The
Iowa Code contains few provisions that speak directly to situations regarding
runaway youth. Iowa Code Section 232.19
outlines provisions for taking youth into custody, and Code Section 232.21
defines criteria for the placement of youth into shelter care facilities. Both
of the Code Sections make specific reference to runaways. Iowa Code Section 710.8 places prohibitions
on harboring a runaway. Those Code
Sections are discussed below.
The
Iowa Code does not lay out any procedures or responsible parties to respond or
intervene specifically after a runaway is taken into custody or has been being
placed in shelter care. Related
responses for the juvenile court and the involvement of other system officials
(county attorney’s, juvenile court officers, DHS, etc.) are, however, laid out
in law for the following proceedings:
Family in Need of Assistance (FINA), Child in Need of Assistance
(CINA), delinquency processing and
civil commitments to substance abuse and hospital settings. Each of those processes is discussed later
in this section.
A
number of sections of the Iowa Code related to runaways are modeled after or
specifically related to federal law - the federal Juvenile Justice and
Delinquency Prevention Act (JJDP Act).
The JJDP Act places restrictions on the use of secure holds for runaways
- status offenders. An overview of
relevant provisions of the JJDP Act is provided under “Federal Law” below.
Immediately
below is an overview of responses both specific to runaway behavior and related
system processing activities. It should
be noted that the Iowa Code contains no formal definition of “runaway.”
For purposes of this report “runaways” will be defined as those
juveniles who leave and remain away from home without permission.
Discussion
immediately below references Iowa Code Sections (and some federal reporting
requirements) regarding processing for youth taken into custody that is
specific to runaways.
It
should be noted that “taking into custody” is the process of removing a youth
from the “street” and determining what further activity will need to take
place. Taking a youth into custody is
somewhat similar to that of placing an adult under arrest. Taking a youth into custody does not,
however, mean that a youth will be
securely “detained” - placed in a locked setting in a jail or a police
department. Iowa Code Section 232.19
(1) allows for peace officers to take youth into custody:
* to
be reunited with their family or removing the child to a shelter care facility if there is reason to
believe the youth has run away,
* by
order of the court,
* for
delinquent acts,
* or
for material violation of a disposition order.
The
Iowa Code provides for a certain amount of latitude as to which youth can be
taken into custody. Clearly, most
runaway youth can be taken into custody for the purpose of being reunited with
their parents or taken to a shelter care facility. Youth that have run away from a court ordered shelter or
treatment facility can be taken into custody for violation of a court order.
Iowa
Code Sections 232.78 and 232.79 also allow for youth to be taken into custody
with ex parte court orders or without court orders in situations where removal
is necessary to avoid imminent danger to the child’s life or health.
Youth Reported as Runaways
to Law Enforcement Agencies
Law
enforcement practices regarding processing of runaway youth vary by jurisdiction,
and can also be influenced by the situation unique to each runaway
incident. Typically, when youth are
reported missing to a law enforcement agency there is immediate radio
notification to all other law enforcement agencies within the jurisdiction, so
that officers can look for the youth while on patrol. Department of Public Safety (DPS) Officials indicate that a
telephone call is all that is required to begin
the process of relocating a runaway.
Regardless,
once a law enforcement agency receives information on runaways
(a
description of the child and circumstances surrounding their disappearance),
that information is to be immediately input on the Iowa On-Line Warrants and
Articles System (IOWA). The entry of
the information on the IOWA system provides immediate access regarding the
details of a given runaway, and is broadcast to all law enforcement agencies
statewide.
Any
information entered on the IOWA system
regarding juveniles is automatically updated to the National Crime
Information Center (NCIC) which is the FBI’s computer system. That system provides nation-wide access for
information regarding runaways (also information regarding wanted delinquent
juvenile and criminal adult offenders).
Law
enforcement officials that take youth into custody can look to both the IOWA
and NCIC systems to determine if the youth is reported as a runaway or is
wanted on any delinquent offense.
Information
on the IOWA system relating to missing persons is forwarded to the Iowa Missing
Persons Information Clearinghouse (MPIC).
Procedures regarding missing persons and a description of MPIC are detailed in Iowa Code Section
694. Upon receipt of information
(including information on runaway youth) from the IOWA system MPIC will assist
law enforcement and families in locating missing persons. Any person may submit information regarding
missing unemancipated minors to MPIC.
MPIC’s functions include: collecting and disseminating information
concerning missing person in Iowa, training law enforcement and other key
staff, cooperating with other states and NCIC, maintaining a toll-free
telephone line to receive and disseminate information related to missing
persons, etc.
Iowa
Code Section 694.10 (3) additionally requires law enforcement agencies to
submit all missing person reports to MPIC.
Missing person reports are to contain information relating to the
missing person, information or evidence gathered by a preliminary
investigation, a law enforcement officers assessment of the case based upon all
evidence and information, etc.
Additionally,
law enforcement agencies or parents
can initiate relocation efforts through the National Center for Missing and
Exploited Children. DPS officials
indicate that the National Center typically does not begin providing assistance
until after a runaway youth has been missing for at least 30 days. Requests for assistance from the National
Center related to parental abduction, involuntary or stranger abduction, or for
a child in immediate danger are acted on immediately. All law enforcement agencies are required to
work with the National Center.
Taking Runaway Youth Into
Custody
Once
a runaway is taken into custody law enforcement officials must make a
determination of what action to take with the youth. The demeanor of the youth and the information provided regarding
the runaway incident will often dictate the action to be taken by the
officer. Often runaway youth are taken
back to their parents home. If it is
determined necessary, the youth can be taken to the law enforcement station
where notification and other processing can begin. Youth in custody may often have to be taken to law enforcement
agencies if there is no parent or responsible relative with whom the child can
be left. It is more common in Iowa’s
rural areas for youth in custody to be taken back to the station.
Many
runaway youth taken to law enforcement agencies wait there until they are
reunited with their parents/guardians.
