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Let’s solve multi-system youth issues together

Let’s solve multi-system youth issues together

When PCSAO’s membership was identifying its strategic priorities for the next two years, the issue of serving multi-system youth rose to the top. “Multi-system youth” is defined as a youth in need of services from two or more systems (child protection, juvenile court, mental health, and developmental disabilities). To say this has not been discussed over the last 30-plus years is quite an understatement.

For those who have been in the field for a while, you may recall “Cluster” in the mid- to late 1980s with state-level funding available to assist counties with paying for multi-system youth placements. From there, county Family and Children First Councils (FCFCs) were codified in statute in the early 1990s with specific mandates to convene all the child-serving systems for the purpose of improving the coordination of services for children across systems. The premise behind county FCFCs is solid, especially when partners are willing to come to the table, work across systems, and resources are plentiful.

Then a great opportunity came forward in the mid-2000s called Access to Better Care (ABC). ABC came about as a result of some legislative pressure to introduce a bill that would eliminate the option of parents relinquishing custody in order to obtain behavioral health services for their child. This resulted in an infusion of new funding for children’s behavioral health, including a designated funding line in what was then the Ohio Department of Mental Health’s budget. ABC was able to start new promising or evidence-based treatment services across Ohio. However, ABC did not last long enough, nor was there enough funding, to truly address custody relinquishment for accessing services.

Of course, there have been improvements in all systems over the last 10 years such as the significant reduction of youth in Department of Youth Services institutions, the recognition of and state support for improving options for families with children on the autism spectrum, the partnership between the Ohio departments of Developmental Disabilities (ODODD) and Mental Health and Addiction Services (OhioMHAS) to fund pilots for high-need youth and to focus on trauma-informed care, and the recent effort between OhioMHAS, Ohio Department of Medicaid, and the Governor’s Office of Health Transformation to redesign behavioral health services, expand the array of services under Medicaid, and “carve-in” to managed care.

While all of these efforts are to be commended and do provide needed community-based services for children, the reality is parents are still making the very difficult decision to relinquish custody of their children when services are not accessible or affordable to the average Joe, even with private insurance. PCSAO’s Factbook revealed that while allegations of abuse and neglect account for 82 percent of screened-in reports, 6 in 10 children in agency custody are there for reasons other than abuse and neglect. These reasons include delinquency, dependency, developmental disability and behavior problems. Another startling data fact is that nearly half of the youth in residential treatment facilities were primarily removed for reasons other than child abuse and neglect. Again, those reasons are child’s behavior problem, delinquency and unruliness.

It is finally time to solve multi-system youth needs. Through advocacy efforts, the legislature agreed that there should be a state-level committee studying the issues of serving multi-system youth. In the final version of the budget, a Joint Legislative Committee on Multi-System Youth will be formed by mid-August consisting of five members of the House and five of the Senate. The committee has been tasked with:

  1. Identifying the services currently provided to multi-system youths and the costs and outcomes of those services;
  2. Identifying existing best practices to eliminate custody relinquishment as a means of gaining access to services for multi-system youths;
  3. Identifying the best methods for person-centered care coordination related to behavioral health, developmental disabilities, juvenile justice, and employment;
  4. Building a system of accountability to monitor the progress of multi-system youths in residential placement; and
  5. Recommending an equitable, adequate, sustainable funding and service delivery system to meet the needs of all multi-system youths.


PCSAO is hopeful that this new Joint Legislative Committee on Multi-System Youth can finally address service access, resolve competing resource issues, and determine the best practices for serving these youth. We encourage all partners, families and state departments to join us in supporting this joint legislative committee. Families are counting on this so that they don’t have to make the unthinkable decision of relinquishing custody of their own child in order to access services. The time is now – let’s finally solve multi-system youth issues together!