OPINION: We must unite quickly to make sure Alaska children have their needs met

Alaska has been dealt a wake-up call on the lack of resources to meet children’s behavioral health and developmental disability needs. The Department of Justice has issued findings that Alaska unnecessarily institutionalizes children with disabilities. The report highlights that Alaska is heavily reliant on institutional settings, and that key community-based services children need are often unavailable. Our data is showing the same.

The lack of community-based services forces children to obtain care in higher level and more expensive settings, including institutional and hospital-based care. These services are a necessary part of the continuum of care. However, insufficient options for care in our communities results in an over-reliance on these acute care settings — often the only options available once the condition has worsened and immeasurable suffering has already occurred. The impacts of failure to provide a continuum of services and unnecessary institutionalization on children and families is immense, including loss of culture and connections, and difficulty reintegrating back into the community. Community-based services are part of the solution but require significant investment and a comprehensive overhaul of policies and regulations to move the dial. Community-based services cannot operate funded by grants and donations alone.

These issues predated both this DOJ investigation, COVID-19, the current Legislature and the current administration. However, the long history of lack of investment in community-based services and workforce requires bold action and system reformation. As Alaskans, we pride ourselves on forging our own paths. But we also look out for each other in time of need. Alaskan children and youth need help. This is a call to action and an opportunity to come together and build a better community-based system.

We are collectively called to change the course and set Alaska’s kids on a better trajectory today and for generations to come. This won’t be solved quickly. Decades of insufficient funding -- paired with policies that disincentivize innovation, efficiency and integration -- will take time to repair.

Dedicated professionals deliver high quality and life-saving community behavioral health services in treatment centers, clinics, homes, schools and communities across Alaska. This system is in crisis. Resources have not kept up with demand, limiting stability and growth of services. We believe that most children in institutional settings could be better served in community-based programs. This would also be a more cost-effective investment of resources, with improved outcomes.

For a robust continuum of care, the state must develop Medicaid rates that cover the costs of care and address workforce shortages and service access, reduce the unnecessary paperwork and regulations on clients and providers, and address the difference of those regulations, rates and paperwork between behavioral health and medical health settings. We are committed to integration of behavioral health across care settings. Hospitals are seeing increased need as well. Every day, we see children and adolescents left in emergency departments, waiting for a connection to the level of care they need and deserve. These children may wait in the hospital days, weeks, or even months for services. We need robust crisis services outside of hospitals, as well as support for the whole continuum of care including prevention, early intervention, resource navigation and long-term supports.

Many of the children referenced in the DOJ findings experience developmental disabilities and are eligible for services that would include respite and home-based support. Unfortunately, there are waitlists due to lack of funding and available providers. Children living at home take lower priority on these waitlists. The developmental disability service system has not had a rate adjustment since 2011. These services are more scarce than ever for reasons described above -- decades of insufficient funding have worsened workforce shortages and system responsiveness.

More funding is needed. Period. But funding alone cannot fix these problems. Alaska’s programs intended to serve the youngest and most vulnerable Alaskans are fragmented in policy, funding, and programming, missing opportunities to better support young children and their families. These systems are fractured and rely on a maze of funding and eligibility requirements. They are difficult to navigate and result in children and youth with the most complex needs left stranded. Not surprising, families living outside of Anchorage experience substantially more barriers to access. Together, we can address key service gaps and barriers that are limiting the system from responding to Alaskans’ needs.

Alaska children deserve to have their health and well-being needs met. We need to come together quickly to make sure children receive services as close to home as possible. This includes immediate and comprehensive solutions and investments, including equitable distribution of resources across the state. We deeply value the ongoing partnership with the state administration and Legislature, as it will take all of us working together to make these worthwhile changes. We stand ready to partner to protect our children, reduce the negative lifelong outcomes associated with trauma and lack of care, and build out the system for behavioral health and developmental disability community-based services.

Sherrie Hinshaw is interim CEO of Alaska Behavioral Health Association.

Kim Champney is Executive Director of the Alaska Association on Developmental Disabilities.

Tamar Ben-Yosef is Executive Director of All Alaska Pediatric Partnership.

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