WASHINGTON – In the wake of disturbing reports of the neglect of nursing home residents in the wake of Hurricanes Harvey and Irma, 46 members of Congress called on Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to maintain current protections for elder Americans against abuse in nursing homes.
In Florida, 12 residents died and more than 100 were hospitalized after a long-term care facility failed to evacuate residents after losing air conditioning in the aftermath of Hurricane Irma. In Texas, similar abuse occurred at a facility that refused to evacuate despite severe flooding. The letter is led by Representatives David N. Cicilline (RI-01), John Conyers, Jr. (MI-13), Henry C. “Hank” Johnson, Jr. (GA-04), Jerrold Nadler (NY-10), Linda Sánchez (CA-38), and Suzanne Bonamici (OR-01).
They wrote: “The horrific reports of abuse at facilities in Florida and Texas in the wake of Hurricanes Irma and Harvey underscore the need for your agency to reconsider upending the legal protections of those who have worked and saved for their entire lives to retire with dignity. This is a time when we should be protecting our nation’s seniors, not rolling back their fundamental right to hold wrongdoers accountable for neglect and abuse.”
Last year under the Obama Administration, CMS finalized a strong rule that prohibited the use of pre-dispute, mandatory (“forced”) arbitration clauses in nursing home admission agreements.
Nursing-home residents stand to lose virtually every cause of action against unscrupulous caregivers unless these current protections against forced arbitration in nursing-home admission contracts are preserved.
As the letter notes, following an extensive notice-and-comment rulemaking process, CMS determined that forced arbitration undermines the ability of health investigators to prevent and remedy abuse in nursing homes.
But under the Trump Administration, CMS has already begun the process to end this protection.
The letter follows a letter from House Democrats—including Representatives Johnson, Cicilline, Conyers, Nadler, and Sanchez—in 2015 that called on CMS to adopt these protections.
The group of House Democrats denounced plans by CMS Administrator Verma to roll back existing protections, writing “Americans in nursing homes deserve better. It is vital that residents and their families are able to enforce their rights and hold nursing home operators accountable for dangerous facility conditions and the inhumane treatment of residents. We strongly urge CMS to protect the health and safety of nursing home residents, particularly in light of recent events, by maintaining the current prohibition of forced arbitration clauses in nursing home admission contracts.”
The reauthorization for the Children's Health Insurance Program (CHIP) was not reauthorized.
What does that mean?
#MedicareForAll
Either that or poor kids are going to have to rely upon foster care to access health care services, which will cost a whole bunch more due to the inherent fraudulent billing of Medicaid.
Besides, failure to provide for the necessary needs of the child is considered abuse and neglect.
Over the weekend, Congress allowed funding for the Children’s Health Insurance Program (CHIP), which covers nearly 9 million children in low-income families, to lapse—failing to pass a reauthorization by Saturday’s deadline after spending most of the year attempting to repeal the Affordable Care Act.
The expiration of the program will not affect all states equally. Some are already scrambling to move money around to make sure no child sees their coverage lapse while others have a healthy amount in reserves that will last them well into next year if Congress does not act.
Though the Senate will hold a markup on the reauthorization on Wednesday, its passage remains uncertain. The House has not yet unveiled its version of the bill, and a House Democratic aide told TPM that while negotiations are ongoing, the parties are still fighting over whether to maintain the same level of the federal funding match for CHIP and whether to require cuts to other parts of the federal budget to offset CHIP’s cost.
“We have yet to reach an agreement,” the aide said. “It’s pretty upsetting that the time tradeoff has been an effort to repeal the Affordable Care Act.”
According to an analysis by the Kaiser Family Foundation, 48 of 50 states, including DC, assumed Congress would reauthorize CHIP when they wrote their 2018 state budgets. That mistaken trust in Congress is already having major consequences.
At least 10 states are on track to run out of money by the end of 2017, and even those that can hold out into 2018 will pay a price.
Joan Alker, the executive director of the Georgetown University Center for Children and Families and an expert on CHIP, told TPM that the severity depends on how long lawmakers drag their feet.
“If Congress can get it done in the next couple weeks, we could avoid some of the worst consequences,” she said. “It’s hard to disentangle what the consequences will be, but we will certainly start seeing them in November.”
