What goes on behind the closed doors of foster care is excluded and exempted from public scrutiny, the same way fraudulent billing of Medicaid pays for the horrific treatment of children in these restrictive institutions.
Another reason the States will make no movement to introduce sunshine policies is because of the push for privatization.
Many facilities are religious-based, with a secondary level of inpenetrability against audits or even contract compliance.
By privatizing child welfare services, the agencies not only self-report, but they handle internal complaints.
Think of it like this: If a child wants to file a complaint of abuse against a staff, the child would have to file the complaint with the staff person who engaged in the transgression.
Many children are placed in state care for the simplist reasons of poverty. The more a state cuts resources and services to families with young children, the more likely there is an increase in the rate of children being placed in care, in a system that was never designed to do much more than to bill Medicaid.
Poverty is not a crime, but according to child welfare law, it is.
Warehousing children is a multi-billion dollar industry of human trafficking which is too big to fail.
This is why there are confidentiality laws.
This is why the abuse is hidden.
An untold number of foster children in South Carolina custody are neglected, drugged, beaten and molested in group homes and institutions where the state warehouses them for millions of dollars a year at taxpayer expense.
Read the Series
Part I: Warehousing our Children: How South Carolina laws hide child abuse inside group homes
What's more, South Carolina keeps the abuse these children suffer secret by using state laws that shield group homes from almost any scrutiny.
Court records shed light on some of the worst cases, but this state-sanctioned secrecy makes it impossible for the public to weigh the difference between well-run group homes and those that resemble a Dickensian orphanage. Even parents who reluctantly send their children to these facilities for treatment can't figure out how to keep them safe behind closed doors.
When Jessica Freeman placed her daughter in Springbrook Behavioral Health last year, she had no idea the state had investigated the Greenville County home 95 times since 2000 for possible abuse and neglect — more than almost any other residential treatment facility in South Carolina. That's because the state Department of Social Services doesn't make the few records that are public readily accessible.
Freeman pulled her daughter from the facility last fall after a therapist told her that several Springbrook staff members had beaten an autistic child in an incident caught on a security camera.
“That's ridiculous,” Freeman said. “You can report a bad hamburger easier than you can report someone abusing your child.”
Springbrook administrator Mike Rowley would not discuss any specific case, but said most allegations made against the facility are cleared by the Department of Social Services.
“If we have anything substantiated, those employees are immediately terminated,” Rowley said. “We don't want them around other children.”
That's why other states have reduced their reliance on group homes by expanding foster family programs or finding relatives for these children to live with. But South Carolina has largely resisted change, dumping tens of millions of dollars every year into privately-run group homes for no other reason than that's how this state has always done it, some experts say.
“I can say, having done this work for 15 years nationally, that South Carolina is possibly the worst I've ever seen on that front,” said Ira Lustbader, the litigation director for Children's Rights, a New York advocacy group.
More than 100 group homes and institutions are scattered across the state, ranging from rural farms to sophisticated psychiatric compounds. At any given time, they house about a quarter of South Carolina's 4,000 foster children.
While group-home supporters acknowledge that some problems persist within the industry, they insist these facilities provide desperately needed services for troubled children who aren't suited for normal homes and have nowhere else to live.
But even Susan Alford, named the new Department of Social Services director late last year, finds South Carolina's numbers problematic.
“Our rate is too high,” Alford said. “We put too many children — especially in the 0 to 12 (age) range — we put too many of them in group homes. Our aim would be to try to decrease that number.”
Troubling findings
South Carolina isn't the only state faced with these problems. Published reports across the country detail a litany of horror stories in which children and teenagers in group homes have been overmedicated for mild behavioral issues, raped by their peers and lured into prostitutionwhile their temporary guardians aren't watching. But many other states are moving away from this model. Meanwhile, South Carolina continues shoveling hundreds of children a year into a system rife with complaints and concerns.
The Post and Courier reviewed lawsuits, visited group homes, filed open records requests and interviewed dozens of state leaders, child welfare experts, parents and former foster children for this series. Among other things, the newspaper's investigation found:
- Nearly a quarter of the children under 13 years old who entered the foster care system in 2013 were placed in group homes and institutions in South Carolina — by far the highest placement rate for this age group in the United States. By comparison, only 2 percent in Tennessee and 3 percent in North Carolina were placed in similar settings. The national average is 4 percent.
- Some children live for months, even years, in group homes because South Carolina fails to recruit enough foster families and the state pays them so little to participate. Some foster parents are paid less than $13 a day to raise a child.
- The South Carolina Department of Social Services spent $28.1 million in 2014 placing children in group homes — more than five times the amount the agency paid foster families. Group homes earn at least $86 per child per night.
