As clinic closes, patients wonder about future

Friday, January 1, 1904

photo Caleb Bryan, 9, plays with a Wii game system under a collection of stuffed animals while at his Cleveland, Tenn., residence. Caleb's mother, Jennifer Bryan, has noticed improvements in her autistic son's development which she attributes to the TEAM Evaluations Center.

LOCAL RESOURCES• Siskin Children's Institute: 423-648-1700, siskin.org• Autism Society of Middle Tennessee: 615-385-2077• Orange Grove Center: 423-629-1451STORY SO FARThe Tennessee Department of Intellectual and Developmental Disabilities declined to fully fund a diagnostic and evaluation program at TEAM Centers Inc., a Chattanooga nonprofit that treats the mentally disabled, leaving thousands of patients without a formerly reliable option.The state offered funding through September, but TEAM's executive director decided to use the money to shut down the agency's clinical care on Aug. 15. State officials don't know why and may look into the issue.

photo The TEAM Centers Inc. is a private nonprofit organization with an office at 1000 Third St. in Chattanooga that handles evaluation and assessment of people with developmental disabilities.

Jennifer Bryan already juggles many worlds.

An unemployed single mom using student loans for living expenses, Bryan runs errands for her mother for extra cash, lives in a cramped apartment in Cleveland, Tenn., and cares for Caleb, her 9-year-old autistic son.

A rising fourth-grader at Stuart Elementary School, Caleb "doesn't really comprehend the emotions of people," his mother said. For example, he's unable to tell the difference between a sad person and an angry person.

"It's significant," his mother said. "He does not know how to socialize with his peers."

When she heard news that Caleb's therapy hub, Chattanooga-based TEAM Centers Inc., was closing its key clinical program on Aug. 15, she was devastated. Her son had his bimonthly appointment on Aug. 16.

"TEAM needs somebody from the outside looking at what's going on," said Bryan, 34, who finances Caleb's care through her ex-husband's private insurance. "Why are they suddenly closing the doors? Something's not right."

This month, TEAM Centers Inc. did not receive a $774,000 state grant it had received for years as part of statewide budget cuts, but records show state officials offered a $193,000 grant to allow the nonprofit to extend clinical care through the end of September. It also would give TEAM extra time to seek alternative revenue options.

But TEAM Centers Inc. Interim Executive Director Peter Charman said he plans to use the $193,000 for severance packages and "shutdown costs," an explanation that's baffled state officials and parents alike.

"It's absolutely a foreign concept to me," said Debbie Payne, assistant commissioner for community services at the Tennessee Department of Intellectual and Developmental Disabilities, which routed money to TEAM. "The term is even new to me -- 'shutdown costs.' That's not terminology that we use."

And using the $193,000 grant "for the purpose of a program to wind down their business is not a responsible use of state funds," said Missy Marshall, the department's spokeswoman.

The department has decided against awarding the grant for now, she said.

"We will not be reimbursing for severance packages and shutdown costs," Marshall said.

Since Caleb's first appointment last October, TEAM staffers have been patient with him, Bryan said. They correctly diagnosed him with autism after years of teachers, principals and doctors dismissing Caleb's symptoms with: "He has ADHD."

TEAM therapists used flash cards to help Caleb distinguish between sad and angry, aiming to mix him with children "at that age where he needs to have some social skills," Bryan said.

He got them.

In April, Stuart Elementary School named Caleb student of the month, a distinction his mother "never thought he would get." And for the upcoming school year, Caleb's special education teacher decided against a behavior plan, an unusual step that indicates progress.

Now that TEAM is no longer an option, Bryan doesn't know where she'll turn. Chattanooga's Siskin Children's Institute "doesn't really do the stuff TEAM Center does," Bryan said.

State government social services are stretched and Vanderbilt in Nashville is "a long way to go" for bimonthly appointments, she said.

Deborah Luehrs, a spokeswoman for Siskin, said the nonprofit, in fact, does much of what TEAM does, at least in terms of disabled patients under 21. But much of the work focuses on diagnosis rather than treatment.

"We do [diagnosis] all day long," she said. "And we refer elsewhere if we don't offer a certain service."

Bryan could bring her son to Siskin, but there is a waiting list, Luehrs said.

"Wait times are always a problem in facilities like this, we're booking into 2012 for assessment appointments," she said.

Luehrs said Siskin saw more than 614 families from six states, amounting to 3,800 visits in fiscal year 2009-10.

Regina Gargus, the area's only board-certified developmental pediatrician, holds appointments at Siskin from 8 a.m. to 8 p.m. on most days, Luehrs added.

"Dr. Gargus relies on creative scheduling for really critical situations when somebody needs to get in quicker," Luehrs said.

Charman said 2,800 families visited TEAM 4,500 times over last fiscal year, which ended June 30. The state was unable to verify those figures Friday.

"I'm really concerned," Bryan said. "I don't know what I'm going to do."