The Rhode Island approach to Child Welfare: Throw away the money, throw away the kids!

The Rhode Island family police agency wants to spend up to $26 million 
to buy and renovate a residential treatment center that closed after revelations 
of widespread abuse. At the time, a state lawmaker said she could tell things 
were getting better because "I could smell the Pine-Sol

The state family police agency plans to spend up to $26 million to buy and renovate the notorious "House of Pine-Sol" RTC

Here’s what the Rhode Island Department of Children, Youth and Families wants to do with the now-closed hellhole institution known as St Mary’s Home for Children (or as it should be known, for reasons discussed below, the House of Pine-Sol):

 Spend $760,000 to buy what would have been a privately-run residential treatment center. Spend up to another $25 million to renovate the entire place and fix environmental problems.  Use only three of the seven buildings on the eight-acre site. Warehouse 16 girls there. 

(If you’re wondering why 16? It’s because large institutions are so inherently harmful that if more than 16 children are in one at any given time, the federal Medicaid program won’t pick up part of the very expensive tab.) 

And those are just the renovation costs. When it was privately run, DCYF was paying the operators more than $1,000 per day per child!

Apparently, no one in DCYF can think of a better way to spend all that money. This also helps explain why Rhode Island spends on “child welfare” at the highest rate in America, well over triple the national average  -while getting such dismal results. 

Rhode Island lawmakers haven’t shown much concern for the kids (or maybe they just don’t understand what’s best for children and won’t do what it takes to learn). But might they at least rebel at the cost to taxpayers? Nah. We already know that some Rhode Island lawmakers are pretty easy to fool. 

Look what happened after first the state’s Office of Child Advocate and then the Boston Globe exposed the extent to which St. Mary’s was rife with abuse. As we wrote on this blog in February 2024:

After her definitely-not-a-surprise inspection, Rep. Patricia  Serpa says things are soooooo much better now!  How does she know?  She told WPRI-TV: 

“What I saw today was encouraging.  The facility is clean. I could smell the Pine-Sol, I could smell the fresh paint. The kids’ rooms were kids’ rooms — they were messy, but an organized messy.” 

Of course!  Everyone knows children are never abused in rooms that smell of Pine-Sol!  And who would ever want to run from a room that was freshly painted?   (Where was Serpa expecting to see kids stay – in dungeons?)  

[DCYF Director Ashley] Deckert took the tour too. Deckert, more than any other individual, has a vested interest in downplaying any problems at the places where her agency institutionalizes children.  And sure enough, she called the progress “tremendous.” She, too, made a point of saying the place “smells nice.”

But in the end, St. Mary’s couldn’t pass the smell test. After DCYF stopped parking children there, the place had to close.

So what lesson did DCYF learn from this? We’ll buy the place and run it ourselves!

The rationale is the one you’ve heard a million times before – and it’s still BS: Some children have such severe problems they simply can’t stay in a home. They have to be in a residential treatment center – but this will be better because we’ll call it a psychiatric residential treatment center – and now, Rhode Island doesn’t have any of those.

That’s supposedly why so many children are being sent to RTCs out of state.

But the real reason Rhode Island sends all those kids out of state is that Rhode Island tears apart families at a rate more than 80% above the national average, even when rates of child poverty are factored in.

Of all the Rhode Island children torn from their families and thrown into foster care in 2024, 80% percent did not involve even an allegation of physical or sexual abuse. In 65% of cases, there was not even an allegation of any form of drug abuse.  Far more common are cases in which family poverty is confused with “neglect.” 

Get the children who don’t need to be in foster care back home, and Rhode Island will have plenty of room in good, safe family foster homes for all the children who really need them. As for those children who supposedly can’t live in a home: They can – if you provide intensive wraparound services to the family or the foster family. That’s an intervention proven to work – as opposed to residential treatment, which, even when the institutions aren’t hellholes, has been proven time and time again to fail. 

