Bring the Kids Home
Bring the Kids Home is a partnership between the Alaska Mental Health Trust Authority, the Department of Health and Social Services, the State planning boards, Families, Youth, Providers, Tribes, and other Stakeholders.
Three primary goals guide the initiative:
- Significantly reduce the numbers of children and youth in out-of-state care and ensure that the future use of out-of-state facilities is kept to a minimum.
- Build the capacity within Alaska to serve children with all intensities of need.
- Develop an integrated, seamless system that will serve children in the most culturally competent, least restrictive setting, and as close to home as possible.
- Kids belong in their homes (least restrictive, most appropriate setting, community based).
- Strengthen families first (strength based, preventative)
- Families and youth are equal partners (family driven, youth driven).
- Respect individual, family and community values (culturally competent, individualized care, community-specific solutions).
- Normalize the situation (meet the child where they are, respect normal life cycles, promote normal and healthy development).
- Help is accessible (coordinated and collaborative).
- Consumers are satisfied and collaborative meaningful outcomes are achieved (emphasis on research, evidence, quality improvement, accountability).
From 1998 to 2004, Alaska’s behavioral health system became increasingly reliant on Residential Psychiatric Treatment Centers (RPTC) for treatment of severely emotionally disturbed youth. Out-of-state placements grew by nearly 800 percent. Alaska Native children were over-represented: 49 percent of children in state custody and 22 percent of non-custody children in out-of-state placements were Alaska Native.
Children were placed outside of Alaska for long periods — even years — for treatment. Families making these hard choices often found that out-of-state placement created unanticipated problems. It was difficult for families to participate in their child’s treatment, transitions back to home were challenging, and Alaska Native children sometimes experienced a cultural loss because their experiences diverged widely from those of their families.
These issues drove the Department of Health and Social Services (DHSS) and the Alaska Mental Health Trust Authority (The Trust) to establish and jointly chair the Bring the Kids Home Focus Group to address the reliance on out-of-state services. Cross-system collaboration became a key BTKH strategy. Family and youth advocates, tribes, schools, providers and community stakeholders participate in the BTKH Focus Group. The Alaska Planning Boards (Alaska Mental Health Trust Board, the Governor’s Council on Disabilities and Special Education, The Advisory Board on Alcoholism and Drug Abuse and the Traumatic Brain Injury Board) are key Focus Group members, bringing statewide stakeholder feedback. Tribal health organizations, the Denali Commission, the Department of Education, the University of Alaska and school districts all partner with DHSS and the Trust on BTKH. Most of those involved in the BTKH Focus Group also participate in project-specific work groups. The Trust, DHSS, the Alaska Legislature and the Governor have allocated the essential resources required to address these problems.
As a result of BTKH planning, capacity development, management and policy shifts, and the investment of new resources, BTKH has been extremely successful at reforming Alaska’s behavioral health system of care for children and adolescents. Many fewer children are now receiving Medicaid funded out-of-state mental health treatment, there has been a significant decrease in recidivism to RPTC (within one year), and new supports are available to support children and their families in the community.
Medicaid Expenditures Data from DHSS BH: Policy & Planning
BTKH Initiative: Indicators for SFY 2011
For updated information on BTKH progress, projects, meetings and other information, see the “BTKH SharePoint Site” at the link on the right, above.