How to NOT fix abuse in group homes and institutions in 8 easy steps. Lessons from Massachusetts and elsewhere

Steps already completed are checked: 

_x_Take away children at a rate far higher than the national average, creating an artificial “shortage” of foster homes. 

_x_Due to “shortage,” use group homes and institutions, the worst form of “care,” at a rate that’s also well above the national average, creating conditions for rampant abuse of children in group homes. 

_x_Newspaper does an excellent job exposing rampant abuse of children in group homes but does not mention the high rate of removal. 

_x_People most responsible for, over decades, creating the climate of fear and demonization of families leading to the state’s high rate of removal, are quoted extensively condemning the abuse, while taking no responsibility for creating those conditions. 

__Lawmakers express shock and outrage and promise sweeping reforms and/or hearings (all duly noted in the traditional follow-up story). 

__Reforms consist entirely of increasing inspections, and screening and training, the same promises made the last time this sort of abuse was exposed, and the time before, and the time before that. This time, they might throw in closing the “age of consent” loophole. 

__Attention fades, and the state continues to take away children at a rate well above the national average. The new training, screening and inspections change nothing. 

__The entire cycle repeats. 

That’s the Massachusetts version. Something remarkably similar is playing out in Alaska.

 Of course, there is one way to break this cycle …

Maryland’s $1.2 billion "child welfare" blunder

It turns out this agency has an enormous amount of money to spend
on institutionalizing children

That’s how much the state is likely to spend over the next five years institutionalizing kids, instead of helping their families

The tragic death of Kanaiyah Ward, a foster youth filed away and forgotten in a hotel, called attention to the fact that Maryland was dumping scores of children in similar makeshift placements. 

Kanaiyah was not in the system because her mother abused or neglected her. Her mother was desperate to get her help with her mental health problems. But because she was poor, she couldn’t go out and buy therapy the way affluent parents do. So her mother had to surrender Kanaiyah to the family police agency – a more accurate term than “child welfare” agency. 

Kanaiyah’s death could have been a wake-up call; a chance to rethink the state’s entire failed “child welfare” system. Instead, the state has come up with the worst possible response: A $1.2 billion blunder that’s bad for taxpayers, and far, far worse for children. 

The state has signed contracts with a plethora of “providers” to spend $744 million over three years to buy 637 beds for foster children, an expansion of 37 over the current number. There’s an option to spend another $496 million to extend the contracts two more years, for a total of $1.24 billion. 

The financial cost is high: 

I’m a tax-and-spend liberal and proud of it. I have no problem with the mind-boggling sum of money. But we all should have a problem with spending that money on what is almost certain to be, by far, the worst form of placement – institutionalizing children at an average cost of $675,749 per bed per year. 

That’s the financial price of institutionalizing children in group homes and so-called “residential treatment centers.” Here’s the state’s breakdown of exactly what type of beds they are:

 

Source: Maryland Dept. of Human Services

 And here’s how much the state is paying, per day, per child, to warehouse children in these places:

Source: Maryland Dept. of Human Services

The human cost is much higher:

Now consider the much greater human cost. These are places that have been shown to be rife with abuse in state after state; places where a U.S. Senate investigation found “The risk of harm to children … is endemic to the operating model.” 

Even when there is no physical or sexual abuse, they are the kinds of places that have been found to be inherently harmful to children. Study after study has found the entire approach is a failure. As the Senate investigation put it: 

[Residential treatment facilities] are costly, not as effective as community-based behavioral health treatment options, and often harmful to youth in their care. 

So what could Maryland do with all that money instead? In 2024, Maryland authorities took 1,268 children from their families and consigned them to the chaos of foster care. For that same $744 million, it could spend $195,583 per year per child on every one of those children. 

How might one spend all that money? 

Consider who these children and families really are: Of all the children torn from their families and thrown into foster care in Maryland in 2024, 87% did not involve even an allegation of sexual abuse or any form of physical abuse. In 60%, there was no allegation of any form of drug abuse -- not just no allegation of opioids or meth, no allegation of any abuse of any drug or alcohol. Far more common are cases in which family poverty is confused with “neglect.” You could go a long way to solving those poverty problems with $195,583 per child per year. 

But what about all those cases in which, the providers love to tell us, the children have such complex needs that no family could possibly handle them? In fact, there is nothing an institution can do that can’t be done better by bringing intensive Wraparound services right into a family home or, when placement really is necessary, a foster home. Once again, here’s a video offering a classic example. 

 

 That intervention almost certainly cost a lot less than $195,583. So imagine what the full $195,583 could do. It might not be quite enough to provide a live-in therapist for every child 24/7, but it comes pretty close – and it sure can buy a lot of intensive therapy for children and families. 

Had Kanaiyah Ward’s mother been given that kind of help, she never would have become so overwhelmed that she felt she had no choice but to surrender her daughter to the system that let her die. 

Maryland has shown it has a whole lot of money to spend on child welfare. But when it comes to guts, vision and imagination, the system is bankrupt. 

Congratulations Phoenix: When it comes to tearing apart families in big cities, you’re still #1!

 

Bipartisanship in action! In Arizona both parties have failed the state's children

(This post is adapted from NCCPR’s press release to Arizona media.) 

