State Moves to Create Locked Foster Homes

In the emotional and often divisive debate over what to do with society’s abused, neglected and abandoned children, at least one rule has long unified social scientists: Don’t lock them up.

To deprive already traumatized children of their freedom is to perpetuate a cycle of degradation, so the doctrine goes. The days of keeping foster children under lock and key went out with Oliver Twist and Victorian England or, at the latest, with the dark almshouses of New York City at the turn of the century.

But today--decades after reformers dismissed as cruel the jailing of street urchins and the bolting of orphanage doors--child welfare authorities in California are preparing to open a new type of group home with locked front doors and perimeter fences. Inside, it will be legal to place children and teenagers in seclusion rooms and to strap them to beds with leather restraints.

The decision to legalize locked foster homes is considered so momentous in child welfare circles that, 12 years after the Legislature approved the move, bureaucrats, group home operators and psychotherapists are still trying to hash out the specifics. The rules under which the homes will be allowed to operate are expected to finally emerge from the negotiations later this year.

“We are bumping up against near biblical beliefs here,” said one state official, describing the painstaking negotiations on the lockups. “You just don’t do this to kids.” The watershed creation of so-called Community Treatment Facilities does not herald a return to the dark days of teeming children’s wards, insist officials in the state departments of Mental Health and Social Services. After all, they say, the law authorizing the opening of such homes sets a 400-bed statewide limit and imposes rigorous regulations on restricting children’s freedom.

Proponents say the new lockups finally will create a place in society for the most difficult and damaged children--kids who start fires, throw fits, lash out violently and run away from all those who would treat them. Children with severe emotional disabilities now typically bounce from foster homes to children’s shelters to group homes and back--their transient lifestyles only exacerbating their pathology.

For the first time outside of mental institutions and jails, the institutions would hold juveniles behind locked doors or bound by restraints. That’s what’s needed, proponents say, to calm violent children or stop them from running away.

“This is an extraordinary time. It really is,” says state Assemblywoman Dion Aroner (D-Berkeley), a liberal and former social worker who has pushed for the licensing of the facilities. “The needs of these youngsters are so much greater than anything we envisioned when we opened the foster care system. They cannot afford the freedom of walking in and out of any home any time.”

Opponents see only expediency--a system that will further victimize already abused and neglected young people. Andrew Bridge, executive director of the advocacy group Alliance for Children’s Rights, called the facilities “the most repressive form of foster care imaginable.”

Bridge wondered how state and local officials--blasted recently by the Los Angeles County Grand Jury for failing to assure humane treatment for children in group homes--can be trusted to oversee potentially even more repressive and dangerous facilities. “The majority of children, even with mental illnesses, can live in the community if they are provided with therapeutic services,” Bridge said.

Other critics described California’s opening of locked foster homes as merely a piece of a national trend toward treating juveniles more punitively. Congress this month passed a bill that would lock up more juvenile offenders, often with adult inmates. In Washington and Missouri, laws allow youngsters to be incarcerated for committing juvenile “status” offenses such as running away from home, underage drinking, truancy and parental defiance.

Even Marjorie Kelly, the top child care official in the state Department of Social Services, is concerned that locked group homes present “a great potential for abuse.”

“The move toward locked doors and not other treatment methods in some ways seduces us into not examining why we have not been more effective with these children,” said Kelly, whose department will license the lockups.

How did the child welfare community arrive at such a crossroads? How can people of generally like mind--dedicated to civil rights and the protection of children--hold such opposing attitudes toward putting young people behind locked doors?

Much of the answer lies in the changing face of the children whom society is forced to care for. Today’s offspring of abusive and neglectful parents are more disturbed, more violent and more numerous than ever before, say social workers, psychotherapists and foster home operators. Some believe this wave of potential sociopaths are the offspring of cocaine-addicted mothers. Others blame the dissolution of the family.

While research into the roots of the crisis continues, the trail of failed solutions is obvious. Several homes that treat the toughest foster teenagers in Los Angeles County have been hit with allegations that they physically abused or over-medicated adolescents.

Living on the painful edge of this dilemma are youths like one 13-year-old girl from South-Central Los Angeles who has been shuffled to 12 foster care placements in 10 months.

Her case, like all foster children’s, is confidential. But two sources who have followed the case described the girl’s saga: Her mother died of a drug overdose when she was 8. Her father is in prison for murder. Two years ago, the girl was allegedly raped by a neighbor. And another relative, appointed to be her caretaker, drank to excess.

