Instead of landing in a hospital bed, Nathan spent roughly six months sleeping on a couch in a state office in between stints at group facilities and one-night stays with foster families that keep kids only from bedtime until breakfast. Eventually, he was sent to a residential treatment facility in Idaho owned by Sequel Youth & Family Services, a company plagued with reports of abuse at several of its dozens of facilities. Laura said Nathan was in 39 different placements during just his first year in foster care.
Now 18, Nathan recalls at least one night when he shared a hotel room with other foster children. “It was scary,” he said. “I was worried all night long about what would happen because I didn’t know anyone there. So, I was constantly worrying about if it’s safe to fall asleep.”
Nathan is one of hundreds of Washington foster children who in recent years have spent days, and sometimes weeks or months, living in hotels or government offices because the state has too few foster families and group homes, particularly for children with mental health challenges and developmental disabilities.
Despite millions of dollars in funding from the Legislature to tackle the problem, the number of nights that foster children spend in hotels and offices has increased steadily over the past seven years. Between Sept. 1 and July 15, a record 233 children spent 2,016 nights in hotels and offices, according to the state Office of the Family and Children’s Ombuds, which provides independent oversight of social service systems in Washington.
A recent federal court order requires the state to finally halt the practice, which, according to advocates, traumatizes children, leads to worsening behavior and threatens their long-term mental and physical health.
Signed on June 29 by U.S. District Judge Barbara J. Rothstein, the order immediately prohibited the state Department of Children, Youth, and Families from keeping children overnight in offices and cars. By Nov. 1, it must cease housing them in hotels and offices altogether.
It is unclear how this new court order will succeed where other efforts have failed, including a previous lawsuit aimed at reducing the number of times foster children are moved.
Advocates for foster children and even DCYF officials have expressed hope, but also uncertainty, that the court order can improve conditions for foster children. The requirements and deadlines set by the court don’t address the state’s long-standing lack of resources for foster children, particularly those experiencing mental health crises and those with developmental disabilities.
In fact, DCYF is already out of compliance with the court order. Between the signing of the order and July 26, children spent 82 nights in offices, according to the ombuds office. DCYF agreed, in a required July 30 report to the court, to have an outside expert review the cases of children being kept in offices to determine how the department can find stable homes for them.
“Am I worried about our ability to comply? Absolutely,” said Frank Ordway, DCYF chief of staff. “We’re not delusional that this problem is going to be solved [by Nov. 1]. But we do think that the pressure that the court is putting on us to solve it, and the way that the order was constructed, is honestly a significant step forward.”
Patrick Dowd, the ombuds office director, began tracking hotel stays in 2015, when children spent just 120 nights in what the state calls “placement exceptions.” A couple of years ago, Dowd said, he remained “somewhat optimistic,” because a relatively small number of children, 70 to 80 out of about 7,000 in foster care today, consistently account for the majority of hotel and office stays each year. Solving the problem for that small number of children “should be doable, but apparently that hasn’t proven to be the case,” he said. “I still think that’s ... something we can handle.”
First, do less harm
The court order resulted from a class-action lawsuit filed in January against DCYF on behalf of three foster youths who have cycled between hotels, state offices, one-night placements with licensed foster parents and group homes. The broader lawsuit seeks to end such short-term placements and improve support services and planning so that children can reunite with their families or find other permanent homes.
Susan Kas is an attorney with Disability Rights Washington, which, together with the National Center for Youth Law and the law firm Carney Gillespie Isitt PLLP, represents the youths. Kas said they filed a preliminary injunction in April to mitigate the harm to children spending nights in hotels and offices while the lawsuit moves forward.
Rothstein, the federal judge, required both sides to agree on an interim plan. The final order addresses all of the plaintiffs’ key demands, Kas said.
“I do believe the department was negotiating in good faith,” she said. “And so I don’t believe the department would have agreed to something that they didn’t think was realistic.”
A first step was supposed to be an immediate end to DCYF keeping kids overnight in offices, unless they enter DCYF custody after 10 p.m. and workers have made an effort to find a hotel room.