NCCPR has updated its Big CityRate-of-Removal Index, comparing the propensity of America’s ten largest cities and their surrounding counties, to tear apart families. Once again, the champion for big-city family destruction, metropolitan Phoenix, Arizona. 

Children are at greater risk of being torn from everyone they know and love and consigned to the chaos of foster care in Phoenix than in any other of America’s largest cities. It’s a long, ugly tradition. 

Year after year, the Department of Child Safety, Arizona’s family police agency (a more accurate term than ‘child welfare’ agency), cuts a swath of destruction through poor families in Phoenix at a vastly higher rate than any other such agency does in any other of America’s ten largest cities and their surrounding counties. 

And while it’s all done in the name of ‘child safety,’ of course, the DCS take-the-child-and-run mentality makes all children less safe. The mentality was revealed to the nation in 2020 when workers in a DCS office thought it would be a laugh riot to wear matching t-shirts emblazoned with the words ‘Professional Kidnapper.’ The workers were fired, but the data show the mentality remains. 

NCCPR’s Big City Rate-of-Removal Index compares the number of children thrown into foster care to the impoverished child population in America’s ten largest cities and their surrounding counties. Maricopa County (metropolitan Phoenix) is an extreme outlier. Children are taken from their parents in Maricopa County at a rate: 

● 50% percent higher than the second-worst region – Santa Clara County.

● More than 60% higher than the third worst, Los Angeles County.

● Nearly two-and-a-half times the national average for big cities.

● More than triple the rate of New York City.

● Nearly six times the rate of Chicago. 

There is no evidence that Phoenix is a cesspool of depravity with vastly more child abuse than any other big city in America. Rather, this is evidence of a take-the-child-and-run mentality, rooted in racial and class bias, that has plagued child welfare in Arizona for decades. 

The problem is compounded by Arizona’s overreliance on the worst, and most dangerous, form of care – group homes and institutions. Arizona institutionalizes 41% of children entering foster care, a rate more than two-and-a-half times the national average. 

You may be sure that DCS will respond to the facts about its abysmal performance with the Big Lie of American child welfare: the false claim that child removal equals child safety. 

But the Big Lie ignores:

● The mass of research showing that, in typical cases, not the horror stories, children left in their own homes typically fare better even than comparably-maltreated children thrown into foster care. That research includes a stunning recent study showing that, under these circumstances, by age 20, the foster children were more than four times more likely to die.

● The mass of research showing high rates of abuse in foster homes and even higher rates of abuse in group homes and institutions – all those news accounts about the horrors of Arizona group homes and institutions are not aberrations.

● The mass of research showing that poverty is routinely confused with neglect. The research is confirmed by data from Arizona, where, in 87% of cases in which children were thrown into foster care, there was not even an accusation of sexual abuse or any form of physical abuse. In fact, Arizona took away more children because of inadequate housing than for physical and sexual abuse combined. In 62% there was not even an accusation of any form of drug or alcohol abuse – not just no accusation of meth or fentanyl, no accusation of any drug or alcohol abuse of any kind.

All this does enormous harm to the children needlessly taken – and also to those who might be spared foster care but still face the enormous trauma of a child abuse investigation – which involves a traumatic interrogation and, sometimes, a stripsearch. Almost always, this trauma is inflicted as a result of a false report or a poverty case. Nationwide, more than half of all Black children will be forced to endure this trauma at some point in their childhoods. But Arizona is different. In Arizona, it’s two-thirds.

But these aren’t the only children harmed. All the time, money and effort wasted harming children in these cases is, in effect, stolen from finding the relatively few children in real danger. That’s almost always the real reason such children are overlooked, leading to the horror stories that, rightly, make headlines. That’s how the Arizona approach makes all children less safe.

Actions by Gov. Katie Hobbs have compounded the problems. These actions include:

● Giving a giant rate increase to a politically-connected group home operator.

● Giving a giant pay raise to foster parents – and, in effect, making poor people pay for it.

● Taking away support for the least harmful form of foster care, kinship foster care, in which children are placed with extended family.

But the governor’s political opponents have no cause to gloat. In a rare example of bipartisanship, governors and legislators from both parties have been failing Arizona’s vulnerable children for decades, something we documented in a report we released on Arizona child welfare in 2007.

It doesn’t have to be that way. In other states, lawmakers and state leaders have worked across party lines to curb needless removal and make all children safer. In Texas, for example, with strong bipartisan support, lawmakers raised the threshold for coercive intervention into families. In New York and New Jersey, governments bolstered high-quality legal defense for families – not to get “bad parents” off but to craft alternatives to the cookie-cutter ‘service plans’ churned out by agencies like DCS. For more solutions, see NCCPR’s Due Process Agenda and for more examples of strong legislation see the NCCPR Good Bill Bank. Together, these bills and other solutions create a true blueprint for child safety.

They represent ways Arizona could turn its system around and make all children safer. All it needs is the will to finally renounce the take-the-child-and-run mentality that has made all of the state’s children less safe.

In “child welfare” the horror stories go in all directions – all year long (2025 Edition)

Part one of NCCPR’s news and commentary year in review for 2025

 Part two, on this blog tomorrow, looks at some of 2025’s finest journalism exploring wrongful removal and other harms to children caused by our current system of family policing. 

