CLEVELAND, Ohio – At least 617 times in the last four years, children were housed more than one day at the Jane Edna Hunter Social Services Center office building because they had nowhere else to go – but Cuyahoga County officials believe they’ve found a solution.
David Merriman, director of the county’s Department of Health and Human Services, which oversees the Division of Children and Family Services, said the county will be proposing several “breakthrough” changes this month to immediately divert youth from the office building into proper residential care and beef up staffing to rebuild and strengthen the area’s social services safety net.
The first is a contract with The Centers for Families and Children, working in partnership with residential treatment provider Cleveland Christian Home, to hold eight beds for emergency county placements. But unlike other contracts, The Centers will not be able to reject or eject any child referred, something Merriman said has hindered the county in finding housing in the past, especially for teens with pending charges or specialized needs.
Merriman did not say how much the new contract would cost but built into it will be funding for The Centers to offer signing bonuses and raises to attract and retain the staffing needed to operate the additional beds.
The county will also propose wage increases for its own DCFS staff that officials say will make Cuyahoga County’s social workers the highest paid in the state and, hopefully, boost staffing levels to reinforce other child protective services.
Those changes will be presented to council when they return from break on Sept. 13, and are expected to be referred to committee for discussion. If approved there, DCFS officials hope council will pass the items on emergency, which could make them effective by Oct. 1.
These are the stopgaps intended to provide immediate relief to problems DCFS staff raised in July, when they begged county council for help because they said children were out-of-control and unsafe living in the office building. But the changes could also turn out to be the long-term solution, Merriman said in an Aug. 17 interview with cleveland.com, which also included DCFS interim Director Jacqueline Fletcher, Chief-of-Staff Bill Mason, interim Sheriff Steven Hammett, Deputy Director of Public Works Matt Rymer, and two members of Executive Armond Budish’s communications team.
It’s too early to know yet whether the changes will be enough to prevent children from spending nights at the office building. But while officials wait to see what works, they’re also preparing a backup plan to convert the county owned Metzenbaum Building into a permanent residential drop-off center for county youth awaiting placement.
This would ensure there is always a bed and pillow waiting for every child in the county’s care, even if other providers deny them.
“We’re going to build capacity,” Merriman promised.
How we got here
Cuyahoga County has been struggling to find short-term emergency childcare beds for youth awaiting placement since at least 2018, according to a timeline the county provided. They keep contracting with new providers – up to 77 of them today, 21 of which are local – but the problem has persisted and even worsened.
In 2019, children were brought to the childcare room at the Jane Edna Hunter building 2,492 times, county records show. In 57% of those cases, the kids found other placements within three hours, and 93% of the time they were rehoused within 24 hours.
But in the remaining 163 cases, kids were left to sleep on cots in the childcare room or overflowing into the hallway for more than 24 hours. Records do not indicate how much longer – hours, days, weeks – and numbers could reflect duplicates, where the same child returned to the office multiple times.
Mason said he and Budish learned of the problem in 2020, when the number of youth in the building was actually reduced by half, amid the COVID-19 pandemic. Yet, records show there were still 138 instances where children spent more than a day there.
Mason said he and Budish “were appalled” by even one child sleeping in an office overnight and ordered former DCFS Director Cynthia Weiskittel to find other housing options. After that initial conversation, Mason said “we thought it was resolved,” and then another child would run away from the office or “something bad would happen, and it would come to our attention and we’re like, ‘there’s not supposed to be any kids in the building. Why are there kids in the building?’”
“I’ve screamed at them about it,” Mason said.
That year, Budish took a more active role in addressing the problem. He expanded one county program that works to place more children with family members and called all the county’s residential providers into a meeting to discuss their contracts and plead for more emergency bed space. He promised them more county-funded placements for their cooperation.
Some stepped up in small ways, which did not fully meet the need. “Most did not,” Mason said.
Last year, kids spent more than a day at the office building 179 times, records show. The county said that number represents 128 individual kids – meaning about a fourth of the children cycled through the building more than once.
Through June of this year, the county reported 137 stays of at least 24 hours, records show.
On any given day, Merriman said there could be three to eight children in the Jane Edna Hunter office building, where social workers and emergency call takers perform essential duties. The children are mostly teenagers with complex needs relating to criminal activity, behavioral problems, medical needs, mental health issues, or all of the above.
And they’re harder to place.
For one child in the county’s care, the team reached out to more than 70 providers for emergency placement, but still haven’t been able to secure a bed, Fletcher said. She did not specify the child’s needs but gave examples of children in county care with attempted murder charges, a history of aggression or other medical or behavioral problems that often lead providers and foster parents to reject placement.
In the absence of local options, the county increasingly must send youth out of state. A weekly report from Aug. 22, showed 2,358 children in the county’s custody, 41% of which are placed at facilities outside of Cuyahoga County. Of those children, 72 are being housed in another state.
The problem was further highlighted at a recent Board of Control meeting where county and council staff approved up to $40,000 in spending for two children to receive out-of-state services – one contract was for 11 days and the other five months. The two teens had cycled through 25 different placements in 2.5 years, officials said at the meeting; one was currently in juvenile detention.
Providers and bed space availability keeps shrinking, Fletcher said.
Cuyahoga County alone has lost 150 placement options over the years, with three of its major residential treatment providers closing in the last decade: Parmadale Institute, Beach Brook, and Children’s Aid Society. Another provider informed Merriman in late August they, too, might be closing. Others have pared down their services amid staffing shortages.
With resources already stretched thin, kids with fewer needs are getting the beds.