“We’ve agreed with the federal court that we would only use staying in an office in an emergent situation,” DCYF Secretary Ross Hunter told the department’s oversight board at its July meeting. “It should be infrequent,” he said, “like really infrequent.” Yet the department, and in particular, DCYF’s Region 6, which covers the Olympic Peninsula and southwest Washington, has struggled to find alternatives since the court order was signed.
Until last year, children rarely slept in state offices. In fiscal year 2019, children spent just six nights in offices. That jumped to 284 nights last year, and 727 just since last September (the start of fiscal year 2021). Some of that increase stemmed from efforts to isolate children exposed to COVID-19, according to the ombuds office. And sometimes hotels refuse to rent rooms to DCYF when children have been disruptive or caused damage, Ordway said.
The order also bars the department from holding children overnight in cars. According to one of the plaintiffs, as well as multiple caseworkers cited in a May KING 5 News investigation, DCYF staffers have made youths spend nights in state-owned cars as punishment for refusing placements in group or foster homes. DCYF has denied having a policy of keeping children in vehicles and said it is cooperating with the ombuds on an investigation of the allegations.
Another change, which Dowd recommended last year, allows children to stay in the same hotel room and keep their belongings there after five consecutive nights spent in a hotel. However, if youths refuse a “suitable” placement, DCYF would not have to keep them in the same hotel room. According to a recent DCYF report to the court, some DCYF offices have not followed this new rule, but the department wrote that it will begin tracking compliance.
DCYF officials have said that some youths refuse placements because they prefer to stay in hotels. But, in the words of one of the plaintiffs, “When you’re a foster kid, a hotel stay is no vacation.” Children are allowed in the room only after 8 p.m. and must leave by 7:30 a.m., wrote 16-year-old D.S. in a statement to the court. Each night, they share the small space with different staff and children, some of whom act out violently.
“You live in fear that there will be a fight, children will have major meltdowns, or some other crisis will happen in the night,” D.S. wrote. She added that the after-hours caseworkers assigned to monitor children in hotels don’t have the skills to calm kids down, a claim that was backed by multiple caseworkers in another recent KING 5 News story.
The court order also addresses the lack of structure, healthy meals and education for children in temporary placements; those children typically spend their days sitting in state offices.
“I basically spend the day in the lobby doing nothing,” wrote D.S., who gave up on school because she didn’t have a quiet space in which to attend online classes during the pandemic.
For that reason, the court order requires DCYF to transport children to school or provide quiet office space and staffing to support online classes. And rather than allowing children to subsist mostly on fast food, it must offer healthy options.
These are “the bare minimum of the changes needed for the well-being of the children,” Anne Farina, a licensed clinical social worker and assistant professor at Seattle University’s department of social work, wrote in support of the preliminary injunction. “Without these changes, and if the current Washington DCYF practices continue, I believe that the children in their care are unsafe and are being harmed,” she wrote.
Prospects for change
In a July 6 memo to workers in its regional offices, DCYF outlined the new requirements, but did not spell out how they could comply. The department is developing more specific guidance for staff in consultation with plaintiffs' lawyers, according to DCYF's report to the court.
In addition to making some immediate changes, DCYF has until Sept. 1 to submit to the court a plan for how it will stop using hotels and offices altogether by Nov. 1.
A key to eliminating hotel and office stays would be to create better options for children like Nathan, who have the most significant challenges.
Most children consigned to hotels and offices spend just a few nights there while awaiting placement with a relative or foster family. But nearly 20% spent 10 or more nights in placement exceptions in fiscal year 2020, and one child racked up 126 nights, according to the ombuds. Of the 24 children who spent 20 or more nights in hotels and offices, 17 had “unique mental health needs” which might have required inpatient psychiatric stays. Half had a history of physical aggression and/or suicidal ideation or self-harm. A number of these children also had acted out sexually with other children, and Washington currently lacks a facility specifically designed to treat them.
