Out-of-State Placements Reporting Pursuant to A.B. 298
Pursuant to AB 298 from the 80th Legislative Session
n or before August 1 of each year, an agency providing child welfare services shall publish on its Internet website a report which includes, without limitation:
- Information on whether the agency achieved the goals established pursuant to paragraph (b) of subsection 1 for each quarter of the immediately preceding year.
- The number of children placed outside this State for more than 15 days during the immediately preceding year, including placements in residential treatment facilities.
- The reasons for the placements described above.
- A summary of changes that could prevent these out-of-state placements.
- A summary of changes or actions necessary to allow children currently placed out-of-state to return.
(a) Efforts to Recruit and Retain Specialized Foster Homes
During FY25, Washoe County Human Services Agency (WCHSA) implemented the following initiatives:
- Maintained communication with Specialized Foster Care (SFC) providers via regular emails, quarterly in-person support meetings, and direct collaboration with SFC agencies.
- Invited SFC agencies to host booths at WCHSA’s Walk with the FAM in September 2024, a community event raising awareness about the need for foster and adoptive parents in Washoe County, allowing agencies to recruit foster homes.
(b) FY 2025 Monthly Average Out-of-State Placements (>15 Days)
- Residential Treatment Center: Average 4 per month
- Parent Placement: Average 1 per month
- Relative Placement: Average 13 per month
- Non-Relative Permanent Placement: Average 3 per month
- Hospital: Average 0 per month
- Total Number of Kids: Average 20 per month
- Median Age in RTC: Average 13.5
- Average Median Age in RTC for FY: Average 13.5
(c)(d)(e) Reasons for Out-of-State Residential Treatment
Primary Reasons:
- Child’s needs cannot be met in a community SFC home and require a higher level of care.
- Limited local options for a comprehensive continuum of behavioral health services, including:
- Acute Psychiatric Inpatient Care: One adolescent-focused facility, no pediatric admissions for FY2024.
- Residential Treatment Centers (RTC): Two centers with limited populations; one is female-only, one has a small pediatric unit (no placements yet).
- Psychiatric Residential Treatment Facilities (PRTFs): One facility, often denies youth with histories of aggression or elopement.
- Psychiatric Care: Psychiatrists and medication management.
- Rehabilitative Mental Health Services:
- Partial Hospitalization Programming (PHP) – two programs.
- Intensive Outpatient (IOP) – four programs, with waitlists.
- Day Treatment – limited admissions due to age and aggression in milieu.
- Crisis Stabilization Services – unavailable in Washoe County.
- Crisis Triage Center (CTC) – unavailable in Washoe County.
Prevention and Clinical Services
WCHSA emphasizes prevention to maintain children safely in the community:
- Implemented Intensive In-Home Services to reduce foster care entries due to mental/behavioral health needs.
- Clinical Services Team (CST) provides:
- Crisis intervention and assessments for children entering care.
- Short-term therapies for individuals, families, and groups.
- Care coordination before, during, and after foster care placements.
- Maintained rotational on-call Clinical Supervisors and staff for seven-day emergency response.
- Engaged community mental health professionals for emergency shelter check-ins.
- Enhanced behavioral services documentation via CaseWorthy for Medicaid billing.
- Clinicians trained in evidence-based treatment modalities (CPP, TF-CBT, EMDR).
Adoption Support
- Pre- and post-adoption services to prevent re-entry into foster care due to behavioral/mental health needs.
- Assistance in accessing community services, safety planning, higher level of care identification, and insurance problem-solving.
- Implementation of support groups for adoptive parents and teens.
Voucher Program for Mental/Behavioral Health/Substance Abuse Services
- Expanded community provider options for services not covered by Medicaid or with long waitlists.
- Over 20 contracted providers offer timely access to essential services (neuropsychological evaluations, psychosexual assessments, etc.).
1915i Home and Community-Based Services Application
- Children in Specialized Foster Care can receive:
- Crisis Stabilization Services
- Intensive In-Home Supports
- Coaching and support for foster parents
- Goal: maintain placement stability, resolve behavioral health issues, and increase success with reunification or permanent placement.
- Currently, one SFC agency is qualified and billing under the 1915i waiver.
Support for Foster Families and SFC Agencies
- Respite services, funding, training, support groups, and quality parenting initiatives.
- Implementation of 30-day preservation plans to stabilize at-risk placements.