Rightsizing Institutional Care

A Meeting Hosted by the Annie E. Casey Foundation and the Youth Law Center

Agency Profiles

Agency Name: KVC Health Systems, Inc. (KVC)

Describe your agency and the services you provide:

KVC is a private, not-for-profit, 501c 3 organization that originated in Kansas in 1970. KVC has grown to provide a strong continuum of behavioral healthcare and social services in Kansas, Missouri, Nebraska, West Virginia and Kentucky. Services include Home- and School-based therapy, Intensive Family Preservation, Child Welfare Case Management, Child Placing Agency, Relative supports, Adoption, Psychiatric Residential Treatment Facilities and Acute and State Hospital Alternative Psychiatric Hospitals for children and adolescents.

Do you run any group facilities?

KVC operates Inpatient Psychiatric Hospitals and Psychiatric Residential Treatment Facilities in Kansas. In addition, KVC is the state contractor for Case Management for all children in the state’s foster care system in the Kansas City region (approximately 2000 youth on any given day), with full responsibility for all placements and services.

If yes, please describe (include criteria for admitting youth):

KVC has a contract with the Kansas Department for Children and Families to provide Inpatient Hospital services under a “no reject-no eject” admissions policy. In addition, KVC facilities operate under this same policy for youth served in itsChild Welfare Case Management contract.

For admission into any Kansas PRTF or Hospital, an independent assessment must be completed by a Qualified Mental Health Professional (QMHP) from a Community Mental Health Center.Strict medical necessity criteria must be met to authorize admission. Additionally, admission into a PRTF requires review and approval by a Community-Based Services Team.

Please share any data you have on length of stay and outcomes for the youth in your group care program(s):

The Prairie Ridge PRTF serves both contract and non-contract children for multiple states with a cumulative average length of stay of 111 days for fiscal year 2012. In addition to monitoring length of stay, readmission rates, client demographics and level of care post discharge data, we also track outcomes through the use of ORYX measures, the Ohio Scales, the Joint Commission HBIPS measures and patient/consumer surveys.

Is there anything else you would like participants to know?

KVC became responsible for child welfare Case Management in the Kansas City region in 1997. This represents a “no reject-no eject” contract to serve every child who is determined to be a “Child in Need of Care” by the Kansas Department for Children and Families and the courts and determined to be in need of out-of-home placement. At that time nearly 30% of all children in out-of-home care were in a congregate care setting (hospital, PRTF, group home, shelter, other). Under KVC’s Case Management, currently only 3% of all children served through this contract are in a congregate care setting; 97% are in community, family homes (birth, adoptive, foster, relative or non-related kin.) This significant reduction has been maintained safely for well over a decade.

We are often asked what the tools are that have driven this number down, and we cannot attribute these outcomes to any one tool or strategy. In fact, we believe that if we tried to identify a specific tool or score our numbers would go up. There is no cookie cutter approach; each child and family is unique and the whole of each and their available resources as well as their extended family/community resources factor into this as well. We believe a culture and core values (isms) that guide our every decision and intervention demand that our staff to be creative in providing whatever supports are necessary to avoid congregate care or to limit it to as little time as necessary. In addition, operating under a performance-based, risk-based contract includes an inherent, added element of urgency to a private organization. Over time, we have also attributed these ongoing outcomes to continual research and the use of empirically validated treatments and strategies. Just one such example is the development and maintenance of a continuum of care that is grounded in trauma informed services (Trauma Systems Therapy) and evidence-based practices.