WAILUKU — The shutdown of Maui's only group home for girls last year means that some teens who need close supervision and care will have to be sent off-island, said mental health experts.

Maui Youth and Family Services closed its girls' residential treatment facility in December, citing staffing shortages and a long-term plan to open more family-based care. But while the agency plans to open special "treatment foster homes" later this year, there are currently no options on Maui for youngsters who need intensive residential treatment for mental health or substance abuse issues, The Maui News reported.

"It's a loss to the community, because we don't have a lot of resources for troubled youth with substance abuse problems," said Colleen O'Shea Wallace, Maui branch director of Mental Health America in Maui.

The December closure marks the second time in less than two years that MYFS has shuttered its residential program.

In 2006, the agency voluntarily gave up its license for the program and closed the girls' and boys' homes after management issues led to problems with oversight and supervision.

The girls' home was reopened in March 2007 with eight beds, while boys were referred to another agency's facility on the Big Island.

Kuulei Wilton, provider-relations liaison for the Health Department's Child and Adolescent Mental Health Division, said MYFS followed through with corrective action plans put in place when the agency was relicensed for residential services last year.

But she said the program was apparently losing money because of a decline in referrals.

Since MYFS receives payment based on the number of children it receives, empty beds represent a loss.

"I believe they tried their darndest to stay viable and provide the service, but they have to make decisions for themselves if they can take those losses," she said.

Tim Murphy, interim executive director of MYFS, said a drop in referrals was not the reason that the agency decided to close the program. Instead, staffing shortages and a long-term plan to move to more family-based care were the most important factors.

"We were unable to hire and maintain staff that could deliver the quality program we felt was necessary," Murphy said.

But he agreed referrals to residential-type facilities are down statewide, largely because the Health Department is also looking to move more children into family-living situations where possible.

"Currently a third of the residential beds that were available five years ago are available now," he said.

Of the five girls living at the MYFS group home when it closed, one was referred to another residential program on O'ahu, while the others transitioned to foster care or were returned to their families, Murphy said.

MYFS is developing "treatment foster homes" in Maui County, which would allow youngsters to get care for mental health or substance abuse issues while living with a family, Murphy said.

The treatment foster homes would receive special training for parents, more money and more support services, and would be limited to only two children, rather than the five allowed at typical foster homes.

Research indicates children improve faster living with a family than they do in an institution, Murphy said.

"They're more integrated into the fabric of the community," he said.

MYFS hopes to open two to three treatment foster homes by May and aims to have five in operation by the end of the year, Murphy said.

"That's probably the number of beds Maui needs for this level of care," he said.

The agency currently operates two regular foster care homes.

While there are other kinds of services available on Maui, the closure of the MYFS facility means there is one less option on the island for children who need more intensive treatment and supervision than foster care can provide, Wilton said.

"The team would take a look at (the child's) needs, and if there isn't a lower level of care that could handle it they would have to go off-island," she said.

Aloha House Executive Director Jud Cunningham said that his agency in the past would refer youth from its school-based substance abuse treatment programs to MYFS when more intensive care was needed.

"We don't have a resource now if we have a child that needs that level of care," he said. "We have to refer them off-island."

That can make treatment more difficult because it reduces the amount of family involvement, he said.

On the other hand, some children do better off-island because they're less likely to run away in an unfamiliar community, he added.

O'Shea Wallace said family-based services, such as foster care, are valuable resources, but they don't replace an intensive residential treatment facility.

"We need and have always needed a full array of services to help kids who have mental health challenges and needs," she said. "There's no one size fits all."

But Murphy said he felt the special treatment foster homes would be able to fill the gap.

"I believe that all the kids we saw could be easily served in the family context with well-trained and supported foster parents," he said.

When a child needs short-term acute treatment, the Molokini II unit at Maui Memorial Medical Center is open again, he said.

A majority of the girls who'd been staying at the facility were not from Maui, he added.

"I'm not hearing about Maui kids needing to be in residential care, and we're not serving them," he said.

For more Maui news, visit http://www.mauinews.com/default.aspx">The Maui News.