Out-of-State Placements & Sequel Update

December 3, 2020

In response to the ongoing national discussion about out-of-state placements, specifically within Sequel Youth and Family Services facilities, DCYF has prepared the attached update. For reasons outlined in the update, DCYF has made the decision to end new placement referrals to Sequel facilities as of September 2020. In addition to the update, DCYF would like to highlight the following information related to its ongoing work to bring youth home from out-of-state placements:

  • When DCYF was created on July 1, 2018, the agency had many youths placed in group care facilities out of state. DCYF leadership committed to bringing as many of these children back to Washington as possible. In keeping this promise, DCYF took steps to review placements and move children and youth back when it was achievable and appropriate to do so. Secretary Hunter and DCYF leadership joined field operations staff in visiting all children in out-of-state placements in person to see each facility and interview the youth placed there.  
  • In August 2018, there were 84 children/youth placed out of state on child specific contracts.
  • DCYF now has 13 youth in out-of-state placements on child specific contracts. These are youth for whom DCYF could not find appropriate placement within Washington state, either because the current Behavior Rehabilitation Services (BRS) providers could not serve the youth safely or because the treatment that is required is not currently available in Washington state.    
  • DCYF is working on several strategies to expand in-state capacity to address critical treatment needs for youth. This will help to eliminate the need to send youth out of state to get their treatment needs met. Immediate strategies and services gaps include the following:
    • Increase the number of residential treatment beds for youth who exhibit sexually inappropriate behaviors. In-state capacity to meet this need is inadequate, often necessitating the placement of youth in states where this type of treatment is more available.  
      • DCYF has been in discussion with the current provider community to increase the number of beds available in this area. DCYF may need to pay a higher rate of reimbursement for this population to entice providers to take on this population. This would need an increase to the BRS budget.
  • Increasing the total number of BRS providers and their capacity for serving youth.
  • DCYF has added 27 facility beds since July 1, 2020.
  • DCYF has providers in the application process that will increase in-state resources in both facility-based care and therapeutic foster care.
    • Increase the number of Child Long-term Inpatient (CLIP) beds administered by the Department of Behavioral Health and Recovery.
  • The Legislature will need to provide more funding to increase the number of CLIP beds statewide. There are currently long waiting lists for youth who need this level of service.  DCYF has had to place for youth to go out of state while waiting for a bed to be ready for dependent youth.
  • DCYF is working to contract for a total of twenty BRS-Mental Health (BRS+) beds across the state. This is a new type of BRS service that seeks to fill the gap for the lack of CLIP beds for youth with severe mental health needs.  
  • Increase placement options for youth who are Developmental Disabilities Administration (DDA) eligible, especially for those youth who are participating in Extended Foster Care (EFC). 
  • DCYF has been working with DDA to better partner on these youth and cost share youth that are cross-system involved.
  • DDA may need special funding to supplement the transition of EFC youth to DDA services. This funding could also help to pay cost shares for the youth come into care with DCYF that have no abuse or neglect. 

Review of Sequel Programs Report