Other such youth may be taken to placement, shelter, foster family care,
etc. Holds in law enforcement stations
for runaways are normally brief (usually from two to six hours) and are to take
place in unlocked areas. The duration
of such holds is often affected by the ability to locate a parent or
responsible relative to whom the child can be released.
Iowa
Code Section 232.21 outlines provisions for the placement of youth into shelter
care. The following must apply for
youth to be taken into shelter care:
* no parent, guardian or custodian, etc.
will provide proper shelter, care and supervision,
or
* the child desires to be placed in a
shelter, or
* it is necessary to hold the child
until a parent, guardian, or custodian has been contacted and has taken custody of the child, or
* it is necessary to hold the child for
transfer to another jurisdiction, or
* the child is placed in shelter
pursuant to an order of the court.
Runways in Shelter Care
Runaways
may and often do meet one or more of the above outlined criteria for shelter
care. Youth cannot remain in shelter
care for more than 48 hours without a court order (verbal or written) within 48
hours. Iowa Code Section 232.21
requires that youth placed in shelter care by law enforcement who are believed
to be runaways shall not be held for longer that 72 hours.
Iowa
Code Section 710.8 makes it an aggravated misdemeanor to harbor a runaway with the intent of committing a criminal act
involving the child or with the intent of enticing or forcing the runaway to
commit a criminal act. Essentially, the
Iowa Code prohibits harboring a runaway
with the intent of involving them in criminal acts.
In
the 1996 Legislative Session Section 710.8 was amended to prohibit persons form
harboring runaways with the intent of allowing such youth to remain away from
home against the wishes of the child’s parent, guardian, or custodian. The provisions of the amended section do not
apply to shelter care facilities. The
change would make it a criminal act to harbor runaways against a parent’s
wishes.
It
is not known how the amended code section is being implement state-wide. It is believed that its use is not
widespread, possibly from lack of knowledge that the new section exists. Also, situations involving runaway youth are
often complex. Certainly that
complexity would be a factor in how the section would be implemented. Additionally, local practice, such as
whether or not a search warrant would be utilized, impact on how the new law is
actually being implemented.
The
Iowa Code contains a number of processes
that, although not provided as
alternatives “specific” for runaways, are being utilized as responses to
initiate formal court involvement on youth with runaway behavior. The processes are as outlined immediately
below.
Iowa
Code Section 232.2(6) defines a Child in Need of Assistance (CINA) as a an
unmarried child who has been abandoned or deserted, abused or neglected, or who
has or will likely suffer harmful situations, or who needs medical treatment,
or who has or may suffer sexual abuse, or who is in need of treatment for
chemical dependency, or who has parents that for good cause desire to be
relieved of parental responsibilities (the Iowa Code definition contains more
than a dozen different subsections defining CINA).
Youth
adjudicated as CINA’s often have runaway behavior as one of the presenting
problems being considered by the court.
In most jurisdictions it would be fairly unusual, however, for youth to
be adjudicated as a CINA merely for runaway behavior. Many times youth adjudicated as CINA’s have a number of different
problems, besides runaway behavior, being presented to the court. CINA’s are often abused or neglected, have placed themselves in harmful
situations, are in need of treatment for chemical dependency, have committed
minor delinquent or property offenses, are truant from school, etc.
Processing for CINA’s
Typical
CINA proceedings begin with a complaint provided to the juvenile court. Complaints can be provided to the court by
mandatory reporters (i.e. law enforcement officers, social workers, teachers,
medical professionals, etc.) or by any person having knowledge of the
circumstances of a given child - such as parents, relatives, friends,
neighbors, etc. The court within a given judicial district designates which
entity (most often juvenile court services or the Department of Human Services)
will be responsible for investigating the complaint and determining if further
action is necessary. Investigation and
supervision of CINA cases clearly differs in Iowa’s eight judicial
districts. In some jurisdictions
investigation and supervision is performed by DHS, while in others the function
is performed by juvenile court services, and in yet other jurisdictions
investigation and supervision is performed jointly by DHS and juvenile court
services.
DHS,
a juvenile court officer, or a county attorney may file a petition alleging a
child to be a CINA if the youth meets criteria as defined in Iowa Code Section
232.2 (6) (see above). If a court has
evidence to sustain the petition and it is determined that its aid is required,
the court may enter an order adjudicating the child a CINA. Following adjudication, the court determines
what type of disposition is appropriate for the child.
Dispositions for CINA’s
A
variety of dispositions are available for youth adjudicated as CINA’s which
include:
* the
child remaining in their home and being placed under court supervision (such court ordered
supervision may also include provisions for
special treatment or care which the child needs for their physical or mental health),
* placement
of the child with a relative or other suitable person,
* placement
of the child in a foster home,
* placement
of the child in a group foster care facility
* placement
of the child in an independent living setting (for older youth)
* placement
of the child at the Iowa Juvenile Home in Toledo, Iowa
More
information regarding above mentioned dispositions and the actual services
available for CINA’s will be provided in the
“Services and Funding for Runaways” section later in this report.
Iowa
Code Section 232.2 (20) defines a family in need of assistance (FINA) as a
family in which there has been a breakdown in the relationship between a child
and the child’s parent, guardian or custodian.
FINA processing is initiated by either parents or youth. The process is an avenue families themselves
can initiate to access formalized court processing.
Processing for FINA
A
FINA proceeding is initiated by the filing of a petition alleging that a child
and their family or guardian are a family in need of assistance. The child or that child’s parents may file
the petition. The court may adjudicate
the family if it finds that there has been a breakdown in the family
relationship, the family has sought services from public or private agencies
and the court has at its disposal services for the family. In all but one judicial district, FINA
petitions are rarely, if ever, filed.
Under
FINA provisions a child must agree to placement in group foster care, a foster
home or other nonsecure setting before such a disposition can be utilized. Some form of family centered counseling
would typically be offered in FINA proceedings. Clearly, to adequately utilize FINA proceedings the family has to
be willing to participate. When the FINA
jurisdiction was created in Iowa Law, it was, to a great extent, meant to be
available to families experiencing non-delinquent parent-child conflicts (such
as running away).
