Before July when it became unlawful, California officials sent hundreds of vulnerable children each year to residential treatment programs as far-flung as Wyoming and Florida.
They were kids who the courts, social workers and probation officers decided were too troubled to place in family foster homes or in local group facilities. Their behaviors were so unsafe and mental health issues so severe, local officials determined, their needs could not be met anywhere in this state of 164,000 square miles and some of the nation’s greatest wealth and innovative social services.
Now, following an investigation by The Imprint and The San Francisco Chronicle into abuse that many of these children suffered or witnessed in privately-run, out-of-state facilities, Gov. Gavin Newsom (D) has signed a law banning such placements. More than 130 children have been brought back to California and counties now have more than $100 million to develop in-state, locally based programs.
Public records, responses from 20 county agencies and interviews with child welfare professionals indicate they may never have had to leave in the first place. The state’s sudden decision last December to decertify out-of-state programs that had long been relied upon left counties scrambling to find local alternatives. State data show they were mostly successful.
By early April — less than four months after their return was ordered by state officials — more than three-fourths of the children who had previously been deemed impossible to treat in California were moved to local treatment programs and the homes of relatives and foster families, according to figures published by the Department of Social Services.
“There were some young people that never needed to go to another state,” said Ken Berrick, founder and CEO emeritus of the Oakland-based Seneca Family of Agencies, which serves thousands of California foster youth. “There were resources in the state that could have accommodated them, but they were sent out of state for less than optimal reasons.”
Today, 52 of the 133 children are living safely with their relatives, independently, or in foster homes — some under exceptional arrangements with live-in professional help, others with specially trained caregivers and educators providing homeschooling. One child recently returned home after a stay in a Northern California treatment program nestled alongside the Pacific Ocean and a national forest of redwoods that serves no more than two clients at a time. It’s a high-cost program, but highlighted by some in the field as a model of individualized care for troubled children.
With a newly approved $139 million investment in services for high-needs youth and a permanent ban on sending kids out of state, even some of California’s most strident critics are expressing optimism.
Jennifer Rodriguez, executive director of the San Francisco-based Youth Law Center, wrote in a May letter to Gov. Newsom and legislative leaders that the novel solutions should serve as a “roadmap” to proper care for all children in the future. In the past, Rodriguez said, kids were sent out of state as “placements of convenience.”
This is precisely how Mialissa Florez feels about being sent from San Diego to the Youth for Tomorrow residential facility in rural Virginia in 2018 — that she was shipped away for being “one of the bad kids” who repeatedly ran away from local group homes.
“It has nothing to do with the treatment that they offer elsewhere, and it’s like it has everything to do with the kid themselves,” Florez said in an interview.
For children already struggling with the trauma and loss of being in foster care, the impact of being sent away, even farther from home, can be devastating — especially when the institutions that are supposed to be keeping them safe are instead abusive.
Last year, California officials reported that Youth for Tomorrow staff had injured kids during physical restraints and stripped them of basic rights. The facility was found to be “failing to provide youth a safe and comfortable home where they are treated with respect.”
“It was a very traumatic experience for me because I had nobody,” the 20-year-old said of her time at Youth for Tomorrow. “I was so lonely, I can’t even explain how that feels. It’s just like emptiness in your chest and your stomach and you can’t do anything about it.”
Describing physical restraints, the once-a-week phone calls she was allowed, and only a few off-campus trips over the course of a year, Florez said the experience made it hard to ever again trust her caregivers.
When Florez heard her peers were pulled from similar placements late last year, she was happy for them, but felt a surprising pang of jealousy, a feeling like, “You should’ve took me out when I was there!”
Still, not all of the children who came home to California achieved hopeful outcomes. The state reports that as of Aug. 10, more than 20% ended up in juvenile detention facilities, ran away or were reported missing. Some ended up in temporary children’s shelters because an appropriate placement couldn’t be found.
The returned youth also wound up in detention facilities in Los Angeles, Riverside, Monterey, Orange, San Diego and Madera counties, according to data obtained through a public records request and interviews with local authorities. One child in San Joaquin County was placed in a probation-run camp, local officials said. Several were arrested and detained in juvenile halls for committing crimes and violating probation, including three youth in San Diego County.
In April, Donnie Ryan, then a spokesperson for the county probation department, said youth from his county had been doing well in out-of-state group homes, with their conditions improving: They’d begun engaging in therapy, were “on track” and “would have benefited from continued time in the program.”
But when they returned to San Diego — two to their homes and one to a residential treatment program — “the negative behaviors escalated,” Ryan said, and officials decided they had to be locked up again. He added that “they were not in juvenile hall as a result of the removal from out of state but as a result of subsequent behavioral needs.”
As of Aug. 10, 13 of 133 youth statewide were missing from their court-assigned placement, state records show. Four children were living in “shelters” because no other homes had been found.
In interviews, child welfare and probation authorities told The Imprint that California still lacks treatment programs willing to accept youth with histories of physical or sexual aggression, and those with repeated instances of running away.
Many local treatment programs “are full or report they are unable to meet the needs of youth with higher level emotional/behavioral health symptoms,” Devin Drake, director of San Luis Obispo County Department of Social Services, wrote in an email.
Roughly one-third, were placed in state-licensed and regulated short-term residential treatment programs. The local facilities are a step down from in-patient psychiatric hospitals, providing around-the-clock supervision and treatment for mental and behavioral health issues.
