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Psych Bed Shortage Could Be Driving Kansas Foster Care Problems

Madeline Fox
Kansas News Service
Susan Fout, a state behavioral health commissioner, presents data about psychiatric residential treatment facilities to the Child Welfare System Task Force. Fout’s testimony frustrated task force members, who wanted more analysis.";

Troubles in the Kansas foster care system might stem in large part from a shortage of places that can help children in psychiatric crisis, say some lawmakers and child advocate groups.

Since 2013, the number of psychiatric residential treatment facilities in Kansas has dropped from 11 to eight, with 222 fewer available beds.

That left many kids who can’t get the care they need sleeping in the offices of foster care contractors when beds aren’t available. The issue came under scrutiny Friday at a meeting of the Child Welfare System Task Force.

Even the boys and girls placed successfully in psychiatric facilities sometimes stay too briefly in residential care, say social workers, lawmakers and contractors.

Child welfare advocates have raised alarm bells that kids’ stays are shorter than they used to be, meaning children return home before they’re ready and are at greater risk of returning to a psychiatric ward in the future.

Since the state’s KanCare program started in 2013, Kansas’ three Medicaid health plan providers have determined whether and for how long children in state custody need psychiatric residential treatment.

Lawmakers and child welfare advocates learned Friday that the length of stay varies widely from provider to provider.  Members of the task force said that state officials seemed to lack a good explanation for the variances.

Foster kids whose treatment was managed by one provider, Sunflower, stayed an average of 60.9 days in 2016, compared to 85.9 with United and 103.1 through Amerigroup.

Officials from the two state agencies that regulate psychiatric care and oversee Medicaid couldn’t explain the varying ranges to the task force.

Members of the panel said they were frustrated. If the differing patterns between the companies have existed since KanCare was born six years ago, they wondered, why isn’t there an explanation?

Credit Madeline Fox / Kansas News Service
Kansas News Service
Sen. Barbara Bollier questions state officials about psychiatric residential treatment facilities. Bollier pressed the officials to examine data to ensure the state’s Medicaid providers were meeting kids’ psychiatric needs.

“I don’t understand why it’s six years in and you’re caught like a deer in the headlights,” said Sen. Barbara Bollier.

Susan Fout, the behavioral health commissioner for the Kansas Department for Aging and Disability Services, suggested measuring the effectiveness of residential treatment stays not by the number of days, but by how many people had to be readmitted. That idea was also championed in a report released last month by a governor’s mental health task force.

Neither KDADS nor the Kansas Department of Health & Environment had data on readmission rates. That also angered Bollier. She said the task force’s frustration at so many unanswered questions might jump-start the agencies’ efforts to get more numbers, and to better explain what those numbers mean.

“These are kids’ lives,” she said. “We have to do better.”

Madeline Fox is a reporter for the Kansas News Service, a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio covering health, education and politics. You can reach her on Twitter @maddycfox. Kansas News Service stories and photos may be republished at no cost with proper attribution and a link back to the original post.

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