America’s massive child welfare surveillance state was built on horror stories.  Stories about children murdered or tortured in their own homes stampeded us into building a gigantic system that destroys children in the name of saving them. This approach has torn apart millions of families needlessly. It’s also so overloaded the system that workers have no time to find the few children in real danger.

A system that attempts to make policy-by-horror-story makes all children less safe. That’s why we’ve long extended an offer to the fearmongers in the child welfare establishment: a mutual moratorium on using horror stories to "prove” anything.

We can do that because we have actual evidence that, in the overwhelming majority of cases, family preservation is not only more humane than foster care or massive surveillance, it’s also safer. But the fearmongers will never give up their horror stories because horror stories are all they’ve got.

That’s why we’ve taken to reminding people that the horror stories go in all directions.  And when it comes to the high rate of abuse in foster homes, group homes, and institutions, the horror stories are backed up by study after study showing the rates of abuse in those settings are appalling.

So now, some examples from 2025:

Willful blindness at the Kansas “child welfare” agency

 

Image designed by Wannapik

Here’s what the Child Advocate in Kansas, Kerrie Lonard, says goes on in the group homes and institutions in which Kansas warehouses foster children, according to this story in The Beacon: 

These facilities have drug use, violence between kids, excessive force among staff and property damage, Lonard said. There’s also lax oversight that makes it easier for children to run away. 

Hard to believe that could happen considering the way the Kansas Department of Children and Families keeps an eagle eye on them – just kidding! Actually, they’re inspected once a year, and the group homes are told in advance when the inspectors are coming. 

Lonard is proposing a radical solution – just kidding again. She recommends that they be inspected more often, and that the inspectors don’t let the institutions know when they’re coming. 

But why would DCF even need anyone to tell them that? Why would they make it a point never to do the kind of inspection likely to turn up the most serious problems?  Because DCF doesn’t dare.  

DCF tears apart families at a rate double the national average, even when rates of child poverty are factored in.  And when you count Kansas’ unique form of hidden foster care, the real figure may be far worse. 

DCF is begging for beds, and beggars can’t be choosers. They don’t do inspections likely to turn up problems because they don’t want to see the problems. 

This also is why even switching to unannounced inspections won’t do much good. You can bet the inspectors will still turn a blind eye to all but the most egregious abuse – and maybe even that. In addition, when an agency investigates abuse or miserable conditions in group homes and institutions, it is, in effect, investigating itself, since they put the children there in the first place. 

It all creates huge incentives to see no evil, hear no evil, speak no evil and write no evil in the casefile.  

All this helps explain why the official figures agencies publish about abuse in foster care are vastly lower than what is found by independent studies. 

But demanding unannounced inspections would solve a problem for one group: Kansas legislators. They then can issue chest-thumping press releases about the bold step they’ve taken to protect children, how “ensuring the safety and well-being in these settings must remain a top priority,” blah, blah, blah. 

Oh, wait, one lawmaker already has said the “top priority” part – while not even committing to demanding unannounced inspections. 

And did she say remain a top priority?

Victims of abuse in foster care shouldn´t have to choose between compensation and justice

Private foster care agencies in New York tell victims of abuse on their watch: If we don´t get a taxpayer bailout, you might not get compensation for what was done to you.  A lawyer for survivors apparently agrees.

 Last month, I wrote a column for the New York Daily News about the attempt by New Yorks´s private foster care, group home and residential treatment agencies to get a taxpayer bailout of up to $200 million.  Why do they say they need it?  To pay settlements in some of the hundreds of lawsuits filed by survivors of abuse in their foster homes, group homes and institutions, going back decades. Otherwise, the agencies say, the could go out of business.

 They say the going-out-of-business part as if it´s a bad thing.  On the contrary. The group homes and institutions are harmful even when they´re not rife with physical and sexual abuse.  The whole model is a proven failure and there are far better alternatives.  But these giant, greedy, well-connected agencies are scarfing up all the money for such alternatives. (And when I say greedy: Have you seen Ron Richter´s salary for running one of them?)

Losing a few of these places would be a net plus, something I discuss in detail (along with Richter´s salary) in the Daily News column.

Fortunately, New York State lawmakers rejected the bailout. They didn´t buy the agencies’ b.s. – though, unfortunately, some media that should know better did.

And, it seems, the agencies have at least one lawyer for the survivors on their side.  According to the child welfare trade journal, The Imprint:

“These victims’ lives have been ruined forever. They deserve justice,” Helene Weiss, a lawyer whose firm is representing dozens of survivors suing under the Child Victims Act, said in an email. “It is incredibly disappointing that New York State decided not to prioritize the needs of survivors of sexual abuse — survivors who were harmed under the State’s watch.”

No, Ms. Weiss.  The state decided not to prioritize the very agencies on whose watch these survivors were abused. It would be perfectly reasonable to create a bailout fund that would apply to survivors of a given agency only after that agency had gone out of business – but not one to keep the agencies alive.

The story also claims that “All sides of the lawsuit [sic] had urged passage” of the bailout.  It´s not clear if this means all survivors bringing all the lawsuits, those represented by Ms. Weiss or something else.