Fifth
Judicial District Juvenile Court Services working with Youth Emergency Services
& Shelter (YESS) in Des Moines is utilizing FINA proceedings to process
certain youth. Youth with runaway or
other acting out behavior work with staff at the shelter to begin the FINA
process. For a FINA petition to be
filed the youth and their family must sign a petition allowing the child to be
placed in shelter and also allowing for the provision of other services. Once the petition is filed the juvenile
court can authorize the payment of services by the Department of Human
Services. In most cases there is no
formal adjudication for youth accessing FINA processing. But the provision of shelter services allows
for the court to access information on youth and their family, so that it can
later be used if a CINA or delinquency adjudication is determined appropriate.
Reasons
why FINA is rarely used in Iowa include the belief that without the ability to
impose certain sanctions (secure placement), FINA dispositions will be
ineffective in many situations. Also,
funding available for FINA services and dispositions (e.g. shelter care, family-centered
services) is considered by many to be inadequate given the demands for available funds by CINA and delinquency
cases. Finally, it is believed that
their is a lack of awareness of its existence.
Iowa
Code Section 232.2(12) defines a delinquent act as the violation of any state
law or local ordinance which would constitute a public or “criminal” offense if committed by an
adult except any offenses excluded from the jurisdiction of the juvenile court. Included as delinquent acts are violations
of federal law or a law of another state which constitute criminal offenses if
cases involving that act have been referred to the juvenile court. Runaway behavior is not presently included
as a delinquent act in the Iowa Code.
As the definition reflects, the delinquency system is the court option
to be utilized for the processing of criminal or “delinquent” juvenile conduct.
Delinquency Processing
Youth
which commit delinquent acts can be referred for processing to the juvenile
court. Many cases referred to juvenile court are diverted from formal system
processing and receive either an informal adjustment (a contract outlining the
conditions of probation signed by the youth and a juvenile court officer) or a
consent decree (a consent decree is similar to an informal adjustment except it
is signed by a judge). Youth which
require formal system processing have a delinquency petition filed, receive
delinquency adjudication and dispositional hearings. A fairly extensive array of dispositional options are available
for delinquent youth which include probation, community services, restitution,
substance abuse treatment, residential placement, etc.
It
would not be possible under Iowa Code provisions to initiate delinquency
proceedings based solely on runaway behavior.
Many youth involved in delinquency proceedings, however, have run away
or have runaway behavior included as one of their presenting problems to the
court. An example of runaway behavior included with delinquency processing
would be a youth that steals their parents car to run away from home.
Iowa
Code Sections 125 (chapter relating to substance abuse) and 229 (chapter
relating to hospitalization of persons with mental illness) include provisions
related to civil commitments. Both of
the code sections provide definitions which specify persons as impaired due to
substance abuse or mental illness. Both
of the code sections outline voluntary and involuntary procedures under which
persons (juveniles and adults) can be held in residential substance abuse or
hospital mental health settings.
Typically such holds are utilized in crisis situations to stabilize the
behavior of the individual and to provide evaluation information for further
dispositions of the court. Youth that
receive substance abuse or mental health commitments often have runaway
behavior as one of their presenting problems to the court.
Many
Iowa Code provisions related to the processing of runaways are modeled after or
specifically related to federal law - the federal Juvenile Justice and
Delinquency Prevention Act (JJDP Act).
The JJDP Act includes provisions specifically related to secure holds
for runaways. CJJP receives information
on youth securely held in jails/lockups, juvenile detention facilities, the
Boys State Training School, etc. to monitor its compliance with the JJDP
Act. States are allowed to have low
numbers of noncompliant holds yet still remain eligible for JJDP Act
funding. An overview of relevant
provisions of the JJDP Act is provided immediately below.
The
JJDP Act was first authorized in 1974 and includes requirements relating to
secure holds for youth. Two JJDP Act requirements “jail removal” and “sight and
sound separation” place restrictions on the use of secure holds for youth in
adult facilities. Another JJDP Act
requirement, “Disproportionate Minority Confinement” (DMC) requires states look
at and include in their planning processes methods to determine if youth of
color are overrepresented in juvenile justice system processing, and, if
overrepresentation exists, develop and implement a plan for reducing DMC.
The
requirement of the JJDP Act most specifically related to runaways is the
“deinstitutionalization of status offenders” (DSO) requirement. The DSO
requirement is overviewed immediately below.
The
deinstitutionalization of status offenders (DSO) requirement prohibits the use
of secure facilities to hold status offenders.
The JJDP Act defines status
offenses as acts committed by youth (such as running away, truancy,
possession of alcohol or tobacco, etc.) which would not be criminal if committed by adults. Consequently, under the JJDP Act, runaways cannot be held in
secure settings such as jails, juvenile detention facilities, locked
residential treatment facilities, etc.
The intent of the DSO requirement is to restrict the use of secure
confinement of juvenile to those behaviors for which an adult could be securely
confined.
Although
the DSO requirement prohibits secure holds for status offenders, a number of
JJDP Act exceptions do allow for the use of secure settings for such
youth. The exceptions are as outlined
immediately below.
24/48 Hour Exception
The
DSO requirement does provide exceptions which would allow for secure holds for
status offenders. One exception would
allow for the use of juvenile detention facility holds for “accused” status
offenders for up to 24 hours before and an additional 24 hours after a court
hearing (total of 48 hours). The
exception was created to allow for brief periods of detention for accused
status offenders when other alternatives are not readily available, or the
detention is necessary to insure a youth’s initial appearance for a court
hearing, or the brief detention is necessary as a transition to another
alternative. No such exception is
present in the Iowa Code.
