Participation Falls Short in Teen Addict Medical Plan : Insurance: County recruited a national company to provide low-cost coverage for youth. But now it may be dropped.

A health-care company may scrub an insurance program covering drug or alcohol treatment for Ventura County youths because not enough parents have signed up.

County officials need to find 20,000 participants by Friday for the Alcohol and Drug Benefits Program to break even, but so far, fewer than 5,000 have enrolled.

“At the rate that they are coming in, we won’t make our minimum,” said Stephen Kaplan, director of the county’s Department of Alcohol and Drug Programs, who recruited a national managed-care company to provide the coverage. “I know the idea is good. It is just a matter of, how do you really market this?”

County officials estimate more than a quarter of county residents either have no insurance or such limited coverage that parents cannot afford substance abuse treatment for their children.

And parents say that if their child gets hooked on speed or cocaine, few insurers foot the bill for costly detox programs, hospitalization and long-term counseling that can total more than $50,000 a year.

So adding to the stress of dealing with a teen addict, parents are often compelled to ruin their finances--liquidate stocks, max out credit cards, take out second mortgages--to get money for treatment.

“Parents really do lose everything,” said a 52-year-old Thousand Oaks mother who refinanced her home and closed out college education funds to pay for $67,000 in treatment costs in 1994 for her daughter, a recovering speed addict. “It’s month-to-month now.”

The special health plan launched in October pledges to protect Ventura County parents from financial ruin by covering up to $10,000 in substance abuse treatment for a $30 annual premium. While no public funds are involved, the county, which helped develop the program, sent 150,000 flyers home with schoolchildren to inform parents of the benefits.

Although plan administrators agree medical costs could surpass the maximum benefits available, they say the program at least would make treatment possible for children whose parents have little or no insurance.

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“It is a very comprehensive benefit,” said Alison Edelstein, western regional sales representative for Value Behavioral Health Inc., which provides coverage for mental health and substance abuse treatment for about 14 million people nationwide. “The goal that the county had was to make this benefit available to the broadest spectrum of people while keeping the program affordable.”

County officials say one of the plan’s best features is the absence of a “preexisting condition” clause. Even youths already addicted to alcohol or drugs qualify for treatment once their parents pay the annual premium and meet a $150 deductible.

But the county does not have the cash to widely publicize the program, one of only three such programs offered by private health care companies in the nation that focuses exclusively on youths, officials said.

Edelstein said denial, not just lack of advertising, may be keeping enrollment numbers down.

“For parents to fill out the form and send us a $30 check, they are consciously admitting that their child is now or may be later using drugs,” Edelstein said. “That is a very, very big hurdle to get past.”

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Another Thousand Oaks mother, a college administrative clerk, said she never imagined her three sons would become addicted to drugs when the family moved to Ventura County three years ago. The boys never touched drugs and thought people who did were stupid, the woman said.

But in trying to fit into a new crowd, the oldest boy, then 17, started smoking marijuana and eventually got hooked on speed. To the horror of the mother and her husband, all three boys eventually started using drugs--to the point that they all needed treatment.

“It has been like a domino effect with our boys,” said the 45-year-old woman. “They are very close and they just went down one, two, three.”

With insurance provided through the woman’s job, the couple managed to place the boys in different treatment programs in the county and elsewhere in California. But the insurer has covered only a portion of the treatment, she said. And every month, the couple is socked with more than $400 in medical bills they will be paying for a long time to come.

“It has devastated us,” the woman said. “I try and think what we did before we had all these medical bills. We don’t buy anything extra. We don’t go anywhere extra. It cut everything extra that we do.”

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Kaplan said he saw a need for an alcohol- and substance-abuse benefits program to combat the increasing use of drugs among youth. After peaking in the mid 1980’s, drug use among young people declined before rising again in the last few years.

A 1994 study by a Washington, D.C., research organization found that 46.5% of California’s high school juniors used at least one illicit drug in the previous six months, up from 35.6% in 1992. During the same period, drug charges filed against juveniles in Ventura County rose from 90 to 442, a jump the sheriff’s department attributes in part to the growing sale and use of methamphetamines--or speed--on the street.

But the rise in drug use in the county has not been coupled with an increase in funding for treatment programs for youth, Kaplan said.

“If you are a 15-year-old in Ventura County and you have a substance abuse problem and your family has no insurance resources, you are out of luck,” Kaplan said.

Five days in a detox program can cost more than $3,000 alone, plan administrators estimate. Costs can mount another $5,000 for 10 days in the hospital and a month of follow-up counseling.

If the plan meets its minimum enrollment requirement, beginning Jan. 1 parents and youths could call a toll-free number for information on alcohol and drug prevention. If necessary, a clinician would refer the youth to a health provider in Ventura County for an evaluation before placing the youngster in a treatment program.

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Although the two Thousand Oaks mothers plan to sign up for the coverage, they say recovery can take longer than the period the program covers. But they said the benefits would still make a difference.

“It is limited,” said the mother of the three boys, “but I think any help at this point is important.”

The woman whose daughter is recovering from a speed addiction said getting a child in treatment sends a vital message. Any money, she said, helps.

“The benefit is not so much the duration but the reassertion of the parental right to intervene,” the woman said. “It tells the kid that we care enough to make sure you do this.”

Kaplan said he plans to find alternative ways to find coverage if the health plan does not meet its minimum enrollment.

“I don’t think I am ready to give up on the idea,” Kaplan said, adding that the coverage might attract more substance abuse treatment programs for youths to Ventura County. “If we have a stable funding source, I think we would see more providers here. There would be more choices for the young person and family.”