(WJET/WFXP)– A new report from the PA Association of County Commissioners found over 250 youths and minors with complex behavioral health needs were forced to sleep somewhere other than a licensed child placement facility adding up to hundreds of nights slept in places like hotels or offices over the first six months of 2023.
After taking a vote to address the needs of children and youth with complex behavioral health issues last March, the PA Association of County Commissioners (CCAP) released their findings on where minors with these needs stayed and the level of care they received.
As a result of that vote, the CCAP created the Complex Case Work Group to report these findings and make recommendations off that report which found hundreds of minors did not stay somewhere other than a licensed child placement facility and others did not receive the care they needed across PA’s 45 counties.
The CCAP defined complex cases as minors who are in the custody of the county for whom there is not a level of care sufficient to meet their mental, behavioral, or physical needs.
This includes minors who are dependent and/or delinquents who may be sleeping in a Children and Youth Services office or hotel and those who have had a higher level of care recommended but isn’t available or exists outright.
The report said the number of cases of complex behavioral health needs has been increasing across both the Commonwealth and the nation.
These cases also require more time to find a placement or treatment regime than most cases and have seen an increase in the amount of children in county custody sleeping in hotels and child welfare offices regardless of efforts.
Between Jan. 1 and June 30, 2023 investigators found the following about where youths and minors stayed:
- 255 slept somewhere other than a licensed placement facility adding up to 772 nights slept in offices, hotels cottages and hospitals
- 175 had to stay in hospitals past their discharge date making for at least 2,651 nights unnecessarily spent in the hospital
- 99 did not get the mental health services needed and were discharged because that care wasn’t offered in the hospital they went to
- 284 were placed in a lower level of care needed
- 33 were placed outside PA when they couldn’t be placed
The Complex Case Work Group said housing minors in offices and hotels can lead to disastrous outcomes as they don’t provide the level of age separation necessary, pointing out it can lead to sexual assault, physical assaults of staff and other deadly or criminal outcomes.
With those findings in mind, the group created the following list of recommended strategies to fix these issues and which level of government and agencies should be responsible for handling them:
- PA develops a no-eject-reject program for youths to have a safe place to stay.
- Responsible parties: state, counties and behavioral health-managed care organizations
- More organized and concentrated efforts to develop programs for challenging behaviors and medical issues coinciding with behavioral health and ways to diagnose these issues.
- Responsible parties: state, counties and behavioral health-managed care organizations
- Collaborative cross-training systems for county teams and state personnel addressing complex cases.
- Responsible parties: state and counties.
- Changes to regulation, policies to create more funding for complex cases.
- Responsible parties: state.
- Improved systems and technology for staff members to increase their time with patients and their families as well as improve referrals for finding the best match for care.
- Responsible parties: state and counties.
- More emphasis on improving staffing on county, state and private levels.
- Responsible parties: state, counties and behavioral health-managed care organizations.
- Develop a PA-wide mental health resource navigation system for families.
- Responsible parties: state, counties and behavioral health-managed care organizations
The CCAP Complex Case Work Group’s full report is available online here along with the executive summary.