The girl began to severely act out, becoming violent and unstable when she hit puberty a year ago, the sources said. But everywhere she went--from foster family to the county’s emergency children’s shelter to mental hospitals--she was too hard to handle.

“She has not even been in this system a year, and all we have done is mess her up even more,” said one person close to the child. “It is really pathetic.”

Exasperated group home operators, who take the brunt of the criticism, say they are fettered in trying to help kids like the 13-year-old. Child welfare laws prevent them from using anything more than a strong or compassionate word to keep unstable young people from hitting the streets.

“You could have Sigmund Freud himself on staff as your psychiatrist, but what good is it going to do if the kid is just going to bolt out the door?” said Paul McIver, who oversees children’s services for the Los Angeles County Mental Health Department.

David Neilsen, a state mental health official said the new regulations acknowledge that foster children are no longer just “poor little wounded birds” but often prone to violence.

This new generation of hardened foster care children persuaded lawmakers to first approve Community Treatment Facilities in 1985. But it has taken 12 years--including several legislative amendments and a painstaking scripting of regulations--to bring the facilities nearly to fruition.

The result is two sets of regulations, written by the state Department of Mental Health and the Department of Social Services and totaling 93 pages. The rules are designed to tightly circumscribe who is placed in the facilities and how they are treated.

The homes will be allowed to have a locked perimeter fence and locked front doors. But, in one compromise, individual rooms for foster children will be open. And isolation rooms will be locked only under limited conditions and only when residents can’t be controlled in any other way. Even then, a specially designed lock will have to be held closed by a staff member, to assure that the isolated child is under constant observation.

The five-point leather restraints--already used in mental hospitals to strap patients to gurneys by their arms, legs and waists--could also be used as a last resort. A psychiatrist or, in emergencies, a nurse, would have to authorize their use for patients determined to be a danger to themselves or others.

Those under restraint would have to be constantly watched and examined every 15 minutes by a nurse and freed as soon as their aggression waned. They would be allowed to eat, drink and use a bedpan, when necessary. Their vital signs would be monitored.

The use of the device, like many activities in the homes, would then have to be reported to two state agencies and to advocates who oversee patients rights.

Proponents of the devices argue that kids who can’t be restrained sometimes punch walls, flail wildly and strike fellow residents and staff members. Without the devices, it can take three or more staff members to hold down a child, thereby leaving the rest of a volatile population unattended, say group home operators who argued for use of the restraints.

Scott Berenson, a state Mental Health Department employee involved in writing facility regulations, said that, even when used properly, leather restraints “make a person like an animal, really.” Berenson said that is why the regulations are designed to assure that the five-point restraints will be used “only as a last recourse. It’s something you would only do when you absolutely have to.”

To damper fears that the facilities would become a dumping ground for all the state’s difficult foster care cases, lawmakers agreed to the 400-bed cap. The cap was a compromise, roughly based on the estimated number of juveniles who would otherwise have to be sent to locked facilities in other states. With California opening its own homes, adolescents could be kept closer to family and friends, proponents argued.

Other rules are designed to tightly control admissions and to speed discharges.

Only juveniles with severe emotional disabilities would be eligible. Their admission would require their consent or the approval of parents or a court-appointed conservator. Teenagers over 14 would be entitled to contest an involuntary placement at a hearing.

Once a month, residents would have their cases reviewed, with the goal of promptly returning them to unlocked homes. Voluntary residents would be entitled to an immediate hearing any time they wanted out.

The rules must still go to the state Office of Administrative Law, to assure that they are clear, meet the demands of the Legislature and do not contradict other laws. Working the final bugs out is expected to take at least until the fall.

Then a statewide request will be made for proposals to operate the homes, with about 120 beds to be targeted for Los Angeles, the state’s largest county.

Many of those who had been uneasy at the prospect of locking child abuse victims behind closed doors say they have been somewhat mollified by the bed limit and the welter of due process hearings for children.

But some child advocates said they fear that group home operators will soon be working to raise the 400-bed limit--a move they said they would fight vehemently.

“As long as this isn’t a trend to locking up more and more kids, it is a reasonable compromise,” said Jim Preis, executive director of Mental Health Advocacy Services, which provides legal aid to the developmentally and mentally disabled in Los Aneles. But Preis added a caution: “A locked door must not become an easy way to deal with kids and, perhaps, forget about them or not give them treatment.”