A state audit on Wednesday uncovered a slew of problems at taxpayer-funded foster homes, a youth mental hospital and a juvenile correctional center, including unsafe medication management and weak training policies.
The audit, presented Wednesday to a legislative audit subcommittee, focused on Summit View Youth Center, a state-operated juvenile correctional center; Desert Willow Treatment Center, a state-run mental hospital; Nevada Homes for Youth, a state-licensed drugs and alcohol treatment center; and Genesis, a Clark County-funded foster care agency.
The providers collectively shelter more than 100 youths in Southern Nevada. The deficiencies revealed in the audit ranged from flawed medication administration policies to a lack of staff training, incomplete treatment plans and missing policies for reporting abuse and neglect.
“It seems like medication management is the issue that bubbles up every time we have these presentations,” said Assemblywoman Maggie Carlton, who sits on the audit subcommittee. “Do we have any idea why we just can’t seem to get a handle on it?”
Deputy Legislative Auditor Sandra McGuirk said the providers need to take responsibility for medication management.
“At the end of the day, they’re the ones who are administering the medicine,” she said.
The audit found the most serious problems at Genesis and Nevada Homes for Youth. At Genesis, a North Las Vegas foster care agency that shelters 35 youth from ages 6 to 18, children were given prescription medication without a doctor’s order in their file. Three of seven youths missed 11 days of medication because staff failed to refill their prescriptions.
The audit also found no evidence to show that certain employees had been fingerprinted or trained to administer medications.
Genesis operates five staff foster homes and two family-run ones.
Owner Curtis Stuckey didn’t dispute the audit’s findings Wednesday, but gave lawmakers an earful about what it’s like to take in Nevada’s most troubled kids.
“I’m not comfortable with my own programs because we don’t have adequate staffing,” Stuckey said. “I’m one of the only agencies to step up and take these kids that no one else will take… . I sleep in the same house that was shot up by the kids. There are no policies and procedures for that.”
County officials told the Review-Journal that no children at Genesis are at risk.
“We have caseworkers visit every month,” Jill Marano, assistant director of the Clark County Department of Family Services, said in an interview. “If we had immediate safety concerns, we’d absolutely intervene right away.”
Nevada Homes for Youth, a drug and alcohol treatment center, lacked policies outlining when consent is needed to administer psychotropic drugs, the audit said. Patient files were missing prescription orders and some staff members were fingerprinted an average of 112 days after they were hired.
Similar problems surfaced at Summit View Youth Center and Desert Willow Treatment Center, the two state-run facilities. Auditors found medical files at Summit View — a correctional facility in Las Vegas — contained dosage errors, missing staff initials, blank spaces and evidence that some kids did not get their medication for up to three days.
At Desert Willow, a mental hospital that housed an average of 18 kids, contained patient files with incomplete consent forms and missing medical information.
State officials said they have updated policies to address the issues outlined in the audit.
“(The state) has improved its medication management practices over the last several years,” said Karla Delgado, a spokeswoman for the state Division of Child and Family Services. “Although we strive for perfection, we are not there yet and appreciate the recommendations from the Legislative Auditors.”
Contact Ramona Giwargis at firstname.lastname@example.org or 702-380-4538. Follow @RamonaGiwargis on Twitter.