- The Department of Social Services reviews hundreds of allegations of child abuse and neglect in group homes, institutions, foster homes and day care facilities every year, yet the agency's team of 10 investigators rarely finds enough evidence to support those claims. The state has investigated 484 allegations of abuse and neglect in group homes and institutions in the past five years, but has only been able to find evidence to prove 44 cases.
- South Carolina makes it easier to know which restaurants are infested with cockroaches than to pinpoint where children have been neglected, or worse, physically and sexually abused.
- Court records allege children who disclose that they've been abused in group care — by adults and each other — are often ignored because state caseworkers are so overloaded that they don't have time to weigh the allegations.
'Dangerous deficiencies'
In January, Children's Rights and the South Carolina Appleseed Legal Justice Center filed a federal lawsuit against South Carolina on behalf of 11 foster children who allegedly suffered from the Social Services agency's “dangerous deficiencies.”
The complaint contends children were abused, overmedicated, separated from their siblings, kept in solitary confinement, fed moldy bread — and the worst of it happened in group homes.
One 16-year-old girl reported that children at the Jenkins Institute for Children in North Charleston hoarded food because they were “frequently deprived.” The group home denied her medicine and feminine hygiene products, and she said a maintenance worker there asked her to take naked pictures of herself on a cellphone, according to the lawsuit.
The lawsuit also alleges that a teenager at Epworth Children's Home in Richland County was prescribed a “powerful psychotropic medication for the first time in his life.” The drug is used to treat bipolar disorder, even though the child had never been diagnosed and hadn't received a mental health evaluation at the group home, the complaint contends.
At Helping Hands, a group home in Aiken County, the lawsuit claims that a 9-year-old boy's toothbrush was smothered with feces.
Epworth Children's Home and Helping Hands did not respond to messages about the lawsuit.
The original complaint also contends that several unnamed group home employees and state caseworkers did nothing when some children tried to report the abuse. One caseworker allegedly told a child, “She had a lot of children on her caseload and so was limited in what she could do to help her,” the lawsuit stated.
Paula Fendley is the executive director for the Palmetto Association for Children and Families, an organization that represents many group homes in South Carolina. She said similar cases filed by Children's Rights in other states have been settled before trial.
“You can allege anything in a lawsuit, but you have to be able to prove it,” Fendley said. “If these things are, in fact, true, then I guess all of that will come out in the court.”
Most children in group homes in South Carolina have been placed there by the Department of Social Services as part of the foster system.
Institutions, such as psychiatric residential treatment facilities, are designed to offer an even higher level of care for children with more severe behavioral health needs.
Some children in group homes and institutions are considered “private placements.” Their parents retain legal custody, but have decided to place them in these facilities for treatment.
Haley's office directed questions about the lawsuit to the Department of Social Services.
Alford would not discuss the pending litigation. “Those are things that I just can't talk about,” she said.
Funding foster families
The federal lawsuit hinges on the widely-accepted premise that social services caseworkers in South Carolina are overwhelmed with work. They don't have time to keep track of all the children that they're charged to protect.
A Legislative Audit Council report published last year shows more than 30 percent of caseworkers statewide were each assigned at least 50 children to monitor, and a few were assigned more than 75. The Child Welfare League of America, a national advocacy group, recommends each caseworker manage no more than 17 families per month.
The Legislative Audit Council report and a string of child deaths prompted Statehouse hearings and calls to reform the child welfare agency. Former DSS Director Lillian Koller, who tried to scale back the number of foster children in group homes, resigned under pressure last year.
Still, the General Assembly has failed to pass any sort of major legislation to reform the Department of Social Services.
“It's not something that legislators get excited about because there's no glory in this,” said Sen. Katrina Shealy, R-Lexington, a member of the Senate DSS Oversight Committee.
“I know that everybody wants to talk about roads and jobs, and we do need to talk about those things and those are important, but if we don't save our children, we don't need our roads.”
Appleseed Legal Justice Center Director Sue Berkowitz said the Legislature needs to broaden its probe into the state agency because child deaths aren't the only problem it faces.
“There's so much more going on,” she said. “What hasn't been focused on is what's happening to our kids once they go into the system.”
Data provided by the Department of Social Services shows about a quarter of the 4,000 foster children in South Carolina lived in a group home, an emergency shelter or an institution on April 1. Experts, including the Department of Social Services director, say that's too many.
“The goal in child welfare is for you, as much as possible, to keep kids in families,” Alford said. “If you can't keep them with their biological family or put them in kinship care, then you're looking at foster care as the next best alternative. That should be your first priority.”
