- Associated Press - Sunday, May 11, 2014

SIOUX CITY, Iowa (AP) - Bloodcurdling screams poured from Jeffery Flores‘ mouth.

His father, Juan, seated in a wooden chair, held him tightly on his lap as his mother, Claudia, inched the buzzing clippers toward the 8-year-old Sioux City boy’s head.

Haircuts are a nightmare in the Flores household. In December, Jeffery’s kicking and struggling bruised Claudia’s body and snapped a leg off the chair, sending him, Claudia and Juan tumbling to the kitchen floor.

Jeffery, who loves to dance and collects balls in a shoe box, was diagnosed at age 3 with autism, a pervasive neurodevelopmental disorder that affects his ability to communicate and interact with others. He also has attention deficit hyperactivity disorder, or ADHD, a condition that causes extreme emotional outbursts.

“He takes medicine, but the medicine don’t do much,” Claudia Flores said of the adhesive patch Jeffery wears on his skin to calm him.

The Sioux City Journal reports (http://bit.ly/1ng7NVg) Flores is using her experiences with Jeffery in her paid position as a family support specialist to help other Woodbury County parents navigate a complex and often confusing mental health care system.

Launched in July by the Iowa Department of Human Services and Magellan Health Services, the state’s contractor for Medicaid-funded services, Integrated Health Homes, or IHH, are designed to help families manage the health care needs of 16,000 Iowa children ages 3-17 who are covered by Medicaid and have been diagnosed with a mental, behavioral or emotional disorder that impairs daily functioning.

In Woodbury County, 1,300 children are expected to benefit from the program offered locally through Siouxland Mental Health Center.

IHH were developed after the Iowa General Assembly enacted legislation in 2011 directing the Human Services Department to lead a redesign of the state’s fragmented mental health services system. According to Woodbury County program supervisor Sheila Martin, the state was spending significant amounts of money on very few children who were being placed in foster homes and psychiatric institutions outside their communities.

“It’s frustrating navigating the system trying to get into a doctor, a therapist, a psychiatrist,” she said. “We’re gonna try to alleviate some of that stress and some of that heartache for the families.”

Jeffery’s family is learning to cope with his outbursts, which are sometimes set off by the word “no,” the color red and loud noises.

“It’s kind of stressful because he starts to scream and it hurts my ears, but I have to get used to it,” his 10-year-old sister, Zipporah, said with a shrug.

The Affordable Care Act requires health insurance plans to cover mental health care, including behavioral assessments for children at no cost. But parents are struggling to find providers.

An Iowa Board of Medicine database lists 10 actively practicing psychiatrists in Sioux City. Only three of them specialize in child and adolescent psychiatry. When children with mental, emotional and behavioral disorders act out, frustrated parents take them to hospital emergency rooms out of desperation.

Physician Thomas Benzoni said these children are often transported to youth psychiatric institutions in Cherokee and Council Bluffs, because there is little he can do for them in Mercy Medical Center’s ER. There are no hospital beds in Sioux City for children who are a danger to themselves or others.

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