Bring the Kids Home
Commissioner's Office of Program Review
P.O. Box 110601
Juneau, Alaska 99811-0601
Alaska Mental Health Trust Authority
550 West 7th Ave., Suite 1820,
Anchorage, Alaska 99501
(907) 269-7966 FAX
Over the past seven years the children’s behavioral health system in Alaska has become increasingly reliant on institutional care - inpatient hospital and Residential Psychiatric Treatment Center (RPTC) care - especially out-of-state RPTC care, for treatment of severely emotionally disturbed youth. In the past six years, acute care admissions increased by one-third and total days of inpatient care increased by 90%. Out-of-state placements in RPTC care grew by nearly 700% and in-state RPTC care grew by 145% from FY’98-FY’03. At any given time, approximately 400-500 children are being served in out of state placements, ranging in age from six to seventeen, (average age between 14 and 15). Alaska Native children are over-represented in the population of children in custody and represent 49% of the custody children sent to out of state placements and 22% of the non-custody children sent to out of state placements.
view DHSS commissioner's office BTKH web site
The Bring the Kids Home Project
The Department of Health and Social Services initiated the “Bring the Kids Home” (BTKH) Project to return children being served in out-of state facilities back to in-state residential or community-based care. The project intends to reinvest funding now going to out-of-state care to in-state services and develops the capacity to serve children closer to home. With financial support, this initiative will focus on successfully building upon the existing infrastructure to treat youth in their own community, region and state. The following long-term goals have been developed to guide the direction of the BTKH project:
- Build/develop and sustain the community-based and residential capacity to serve children with all intensities of need within the service delivery system in Alaska.
- Develop an integrated, seamless service system in Alaska that will allow children and youth to be served in the most culturally competent, least restrictive setting, as close as possible to home as determined to be safe and appropriate.
- Significantly reduce the existing 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.
Strategies for Change
The scope of this project requires that four levels of the system of care must be addressed concurrently: community, regional, in-state, and out-of-state care. Further, there are additional issues that are applicable to the overall system of care i.e. policy development, management of authorization, utilization, and enhanced care coordination, workforce development, funding, expansion of facilities and infrastructure, and expansion of services. In order to accommodate the scope of the BTKH Project, seven strategies for change have been identified and will be used to facilitate the organization of the project.
1. Theory of change. Articulate and communicate a formal theory of change and continue ongoing communication.
2. Strong family voice. Develop a strong family and youth voice in policy development, advocacy, family education and support, and quality control/assurance and evaluation.
3.Examine financing & policy issues
4. Performance & QA measures. Ensure that strong performance measurement/continuous quality improvement procedures are in place.
5. Home & community-based services (DBH SED Youth). Develop a wide range of accessible home and community-based services that reduce the need for kids to enter residential care and ease transition back into the community for those in out of home care.
6. Work force development. Build the capacity and core competencies of in-state providers to provide services that meet the needs of kids with severe behavioral health disorders.
7. Assessment & Care Coordination. Develop “gate keeping” policies and practices and implement regional networks to divert kids from psychiatric residential care.