Each year, thousands of Minnesota children are placed away from their homes for care and treatment. For example, victims of abuse or neglect might be placed with a foster family until they can safely return home or enter other "permanent" living arrangements. Some delinquent juveniles are sent to correctional facilities that aim to hold offenders accountable for their actions, protect the public, or provide therapeutic programs. Juveniles with emotional disturbances or serious drug or alcohol problems may be sent to residential programs that offer treatment.
In recent years, counties have worried about the impact of out-of-home placement costs on their budgets, and state legislators have questioned whether placement facilities adequately serve Minnesota juveniles. The 1998 Legislature placed a temporary moratorium on the development of large new facilities (and large expansions of existing facilities). The Legislature also requested this evaluation, and we asked the following questions:
How do counties and courts decide when to make placements? Is there adequate screening and assessment of children?
What is the total public cost of out-of-home placements in Minnesota, and what trends in placements and spending have occurred? To what extent do counties vary in their placement spending, and what are the reasons for the variation? What strategies have counties used to control placement spending?
What are the characteristics of the children served in out-of-home placements? In what types of facilities are they placed, for how long, and how far away from home? To what extent do children complete the programs they enter, and what are the reasons for non-completion?
Does Minnesota need more beds to serve children placed out of home? If so, what types of beds (or supportive services) does the state need? Does Minnesota have sufficient non-residential alternatives to placement and aftercare services following residential placements?
Is there sufficient information on the performance and operation of Minnesota's out-of-home placement system?
To answer these questions, we analyzed existing statewide information on child placements and their costs. We also surveyed county corrections supervisors, human services directors, and district court judges throughout the state. We visited seven counties, reviewed case information for more than 250 individual juveniles, and interviewed numerous state, local, and facility staff. We examined placements at various types of residential facilities licensed by the Department of Human Services or Department of Corrections, including family foster homes, "Rule 5" mental health treatment facilities, "Rule 8" group homes licensed to serve ten or fewer residents, chemical dependency treatment facilties, child shelters, detention facilities, and correctional facilities for delinquent juveniles.
Overall, we conclude that Minnesota generally has a more pressing need for additional non-residential services for its juveniles than additional residential services. Minnesota does not appear to face significant statewide shortages of beds (with the possible exception of foster care), although the services in existing residential facilities do not always adequately address the needs of juveniles in placement. Unfortunately, Minnesota has little information on the effectiveness of services for juveniles, and we think that the Legislature and state agencies should take steps to improve information on service outcomes.
There are several ways that Minnesota children can be placed in publicly-funded out-of-home care. First, peace officers may temporarily place a child in detention or shelter care. State law requires the court to hold hearings within 72 hours to determine whether the child should remain in custody. Second, the courts may order placement of a child who has been found by the court to be delinquent or in need of protection or services. Third, parents or guardians may enter an agreement with a local social services agency to "voluntarily" place a child--often when the agency is considering asking the court to remove the child from home. County social services and corrections agencies play key roles in selecting placement options, assessing child needs, and advising the juvenile courts.
Court-ordered placements are the most common type of out-of-home placements among Minnesota children. State law requires the courts to articulate in writing the reasons for child placement and for rejecting other possible options, but our review of individual cases suggests that the courts often have not explained their actions thoroughly or clearly. Furthermore, our surveys indicated that:
There are a variety of possible reasons for inconsistency in the child placement process, both within the courts and within the county agencies that help make placement decisions. First, most counties and judicial districts do not have written criteria that identify specific circumstances that justify out-of-home placement. <FN-For instance, the 1994 Legislature directed judicial districts to develop disposition criteria for delinquency cases, but seven of the ten districts identified factors to consider in the case disposition process rather than specific guidelines indicating when out-of-home placement might be appropriate.> This may reflect the lack of consensus about which types of children benefit from out-of-home placement. Second, some Minnesota counties involve few county staff in placement decisions. For example, only about half of Minnesota's county social services agencies have multi-disciplinary "juvenile treatment screening teams" authorized by state law (Minn. Stat. §260.152, subd. 3) to review cases recommended for placement. In addition, officials from only half of all county corrections agencies told us that their agencies typically involve at least one supervisor or manager in placement decisions.