Valid Court Order Exception
Additionally,
the JJDP Act provides for participating states to utilize the valid court order
exception (VCO). The VCO exception
allows for youth brought before the court for a status offenses (such as
runaway behavior) to be held in secure juvenile detention or correctional
facilities if they violate the conditions of an order issued as a result of
that status offense. For this exception to apply, the juvenile court must have
jurisdiction over status offenders, such as runaways. To utilize the VCO
exception states are required to provide certain procedural and due process
requirements.
A
number of states across the nation utilize the VCO exception. How it is actually implemented is unique to
individual states. For example, in
Missouri an average of fewer than 150 youth per year are held pursuant to VCO
provisions. Whereas, in Ohio (the state
that holds the most youth for VCO violations), it not unusual for in excess of
1500 youth per year to be held for VCO violations.
The
procedural requirements of the VCO exception do not exist in the Iowa
Code. An overview of the specific
requirements of the VCO exception is provided in Appendix A.
Mental Health Commitments
The
DSO requirement of the JJDP Act also includes an exception which allows for
secure holds of status offenders in hospital settings for mental health
services providing there are separate civil commitment statutes governing such
holds. Iowa Code Sections 229 and 125
provides the civil commitment statute which allows Iowa to utilize this
exception.
The
above discussion regarding state and federal law has been provided to
illustrate how the law speaks to runaways.
That discussion is intended to explain how runaways come into contact
with the system and how they can or cannot be processed in the system. Another important major component of the system,
however, is its network of services.
This
section will provide information on a number of services that are, or that
might be, accessed by runaways.
The
section differentiates services by how specific their intended focus is for
runaways. Shelter care and family
preservation have a fairly specific focus for runaways, while other related
services such as group or family foster care (which definitely serve youth that
have runaway behavior) may not have as specific of focus toward runaways. This section also differentiates services as
to how they are accessed and implemented, whether that be at the state or local
or community level. For example,
shelter care is presented as a state service for runaways, while attendant care
is overviewed as an option more specific to a community or locality. The
federal Runaway and Homeless Youth act funds, federal funds specifically
earmarked for runaways, will be overviewed.
Any
discussion of the services available to runaways in Iowa would be incomplete
without some background information regarding changes that have collectively
had a major impact on the juvenile justice/child welfare system of services and
how those services ultimately are administered to runaways. Some of the changes to be discussed in this
section which have had an impact on services include: the group care “cap” established by the Iowa Legislature in
1992, the recent growth of Iowa’s in-home Family-Centered Services, a Medicaid
Initiative related to placement and non-placement services, managed care - for
mental health and substance abuse treatment, and the “decategorization” of
certain DHS funding.
In
1992 the Iowa General Assembly passed legislation to establish a group “cap” that placed increased emphasis on
placement prevention services and limited the historical growth of group foster
care and residential treatment expenditures.
In fiscal year 1997 a new type of
“cap” was established that put limits on the amount of funding (rather
than the number of beds) available per DHS region. DHS and juvenile court officials, working in local collaborations
with service providers and others, continue to develop plans for alternative
services for youths who in the past would have been placed in group care. In
November of 1992 there were 1,377 youths in group care compared to 950 in June
of 1996.
There
is widespread believe among system officials that limited placement
availability created by the cap has “stacked up” youth in, among other programming,
shelter, detention and family preservation services. Program slots that were perhaps once available for runaways in
these services are now being held by youth that may previously have been in a
placement setting.
The
Medicaid Children Services Initiative began in November of 1993. Local DHS staff, contract service providers,
juvenile court officers and others spent many months establishing and learning
the new system and time-consuming procedures (redefined services; established
new contracts and service rates; began new client assessment, case planning and
monitoring activities; established and implemented new record keeping and
program documentation efforts) to allow the state to draw upon previously
untapped federal funding for both placement and non-placement services for
children, youths and families. While
this initiative greatly increased the pressures on local communities to plan
and implement new service and case management approaches, it has greatly
increased the amount of federal funding available for child welfare and
juvenile justice services. The Medicaid funding process has required
communities to look differently at how some services must be provided and this
has likely had an impact on their relevancy to runaways.
A
number of juvenile justice system officials contacted for completion of this
report indicate that the approval process
necessary to determine eligibility for Medicaid funding takes a great deal of
time and energy for staff at local DHS, juvenile court and youth service
providing agencies. They indicate that
prior to the Medicaid initiative far less effort was necessary to get youth
into and keep youth in services, and that less effort was necessary to move
youth from one level of services to another.
Two
years ago, a mental health access plan was developed for Iowa to provide
Medicaid-funded services through a managed-care provider. As a result, many new case management and
service eligibility and delivery policies and procedures were developed and
have been implemented across the state through state contracts with a managed
health care provider. Last year, a
similar managed-care approach was instituted for Iowa’s substance abuse
treatment services. The new service
policies and procedure associated with these initiatives have not been without
controversy and have required many adjustments to local juvenile justice and
child welfare service system plans.
Iowa
was one of the first states in the nation to establish a state-wide system of
in-home, family-centered services. This
DHS funded program, which has grown by millions of dollars in the last several
years, continues to serve as a center-piece of Iowa’s juvenile justice/child
welfare system. Its recent growth,
including the development and rapid expansion of family preservation services,
has resulted in an increased need for program and case management adjustments
to coincide with other system changes described in this section. The goal and nature of family centered
services has made it a viable alternative for runaways, as well as for many
other varied populations of youth and their families.
Some
system officials indicate that to access Medicaid funding there is a necessity
to focus on the needs of the “youth” as opposed to the needs of the
“family”. They stress that such a focus
is inconsistent with the original “family” focused approach of family-centered
services.
In
1987, the Iowa Legislature mandated that DHS begin a process that would start
“decategorizing” the child welfare system.
Iowa’s decategorization initiative is being designed and implemented
throughout the state to allow local communities to redesign their child welfare
and juvenile justice service systems through increased funding flexibility. Largely in response to the need to reduce out-of-home placements,
many communities have taken advantage of the decategorization concept to
increase the number and effectiveness of early intervention and prevention
services.
