Hospital for Special Care opening state’s first autism inpatient unit

The Hospital for Special Care announced plans to open an eight-bed inpatient unit next month for young people with autism spectrum disorders as well as aggression, self-injury or severely impaired functioning – something hospital officials and advocates say will be an alternative to children being sent to out-of-state hospitals, facilities that don’t meet their needs, or getting stuck in an emergency room while waiting for services.

“It’s desperately needed,” said Sara Reed, director of advocacy and family services for Autism Services and Resources Connecticut, a nonprofit based in Wallingford. “Many of our young people who need that type of intensive treatment are often put in more generalized psych wards, and without the expertise about autism spectrum disorders and how that works, sometimes the interventions don’t work as well as one might like them to.”

The unit is expected to open next month and serve people ages 10 to 21, with an expected average stay of 30 to 45 days. It is intended to serve children and adolescents who need intensive treatment for aggression, self-injury, or severely impaired functioning that threatens their safety or the safety of others in the community.

Plans for the inpatient unit were years in the making. The New Britain hospital opened an outpatient autism program in 2012 and had plans for an inpatient unit, but no way to fund it, said Lynn Ricci, the Hospital for Special Care’s president and CEO.

Then the state Department of Developmental Services issued a request seeking proposals to build up to three specialized inpatient hospital beds for people experiencing acute, complex autism spectrum and co-occurring psychiatric disorders. It grew out of a 2013 autism feasibility study and a plan Gov. Dannel P. Malloy issued last year in response to concerns about a surge of children and teens with significant mental health needs spending hours or days in emergency rooms while waiting for a spot in a treatment facility.

The hospital responded to the request and received a grant of up to $500,000 to develop the program. As part of the arrangement, three of the unit’s eight beds will be dedicated to patients covered by Medicaid.

According to the hospital, patients will receive comprehensive assessments that evaluate medical, behavioral, speech, occupational, family and environmental factors that could contribute to problem behaviors. Treatment plans will be individualized for each patient, and care will focus in part on preparing children to return to their lives outside the hospital.

The hospital already has an eight-bed unit that it used while building a new facility for its neurobehavioral program.

“This service will help ensure that children with [autism spectrum disorders] receive the clinical treatment and support services that they need and deserve,” Malloy said in a statement. “With access to the right services and resources, many children with ASD grow up to lead independent lives, succeed in fulfilling careers, establish rewarding relationships, and make strong impacts in their communities. The Hospital for Special Care’s in-patient program will have a critical impact on the lives of many here in Connecticut. It should be celebrated.”

Ricci said there’s no official waitlist for the program, but physician offices have already been calling to ask about getting patients on a waiting list. “We’ve been getting calls for months just saying, ‘We heard you guys might be developing a program,’” Ricci said.

Because there are no inpatient beds in Connecticut for children with autism spectrum disorders, some children end up in facilities in Maine, New Hampshire, Rhode Island or other states, Ricci said.

Children and teens with autism also visit the emergency room more often than their peers. According to data released last year by the Malloy administration, nearly half of the youth covered by Medicaid in Connecticut who had autism had at least one emergency room visit between Jan. 1, 2013 and June 30, 2014. Nearly half were related to behavioral health issues. Overall, only 7 percent of emergency room visits by young people in Medicaid were for behavioral health reasons.

Finding appropriate treatment for children and teens with both behavioral health needs and autism spectrum disorders can be particularly difficult, clinicians say.

Programs that primarily address mental or behavioral health issues without an understanding of autism spectrum disorders can be problematic, Reed said. For example, she said, classic interventions like group therapy often don’t work well for young people on the autism spectrum who have challenges with social communication.

“They’re not going to necessarily have a good perspective on what’s being said to them or be able to explain themselves in a way that makes sense,” Reed said. “That’s often what lands them where they are in the first place, the fact that they misperceive social situations.”

Reed said she’d like to see inpatient beds available in other parts of the state as well, and said there’s enough for more than eight beds.

“It’s a drop in the bucket, but we’ve got to start somewhere,” she said.

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