On Monday, Governor Hutchinson announced seven juvenile treatment and correctional facilities taken over by the Arkansas Department of Human Services on Jan. 1 will be placed back in private control as soon as next July. By the end of the year, the governor said, the state will issue a solicitation for one or more contractors to operate the youth lockups, with the winner or winners likely to be announced in March.
For over two decades, the DHS’ Division of Youth Services (DYS) paid two Arkansas-based nonprofits to run the facilities, but in 2016 a political fight erupted over the state’s attempt to switch to an out-of-state company instead. Legislators sympathetic to the ousted nonprofits blocked the new contract in December, and the governor was forced to step in at the last minute to avoid a shutdown of the lockups. Hutchinson directed the DYS to assume provisional management of the facilities, comprised of sites in Dermott, Mansfield, Lewisville, Colt and Harrisburg. (The state's eighth and largest facility, the Arkansas Juvenile Assessment and Treatment Center in Alexander, continued to be managed by a separate private provider.)
Hutchinson said today that the seven facilities “have improved services” during the past seven months of DYS control, citing their provision of mental health and substance abuse therapy, a new virtual education program and a new family engagement initiative. The agency’s direct management of the lockups has allowed it to “get a better handle on the services that are delivered,” the governor said, “not just in an oversight role but in a more detailed fashion, so that they could determine and make recommendations in regards to the future and how those services would be delivered.”
According to a letter sent to the DYS in January by the advocacy group Disability Rights Arkansas, the state initially stumbled when it came to both therapy and schooling at the lockups. There were months-long lapses in mental health treatment following the takeover, the disability rights group said, along with “a failure to provide required and necessary education.” Since then, however, the DYS has contracted with community mental health centers — by way of the Division of Behavioral Health Services, a separate arm of the DHS — and each lockup now has a therapist on-site. The DYS has also initiated a partnership with Virtual Arkansas, a project of the Arkansas Department of Education that provides online coursework to public schools across the state.
Following the governor’s announcement Monday, DYS Director Betty Guhman described the agency’s new family engagement efforts, including a July 30 “Family Day” event that welcomed parents and other relatives to each of the facilities for games and activities. Guhman said the event was the work of a new family advocate position created within the DYS central office, and “each of the facilities now have someone who’s focusing on families.”
Asked later why he sought to relinquish state control of the lockups if the DYS has made positive changes since the takeover, Hutchinson said that a private provider could make further improvements still. “Basically, he was pleased with what DHS and DYS were able to do but he also recognizes that there’s more to be done,” J.R. Davis, the governor's communications director, said Monday afternoon. “In the private sector, there are those who have the capacity to do more and be more efficient.”
Hutchinson and Guhman also announced several internal and external reviews of the agency. The governor said he is seeking a consultant to provide “an outside, independent look at not just facilities, but our whole system of youth services.” That study will resemble the 2015 report on the Arkansas child welfare system delivered by consultant Paul Vincent, the governor said; it’s not yet clear who will conduct the review. Meanwhile, a security audit of the lockups, including the facility in Alexander, will be performed before the end of the year. A consulting firm retained by the DHS will identify ways that the state can maximize its Medicaid funding for youth in DYS custody, thereby reducing the agency’s reliance on state general revenue.
Guhman is initiating a broad internal review of DYS “programs and policies” to ensure that the facilities meet American Correctional Association standards. “That’s what we’re here to do,” she said. “We need to make sure we’re doing that, both in written policy and in actual practice.” And, she said, the agency is “looking at community-based programs at the same time we’re looking at our residential [facilities], so that we’re strengthening the services that judges have available to them.”
Sharon Strong, an attorney for Disability Rights Arkansas, said many of those plans constitute “a step in the right direction,” such as ordering the independent review of the system. “To get a fresh set of eyes on it — I think that would be a really good idea,” Strong said. The DYS’ family engagement initiative is “commendable, a big positive,” she said. “They’re working on [youth] transition after they get released; I think that’s all very good, and an important piece that’s been missing.”
Strong said she has concerns about the use of Virtual Arkansas. “My understanding is that that’s a tried-and-true tool that’s used throughout the state ... but it’s supposed to be used as a supplement, not the primary method of education.”
She also noted that the state’s eventual contract with a new private provider, or providers, won’t necessarily look like its old contract with the nonprofits. “They’re still wanting to maintain the piece about behavioral health, community mental health, so it sounds like there will be some state involvement. … The governor said he wants the ability ‘to hold contractors accountable,’ so maybe they want to bid out the day-to-day operations but still manage pieces of it.”
Scott Tanner, the state juvenile ombudsman at the Arkansas Public Defender Commission, was also cautiously optimistic. “Potentially, there could be some very positive outcomes to increased collaboration with [the Division of] Behavioral Health,” he said. “Behavioral health is a component that’s needed on the community level and also on the residential level, particularly for youth coming into DYS’ residential system and existing that system.”
Tanner also said the state was correct to look into maximizing its use of federal Medicaid money. Under Arkansas’s Medicaid program, federal dollars match state dollars at a 70/30 rate. But while most youth remanded to the DYS custody are eligible for Medicaid before they are confined, Tanner explained, their eligibility typically ends once they are locked up in a treatment or correctional facility. That means the DYS must pay for a confined youth’s medical needs entirely out of state general revenue.
“Placement in detention cuts off Medicaid funding, because they're considered to be in a secure, confined area, and Medicaid dollars are only supposed to be spent on medical services and rehabilitation. So there’s just been a historic prohibition on using any Medicaid funds,” he said. “But, there has been some windows of opportunity for youth committed to DYS that do need a residential psychiatric placement, like at the [Arkansas] State Hospital, or Youth Home or Piney Ridge in Fayetteville. And so for those committed youth that are going into providers that can bill Medicaid, there needs to be some allowance.”
Supplementing the DYS budget with additional Medicaid money, in places, could allow the state to make progress toward its long-stated goal of reducing reliance on confinement of youth and increasing community-based programs, Tanner said. “It’s a way of stretching our general revenue monies, because the mission is always greater than the budget. … The focus on making sure that we are being the wisest steward of both [state] general and federal resources is critical. If we hope to reduce reliance on secure incarceration, we absolutely have to increase capacity in the community to address those needs and issues.”
As for the return of the lockups to a private contractor, Tanner said, the youth services agency must continue to stay as engaged as it has been since the takeover: “The most important piece is that once we have new providers in place in July 2018, DYS and its various stakeholders are wide-eyed about the areas that we need to watch and improve.”
This reporting is courtesy of the Arkansas Nonprofit News Network, an independent, nonpartisan news project dedicated to producing journalism that matters to Arkansans.