Some states have laws on the books that would force them cap enrollment or end health coverage for the CHIP population altogether if federal funding lapses. Others are anticipating cuts to other CHIP-funded programs, including coverage for low-income pregnant women and children.
Without knowing when Congress will act, Alker says several states are torn about whether to send out notices to families warning that coverage could be cut off or enrollment frozen.
“States only have bad choices here. They don’t want to alarm families but at some point they have to act,” she explained. “Congress has been talking all year about taking away health coverage from families, so if a family gets a notice that says, ‘Your coverage maybe taken away,’ there are many reasons for them to think it’s a strong possibility. It is all very bad news.”
Here are the states that may be hit the hardest:
Utah
Utah’s senior Republican senator Orrin Hatch (pictured above whispering with Senate Majority Leader Mitch McConnell) chairs the committee in charge of funding CHIP. He told reporters last week that the program will be reauthorized “shortly,” but that will not be soon enough for his struggling state. Utah officials have said that they will run out of funding by the end of the year and are making plans to close the program, impacting upwards of 20,000 children.
Minnesota
The commissioner of Minnesota’s Department of Human Services, Emily Piper, told her congressional delegation in September that without renewed federal funding, she will have to take “extraordinary measures” to prevent people from being kicked off of CHIP.
“The pregnant women covered by CHIP would be at risk of losing coverage altogether,” she wrote. “However, we are exploring ways to continue coverage temporarily by carrying over FY 2017 CHIP funds so that their prenatal and postpartum care continues uninterrupted. This action, however, comes with a significant financial penalty.”
That penalty, she estimates, will be a $10 million hit to the state’s general fund.
Arizona
Arizona’s CHIP funding, which provides coverage for more than 22,000 children, will run out by the end of the year if Congress does not pass a bill. Because the state passed a bill in 2016 that would force its CHIP program to halt new enrollment if the federal government eliminates funding, the state is already warning health insurers and families that they may implement an enrollment freeze.
The last time this happened, during the Great Recession in 2009, the rate of uninsured children in Arizona climbed sharply.
Texas
Texas, which temporarily waived the fees families have to pay for CHIP in the wake of Hurricane Harvey, could burn through its budget sooner than projected, threatening health insurance for 390,000 children.
West Virginia
State law requires West Virginia to shut down its CHIP program if federal funding levels drop by a certain amount. They are currently scrambling to get a legal interpretation of whether that means this week or when the state exhausts its reserve funding in early 2018.
The state expects that about one-third of children enrolled in CHIP would become uninsured with closure of the program, unable to enroll either in a parent’s employee insurance plan or on the individual market.
Nevada
Should Congress’ inaction continue, Nevada is preparing to freeze enrollment on Nov. 1 and end coverage altogether on Nov. 30 for about 27,000 children.
“We’d have to look at our options for limiting the services that are available,” Nevada’s deputy administrator for Medicaid Cody Phinney told the Las Vegas Review-Journal.
“If Congress does not quickly reauthorize CHIP, states like Nevada will need to either send notices of termination to program beneficiaries or develop alternative funding,” Gov. Brian Sandoval (R) warned in a statement.
The state legislature has not yet called a special session to plan for the potential shortfall.
For those who are just now popping in, we have a routine when it comes to children being legally kidnapped by Child Protective Services, so let's begin with the basics.
Repeat after me....
"You cannot audit God".
This statement is to mean that any 501c3, tax exempt, privatized, not-for-profit organization, which includes religious or anything dealing with children, are excluded and exempted from any form of external scrutiny, through self-reporting, for the purposes of maximizing revenue.
TRANSLATION: Child welfare is the extremely profitable industry of human trafficking.
The following video is from 2013, but I post it for the purposes of demonstrating that the State of California, the rest of the nation, refuses to address what "lying" in a child welfare proceeding means.
It means fraudulent billing through the filing of false claims.
Deputy Ben Fields has damaged property of the state of South Carolina in the form of child abuse in the second degree.
The Sheriff Department claims the student needs to apologize and blame the parents and her community.
The girl is an orphan who has been placed as a ward of the state in foster care; therefore, the Sheriff was correct. The state needs to be blamed with the way they have been raising its children.
Foster children, no matter what state, quickly learn how to defend themselves from people like Ben Fields everyday and if the public does not believe in the horrors of child welfare, then you need to ask yourself why I have been proselytizing for the promulgation on the way society views children.
