State could save millions in human services budget, audit shows

State could save millions in human services budget, audit shows

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SALT LAKE CITY — A new legislative audit says the state could save millions if it reduced juvenile recidivism and more strictly complied with statutory limits on how long forensic patients stay at the Utah State Hospital.

But the agency that oversees both divisions of state government, the Utah Department of Human Services, says the cost savings in juvenile justice may be overstated and there are multiple factors that can influence patients' lengths of stay in the state hospital's forensic unit.

The audit, an in-depth review of the department's budget, was scheduled to be released to the Audit Subcommittee of the Utah Legislature's Management Committee on Tuesday morning.

The audit says the state of Utah could save $6 million a year by reducing recidivism "through improved program monitoring and targeting high-risk youth offenders."

The audit says Utah's recidivism rate, when compared with surrounding states, is approximately 20 percent higher.

"Youth recidivism was 53 percent in 2013. From 2010 through 2013, the high-risk youth population (those most likely to recidivate) increased from 64 percent to 70 percent of youth in custody," the audit states.


Youth recidivism was 53 percent in 2013. From 2010 through 2013, the high-risk youth population increased from 64 percent to 70 percent of youth in custody.

–Audit


Tracking and comparing recidivism rates presents many challenges, according to the written response of the Department of Human Services.

"The Utah Division of Juvenile Justice Services accounts for charges in both the juvenile and the adult system. Most states only track recidivism if it occurs in the juvenile system; therefore, state-by-state comparisons are difficult," the agency's written response states.

"Preliminary data indicates, however, that only about 25 percent of youths who recidivate receive a new (Juvenile Justice Services) disposition. Further, as the report acknowledges, the proposed savings do not take into account fixed costs of operating a secure facility. Thus, the $6 million figure may be an overestimate of the division's direct cost savings," the Department of Human Services response states.

Pilot program

Susan Burke, director of Utah's Division of Juvenile Justice Services, said Utah is one of five states taking part in a national pilot program to further home in on policies and practices to improve outcomes for youths in juvenile justice programs. Reducing recidivism is a key objective of the program, which is already underway.

"Ultimately, at (Juvenile Justice Services), our goal is to turn around young lives. Recidivism rates are important to us," Burke said.

That said, recidivism rates are one of several measures Juvenile Justice Services considers as it evaluates the progress of youth in its care, she said. The division also tracks behavioral outcomes, educational attainment and family stability.

"We need to do a better job of attaching measurements to those things as well," Burke said.

Utah State Hospital housing

The audit also reviewed budget issues related to housing forensic patients at the Utah State Hospital. Forensic patients are adults whom courts have found not competent to stand trial. They are held in a secure facility until competency can be restored.

Auditors found that some patients' length of stay has exceeded what is allowed by law.

Over the past five years, 64 patients have been held longer than 365 days, the audit states. "Twenty-seven patients were held beyond the maximum length of stay; had they been released before the legal deadline, the state could have saved up to $3 million; had they been civilly committed, the state could have saved up to $289,000. In addition, beds would have been made available for patients on the waitlist," the audit states.

Many factors affect forensic patients' length of stay at the Utah State Hospital. Some patients are civilly committed to the facility after their forensic evaluation or treatment ends. Some have changes in their legal status that render them exempt from statutory guidelines, the agency response says.

"The Department of Human Services has custody of individuals receiving competency restoration until the court terminates the order," the agency response states.

''When taking into account all factors, the actual number of individuals who remained at the hospital outside statutory guidelines is less than 4 percent of the total persons served during the five-year study period."

Dallas Earnshaw, superintendent of the Utah State Hospital, said there were 45 patients on the hospital's waiting list Monday. The hospital agrees with auditors that the state needs to consider options for addressing the growing demand for competency restoration services, "which is a national trend," the audit states.

The hospital has proposed four options to address the growing forensic population:

• Provide pre-admission jail-based competency restoration services ($300,000).

• Privately contracting to provide jail-based competency programming ($2 million).

• The Utah State Hospital staff a step-down unit at the hospital for forensic overflow ($4 million).

• Build additional beds at the Utah State Hospital ($20 million) plus staff ($4 million per unit of 26 beds).

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