No survivor is quoted. But certainly for those who haved endured the unendurable, if presented by their lawyers with a claim amounting to something like: “look, if the agencies´ claims about going broke are true, this may well be the only way you´ll see any compensation for what was done to you” no one could begrudge them supporting it.

But what if it were presented a different way?  What if it were presented like this:

If the agencies´claims about bankruptcy are true and if bailout fails, your payment will be delayed: it´s possible you´ll never see a dime.  But if the bailout passes, the message to the agencies will be: You can let this keep happening to children on your watch over and over and over, for decade after decade after decade.  The agencies will get the message that they´re too big to fail and they can get away with anything.” 

In that scenario, the survivors get payment – but would they view that as justice?

I hope no survivor ever has to make such a choice.  But if it came to that, I would begrudge no survivor any answer they chose to that question.  I just hope someone asks.

The group home industry excuse machine leaps into action after still another tragedy

Two girls ran from a group home in Arizona.
Their bodies were found here.

On Jan. 7, two girls, one age 17, the other 15, ran away from a group home in Mesa Arizona. Two weeks later their bodies were found in a nearby pond. 

The only solution the operator of the group home can offer is to imply that such places should be able to be more like jails.  The lawyer for the group home said there was nothing they could do because they’re not allowed to lock young people in, but as soon as they left they called Arizona’s family police agency, the Department of Child Safety, to report them missing.  We don’t know what, if anything, DCS did. 

If that sounds familiar, it may be because it’s the same answer offered by the residential treatment industry and their media and government allies in Colorado, after similar tragedies there.  There also have been similar tragedies in Kentucky. 

It never seems to occur to the industry that if children keep running to the point where the only way to keep them in your institution is to lock them in, maybe the problem isn’t with the children but with the fact that you are institutionalizing them.  Or maybe it does occur to residential treatment “providers,” but to mention it would encourage people to draw the logical conclusion: that such places should be shut down. 

There are no allegations of abuse at the group home in Arizona, which opened about three months ago.  But the problem with institutionalizing children is that it is inherently abusive, inherently dehumanizing.  And an overwhelming body of research shows such places are not necessary.  Of course children want to run. 

And of course you’ll hear the usual excuses: There supposedly aren’t enough foster homes, or, to use the industry’s own offensive phrase, these children “blow out” of foster homes.  That’s just industry b.s. 

Arizona, Colorado, and Kentucky all tear apart children at rates well above the national average.  Stop doing that and there will be plenty of room in good, safe foster homes for the few children who really do need to be taken from their parents.  Then provide wraparound services, in which birth families or foster families get all the help they need to care for children with behavioral problems.  There is nothing residential treatment can do that can’t be done better with wraparound programs. 

That’s what the residential treatment industry doesn’t want you to know. 

An “advocate for foster families” is no better 

Perhaps even more offensive are the comments from someone described as an advocate for foster families.  (I’ve yet to see a story that quotes an advocate for birth families.) 

The only solution she can come up with is, well, it’s not clear exactly what it is, but it seems to involve telling authorities that, after children run away, they have to start looking for them sooner.  She told Phoenix television station KNXV: 

“I do feel like there needs to be legislative changes, with some teeth behind it, some deliverables behind it, to ensure that for each and every child that goes missing that there are procedures that are being followed and adhered to. … This is the perfect opportunity to show that these girls did not die in vain. 

But if all the state of Arizona can come up with is some cruddy little piece of feel-good legislation (even if it does have “deliverables behind it”) it won’t just mean these girls died in vain.  It will be like spitting on their graves.

What do you do when you’ve institutionalized children as young as age 7 in a place that was the subject of a “cascade of complaints” alleging abuse? If you’re New Hampshire, you give ‘em a $9.8 million contract, of course!

This excerpt from a report by the New Hampshire "Office of Child Advocate" describes, and illustrates,
the "quiet room" at the Nashua Children's Home.

On the surface, this story from New Hampshire may seem like just another example of children institutionalized in a place that has been the subject of multiple allegations of abuse.  In fact, it’s much more. 

● It’s a story about the willingness of regulators to bend over backwards to dismiss complaints against such places. 

● It’s a story of how a state “child advocate,” even as she wrote a report that offered tepid criticism of serious alleged abuses at the place, suggested changes that are almost meaningless. 

● It’s a story about how the same “child advocate” unintentionally pushed the state to rely on such institutions. 

● It’s a story about how institutional providers dismiss the overwhelming evidence that, even when there is no abuse, institutionalization harms children. 

● It’s a story about how the limits on such places supposedly imposed by the Family First Prevention Services Act are as toothless as some of us predicted. 

● It’s a story about an institution that says it’s going to change its practices to conform to a new contract but denies that there is anything wrong with the way it did things under the old contract.  As a report from the “Office of Child Advocate” (OCA) puts it: 

[T]he [institution] expressed skepticism of the provision of evidence-based care now included in contract expectations. They questioned the value of evidence-based practices and noted conversations … in which they suggest [their] “practice-based evidence” informed their own development of a practice model 

Yet the Office of Child Advocate seems to believe the new contract will be enough. 