Some
communities have utilized DHS’ decategorization initiative for operational or
special programming costs in shelter care.
It is assumed that the shelter care funds have either directly or indirectly
allowed for the provision of services to runaways.
The
basis of decategorization is to provide for local control of resources for the
specialized needs of a given jurisdiction.
Communities are encouraged to incorporate funding and services in a fashion
that allows for them to “follow” youth.
Communities that wish to target services to respond to runaways behavior
can utilize the decategorization initiative to allow for the provision of
services through local DHS, juvenile court, school, or private providers
offices.
Program Access
DHS
officials report in FY 1996, there were 20 operating decategorization projects
within 36 counties and approximately 65 percent of Iowa’s child
population. In FY 1997, this number is
expected to increase to 26 projects, 62 counties, and almost 75 percent of
Iowa’s child population. Local DHS
offices working with other juvenile justice and child welfare system officials
have a larger amount of local control over certain DHS funds through the
decategorization initiative.
There
are federal funds administered to Iowa providers and providers in most other
states specifically to service runaways.
A number of Iowa communities provide local programming with these
federal dollars. An overview of that
federal program, the Federal Runaway and Homeless Youth Act Funds is provided
immediately below.
With
the intent of creating prevention and
non-punitive systems of social services for status offenders and other
vulnerable youth and their families, Congress authorized resources to help fund
youth shelters and family support services under the Runaway and Homeless Youth
Act (RHY Act), Title III, of the Juvenile Justice and Delinquency Prevention
Act (JJDP Act) of 1974. Federal funding
through the Department of Health and Human Services specifically targeting
runaway and homeless youth is awarded through discretionary grants for “Basic
Center” programs and “Transitional Living” projects. Supplemental funding for “Street Outreach” programs is authorized
under the
Violent Crime Control and Law Enforcement Act of 1994. Each of the Programs/projects is discussed
below. A major focus of RHY Act funding
is to keep non-criminal youth away from formalized system processing.
Funded
at $43.6 million dollars for federal fiscal year 1996 (October ‘95 - September
‘96), the “Basic Center Program” of RHY Act supports over 300 shelters and
private providers nationwide. Five Iowa
agencies access Basic Center funding, but actual services are subdivided
and are provided in Ames, Cedar Rapids,
Council Bluffs, Des Moines, Indianola, Iowa City and Mason City. The purpose of the “Basic Center
Program” of RHY Act is to support agencies
that provide crisis intervention and counseling services to runaway and
homeless youth outside the traditional juvenile justice, law enforcement, and
welfare systems (maximum 14 day emergency shelter and accompanying support
services). The program seeks to reunite
families whenever possible or arrange for other suitable living arrangements
for the youth.
Transitional
Living projects are funded to serve older homeless youth (ages 16-21) for up to
18 months with a focus on developing independence and self sufficiency
skills. In federal fiscal year 1996
$14.9 million in funding was available nationally. Programs in Ames and Des
Moines are funded with Transitional Living program funds.
Street
Outreach projects are to provide street based outreach and education (including
treatment, counseling and provision of information and referral) for runaway,
homeless and street youth who have been subjected to or at risk of sexual
abuse. A total of 55 Street Outreach
grants were awarded nationally. These
are $100,000 grants with a one year duration.
One Iowa program accesses Street Outreach funding and provides services
for youth in Ames and Des Moines.
Program Access
All
grant applications are awarded competitively through a national paneling
process. In the case of Basic Center
grants, states are given a certain state allotment for new awards as well as
for continuation awards. The amount of
the State allotments is taken from a formula based on census data regarding the
number of youth in a state. Basic
Center grants have three year project periods.
For non-competing Basic Center grants, grantees submit applications to
the Regional Offices for continued funding.
Awards from RHY Act programs are made directly to community agencies in
Iowa. No state agency is involved in
disbursal of the federal funding to local programs.
Note: There is no longer national funding for Drug
Abuse Prevention Program grants under RHY Act.
Agencies in Iowa City and Des Moines recently lost funding under that
program.
There
are no state funds specifically earmarked for runaways. Provided in this
section is information on state services that may have more of a direct focus
of working with runaways, as well as some other state services related to work
with youth that have runaway behavior as one of a variety of presenting
problems to the court.
Additionally,
in this section and in the “Local Services for Runaways” section discussed
later in this report is some basic statistical information describing the
populations of youth accessing the various services discussed. The information is taken from DHS’ Family
and Children’s Services System (FACS).
The Department has developed the automated case management system to improve
collection of demographic and service data on children and families receiving
child welfare services, as well as service providers. Most of the statistics are for the report month of May 1996.
Provided
in this section is information on state services that may have a more direct
focus of working with runaways, although there are few state services that
maintain a singular focus toward working with a runaway population. In fact many state services are accessed by
fairly diverse populations of youth.
For example, on any given day a shelter care facility could have in its
population young delinquent youth, adjudicated CINA’s awaiting placement and
youth whose families are in a crisis (such as a runaway). Included immediately below is an overview
of certain Iowa services with relevance to runaways.
Shelter
care provides 24-hour emergency care for children unable to remain in their own
home, until they can be returned home or other permanent arrangements can be
made. Shelter care is designed to serve
children a maximum of 30-45 days.
Shelter care services primarily include crisis intervention and daily
supervision. Associated activities
include social casework, court involvement, payment and recovery. Shelter care services are provide by private
or public agencies..
Shelters
in Iowa were originally designed to serve a population including runaway youth.
Much of the funding was county based and many of the youth in shelter care had
a low level of system involvement. The
population of shelter care has shifted in recent years to one comprised more
largely of system involved youth, due, in part, to changes in the system itself
such as how services are funded.
