* Tribune…

Children in the state’s welfare system are being warehoused in psychiatric hospitals and emergency shelters hundreds of days longer than they should be in many cases because the agency does not have a place for them, a new report found.

The highly critical review of Illinois’ Department of Children and Family Services came from the state auditor general’s office, even though DCFS did not track and could not provide most of the information the auditors sought, according to the report released Thursday. The data DCFS did provide were not ideal, as auditors questioned their accuracy and completeness.

The inspectors found that the delays stemmed in large part from a lack of available placements, scheduling and wait lists. One state ward remained in an emergency shelter 357 days last year, which is a staggering 10 times longer than the court-ordered 30 days, according to the report. Last year 380 children stayed in a shelter beyond 30 days, an improvement from 451 children in 2014, the audit found.

During that same period, the number of children who languished in psychiatric hospitals beyond medical necessity more than doubled to 168 in 2015. The average length of stay for those youths went up to 40 days in 2015, though the report found that one child remained at a psychiatric hospital 184 days after being cleared for discharge.

“Meanwhile, the children are suffering,” said Benjamin Wolf, legal director of the American Civil Liberties Union of Illinois. “I talked to a child who was trapped in a psychiatric hospital, and he was just weeping because he felt abandoned by everybody. What can you say? He has been abandoned. Like a shelter, it’s a miserable place to spend a big chunk of your childhood.”

Go read the whole thing.

* The full audit is here. A sampling from the summary…

• The number of children who remained psychiatrically hospitalized beyond medical necessity was 75 in 2014 and 168 in 2015. The average length of stay beyond medical necessity was 28 days in 2014 and 40 days in 2015.

• The number of children who remained in emergency shelters beyond 30 days was 451 in 2014 and 380 in 2015. The average length of stay for these children, from the date of admission was 72 days in 2014 and 80 days in 2015.

• The number of children who remained in a detention facility solely because the Department could not locate a placement was not available from the Department.

* Just as bad, though, is the fact that DCFS doesn’t seem to be tracking children very well. For instance…

• Psychiatric Hospitals – The Department does not specifically track in its computer systems the date a child is declared “beyond medical necessity.” Because this date is not captured in its systems, we could not obtain a download of children who stayed at a psychiatric hospital beyond medical necessity for calendar years 2014 and 2015. Instead, the Department maintained a list of children, including the beyond medical necessity date, in a spreadsheet that was separate from its computer systems. However, we had no way of verifying the completeness of this information.

• Emergency Shelters – The Department provided data for all children who had been in an emergency shelter in 2014 and 2015; however, we encountered issues that made reporting the number beyond 30 days difficult. The data required manual editing by auditors to determine the number of children in emergency shelters beyond 30 days. This was due to disruptions in stays, such as the child going on the run from the shelter. There is no statutory requirement that DCFS place children within 30 days of entering a shelter. The 30 day standard is outlined in the B.H. Consent Decree. (88 C 5599 (N.D. Ill.))

• Detention Facilities – DCFS was unable to provide this data because it does not track scheduled release dates for youths in detention. Without knowing a scheduled release date, we could not determine if a youth was held beyond that time. (pages 19-22)

Ugh.

*** UPDATE ***  From DCFS…

Statement from Director George Sheldon regarding the Auditor General report:

This is one of the most intractable issues we have been dealing with. These are very challenging categories of youth.

To reduce the number of kids in emergency shelters, we have created emergency foster homes. Every child being removed from their own home needs to go to a home setting in their community, not to a shelter. That’s our goal. In June of 2014 we had 136 children and youth in emergency shelters. A year ago it was 91. Today we are at 43.

With respect to youth in detention, we now have two new contracts to provide placements with the supports these young people need, and two additional programs are being developed.

The children and youth in psychiatric hospitals beyond medical necessity are really very challenging cases. There are two categories here. For children already in our care, we are developing a pilot program to have very sophisticated and knowledgeable experts work with our case managers for these cases to get the kids reunited with their families with appropriate services and supports or stabilized in community placements.

Then there are children who are at risk of coming into our care because their families can no longer handle the cost of care on their own. Those are referred to as lockouts, but this is desperation for many families. Our ultimate goal is to provide families the support they need so parents don’t have to lock children out. We are working with the Department of Health Finance (HFS) and Human Services to develop a program and funding to make it possible for these children to stay in their homes.
Four times as many children and youth beyond medical necessity were discharged from the hospitals during the fiscal year just ended than in the year earlier.
We are developing a therapeutic foster care system, with trained professionals as fulltime foster parents, to work with young people who have severe medical or behavioral health needs. Again, it takes time to build this system, but we have three substantial pilot programs in place.

We have more data tools in place now, and our placement staff is tracking each and every child or youth in these categories.

BMN Youth in hospital

We had 16 discharged last week
2 will be discharged this week
Today, we have 21 BMN youth in hospital.
We have 127 total youth in psychiatric hospitals today. We usually have under 150 youth at any one time.

Right now, there are 10 youth in the hospital that are BMN and have pending lock-out investigations, meaning their families do not wish to have them back in their homes.
They are other children who are in hospital Beyond Medical Necessity who may have a pending abuse or neglect allegation so we have to wait to do our due diligence to determine whether they will enter care.

This is actually a growing problem, because families are struggling to cope with the cost and logistics in these cases. We have an Interagency Agreement signed to help address the challenge of lock-outs by parents who need our help, it will address the issue of children being locked-out of psychiatric hospitals by parents.

This is a historical snapshot of BMN

7/1/14 to 6/30/15 75 discharges
7/1/15 to 6/30/16 302 discharges
7/1/16 to date 59 discharges