Child Advocate office raps lack of oversight at youth addiction facility

CONCORD - New Hampshire's Director of the Office of Child Advocate on Monday expressed concerns over the apparent lack of oversight of children with severe emotional and mental health issues who were placed at a facility that had no DCYF supervision.

Moira O'Neill, Director of office, made the observation in the wake of a November DHHS report that found glaring shortcomings regarding the operation of Granite Pathways, which was charged with caring for those with addiction issues.

The state DHHS report was issued upon learning of recent incidents involving children who were at the Youth Treatment Center (Treatment Center) operated by Granite Pathways for substance use treatment, but were found to have much more substantive mental health needs, including recent suicidality and selfharming behaviors.

The Treatment Center was unusual in that it was a residential treatment program for children but was not certified by DCYF.

Without certification, the Treatment Center was not under DCYF's supervision for quality and safety. O'Neill said it is unclear who had oversight over the care of the children at the facility. Although DCYF did not certify the facility and did not directly place children at the Treatment Center, some of the children were known to DCYF.

In accordance with RSA 170-G:18, IV(a), the Office of the Child Advocate was notified of the critical incidents on Nov. 26.

O'Neill stated a preliminary review of the children's records was immediately undertaken.

"Several of the children placed at the substance use treatment program had far more complex needs than substance use. If we are going to understand the circumstances that prompted seven ambulance transports, we must understand how those children came to be at the facility and what transpired in assessing and treating them."

Having been assured of a full investigation, the Office of the Child Advocate forwarded a list of investigation questions to the Department on Nov. 27.

The questions were intended to prompt examination of what the facility knew about the children, their capacity to match children's needs, and what supervision of the program existed. As of today, the Office has not received a response to the questions.

"We cannot learn from these events and improve the system until we have looked at the whole situation from all angles," O'Neill said. "That includes better understanding what children need and making sure the array of services is equipped to meet those needs."

O'Neill noted that the Office of the Child Advocate is monitoring children removed from the Treatment Center with open DCYF cases to ensure they access appropriate care, including support for exposure to the traumatic events they experienced at the facility.