Ambitious youth mental health initiative stalled by bureaucratic logjam

28 March 2023

Last fall, state lawmakers approved spending north of $200 million of federal American Rescue Plan dollars on a wide swath of mental and public health initiatives to help address what lawmakers termed a “crisis” around children’s mental health services.

But almost seven months later, the state agency charged with spending those federal dollars says it has only filled 10 of 66 budgeted positions because of bureaucratic delays, leading to sharp criticism from state lawmakers during a budget hearing last Tuesday.

Assemblywoman Daniele Monroe-Moreno (D-Las Vegas), who chairs the Assembly budget committee, called the delay in creating and hiring out the positions “frustrating,” and reiterated concerns that delays in spending ARP dollars could risk the state having to pay back the federal funds.

“We have a limited amount of time to use these funds that we didn’t have before,” she said. “We’re going to miss that window. And in doing that, we’re truly having a negative impact on children’s lives and their families’ lives.”

To underscore the issue, a lobbyist for Clark County said during the hearing that 141 families had surrendered their children to the county since August 2021 “because of unmet mental health needs.”

“That is definitely not something that we want to see,” county lobbyist Joanna Jacob said. “It is happening. And we need to take action.”

Last fall, lawmakers on the Interim Finance Committee approved a multimillion-dollar package of allocations for youth mental health services, including spending for programs such as expanded mobile crisis response teams in Clark and Washoe counties, wraparound and intensive care for youth with serious needs, intensive family in-home services and a children’s behavioral health authority.

Melanie Young, deputy administrator of the Division of Child and Family Services (DCFS), said Tuesday that the agency had struggled to get many of the funded positions in place because of back-end issues with establishing job positions with the state’s human resources agency and determining appropriate levels of pay, which then require final approval from the Governor’s Office of Finance.

According to a spreadsheet of ARP-funded positions provided by the agency to The Nevada Independent on Monday, nine of the 66 positions are being filled with contractors, one will be filled by a state employee starting early next month, and two are under active recruitment. The rest of the 54 positions are either not established (41) or listed as vacant (13).

Of the vacant or not established positions, the agency reported that 28 are “pending” with the state’s human resources division, while 19 are listed as pending and 28 listed as not received by the Governor’s Finance Office. 

A spokeswoman for the agency said in an email that recruitment will start “as soon as all positions are established for the Division to be able to recruit” and that in the meantime, DCFS will “work a dual process of hiring contractors in the hopes of bringing them on as state employees.”

Young said that the ball was partially dropped by DCFS as the agency underwent a “reconciliation” in January to check the status of the funded positions and determined that around 20 of them had never been submitted to the state human resources division. She said delays for establishing the other positions could be attributed to lengthy back-and-forths between state agencies.

“I’m going to have to unfortunately state this — we’re all facing an HR crisis, right? We all have a lack of resources, and are doing more with less right now,” she said.

Senate Majority Leader Nicole Cannizzaro (D-Las Vegas) said it was “not acceptable” for the state to have to reallocate or revert federal funds meant to address children’s mental health because of delays in establishing positions, amid concerns about the deadline for states to obligate ARP dollars by the end of 2024.

“Bureaucratic issues cannot be the reason why we say to kids, ‘We cannot help you,’ or say to parents and family members, ‘We cannot help you,’” Cannizzaro said.

Assemblywoman Sandra Jauregui (D-Las Vegas) added that lawmakers had wanted to allocate the ARP dollars toward children’s mental health programs in light of the post-pandemic significant increase in “self-harm behavior, anxiety, depression, outbursts of aggression and violence against peers and staff.”

“These are the youth that had no one there to help them, because we didn’t fill those positions,” she said. “We failed the people in our state, and that needs to be fixed.”

During Tuesday’s budget hearing, division Administrator Cindy Pitlock said the agency was relying “heavily” on contract staffing to beef up response to mental health care needs as hiring contract staff is faster than interviewing and hiring for a full-time state position, and the agency has the goal of transitioning contractors into full-time state employees. 

Still, legislators said they were concerned that excessive contracting would prove to be more expensive than hiring full-time employees, and that it was a stopgap solution to an ongoing crisis.

“It’s hard to fill positions that don’t exist,” Jauregui said. “You say it’s not like you’re leaving them empty. They don’t even exist. They’re being left empty.”

The post Ambitious youth mental health initiative stalled by bureaucratic logjam appeared first on The Nevada Independent.

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