In reviewing these reports, staff noticed a worrisome trend, i.e., despite the inability of the services funded by the State of Connecticut to contribute to the well being of these children, the large amount of money expended for them was extraordinary. 

The cases brought to the Child Advocate’s attention because of concerns about the appropriateness of the service plan were characterized by the almost exclusive use of long-term institutional and residential care. While the average annual cost of residential care as calculated by the Department of Children and Families (DCF) is about $50,000, for many of the children brought to the attention of the Child Advocate, average annual costs ran to $90,000 and above.  When care included significant utilization of both psychiatric hospitals and State-run facilities this annual cost was triple or even quadruple the usual state average.  More disturbing was that each of these children had spent or appeared destined to spend a significant proportion of their childhoods trapped in such treatment patterns. And this was the case despite the appearance in case records of periodic requests and recommendations from families and professionals that community-based services could be implemented to treat children while allowing them to remain in their homes.

During this same period the Child Advocate and the Attorney General have collaborated on a number of investigations that have explored serious allegations of shortcomings of the Department of Children and Families and Connecticut agencies at all levels responsible for the welfare of children. Through these investigations we have developed a strong mutual concern about the approaches taken by DCF and other agencies charged with planning care for children. In order to highlight these concerns we have undertaken to bring to public attention the story of one of the youngsters whose tragic personal story illustrates the tremendous costs associated with the failure to provide appropriate services in a timely fashion.[1]

Failure is Expensive

The child who is the primary focus of the report is one who is now “aging-out” of the care of the Department of Children and Families.[2]  While she came to the attention of the Department as a result of protective services concerns, she has ultimately received long-term assistance because of diagnosed mental and behavioral health needs.  She had, through much of her time in care, an involved family, who regularly made clear that they would care for her at home if they could receive some support and assistance. Many of the community supports her family required were not available at all, or were severely limited by policy or funding. Because many community services that were delivered focused only on immediate crisis, they were withdrawn before they could be effective in meeting long-term needs. Some supports were never tried.  Instead, this youngster has been the “beneficiary” of 24 institutional / residential placements spanning ten years.  Over the last eight years, she has spent over 2700 days in one kind of congregate facility or another.

As you will see, the cost to the State of Connecticut of the one child featured here came to over 1.8 million dollars.  Because she has spent so many years in residential and institutional placements, the total cost for her care has been predictably high.  Because her treatment needs were not met by the care provided, her behavior seriously deteriorated over the years.  As the demands she placed on facilities increased, finding agencies to accept her became increasingly difficult, leaving the more expensive state run facilities as placements of last resort. 

But this child was not alone among the children reviewed in the level of her annual costs.  She differed from several of the children only in that she had aged-out of the system. Some children’s cases reviewed had similar annual costs, but at this point were still early in the cycle that the featured child had already completed.  Others, as a result of the system’s failure, came to an end of services earlier by running away or entering juvenile and adult correction programs, or, as in the case of one teenager we investigated, by committing suicide.

Despite the extremely high costs, the efforts on this child’s behalf have yielded little.  Now an adult, she faces a future in which her primary mental health difficulties have never been fully or effectively addressed. Her marketable skills have never been recognized or encouraged.  Her abilities to carry out basic tasks necessary for an 18 year old to begin life as an adult have never been developed.  In fact, it is likely that this young woman will continue to require even larger public expenditures for mental health, income support, and, perhaps even correctional services if she is not able to function in society.   If the goal of these large State expenditures was to improve the child’s prognosis, the State of Connecticut has failed.