Out-of-Home (OOH) placement describes the situation of children who are in the care and custody of the State for a variety of reasons, and is often used when less restrictive interventions have failed. Children and youth may enter OOH placements for a variety of reasons including the following:

• Children who experience abuse or neglect may enter the child welfare system (e.g., kinship care, foster care). “Eighty percent of youth involved with the child welfare system require mental health intervention and services due to developmental, behavioral or emotional issues” (National Conference of State Legislatures). 
• Delinquent youth may enter the juvenile justice system. “Sixty-seven to seventy percent of youth in the juvenile justice system have a diagnosable mental health disorder” (National Center for Mental Health and Juvenile Justice).
• Children and youth with behavioral health disorders may enter care for residential treatment, either through a Voluntary Placement Agreement (VPA) or though the public behavioral health system. “Children and youth in residential treatment centers, 69 percent of whom come from the juvenile justice and child welfare systems, have extremely high rates of mental and behavioral health disorders compared to the general population (National Center for Children in Poverty).

According to the FY2018 Out-of-Home Placement Report and Resource Guide, the County OOH placement rate for 2018 is 5.9, the highest County rate of the past 4 years. In actual numbers, the 2018 rate of 5.9 represents 646 County children and youth placed out-of-home.

The overarching goal of the First Step program is to prevent children and youth from entering or further penetrating the juvenile or adult justice system (e.g., detention), the child welfare system (e.g., foster care or residential placement), and/or the behavioral health system (e.g., psychiatric hospitalization, residential placement, substance use treatment). In FY19, First Step provided clinical counseling services for a total of 80 families*. 

• MD Department of Juvenile Services
• Baltimore County Public and Private Schools
• Baltimore County Police Department
• Baltimore County Department of Health / Bureau of Behavioral Health

First Step provides clinical counseling services for children, youth, and young adults that focus on addressing behaviors or symptoms which indicate a behavioral health condition.  Services are delivered in a manner that:  a.) supports the participation of children, youth, young adults, and their families in counseling services; b.) provides timely and effective intervention; c.) reduces the need for more intensive and intrusive intervention; and d.) improves functioning.

The target population is any Baltimore County resident age 7-23 years old seeking treatment for a behavioral health condition (mental health and/or substance use-related).

ACES