In addition, we concluded that practices for assessing children prior to placement could be improved. A majority of county officials surveyed told us that judicial placement decisions are generally based on sufficient consideration of children's needs, but more than one-third of the human services directors said that children's needs are not considered sufficiently (see Table 1). In addition, state chemical dependency staff told us that many adolescents in residential corrections and mental health facilities have chemical abuse problems that have not been treated. Most judges we surveyed gave high marks to the timeliness and thoroughness of county chemical dependency assessments, and they gave somewhat lower ratings to counties' assessments of juveniles' mental health. We were unable to examine the outcomes of mental health screening in a systematic way because few counties have complied with state requirements for reporting this information annually. Finally, assessments of juvenile offenders' risk of committing new offenses can help the courts and counties determine what services should be provided, but nearly half of Minnesota counties do not formally do such assessments.
(N = 82)
|Human Services Directors
(N = 84)
|Do judges make dispositions based
on sufficient consideration of:
|Children's mental health needs?||83%||13%||62%||37%|
|Children's chemical dependency problems?||87||10||61||36|
|Children's cultural and ethnic backgrounds?||71||21||55||39|
|Facilities' ability to meet children's service needs?||87||10||54||45|
NOTE: Percentages of officials who responded "don't know" are not shown.
To make consistent, appropriate placement decisions, counties and courts not only need information about the child and family, but they also need to understand the strengths and weaknesses of service options available. In our surveys, a large majority of county staff told us that they have sufficient information describing the services offered by various programs. But less than half of the officials we surveyed said they have enough information about (1) recurrence of juveniles' problems following residential placement, (2) the extent to which children run away from placement facilities, and (3) the extent to which children "complete" the programs in which they are placed.
Using information we collected from state data sources and surveys of local agencies, we estimate that:
Table 2 shows spending, placements, and days of service for major categories of residential settings. Foster homes have relatively low average costs per day ($35), but they accounted for a third of all Minnesota placement spending because children tend to stay in foster homes for long periods. Correctional facilities accounted for 26 percent of all placement spending, ranging from numerous short-term placements in juvenile detention centers to longer-term placements intended to hold juvenile offenders accountable for their actions. On average, Rule 5 mental health treatment facilities had relatively long stays (168 days) and high costs per day ($179), so they accounted for 21 percent of statewide placement spending despite having only 4 percent of the placements.
|Percent of Placements Made in 1997||Estimated Average Length of Stay (Days)a||Percent of Days of Care Occurring in 1997||Average Cost Per Day||Percent of Total 1997 Placement Spending|
|Family foster homes||21||285||66||35||34|
|Rule 8 group homes||4||119||5||99||8|
|Rule 5 facilitiesb||4||168||8||179||21|
|Chemical dependency facilities||4||40||2||135||3|
bIncludes placements at Brainerd and Willmar regional treatment centers paid by Medicaid.
cIncludes placements and days of care that we could not allocate to the categories shown.
SOURCE: Program Evaluation Division analysis of data from the departments of Human Services and Corrections and June-July 1998 survey of counties.
In 1997, per capita spending for out-of-home placement varied widely among counties, ranging from $25 per county resident under age 18 (Red Lake County) to $322 (Hennepin County). Likewise, placement spending per child in poverty ranged from $156 to $1,954 among Minnesota counties. We found that the group of counties with the highest per capita spending placed more children, for much longer periods, and for slightly higher costs per day than the group of the lowest spending counties. In addition, we found that high spending counties (as a group) had substantially higher spending per capita in each of the six categories of facilities we examined. <FN-The group of high spending counties included the 28 counties with the highest placement spending per county resident under 18; the low spending counties included the 28 counties with the lowest per capita spending.>
The widespread variation in placement spending appears to reflect county differences in underlying social conditions as well as placement policies and practices. For example, we found that counties with high poverty rates tended to have high levels of placement spending. But we also found that some counties with very low placement rates have (1) procedures for closely scrutinizing placement recommendations and children already in placement, and (2) strong preferences for using community-based services rather than out-of-home placement.
Counties have expressed concerns about recent growth in placement costs, and we found that:
The highest rates of increase in inflation-adjusted spending were in correctional and chemical dependency facilities, which rose 39 and 37 percent, respectively. There were lower rates of increase in family foster homes (14 percent), Rule 8 group homes (21 percent), and Rule 5 mental health treatment facilities (26 percent).