The county started paying providers an average 10% more for services at the beginning of 2022 as an incentive for them to accept more children, but it did little to alleviate the problem. Providers continued to be selective about who they were willing to accept.
“At some point we need our providers to commit to not rejecting and not ejecting every kid we send them,” Merriman said. “We can buy all these beds and if, at the end of the day, they don’t let us refer the kid, it’s not going to make a difference.”
A widespread crisis
The county’s struggle is reflective of a statewide placement crisis, where the supply for residential beds isn’t keeping up with demand.
In February, the Public Children Services Association of Ohio released a report showing “the challenge of securing timely and appropriate placement continues to grow, particularly for youth coming into care with significant behavioral health needs, developmental/intellectual disabilities, or as a diversion from juvenile corrections.”
The study, which included 19 participating counties, looked at the total number of children entering the system in 2021 and found 24% of kids were being referred into county care, not because of abuse or neglect, but because their families couldn’t accommodate their challenging needs. Extrapolated statewide, the report estimated that could amount to roughly 3,145 youth.
“Child Protective Services has become the system of last resort for any youth whose behaviors require assistance outside the family, regardless of whether the child has been abused or neglected, and our system does not have the tools to serve these youth,” PCSAO’s Executive Director Angela Sausser said in a news release about the report.
Public children services agencies are still required to accept those children and try to find timely and appropriate placements. But that process requires 50 to 100 calls for some children, the report said, leaving offices “with the only other option: for the youth to stay at least one night in their agency.”
In 2021, the report noted 179 youth spent at least one night at a county agency. Cuyahoga County was not included in the study, but PCSAO estimated that, statewide, “786 youth could have had such a traumatizing experience in 2021.” The 128 children who slept at the Jane Edna Hunter office, that year, would account for 16% of those youth.
“It’s simply unsustainable, and it will lead to further trauma for the youth and unsafe conditions for staff and the community,” Sausser said in her release.
Cuyahoga County is already seeing ramifications.
A cleveland.com analysis recently found numerous examples of youth harming themselves in the building, fighting with each other, destroying property, attacking staff and running away 135 times in the first six months of the year. Records also confirmed children becoming victims of sexual abuse or rape while in county custody.
PCSAO’s study called for counties to identify alternative ways to treat underlying developmental, intellectual, behavioral and criminal issues before youth enter the system. It also recommends establishing “regional emergency short-term crisis beds for youth with high-acuity needs,” to meet the placement demand and keep kids out of office buildings.
“In conclusion, this survey reveals that Ohio’s youth are not being served well, their needs are not being met, PCSAs are struggling to maintain the resources to address their needs, timely and appropriate placements are not readily available, and alternatives in communities are greatly lacking,” the report says. “Action is needed now.”
Cuyahoga is trying to heed the call.
For the first time, the county partnered with the Alcohol, Drug Addiction and Mental Health Services Board, Department of Developmental Disabilities, and juvenile court to craft and score a request for proposals for emergency placements that could meet their combined needs, as they’re all competing for the same beds. It received seven responses, of which only The Centers offered an open-door policy.
The agencies are each also contributing to a $50,000 contract with the Educational Service Center of Northeast Ohio to assess the county’s bed space capacity.
“By working together, we’re all acknowledging what’s going on and solving this together,’ Merriman said. “All of us need a robust and effective residential system.”
When the DCFS workers first revealed unsafe conditions at the office back in July, the state sent its Rapid Response Team to evaluate the allegations and ensure the county was making changes. Now, county officials say they may be the ones helping the state. If the county’s partnership model works to increase bed space and make it easier to secure placements, they say the state has indicated they may replicate the model in other counties.
“They’re very impressed with the work that’s been done to date,” Fletcher said. “They’ve actually verbalized that we appear to be ahead of the curve on what we’re doing here in Cuyahoga County.”
In addition to getting youth out of the office building, the county has been taking action to correct other areas of concern, and plan future solutions.
It assigned a sheriff’s deputy to the building full-time to respond to violence, protect staff working in the office, and arrest youth involved in criminal activity, including youth trying to leave the building after curfew. And it added new day-time programming to cut down on the time youth are spending at the office while awaiting placement.
The county is also working with law enforcement agencies to draft a protocol for what steps officers must take before they can turn a child over to county custody. It includes de-escalation tactics that might allow a child to remain at home.
If all else fails, the county is drafting plans to convert the Metzenbaum center into a permanent residential drop-off site where kids can receive other services while they await placement. The building already has the infrastructure for residential use, having served as an orphanage and then residential treatment center for troubled youths until 2014.
Roughly 75% of the building is currently used by the juvenile court, but one of the vacant wards could easily be repurposed into a 16-bed residential facility, Matt Rymer with the county’s Department of Public Works said. That work is estimated to cost up to $500,000 and could begin by the fall, he said.
Another long-term option would be to renovate the entire complex into a residential facility that all child-focused agencies would share. That option could cost between $3-8 million, Rymer said.
The county is continuing to explore those options but has not decided whether to pursue either, Mason said. If the county creates the drop-off center, it must fund it indefinitely, he said, and that money would need to be added into the budget.
It’s likely that the final decision on whether to use the Metzenbaum building will be up to the next executive, Mason said, but Budish wants to have the plan thought out and ready to implement before he leaves office.
The county will never stop serving area youth in whatever way necessary, Merriman said, but he hopes the proposed fixes mean that work can occur outside of the office building. For most of the harder-to-place youth, it also would ideally occur out of the children services system, altogether, with kids receiving more services and support at home.
Parents need to be part of the solution, Merriman said, “because as good as we are, we’re never going to replace a family.”