Disability Rights Ohio (DRO) is welcoming state action to suspend admissions at a Youngstown youth treatment facility but worries plans from state mental health regulators to correct problems there don’t get to the underlying causes. The Ohio Department of Mental Health and Addiction Services (OhioMHAS) says it is in contact with the facility regularly to respond to complaints but faces statutory limits on its powers.

DRO, a nonprofit designated by the state to advocate for people with disabilities and mental illness, recently issued a report highlighting serious concerns about Youth Intensive Services, including use of dangerous restraint techniques and frequent instances where youth walked off the site and later returned showing evidence of drug use or sexual assault.

DRO said upon issuing the report that it felt OhioMHAS was not doing enough to address the problems. The department responded with assurances it was working with the facility and DRO, and about two weeks ago it announced suspension of admissions at the facility, as well as requirements for corrective action by YIS. OhioMHAS said it was prepared to take further action if the situation does not improve. (See The Hannah Report, 6/28/24.)

In a phone interview, DRO Executive Director Kerstin Sjoberg told Hannah News she was glad to hear about OhioMHAS’ latest actions but remains worried that the state agency isn’t doing enough to address the problems.

Sjoberg said the state’s findings don’t address the problem of “AWOLs” – instances where youth leave the site unaccompanied. She said the frequency of AWOLs at YIS indicates a lack of programming and adequate supervision by staff. “Other facilities have much less frequent AWOLs that we have visited, so it can be done,” she said.

“Addressing that sort of core, underlying problem – the pervasive lack of adequate, trauma-informed, therapeutic programming at the facility – would also likely address AWOLs, right? If kids are bored, and they don’t have anything to do and they don’t feel like they’re getting anything out of where they’re at, that’s going to lead to them likely leaving,” she said.

Sjoberg said plans for OhioMHAS to rely on documentation as evidence of improvement, like sign-in sheets for staff training sessions, also concerns DRO. She said after a prior mandate by OhioMHAS for YIS staff to be retrained after reported use of dangerous restraint techniques, use of such techniques continued.

An apparent dearth of programming also raises questions about whether YIS should maintain its certification by OhioMHAS as a qualified residential treatment program (QRTP), Sjoberg said.

DRO put its concerns into writing this week in a letter to OhioMHAS Director LeeAnne Cornyn in advance of an upcoming meeting planned with her.

“We really want to work with them. I know it sounds like I’m criticizing OhioMHAS a lot here …. We have hope based on the fact that they did immediately suspend admissions,” she said.

“We understand that they can’t be everywhere. They cannot be everywhere and making sure everything is perfect, and we only bring concerns to them when they are egregious and the facility’s not willing to work with us,” Sjoberg said.

The letter asks that OhioMHAS add AWOLs to the list of incidents that facilities like YIS must report to the state agency. It also requests that the department further examine YIS’ therapeutic programming to ensure it meets QRTP certification requirements. As to DRO’s concern about relying on documentation, the letter says DRO knows of several incidents that were either inaccurately depicted in reports or not reported at all, raising questions about the reliability of documentation.

Eric Wandersleben, spokesperson for OhioMHAS, said in an email that it’s important to consider that facilities like YIS serve a mix of clients, some mandated to be there, some not. “These are not maximum security facilities and, as such, are not meant to be locked down,” he wrote.

Wandersleben said state law does not treat AWOLs as reportable incidents, meaning OhioMHAS can’t take action against a provider for an AWOL incident, but said OhioMHAS does have the expectation that providers immediately report missing youth to law enforcement. “In the case of YIS, our licensure and certification team ascertained that YIS leadership had worked with local law enforcement to establish a protocol for how the two entities would respond when a youth left the facility AWOL,” he wrote.

As to the issue of OhioMHAS’ onsite presence at YIS, Wandersleben provided a list of seven occasions in the past 20 months where the department conducted onsite reviews in response to complaints, saying the majority were unannounced visits. On two of those occasions – in December 2022 and May 2023 – the department identified findings of non-compliance and issued corrective action plans. “Each time, the provider corrected deficiencies to come into compliance with retraining and policy requirements. In addition, in order to offer support and technical assistance, beginning in July 2023, OhioMHAS’ legal and licensure/certification teams began meeting monthly with YIS’ owner and legal counsel,” he wrote.

Sjoberg’s letter to Cornyn is available at www.hannah.com>Important Documents & Notices>Library.