● Most of all, it’s a story about foster-care panic – about what happens when a state family policing agency, in this case, the Division for Children, Youth and Families, responds to a high-profile tragedy with a sharp sudden increase in removals of children from their homes.  New Hampshire now tears away children at a rate double the national average - in part because of the “Child Advocate” herself.  DCYF created an artificial “shortage” of foster homes.  So DCYF  institutionalizes children as young as seven, responds to allegations of abuse with bureaucratic gobbledygook and agrees to pay the institution $71,050 per year per child! 

All of this (except the part about the foster-care panic) is made clear in the report noted above from New Hampshire’s “child advocate,” Moira O’Neill, and a subsequent news story from WMUR-TV. 

So let’s take a close look at the case of the Nashua Children’s Home 

The first thing to know about the Nashua Children’s Home is it’s not a home.  It has 37 residents and is licensed for 55. That makes it an institution.  Children as young as seven have been stuck there.  So let’s be clear: The state of New Hampshire is willing to institutionalize seven-year-olds. 

The second thing to know about the Nashua Children’s Home is that even had there never been an allegation of abuse, the place would be bad for children of any age.  That’s because institutions are inherently the most harmful form of care – and they are unnecessary.  As is discussed below, there is nothing an institution can do that can’t be done better with Wraparound programs.  Institutions are especially bad for young children, which is what makes New Hampshire’s willingness to institutionalize seven-year-olds particularly horrifying.  

The third thing to know is that between March, 2019 and October, 2020 this one institution, the Nashua Children’s Home, was the subject of what O’Neill describes as “a cascade of complaints” to her office, 17 in all. Below I discuss two of them.  (I only hope that readers who probably have read many accounts of institutional brutality that are even worse than anything alleged concerning the Nashua Children’s Home have not become jaded to the trauma allegedly inflicted by this institution’s staff.) 

● Dennis was subjected to 27 “restraints” and removal to what the institution calls its “quiet room” – which looks more like a cell.  Under state law, restraints are only supposed to be used when there is a “substantial and imminent risk of serious bodily harm” to the child or to others.   But Dennis was restrained and/or hauled off to the quiet room for things like hiding in a closet or under his bed.  Dennis was eight years old. 

● Anthony was older, he was all of 16.  When he tried to leave the “quiet room” he wound up restrained, prone, on the floor, by three adult male staff – for an hour and 20 minutes.  A complaint to the division of DCYF that investigates alleged abuse in foster homes and institutions said that these actions “inhibited [anthony’s] breathing.” 

But DCYF concluded there was no abuse because Anthony suffered no actual injury (after all, it’s not like he actually stopped breathing) and the restraint was being used for “behavior management purposes.”  They did refer the matter to a separate unit that handles licensing of institutions.  

The licensing unit initially thought there was a problem.  But then the institution explained how the whole thing was just a result of their deep concern for Anthony’s safety.  You see it was very cold outside that night, and if Anthony had left not only the quiet room but also the entire institution, he’d be really, really cold. 

Although the OCA reports no evidence of anyone at the institution making any such claim at the time, the licensing unit accepted the institution’s explanation. 

I’m sure all readers would agree that all of these various authorities would have reached exactly the same conclusion had birth parents “restrained” their own children that way. 

Are they “creaming”? 

You would think that the institution wouldn’t be having so much trouble since it also appears to engage in a common industry practice known as “creaming” – as in skimming the cream.  They get to pick and choose who they’ll accept – and they get to kick them out when things get tough. 

Consider the case of 16-year-old Jake, also the subject of an allegation of excessive use of restraint.  Jake apparently was a juvenile justice placement.  (We should pause here to note that the OCA report expresses no concern – indeed, does not even mention, that 16-year-olds placed through the juvenile justice system are in the same institution as seven and eight-year-olds placed through the “child welfare system.”) Jake was restrained in a prone position for a mere 15 minutes – because he’d been sitting in the doorway of his room and yelling after his DVD player was confiscated.  That happened because his mother had given him R-rated videos.  Yes, really. 

The day after the incident, the director of the institution made clear he’d had it up to here with Jake.  He sent a slew of emails to Jake’s juvenile probation and parole officer, one of which said: 

"...I want this kid OUT on Monday...send him back to SYSC...convince a judge to make it happen. You know our reluctance in taking him. Especially during this time, can't have this kid endangering my staff like this.” 

Oh, and in case you’re wondering what SYSC is – it’s the Sununu Youth Services Center, which as one news account last year put it, has seen 

recent abuse allegations made by more than 300 men and women who say they were physically or sexually abused as children by 150 staffers at the state’s facility from 1960 to 2018. Eleven former workers have been arrested since April …   

Family First won’t fix this 

Back when the Family First Prevention Services Act first was introduced in Congress in 2016 we wrote that no one should believe the hype about how it would curb institutionalization.  On the contrary, we said, it institutionalizes institutions.  As we said at the time: 

If the bill becomes law, the federal government would stop reimbursing states for part of the cost of group home and institutional placement after two weeks. But it creates a giant loophole: funding would continue for something called a “Qualified Residential Treatment Program.” 

What does it take to become a QRTP?  Very little: 

● Write lots and lots of plans filled with appropriate buzzwords. (Drop the word “trauma-informed” into every third paragraph and you should be fine.)

● Hire nurses during working hours and have them on call the rest of the time.

● Get a rubber-stamp seal-of-approval from an accrediting agency.

