NASW Alaska | The Alaska Chapter of the National Association of Social Workers

At any given time there are 350 to 400 children in out-of-state Residential Psychiatric Treatment Centers (RPTCs) receiving services. The unduplicated count of Medicaid recipients by custody status from FY1998 to FY2005 according to the State of Alaska, Department of Health and Social Services, Division of Behavioral Health and the Mental Health Trust Authority Bring the Kids Home Annual Report (December 2005) (Table 1 below) shows the continued need for more alternatives that will keep Alaska’s children closer to home.

Table 1
Unduplicated Count of Medicaid RPTC Recipients by Custody Status

IS = In-State, OOS = Out-of-State

The Department of Health and Social Services has partnered with the Alaska Mental Health Trust to complete multiple studies related to Alaskans’ dependence on residential care. These studies have given the state some insight on the behavioral health system. Between 1998 and 2004, placements in RPTCs grew nearly 800 percent. Overwhelmingly, children placed Outside exit with both mental health and substance abuse diagnoses. Most children have had prior Juvenile Justice contact. Residential placements in-state stayed relatively flat during the same time period. Alaska Native children are over-represented within this population.

The mission of the Bring the Kids Home Project is to return children being served in out-of-state facilities back to in-state residential or community-based care The Trust and the DHSS want to reinvest funding into local capacity efforts that would have been spent Outside on residential care. This includes building residential facilities in Alaska, building capacity in therapeutic foster homes, and increasing community supportive services. Between FY04 and FY05, the out-of-state youth and children receiving out-of-state residential services decreased by 5.1 percent, which is the first decrease since 1998. During the same time, the number of children receiving in-state residential treatment services increased by 34.7 percent. After steady increases, the number of non-custody children receiving out-of-state residential services decreased by 6.6 percent. In Anchorage alone there was a 16 percent decrease in the number of children sent out-of-state for residential treatment services (Bring the Kids Home Annual Report, 2005). Alaska needs to continue this trend of in-state treatment of high needs youth and children. NASW Alaska Chapter supports the development of appropriate in-state care for the youth who otherwise are sent Outside for their mental health and substance abuse problems. However, institutional care is overly emphasized. Prevention and early intervention at the community level will prevent future institutional placements of Alaska children.