Wraparound also is far less expensive than residential treatment. You can buy a whole lot of it for $26 million – which apparently is readily at hand at DCYF. 

As for what might be done with the St. Mary’s campus: 

In 2024, Rhode Island threw more children into foster care because of inadequate housing than because of physical and sexual abuse combined. So how about renovating the place and using all seven buildings for housing for families that might otherwise lose their children to foster care, .  with some other agency – not DCYF – in charge of it.  Or, it might be used for a residential program that really can work: inpatient drug treatment where parents are allowed to stay with their children. 

Just don’t forget to keep a little extra money around for Pine-Sol.

Before you believe a column claiming that residential treatment is wonderful – read the “sequel”

A word of advice to those writing puff piece op-eds about the joys of residential treatment: You probably shouldn’t cite a for-profit company that was the subject of exposes concerning allegations of widespread abuse at one of its institutions – and abuse allegations plus a riot at another.

Clarinda Academy, the "flagship" institution run by Sequel Youth and Family Services
(Photo from Disability Rights Washington.)

Well, I suppose they deserve credit for chutzpah.

There’s a column in the Chronicle of Social Change about the joys of what is probably the single worst intervention in child welfare – residential treatment.  The column cites no actual evidence that residential treatment works – because there is none.  Even the former head of a trade association that includes such providers admitted that “we find it hard to demonstrate success.”

Instead the column gives us a single anecdote, and the usual boilerplate about how supposedly nothing else works for some children so we should spend a lot more money on these places, blah, blah, blah.

The column was coauthored by Susan Dreyfus, the current head of another trade association for residential treatment centers and other providers, and Elizabeth Carey, CEO of Starr Commonwealth, which runs – of course – residential treatment centers.

But here’s what sets the column apart:  The youth in that one anecdotal success story achieved his success, the column claims, “[w]ith the help and support of residential behavioral health treatment provided by Sequel Youth and Family Services …”  The author’s note at the end of the column explains that Carey’s RTC “partners with Sequel Youth and Family Services, a behavioral health provider across the nation.”

If you’re thinking “Sequel – that name rings a bell…”  it should. 

Sequel in the news

Sequel, a for-profit chain of residential treatment centers, has been in the news a lot lately – over allegations of widespread abuse at one institution, and a riot at another. They run the institution where, according to one resident, you can be punished for trying to wipe away a year.

It began when Disability Rights Washington issued a scathing report on what news accounts call Sequel’s “flagship institution,” Clarinda Academy in Iowa.  What DRW alleges is appalling.  There’s a summary, with a link to their full report, here.  Sequel denies the allegations in the report.

The DRW report got NBC Nightly News interested. Here’s whatthey found :

Then, Nightly News broadcast a follow-up story:

At another Sequel facility, Red Rock Canyon school in Utah, a SWAT team had to be called in, guns drawn, to quell a riot.  

The riot may have been just the tip of the iceberg.  Just yesterday, the very day the Chronicle pubished the op-ed praising Sequel, a story in the Salt Lake Tribune ran under this headline: “After a riot, increasing violence and now sex abuse allegations, Red Rock Canyon school will close.” (Sequel says they decided to close the school voluntarily.) UPDATE, JULY 15: Sequel is reportedly closing a second facility in Utah as well, though the company claims they may "repurpose" this one.

But even if no child ever was physically abused at a Sequel facility, even if had there never been even one riot, that still wouldn’t be enough to justify such places’ existence.  Even the executive director of the group that calls itself Children’s Rights (A group that is not exactly family-friendly) Sandy Santana, told NBC that children should not be institutionalized – period. Said Santana:

“A well-functioning system places kids in families and wraps around supports … to keep those kids in families.”

But hey, not all the news for Sequel is bad. Last year, Investigate West reported that “A private equity firm acquired a majority stake in Sequel last year, citing ‘tremendous continued growth opportunities.’” 