My questions now arise to be presented as to why there was no IEP on record for the child being in foster care or for emotional issues on file with this so-called school officer.
When a child is at school and/or foster care, the responsibility to protect and serve falls upon the state as de facto parents.
South Carolina failed to protect the student.
What the nation has witnessed is an everyday occurrence of the trauma of what goes on in child welfare which includes schools and foster care,.
If it was not for the videos of the other students, this would never have made national media, the Deputy would still have his job and I would not possess the vision for the change in how we treat our most precious treasures, children.
Niya Kenny stood up for the victim and was then put in handcuffs. Because she is 18 years old she was sent to Alvin S. Glen Detention Center. She says she was crying her eyes out and said she had to stand up for the victim. She also says the victim had a gash on her forehead. Niya was charged with disturbing school. SHARE. We will have more tonight at 6 & 11pm. Spring Valley High School (South Carolina) Richland County Sheriff's Department Check out video from Tony Robinson below....he is the student who recorded the video that went viral. He tells you the victim BEGGED for FORGIVENESS about her phone. See Below.
Posted by Alicia Barnes on Monday, October 26, 2015
I await charges from the State Attorney General if not the FBI.
Life for a 16-year-old black girl in the New South living in a foster home is no crystal stair.
In an interview with the Daily News, Todd Rutherford, the respected Columbia, S.C., attorney representing the assault victim of the recently terminated Deputy Ben Fields, revealed that his client, in addition to suffering injuries on her face, neck, and arm, is a recent orphan living in foster care.
Deputy Ben Fields was fired after video surfaced showing him flipping a South Carolina high school student backward in her desk and tossing her across the floor.
While her identity, no doubt, will eventually be leaked to the media, it's the goal of her foster mother to protect and care for her as well as she can considering the circumstances. She communicated to us that the young victim is devastated and emotionally traumatized by all that has happened to her.
School, as you can imagine, could be particularly tough for a young girl who has experienced so much pain and loss in her young life. To think that she has now suffered police brutality and is facing trumped up criminal charges for age-appropriate classroom behavior is just despicable.
South Carolina sheriff’s deputy Ben Fields has been fired
NY Daily News
Some trauma cannot be undone. The experience of police brutality is an example of such trauma.
Our kids, who already face enormous pressure in life, should never be subjected to state-sponsored violence while in school. For this young girl, Spring Valley High School should've been a refuge.
If you rarely, even take the time to read what I present, I strongly encourage everyone to read, share, then open discussions because there is so much more to the cost of children than could ever be imagined.
Washington State has such a high payout of child welfare lawsuits strictly because there are bold attorneys who are not afraid to brandish the facts, in a court of law, of what happens to a child in foster care.
In most states, particularly Michigan, the legal profession has an unspoken code of being "blacklisted" if an attorney goes up against the state in a matter of child welfare. Then there is that pesky matter of one being able to afford an attorney to represent their child, or even themselves as the parent.
The stigma of being involved with Child Protective Services is so deeply embedded in social culture that it makes sense for everyone to remain silent, even the children who are, for whatever reason (i.e. unnecessarily, involuntarily, poverty) so that no political leader will directly touch this "tar baby" a ten-foot pole.
I must give credit to to Congresswoman Karen Bass and her founding of the Congressional Caucus on Foster Youth but it is a dearth, if any, activity in addressing the structural issues of the entire foster care system, mainly the billing and civil rights.
Political candidates of both sides of the aisle only have joined the aforementioned congressional caucus for D.C. political posturing, and not even for their constituents. I can attest, personally, first hand knowledge, that Congressional Chiefs of Staff will ignore and omit anything dealing with the child welfare system from the Offices.
(I would name names, but I believe it will be much more enjoyable to sit back and watch certain Chiefs of Staff to be escorted off the Hill.)
Why? Because they consider this to be a state issue and have never taken the time to even investigate as child welfare is a closed, secretively administered system.
State political leaders will vehemently exclude anything about child welfare from their rhetoric as it comes across as defending bad parents and an hindrance in helping the "poor, abused kids".
Child welfare is the last frontier of civil rights. Stated in this article, reiterated by my previous scribings, children have no civil rights because they do not pay taxes and cannot vote.
