May 21, 2016

In Texas’ Troubled Foster Care System, Treatment Centers Are a Bright Spot

Reporting Texas

The quaint white cottage in North Austin doesn’t look like one of the most restrictive possible settings for children in the embattled Texas foster care system.

The house is run by the Settlement Home, a 100-year-old foster care provider. Inside, the living room and bedroom walls are all painted in different pastels, and the rooms are spacious and clean. Only the locks on the cabinets and the cameras tucked in the corners of the ceilings suggest this is part of a residential treatment center, one of three such cottages on the Settlement Home campus.

Treatment centers such as the one at the Settlement Home are meant to be a last resort for foster children, reserved for those with histories of severe trauma caused by neglect or abuse. Most often, residents land there after being shuffled through home after home until they need a higher level of care. The centers also are a rare example of effective treatment in the foster system, according to experts.

In December, U.S. District Judge Janis Jack of Corpus Christi ruled that the entire Texas foster care system was inadequate in caring for its children. Her ruling listed problem after problem, criticizing the system for improperly training foster parents, overwhelming caseworkers with large workloads and inappropriately handling reports of abuse and rape. Jack ordered the state to make changes and appointed a special master to oversee them.

“Texas’s foster care system is broken, and it has been that way for decades,” the opinion reads. “It is broken for all stakeholders, including DFPS employees who are tasked with impossible workloads,” it said, referring to the state Department of Family and Protective Services. “Most importantly, though, it is broken for Texas’s PMC children, who almost uniformly leave state custody more damaged than when they entered.” PMC refers to children in permanent management conservatorship, or foster care.

The state had temporary custody of more than 31,000 children in 2014, according to the  Family and Protective Services. Judges order them into the system after finding they cannot live safely at home, and the goal is to serve as a temporary stop while the state finds children permanent, safe living situations. The state spent $366 million on children in residential care in 2014, $75 million of that on residential treatment centers, according to the department. Depending on the children’s needs, the centers receive between $45 and $260 per day for each child.

“Some children do require for their own well-being a more restrictive non-family-like environment for a time,” said Sara Bartosz, a lawyer at Children’s Rights, a legal defense group for foster children that filed the lawsuit which resulted in Jack’s order. “These are children whose traumas have affected them in a way that’s difficult for them to recover. These congregate facilities can be good for those children.”

About 1,600 children live in residential treatment centers at any given time, according to DPFS. The centers all operate similarly, meeting licensing procedures of the state.

Like all residential treatment centers in Texas’ foster care system, the Settlement Home’s center has full-time house moms who provide 24-hour care as well as therapists who assess the children’s progress and well-being. The center houses up to 27 girls at a time in three cottages with nine beds each, said Darcie DeShazo, executive director of the home. The residents stay between six and eight months, according to Settlement Home spokeswoman Danielle Quist, and state payments make up about 66 percent of the center’s operating budget. The remainder comes from fundraising and grants.

The Settlement Home campus includes three other cottages that are group foster homes, weith less restrictive settings.  DeShazo said some girls in the residential treatment center may over time transition to the group homes.

It’s the dedication of the house parents and therapists that make residential treatment centers effective for children, said Daren Jones, training specialist at the Texas Christian University Institute of Child Development.

“The individuals that would apply to work in such intense settings … they really have a heart for these kids,” Jones said. “In my experience, it’s actually been helpful to have, what I would say, an extended family to nurture and care for these kids.”

DeShazo said the Settlement Home works to make the living spaces comfortable for their residents, despite state licensing restrictions, which include requiring the centers to monitor the children and lock up sharp objects.

“That’s one of the evils of residential treatment – we have to do that,” DeShazo said. “But we try to make up for that by having everything else feel really comfortable.”

Part of that, DeShazo said, is providing a community environment where kids feel they have a home that they can make their own. On one side of a  shared bedroom in the center, for example, boasts a neatly made bed that won the “Cleanest Bedroom” award that month. The other side of the room is a little more decorated, with a loose canopy hanging from the ceiling and a collage of more than 100 zombie pictures screaming out of the wall.

Although the treatment centers are a last resort, no child is meant to stay there for good. When therapists and case workers determine the children are ready, they typically are moved to a less restrictive environment. Dimple Patel, policy analyst at TexProtects, a child abuse prevention advocacy group, said children often regress in behavior with fewer restrictions, meaning they need to return to a residential treatment center. The state says it does not keep statistics on how often that happens.

“Routine is so important to these kids,” Patel said. “…When they go to a place where there is less structure, that’s where we have kids relapse.”

Helping Hand Home, an Austin foster care provider founded in 1893, also operates a residential treatment center, which houses up to 41 children up to age 7 at any time, according to Micki Marquardt, director of clinical services. Most children stay at the Helping Hand for 12 to 18 months, Marquardt said.

“They may make gains in a real therapeutic and structured environment, but it’s not as if we put a cast on a broken arm and it healed and is ready to go,” she said. “We have to work really hard at discharge.”

DeShazo said at the Settlement Home, the house parents and therapists emphasize helping residents internalize what they’ve learned from their time in a treatment center, providing  one-on-one attention and helping them transition to their next setting.

“We have always operated from a place of focusing on the importance of relationship, building self-esteem, teaching skills and helping kids move on,” DeShazo said. “We don’t want kids to stay one day longer in a residential treatment center than they need to.”

While treatment centers might have fared better in the judge’s withering ruling than the foster system as a whole, advocates for foster children remain wary of them.

Bartosz said regardless of their effectiveness, children should never find themselves in need of a treatment center.

“A lot of the times kids go into RTC … because the system has added trauma on top of trauma ,” she said. “The system that gets them up there is a broken system. That same broken system can’t be expected to do a quality job.”

Madeline McClure, director and founder of TexProtects, the advocacy group based in Dallas, said the centers are never in a child’s best interest.

“Residential treatment centers are not homes for children; they are institutions,” McClure said. “Really, they are a new label for what are orphanages in a way.”

While Bartosz believes residential treatment centers have a role to play in the foster system, she concedes that many centers around the state do not provide adequate care, mostly because they lack money and resources.

DeShazo said 34 percent of the money the Settlement Home spends on children comes from funds beyond what the state provides, meaning fundraisers and grants from the community. Its biggest fundraiser is a huge garage sale it organizes each fall.

Helping Hand Home receives about $160 from the state for each child but spends about $260 a day, according to Marquardt. Community support makes up the difference, she said.

Barsotz said the state is failing to put enough money into its foster care system, making it difficult for the residential treatment centers to reach their full potential.

“These RTCs operate in a bigger world,” Barsotz said. “When that bigger world of the child welfare system is out of whack, it makes it harder for these RTCs to operate consistently well.”

Editor’s Note: The name of the advocacy group TexProtects, incorrectly represented in an earlier version of this story, has been corrected.