Given Nathan's erratic behavior brought on by the brain injury, Laura was also concerned about him harming other children. But once in DCYF’s custody, Nathan rode around in a van with other kids and shared hotel rooms with them. “To me, that seemed really irresponsible,” Laura said. “They’re doing things that, if a parent tried to allow something like that, they’d be in big trouble for.”
Some of the youths staying in hotels and offices today would have been in juvenile detention in the past, said Ordway, the DCYF chief of staff. A 2019 state law eliminated detention for running away and other noncriminal offenses by minors. “This is a positive,” Ordway said, but the state hasn’t backed up the change with adequate alternatives for these young people.
At the same time, the state is still trying to rebuild social services that were cut after the Great Recession, which began in 2007. Recent investments in child welfare have been slow to yield results.
A 2019 increase in the amount DCYF pays group homes — the first raise since the recession — has not resulted in a significant increase in capacity. The department is studying further rate increases but is “not necessarily looking to expand tremendously this kind of care,” Ordway said. With prodding from federal legislation, states are reducing the use of group homes because children tend to fare better with families.
Lawmakers also allocated funding in the 2020 supplemental budget for 21 long-term beds that include intensive mental health services, with providers of those services being paid more than those in regular group homes. More than a year later, only six spots are available, all in eastern Washington. “I thought that that would be adequate to solve the problem,” Hunter told the oversight board, “and it will not be.”
The lack of progress is disappointing, said Karen Brady, executive director of Ryther, a Seattle child mental health agency that stopped admitting foster children to its residential treatment program in early 2020, when even the higher reimbursement rates failed to cover Ryther’s cost of doing business.
“In spite of legislation, and in spite of lawsuits, in spite of a new department [of Children, Youth, and Families, which took over foster care in 2018] ... we are exactly where we have always been,” Brady said. “Which is [with] not enough providers, and we have children in offices and hotel rooms, just like we did.”
Brady added that agencies such as hers would be willing to provide the services children need if the state “paid a sustainable rate.”
In December, DCYF issued a report outlining solutions to the growing problem of hotel stays. Several key recommendations rely heavily on other state agencies and will require additional funding. Those include increasing the capacity of the Children’s Long-term Inpatient Program by 25 beds, up from the current 84. Children currently must wait an average of 83 days for inpatient psychiatric care through the inpatient program, according to the Washington State Health Care Authority, which oversees the program. Next summer, the agency will add inpatient capacity for 12 children with autism or other intellectual or developmental disabilities, but advocates say more spots are still needed.
In the meantime, Hunter told the oversight board, DCYF has begun “saying ‘no’” to taking children who are being discharged from psychiatric care and who, like Nathan, are not victims of abuse or neglect, but whose parents are unable or unwilling to care for them at home.
“Being in the child welfare system causes further damage to children. It creates legal sanctions on their parents,” Hunter said. “So, we’re trying to not do that, and have the health care system provide behavioral health services for these children.”
The department also is starting to better coordinate with the state’s Developmental Disabilities Administration and juvenile detention facilities to halt the inflow of children from those systems, Hunter said. And for those already in its care, DCYF is considering options such as supportive living with intensive case management for older teens.
Those teenagers are often the ones refusing to go to a group home and instead spending the night in a hotel, office or even a car. “I can’t agree to not use hotel stays until I have ... an adequate set of placement options,” Hunter said. “So, we are going to have to figure out a set of options that are acceptable to 16- and 17-year-olds.”
All the solutions to the hotel-stay crisis proposed so far will take months, or even years, to bear fruit. Whether the court order can spur near-term change remains to be seen.
In the meantime, Laura, the mom who voluntarily placed her autistic son in DCYF’s care, wonders whether the state often does more harm than good. The extreme instability that children like Nathan endure piles “trauma on top of trauma,” she said.
“In comparison, well, how bad was the biological home?” Laura asked. “Wouldn’t it have been better to put services in there, if possible? Because what the state exposes them to, in my mind, it borders on abuse as well.”