Among 34 counties that spent more than $1 million for placement in 1997, we found considerable variation in 1992-97 placement trends. At one extreme, Pine County's inflation-adjusted placement spending increased 126 percent during this period; on the other hand, St. Louis County's spending decreased 19 percent. As a group, counties with the largest overall spending increases between 1992 and 1997 had above-average increases in spending in all categories of juvenile residential facilities, not just some categories.
Seventy-six percent of local human services directors and 54 percent of corrections supervisors told us that they expect placement spending in their counties to increase faster than inflation during the next three years. However, about half of the local officials told us that there are additional steps that their counties could take to control placement costs without sacrificing service quality.
About three-fourths of Minnesota's 1997 placement costs were paid from the budgets of local social services agencies. For these expenditures, property taxes were the main county revenue source, although counties also received general purpose aid from the state. The main sources of federal funding were Title IV-E of the Social Security Act, which paid for a portion of placements at certain types of residential facilities, and a social services block grant funded under Title XX of the Social Security Act. The largest source of state funding was Minnesota's Community Social Services Act block grant. For all 1997 placements paid for by local social services agencies, we estimate that:
Compared with other states, Minnesota relies much more on local revenues and less on state revenues to pay for social services (including child placement costs).
Funding sources for out-of-home placement vary considerably among counties. For example, the percentage of 1997 spending paid for by county revenues varied from 33 percent (Clearwater County) to 79 percent (McLeod County). Such variation likely reflects differences in counties' (1) eligibility for (and possibly pursuit of) federal funds, (2) use of facilities eligible for federal reimbursement, and (3) overall levels of placement spending.
About half of the county corrections supervisors and human services directors told us that budget considerations have limited their ability to provide the care and services that children need. When asked whether counties would likely place more children out of home if state or federal funds paid for a larger proportion of placement costs, most human services directors (63 percent) said they would not, while county correctional supervisors were evenly split.
Children are placed away from home for a variety of reasons. Based on an analysis of all types of Minnesota child placements in 1997, we found that:
As shown in Table 3, 46 percent of the time children spent in out-of-home care resulted from parents' conduct, and other parent-related reasons accounted for another 12 percent. A large majority of foster care placements resulted from parent-related reasons, while most delinquency, chemical dependency, mental health treatment, and group home placements resulted from child-related reasons.
|Reason||Percentage of Days of Care|
(Child neglect/abuse, child abandonment, parental
substance abuse, incarceration, other)
|Other parent-related reasons
(Disability, temporary absence, other)
|Child misconduct (Delinquency, status offenses, substance abuse, behavior problems)||30.3|
|Other child-related reasons (Disability, other)||5.9|
|Family interaction problems||5.4|
NOTE: For placements funded by social services agencies, counties regularly report reasons for placement. For correctional and chemical dependency placements not funded by social services, we assumed that the reason for placement was child conduct.
SOURCE: Program Evaluation Division analysis of DHS placement data, June and July surveys of counties, DHS Consolidated Chemical Dependency Treatment Fund data.
Children in out-of-home placement range in age from infants to adolescents. In 1997, nearly half of Minnesota children in family foster homes were under age 10, while correctional facilities, group homes, chemical dependency facilities, and Rule 5 mental health treatment facilities generally served older children. Boys outnumbered girls in all categories of residential facilities, but especially in correctional and Rule 5 facilities.
We found dramatic differences in rates of child placement among various racial and ethnic groups. In particular,
Only 4 percent of Minnesota children are African American, but African American children accounted for 22 percent of all Minnesota children in placement in 1997. Likewise, only 2 percent of Minnesota children are American Indian, but American Indians accounted for 12 percent of 1997 children in placement. About 8 percent of Minnesota's African American and American Indian children were in out-of-home placement at some time during 1997, compared with 1 percent of Minnesota's white, non-Hispanic children. In addition, African American and American Indian children had longer placements, on average, than white children. Also, African American and American Indian children had at least 12 times as many days in placement per capita in 1997 due to parent-related reasons as did white, non-Hispanic children in placement.