The December exposé that triggered the children’s return focused on a for-profit residential treatment provider that California had long contracted with, the Alabama-based Sequel Youth & Family Services. Reporters examined numerous public documents from five states revealing that the California Department of Social Services knew of reports that youth at Sequel-run facilities had been slapped, punched and choked by staff.
Still, the state allowed counties to continue sending more children to Sequel-run programs — even after the 2020 death of 16-year-old Cornelius Fredericks, who died after staff members smothered him during a physical restraint. Cornelius had tossed a sandwich in the cafeteria at Lakeside Academy in Kalamazoo, Michigan.
On Dec. 9, presented with reporters’ findings about conditions at the facilities, the Department of Social Services ordered all children placed out of state to be returned to their home communities and decertified all out-of-state programs, regardless of the provider. The swift action gave county probation and child welfare agencies 45 days — amid the harrowing winter coronavirus surge — to find new homes and treatment programs.
Problems were seemingly everywhere. The facilities violated dozens of rules, inspection reports show, creating environments that were more punitive and jail-like than therapeutic, with restrictions on everything from phone calls with loved ones to using the restroom.
At Youth for Tomorrow in Bristow, Virginia, where Florez spent a year, state documents show that staff relied on “improper” discipline, including, requiring youth to submit to random drug testing to participate in activities, and cancelling home visits “as a punishment to modify behavior.” California officials found that unwarranted physical restraints lasted longer than permitted and that the methods were deployed at times with excessive force that caused injuries and bruising.
At four Rite of Passage facilities in Nevada, inspectors found staff used restraints with “minimal or no use of de-escalation interventions,” and allowed inappropriate sexual contact between youth. At a Devereux Advanced Behavioral Health campus in Viera, Florida, violations included staff using physical force, “instigating youth to act out” and denying access to food and restrooms. And at Turning Point Family Care in Utah, youth were denied visits with family at holidays and limited to 15 minutes of phone time per week, violating personal rights protected by California law.
Following public exposure by the media, while bringing the California children home from these facilities, the state social services department publicly reported its progress on a new data portal. Biweekly updates listed the number of youth who had returned, and where they had landed. The state also posted decertification notices and communications it sent to the facilities, detailing problems found at each site.
By April 7, all 133 children were back in their home state. Their cases are kept confidential, but reporters with The Imprint were able to gather basic information about their circumstances.
One was placed at Birch House, run by the Ukiah-based nonprofit Redwood Community Services. The facility, state-licensed in October 2019, is run out of a single-family home with a hammock on the front porch, a cat, dogs, chickens and a barn full of arts and craft supplies. Located on 1.5 acres in Mendocino County, the home has a basketball court and other youth-friendly features, but the property is fenced to deter runaways.
At roughly $34,000 per month for each child, “it’s an expensive model,” CEO Victoria Kelly acknowledged. “And I think that’s one of the biggest things that counties in our state are struggling with.”
But she added that “for some of these higher-needs youth, I don’t think you’re going to see lasting behavioral changes if they’re in a milieu with 10 or more kids.”
Birch House crafts its three- to-five-month treatment plans to children’s specific needs, bringing in additional staff for some residents, or reducing staffing levels when needed, to allow family members a greater role in caregiving.
The program was initially created to serve one teen who’d been rejected from other programs, Kelly said. “She was probably one of the more difficult and behaviorally challenging youth that we've ever served. We just had all hands on deck for the five to six weeks that she was with us.”
The child who came to Birch House this year after being removed from an out-of-state placement has since returned home to her mother.
In a public meeting in the state capitol in March, a state official declared efforts to find in-state placements a “tremendous success.” But local probation and child welfare officials maintain they’re still competing for scarce vacancies, and they describe the transition to keeping all kids closer to home as anything but easy. There are simply too few in-state beds, and the competition for the ones that exist is even higher now, numerous county officials and service providers told The Imprint.
“While California is heading in the right direction, there are still significant challenges to finding the right treatment options for high-needs youth,” said Mark Ferriera, chief probation officer for Stanislaus County.
In recent years, reforms to California’s child welfare system have focused largely on reducing the use of group homes and placing most youth in residential settings only when they are short-term and offer quality treatment. As a result, many providers have opted to close rather than adapt to higher and more costly new standards.
As a result, Drake of San Luis Obispo County said children are denied placements, or they are too quickly issued “14-day notices” to move out when problems arise. “These are the same issues we faced previously and which led to the youth being placed out of state to begin with,” he added.
Still, all agree there are innovations on the horizon, prompted in part by public exposure of dangerous conditions kids had long been subjected to, outside the watch of state authorities.
A recently approved statewide pilot program will create additional levels of care for California children in acute mental health crises, including those who may be dangerous to themselves and those around them — the types of children who historically have been sent out of state. The five-year project, set to launch next year, will establish “crisis continuums,” providing everything from 24-hour mobile response units to additional in-patient psychiatric beds. Regional teams of professionals will respond to youth in crisis, assigning them care and treatment staff based on individual needs.
Berrick, who helped design the program, said this allows for a more holistic approach — rather than providers simply filling congregate care beds to cover costs.
Though California is equipped in many ways to care for many of the youth who had, in the past, been sent far from their homes to so-called “placements of last resort,” Berrick said the state is still failing to meet their mental health needs.
“There are still times when we are caught unprepared,” he said. “We simply don’t yet have all of the resources necessary to meet some children’s needs.”