High school science teacher Ty McVicker gives a student a high-five during class at Griffith Centers for Children on May 19, 2017 in Colorado Springs. Griffith Centers for Children teaches students who were truant or had behavior problems so bad that many were kicked out of public school.
Colorado once sent more foster children to austere and clinical residential centers than it did to the homes of relatives, institutionalizing more than 1,000 of the most challenging wards of the state each year.
That has shifted dramatically over the past decade, a transition so swift and stark that more than 20 residential treatment centers in Colorado have closed.
Calm, nurturing homes are better for kids, say child advocates and government officials. The downside, though, is that children with more acute needs — those who in the past would have gone to treatment centers with round-the-clock paid staff — now are going to foster parents and relatives who in some cases are overwhelmed.
And although nonprofits that once operated residential centers are embarking on new business models to bring therapy to kids in their homes, some worry the shift was too abrupt for community-based programs to keep up and say funding for the new programs is inadequate.
Colorado tallied 1,483 child welfare placements in residential treatment centers in 2003, a number that dropped to 526 by 2016, according to data gathered by the Colorado Association of Family and Children’s Agencies and presented to state lawmakers in March. At the same time, the number of placements with relatives, called “kinship” placements, rose from 1,308 to 2,401.
Colorado’s goal is to reduce its percentage of kids sent to “congregate care” — which includes residential centers and group homes — to less than 15 percent of the total 4,880 kids who spent time in out-of-home placements last year. That percentage has dropped from 24 percent in 2012 to 17.8 percent last year — specifically, from 1,109 kids to 870 — according to state Department of Human Services data.
“We know that congregate care is not where children need to grow up,” said Paige Rosemond, associate director of programs for the state Division of Child Welfare.
Residential treatment centers for children began their boom in the 1990s, after Colorado closed hundreds of psychiatric beds for children across the state. Children with severe mental illness who would have used those beds began filling up residential treatment centers, at high cost to state and county child welfare departments. Then the state changed its payment policy, forcing counties to foot a higher portion of the cost of residential care.
At the same time, research piled on, concluding that children were better off in family environments. Children placed in congregate care are almost three times as likely to have a mental disorder and six times more likely to have been removed from a home because of a “behavior problem,” according to a report from the U.S. Department of Health and Human Services.
Griffith Centers for Children is among the agencies that shut down residential treatment centers in recent years in Colorado. The nonprofit has closed 280 beds in Larkspur, Rifle and Grand Junction since 2010. Griffith now has just 37 beds in Colorado Springs.
Griffith instead has opened new programs to bring therapy to 1,500 families, including programs to help at-risk youths who have skipped enough school to trigger action by child protection caseworkers. Youths with the most severe problems still require residential care, but their stays are shorter than they once were.
A student reads during english class at Griffith Centers for Children, that teaches students who were truant or had behavior problems so bad that many were kicked out of public school, on May 19, 2017 in Colorado Springs. Because many of the students are wards of the state they could not be identified in the photos.
Marley Day, an eighth-grader who attended school only a handful of days in two years, is among the more than 500 kids who will spend time in Colorado residential treatment centers this year. His mother dropped him off about a month ago at Griffith’s residential center in Colorado Springs, where he has no choice but to wake up at 6:45 a.m., eat breakfast at 7:15 and get to an on-campus classroom by 7:45.
“He’s doing something now,” said Marley’s mother, Gigi, who once tried, unsuccessfully, to get him to school by dragging him by his sweatshirt hood.
Three years ago, most of the 40 students at Griffith’s school lived in the next-door residential treatment center. That number has dropped to half. And to help them return to public school sooner, Griffith in August started a program that assigns each student a long-term therapist to help with the transition.
Another agency that closed its residential center is Excelsior, which ran a “last resort” facility in Aurora for adolescent girls, a place for teens who typically had already been through numerous foster homes and had run away more than once. The 33-acre campus, with 250 girls in living quarters and an on-site school, closed in August.
Instead, Excelsior began offering in-home mental health therapy for youths and took on an early-childhood program that teaches struggling parents how to bond with their kids, from infants to 6-year-olds, before they are removed from their homes. The nonprofit receives state money to work with people who are court-ordered or required by child welfare departments to take parenting classes.
Excelsior’s staff has dropped to 60 from 150 a year ago, marking the hardest part of its transition from residential care to child abuse prevention, said Nicole Bennett, communications manager. The increase in community-based services, therapies and help that come straight into the home where a child is living, whether with their parents or a foster family, is especially helpful for kids who didn’t belong in residential care facilities, she said.
“Some, frankly, got worse, because they were surrounded by peers with bigger issues,” Bennett said. Other youths would improve at Excelsior, only to return home to the same situation and then regress, she said.
“In residential treatment, you get only glimpses of success,” she said. “These kids are very damaged, and it takes a long time for them to change. We are still here and we are doing great things. It’s just different now.”
Mount Saint Vincent, a home in Denver for children with severe behavioral issues who have often lived in several foster homes, began taking children from other states in 2015 to fill beds left vacant by Colorado’s policy shift. Despite adding kids from California, Wyoming and Idaho, the average number of kids living at Mount Saint Vincent on any given day has dropped from almost 30 in 2012 to 21 this year.
Mount Saint Vincent has taken on a foster care recruitment program, setting up information booths at churches, community events and large companies in the hopes of finding families willing to take kids who are ready to leave residential care. Mount Saint Vincent staff train and certify new foster parents, then collect an administrative fee from county human services departments, although the business model is not a moneymaker, said Kirk Ward, executive director of the northwest Denver home that was once an orphanage.
Ward agrees that kids who are ready are better off in homes than a treatment center. Instead of focusing on meeting a target number of kids in residential treatment, including the 15 percent set by the state or a goal of removing kids from residential treatment by the three-month mark, child welfare officials should decide what’s best for each child, he said. “The system is so overburdened and doesn’t have the resources it requires to take care of all these kids. Sometimes that gets lost,” he said.
Fewer residential treatment beds, combined with dwindling psychiatric beds in the state, move kids with more acute mental health needs further down the chain of care. “It just pushes it down all the way to foster parents,” Ward said.
In response, Colorado has developed “treatment foster care,” a level between a group home and a foster home. Treatment foster families receive extra training and are linked with a “wrap-around” team to help with counseling and other in-home therapies.
A “warm, soothing setting,” where a parent or foster parent can respond to behavior and there is less feedback from peers, helps kids learn to self-regulate their emotions, said Camille Harding, division director of community behavioral health at the state Department of Human Services. “Ideally, a kid might go into a treatment center for a short time but then go back into a lower level of care with lots of supports around them,” she said.
Math teacher Heilleen Klos radios for an a student to be escorted to the restroom at Griffith Centers for Children, that teaches students who were truant or had behavior problems, so bad that many were kicked out of public school, on May 19, 2017 in Colorado Springs. Because many of the students are wards of the state they could not be identified in the photos.
State reimbursement rates to the agencies providing community programs to at-risk youths are “critically low,” so low they are “jeopardizing the well-being of Colorado foster (youths),” said Skip Barber, former director of Denver Children’s Home and now head of the Colorado Association of Family and Children’s Services. Agencies that provide the programs are struggling to hire and retain staff at a time when they are helping children with more acute needs, he said.
Kids who don’t need a residential treatment center shouldn’t live in one, but at the same time, child protection officials shouldn’t send kids who aren’t ready to live in a family home to foster parents or relatives, Barber said. The system “burns out” foster families.
“We put kids in their home and there is no way they can manage them,” he said. “The trick is getting right service at the right time for the right kid. That’s where we are still struggling.”