Now flash forward to 2022, and the case of the Nashua Children’s Home. 

The Office of Child Advocate recommendations all boil down to: blah blah blah trauma-informed, blah, blah, blah, trauma-informed.  So basically, everything should be fine if the institution follows through on a new contract with the state that is filled with all the buzzwords needed for the state to keep collecting federal aid for institutionalizing children at the Nashua Children’s Home.  The contract is for $9.8 million over three years for 46 beds – or $71,050 per child per year. 

I suppose we’ll never know if children would be better off if the state just gave the $71,050 to the children’s families so they could buy whatever help they or their children need – but I think we can guess. 

As for accreditation, accrediting agencies are generally dominated by providers and make their money by accrediting fellow providers.  That’s not exactly an incentive to get tough.  The institution gets to choose its accreditor from a list of several. 

And sure enough, in its response to the Child Advocate, the Nashua Children’s Home reprinted nearly two single-spaced pages of gushing praise from the accreditor they chose. 

This behavior by the institution is crucial for another reason.  The Child Advocate is counting on the institution to obey all the terms, and all the blah-blah-blah trauma-informed in the new contract from the state.  But the institution has made abundantly clear it doesn’t really believe in all that blah-blah-blah.  Again, as the Office of Child Advocate report notes: 

[T]he [institution] expressed skepticism of the provision of evidence-based care now included in contract expectations. They questioned the value of evidence-based practices and noted conversations … in which they suggest [their] “practice-based evidence” informed their own development of a practice model. 

The institution’s rebuttal to OCA makes clear they think there is absolutely nothing wrong with the way they did things before the new contract – and they know better than a bunch of ivory-tower regulators anyway!  Indeed, the institution’s director, David Villiotti, told WMUR: 

“We think our staff should get a lot more kudos and recognition and congratulations than they do, rather than be criticized by somebody sitting up on Pleasant Street in an office or sitting at home.” 

Perhaps all this explains why, even though staff at the institution began getting “trauma-informed care training” in September, 2020, the OCA report concluded the training has had “no demonstrated effect yet.”

As for the quiet room, Villiotti said: 

“Our response is most of the people critical of it have never been in the position of having to deal with an out-of-control child.” 

But the gentleman in the video below has. His name is Karl Dennis.  He’s a pioneer in replacing not just “quiet rooms” but entire institutions with Wraparound programs that bring whatever help a child needs into the child’s own home or foster home.  Listen as Dennis describes how Wraparound deals with youth who are far more out-of-control than an eight-year-old hiding under a bed. 

Once again, the price of panic 

The other problem with the new contract is that, as a practical matter, it’s unenforceable.  DCYF wasn’t exactly aggressive about problems under the old contract.  Why should anyone think that would change? 

In fact, it can’t change.  That’s thanks to DCYF -- and the “Child Advocate” herself. 

Because right now in New Hampshire, it’s a sellers’ market for residential treatment “providers.” 

The video version of WMUR’s story ends with the statement that the state has 662 family foster homes but says it “needs” 1,000 such homes.  The implication is that this is why DCYF has no choice but to institutionalize young children. 

But the “shortage” is only because New Hampshire tears apart families at one of the highest rates in America, double the national average even when rates of family poverty are factored in. 

It wasn’t always so.  Entries into care in New Hampshire began to skyrocket in 2015.  And though, of course, DCYF and other foster care apologists will blame opioids, plenty of states with serious opioid abuse problems don’t tear apart families at such an obscene rate.  More important, as has been documented over and over, the problem isn’t opioids as much as it is child welfare’s knee-jerk take-the-child-and-run response to opioids. 

No, what happened in New Hampshire was a classic foster-care panic – a rush to tear apart more families in the wake of high-profile child abuse tragedies, such as one that occurred in New Hampshire at the end of 2014.  Such tragedies often lead to bad “solutions” including creating “child advocate” offices which almost always throw gasoline on the fire.  Maine is a recent case in point, there have been many others. 

That includes New Hampshire, where the panicky response to tragedy included creation of O’Neill’s office.  O’Neill’s very first report annual report, in 2018, in the midst of skyrocketing removals, embraced the Big Lie of American child welfare – that children are endangered because lawmakers and courts supposedly are making the “best interests of the child” subordinate to “parents rights.” The data, of course, tell a different story. 

So O’Neill herself helped create an artificial “shortage” of foster parents which, in turn, means the state will keep on relying on institutionalizing children as young as age seven.  (It doesn’t help that, according to O’Neill’s report, on at least two occasions, the Nashua Children’s Home allegedly behaved in ways that helped undermine the transition of children into family foster homes – charges the institution denies.) 

All this is why all O’Neill’s blah-blah-blah about “trauma-informed” this and “trauma-informed,” that has such a hollow ring.  The problem isn’t that it’s wrong to be “trauma-informed” the problem is that people like O’Neill effectively stip the concept of all meaning.  Because, like so many others who invoke the phrase, O’Neill seems to be startlingly ill-informed about one of the worst traumas one can inflict on a child: Taking that child needlessly from her or his parents.

UPDATE: Confronted with the horrors at his shelter, NYC child welfare chief acts immediately – to pass the buck.

But a judge finds that, in one particularly egregious case, the city's Administration for Children's Services couldn’t even get the buck-passing right.

