Across New York state, the footprint of group homes for children in foster care has steadily shrunk or disappeared altogether.
Back in 2013, the St. Anne Institute, a tidy three-story brick building in Albany, was home to as many as 88 teenage girls, but by last summer, the agency had cut its capacity to just 35. Last year, OLV Human Services closed two 8-bed group homes near Buffalo and downsized another. And Graham Windham — the agency that grew out of the orphanage founded by Alexander Hamilton’s widow Eliza — closed its 120-year-old residential campus just outside New York City, taking 70 beds offline.
Under the Family First Prevention Services Act, a law passed by Congress that took effect in New York in late September, federal funding for congregate care has been dramatically reduced. The law referred to commonly as “Family First” reflects the growing consensus that children thrive in family homes, not institutions, and that lengthy stays in residential programs without specific treatment goals can cause lasting harm.
In New York, nonprofits that run residential programs have known for years they would soon be subject to much stricter placement rules and greater court oversight. Amid a consistent decline in children entering foster care and those referred to group placements, industry leaders have had little choice but to plan for significant downsizing, and to shift their focus to community-based foster care and family support services.
“New York was pretty transparent that reliance on congregate care was going to decrease further under Family First,” said Mary Swygert, chief officer of clinical services at OLV Human Services in Lackawanna, just south of Buffalo. “It was a difficult decision to change our programs completely, but we had already started to see a very low census in two of our group homes.”
The agency decided to focus on placing more children with foster parents; it now manages the cases of 70 children living in foster homes, up from an average of 55 before the two group homes closed; a third remains for brief emergency stays. OLV staff are also working to help more kinship caregivers get certified as foster parents, which will give them access to significant financial and health benefits for the children in their care.
State data shows a downward trend in the number of foster children placed in congregate care settings, even before the federal law was signed in 2018. By early 2019, only about half of New York’s roughly 6,000 congregate beds were filled, primarily by teenagers.
Since then, the number of available beds in group care facilities statewide has shrunk to 4,000. Despite the cuts, about half of available beds are still unused, according to data from the state Office of Children and Family Services, indicating that far fewer children are being referred to group placements.
Legal advocates for youth in foster care say such data is a promising sign that New York is finding more ways to keep vulnerable children in family homes. Yet those youth who remain in group settings are staying “much longer than they should be,” said Betsy Kramer, director of policy and special litigation at the New York City-based Lawyers for Children.
“We are hopeful that Family First will compel social services districts to take a close look at whether those placements are really necessary for those youth, and whether they are actually benefiting from the placements,” Kramer said. “And, if they are not, that the law will push the agencies to find more appropriate placements with family or in foster homes.”
Teenagers have typically been placed into residential care when their caregivers struggle to manage their mental health needs or behavioral challenges, and can’t find sufficient support services in their community. Others have ended up in institutions simply because there were no foster homes available for older children, who have typically suffered multiple traumas and years of disrupted connections with adults.
Yet youth who spend extended time in residential institutions experience more dire long-term outcomes. They are less likely to find a permanent home and less likely to graduate high school, according to research compiled by Casey Family Programs.
Under Family First, states can receive essential federal funds for group care for no more than two weeks, unless a clinician and family court judge agree they have specific clinical needs that can only be provided in a residential setting; group homes can no longer simply be a last resort when family homes can’t be found.
To qualify for federal reimbursement, residential facilities also must now be approved by the state as a Qualified Residential Treatment Program (QRTP), a licensed, accredited facility with clinical staff available around the clock. QRTPs must use a trauma-informed model of care, involve family in treatment planning and provide aftercare for six months.
These requirements were made clear well in advance of this fall’s deadline, several New York providers told The Imprint, yet only about half of residential facilities applied for the QRTP designation.
As of January, nearly 300 facilities held a license to care for youth in the custody of New York child welfare agencies, although some did not primarily serve foster youth and others had recently closed. Of these, 158 applied for and received QRTP approval by mid-October, a spokesperson for the state child welfare agency said.
Facilities that applied tended to be located in larger metro areas. Those located in less populous regions say they’ve struggled to hire staff and fund round-the-clock clinical care for just a handful of young people.
In Watertown, an upstate town of about 25,000, the Children’s Home of Jefferson County’s services had for decades been centered on a four-cottage residential program, where youth typically stayed for one to two years. But in 2018, with referrals dipping, staff turnover rising and Family First on the horizon, longtime Executive Director Karen Richmond began to question the program’s sustainability. This summer, with just four children remaining, she closed the cottages.
“We like to focus on our local families and children, but we found we could only fill our beds by taking in kids from far away,” she said. “Plus, once you’ve removed a child from a home, it’s so hard to get them back there.”
Now, the only residential care the Children’s Home offers is a six-bed crisis respite program, where the maximum stay is two weeks and discharge planning starts on day one. It has also developed a foster care program that serves about 200 children in family homes, and a program that aims to prevent entry to foster care by providing families with trauma-informed therapy.
Other providers are still waiting to see if the number of referrals to residential care stabilizes or continues to decrease. For several years, the House of the Good Shepherd’s residential program in Utica has cost more to operate than it brings in, a deficit that grew when it had to increase wages to retain employees during the pandemic. The agency has downsized its congregate care capacity by a third, but its director said if referrals to the program drop again, further cuts may not be practical.
“If I take a few more beds offline, then I’ve got to think about the viability of being a residential provider, because without a certain scale, you can’t pay your bills,” said CEO Brian McKee. “It’s not because people don’t like us, it’s just that the number of kids in congregate care is going down.”
For now, the agency has been able to absorb the financial losses from its residential program thanks to steady revenue from its other services that include finding foster or kinship homes for children. This year, the agency certified more than double the number of kinship foster parents as it did in 2019, McKee said.
In her five decades at the St. Anne Institute in Albany, Chief Operating Officer Terry Gabriel has witnessed a dramatic shift in the country’s approach to caring for vulnerable young people. When she began working at the home for troubled girls in 1970, it was run by an order of nuns, and most of the 200 teens lived there for several years before moving out on their own.
By 2018, girls typically stayed at St. Anne for close to a year, Gabriel said, but after Family First was announced, county social service departments began returning children more quickly to family homes. Today, most teens stay for three to five months.
Gabriel and CEO Richard Hucke said they are worried that county agencies may now push to move young people out of residential care before they are stable and a suitable long-term placement has been found.
“We need to acknowledge that only kids with intense mental health and behavioral needs will meet the level of care in a QRTP, and those issues are not quickly resolved in a positive, successful way,” Hucke said. Under the new stricter oversight, he must now explain to the state child welfare agency any lengths of stay longer than six months.
Still, Hucke said, the agency supports the overall intent of the new law.
“We all agree with the philosophy of Family First,” he said, “and that limiting the time kids spend in a high level of care is a good thing.”