A national report published by the Baltimore-based Annie E. Casey Foundation this year said group homes aren't designed to offer the “individualized nurturing” that children need.
“In many cases, a child ends up living in a group placement simply because an agency has not found an appropriate facility,” the report's authors wrote.
On May 1, 2,310 foster homes were licensed to accept children in South Carolina — too few for the nearly 4,000 children in the system. But the child welfare agency can't recruit enough families, partly because they're paid so little to participate. Foster parents only make between $12.77 and $17.27 per child per night — no more than $6,303 a year to clothe, feed and care for a child.
In response to a public records request filed by The Post and Courier, the Department of Social Services said it spent $28.1 million in the 2014 fiscal year to house children in group homes and institutions, but only $5.5 million on foster families.
Critics argue it makes no sense that the state spends more than five times the amount of money to house less than a quarter of all foster children in group homes because many of them shouldn't be there in the first place.
“It's bad for kids, but it's also a total waste of taxpayer money,” said Lustbader, of New York's Children's Rights. “That's the part that doesn't get as much attention as it deserves.”
Some group facilities for children earn additional income from other agencies. The state Medicaid agency, for example, spent $23 million during the 2015 fiscal year on South Carolina children in psychiatric residential treatment facilities, which offer the highest level of care.
Most “Level 3” group homes — a step down from residential treatment facilities — pull in $151 per child per night, or more than $50,000 per child per year. “Level 1” and “Level 2” group homes largely accept children without any psychological problems and earn either $86 or $98 per child per night.
Meanwhile, a 2012 national report shows only five states paid foster families lower rates than South Carolina. Even some group-home advocates acknowledge these foster family payments aren't sufficient.
“It's less than you would pay to board your dog,” said Deborah McKelvey, the executive director of Windwood Farm, a combined “Level 3” group home and psychiatric residential treatment facility for boys in Awendaw.
South Carolina needs more foster families, she argued, but some group homes offer children a measure of security that a traditional family can't provide.
“I know the national picture says children under 12 shouldn't live in a group setting,” she said. “I say children under 12 frequently are too afraid to bond with a family. They feel safer in a group setting where they know somebody is awake 24 hours a day watching their back.”
Children eat family-style meals together at Windwood Farm, she said. They go to the beach. Windwood almost resembles summer camp, complete with an obstacle course, ponds for swimming and fishing, and a fitness trail, she said.
Jody Tamsberg, chairman of the Windwood Farm board of directors, said that even though South Carolina agencies pay Windwood significantly more than foster families to care for children in state custody, those payments don't cover its bills. The nonprofit group home still must raise at least $500,000 a year to break even, he said.
“I love good foster families and there are lots of them, but even the good ones, they can't take a kid that's been abused, that's on eight medications, that's totally out of control,” Tamsberg said. “There's got to be a place where they can come, stabilize, be safe and have skilled professionals — nurses and doctors — tend to them.”
Brendin and Faith
Brendin Cecere and his mom, Faith Rice, moved out of their Summerville house right before Thanksgiving three years ago following a physical fight between Rice and her ex-husband. The ordeal was particularly traumatic for Brendin, who is diagnosed with autism spectrum disorder.
“Brendin's whole world that he knew was done. Everything that was familiar — his routine, his home, his neighborhood — everything that he was familiar with, with the exception of school, was out of sorts for him,” Rice said. “By January, he pretty much broke down.”
Brendin, now 13 years old, threatened his mom with a knife. He hurt the dogs. He threatened to hurt himself, too.
“At that point, there wasn't anything more I could do but place him in a facility,” Rice said. “As much as it killed me, there was nothing more I could do.”
Brendin spent nine months at Three Rivers Behavioral Health, a psychiatric residential treatment facility near Columbia, and more than a year at Willowglen Academy, a similar facility in Kingstree. Rice believes he was abused at both homes.
At Three Rivers, Brendin's arms and chest were bruised, he told her, by a nurse who hit children with an open hand.
At Willowglen Academy, Brendin said a staff member broke his arm.
The Department of Social Services investigated Brendin's allegations at Willowglen Academy but determined his claims were not credible, Rice said. The group home told Rice that he fell out of a window and that children with behavioral issues or special needs like Brendin tend to embellish the truth.
“I said, 'What about these other kids that can't defend themselves, who are not verbally expressive like my son?'” Rice said.
She couldn't even get a copy of the official 11-page state investigation into Brendin's injury, she said. A Department of Social Services supervisor in Williamsburg County told her the document was protected by state law because the case was determined “unfounded.”