In
the report period of May 1996, 300 youth
received shelter care services. Most
youth in shelter care are older (57
percent age 12 - 15 and 34 percent age 16 and over). Boys comprised 54 percent and girls 46 percent of youth
held. Youth of color comprised 12
percent of all youth held (African American=7 percent, Hispanic=3 percent,
Asian=2 percent - Caucasians=77 percent, Other=10
percent). The FACS system provides information
on reasons for removal. “Child issues”
were listed as the removal reason in 53 percent of the holds ( the other
reasons for removal include: delinquency=16 percent, parental issue=12 percent,
abuse=16 percent and other=3 percent).
It is assumed that “child issues” often includes runaway behavior for
children as one of the reasons for placement in shelter care. Source (DHS): FACS KPI report for May 1996.
Funding
sources include state and county funds, RHY Act, Social Services Block Grant
funds, Tittle IV-E Foster Care funds, Title IV-B Child Welfare funds, Title
IV-A funds, children’s income (such as Social Security, SSI, and Veterans
benefits), child support, parental liability, court funds, etc.
Access to Shelter Care
DHS
administers state and federal funding for foster care services. Iowa Code Section 234.35(1)(h) provides that
such foster care funds are to be available to pay the costs of shelter care (up
to 72 hours) involving runaways.
Shelter care facilities also often rely on federal and county or other
local funding.
Family
Preservation is a highly intensive and time-limited intervention that was
developed to prevent out-of-home placement of children. Services are provided in-home and are
tailored to meet the individual needs of families in crisis (such as runaways)
and consist of one or more of the following components: therapy and counseling,
skill development and psychosocial evaluation.
Other services such as supervision, transportation, and community
resource building are also available to families.
Family
Preservation services are designed to complement an existing array of
family-centered services and are distinguished by:
* Brief (45-day average) service
duration
* Small caseloads with staff-client
ratios of 1 to 3.5.
* 24-hour-per-day service response
capabilities.
* Initial face-to-face contact within 24
hours for regular referral and three hours for emergency
referrals.
* Availability of family assistance
funds that workers can use to purchase “hard” resources,
such as food, clothing, emergency shelter and other time-limited assistance when such assistance would
directly help prevent placement of the child.
The
number of families served with family preservation services has increased from
702 families in 1990 to 2,750 in 1996.
In May 1996 the average length of service for family preservation
services was two months. The population
served is 49 percent boys and 51 percent girls. Most youth served are Caucasian (76 percent).
Youth of color comprise 9 percent of those children served (African American= 5
percent, hispanic/latinos=2 percent, Native Americans=1 percent, Asians
1=percent). 16 percent of those served
were race/ethnicity of “other”. Source
(DHS): FACS KPI report for May 1996.
Family
Preservation services are provided by approximately 20 private agencies under
contract with the state. Until November
1, 1993, family preservation services had been funded entirely by state
appropriations. Effective November 1,
1993, family preservation services were included as part of rehabilitative
treatment services under Iowa’s Medicaid State Plan.
Program Access
The
provision of family preservation services to the families of runaways would
often begin through a child abuse investigation or possibly through
self-referral to a DHS office (in situations similar to that of youth accessing
family centered services - family centered services are discussed below). If DHS determines (through use of criteria)
that family preservation services are appropriate a request for approval would
be submitted for reimbursement through Medicaid funding. Reimbursement for family preservation
services can be provided from date of referral. Family preservation services are provided by private providers.
The ability of runaways to access family centered services is dependent upon
the ability of DHS workers to get
approval for funding of the service.
The amount of funding available
for these services can be an issue related to accessing the service, as can the
extent to which the runaway’s presenting problems are consistent with service
rules designed, in part, to comply with Medicaid eligibility policies.
Family
Centered Services are interventions designed to prevent or treat child abuse,
neglect and delinquency, to prevent or reduce out-of home placements and
maintain family reunification. In the
family-centered program, rehabilitative treatment service components are: therapy and counseling, restorative living,
family and social skill development, and pschosocial evaluation services. With the help of family-centered services,
families can resolve immediate crises and keep or gain a responsible level of
control over the child’s activities and in the community.
There
are over 150 private agencies throughout Iowa that provide family-centered
serves. In FY 1996, approximately $21
million was appropriated for the family centered program. Program expenditures have risen from $17.08
million in 1994 to $32.30 million in 1996.
The funding sources include state and federal Medicaid funds. In SFY ‘95, federal IV-A Emergency
Assistance funds were also included to fund the program..
The
number of families served with family centered services has increased from 999
per month in 1991 to 4,400 in 1996. The
average length of service for family centered services is seven months. The population served is 55 percent boys and
45 percent girls. Most youth served are
Caucasian (80 percent). Youth of color
comprise 11 percent of
those children served (African American= 7 percent, hispanic/latinos=2 percent,
Native Americans=1 percent, Asians 1=percent).
9 percent of those served were race/ethnicity of “other”. Source
(DHS): FACS KPI report for May 1996.
Program Access
The
provision of family-centered services to the families of runaways would often
begin through a child abuse
investigation, a self-referral to a DHS office or possibly through a private
provider working with a family accessing family preservation services. Some juvenile court offices will also assist
in beginning the process to start family centered services. It would be a DHS office, however, that
makes the approval for the service.
If,
through its criteria, DHS determines that family-centered-services are
appropriate, a request for approval would be submitted for reimbursement
through Medicaid funding. Once approval
is received family-centered-services could begin.
It
is reported that some jurisdictions have waiting lists for family centered
services of up to three or four weeks. Family-centered services are provided by
private providers. The ability of runaways to access family centered services
is dependent upon the ability of DHS
workers to get approval for funding of the service. The amount of funding
available for these services can be an issue related to accessing the service,
as can the extent to which the runaway’s presenting problems are consistent
with service rules designed, in part, to comply with Medicaid eligibility
policies.
