Other commitments have kept us away from the Blog today. They also kept me away from all but a few minutes of the legislative hearing related to the Lord's Ranch and other residential treatment centers for kids with emotional problems.
The room was packed with lobbyists, both for residential treatment centers and for community-based services. I caught most of the presentation of a visiting expert who said, in brief, that Arkansas spends a disproportionate amount of money on residential treatment centers that undergo no certification review and no review of whether their services do any good. Community services are cheaper, better, more accountable and keep kids in their families. There's no standard assessment process for putting kids in the residential centers, which charge enormous sums (reimbursed by Medicaid).
Arkansas Advocates for Children and Families has entered the issue. This well-respected group said placement in residential facilities is "often not the most effective long-term strategy in treating seriously emotionally disturbed youth. Rather, children are usually better served by proven interventions in their homes and communities alongside their families or caregivers."
Spending on mental health for children has jumped from $100 million to $200 million in four years (not for residential treatment alone, as I wrote erroneously earlier.) But some $112 million is spent on residential treatment. We spend in excess of the state of Ohio, which has more than four times as many people. Today's expert mentioned that Idaho is trying to rein in residential treatment costs -- now at only $5 million is so.
The unspoken story in this meeting is political influence. Sources I trust tell me that the residential centers such as the Lord's Ranch have resisted the most routine sorts of regulation. They've been able to do so by spending tens of thousands in political campaign contributions, more probably than even those I've been able to detail so far. I'd found five names under which the Lord's Ranch gave money to legislators in 2004. Another sleuth on the case says he's found nine corporate veils for the Lord's Ranch operator.
UPDATE -- We're told a DHS official dodged a legislator's question about Lord's Ranch. Otherwise, it was all about the issue of the smarter expenditure of state money on community treatment versus outlandishly expensive, questionably useful residential treatment. And that IS the issue. (Along with, of course, why legislators fight so hard for the more expensive, less useful method.)
We'll give you some more on this meeting when we have it.