Cheryl Schaefer, 28, and three siblings suffered years of abuse in a foster home under DSHS supervision in northeastern Washington. She was angered to learn from a reporter there was no apparent record of discipline for...
Over the past eight years, the state Department of Social and Health Services’ child-welfare division has been hit with scores of lawsuits, paying $141.4 million for failing to protect children under its care.
The state of Washington’s largest department is tasked with caring for the state’s most vulnerable residents — abused children, foster kids, mentally handicapped adults. But time and again, it has failed.
Over the past eight years, the Washington state Department of Social and Health Services (DSHS) has been hit with scores of lawsuits, ultimately paying $166.4 million for personal-injury claims. Many of the most severely injured were children who were tortured, starved or raped. Some died.
DSHS employees behind these failures rarely are punished, The Seattle Times has found.
From those scores of lawsuits, the newspaper selected one dozen of the high-cost, child-welfare cases for which records were readily accessible. Many of these cases made headlines and resulted in verdicts or settlements ranging from $750,000 to $11 million, some $75 million in all.
Using court records, public records and interviews, the newspaper identified 48 DSHS staffers involved in the failures in these 12 cases.
None of the 48 was fired or suspended. None was demoted or lost pay.
That is according to DSHS, which ran the 48 names through its human-resources databases at the newspaper’s request. (The database only shows records that affect compensation.)
Whether any of the 48 staffers were given lesser forms of discipline, such as reprimand letters, is unclear. DSHS in May said it would takes several months to provide answers. (Recently, the agency said one staffer had been given a letter of reprimand. It hasn’t completed its research.)
Slightly less than half the 48 still work for DSHS; some have retired.
The review of the 12 cases — as well as several dozen interviews with present and former DSHS employees, state employee-union officials, personal-injury lawyers, children’s advocates and others — turned up some common failings: overlooked complaints of abuse; delayed or inept investigations; placement of children in unsafe homes.
DSHS’ lack of focus on personal accountability is a significant problem, said Tim Tesh, a personal-injury lawyer who has sued DSHS many times. Policymakers can suggest reforms, he said, but “often, it’s that the worker didn’t follow procedures that are already in place. What good does reform do you when the worker just doesn’t follow them?”
DSHS said paying a victim does not mean an employee made a mistake.
“I don’t think anyone in the field can credibly deny that there’s a scary connection between overburdened workers and risk of harm to kids.” - Ira Lustbader, litigation director of Children’s Rights"
Jennifer Strus since 2013 has been head of the Children’s Administration, the division responsible for payouts of $141.4 million. She would not comment on how her predecessors handled employees who may have made mistakes years earlier.
Any failures must be well-documented before the agency can take action, she noted. DSHS in recent years has improved training and how it tracks complaints of abuse and also reviews the performance of employees implicated in claims against the agency.
Being a social worker is the “toughest job in state government,” Strus said. A combination of large caseloads, employee turnover and budget cuts makes it “pretty hard to do great work,” she said.
Cheryl Schaefer, 28, isn’t comforted by these words. She and three siblings suffered years of abuse in a foster home under DSHS supervision in northeastern Washington. Up until 2001, court records show, they were beaten, forced to overeat, throw up and eat their own vomit, and suffered sexual abuse.
According to court records, Schaefer and her siblings said the caseworker repeatedly ignored their cries for help.
A 2012 lawsuit, filed by Tesh against DSHS, was settled for $5.3 million. To Schaefer, money does not equal justice.
Paying for mistakes
DSHS paid out $166.4 million over eight years for injury claims. The largest cases involved the Children’s Administration, its child-welfare division.
Sources: Washington Department of Social and Health Services; Washington Department of Enterprise Services(Reporting by Will Drabold / The Seattle Times; Graphic by Mark Nowlin / The Seattle Times)
have tagged the agency for years. In 1998, lawyers for 13 foster kids filed a class-action lawsuit against the state, saying foster children were being harmed across the board by inadequate care. The state Supreme Court, in the landmark 2003 Braam decision (named after one of the plaintiffs), upheld a lower court and put Washington’s child-welfare system under judicial oversight.
The Braam case led to several improvements, including sharply cutting back on children bouncing from one foster home to another. The court oversight continues, in part because a key court-ordered mandate remains unfulfilled: foster-child caseloads of 18 or fewer for 90 percent of social workers.
