Senators press HHS on short‑term use of Life Skills Transition Center for youth with complex needs

Health and Human Services staff described to the Senate Human Services Committee how the Life Skills Transition Center, a residential behavior‑focused facility, is being used as a short‑term safety net for a small number of children and youth with complex behavioral and medical needs as members considered language in Senate Bill 2113 to expand who may be placed there.

Jessica Thomason, Health and Human Services, told the committee, "you can think about it as they have, a couple of buildings that they've set up as residential pods and they're set up really on a suite model. So everybody has private bedroom, shared living spaces, shared kitchen, so they cook together." She said staffing and physical organization are adjusted frequently to match the age, gender and needs of the person placed.

Committee members pressed HHS on whether placements at LSTC would put other residents at risk and on the facility's role as a temporary observational and stabilization setting rather than a long‑term placement. Vice Chair Senator Weston said security and the plan for a next step were key concerns and argued any expansion should be temporary with monitoring. "If we approve this, it needs to be temporary with monitoring so that we don't... make it the easy button," Weston said.

Thomason described LSTC's clinical supports: "they have on‑site psychologists. They have ABAs. They have a contracted psychiatrist who's worked with them for a long time. And then they have relationships with people around the state as well." She added on nursing and physical‑care supports that LSTC has on site. On access and throughput she said, "There are 14 youth today at LSTC. 14 youth. That number is down. And actually, our census is the lowest it's ever been. We're currently at 46 for the census at LSTC."

Lawmakers and witnesses discussed alternatives and gaps across the continuum of care: PRTFs (psychiatric residential treatment facilities), ICF‑level group homes for developmental disabilities, specialized inpatient beds in Minot, Fargo and Bismarck, and state facilities such as Ruth Myers. A committee member asked whether states use ICF‑level facilities for adolescent psychiatric needs; Thomason said some states are exploring alternatives but emphasized workforce, facility and funding limits. "The limitations are facilities, funding, and workforce," she said.

Multiple senators urged that any temporary expansion include a clear path to less‑restrictive, family‑oriented placements such as therapeutic foster care or professionalized foster settings. Thomason said teams around each case exhaust available community options and that LSTC is "never their first choice." She also told the committee, "We say no a lot more than we say yes," describing frequent denials when providers cannot safely serve a person.

Committee members suggested creating a task force or interim reporting mechanism to track how many placements occur, why they are used, and what steps are being taken toward permanent solutions. Several legislators asked HHS to bring concrete contingencies and a regular reporting schedule back to the committee if the bill moves forward.

The conversation included clinicians and advocates who urged that any expansion be narrow and accompanied by investments to grow community capacity and provider willingness to accept high‑needs youth. Witnesses noted that changing eligibility without increasing available, appropriate placements risks turning a short‑term clinical placement into a long‑term default for youth with nowhere else to go.

No final committee vote on Senate Bill 2113 or related language was recorded in the transcript excerpt; members instructed staff and stakeholders to develop monitoring and planning proposals to present to the committee.

Thomason and committee members identified several immediate follow‑ups: confirm pod size and typical staffing (estimated at about eight residents per pod), produce counts of current denials and admissions to LSTC, and draft a short‑term monitoring plan if the committee adopts any temporary expansion of eligibility.