Among children who were in a placement that lasted for more than three days during 1995-97, 45 percent had multiple placements of this length during this period. Of children who were in placement on January 1, 1995, 23 percent remained in placement continuously for at least the next three years.
By definition, children in out-of-home placement live apart from their immediate families. Legislators have questioned whether some children are placed too far from home, making it more difficult for service providers to work with the child's family and help children successfully return to their home communities. Table 4 shows the distance placed from home, by category of residential facility. We found that:
|Percentage of 1997 Days of Care Spent in Placements:|
|Facility Type||Total Days in Care in 1997||Within Same County||In Border County||In State and Within 100 Miles, But Not in Same or Border County||In State, But More than 100 Miles Away||In Another State||TOTAL|
|Family foster homes||2,086,280||71.6||13.5||6.5||4.9||3.4||100|
|Rule 8 group homes||166,279||25.8||26.4||23.3||20.7||3.8||100|
|Rule 5 facilities||228,579||12.9||17.0||31.1||25.2||13.8||100|
Juveniles placed in shelters and foster care usually remained in their home counties, but those placed in mental health treatment facilities, group homes, and correctional facilities were more commonly in distant counties.
Most cases of out-of-state placement have involved children placed in (1) foster homes, or (2) facilities certified by Minnesota's Department of Corrections (DOC) to serve delinquent juveniles. <FN-Under state law, the commissioner of corrections must "certify" that out-of-state facilities meet Minnesota facility standards before delinquent juveniles (or preadjudicated delinquents) from Minnesota can be placed there. Many of the DOC-certified facilities are correctional facilities, but some are comparable to Minnesota's Rule 5 and Rule 8 facilities.> Among foster care cases, most out-of-state placements have involved Minnesota children who are living with relatives in other states. For delinquent juveniles, counties have used out-of-state facilities for a variety of reasons: for programs that are longer or address specialized needs better than those available in Minnesota; for lower costs; to discourage juveniles from running away; and because out-of-state facilities are closer than in-state facilities for some counties. Two counties (Ramsey and Hennepin) accounted for two-thirds of all 1996-97 out-of-state placements at DOC-certified facilities, and Ramsey County had far more children per capita in such out-of-state placement than other judicial districts in Minnesota. The states whose facilities were used most often for delinquent juveniles were South Dakota, Iowa, and Colorado.
It is difficult to assess the need for additional residential services without considering the availability of placement alternatives. In some cases, it might be possible to avoid (or shorten) residential placements if there are appropriate non-residential programs in the juvenile's home community. In our surveys of county officials, we found that:
Seventy-one percent of county corrections supervisors and 64 percent of county human services directors said that non-residential services would be a higher spending priority than residential services if additional funds were available. In addition, we asked counties to assess their satisfaction with 25 categories of services, and most counties expressing dissatisfaction with particular services said that their most pressing need in these categories was for non-residential services. Human services directors and corrections officials both identified truancy services as the category of service with which they were least satisfied.
Judges, county human services directors, and county corrections supervisors told us that some out-of-home placements could be avoided with improved non-residential services. For example, more than one-third of judges said there is "significant potential" to reduce placements of truants, runaways, and misdemeanor-level offenders through non-residential services, and a majority of judges said that there is at least "some potential" for placement reductions in all categories of juveniles except "extended jurisdiction juveniles" and felony-level violent offenders. <FN-"Extended jurisdiction juveniles" are felony offenders for whom the court has executed a juvenile disposition, along with a stayed adult sentence. The court can maintain jurisdiction over these offenders until they reach age 21, and the adult sanctions may be executed if the offender commits a new offense or violates the conditions of the stayed sentence.>
To help us assess the need for additional beds in residential facilities, we examined occupancy rates in selected categories of facilities. Although counties sometimes have difficulty finding available beds, we found a considerable amount of unused capacity in several categories of residential facilities. Statewide, we found that 88 percent of beds in secure correctional detention and residential facilities were occupied, compared with 77 percent of non-secure correctional beds (detention and residential), 67 percent of Rule 8 group home beds, and 65 percent of Rule 5 mental health treatment facility beds. <FN-We estimated that 45 percent of Minnesota's licensed family foster home beds were occupied in Fall 1998, but human services officials told us that it would be unrealistic for many foster homes to serve the maximum number of children allowed by their licenses.>
We also surveyed county officials about service needs and, as shown in Table 5, we found that:
|Percentage of Officials Who Said There Is:|
|No Need for New Beds||Some Need for New Beds||Significant Need for New Beds|
|Human services directors (N=84):|
|Treatment foster care||15||54||29|
|Regular foster care||5||46||48|
|Relative foster homes||14||40||40|
|Rule 5 mental health facilities||52||38||6|
|Corrections supervisors (N=82):|
|Secure detention facilities||33%||50%||15%|
|Secure residential facilities||28||45||26|
|Non-secure correctional facilities||35||51||10|
The 1994 Legislature authorized construction grants for secure detention and secure residential beds in all of the state's judicial districts, and this has helped to address the need for more secure juvenile correctional facilities. Fifty-nine percent of corrections supervisors told us that the availability of secure detention beds in Minnesota improved in the past three years, and 45 percent said that the availability of secure residential (post-disposition) beds improved. Some judicial districts are still constructing or planning their new secure correctional facilities, so reductions in occupancy rates are likely.
