Few foster care options for kids with extreme mental health issues

State officials have a new plan for an aspect of foster care that became more of a challenge for the Wilkes Department of Social Services in 2020.

The focus is on children with high-intensity behavioral health issues needing foster care, said Wilkes DSS Director John Blevins during the Jan. 19 Wilkes County commissioners meeting.

Blevins said usual individual or group foster homes aren’t an option for them due to their behavioral health needs and there are far too few specialized care options they need, so Wilkes DSS ends up housing them in local motels for days or sometimes weeks at a time.

Two social workers at a time, working in shifts spend nights with them in motels. Most of the youths can’t go to school so they usually spend daytime hours watching TV in a Wilkes DSS conference room while placement efforts are underway. Social workers are still with them.

Blevins said Wilkes DSS social workers spent 61 nights in motels with children with high-intensity behavioral health needs in 2020, up from 10 nights in 2019. He said increased stress on families during the COVID-19 pandemic was partly the cause of this increase.

Blevins said that in addition to being undesirable for youths, staying in motels is costly and results in social workers having to be away from their families.

In December, he said, the N.C. Department of Health and Human Services announced a short-term solution to the lack of rapid access to services these children need.

A DHHS working group of people with mental health, social services and Medicaid expertise will meet each weekday morning to review these cases, which will be submitted by county departments of social services after placement attempts are exhausted. Documentation of county level efforts must be included with each case referred.

Another team consisting of DHHS executive leadership will meet every Tuesday, Thursday and Friday morning to review these cases referred by the initial review team or when the youths have been at DSS offices or hospital emergency departments over seven days awaiting placement.

Blevins said creating the two review teams “brings these cases to the attention of people with more resources and clout to do something about them…. They’re still going to have to figure out a long-term answer” to this dilemma involving availability of beds and providers. “There just aren’t a lot of beds for them.”

Blevins said youths in these cases typically have very aggressive or violent behaviors, sometimes highly sexualized behaviors and other mental health issues

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