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Joint Committee on Health and Children, 19 December 2013 Question from Senator Jillian van Turnhout (very kindly

asked by Senator Colm Burke on my behalf as I was limited to 3 questions) to Minister for Children and Youth Affairs, Frances Fitzgerald TD in relation to Special Care Placements: The need for the Minister to outline the following in relation to Special Care Placements(a) What is the waiting list for Special Care placements? (b) How many applications have been made in total this year and (c) How many of these applications were successful? (d) How many State provided places are there in mainstream residential care? (e) How many are provided by Private Providers? (f) What is the allocated budget for private provision? Reply from Minister: (a) What is the waiting list for Special Care placements? Special Care involves the detention of a child for his or her own welfare and protection in a Special Care Unit on order of the High Court. As with High Support, Special Care Units differ from ordinary residential care in that the Units offer higher staff ratios, on-site education as well as specialised input such as psychology and child psychiatric services. The child is not detained as a result of criminal offences, but is placed under a High Court order for their own safety and protection. The application to place a child in special care is made by a social worker to the National Special Care Admission and Discharge Committee (NSCADC) who consider the application. If the application is successful, the HSE will then apply to the High Court for an order to place the child in special care. If there is no placement available in special care, the application will remain approved and placed on a waiting list. This waiting list is reviewed regularly and the social workers will provide updated information to assist in prioritising this waiting list. The HSE has advised that as of the 27th November 2013, there are 16 young people waiting for a place having been approved for Special Care and a further two young people are under consideration. (g) How many applications have been made in total this year and (h) How many of these applications were successful? The HSE has advised the number of applications for National Special Care Services from January to October 2013 is as follows: No. of Applications made to the NSCADC: 83 No. of Re-Applications made: 14 No. of Applications approved: 38 No. of Applications deemed not suitable: 28 No. of Applications withdrawn/Removed: 12 No. of Applications under Consideration by the NSCADC: 5

(i) How many State provided places are there in mainstream residential care? (j) How many are provided by Private Providers? All Special Care placements in Ireland are within HSE operated facilities and are under the direction of the High Court. More generally, at end August 2013, there were 138 Children’s Residential Centres in operation throughout the country; 45 of which were HSE managed; 28 were run by the voluntary sector; and 65 were operated by private providers. These centres are typically found in domestic homes in housing estates, on the outskirts of towns and villages. The centres typically have between 3 to 6 children. These children are usually in their teens. There is always some flux in placements available as services adapt to meet the needs of the resident children. In September 2013 there were 359 children in care placed across the different types of residential care. Of these 226 children were placed with HSE and voluntary sector mainstream residential care, high support and special care centres. There were 133 children placed in privately run centres, including young people placed abroad. (k) What is the allocated budget for private provision? The cost of the provision of residential placements in the 65 privately-owned children’s residential centres for 2013 is approximately €50m. To date private placements have been commissioned on the basis of a child’s needs which will influence staffing ratio, the need for live-staff at night and additional supports to the child in the placement. There has been a consistent and predictable spend in respect of this type of residential provision, which reflects demand. Significant work is under way within Children and Family Services to secure the most appropriate and cost effective care for children in the different settings in which they are accommodated. In early 2012 Children and Family Services undertook a tendering campaign to secure 80 places at a cost of €18.7 m per annum or €4,500 per place purchased for a two year period (extendible for a further two years if required). This arrangement will be for children whose needs can be met in a centre caring for 3 or 4 children. The process is now complete and contracts are currently being awarded in respect of 2014. It is estimated that the procurement arrangements utilised will reduce the spend in this area by €3.9m in 2014. Additional places that will be required will be purchased on an individual (spot) basis and in some cases may be more expensive as bespoke placements are commissioned to meet the needs of young people with challenging needs. Children and Family Services have been working to increase value for money in this area by:  Moving to fostering where appropriate,  Moving to private provision when that provides the requisite flexibility and responsiveness to local need. Children and Family Services intend to undertake a centre activity audit of all aspects of residential care in 2014, and this will allow for a level of comparison of cost of placement across private and public group children’s centres and individual placement arrangements.