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on placing Children in out-of-state facilities

These news stories report the harm done to children and families when child welfare agencies and managed care organizations routinely place children in out-of-state facilities. As Louisiana learned from the Gary W. case filed in 1974, placing children far from home, out of sight, and out of mind, allows bad things to happen to them – often repeatedly – due to lack of monitoring. A summary of Gary W. Is available on the Civil Rights Litigation Clearinghouse.

There are rare occasions when the specific treatment a child requires is only available in another state. In those unique situations, out of state placement may be appropriate, but the routine, systematic out-of-state placements are always dangerous and disrespectful of the child and family.

Out of state placements become routine when states without sufficient resources for children fail to prioritize the well-being of children, and seek to resolve the resource shortage in utilitarian ways. States that do not to create the services children require, look for easy outs when the needs of children exceed available resources and services.

As you read these articles you see that when horrible events happen, states which have sent children out-of-state for fiscal reasons (such as refusing to invest in services for children) are forced by public outrage or moral pressure to bring their children home. Some like Louisiana cease the practice due to Federal oversight, but later forget the reason out-of-state placements were bad for children, and then reintroduce the practice when dollars can be saved. (Louisiana’s Medicaid managed care system restarted the practice when it was determined that use of out-of-state facilities were good for MCO profits).

1. Far from home, far from safe, a San Francisco Chronicle Special Report, tells of thousands of California children sent to out of state facilities, all of which “violated the state’s licensing standards”. The article is a collaboration between The San Francisco Chronicle and The Imprint, an independent, nonprofit publication dedicated to covering child welfare, juvenile justice, mental health and educational issues faced by vulnerable youth.

2. Thousands of Foster Children Were Sent Out of State to Mental Health Facilities Where Some Faced Abuse and Neglect, is a collaborative investigation by ProPublica Illinois and the Chicago Tribune, which reports on the thousands of children in foster care sent from state to state to mental health institutions.

3. More mental health resources coming to Colorado youth after dozens of kids have to go out of state for help, describes steps that Colorado, where children’s mental health is in a state of emergency, is implementing in an effort to prevent children from being placed out of state.

Generally, children are sent out of state for one of three reasons.

First, children should be sent out of state only when their special needs cannot be met in their home state. (But this is not permission for any state to underfund services for children.)

The other two reasons are unjustifiable:

Second, a child may be placed out of state because her home state underfunds services for children, and the resources children require are unavailable.

Third, a child may be placed out of state because a child welfare agency or managed care organization wishes to save money or improve its bottom line by placing children in less expensive services. These placements may happen even when the receiving, out-of-state facility fails to meet the minimum licensing standards of the originating state.

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