Overall, given the relatively low occupancy rates of many facilities, the ongoing construction of additional juvenile corrections beds, and the preference of many counties for improved non-residential services, we concluded that:
Individual counties may have occasional difficulties finding specialized residential services, such as correctional services for juvenile offenders with low intelligence or secure correctional beds, and sometimes they cannot find an immediate vacancy in a preferred facility. For example, 50 percent of judges told us that there are not usually sufficient residential options for the "children with the most serious problems." But, in general, we think that Minnesota's total number of residential beds is adequate (or nearly adequate), and the beds are distributed quite evenly throughout the state.
Even if Minnesota has enough of most types of residential beds, it is important to consider whether existing facilities effectively serve children's needs. Our surveys of county officials revealed various concerns about the adequacy of existing services:
Corrections and human services officials were less satisfied with the availability of short-term placement options (less than three months) than with the availability of longer-term options.
Human services officials cited group homes and corrections officials cited correctional facilities as the types of residential facilities that least adequately tailor services to meet juveniles' needs.
County corrections and human services officials said that residential corrections facilities have not worked with families of the children they serve as well as other types of juvenile facilities.
In all categories of facilities, county corrections staff reported a need for improved "aftercare" services following residential placements; human services directors said that aftercare services are least adequate following placements in correctional and chemical dependency programs.
Among counties in which minority groups comprise at least 5 percent of the population, more than one-third of human services directors and correctional supervisors said that residential facilities are often insensitive to cultural and ethnic differences in the children they serve.
Fifty-five percent of human services directors and 35 percent of corrections supervisors said that residential facilities discharge too many children for violating facility rules.
Staff with the departments of Human Services and Corrections told us that improvements in facility and aftercare services are likely to result from proposed facility rules drafted jointly in 1998, at the direction of the Legislature. In addition, the departments have taken steps recently to foster development of more responsive services--for example, through the revision of programs at the Red Wing correctional facility and the encouragement of more community-based mental health programming.
It would be useful to know more about the effectiveness of Minnesota's residential programs for juveniles. In recent years, some counties have reduced the length of time that children remain in placement, others have made fewer referrals to residential mental health treatment facilities, and some counties have diverted to non-residential services juveniles who previously might have been placed out of home. For the most part, the results of these changes are unclear. Only 7 percent of county human services directors and corrections supervisors told us that their agencies produced summary information during the past year on the success of children subsequent to out-of-home placements. The Department of Human Services worked with counties during 1998 to identify child welfare performance measures that could be tracked in the future, and this was an encouraging first step.
But, to properly measure service outcomes, it is necessary to consider the goals of each child placement. For example, depending on a child's circumstances, the desired outcomes of placements might include law-abiding behavior, sobriety, placement in a permanent home, protection from maltreatment, or other goals. Unfortunately, as shown in Figure 1,
Not only is there insufficient information on the outcomes of child placements, but there is also incomplete information about the placements, their costs, and the characteristics of the children in placement. The Minnesota Department of Human Services (DHS) collects and analyzes information on placements paid for by county social services agencies, but some child placements are paid for by other local agencies. For example, DHS has little information on children placed at county-operated "home schools" for juvenile offenders, including some of Minnesota's largest juvenile facilities--such as the Hennepin County Home School and Ramsey County's Boys Totem Town. Also, there has been limited statewide information collected on individuals in juvenile detention because most detention placements are funded by local corrections or law enforcement agencies. It is understandable that DHS has focused its data collection efforts on services paid for by social services agencies, but the information missing from this database has limited its usefulness to policy makers.
