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Life-changing residential treatment will soon be available for kids on Medi-Cal

Fifteen-year-old Maddie Harvey’s love of music started when her grandpa bought her a ukulele a few years ago. She said she quickly learned how to play Vance Joy's '"Riptide" — a popular ukulele song. From there, Maddie was hooked.

"A year or two later I saved up the money to buy my acoustic guitar and started learning that — that was a lot harder," Maddie said.

Next came an electric guitar. Maddie said she enjoys playing music with friends from the junior reserve officer training corps (JROTC) at San Marcos High School. That's where she found her friend group, or as she put it — her "tribe."


"I joined JROTC and like the first day I went into my flight — I was like okay these are going to be my people," she said.

JROTC students participate in drill teams and raiders competitions where someone's physical fitness is put to the test.

"It’s just do the workout and get the best time — and that's a lot of fun," Maddie said.

A freshman at San Marcos High, Maddie has done well in the program. Her instructor Mark Mclought said she is set to take on a leadership role in the class next year.

"She really lit up — she just goes after all the things that we do," Mclought said. "She comes in with energy, she puts her drive into it and doesn’t take no for an answer."


The road to get here has not been an easy one. Maddie has struggled with her mental health over the years. Her parents Cindy and Steve Harvey found out she had a sensory processing disorder at five years old.

"She would get so upset with a teacher — for example wearing high heels — that clicking sound would drive her crazy and she would have to be excused from class and she would be outside beating her head off a brick wall trying to create any other sound than those high heels," Steve said. "That was probably at the worst of it."

A CDC report from earlier this year said mental health among students is getting worse. In 2021, 22% of  high students reported considering suicide and about 40% reported persistent sadness.

Maddie's parents first sent her to a residential treatment center when she was in fourth grade. She ended up going three different times.

"We were really worried about the self-harm issues and a few trips to the hospitals too and we were like, 'Okay we need more care,'" said Maddie's mom Cindy.

The family lived in Northern California at the time and thought sending her to treatment in San Diego was the only option left.

"That was tough," Steve said. "As a parent you don't want to like give your child to anybody else to care for — but we did not have the tools necessary to get her to where she is right now."

Residential treatment is a higher level of care that sees kids staying at facilities for days, weeks or months at a time. At the San Diego Center for Children the program involves everything from psychiatry to counseling and therapeutic activities. CEO Moisés Barón said it is a key part of care, especially for kids who may be going to the emergency room for mental health reasons.

"We know that when we can provide the appropriate level of care — we’re able to provide what the youth and family needs," Barón said. "And hopefully prevent this revolving door from continuing or a problem that could be addressed, becoming more serious."

Barón said there is a gap in the system. While residential treatment is available for kids who have private insurance, referrals from schools, in the foster system, on probation or those with welfare services — it is not available for kids who just have Medi-Cal. That is the state’s health plan largely serving low income residents.

"If the child is in the hospital or emergency department and staff knows this child needs a higher level of care but they have medical — that’s not an option and that’s what needs to change," Barón said.

Assembly Bill 2317 is changing that. It was signed into law last year. The legislation creates a new license category that will allow psychiatric residential treatment facilities to serve everyone — including kids with Medi-Cal. Barón said the California Department of Health Care Services is still working on regulations for exactly how it will rollout.

"We have story after story, after story of success and we have families tell us, 'If it hadn’t have been for this level of care I don't know what would have happened to my child.' We want families with Medi-Cal to be able to tell those same stories," Barón said.

Maddie’s most recent time in residential treatment was a seventh month stay at the San Diego Center for Children where she said everything turned around.

"I understood why this time — it was the self-harm thing and I needed to get more serious help because what was happening wasn’t going to work," she said. "I met some really great counselors and staff that also deal with the same things I deal with and have the same stories and we clicked immediately."

Maddie’s parents said the residential treatment has been life changing.

"That’s just it — without the insurance that we had or had at the time there’s no way — she would have been in and out of hospitals every other weekend probably doing the 72 hour hold," said Steve.

A 72-hour hold can be used by health workers or first responders when someone is a danger to themselves or others. Maddie's mom said it was learning how to cope with triggers from sensory processing disorder that has helped.

"Now since she’s out of the center she has a good head on her shoulders — she has the coping skills," Cindy said. "It’s more fun and relaxed now than what it was. It’s not eggshells, it’s nice."

Maddie said the relationship with her parents has greatly improved. Her parents said the future is bright. At 15 years old, Maddie is looking forward to getting her first job soon and driving.

"I can get my permit in October and I’m so excited," Maddie said.

The military is also on Maddie's radar. Her dad was a U.S. Marine and she wants to follow in his footsteps. She is not ruling out one day working at a place like the San Diego Center for Children.

"Knowing that I’ve been there and knowing how much the center has helped people — I know the center will still be running by the time I'm an adult," she said. "Considering how much it’s helped me and other kids — I know they’ll still be running."

If you or someone you know struggles with thoughts of suicide, resources are available. People can call the Suicide and Crisis Lifeline at 9-8-8 for assistance.

The child care industry has long been in crisis, and COVID-19 only made things worse. Now affordable, quality care is even more challenging to find, and staff are not paid enough to stay in the field. This series spotlights people each struggling with their own childcare issues, and the providers struggling to get by.