On
March 1, 1995 the Mental Health Access Plan (MHAP) was launched in Iowa with a
managed care organization providing the management of the program. The intent of the program is to expand the
access and range of appropriate mental health services and to help contain
federal, state and county expenditures for mental health services. Mental Health services provided
include: inpatient, partial
hospitalization, day treatment, residential, intensive outpatient, outpatient
(individual, marital and family, group), crisis intervention, targeted case
management, mobile treatment. Depending
on the situation of a runaway youth and their family, any of the MHAP services
mentioned above may be appropriate.
Runaway youth are presently accessing MHAP services.
The
distinction or change with the MHAP system is that a part of accessing some of
the various services is the need for a diagnosis of the mental health problems
for the persons involved.
Classification as a runaway would not, in and of itself, merit a
psychiatric diagnosis, although concurrent emotional or behavioral problems
might. The diagnosis is necessary to
engage the system
An estimated
165,000 Iowa Medicaid recipients are covered by MHAP. With certain exceptions, recipients include those eligible
through the Family Investment program (Iowa’s AFDC) and related categories, as
well as people eligible through Supplemental
Security Income (SSI) and related categories who are also under the age of
65. Persons who are ADC related
Medicaid eligible that receive services through an HMO are not included in the
MHAP program.
Service Access
Clients
may access MHAP services by calling a toll free number to receive a referral to
and authorization for the most appropriate level of care. Clients may also go directly to a
participating provider or facility, community mental health center, or their
MediPASS (Medicaid medical or surgical)
provider to access care. When
emergency services are needed, MHAP clients are encouraged to go directly to an
emergency room. Approval of the
emergency services must be obtained within limited time frames thereafter. Youth over age 12 must agree to hospitalization
to be admitted. If they do not agree,
but meet criteria on the basis of danger to themselves or others, they may be
held for observation pending court commitment proceedings. Mental health and substance abuse civil
commitment procedures were overviewed earlier in this report.
Services
similar to those described in the MHAP system may be available through the
private insurance coverage’s held by some families. Mental health services are being provided to runaways in families
covered by private insurance. The array
of services actually available would be dictated by the individual coverage’s
of those families.
Families
without insurance coverage that are not eligible for MHAP coverage would be much more limited as to the mental health
options available. Some communities do
have mental health centers or other counselors or mental health providers that
will provide services on a sliding fee scale basis. They may qualify to receives State Psychiatric services at the
University of Iowa. Psychiatric
Hospital. Funding for these services is
administered according to county of residence.
On
September 1, 1995, Iowa launched the Iowa Managed Substance Abuse Care Plan
(IMSACP). This was a joint project of
the Iowa Department of Public Health and the Department of Human Services. The basic concepts of the plan are similar
to MHAP. Eligible Medicaid clients
(with certain exceptions) are included in the group of persons covered by
IMSACP
Through
IMSACP, eligible clients can access a full range of substance abuse treatment
services, including assessment and referral, treatment, discharge and continue
care planning. Substance abuse services delivered to Medicaid clients at the
most intensive levels of care (intensive outpatient; residential: medically
monitored residential; inpatient) require treatment authorization, and, are
subject to care management and concurrent review. For Medicaid services at all levels of care IMSACP processes and
pays claims.
Program Access
Clients
(including runaways and their families) may access IMSACP services directly by
calling a toll free number where they will receive referral information to
appropriate treatment resources.
Clients may also go directly to an IMSACP network provider or facility
to access care. Providers contact
IMSACP to verify eligibility for all Medicaid clients. Similar to MHAP, when emergency services are
needed, IMSACP clients are encouraged to go directly to an emergency room. Approval of the emergency services must be obtained
within limited time frames thereafter.
Substance
abuse services are being provided to runaways in families covered by private
insurance. The array of services
actually available would be dictated by the individual coverages of those
families. Some officials contacted for
completion of this report indicate that inpatient programs specifically for
adolescents are few in number, though youth with both substance abuse and
mental health problems may be hospitalized for psychiatric services. On the opposite, least restrictive end of
the continuum are substance abuse services offered through high schools and
supported by programs for students at-risk.
Through
funds supplied to the program by the Department of Public Health, IMSACP is
able to continue to serve clients that are NOT Medicaid eligible. Eligible non-Medicaid clients
include individuals who can demonstrate that their annual income is below 400
percent federal poverty level.
Provided
immediately below is information on other state services that may not have a
direct focus on working with runaways, but work with youth that have runaway
behavior as one of a variety of presenting problems to the court. Some, but not all of the services, work with
youth that are engaged in formal system processing.
Juvenile
court services offices typically deal with youth that have committed delinquent
acts, although offices in some jurisdictions additionally work with youth
engaged in CINA or FINA proceedings.
Even though most youth under the supervision of juvenile court services
are delinquents, it is also clear that many such youth often have runaway
behavior as one of their presenting problems to the court. All juvenile court offices provide
supervision and case management services, one objective of which is to effect
change in the juvenile or prevent certain behaviors in the future. The basic type or style of supervision and
case management can vary from one district to the next, and juvenile court
officers’ individual techniques are likely to vary within the same judicial
district. The manner in which community
service and restitution programs are managed can vary among offices and
officers. There are also a fairly wide
variety of education/experiential programs provided or coordinated by juvenile
officers, such as peer court, OWI
awareness programs, shoplifters diversion program, etc., that are designed to
serve as a primary or supportive intervention.
Juvenile court office services are provide through both informal
adjustments and formal dispositions.
Juvenile
courts also have done fairly extensive work with four new programs originally
proposed to the Iowa Legislature in the 1995 budget which deal with
delinquents. The four programs
include: school based supervision
projects, adolescent tracking, supervised community treatment and life
skills. The new programs allow for
intensive work with youth while they remain in the community, and are designed to promote collaborative work among
DHS, Juvenile Court and the school system.
The school based supervision projects will be discussed in greater
detail in the “Local Services” section later in this report.
Juvenile
court services offices typically make recommendations to the juvenile court on
potential case actions. Based on those
recommendations and other information provided for a given case the court will
dispose a case accordingly. Often some form of treatment service will be court
ordered. Most or many of the treatment
services ordered by the court will be reimbursed with funding through DHS.