In New York State, individual counties and New York City run child welfare, but services for the mentally ill and the developmentally disabled are provided by state agencies. 

So I suppose no one should be surprised at what happened when a New York City Council committee tried to call David Hansell, the commissioner of the city’s Administration for Children’s Services to account for the horrible conditions at the Bill de Blasio / David Hansell Children’s Center. (That’s not the center’s real name, but, as I explained in a previous post to this blog, the more often we call it that, the more likely it is that the worst of the problems will be fixed.)

Hansell blamed the state.  Since some of the problems involve older youth with mental health and developmental disability issues his response to the chaos at the center boiled down to: Hey, not my job!

There is actually a lawsuit over this. Perhaps in the end it will turn out the state really does share responsibility (though it’s important to note that many of the longstanding problems at the de Blasio / Hansell Center involve children and youth for whom Hansell’s agency has unambiguous responsibility).

But even if part of the fault rests with the state – in fact, even if all of the fault rests with the state, a few things should be obvious:

● As long as the youth are in your custody you do not allow children, youth and young adults to be jammed together in an overcrowded shelter.

● As long as they are in your custody, you don’t allow them to bully and terrorize each other.

● And as long as they’re in your custody you do not allow a youth who suffered brain and spinal injuries to be stuck there for a year, with no therapy, without even a working wheelchair, sometimes left sitting in his own urine. 

You don’t let the horrors continue until the jurisdictional niceties are worked out.  You fix it first, then fight over who foots the bill.

The case of the brain-injured youth was so bad that a judge ultimately held Hansell in contempt.  She found that ACS couldn’t even get the buck-passing right: Hansell’s agency repeatedly missed deadlines for submitting applications to the relevant state agency.

Is ACS angling to open more group home / institution beds?

But it gets worse. Hansell also blames the problems at the center in part on the closing of some beds in group homes and institutions – which suggests he might want to reopen some of them.

But the reason they were closed in the first place is that they’re so bad for children, and because many of them were at the center of scandal after scandal over abuse and exploitation – (here’s a case in point) – just like the Bill de Blasio / David Hansell Children’s Center.

So let’s recall, again, the history of the shelter.  An earlier shelter had been shut down as a hellhole in 1977.  But when the new one opened, in 2001, Nicholas Scoppetta, the ACS commissioner at the time, promised that this time it would be different.  Of course it wasn’t.

So consider: The old shelter became a hellhole and was shut down.  Then a new shelter is opened amid promises that this time it will be different.  Then the new shelter becomes a hellhole.  So now Hansell hints that maybe the solution is to open some other institution. Really?

If he’s allowed to get away with it, I’m sure he’ll be at the dedication ceremony, explaining why this institution will be different.

Group home industry admits what we’ve always known: It’s $ first, kids second

● Their public face is all about how they don’t even think about money (except that they wish they had more of it to help those poor, helpless children, of course.) But when they think we’re not listening the talk is all about “capital” “revenue” and “equity portfolios.”

● And when they think we’re not listening they admit that tens of thousands of children warehoused in institutions don’t need to be institutionalized.

No, the people who run residential treatment
centers are not like Montgomery Burns
on The Simpsons. But financial incentives for
needlessly institutionalizing children are very real.

 Discussions about financial incentives in child welfare usually revolve around incentives for governments.  Sometimes that discussion is oversimplified with claims that governments “make money on foster care.”

Actually they don’t.  But the reality is almost as bad. A series of perverse incentives lead to a situation in which governments sometimes lose more money by helping a family than they lose by just consigning the children to foster care – even though the help for the family costs less in total dollars.  So even though governments don’t literally make money on foster care, there are financial incentives to misuse it and overuse it.

Another set of perverse incentives encourages quick-and-dirty slipshod adoptive placements, by paying bounties for every finalized adoption over a baseline number.  Even when the adoptions fail, the states still get to keep their bounties.  There is no similar incentive for reunifying a family.

Incentives for private agencies

But there is another set of even worse incentives that gets far less attention: incentives for private agencies. Such agencies typically provide most of the worst, and most expensive forms of “care” – group homes and institutions. In some states and localities they also oversee foster homes. 

These agencies typically are paid for each day they hold a child in their care.  So of course, they have a profound incentive to encourage needless removal of children and then hold them in foster care for a long, long time. 

This does not mean that your typical private agency leader is like Montgomery Burns on The Simpsons, gleefully rubbing his hands each time another child is placed in his group home or institution.  Rationalization is powerful. So the group home industry, (a term that encompasses all forms of “congregate care” from your basic group home to your “residential treatment center,”) convinces itself that, contrary to a massive amount of evidence, the children really, truly benefit from being institutionalized and really, truly have to be in their care for a long, long time.

(The term group home industry itself was coined by the director of a residential treatment center who had a crisis of conscience and had to fight the industry when he sought to vastly reduce institutionalization and emphasize services to children in their homes or foster homes.)

Nonprofits can be greedy, too

The various components of the group home industry are typically, though not always, nonprofit organizations.  That’s a big blind spot for journalists.  Reporters are trained to be skeptical of government and of big corporations. But there is surprising naiveté about the so-called “independent sector.”  But the will to survive can induce in nonprofits a form of greed that is as corrosive of common decency as the worst corporate behavior.

