Human Services Agency

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
Note: Children placed out-of-state with parents, relatives, or non-relatives generally have a plan to achieve permanency and are not typically expected to return to Washoe County.

(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.
Call 311 to find resources, ask questions, and utilize Washoe County services. Learn More »
Call 311 to find resources, ask questions, and utilize Washoe County services. Learn More »