Three Rivers Behavioral Health and Willowglen Academy, both owned by out-of-state, for-profit corporations, did not respond to questions about Brendin.
The Department of Social Services opened 100 investigations into alleged abuse and neglect at multiple Willowglen Academy facilities and 97 investigations at Three Rivers since 2000, but the agency would not tell The Post and Courier how many of these allegations it could prove.
Brendin left Willowglen Academy late last year to live with his grandparents in Simpsonville. Rice, who was recently diagnosed with cancer, didn't feel safe choosing another group home. She's still trying to figure out what really happened last fall.
“I spoke to the SLED (State Law Enforcement Division) department. I spoke to Nikki Haley's office, who bounced me to Lindsey Graham's office,” she said. “Both offices told me they are not able to handle cases like this.”
'Looking for loopholes'
The South Carolina Department of Social Services receives hundreds of reports alleging abuse and neglect in foster homes, institutions, group homes and day care centers every year. But 10 years of DSS data shows the department rarely finds sufficient evidence to prove that a child has been abused in one of these “out-of-home” settings.
In 2010, for example, the department investigated 132 reports of abuse in group homes and institutions, but found enough evidence to prove only six cases. In theory, some cases were handed to local law enforcement agencies for investigation. But the Department of Social Services would not tell The Post and Courier how many abuse reports were handled by police or which agencies were involved.
Four years ago, this prompted some child advocates in South Carolina to question if these reports were always properly investigated. They wanted to know why the number of “founded” cases was so low.
The South Carolina Citizen Review Panels, three independent groups set up to evaluate child protective services, were particularly worried by a report that boys in a group home were sexually abusing each other as an initiation ritual.
At the time, Social Services explained that the incident was not “indicated,” or proven, by its Out-of-Home Abuse and Neglect division because child-on-child abuse is not specifically addressed in state law.
“They were looking for loopholes so they don't have responsibility. That's just crazy,” said Donna Xenakis, a former chairwoman of the Lowcountry Citizen Review Panel.
Only 13 reports of abuse in group homes and institutions were determined “indicated” or “founded” last year.
A team of 10 investigators at the Department of Social Services examined fewer than half of all reports filed in the 2014 fiscal year for out-of-home abuse and neglect. Some of the reports were “screened out,” the agency explained, because they did not meet the “statutory criteria” to warrant an investigation.
'Never going to change'
Jessica Freeman's adopted daughters Jaylin and Olivia were discovered bound together with a bungee-cord in their Tennessee home before they were taken into state custody more than 10 years ago.
“Jaylin came to me at 5 years old. She weighed 22 pounds and had STDs,” Freeman said.
Olivia, 4 years old at the time, weighed 23 pounds and also was sexually abused.
“They didn't talk,” she said. “They weren't potty-trained.”
The girls, now teenagers, require out-of-home treatment in group facilities in North Carolina.
“Both of my girls are going to need care like this for the rest of their life,” Freeman said. “It's overwhelming, as a mom, because you want to protect them and you want to keep them safe and you reach a point when you can't do that anymore.”
Last year, Jaylin lived at Springbrook Behavioral Health in Upstate South Carolina until her therapist told Freeman that staff members beat an autistic child in front of other children in the gymnasium.
“The reason why this stuff continues is because the children don't have a voice to speak up,” Freeman said. “I think as long as people are quiet it's not going to get any better.”
Mike Rowley, the administrator for Springbrook, said the facility takes every allegation seriously and self-reports any suspected child abuse case to the South Carolina Department of Social Services.
“I don't think there's anything we do that should be secretive,” Rowley said. “It's a great place for kids.”
The Department of Social Services denied an open records request filed by The Post and Courier to review any “Out-of-Home” abuse reports, even reports that determined abuse allegations in the group homes were valid. State law exempts these documents from disclosure, the agency's lawyer said.
“Confidentiality is such a big thing in child welfare,” Alford said. “By statute, a lot of what we do is not considered to be public knowledge. That's one barrier. I think the department is trying to be a lot more transparent.”
Alford acknowledged that potential child abuse in these facilities keeps her up at night.
“We have to be concerned with their safety all the time,” Alford said. “We're legally responsible for that by statute. We're morally responsible for it. Of course it concerns me.”
Berkowitz, the Appleseed Legal Justice Center director, said the Department of Social Services needs to admit its problems before the agency can solve them. She doesn't trust the department's own data.
“These are our poorest kids, our most vulnerable kids,” Berkowitz said. “I have heard so many people over the years and seen so many reports. 'We're going to fix this. We're going to fix that.' And I just think unless there is some structure that will require this to happen it's never going to change.”
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