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Communication could help federally funded residential facilities avoid abuse

by Joe Gamm | February 28, 2022 at 4:00 a.m.

In 2021, after hearing about years of abuse and neglect of children at the hands of religious-based child residential home administrators, Missouri took steps to gain some oversight over the facilities.

The Legislature passed and Gov. Mike Parson signed into law House Bill 557, which Rep. Rudy Veit, R- Jefferson City sponsored. The law requires license-exempt homes to have minimal reporting requirements to help ensure the safety and well- being of children housed there. The Child Residential Home Notification Act requires homes to conduct background checks of all employees and volunteers at the homes.

Up until its passage, victims of abuse at the homes said the state had failed them.

Last week, the U.S. Government Accounting Office (GAO), which works for Congress, released a report on claims that states failed to oversee federally funded child welfare facilities within their borders.

While not equivalent to the faith-based facilities, the reports of abuse are very similar to those that surrounded them.

The GAO came to a simple conclusion -- U.S. Health and Human Services should facilitate better communication between states concerning promising practices for preventing and addressing maltreatment in residential facilities for youth.

Acknowledging federal facilities are far different than faith-based facilities, Veit said last week that states have an obligation -- if they have organizations that operate facilities in multiple states -- to notify the other states about potential abuses.

The GAO looked into concerns about maltreatment in facilities after receiving numerous media reports.

It interviewed officials overseeing and monitoring residential facilities funded through Medicaid (or the Individuals with Disabilities Act) in Arkansas, California, Massachusetts and the District of Columbia.

The report acknowledged little public information about incidents of maltreatment is available.

"Several state agencies -- including those responsible for child welfare, facility licensing and education -- work with federally funded residential facilities for youth to help prevent and address incidents of maltreatment," according to the GAO report. "Maltreatment could include either abuse or neglect, and could result in injuries or even death. State agencies try to prevent the maltreatment of youth by requiring background screenings of facility staff, training staff and increasing inter-agency coordination, among other things. When maltreatment occurs, states may respond in various ways, such as prohibiting a facility from taking in new residents or revoking its license."

A challenge, according to the report, is that it is difficult at times to identify what constitutes maltreatment, causing facilities to oftentimes over- or under-report them.

That complicates states' data-collection efforts, the report stated.

Some states have taken steps to make it easier for residential facility staff to determine what types of incidents they should report, such as providing technical assistance on legal reporting requirements.

Other steps that might be helpful, stakeholders suggested, would include improving investigator training, improving oversight and increasing provider accountability.

DHHS officials emphasized to the GAO that states are primarily responsible for oversight of residential facilities and their efforts to prevent maltreatment. However, they can provide guidance and technical assistance.

Unfortunately, the GAO report said, officials in the four studied states said they had little contact with federal officials -- including the DHHS Administration for Children and Families, which is responsible for administering federal programs that provide for the safety of children.

"By facilitating information-sharing among states about promising data-collection practices, training, oversight and strategies or holding facilities accountable through stronger enforcement mechanisms," the report says, "DHHS could help states prevent and minimize further trauma for youth in these facilities and potentially save lives."

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