Besides the court, state lawmakers recently required DSHS to be more accountable for mistakes.
DSHS was required to do automatic reviews of botched child-welfare cases only when someone died in state care, a “fatality review.”
As of July 24, under “Aiden’s Law,” DSHS must review worker actions if a child experiences a “near fatality” within one year of a previous incident of abuse.
State Sen. Steve O’Ban, R-University Place, who sponsored the legislation, called it an improvement. That lawmakers had to force DSHS to review such cases “speaks volumes,” he said.
Most of the multimillion-dollar settlements come from the DSHS Children’s Administration division. There more than 1,800 social workers oversee nearly 10,000 children in foster care and last year looked into 90,000 reports of child neglect or abuse. Turnover is high — about one in six staffers leaves each year. Starting pay can be as low as $32,688.
Joyce Murphy, a social worker in Vancouver who’s worked for a decade at the agency, said she has failed to see children once a month, as required by DSHS policy. She blames it on her caseload, which she says over the past four years has averaged about 25 children — well above the national standard of 15 and the DSHS average of 19.
"When we are some 30 percent above a reasonable caseload, that can be like sending the Seahawks to play the Super Bowl with two-thirds of a team, then firing them when they lose.” - Kevin Quigley, DSHS Secretary"
“I can’t do my job,” she said. She worries each night that one of her clients will die on her watch.
No one died in the case of two young Snohomish County boys, ages three and six, who were being starved and beat by their father and his girlfriend in 2006, but it does illuminate the tragic results when workers utterly fail to do their jobs. The case is one of many that reveals the personal consequences for such failures can be slight.
Between May and July 2006, a neighbor filed four complaints with DSHS, saying two young boys were being starved and beaten by their parents. She would later say that no one at DSHS ever followed up with her, court records show.
The father, Danny Abegg, and his girlfriend, Marilea Mitchell, kept a padlock on the refrigerator and withheld food to punish the boys. A social worker, Aubrey Kilgore, in one visit reported that the house “had plenty of food in it.”
He went back a second time after a sheriff’s deputy, shopping at Wal-Mart, saw bruises on the face of the 3-year-old, and alerted DSHS. This time, Kilgore required the parents to see a family therapist, documents show.
The child-welfare case was transferred that fall to another social worker, Deanna Neff. Among her failures, she gave Abegg eight-days notice she would be visiting the home, giving him time to hide evidence of abuse. Nor did she speak to the more severely abused younger brother, Shayne, records show.
A few months later, Ada Sharp, who had no experience or training investigating child abuse, was given the case, court records show. Other warning signs surfaced, records show, but Cherokee Screechowl, the area supervisor, ended the investigation in February 2007.
A month later, someone alerted authorities that a little boy was being “starved.” Paramedics rushed Shayne, now 4, to the hospital where he was found in urine-soaked clothes, emaciated, with a body temperature of 87 degrees. After being given food at the hospital, the boy told doctors not to let his parents know that he had eaten. A veteran paramedic later said he had not seen “a worse case of neglect or malnourishment.”
After Abegg and Mitchell were charged with first-degree criminal mistreatment, the case, with its sickening details and claims of DSHS failures, exploded in the news. Gov. Chris Gregoire asked for a special review, and DSHS said its employees failed to protect the two boys.
At the time, a DSHS spokesman said two employees linked to the case had resigned. DSHS recently said one of the four did receive a letter of reprimand.
Kilgore and Sharp still work at DSHS. Neff resigned from the agency. Screechowl resigned in 2007, came back in 2011 and then re-retired.
Screechowl could not be located; the other did not return calls for comment.
Shayne Abegg received $5 million from the state in 2009 after a judge compared him to a concentration-camp survivor. His older brother received $2.85 million two years later.
Danny Abegg sits after being arrested for criminal mistreatment of son Shayne, 4, who weighed 22 pounds. Shayne got $5 million from the state after judge compared him to a concentration-camp survivor. (Snohomish County Sheriff’s Office)
“It is a war zone”
If the high-profile Snohomish stavation case didn't result in someone being punished, what sort of case would?
“This story has been going on for 30 years,” said Dennis Braddock, DSHS secretary from 2000 to 2005. He oncedescribed DSHS’ culture as “bunkerlike” and said he tried to hold staffers to account but faced an uphill battle.
