By Dana Amihere, dana@marylandreporter.com
ANNAPOLIS—The Juvenile Services Department’s so-called “Maryland model” aims to reduce reliance on out-of-state treatment facilities for youth sentenced in juvenile court but has set aside about $8.5 million to send less than a score of them to centers across the U.S. over the next three years.
The Board of Public Works last week approved four contracts to send up to 18 youth, ages 6-20 years old, to residential treatment facilities (RTCs) in Pennsylvania, Georgia, Florida and Arkansas.
Although millions of dollars have been allotted, the state only pays per diem rates used by the child. There are about 130 youth in some type of residential treatment outside Maryland at any given time, said Jay Cleary, Juvenile Services Department communications director.The youths have an average length of stay of 294 days, or about 10 months.
“It’s rather discouraging after two decades of efforts to realize that it’s not good to send kids out of state that we’re actually looking to increase opportunities to do that,” said Bart Lubow, director of Annie E. Casey Foundation’s Juvenile Justice Strategy Group.
“All the evidence seems to be that it’s expensive and you separate kids from their families, the state doesn’t pay any attention to what’s going on with those kids in those places.”
Can be cheaper out of state
There are instances when it’s cheaper to send a youth out-of-state for treatment. For example, the rate at the newly established J. DeWeese Carter Center’s treatment program for girls in Chestertown, Md. is projected to be around $446 per day. That is more expensive than all the newly contracted facilities except the Devereux Children’s Behavioral Health Center in Pennsylvania, a psychiatric hospital. The other out-of-state facilities range between $300 and $370 per day for care.
While money is a significant factor, the numbers ultimately boil down to a lack of adequate facilities in state.
“In Maryland we have a shortage of treatment beds. A lot of the kids that go out-of-state tend to have very high needs or very, very specialized needs,” said Cleary.
Second degree assault — resulting in physical injury to another and punishable up to 10 years imprisonment in the adult criminal justice system — and other violent offenses are the most prevalent charges among Maryland’s delinquents placed in other states, Juvenile Services reported in fiscal 2011. Offenders were most likely to be 17-year-old black males, more than 56% from Baltimore City.
According to a report released by the governor’s StateStat office, Juvenile Services hoped to decrease the number of youth sent out of state by 20% in 2010 and by half in 2011. However, the number of kids treated out of state actually increased slightly in FY 2010, Juvenile Services reported.
Baltimore’s Advocates for Children and Youth says that the number of out-of-state placements can be drastically reduced by expanding multi-systemic therapy opportunities in the community for lesser offenses, a move which could save more than a half million dollars spent on the state’s residential treatment centers.
Similarly, says ACY, generating new in-state placements that address the specific needs of youth placed out-of-state would help fill the department’s gaps in service. Moreover, more in-state beds would help the state move toward a juvenile justice system more like Missouri’s best evidence-based practices of regionalized in-state treatment, a model which has a very low recidivism rate.
Severe problems treated
While Maryland’s 11 state-operated treatment facilities do provide some form of mental health, out-of-state placement services most often deal with severe mental and behavioral health problems such as bipolar disorder, schizophrenia, depression and attention deficit and disruptive behavior disorders, impulse control disorders and intermittent explosive disorders.
“The ideal would be to treat as many Maryland youth in Maryland so we wouldn’t have to send them out of state but that’s something right now that we’re trying to work on by developing more treatment space in Maryland,” Cleary said. The planned treatment centers at Cheltenham, a separate project from the detention campus approved in May at the same facility, however, is secondary to a 48-bed Baltimore City detention center in the works.
While 38% of the $272 million juvenile services FY 2011 budget is devoted to state-run youth centers and treatment facilities, there is a severe shortage of placement beds for youth pending placement. It’s not uncommon for youth waiting for a treatment opening to make up more than half of the detention center population, Cleary said.
“While it’s not ideal for us to have youth in treatment out-of-state at least they’re getting treatment. The youth who are pending placement are in secure detention facilities which aren’t designed or equipped to provide treatment services,” he said.
DJS data suggests that the percentage of rearrest, re-conviction and re-incarceration are consistently lower for recently released out-of-state placements than for youth treated within Maryland — 9% across the board in FY 2010. By comparison, more than 57% of youth treated in Maryland are rearrested, 20% are convicted of another crime and 14% find themselves back behind bars.
While it seems that Maryland’s in-state care is far less successful with youth one year following their release, the data is based on only 22 youth released from out-of-state custody in FY 2010 versus nearly 1,600 from Maryland programs.
“Look at the numbers. Eighteen kids for $8.5 million? You mean to tell me that we couldn’t do better? What we’re doing is putting kids out of sight and out of mind, and that’s not to say that (the out-of-state facilities are) bad places, I just question whether or not Maryland doesn’t have sufficient resources to deal with these kids in an effective way,” Lubow said.