A child with specialized needs was seven days away from being discharged from a group home unless Scioto County paid a $76,020 bill, forcing commissioners to approve an emergency payment at Thursday’s meeting.
Commissioners added an emergency payment to Thursday’s agenda after receiving a letter from Step Into New Beginnings, a group home that provides specialized treatment for children with significant needs.
The letter gave the county seven days to pay or the provider would discharge the child from its care.
“We received a letter yesterday—a seven-day notice to discharge a child out of care due to slow payment,” Commissioner Scottie Powell said. “This is in the amount of $76,020.”
Commissioners authorized the payment to make sure the child could remain in the placement and continue receiving treatment.
Powell said the bill reflects several problems hitting the county at once: the rising cost of specialized foster care, rapidly increasing provider rates, and long delays in receiving federal reimbursement money.
“This has to go through, or this group will do a seven-day discharge,” Powell said. “There’s nothing we can do here today other than bring awareness to it and, quite honestly, pay the bill so we can ensure kids continue to receive the care they need.”
Costs Have Tripled
Powell said his calculations show the county is now paying roughly three times as much for each child in care as it did just a few years ago.
Children with serious behavioral, medical, developmental, or mental health needs may require highly specialized placements that can cost hundreds or even thousands of dollars per day.
Counties have little control over those rates when a child needs immediate care and only a limited number of providers are able or willing to accept the placement.
Powell questioned how a provider could give only seven days’ notice before removing a vulnerable child from care.
“I don’t even know how this is legal,” he said. “In the nursing home world, you’ve got to give a 30-day notice. Really, in any housing.”
Powell said the rules governing residential treatment providers need to be addressed at the state level.
“This industry and its regulations need worked on, and unfortunately, that’s at the state level,” he said.
County Waiting on More Than $400,000
Commissioner Merit Smith said another major part of the problem is the slow arrival of federal Title IV-E reimbursements.
Title IV-E is a federal program administered through the Ohio Department of Children and Youth. It reimburses county agencies for eligible foster care, adoption assistance, and kinship guardianship expenses.
Smith said Scioto County is currently owed more than $400,000 in Title IV-E money.
“Last week, I put together a letter to Congressman Dave Taylor’s office about the IV-E money,” Smith said. “They have opened an inquiry as to why the money is so slow.”
Smith said he did not know whether the child involved in the $76,020 payment was eligible for Title IV-E reimbursement. However, he said delayed payments from the program are a major strain on the county’s finances.
“If so, it could be a big part of the problem because we’re not getting the IV-E money as quickly as we’d like to,” he said.
County Could Face Fiscal Emergency
The county must pay providers while waiting for reimbursement, creating a growing hole in the budget.
Powell has repeatedly warned that the rising cost of caring for children with complex needs could put Scioto County into fiscal emergency if the system does not change.
Commissioners have said the number of children in county care has fallen, but the cost per child has climbed sharply. A small number of children requiring extremely specialized treatment can consume a large portion of the Children Services budget.
Thursday’s payment prevented one child from being removed from care, but it did not solve the larger problem.
For now, county leaders say they are left paying rapidly increasing bills while waiting for state and federal officials to address provider regulations and delayed reimbursements.