Washington's child welfare system is failing to adequately serve foster youth with the most vexing needs, resulting in hotel stays and out-of-state placements, according to a new report by the state's Office of the Family and Children's Ombudsman (OFCO). The report, released late Monday, sounds the alarm over the rising use of hotels to temporarily house foster youth. It also draws attention to the lack of therapeutic foster homes in Washington to serve the most hard-to-place children. "I'm very concerned about this small group of children with the highest needs that we are not adequately serving," said Patrick Dowd, who directs the OFCO. Dowd traces the roots of the problem to budget cuts during the Great Recession that reduced the number of providers who served high-needs youth. The report found that between September 1, 2017 and August 31, 2018, 195 children spent more than a thousand nights in hotels or in child welfare field offices, up from 824 nights the previous year. This included a 16-year-old girl with a history of running away who spent 67 nights in a hotel before she was ultimately sent to an out-of-state facility. Another child, a 9-year-old boy with significant mental health needs, spent 15 nights in a hotel after the group care facility where he was living closed. The youth sent to stay in hotels were disproportionately children of color, tended to be older and often had significant mental health or behavioral needs, according to the report. Most of the hotel stays happened in the Puget Sound region. Of the 195 children, 31 who were the most challenging to place accounted for the majority of the nights in hotels.

"Spending the night in a hotel or office, even just once, can be traumatizing for children who have experienced abuse and/or neglect, and creates unreasonable demands for Department staff," the report said. When youth are placed in hotel rooms, they must be supervised around the clock by caseworkers from the Department of Children, Youth and Families (DCYF). The report also found that youth sent to hotels were more likely to come into contact with police. This included a 13-year-old African American boy who spent 41 nights in a hotel and whose behavior triggered staff to call the police multiple times, including once when he refused to go to school. One of the report's recommendations is that DCYF develop clearer protocols about when police are called and ensure that caseworkers are sufficiently trained in deescalation strategies. Of the 13 youth who spent 20 or more nights in a hotel, over two-thirds were eventually placed in group facilities, also known as congregate care, including six who were sent to out of state facilities. A recent report by Disability Rights Washington called on the state to end the practice of sending youth to facilities in other states. Besides hotel stays, the OFCO report highlighted the case of a 7-year-old boy who spent more than a month in an adult psychiatric unit, despite efforts by the hospital to discharge him. "They were calling almost daily saying this is not appropriate, this is harmful for the child," Dowd said.

But caseworkers "refused to pick up the child," according to the report, because there was nowhere to place him. After investigating, the OFCO found that it was "clearly unreasonable" and "harmful to the child" to leave him in the hospital. OFCO also noted that there was no effort to make sure the child had access to school while he was in the hospital, in violation of state policy. Another child, a 9-year-old boy, didn't attend school regularly for six months as he bounced between hotels, foster homes and a group home. During this time, he was also hospitalized for suicidal ideations. Multiple efforts to enroll the boy in school failed or were interrupted by his frequent placement changes, the report said. Eventually, he was enrolled in a therapeutic school 45 miles from his foster home. Other issues raised in the report included long wait times on the phone to report allegations of abuse or neglect to Child Protective Services and unreasonable delays in licensing new foster parents. The OFCO is recommending the state fund a new, faster online system to speed up foster care licensing and help address the shortage of foster homes. DCYF has requested funding for this upgrade. To address the lack of placement options, the report recommends the state fund more therapeutic foster homes, create a cadre of professional therapeutic foster parents and improve access to children's mental health services. The report also calls for exanded programs to support foster parents and kinship families. "The ongoing practice of placing children in hotels and state offices highlights a shortage of foster homes and therapeutic placements, perhaps the single greatest challenge facing DCYF," the report said. "It is therefore essential we build an array of placement resources, enhance mental health care for children, and increase support for foster parents, relative caregivers, and parents."

Disability Rights Washington (DRW), which sued the state in 2009 on behalf of youth with serious mental health needs, praised the call for more mental health services for foster youth. The case, known as the T.R. lawsuit, settled in 2013. "One of the primary challenges of implementing the T.R. settlement has been to coordinate the child welfare and behavioral health systems well enough for young people in foster care to be able to access the intensive mental health services required by the agreement," wrote Susan Kas, a DRW attorney, in an email. The findings in the ombudsman's report came as no surprise to DCYF Secretary Ross Hunter, who took over Washington's child welfare system from the Department of Social and Health Services on July 1. In a letter this summer accompanying his agency's budget request for the next two years, Hunter offered a dire assessment of the system he had just inherited. "Due to increases in caseload over the past few years the system does not have adequate staff to meet national standards and previous legal settlements," Hunter wrote. "This puts the state at risk of not keeping children safe and contributes to the excessive turnover in the agency, which aslo risks child safety and delays permanence for children."