff helped José to realize how dangerous it is to lie in the road.

"They have not given up on my child," Flanders says. Other residential facilities, Flanders says, have been so frustrated by José that they made her come and pick him up early. Flanders has heard from some of those same places now that High Meadows is trying to discharge José: They told her they won't accept José again.

Commissioner Hamilton is making the case that community-based treatment centers, like the ones that don't want to deal with José, are better suited to care for Connecticut's sick kids. She says it's better for kids to be at home with parents and receive care in the community instead of being in a state-run facility.

Parents, staff and advocates for these kids say that's true in most cases, but they argue that High Meadows kids need more intensive care.

Rep. Elizabeth Esty (D-Cheshire), a member of the Public Health Committee, says the notion that nonprofit facilities will take care of these kids is mistaken.

"Quite the contrary, when private placements can't take them and when out-of-state placements reject them, High Meadows is where these boys go."

José's fate is now in the hands of the Office of Health Care Access, which is run by Rell appointees. Because Rell stocked OHCA, High Meadows staffers worry she'll get what she wants.

Hamilton asked for and received an expedited hearing on the closing of High Meadows. At that hearing, held Sept. 18 at the Capitol, she explained why it should be closed (see sidebar). But before OHCA could come to any conclusion, a representative from High Meadows' two unions asked that the hearing be rescheduled, because there was insufficient time to request "intervener" status, which would give staffers' testimony additional legal weight.

The request was granted, and the hearing has been rescheduled for Oct. 23.

OHCA is supposed to base decisions on whether to close health-care facilities on need. Does it function, for instance, in the absence of some other service?

Hamilton, however, has repeatedly asserted cost as one of the main reasons to close High Meadows for good.

In a July 28 letter to her staff, she wrote:

"All agencies are continuing to face increasingly difficult fiscal constraints that necessitate the closure ... of certain programs. I am writing to inform you that the Department must move to close High Meadows."

Hamilton continued to address cost in testimony before OHCA until Christine Vogel, that agency's commissioner, reminded Hamilton of OHCA's mandated parameters.

"OCHA does not make decisions based on the budget, rather based on need," Vogel said. "Obviously, [cost] is a factor, but let me ask you ... with or without this budget, would DCF have done this?"

"Clearly this decision is driven by the reduction in need," Hamilton said.

Hamilton says the need for state-run residential treatment centers in Connecticut has fallen by more than 40 percent in the past few years, because of new community-based treatment centers run by nonprofits.

Jeanne Milstein, Connecticut's child advocate, agrees that sending kids with terrible psychological and behavioral problems to community-based treatment centers is ideal. If that were the case here, she says, that would be fine and dandy.

Problem is, it's not.

"Most of these kids aren't going to community-based treatment centers," Milstein says. "They're going to another huge DCF facility."

Milstein has reviewed discharge plans for the remaining boys at High Meadows, and for those already transferred. Some are good, she says; others she calls "worrisome."

But where kids are placed, she says, is less important to her than why.

"Is it the right place for the child?," she says. "Or [is DCF] moving them out because there's a desperate need to get them out [of High Meadows]?

"Children are not chess pieces."

Juan Reyes is one of the 12 chess pieces. Two weeks ago, DCF informed his mother, Martha Reyes, that he was being transferred out of High Meadows to a DCF facility in East Windsor. She had two days' notice.

"No one consulted me," she says. "No one called me. No one said, 'Martha this is the plan, how do you feel?'"

She felt it was a bad idea to unnecessarily uproot her son, so she said no.

Juan, 15, has obsessive-compulsive disorder and bipolar disorder. He's paranoid and he soils himself, because he's afraid of going to the bathroom.

Reyes credits High Meadows with helping her son to stop "having accidents." He's been doing very well at High Meadows, she says.

But now, Reyes says DCF is using "scare tactics" on her. A few days after she said no, DCF staff told her Juan may be sent out of state if she didn't agree to the East Windsor transfer.

"The fear of that alone just drives me nuts," she says in tears. She gave in to the pressure.

When Juan moves to East Windsor next week, only 11 boys will remain at High Meadows.

Normally at High Meadows, transfer options are discussed. Parents have time to think and children have a say. Not anymore. DCF is even going around High Meadows staff.

"We're being left out of it," a high-level staff member says, who asked for anonymity out of fear for his job. "It's callous and impulsive."

Staff worry DCF is rushing to transfer as many kids as possible before next week's hearing, making High Meadows' closure inevitable.

Many others are outraged by what Rell and DCF are doing.

A veteran nurse at Riverview, Connecticut's psychiatric hospital for children, fumes over what's happened to kids there. Instead of going to High Meadows, some are being shipped out of state. Others ready for less intensive care are languishing because there's nowhere else for them to go.

"[DCF] told us we could only send kids to High Meadows if they would be ready to leave there by September or October," says the nurse, who requested anonymity for fear of retaliation.

"They set those parameters so they can close [High Meadows]."

But Gary Kleeblat, DCF spokesman, claims Riverview patients don't usually go to High Meadows.

"I'm sure there are occasions when that's occurred," Kleeblat says. "But it's not common."

Not so, the nurse says: "We have 10 kids we could send to High Meadows right now."

Those boys can't go anywhere else in the state either because High Meadows boys have been given priority at the private facilities, say staff.

According to an internal DCF document dated Sept. 4, 2009, one boy had been waiting to be transferred from Riverview for 84 days. Another for 99 days and yet another for 150.

That kid has been waiting since March, right after High Meadows admissions closed.

Fact Vs. Fiction

"Liar," whispered a teacher during DCF head Susan Hamilton's testimony before the Office of Health Care Access (OHCA) on Sept. 18. During the hearing, she explained why DCF wants to close High Meadows, a state-run facility for boys with complex mental, health and psychiatric disabilities. OHCA has the final say. High Meadows staffers say Hamilton's and her staff's testimonies were filled with lies, or half-truths at best.

Here, we separate fact from fiction:

Claim: Transferring boys out of High Meadows is OK, because DCF's contracts with private providers have an "eject/reject" clause, meaning they won't kick out or refuse to treat a child transferred from High Meadows.

Fact: Several kids have already been rejected by private facilities. One boy with severe diabetes was promptly returned to High Meadows, because he was too difficult to treat. José Flanders has been rejected by several facilities.

Claim: The need for residential treatment has decreased by 40 percent, because there are now more community-based services in operation that can serve these children.

Fact: The need for care for children with less-severe needs has indeed dropped. The need for complex care, however, has not. Furthermore, the number of boys needing care at High Meadows each year has remained consistent. In 2001, 92 kids were served. In 2008, it was 95. There are nearly 350 children receiving treatment out-of-state, because no in-state facility can or will treat them. High Meadows staffers say many of them could be treated at High Meadows.

Claim: One reason nearly 350 DCF kids are out-of-state (as far away as Illinois and Florida; most are in Massachusetts and Rhode Island) is because High Meadows doesn't treat children who are chronic fire starters or who have sexual behavioral problems.

Fact: Alton Allen, a child psychiatrist who has worked for the state since 1980, says he has treated dozens of fire starters and kids with problematic sexual behavior at High Meadows.

"High Meadows has always treated sexually reactive kids," Allen says. Ditto for fire starters.

Gary Kleeblat, DCF spokesman, responds: "Children have been successfully placed and we're confident the remainder will. We understand how difficult this is for the staff. They've done a good job. However, we're viewing this in the context of a long-term trend to improve children's mental health services in Connecticut. There's no dispute that children are better served, when appropriate, in the community or in their homes."