New York City is no longer allowed to keep troubled foster-carechildren in psychiatric hospitals after doctors have recommended their release, and must closely adhere to laws that require such children to be placed in the least restrictive setting possible, after reaching a settlement agreement in federal court last week.
The agreement came less than a year after a class action lawsuit was filed against the Administration for Children’s Services, which oversees the care of nearly 15,000 foster children in the city. The suit, filed in United States District Court in Brooklyn, alleged that the agency confined children in psychiatric hospitals for prolonged periods, sometimes when there was no need for them to be in the hospital at all, and that it used the hospitals “as if they are detention centers.”
Under the terms of the settlement, the city agreed to issue mandatory guidelines regarding children who are admitted to psychiatric hospitals, to track and monitor the children and to provide training for city employees and their counterparts at contract foster-care agencies who make the hospital referrals.
A key component of the agreement was a requirement for the Administration for Children’s Services to notify a child’s lawyer as soon as the child is placed in a psychiatric hospital. “It certainly will assist in moving these cases along because there is plenty of advocacy we could do to ensure our clients don’t languish,” said Tamara Steckler, the lead attorney of the juvenile rights practice at the Legal Aid Society, which filed the suit along with lawyers from Patterson Belknap Webb & Tyler.
The city must issue regular reports to the plaintiffs’ lawyers under the agreement, which remains in effect for five years.
The settlement also awarded monetary damages to the three lead plaintiffs in the suit — children who were identified only by their initials — and legal fees to their lawyers. The amounts of the awards have not been determined. The city admitted no wrongdoing in the case.
According to the original complaint, the lead plaintiffs were held in psychiatric facilities for weeks and months beyond the dates doctors deemed them ready for release. They were rarely permitted to leave the hospital, regularly administered psychotropic medications and sometimes chemically restrained with tranquilizers. Ms. Steckler said they had since been released to more appropriate settings.
State law requires the city to place each foster child in “the least restrictive and most homelike setting in which the child can be maintained safely.” Emergency psychiatric care is generally considered the most restrictive. Less restrictive settings include residential treatment facilities, group homes and foster-care homes in which the foster parents have been specially trained to treat troubled children.
The foster-care agencies have, however, often had difficulty persuading less restrictive homes to accept children with a history of psychiatric trouble. Thus, children languished while the agencies tried to find them homes.
The Administration for Children’s Services said it had been working with foster-care agencies to train and assist them in finding treatment options, and had already moved to put in place many changes required by the settlement. The commissioner of the agency, John B. Mattingly, issued a memorandum in May 2010, about two weeks after the lawsuit was filed, detailing changes to the way the city provides psychiatric care for children in foster care.
A lawyer for the city characterized the settlement as a culmination of efforts to improve care for the children. “We are pleased to have been able to resolve this matter amicably,” Martha Calhoun, senior counsel in the city’s law department, said in a written statement. “A.C.S. has been building a stronger system for foster children and youth with psychiatric issues for a number of years.
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