DENVER — A letter penned to state lawmakers and leaders depicts a state system failing to meet the care of youth in foster care who are experiencing mental health issues.
The letter sent Sept. 9 by the Colorado Human Services Directors Association (CHSDA) and Colorado Counties Inc. (CCI) to Gov. Jared Polis and the directors of the state Department of Human Services and Health Care Policy and Financing says the state’s system to serve Colorado’s highest acuity children is failing. The nonprofits claim the state lacks sufficient psychiatric services and beds at state-licensed facilities to meet children’s mental health needs.
“There also exists little accountability to ensure facilities are programmatically able to meet the needs of higher acuity children they are licensed to serve,” the letter read.
On Thursday, Gini Pingenot, the director for external affairs for CCI, sat in on a meeting held by the Behavioral Health Transformational Task Force. During the gathering, Jamie Ulrich, the Weld County director of the Department of Human Services, described in detail the mental health crisis a 15-year-old in county custody experienced while in Colorado.
“On January 5, 2020 she overdosed on Tylenol and Advil and was hospitalized for ten days,” Ulrich said. “On January 26, 2021 she wrapped a cord around her neck and stabbed herself in the leg and was hospitalized for seven days. On February 3, 2021 she attempted to strangle herself while at school with a computer cord and stabbed herself with a pencil.”
Lexie Kuznick, the association director of CHSDA, believes the pandemic fueled the mental health crisis children are experiencing. She said Ulrich’s description depicts the dire crisis.
“We have children and youth that have attempted suicide a dozen times who cannot stabilize,” Kuznick said.
She said case workers are spending hours on the phone daily tracking down facilities across the state and U.S. searching for open beds to place children.
“We have kids stuck in the emergency rooms for sometimes months on end,” Kuznick said.
Resources and welfare workers tasked to help foster children are stretched thin.
“We have child welfare workers who are staying with kids in hotel rooms while we are waiting to find a bed,” Kuznick said.
Pingenot believes the state is about 500 to 600 beds short of what is needed and that the shortage is leaving youth in limbo or bouncing in and out of unstable and inadequate care environments.
“We are having to send a lot of them out of state for the services that we really want to be able to provide them here in the state,” Pingenot said. “We do know that outcomes for kids that we send out of state are not good, simply because we are separating them from any sense of family and support that could help them bounce back and overcome the trauma.”
Advocates are calling for transparency to help hold facilities accountable for prioritizing out-of-state children over local residents.
At the end of June, more than 4,200 children were in out-of-home placement, according to CHSDA.
A survey conducted by the association in 36 county welfare divisions found 26 children and teens in county custody are in a hospital, 24 have been placed in out-of-state residential facilities, and 91 are waiting for a treatment bed. The most egregious finding was that 69 youth in county custody are missing and believed to be on the run.
“We know the challenge involves even more children and youth than are represented in county-custody numbers alone,” the letter stated.
Pingenot is hopeful the Behavioral Health Transformational Task Force will inject into the state welfare system the necessary funds to increase the number of beds and resources to meet the needs of youth struggling to cope with trauma.
The state plans use stimulus money to add between 15 and 20 crisis beds by November. The Colorado Department of Health Care Policy and Financing also hopes to use stimulus dollars to recruit providers with specialized programming, but the timeline is unclear, and advocates say it will not help the immediate crisis.
In the long-term, Colorado expects to have 70 additional Psychiatric Residential Facility beds across three new providers as they shift their licenses. But advocates argue that without accountability and stricter requirements they fear the additional beds will fail to close the gap.
In May, Children’s Hospital Colorado declared a state of emergency for youth mental health. The hospital’s psychiatric unit has been full for more than a year, multiple patients brought in have suicidal thoughts.
“In large numbers, we also continuously have several patients in our hospital who no longer meet criteria for either a medical or psychiatric admission, but because there’s nowhere else for them to go (such as a foster home or step-down residential treatment facility), we have severe difficulty discharging them,” read a statement from Children’s Hospital Colorado.
With school back in session, the hospital expects the number of children admitted into emergency department with behavioral health needs to double. They estimate about 50% will need to be admitted.
Kuznick believes lawmakers are taking the issue seriously. To help reach a solution, she believes it’s vital to invest in beds, the welfare workforce and community based behavioral health services throughout the state.