So, to review: On the one hand there is an overwhelming body of actual evidence that residential treatment doesn’t work, and there are far better alternatives – evidence summarized here.

On the other hand the head of a child welfare agency trade association, and the head of a residential treatment center that proudly partners with Sequel Youth and Family Services say they’re wonderful.

Child welfare and sex trafficking: The problem with residential treatment centers for sexually trafficked youth is residential treatment itself

The New York Times published a story Wednesday about how some residential treatment centers are having problems “treating” victims of sex trafficking. The problem: the young people keep running away.

The story focuses on two institutions, Pleasantville Cottage School and Hawthorne-Cedar Knolls in Westchester County. According to the story:

People who have worked in child welfare in and around New York City say there is a pipeline from centers like the ones here back to the streets, where children fall prey to the abuse that they were supposed to escape. Over the last 18 months, the state, which oversees residential treatment centers like Hawthorne, stopped sending children to Hawthorne and to the nearby Pleasantville Cottage School. Among the 51 centers statewide, Hawthorne and Pleasantville are the only ones to have faced such severe sanctions over missing children in recent years.

Although not mentioned in the story, both institutions also have had severe problems in the past. For example, a 1990 New York Newsday story found that Hawthorne-Cedar Knolls was

 plagued by violence, unchecked sex, and poor supervision. ...  Said one counselor: "They have lost sight that the program is no longer safe to kids.  It's outrageous."

 
The “dilemma” that overlooks the obvious

Wednesday’s Times story goes on to discuss the supposed dilemma: They can’t “treat” people who keep running away, but if you make it harder for young people to run then the places become more like jails – and people who have been victims of sex trafficking shouldn’t be treated like criminals.

Hawthorne-Cedar Knolls opted to go the jail route. They’ve added security cameras, new lighting and “installed a six foot high fence that stretches 200 feet through trees and bush.” The institution may have been prodded by the fact that the Westchester County town where it is located started imposing a $250 fee for every call about a missing child.

And, of course, the institutions say the solution is to give them more money for programs that “engage” the residents – because the more than $400 per day per child they already get clearly isn’t enough.

But once again, the institutions and their supporters overlook the obvious: The solution to the problems of institutionalizing children is to stop institutionalizing children.

There is overwhelming evidence that residential treatment is a failure.  Even the former head of one of their own trade associations was forced to admit that  they lack “good research” showing

residential treatment’s effectiveness and “we find it hard to demonstrate success...”

There is nothing a residential treatment center can do that can’t be done better with Wraparound services – in which an intensive array of services are provided to young people in their own homes or in foster homes.

That’s what the Westchester Journal News found in 2009 when the failures of institutions in Westchester prompted the newspaper to take a long, hard look at institutionalization, and at better alternatives.  Unfortunately those excellent stories no longer are available online, but I’ve highlighted some of their findings here.

And if anyone still doesn’t believe Wraparound is a better option, even in the toughest cases, have a look at this video from Karl Dennis, who pioneered that approach.

The fundamental failure of institutionalization

If anything, sexually trafficked youth appear to be a particularly poor choice for institutionalization.  It is a classic example of the fundamental failure of institutionalization - the idea that taking children who have endured severe trauma and putting them all together in one place at precisely the age when they are most vulnerable to peer pressure somehow is a good idea.

It should be obvious that this approach would lead to precisely the pipeline referred to in the Times story. Indeed, what the Times found in the Westchester institutions, and worse, has been the pattern all over the country.

The Times story also says this, citing the head of the agency that oversees the Westchester RTCs:

The majority of the children return to their homes or are sent to a foster home or other setting closer to their families in less than a year 

That is another indication that, had they used Wraparound, the chances are excellent that the children need never have been institutionalized in the first place.

The headline on the Times story is: “How Do You Care for Sex-Trafficking Victims if You Can’t Hold On to Them?”

And the answer is obvious: You place them with people they want to hold on to – in other words, a family.