RD45 - Residential Services for Children in the Comprehensive Services Act Utilization, Length of Stay and Expenditures Statewide and by Locality - Program Year 2009


Executive Summary:
The 2009 Appropriations Act (Item 283, B 2.d) requires the Office of Comprehensive Services for At Risk Youth and Families (OCS) to report to the Governor and Chairs of the House Appropriations and Senate Finance Committees on utilization rates and average lengths of stays in residential care statewide and by locality. Each locality is required to submit to OCS “information on utilization of residential facilities for treatment of children and length of stay in such facilities.”

Historically, this report defined residential care as group homes, residential treatment facilities, and psychiatric hospitals. Beginning in 2009, the Commonwealth enacted the Annie E. Casey Strategic consulting Group policy advice to strengthen CSA financial incentives to reduce reliance on residential care (see section FY09 Major Initiative to Manage the Use of Residential Care; page 3). In short, the policy modification reduced the local match on community care and increased the local match on the use of congregate (residential) care. Refer to the “Status on the Implementation of the Comprehensive Services Act Match Rate Incentive for Residential Care”, November 2009, for additional information regarding initial results from this major policy initiative.

To more closely monitor expenditure trends, the State Executive Council, at the June 12, 2008 meeting, developed final CSA match rate and service categories along with service definition. Beginning in 2009, the service categories comprising residential care include group homes, residential treatment facilities along with temporary care facilities, and congregate care education cost for both non-Medicaid and Medicaid funded cases. Previously, the temporary care facility and residential education categories were included in the group home, residential or psychiatric hospital for cost and census information. Beginning in PY09, psychiatric hospital cases were no longer included as part of the residential category.

The attached schedule (Schedule 1) provides utilization (# of Children in Residential Care), length of stay (Average # Residential Days/Child), and expenditure data on residential placements statewide and by locality for program years 2005 though 2009. Program Year (PY) is defined as all children’s services that were provided using CSA funds from July 1 through June 30 of each year.