Nevada agencies responsible for children who need residential psychiatric care all wrestle with the same problem: in-state services are lacking.
That’s why state officials are developing a new regulation they hope will ultimately reduce the number of children sent to out-of-state treatment centers.
The core of the problem is the state’s current regulation for health care facilities. Nevada Administrative Code 449 doesn’t define what constitutes a psychiatric residential treatment facilities for youth, said Kyle Devine, chief for the state’s Bureau of Health Care Quality and Compliance. The lack of a definition means the state has no framework for licensing such facilities.
“I don’t think that’s going to be the magic bullet that’s going to solve the problem overnight,” said Clark County Family Court Judge William Voy this week of the effort to correct the regulatory omission. Providers who have come to him over the years were more interested in getting a commitment from the state or the county that their beds would be used, he said.
Since psychiatric residential treatment facilities are not defined, the state can’t license them. The facilities that now provide such services in Nevada are licensed as full psychiatric hospitals. NAC 449 was last revised in April 2012.
As of Wednesday, state officials didn’t know why the issue hadn’t been addressed before.
“We have identified it as an issue now and we are trying to write a regulation to allow these facilities,” Devine said.
A health care facility also must be licensed by the state to be eligible for certification by the federal Centers for Medicare and Medicaid Services, Devine said.
If such facilities were to operate in the state under current regulation, they would have to operate as a full psychiatric hospital.
Desert Willow Treatment Center, with 58 beds, is the only public hospital currently offering residential treatment for youth in Clark County. Those working with children and youth who need such services have said the facility can’t meet the demand.
Clark County Department of Juvenile Justice Services sends an average of about 50 children and teens in need of residential mental health care out of state each year, Voy said. There were years when that number approached 200.
The numbers have gone down as the department has moved to provide more wrap-around services for youth and the intensive supervision program for youth who remain in the community, he said. The wrap-around services range from counseling to close supervision.
State officials hope the new regulation will encourage providers to open psychiatric residential facilities in the state, Devine said.
“We are pushing to try and have the regulation before the State Board of Health in June,” Devine said.
The new regulation “would keep children closer to their families,” said Kristi Jourdan, spokeswoman for Clark County Family Services.
“This is about providing quality of care to children for a variety of specialized issues that include sexualized behaviors and fetal alcohol syndrome, among others,” she said.
As of January, there were 11 juveniles in the care of Family Services who were in residential treatment centers out of state, according to Jourdan.
The regulation has to be approved by the State Board of Health, but before it goes to the board, the state will hold public workshops for input.
If approved by the State Board of Health, the regulation would then go to the Legislature for approval, Devine said.
“I think the biggest change is that we would have psychiatric residential treatment facilities open in the state of Nevada to provide better access to our youth,” Devine said.
Montevista Hospital, a private psychiatric 90-bed facility in Las Vegas, last spring invested more than $10 million in improvements that include 72 additional beds, with 48 devoted to residential treatment for youth.
The 48 residential beds will operate under the hospital’s license, said Doug Ginn, executive vice president of operations for Strategic Behavioral Health based in Memphis, Tenn. and owner of Montevista.
The expansion is slated to be completed in August.
The hospital will be rolling out the 48 residential beds on a gradual basis, starting with 12, Ginn said. The company’s approach has been to have the acute care and residential treatment together because staff have the medical expertise in close proximity, he said.
But there are a lot of stand-alone residential treatment facilities in other states and they do a good job, Ginn said. The new regulation would attract more providers to Southern Nevada, which are needed.
“Our 48 beds aren’t going to come close to meeting the needs of Clark County alone,” he said. “Even after our 48 beds are running at capacity, there will still be need.”
Reporter Yesenia Amaro can be reached at firstname.lastname@example.org or 702-383-0440.