One female client is left at the Iowa Juvenile Home at Toledo, and she will move to a new placement before the facility is scheduled to close next week, the Iowa Department of Human Services said Friday.
Of the last 48 mostly female residents of the Juvenile Home who have moved out of the facility since July 1, 13 have transferred to residential treatment programs operated by Four Oaks, the not-for-profit children and family services agency with headquarters in Cedar Rapids.
Jim Ernst, president and CEO of Four Oaks, said this week that his agency has had programming in place that is appropriate for the Juvenile Home referrals for about two years after the Iowa Legislature decided that it no longer wanted difficult Iowa juveniles transferred to out-of-state facilities and programs.
As a result of that legislative decision two years ago, Ernst said Four Oaks developed a "trauma-informed" treatment model appropriate for juveniles with severe emotional challenges.
About 25 juveniles have either been returned from out of state or have been diverted from going out of state and have entered the Four Oaks programming, Ernst said. All 25 have been successes and continue to be success, he said.
"It’s a very similar group of kids who have been served at Toledo," Ernst said of the youth whom the agency has helped before the sudden news by Gov. Terry Branstad last month to close the troubled Toledo facility.
"They have similar challenges, similar issues, similar degrees of emotional disturbances," he said of those who have come to Four Oaks from Toledo. "They can have some pretty severe behaviors, meaning they can self-harm, they can be assaultive when triggered. Those types of behaviors tend to be things they can do that make them unsuccessful in other placements."
Ernst said the Iowa Department of Human Services is providing Four Oaks with enhanced funding support to work with these "higher-end kids" whom he said demand a higher staff-to-client ratio. The financial support is helping the clients and allowing the agencies to be able to afford to work with them, he said.
In a general sense, he said the trauma-informed programming technique tries to eliminate power struggles between staff and clients, in part, by understanding that certain interactions between adults and traumatized children can trigger unexpected behavior that would typically not occur between adults and children.
Ernst said Four Oaks’s programs in and around Cedar Rapids have been able to work with every referral made to it from the Iowa Juvenile Home.
At the same time, he said it’s not his role to opine on the state’s decision to close the facility.
"If they ask us to serve a kid, and if we feel we can, we will," Ernst said. "And we will continue that practice. As to what that means or should mean for Toledo, I just don’t know. Those are determinations that they need to make."
Ernst said Four Oaks deals with juveniles with emotional and mental health issues, and some of those also may have correctional issues as well. Four Oaks’s programs are staffed around the clock, but none of them are locked facilities, he noted.
There are times when some Four Oaks clients are hospitalized for hurting themselves or trying to commit suicide, and there are times some go to a detention center if that’s where the Juvenile Court officer or law enforcement decides they should be.
Some of those then can come back to Four Oaks’s treatment programs, he said.
Linn County Supervisor Ben Rogers this week expressed some concern that the closing of the Toledo facility could result in the Linn County Detention Center being asked eventually to house some of those Toledo clients in its facility, which he said is not set up to hold juveniles long-term or to counsel and educate them as the Toledo facility had been designed to do.
"I think it caught a lot of people off guard in the programming arena that Toledo was going to close," said Rogers, who is the Linn supervisor representative on the newly created regional board for mental health and disability services in East Central Iowa.
Amy McCoy, spokeswoman for the Iowa Department of Human Services, on Friday said that the state agency has worked "carefully" with joint treatment planning teams and the courts to limit the disruption to the last 21 juvenile residents of the Iowa Juvenile Home.
All have found new placements in licensed and/or accredited settings or have returned home, she said.
"These placements, all in Iowa, are based on input from a number of people involved with the youth, and only take place if a court agrees and orders a new level of care," she said. "Other state facilities and private providers have demonstrated their capacity to treat these youths."
McCoy said Toledo had discharged 48 residents, mostly girls, since July 1.Of those, she said 15 have returned home; 14 have gone to group care; 6 to detention, including the Linn County Detention Center; 4 to shelter services; 3 to psychiatric medical institutes for children; 2 to family foster homes; 1 to independent living; 1 to a waiver home; 1 to a state mental health institute; and 1 to the State Training School for Boys in Eldora.