Greater Assurances Are Needed That Emotionally Disturbed and Handicapped Children Are Properly Cared for in Department of Defense Approved Facilities

The three major types of specialized treatment facilities approved for participation in the Civilian Health and Medical Program of the Uniformed Services are psychiatric residential facilities for children and adolescents, day care and residential facilities for the handicapped and retarded, and specialized inpatient treatment centers for such problems as alcoholism, drug addiction and neurological disorders. After investigating existing facilities and procedures, GAO recommends that: (1) better standards be developed for delivery of care; (2) periodic inspection of facilities be performed by qualified inspectors; (3) preadmission approval procedures be adopted for emotionally disturbed minors; (4) procedures be adopted for approving care in facilities that have definite determinations about admission, length and benefit of treatment, parental involvement, opportunities for children to function normally during treatment, and opportunities for care by means other than residential care; (5) facilities be required to adopt utilization review and discharge planning programs; (6) long-term care cases be studied to determine whether sponsors need assistance in coping with concurrent responsibilities; (7) formal contracts be written for services and charges; and (8) equitable government and sponsor's payments be determined for residential handicap care.