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Children in Residential Treatment Centers Are Especially Vulnerable to COVID-19

Tens of thousands of children are in congregate care settings around the country, and some have already started to get sick.

Photo illustration by Kat Wawrykow. Photo from Getty Images.

Simon is a 14-year-old living at St. Mary’s Home for Boys, a residential center 10 miles west of Portland, Oregon that treats, according to its website, “emotionally and behaviorally disturbed boys.” 

Sixty-seven boys live on the campus; they come from the foster care and juvenile justice systems, and are schooled onsite. Simon, who has been in the child-welfare system for a decade, had earned off-campus weekend visits with his parents. But the novel coronavirus has abruptly changed life for Simon, his family, and the tens of thousands of kids like him around the country.

In 2018, about 47,000 foster children lived in institutional settings or group homes; last year, nearly 15,000 more youth were committed to such facilities through the juvenile justice system. Still others have been sent by their families to live in these youth facilities around the country, which offer a broad spectrum of services: some are wilderness or boot camps; many are drug treatment programs, while others focus on helping victims of sexual abuse. Though some provide a needed lifeline to struggling children and families, many are rife with physical and sexual abuse.

A 2007 US Government Accountability Office report found thousands of abuse allegations at facilities around the country, including 10 civil or criminal cases involving the deaths of teens. In 2018, Congress passed the Family First Prevention Services Act, which in part aims to reduce the use of residential treatment centers for foster children by restricting the amount of time most youth can stay in them, and by enacting new, higher standards RTCs must meet in order to receive federal funding. 

As governors issue shelter-in-place orders to reduce the spread of the novel coronavirus, residents of these facilities which, like those in nursing homes and prisons, house a concentrated group of people that often have underlying health issues, are especially vulnerable. Like nursing homes, residential treatment centers around the country are beginning to report COVID-19 cases among staff and residents.

On April 3, the Reno Gazette Journal reported that 24 children and 11 staff members at the Willow Springs Center tested positive for the virus; by May 4, 40 residents and 29 staff members were infected. One Willow Springs staff member has died. One woman told KUNR that she wasn’t able to contact her son at the facility for nearly a week before staff called to tell her he had tested positive for COVID-19; an employee at the facility said they weren’t given proper protective gear and that employees who had tested positive were still working.

Staff members working in at least two facilities in Philadelphia have tested positive for COVID-19. A state-run facility near Kansas City, Missouri, has confirmed cases in both residents and staff. And in New York City, Mayor Bill de Blasio has approved more funding for nonprofits to offer boost pay for their staff members at residential treatment centers, in an effort to keep employees working as staff and residents begin testing positive.

The Jewish Child Care Association (JCCA), operates four residential treatment centers for about 300 foster children on its Pleasantville Cottage Campus in Westchester County. Ronald Richter, JCCA’s executive director and former head of New York City’s Administration for Child Services under Mayor Michael Bloomberg, told The Appeal that “several” staff members and residents on the compound have tested positive for the virus. “Because of how this illness manifested itself, we didn’t know that people who were working on the campus several weeks ago were actually positive,” Richter said in an April 7 phone interview with The Appeal. 

The staff has isolated residents who tested positive in a single “cottage,” which houses about eight to 10 children. Children who normally attend school on campus are now engaged in  distance learning, and all residents are barred from the recreation center, the cafeteria and sometimes even their friends, because intermingling between people from different cottages is forbidden. That’s especially hard, Richter said. “In a setting where you have teenagers, like teens everywhere, that are not designed to follow rules and are not interested in social distancing,” he said.

JCCA has sourced protective personal equipment for its staff members and they are receiving boost pay to acknowledge the additional risk, Richter said. Every resident, and everyone who comes onto campus, has their temperature taken daily. Still, many are nervous. “It’s really palpable. People are really stressed out. The staff that are working directly with people everyday, they’re going home to their families,” Richter said. “And then the anxiety level among the staff is obviously very much felt by the kids. So figuring out how to make the staff feel as safe as possible has been the priority.”

Life in an RTC was highly restrictive before the COVID-19 pandemic, and with the threat of an outbreak, its been made even more so: Simon told The Appeal that his schooling at St. Mary’s Home for Boys was abruptly canceled, and he had yet to begin distance learning even after a month of lockdown. His parents’ visits were canceled, he said he hasn’t seen his caseworker in nearly four months.  He’s able to communicate with his lawyer, Paul Aubry, by phone, but Aubry told The Appeal that said it’s difficult to ensure that their conversations—which are privileged and confidential—are private. 

A representative from St. Mary’s denied Aubry’s request for video conferencing for both legal and family communication, writing in an email that “internet infrastructure and computers with sound and webcams available are just not available to us at the moment.” 

There’s just no excuse for not having a video capability,” Aubry said. “To not have any eyes or ears on the most restrictive placement I think is just shameful.”

St. Mary’s Home for Boys did not answer repeated requests for comment from The Appeal.

Dawn Post, the deputy director of A Better Childhood, a non-profit child welfare advocacy group, brought a class-action lawsuit last year against the state of Oregon on behalf of Simon and others for violating their rights by providing them inadequate care. She told The Appeal that children in institutional settings are already severely isolated, which makes them particularly vulnerable to the isolating effects of COVID-19 protocols. “They’ve lost contact with their communities and families by virtue of the fact that they’re located far away from their homes—and there were issues in Oregon where they weren’t visiting children regularly in these facilities and there was a lot of abuse happening,” Post said. 

Post said she’s concerned that inadequate physical supervision of children in residential treatment centers could lead to increased incidences of child abuse, and to isolation policies that further harm their mental health. “Children also have rights; that’s the focus of the lawsuits we bring,” Post said. “Those can quickly be swept aside in the name of, ‘This is a crisis that no one could have anticipated.’”

Simon and the other residents can’t play basketball or hang out in groups, and are told to stand six feet apart at all times, a challenge in the residence he shares with 15 others. “The staff, they’re a lot more nervous around us—they don’t want to be as close to us,” he said. 

It also appears that Simon is not accessing accurate information about the virus—he said he thinks people are overreacting and that young people are “basically immune” to it—but he is worried about his grandfather, who has health problems. He said life at St. Mary’s, already difficult, has become unbearable with the loss of his family visits, his one link to the outside world. 

“It’s difficult not being able to see my family,” he said. “I’d much rather be with them than here—at least if they got sick, I’d get sick.”