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 in Oregon: An epidemic of willful ignorance

● The child welfare agency keeps children in an out-of-state institution even after learning about allegations of widespread abuse.

● The Oregon lawmaker who never misses an opportunity to grandstand about child welfare ignores real solutions.

Last year, Disability Rights Washington (as in Washington State) published a report, discussed here, alleging serious, widespread problems at Clarinda Academy, an Iowa institution to which Washington State regularly shipped foster children it didn’t know what to do with.

The Washington State child welfare agency responded by doing the bare minimum: They promised to get the children out of Clarinda by the end of last month (I have seen no news accounts checking to see if they succeeded).  But that didn’t necessarily mean things got better for the children; some were simply institutionalized elsewhere, sometimes even farther from home.

Could any state possibly respond with even less concern and less compassion?

Actually, yes. When it comes to child welfare failure, never underestimate Oregon.

Last week, Oregon Public Broadcasting reported that Oregon also has been shipping foster children to institutions all over the country – including Clarinda and others run by Sequel, the for-profit chain that owns Clarinda.  But even though Oregon authorities know all about the Disability Rights Washington report, they are leaving the children in Clarinda and the other Sequel institutions.  According to OPB:

After the allegations of abuse in Iowa surfaced, a spokesman from the Oregon Department of Human Services said in an email, a representative of Clarinda Academy and Sequel visited Oregon to respond.

Oregon staff also flew to Iowa to check on the children at Clarinda, according to a DHS spokesman. In addition, the state says, Oregon contracts with third-party professionals to monitor children at all out-of-state facilities. Based on those visits, Oregon officials determined foster children being sent elsewhere are safe.

Right. Because of course, before deciding which children to subject to alleged abuse or other ill-treatment, staff are always going to ask what state they’re from.

Of course the real reason neither Oregon nor Washington State will simply bring the children home is because they have no place to put them.  But the reason for that is because Oregon and Washington State both tear apart families at rates well above the national average – and that national average is, itself, too high.  Same thing with Rhode Island, which, as we documented in this report, (starting on page 25), also is an extreme outlier when it comes to taking away children, and also has had a chronic problem of shipping children out-of-state.  And it’s a perennial problem in West Virginia, which tears children from their families at one of the highest rates in America.

Lessons from Connecticut

Compare these states to Connecticut – which used to have the same problem, but doesn’t anymore.

Connecticut used to tear apart families at a rate above the national average.  It relied heavily on institutionalizing children – sending many to institutions out-of-state.  Every high-profile death of a child “known to the system” would set off a foster-care panic – a sharp, sudden increase in children torn from everyone they know and love, and that would make everything worse.

So, of course, when confronted about its use of out-of-state institutions, Connecticut officials would use the same excuses heard now in Washington State and Oregon and West Virginia: Oh, we really hate to do this, but we have this terrible “shortage” of foster parents, so we have no place to put all these children

Then, in 2011, Joette Katz was named Commissioner of the state’s Department of Children and Families.  She refused to tolerate foster-care panics. She focused on safe, proven alternatives to taking away children.  She increased the use of kinship foster care – placement of children with relatives instead of strangers. And she pioneered an innovative in-home drug treatment program for cases in which substance abuse was an issue.

By curbing needless removal and increasing the use of kinship care, space opened up for all those children institutionalized out of state – and almost all of them were brought home.

New Jersey embarked on similar reforms, prompted by a class-action lawsuit consent decree.  New Jersey also benefitted from bold leadership in the immediate aftermath of that decree. Now New Jersey also takes children at a rate well below the national average – and New Jersey also has drastically reduced institutionalization in all forms, including out-of-state placements.

How one Oregon legislator makes everything worse

Oregon State Sen. Sara Gelser

Though I’m glad Oregon Public Broadcasting exposed the fact that Oregon is refusing to remove children from Sequel’s institutions, one part of the story was frustrating.  OPB did what Oregon media always have done in recent years – they turned for the obligatory expression of shock and outrage to someone who has unintentionally made all of the state’s child welfare problems worse: State Sen. Sara Gelser.

It’s not that Oregon child welfare was wonderful before Gelser came on the scene; in fact it’s been awful for decades.  And it’s not that Gelser wants it to get worse.

But Gelser has poured gasoline on the fire – using every opportunity to push an agenda that can be boiled down to “take the child and run.”  She first came to prominence taking data out of context to claim that Oregon wasn’t subjecting enough children to traumatic child abuse investigations. Then she engaged in grandstanding when state child welfare leaders admitted the obvious: they can’t guarantee that all children in foster care are safe.  Then she helped to effectively kill one of the very few efforts Oregon has undertaken to try to curb needless removal, a differential response initiative. 