“Republicans don’t like administration,” he recently said. “Democrats all side with the union. So management gets the short end of the stick in [employee] disputes.”
It’s a proven formula: To effectively serve children and families, social workers need a reasonable number of cases to manage, a finding backed by decades of state and national studies.
Currently, the average caseload for child-protective-services (CPS) workers — Children’s Administration employees who investigate reports of child neglect — is 16, well above the national standard of no more than 12. Also, it takes on average two years for a CPS investigator “to become proficient,” DSHS said.
Since 2008, the Children’s Administration has lost 300 employees. This year, for the first time since, the division received an additional $7.2 million for 43 employees and other resources, an attempt to lower caseloads and improve investigations.
Greg Devereux, executive director of the Washington Federation of State Employees, which represents unionized DSHS staff, describes social-worker caseloads, burnout and turnover in dire terms: “It is a war zone.”
Some former DSHS officials and child advocates point to his union when noting that individual discipline doesn’t always occur. DSHS is required to have substantial documentation to punish negligent employees, they assert, and the arbitration process can be time-consuming.
“That’s ridiculous,” Devereux said. The union makes sure DSHS “fairly holds people accountable.”
In the past eight years, the union went to arbitration on only two cases of Children’s Administration social workers who were terminated, he said. One firing was upheld; the other employee was reinstated.
“I don’t think anyone in the field can credibly deny that there’s a scary connection between overburdened workers and risk of harm to kids,” said Ira Lustbader, litigation director of Children’s Rights, a national organization that advocates and files lawsuits to bring accountability to child-welfare systems.
Lustbader’s organization has filed lawsuits in other states arguing high caseloads are a civil-rights violation for children because it puts them in harm’s way.
“They’re poor. They’re disproportionately of color. They’re not a legislative priority.”
“These kids don’t vote. They’re poor. They’re disproportionately of color. They’re not a legislative priority,” he said.
Not held accountable
Even so, heavy caseloads cannot always explain away mistakes or why they go unpunished. According to interviews with 10 plaintiff attorneys who have brought personal-injury cases against DSHS, none of them has heard of a social worker being disciplined for failing to protect someone.
David Moody is a Seattle lawyer who has brought lawsuits against DSHS that resulted in $86 million in verdicts or settlements since 2000. “There’s a constellation of warnings and a corresponding constellation of failures by DSHS to heed those warnings,” said Moody, lawyer for the Abegg children. “No one is held accountable.”
DSHS Secretary Kevin Quigley declined to be interviewed. In an email, he wrote that the agency has an improved performance-evaluation system and is more aggressive about dismissing subpar workers during their probation period.
“I understand the solution for some is to blame the caseworker every time a mistake is made but when we are some 30 percent above a reasonable caseload that can be like sending the Seahawks to play the Super Bowl with 2/3 of a team then firing them when they lose,” Quigley wrote.
Some officials note that the state does have another tool to hold DSHS accountable: The Office of Family and Children’s Ombuds. Director Patrick Dowd says the office plays a neutral role when it intervenes in cases in which DSHS failed to act or was unreasonable.
However, he said, his office’s “focus is on the actions of the agency and not the specific caseworker.”
State laws hiding child abuse in foster care are inclusive of all the States.
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.
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.”
Two Springbrook employees have been fired for child abuse or neglect in the last three years, he said.
Despite stories such as Freeman's, South Carolina continues to send its youngest foster children into group homes and institutions at a higher rate than any other state in the country, federal data shows. This trend persists even though a growing body of evidence points out that children should grow up with their own families or in foster homes.
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.
Johanna Martin-Carrington, director of the Jenkins Institute for Children, said the allegations aren't true. “Children make those claims,” she said. “But we know it didn't occur.”
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.”
Alford and Gov. Nikki Haley, both named defendants in the lawsuit, agreed to participate in early court mediation, public records show.
According to the South Carolina Department of Social Services, “group or congregate care is designed to meet the needs of children/youth who are unable to live at home or in a foster family and require temporary care in a group setting.”
Some of these facilities, often called “children's homes,” are vestiges of old orphanages and they provide a variety of different services.
For example, “Level 3” group homes offer behavioral health treatment for children, while “Level 1” group homes generally keep children without any mental health diagnoses.
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.
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.”
