06-30036-06

SUMMARY OF: A Special Report on the Department of Health and Social Services, Kenai Peninsula Community Care Center, Selected Operational Issues October 13, 2006.

Purpose of the Report

In accordance with Title 24 of the Alaska Statutes and a special request by the Legislative Budget and Audit Committee, we conducted a performance audit of the operations at the residential child care facilities of Kenai Peninsula Community Care Center (KPCCC or the Center). Included in the scope of the audit were some operational decisions and functions of the Office of Children’s Services (OCS), and the Division of Juvenile Justice (DJJ), state agencies organizationally located under the Department of Health and Social Services.

Report Conclusions

We were directed to review and assess various issues related to the operations of KPCCC, in particular the Center’s residential child care facilities. We concluded the following:

  • The treatment environment at KPCCC is not inappropriate or unduly harsh, even in the light of serious incidents and what appears to be a high rate of runaways. The basis for this central conclusion is:
    Notable incidents involving staff and residents were isolated events

        . We saw no report, nor received any report from contacts with state caseworkers, parents, or foster parents of ongoing abuse or harsh treatment of residents by KPCCC staff. OCS managers have commented that supervision of youth by staff could be improved. However, OCS and DJJ workers we interviewed do not believe the circumstances of the past serious incidents reflect a systemic deficiency in KPCCC’s behavioral treatment model or the general capability of staff.

    High runaway rates reflect the nature of the residential setting and youth involved, rather than major operational deficiencies

        . KPCCC has no written procedures on how staff is to handle youth who run away. The Center’s management trains staff to counsel youth against running away, but do not encourage the physical restraint of residents about to runaway. Since KPCCC provides treatment in a semi-secure setting, staff does not have the authority to forcibly hold youth who want to leave.
        State law requires youth in state custody, adjudicated or not, to be placed in the least restrictive setting. This policy often leads to situations where high risk youth are receiving treatment in a semi-secure setting. Before the youth can be placed in a more restrictive setting, the juvenile is given the opportunity to succeed in a less restricting placement. Doubt as to the level of supervision required for a given juvenile is typically resolved to the benefit of the youth, and the least restrictive option is chosen. Given this state policy, coupled with the semi-secure treatment setting, the rate of runaways is more a result of the combination of these factors rather than a reflective of a harsh treatment environment.

    Limited survey responses indicate few problems or concerns with KPCCC

      .
  • Juveniles discharged from KPCCC to foster care were placed in appropriate settings
  • Treatment and service delivery are generally consistent with Medicaid documentation requirements
  • Facility and staff qualifications generally meet standards
  • Work done at KPCCC by OCS staff is consistent with the agency’s staff development policy
  • KPCCC’s expenditures and revenues are consistent with reported budget amounts
  • Transportation expenditures for youth travel appears reasonable

Findings and Recommendations

  1. The executive director of the Kenai Peninsula Community Care Center (KPCCC) should strengthen the procedures related to maintaining adequate documentation, required by state regulations, on the treatment of youth.
  2. The executive director of KPCCC should assign a staff member the specific responsibility to develop and maintain required personnel files documents.
  3. The ethics officer for the Department of Health and Social Services should coordinate with OCS’ management to develop a policy regarding disclosure of state employees’ work with community based agencies while on educational leave.