For young people with serious behavioral health challenges, a new report showed Pennsylvania's congregate-care settings may be the best option.

The report's authors surveyed 20 providers of congregate care, in facilities housing from about a dozen kids to almost 300.

Jaclyn Kreshock, director of children's behavioral health services for the Pennsylvania Council of Children, Youth and Family Services and the report's co-author, said there is a growing movement to transition youth to more community-based and homelike settings. But feedback from the survey shows many young people still require the more comprehensive help that congregate care can offer.

"One of the key findings is that all of the services that the youth can access are located within that congregate care setting," Kreshock explained. "If it's not within that congregate care setting, the staff in that setting set services up with outside providers."

Kreshock pointed out such settings can be a comprehensive treatment option for young people when less restrictive services either are not available or have already been tried. The report reported for children with complex needs, it may be the only level of care at which they can thrive.

Kreshock added their survey found most youth in congregate settings who received collaborative care from a treatment team were able to be discharged, and they transitioned more smoothly into services afterward.

"Ninety-five percent of the congregate care providers reported that about 15 or more youth successfully discharged in fiscal year 2022," Kreshock noted. "Only 62% reported one to five youth experienced reentry."

She added successful discharge means the young person completed the goals in their treatment plan prior to being released.

Kreshock emphasized one challenge faced by the facilities is a workforce shortage, and more funding would help.

"I think that if the congregate care facilities are supported, and adequate funding is allotted to these facilities -- such as an increase in their daily rates -- that would definitely be a benefit to the youth with complex needs that require their services," Kreshock urged.

She said a juvenile court ruling, behavioral health needs and a lack of alternatives can all result in a young person being placed in congregate care.

Ohio child welfare advocates are urging lawmakers to restore more than $60 million in funding to address the state's ongoing foster care placement crisis. A decision is expected by the end of June.

Gov. Mike DeWine and state House leaders included funding in the budget to expand the State Child Protective Allocation and create new child wellness campuses. But the Ohio Senate removed both investments.

Scott Britton, assistant director of the Public Children Services Association of Ohio, said counties can't manage this crisis alone.

"Children deserve a safe place to sleep that meets their behavioral health and their well-being needs. The cost of foster care placements is outpacing inflation - 68%, or $158 million more today than just five years ago - and federal reimbursement is declining," he explained.

The Senate cut $61 million from the House budget: $31 million from county child protection funds and $30 million from proposed wellness campuses. Conference committee members are working to finalize the budget by June 30.

Britton said the proposed child wellness campuses would help reduce the number of children sleeping in county offices. He adds that the governor, House, and a cross-agency group support the plan.

"The campuses are going to be trauma-informed places where children can be properly assessed and supported," he said. "Our cross-system working group prioritized this solution, so we believe Ohio could be a national leader with the strategy."

Advocates say restoring the full investment would help stabilize foster care costs and better serve children in crisis across Ohio.

With school out for summer vacation, maintaining healthy sleep habits can be a challenge for parents and children.

Longer daylight hours and shifting schedules can disrupt sleep patterns, leaving families feeling off balance or out of sync.

Dr. Chafen Watkins Hart, pediatric sleep specialist at National Jewish Health in Denver, said sleep routines do not begin just before bedtime, they are shaped by what happens all day long. She stressed it is important to keep the time kids wake up relatively consistent, even if they get to sleep in during summer months.

"I recommend parents keep the wake time as stable as possible, within 30 minutes to an hour," Hart explained. "Getting them out into the sun early in the day is really important. Keeping meal times structured around the same time each day."

Hart noted there is no one-size-fits-all approach to sleep and encouraged parents to find a routine that works best for their child. While elementary-age children typically fall asleep more easily, teenagers may struggle due to natural shifts in their circadian rhythms during puberty.

Warmer nights can also interfere with the body's natural cooling process, making it harder to fall and stay asleep. Hart suggested turning off phones and other screens and no eating at least one hour before bedtime.

"Maybe set a timer for bedtime. Change the lighting," Hart outlined. "Dimmer lights can help the brain sort of process that nighttime is coming, that sleep should happen in the next couple of hours."

As the new school year draws near, Hart said it's best to gradually adjust sleep times to get children of all ages to bed earlier. And helping kids go over tomorrow's plans can help ward off any nighttime anxiety. If kids cannot fall asleep and are just laying awake for 40 minutes or more, she suggested getting out of bed and doing a quiet activity in a dimly lit area, ideally outside their bedroom.

"If they can get out of bed, it will help their brain associate their bed with sleep and not just with laying there being anxious," Hart added. "Then try to go back to sleep 30 or 40 minutes later. That can help reset the brain, and they might have better luck falling asleep the second time around."


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Childhood trauma is costing Kentucky millions each year, according to a new report released today by Kentucky Youth Advocates and Bloom Kentucky.

The report claims that between 2015 and 2020, 62% of Kentucky adults reported having at least one adverse childhood event - with those experiences resulting in a total economic burden of $295 million per year.

Communities have a responsibility to invest in prevention and policies aimed at improving child well-being, said Sara Hemingway - the executive director of the Marilyn and William Young Charitable Foundation.

"It's difficult enough to overcome trauma when you're an adult, much less a child," said Hemingway. "And I think that as a state, as communities, I think we need to be working upstream and not downstream."

The most commonly reported experiences are parental divorce, household substance use, and emotional abuse.

The report calls to expand access to child care, increase usage of home-visitation programs, and embed trauma-informed approaches in schools.

Hannah Edelen, policy and advocacy director with Kentucky Youth Advocates, said while experiencing adversity in childhood can increase the likelihood of hardship later in life, positive experiences have the opposite effect.

"The new research talks a lot about positive childhood experiences and the impact of having a mentor in your life," said Edelen, "and there's real opportunity to create policy, as well as invest in those types of programs."

Barry Allen - president & CEO of the Gheens Foundation, and a leader of the Bloom Kentucky Coalition - said he hopes the report helps lawmakers understand that the experiences of children impact the state as a whole.

"Our intent is to take this report and take some action with it," said Allen, "as it relates, not only to the providers of services to children, but also to the legislature - for stepping in and making some policy decisions."

He pointed to legislation such as the Trauma-Informed Schools Act of 2019, which promoted trauma-based programs and teacher education, as an important step forward for kids in the Commonwealth.