Service Access
Access
to the juvenile court services is unique to the various judicial districts
across the state. Juvenile court
services offices receive most of their
referrals through law enforcement agencies.
Referrals may be received as well , however, through DHS and
schools. Jurisdictions often have to
coordinate with DHS especially on cases where presenting problems to the court
involve issues related to both delinquency and CINA (in most jurisdictions DHS
supervises CINA cases).
Psychiatric
Medical Institutions for Children (PMIC’s) service children with psychiatric
disorders who are able to be treated in a physically nonsecure setting. Funding sources for PMIC’s are state and
federal Medicaid funds. Most youth in
PMIC facilities are CINA’s (85 percent).
Most youth in PMIC’s are older (30 percent are over age 16 - 49 percent
fall in the range of ages 12 - 15).
Many youth have engaged in runaway behavior by the time they have been
placed in a PMIC setting.
Service Access
Effective
January 1996 PMIC’s placements are managed under IMSACP. Placement of a youth in PMIC for substance
abuse treatment would need to follow the approval procedures of the managed
care contractor.
Group
care provides highly structured 24-hour treatment services and supervision for
children who cannot be served at a less restrictive level of care due to the
intensity or severity of their emotional/behavioral problems. Group care also offers services to families
and children in order to implement plans for permanent placement. Permanency goals for children in foster care
include reunification with family, placement with a relative or guardian, adoption,
independence and long-term care. Many
youth in group care have, in all probability, had runaway behavior as one of
their presenting problems to the court.
Runaway behavior alone, however, would not ordinarily be the basis for
placement of a child in a group care setting.
Group
care services include counseling and therapy, social skills development,
restorative living skills development, family skills development, and
supervision. Associated activities
include social casework, court involvement, licensing, payment and
recovery. Group care services are
purchased from private agencies. There
are four levels of group care: community, comprehensive, enhanced, and highly structured.
Funding
sources for group care include: state funds, Social Services Block Grant funds,
Title IV-E Foster Care funds, Title IV-B Child Welfare funds, Title XIX funds,
children’s income (such as social Security, SSI, and Veteran’s benefits), child
support, and parental liability.
Group Care Access
Obviously,
the group care “cap” discussed earlier in this section has had a significant
affect on the numbers of youth being placed in group care. Given the limited availability of group
care placements, only children with the most severe emotional/behavioral
problems are being placed in that setting.
A variety of alternatives have, in all likelihood, been attempted prior
to a youth being placed in group care.
Youth
placed in group care have typically been adjudicated (either as delinquent or
as CINA) and have had approval for the placement to utilize Medicaid
funding. Youth can be placed in group care without approval
for Medicaid funding, and such holds are then paid for with state funds. DHS officials indicate that because group
care placements can be made without Medicaid funding approval, the overall
impact of the Medicaid initiative on access to group care has been
minimal. A number of local officials
stress that the “process” of determining eligibility for Medicaid funding takes
a great deal of time and energy. They indicate that prior to the Medicaid
initiative far less effort was necessary to get youth into and keep youth in
services.
Family
foster care provides 24-hour temporary care for children unable to remain in
their own homes, while also offering services to families and children in order
to implement plans for permanent placement.
Permanency goals for children in foster care include reunification with
family, placement with a relative or guardian, adoption, independence and
long-term care. Certainly some of the
youth in family foster care have runaway behavior as one of their presenting
problems to the court, but many of the youth accessing the service are younger
children that have been removed from abusive homes.
Family
foster care services may include counseling and therapy, social skills
development, restorative living skills development, family skills development,
behavioral management for children in therapeutic foster care and
supervision. Associated activities
include social casework, court involvement, licensing and training, payment and
recovery. Family foster care services
are provided directly by DHS or they are purchased from private agencies. Family foster care includes three levels of
care: basic, emergency, and treatment.
Funding
sources for foster family care include: state funds, Social Services Block
Grant funds, Title IV-E Foster Care funds, Title IV-B Child Welfare funds,
Title XIX funds, children’s income (such as social Security, SSI, and Veteran’s
benefits), child support, and parental liability.
Youth
spend an average of 15.2 months in family foster care. DHS has calculated that average from
children discharged April through June 1996.
Foster Family Care Access
Youth
placed in foster family care have often been adjudicated (either as delinquent
or as CINA) and have had approval for the placement to utilize Medicaid
funding. A variety of alternatives
have, in all likelihood, been attempted prior to an adjudicated youth being
placed in foster family care. Foster
family care is, additionally, often used for children in removal situations in
the case of abuse or neglect. Many
youth in foster family care, especially older youth, have engaged in runaway
behavior.
Independent
living provides a level of care and supervision that is midway between
traditional foster care and total discharge for older youth in foster
care. In this level of care, the child
lives in an apartment under supervision of a DHS/Juvenile Court Services or
private agency worker. The goal of the
program is to promote independence.
Many, but by no means all of the youth in independent living have had
fairly extensive involvement in the juvenile justice/child welfare system. Many of the youth in independent living have
at some point in their contact with the system run away.
In
order to be eligible for independent living placement, the youth must meet one
of the following criteria:
* be age 16 - 18, working and attaining a
high school diploma or a GED, or
* be age 18 or older, working and making
satisfactory progress toward attainment of
a high school diploma or a GED.
According
to DHS during SFY 96 there were an average of 131 youth per month in
independent living.
The
program is funded with state funds, Title IV-B Child Welfare funds, children’s
income (such as Social Security, SSI, and Veteran’s benefits, child support,
and parental liability, RHY Act funds.
Independent Living Program
Access
Most
youth accessing the program have been adjudicated either CINA or delinquent and
have been placed by court order. Youth
& Shelter Services of Ames operates a Independent Living program with RHY
Act funds - the nature of the funding allows access to the program for some older
youth not involved in system processing.
The Toledo Juvenile Home is a state institution which provides residential treatment for males a