And that brings me to a column written by Jennifer Jones and Theresa Covington, two leaders of the so-called Alliance for Strong Families and Communities.  That’s one of those Orwellian names so-beloved in child welfare. It’s actually a trade association for human services agencies, including many that run group homes and residential treatment centers.

Writing in what they apparently consider their safe space, the Chronicle of Social Change, they effectively admitted that what really concerns many of their members is: Money, money, money.

The column deals with the so called Family First Prevention Services Act. They claim that “One of the areas that will be most impacted [sic] by the bill is residential care.” (In fact, that part of the law is so strewn with loopholes that, unfortunately, the “residential care” industry is unlikely to be impacted – or even affected – much at all.) They go on to write about how they’re conducting “a series of cohort initiatives to help inform and advance a transformational shift …”

True confessions, part 1:

But two elements of the column are striking. First, this trade association that includes so many residential treatment providers admits, in writing, that a huge proportion of the children their members have institutionalized don’t need to be in institutions.

They write:

“Therapeutic Residential Care,” as it is known, focuses specifically on providing treatment for youth who have a mental health diagnosis or have experienced trauma and need help regulating their emotions. … However, according to recent data, more than 4 in 10 children who are currently in residential care have no mental health diagnosis, medical disability or behavioral problem that would warrant such a setting. [Emphasis added.]

… Recent research suggests that young children living in residential programs are at a higher risk for developing physical, emotional and behavioral problems. These young children are also less likely to be placed in a permanent home than those who live in foster care.

The “recent research” comes on top of the vast store of research that has told us as much for a long, long time. Back in 2005, Shay Bilchik, who then was running another trade association for agencies that has an Orwellian name, the Child Welfare League of America, admitted that they lack “good research” showing residential treatment’s effectiveness and “we find it hard to demonstrate success...”

What’s new is that now the so-called “Alliance” is admitting it as well, and suggesting that tens of thousands of institutionalized children should not, in fact, be institutionalized. (The 4 in 10 number is an underestimate. There is no evidence that residential treatment is successful for any population – but, hey, it’s a start.)

True confessions, Part 2:

So, what is it that is stopping the Alliance’s member agencies from abandoning this largely worthless endeavor?  After all, these agencies tell us over and over that their only concern is the best interests of the children, and they don’t even think about what the agencies themselves need. 

But now Jones and Covington tell a different story:

This shift requires residential providers to make significant changes in policy, practice, budget, historical programming and organizational culture. The growing evidence base continues to point to this change movement as being in children’s best interests and necessary, yet providers continue to seek out clearer and more efficient pathways to understand this new reality and make this transformation a reality.

Translation: We might be willing to do this, but only if we don’t lose any money, or, God forbid, go out of business.  Money first, kids second. 

Jones and Covington cite figures from one of their member agencies indicating that residential treatment brings in a disproportionate share of its revenue. And, they write,

Many child welfare providers and operators of residential treatment facilities have a tremendous amount of equity and capital in their physical structures and campuses and a large portion of their organizational identity is encompassed in their role as residential providers.

Translation: If we do what’s best for the kids, where will we get our money?  We’ve got all that equity and capital to think about! 

Jones and Covington continue:

It can be challenging for leaders and board members of these organizations to still deliver on their stated mission when such a large part of that mission is being transformed.

But if the stated mission is institutionalizing children, then the mission is crap and it should be scrapped. 

Jones and Covington again:

Child welfare providers are among the oldest community-based nonprofits in the country, with a significant number of them owning and operating facilities that began as orphanages more than a century ago.

Actually, they’re still orphanages.  “Residential treatment” is largely an exercise in rebranding. 

And finally, Jones and Covington tell us:

These physical campuses make up a large part of their equity portfolio and many organizations are hesitant to make the leap to repurpose or divest these resources.

But why?

If all they care about is what’s best for the children, as they keep telling us, they should be thrilled to follow pioneers such as Children’s Village, EMQ Child and Family Services and Youth Villages which all have dramatically altered their mission to put far more emphasis on services in children’s own homes, in foster homes.

Unless of course, what they really care about is self-preservation.

Meanwhile, back at the whine cellar …

And, of course, no column by a trade association of providers would be complete without whining about how they don’t get enough money for whatever it is they provide. So, Jones and Covington write:

The theory of change represented within the [Family First] bill requires a robust array of home- and community-based services, yet there was no federal funding put in the bill to help states build up that part of the system. So, state legislatures and local governments are going to need to make further investments into developing this part of the system in order to keep children in the least restrictive, most family-like settings. 

Actually, that’s not quite true. As the authors note in the same column, Family First does include some funding for reforms. It allows money once limited to substitute care to be spent on better options – though the options are severely limited, so very little money actually is likely to be available.

But more important, you get the money for alternatives to institutionalizing children by not institutionalizing children. 

Institutions are not just the worst form of care, they’re also the most expensive.  So pretty much anything else you do for a particular child will cost less than institutionalizing the child. So all you need to do to “make further investments” in better alternatives is to take the state and local money you would have spent to institutionalize children and spend it on those better alternatives. 

That is, if all those concerns from agencies about “capital” “revenue” and “equity portfolios” don’t get in the way.