RD353 - At-Risk-Youth Served in Out-of-State Residential Facilities


Executive Summary:
In March 2005, the Virginia Commission on Youth directed staff to study the practice of placing troubled and at-risk youth and adolescents in out-of-state for residential treatment. Staff was directed to:

• Determine the number of children receiving services in out-of-state residential treatment centers in lieu of being served in the Commonwealth;
• Determine the reasons these children are being placed outside of the Commonwealth, as well as the cost; and
• Assess whether there is service ability in the Commonwealth to serve these children.

Virginia policymakers and mental health practitioners recognize the benefits associated with children remaining within the home and receiving treatment in the community. When it is impossible for the child to receive the necessary treatment within the home or in a community-based environment, Virginia seeks to place the child in a setting that is as close to the home as possible.

There are instances, however, whereas a child's mental needs exceed the service capacity that can be provided within the home, community or the Commonwealth. Most of the children who are placed out-of-state require specialized treatment that is not available within the Commonwealth. These out-of-state placements are made to ensure that the child receives the necessary and most adequate treatment possible.

The practice of placing youth and adolescents in out-of-state for residential treatment poses a number of concerns, including the:

• Impact and effect on children who are placed out-of-state;
• Conditions for which youth are placed out-of-state; and
• Fiscal impact of placing youth out-of-state.

This report focuses on Virginia's troubled and at-risk children and adolescents who receive services in out-of-state residential treatment centers in lieu of being served in the Commonwealth. The purpose of this report is to determine the reasons why children are being placed out-of-state, the consequences and impact of placing children out-of-state and the best scenario for children who have needs that exceeds Virginia's ability and/or capacity to treat.

In studying the issue of out-of-state placements, the Virginia Commission on Youth examined two areas of interest: the Interstate Compact for the Placement of Children (ICPC) and the Office of the Comprehensive Services for At-Risk Children and Families (OCS). Based on analysis of the identified issues, the Virginia Commission on Youth adopted the following recommendations.

VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Recommendation 1
Request that the Department of Social Services update its policy manual for theInterstate Compact for the Placement of Children by June 30, 2006.

Recommendation 2
Request the Department of Social Services, in conjunction with the Virginia Institute for Social Services Training Activities, to develop a training manual for the Interstate Compact for the Placement of Children (ICPC) progress. All local social services workers in the areas of foster care and adoption and their supervisors should be trained on the ICPC progress. This training should be ongoing and shall be included in the training of all new social services case workers in the areas of foster care and adoption.

Recommendation 3
Request the Department of Social Services to monitor the placement of children served by the Interstate Compact for the Placement of Children (ICPC) through an automated reporting and tracking system. This will include information on children served by ICPC, including those referred by other agencies. The Department of Social Services, in developing this system, will determine whether this system should be linked to the OASIS system, as well as other existing data systems. The Department of Social Services shall report on these activities to the Virginia Commission on Youth prior to the 2007 General Assembly Session.

Recommendation 4
Request the Department of Social Services to report annually to the General Assembly about the number of Virginia's children being served in out-of-state placements, including those being served in residential facilities. The report shall include information regarding the number of children receiving services in out-of-state residential treatment centers, the reasons these children are being placed out of the Commonwealth and the cost.

Recommendation 5
Request that the Department of Social Services review the state's Interstate Compact for the Placement of Children (ICPC) system, including its management, staffing, caseloads, paper and electronic process, tracking systems and databases to develop amore efficient, accountable ICPC system for all those who participate in the ICPC process. Further, the Department of Social Services shall ensure that Virginia is incompliance with all state and federal laws and regulations. The Department of Social Services shall report on these activities to the Commission on Youth prior to the 2007 General Assembly Session.

OFFICE OF THE COMPREHENSIVE SERVICES FOR AT-RISK CHILDREN ANDFAMILIES

Recommendation 6
Request the Secretary of Health and Human Resources, in conjunction with the State Executive Council (SEC), to investigate the feasibility of utilizing a unique child identifier across all child-serving agencies. Request the SEC to coordinate with the data workgroup to evaluate the need to modify the reasons for service fields so that they are more helpful for ascertaining the reasons for service for program development. A report on these activities shall be made to the Virginia Commission on Youth prior to the 2007 General Assembly Session.

Recommendation 7
Request that the Office of Comprehensive Services for At-Risk Children and Families (OCS) to improve the information available in and revise the system through which provider information is placed in the Service Fee Directory. Request that OCS update the Directory and request that locality-specific, service-specific and licensing information be included.

Recommendation 8
Request the State Executive Council to coordinate with the data workgroup to evaluate the need to modify the reasons for service fields so that they are more helpful for ascertaining the reasons for service for program development.