Medical experts call on Minnesota lawmakers to address youth ‘boarding’ crisis in hospitals
Some of the most vulnerable Minnesotans are being left in hospitals for weeks, even months, with no way out.
Health professionals call it “boarding,” where kids and teens with behavioral, mental health, or substance abuse issues are dropped off at a hospital but can’t be released because of a lack of beds at mental health facilities.
“Why is it OK for a child to be left in a hospital?” asks Sen. John Hoffman, DFL-Champlin.
On Friday, a panel of medical experts testified before state lawmakers about “boarding” practices — an issue they say is getting worse.
“Right now, for many children with mental health needs, accessing the right level of care feels impossible,” declared Dr. Amy Sznewajs, an assistant medical director for pediatrics at Children’s Minnesota. “For many, their mental health gets worse while they are stuck in the hospital, living in our hospital, waiting for community or residential placement.”
The panel told lawmakers that most young patients are typically cleared from an emergency room in a day or less.
But right now, they say, there are not enough beds at mental health facilities or other safe spaces.
“These children sit in emergency rooms with no place to go,” noted Wendy Ulferts, the vice president of patient care at North Memorial Health. “Our team spends hours trying to find placement for these children and families. Often placement is found several hundred miles from home, and this is the only option we can offer.”
The group says nearly a thousand children were boarded at area hospitals during the first five months of this year — some staying the entire time.
At Children’s Minnesota, 165 kids were boarded, and ther were 60 more at Hennepin County Medical Center.
“Due to elopement and safety risks, the adolescents are boarded in a highly restricted setting,” explained Dr. Sandeep Patel, a Hennepin Healthcare pediatrician. “Deprived of normal activities such as the ability to go outside, to access school, to have peer interactions.”
The Department of Human Services says it hopes to complete a census of boarded children by September.
That would give lawmakers and hospital officials a better idea as to where these youngsters are staying and what their status is.
There was no action on any of this Friday, but hearings like this are typically preparation for lawmakers meeting at the next legislative session– coming in February.
The panel urged lawmakers to fully staff child mental health facilities, cut red tape for admissions, and develop a single statewide system to process cases.
“Remove the barriers for lateral admissions,” said Dr. Mary Beth Lardizabal, a mental health and substance abuse specialist with Allina Health. “Create a rapid response system to prioritize the needs of these complex kids that are languishing in our acute bed facilities.”
M Health Fairview issued the following statement on the matter:
“Over the last two years, the scenes playing out in emergency rooms at health systems across the state are some of the most challenging situations our teams have faced working in health care. Children with developmental disabilities, often with behavioral challenges, are left by their county social workers, group homes, residential treatment facilities or other caregivers, in emergency rooms for days, weeks and months. This is referred to as ‘boarding.’
“Simply put, this is a violation of their human rights.
“In most cases, these are children who don’t have an emergent medical need requiring hospitalization; they need a loving home and long-term, stable support. The silent erosion of the health and human services that they need is taking a devastating toll on these children and our frontline staff.
“Hospitals are not the optimal environment to provide long-term residential treatment care. We will not abandon these children, but we cannot be the only thread holding up society’s safety net. This a complex challenge with few easy answers, but we must reckon with how to fix this – urgently – as a society. State agencies, counties, community providers, and health systems all need to be responsible for their individual parts to ensure that the future for these children is an environment that supports their physical, psychological, and emotional development in the most appropriate, least restrictive setting.”