In addition, we found various problems with the accuracy of DHS' county- reported data on child placement. The problems included missing cases, inaccurately reported placement discharge dates, duplicate placements, and single placements inaccurately reported as multiple placements. If uncorrected, these problems can result in inaccurate information on individual counties' number of placements, days of care, and average placement length. For example, among eight counties that we examined in detail, we estimated that DHS overstated the actual days of care by at least 20 percent for four counties in 1996. Given the recent interest of the Legislature, DHS, and counties in tracking the length and outcomes of child placements, we think it will be important for DHS to monitor and correct the types of problems we found. We saw evidence that the department was doing a better job of this in 1997, although some problems remained. In addition, the department is implementing a new information system that is designed to improve the accuracy of placement information in the future.
Historically, the state's role in child placement has been very limited. The courts and counties have considerable discretion about whom to place, and county funds have paid for the largest share of placement costs. State agencies license the facilities in which children are placed, but it is up to the courts and counties to select the facilities that best address children's needs. We think there are steps the Legislature and state agencies could take to improve Minnesota's child placement system, while preserving the important roles played by the courts and counties.
We have no recommendation regarding the proper level of state funding for out-of-home placement or child welfare services. On the one hand, counties have considerable discretion about which children to recommend for placement, so a significant local role in placement funding may encourage better decisions and closer scrutiny. Also, some analysts have suggested that Minnesota has not made maximum use of non-state revenue sources for out-of-home placement, such as federal funding and parental fees. On the other hand, a larger state funding role might be justified by (1) inadequacies in some residential and non-residential services, (2) the inability of counties to fully control costs for placements that are often made by the courts, and (3) the burdens that placement costs impose on poor counties, due to the fact that placement and poverty rates are positively related. The 1998 Legislature authorized $30 million in state family preservation aid in 2000--largely in response to county concerns about growing out-of-home placement costs.
There are a variety of ways that the Legislature could allocate state funding for children in placement or at risk of placement, and we did not conduct an in-depth analysis of alternative measures of county need and fiscal capacity. However, we think that a funding approach that is tied too closely to out-of-home placements could create incentives for placement or penalize counties that have invested in placement alternatives. Thus, we recommend:
Likewise, as a general rule, we think that the Legislature should not restrict the use of funds to reimbursement of out-of-home placement costs. Counties expressed a strong desire in our surveys for improved non-residential services. In our view, counties should have the flexibility to use funds to pay for whatever residential or non-residential services will best serve the needs of children and families.
Although we did not find that Minnesota needs large numbers of new beds in residential facilities, we recommend that:
For several reasons, we think that an extension of the moratorium could unfairly constrain placement options for counties (which pay for most placement costs) and courts (which are responsible for making case dispositions that serve the child and protect public safety). First, counties expressed to us some concerns about the quality and cost of residential services now available in Minnesota facilities, and we think that it is important for counties to have a variety of placement options. A moratorium might protect existing facilities from new competition and make them less responsive to the needs of counties and courts. We think that counties and courts are in the best position to judge whether to place their children in new or long-standing facilities, or in large or small facilities--so long as the facilities meet basic licensing requirements that help to ensure quality service. Second, the moratorium was adopted in 1998 largely in response to concerns about additions of correctional beds, but our survey of county corrections officials indicated that more would oppose rather than favor an extension of the moratorium. <FN-Human services directors tended to favor an extension of the moratorium, but DHS has not received a proposal for a facility large enough to be subject to the moratorium for more than 25 years.> Third, while some people believe that counties and courts will fill to capacity whatever number of beds Minnesota licenses, this is not currently the case. There are many vacant beds in juvenile residential facilities, and counties have increasingly looked for alternatives to expensive, long-term residential placements. Overall, we do not think that Minnesota has a significant shortage of residential beds for juveniles, but we think that a moratorium could limit the responsiveness of service providers to juveniles' needs.
