Warehousing our children

An apparent shift toward more institutional care of foster kids has some child-welfare advocates worried that America is straining against 100 years of research.

These are no angry behemoths hulking on downtown streets or rising on the hills of distant railroad towns. Often, today's American orphanages look so unlike their Dickensian predecessors that you could almost believe the brightly colored cottages were sets for some Disney fairy tale.

The children, too, seem distant from the privations of old. They have food, clothes, and a measure of stability - most even have parents, beyond the wilds of the foster-care system.

Look deeper, though, and perhaps not so much has changed in 150 years.

"The orphanage never really went away," says child welfare expert Richard Wexler. "It sort of metamorphosed" into the system of shelters, group homes, residential treatment centers, and residential educational academies that provide the bulk of institutional foster care in the US today. "But they couldn't change the facts: Institutional care is bad for kids."

Mr. Wexler, executive director of the National Coalition for Child Protection Reform (NCCPR), is among a growing number of analysts drawing attention to what he calls a "back to the orphanage" movement now under way. The population of American foster children in institutional settings is quietly growing, they say - not due to any concerted social or legal effort, just a pieced-together system that affords comparatively few services to families in need but offers fiscal incentives to take children away.

These analysts are not the only ones concerned: Last week the US House Ways and Means Committee heard testimony on a Bush administration proposal that would allow states to take their annual foster care money - currently the only bottomless pool of funds available for poor kids - in an up-front sum that could be used for family-preservation services. The child welfare community is divided: some Bush detractors actually support the proposal, citing its potential to strengthen family services; many institutional care providers oppose it.

Half a million in foster care

Today, more than half a million children are in foster care in the US. According to the latest Department of Health and Human Services (HHS) figures, roughly 100,000 live in group facilities: emergency shelters, group homes, and institutions.

But numbers of children in state care are notoriously slippery: Though states began enacting foster-care laws in the late 19th century, and though the first major study of its outcomes was published in 1924, the federal government did not begin to keep comprehensive nationwide data on children in foster care until 1998. Before that, states reported on kids in care voluntarily - and sporadically.

While the four years of available data do not show a rise in group care of foster kids, many in the field say they believe the proportion of children in such care is on the rise.

"It's not a huge upswing, but it's been my impression that it's growing," says Paul Vincent, director of the Child Welfare Policy and Practice Group in Montgomery, Ala.

At the same time, says Madelyn Freund-lich of the child advocacy group Children's Rights, a number of states are currently building new institutions, or expanding existing ones, to house these children. In theory, she says, the system's goal is to reunite these kids with their own or foster families, but in practice many kids who land in institutions stay there for the long haul.

Add to that a growing number of faith-based groups - particularly in Florida and Georgia - working to bring back orphanage care as an intentional part of the foster care system, and what you have, says researcher Mary Ford, of the North American Council on Adoptable Children, is troubling.

"All this focus on [institutional] permanency goes against a hundred years of child welfare policy," Ms. Freundlich adds. "Why are we promoting this against all our policy directives?"

A system under strain

Whatever you know about this country's foster-care system, you've probably heard it's a mess: the kids too many and too troubled, their families incompetent or worse, foster parents too few and sometimes abusive, and resources chronically scarce.

Margie Bruszer, director of SOS Children's Village, a Florida group-care complex, says family foster care often leaves children so emotionally exhausted that group care comes as a relief. "For children who have problems establishing close relationships [with adults]," she says, "there's some safety in numbers. If they're in a group setting, they don't feel as much the expectation that they're going to have to attach to their caregivers."

While critics of institutional care argue that's exactly why it's unconscionable, they agree that the foster care system needs work. Funds and services to help families before their children are taken away are hard to come by, they say. A small number of parents are intentionally brutal. A few kids will always pose a serious danger to themselves or others, and there are indeed more children needing foster homes than foster parents ready to take them in.

Enter the proponents of institutional care: personalities like Mary Jo Copeland, dubbed "Mother Teresa of Minneapolis" by her local press, who's now raising funds for a 200-bed facility there; and local governments - as in San Diego County, which in 2001 opened a new facility that hopes to house 250 children - searching for new solutions to overcrowded foster systems.

For-profit companies, too, are increasingly getting into the child-care business, due to a 1996 change in the welfare laws. (Previously, such companies were ineligible to compete for the billions in federal funding dispensed each year to foster-care providers.) The Urban Institute estimates that in 2000, the most recent year for which figures are available, federal, state, and local spending on out-of-home care totaled $20 billion.

The position of such group-care providers - that safe institutions are preferable to a flawed foster system - is bolstered by critics like Richard McKenzie, editor of the 1999 pro- orphanage study "Rethinking Orphanages for the 21st Century"; by movies like "The Cider House Rules" that portray institutions in a sort of early-evening glow; and by an overwhelming public sense that the existing system is failing to ensure the safety of vulnerable children.

Moreover, many institutional-care providers argue they're doing states a favor by taking off their hands troubled kids who would be difficult to place in foster, group, or adoptive homes.

The problem is, over a hundred years' worth of child-development studies have indicated that while troubled kids can often get the medical and mental-health services they need in group care, institutions are bad for children's emotional and cognitive development. As a 1996 Boston University Medical School review of pediatric and child psychiatry research found, "Scientific experience consistently shows that ... in the long term, institutionalization in early childhood increases the likelihood that impoverished children will grow into psychiatrically impaired and economically unproductive adults."

In addition, many argue that grouping kids with severe behavioral problems with those less troubled only magnifies the dysfunction. "You put a bunch of troubled people together, you're going to have more troubled people," says child policy researcher Mark Courtney.

What's more, child welfare workers say, kids who spend significant time in orphanages often become institutionalized - less able to function in society, more apt to find themselves in the juvenile, and later in the criminal, justice systems.

Finally, it's expensive. On average, Mr. Wexler says, group care costs states 10 times what they'd pay for a child in family foster care.

But these are all symptoms of institutional care, not the cause of the problem, says Dr. Courtney, director of Chapin Hall Center for Children at the University of Chicago.

To get at that, he looks to the number of children in the system. Because child welfare is no candidate's political priority, he says, it rarely makes the news unless a child dies. Then, "either they die in their home, and everybody asks: How could we leave them there? Or they die in foster care, and the question is: How could we have taken them from their families?"

Public hysteria, he argues, should not shape national priorities about whether to remove children from their families or work to improve those families. Only about 30 percent of the children taken from their families each year are victims of substantiated physical or sexual abuse, according to HHS. Most of the rest are removed due to "neglect," which commonly means children left unsupervised or living in unsafe housing.

In other words, says Courtney, neglect often equals poverty. "Not to say that all poor people neglect their kids - of course they don't. But if we had better jobs policies, better housing policies, better healthcare, we'd have a lot fewer kids in foster care."

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