All that is certainly not the only reason the number of Oregon foster children shipped out-of-state has doubled since 2017; it’s probably not even the main reason. But she sure isn’t helping. (And neither are other Oregon politicians, by the way.)

And now, Gelser has the nerve to say she doesn’t know how to solve the problem, telling OPB:

“I don’t know the answer. If we bring them home, where do they go?” she said. “… We have kids with significant needs, and we don’t have what they need to help them and those kids don’t have time to wait for us to figure it out.”

Of course Gelser doesn't want children to be hurt.  I'm sure she believes her agenda will help them. But the problem with her agenda is that it's not really a children first agenda. Over and over, Sen. Gelser has failed to put the needs of children first.  

A children first agenda means learning from other states. A children first agenda means understanding that child removal does not equal child safety. A children first agenda means curbing Oregon’s obscene rate of removal. A children first agenda means embracing Wraparound programs, which do anything an institution can do, and do it far better, instead of building more institutions.  A children first agenda means bringing the children home, and keeping more of them in their own homes.

If Sen. Gelser doesn’t know the answer, then she is willfully ignorant. Other states have found answers, but Sen. Gelser doesn't seem to want to look. 

So here’s how Oregon can find the answer. Check out what Connecticut did.  Check out other states that have safely reduced the number of children trapped in foster care.  And stop paying attention to a grandstanding politician who doesn’t know the answer because she doesn’t want to see it.

Catching up slowly: The Des Moines Register finally notices the problems at an Iowa RTC

Even a thin story is better than none.  Unfortuinately, that’s what Iowans got.

Clarinda Academy (Photo from Disability Rights Washington)

Last month, after Disability Rights Washington (DRW) released a scathing report about a residential treatment center in Iowa, to which many Washington State children were sent, I wrote: 

The story was not “broken” by any big media organization in Washington State.  And it was not broken by any news organization in Iowa, even though the institution where all these abuses took place – Clarinda Academy - is in Iowa.  Indeed, in Iowa, coverage of this prison-like facility for children who often have committed no crime appears to have been confined largely to reporting the scores of games played by Clarinda’s sports teams.  (And no, the collapse of the newspaper industry is no excuse. That started around 2006. Clarinda opened in 1992.) …

After DRW did the actual reporting, Washington State’s largest newspaper, The Seattle Times was reduced to writing a story based entirely on DRW’s findings.  And Iowa’s largest newspaper, the Des Moines Register, was reduced to reprinting the Seattle Times story.

Now the Register has begun to catch up; slowly. But the story in the Register this week does little more than regurgitate police reports and give enormous amounts of space to statements from an executive from Sequel, the for-profit chain that runs Clarinda.  The story includes no interviews with current or former residents.  And it gives readers no way to understand the oppressive climate of day-to-day life at Clarinda that DRW found.

If anything, the Register further dehumanizes Clarinda residents by suggesting they’re all delinquents – the DRW report makes clear that’s not true – and citing one former resident accused of a recent murder.

But the story does serve one useful purpose. If you first read the full DRW report – and, in effect, hear the voices of those forced to live there, and you get a feel for the day-to-day oppressiveness of the place, then you will wonder about the willful blindness it take for Iowa authorities to do nothing.  That blindness allowed the Sequel executive to gloat that “In September, the state of Iowa completed their on-site audit at Clarinda, which noted no deficiencies and renewed our full licensure status."

Read the DRW report and you might also be more concerned about this revelation, buried at the end of the Register story:

After the eight boys ran away this year, inspectors determined that the teens who fled were separated from others for weeks after they were found. 

Those students were supposed to have their status reviewed every three days, but [A state inspector] found that after he began an investigation in May, staffers falsified student supervision plans and forged students' signatures.  The facility was given a provisional license afterward, but [the inspector] recommended its full license be restored.

Of course, even more than Washington State, Iowa has a strong incentive to ignore problems in group homes and institutions – when you take away children at the ninth highest rate in the country, as Iowa does – a rate more than double the national average - you’re always begging for beds. And beggars can’t be choosers.

So it’s no wonder that, the Register reports,

Gov. Kim Reynolds has said little about Washington State’s probe into the treatment of youth at Clarinda and has taken no steps to remove any Iowa children from the facility.

Of course not. There’s no public pressure on her to do anything. 

See these young people as just names on police reports – or worse – and no one cares.  See them as human beings – as DRW did – and perhaps someone will
.