An alternative to a moratorium might be a requirement for facilities to demonstrate to state licensing officials that they are "needed," prior to receiving a license. Some people expressed concerns to us that Minnesota communities may encourage development of new facilities as a way of luring jobs and redevelopment, without sufficient consideration of how these facilities would address the needs of Minnesota children. We share this concern, although we think that it would probably be best to let counties and courts determine which facilities are "needed" through their actual placements, rather than having state regulators try to evaluate the "need" for a facility before it has opened. <FN-The "need" for a facility may be difficult to evaluate before it begins to offer services. For example, a facility might be needed if it provides services that other facilities do not, but it might also be needed if it provides duplicative services more effectively or at lower costs than other providers.>
To address the problem of inconsistency in placement decisions, we considered whether to recommend statewide or county placement criteria that would identify circumstances that justify child placement. However, counties expressed limited support for such a state requirement, and research literature has provided limited insight into which types of children fare best in out-of-home care. As an alternative means of ensuring more consistent, thoughtful decisions on child placement, we recommend:
Presently, these screening teams are optional. We think that multi-disciplinary teams should review all placements in treatment facilities and all court-ordered placements potentially exceeding 30 days--including post-dispositional placements in facilities licensed by the Commissioner of Corrections. In our view, an expanded role for juvenile screening teams will enhance accountability, while helping to ensure that juvenile service needs are identified.
In addition, risk assessment (and corresponding needs assessment) can help agencies decide which juveniles need the most attention, and it can also help them to develop service plans. Similar to state requirements for adult offenders, we recommend that:
There is little systematic monitoring of service outcomes for juveniles in placement, partly because the goals of these placements vary widely and are not always well articulated. To supplement the individualized case planning done by counties and service providers, we recommend:
After this working group completes its tasks,
Many county staff expressed concerns about the adequacy of services for juveniles in placement (and following placement). For example, they cited a need for facility staff to work more effectively with the families of juveniles, and they said they would like better "aftercare" services. We think it is reasonable to expect counties to help develop plans to ensure that these types of services are provided, and many counties do this now. In fact, proposed rules recently drafted by the departments of Corrections and Human Services refer to county "case plans" and "transitional services plans" for each juvenile in certain types of placement. However, current law does not require counties to develop case plans for delinquent juveniles, and the law does not clearly indicate whether counties are responsible for monitoring aftercare services identified in the transitional services plans. We recommend:
To help ensure that juveniles receive the services they need following placements in residential facilities, we recommend:
In addition, county human services agencies expressed concerns to us about the absence of clear definitions of "treatment foster care"--that is, foster homes that provide in-home therapeutic services. We recommend:
There are very high rates of child placement among certain racial and ethnic groups, and many county officials told us that there is room for improvement in residential programs' sensitivity to cultural differences. Proposed rules drafted by the departments of Human Services and Corrections would require residential facilities to provide "culturally appropriate care," but we think the departments should provide counties and facilities with practical assistance. We recommend:
Finally, we think that state agencies should initiate steps to improve existing information on child placement. In particular, they should find ways to supplement placement and spending information currently collected by DHS. We recommend:
The departments of Human Services and Corrections should establish a work group to identify ways to collect comprehensive statewide information on juvenile placement spending and individual juvenile placements.
To the extent possible, the Department of Human Services should identify and correct errors in its existing juvenile placement database that have resulted (and may continue to result) in misrepresentations of the number of children in placement, the characteristics of those children, and the days spent in placement.
State rules should require facilities to collect program completion information and make it publicly available. The departments of Corrections and Human Services should establish a working group to adopt uniform definitions for measuring program completion rates.
The Program Evaluation Division was directed to conduct this study by the Legislative Audit Commission in April 1998. For a copy of the full report, entitled "Juvenile Out-of-Home Placement," (99-02), 114 pp., published on January 11, 1999, please call 651/296-4708, e-mail Legislative.Auditor@state.mn.us, or write to Office of the Legislative Auditor, 658 Cedar St., St. Paul, MN 55155.
Staff who worked on this project were Joel Alter (project manager), Dan Jacobson, and John Patterson