Louisiana had nearly 8,200 foster children in SFY 2015. There were roughly 2,200 foster homes.

With extremely limited emergency shelter care – unavailable in nearly every region of the state, a persistent and significant shortage of therapeutic group homes, too few therapeutic foster homes, and endangered children’s homes, the resources of Louisiana’s child welfare and behavioral health systems are insufficient today for the needs of Louisiana’s children.

Placing children in other states was halted for decades by Gary W., but in the last few years, Louisiana has restarted the practice of placing children out-of-state and away from their families. Evidence indicates this practice is increasing. Louisiana has done this in the past and the state paid greatly for it. Worse than that, the outcomes for children and their families were not good.

So, let’s begin with a snippet from Louisiana’s child welfare history. Gary W. vs. Louisiana was a class action lawsuit filed in the US District Court for the Eastern District of Louisiana on September 3, 1974, against Louisiana’s Health and Human Resources Administration on behalf of “all mentally retarded, emotionally disturbed, and other children from Louisiana who have been placed in Texas institutions either by direct action of the State of Louisiana or with financial support from the state.”

The lawsuit alleged that constitutional and statutory rights of these children were violated because they were placed in Texas institutions where they received poor care and inadequate treatment. The trial lasted two years.

Following the trial, on July 26, 1976, Judge Alvin Rubin ruled the children’s rights had indeed been violated. He found that children placed out-of-state had not received the same level of care as those in Louisiana facilities and that they had been denied even simple privileges like family visitation. (Family visitation and participation in treatment is a strong predictor of how likely a child will successfully return home from out-of-home care.)

What we must remember is that no employee or manager of Louisiana’s Department of Health and Human Resources Administration wished for anything but the best for those identified children. The wrong done was not intentional. Rather, it happened for bureaucratic and financial reasons: Louisiana had too few placement resources for children and Louisiana could not adequately monitor the care of children at a distance.

Now, let’s return to the present. Today, states like California find themselves in a similar dilemma. When a state is without sufficient residential resources, children who require residential care are placed out-of-state into facilities which are too far away for adequate attention or family participation.

“Out of Options, California Ships Hundreds of Troubled Children Out of State“, an article published online at https://www.propublica.org/article/california-ships-hundreds-of-troubled-children-out-of-state, describes the situation in California which seems similar to the Gary W. case in Louisiana during the 70’s.

The article reports that more than 900 of California’s children are being placed out-of-state and are not being monitored as well as they would be if they were placed in their own state. All are being placed away from their families. This is an important point. Out-of-home care is more successful if families are actively involved in the care and treatment a child receives.

What do Gary W. and California have to do with Louisiana’s child welfare system? Just this: They serve as dark reminders that when we fail to ensure sufficient resources are available for our children, our children will be placed far away. When that happens, the consequences for children, families, and the state are disastrous.

I believe Louisiana’s current child welfare situation must be addressed quickly before we wade too far into the swamp a second time. To the point, Louisiana is short of residential care and treatment resources for children. We must make a correction.

Today, Louisiana continues shifting resources and support away from residential treatment toward community-based programs and in-home services. Hear this: Creating these non-residential, community-based programs is vitally important to ensure Louisiana has the necessary prevention, early intervention and local treatment services our children require in their own communities. (If the rules did not prevent it, these community-based services could simultaneously help families while their children are in residential treatment, enhancing the possibility of good treatment outcomes – but that’s a different matter.)

It is poor planning to lose necessary child residential services while building community-based services. Both services are desperately needed in Louisiana where the community-based service network is now and has been weak – especially in the rural areas which comprise 80% of our state. (Also, see The Advocate‘s article, “Report: Louisiana earns poor rating for mental health care access, but new approach coming.” )

During the last few years, as a consequence of Louisiana’s effort to move child welfare services into behavioral health, Louisiana has lost good residential providers. Because we have lost the beds provided by these closed homes and we have eliminated certain types of residential care in entire regions, Louisiana now struggles to find the residential services necessary for abused and neglected children.

During the state’s recent transfer of child welfare services into the behavioral health system, Louisiana’s residential care providers were weakened. The state lost some good organizations. Today, most therapeutic foster care and residential care providers in Louisiana struggle to maintain operations with costs of care which are not covered by the reduced amounts paid by Louisiana’s Department of Children and Family Services and Department of Health and Hospitals for children in the custody of the state for reasons of abuse, neglect or treatment.

Unfortunately, when Louisiana finally realizes how desperately her children require out-of-home treatment options, potential providers will have closed or will be without the resources to meet the identified need. This will leave Louisiana with the option no state desires: placing even more of her children into other states.

No state can effectively monitor the care its children receive in out-of-state placements. The children are too far away! Louisiana learned this expensive lesson with the federal Gary W. case.

For 26 years, Louisiana has an average rank of 49 among the 50 states for child well-being. It is clearly time for change. We cannot afford to leave our abused and neglected children, “out of options”.

What can you do?

1. Consider becoming a foster parent. If you cannot become a foster parent, support those in your community who do become foster parents. It is difficult, rewarding work.

2. Bug your legislators to make sure Louisiana fully funds services for children. The sad irony of placing a foster child out of state is that it costs Louisiana even more to send a case worker to supervise the out-of-state placement!

3. Encourage your State Representatives and State Senators to pay special attention to child welfare in Louisiana. Louisiana invests significantly in some industries while historically under-investing (both time and money) in child well-being. This is one reason Louisiana has ranked poorly for so long on matters related to our children.

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A final note: a number of Louisiana children were placed in Texas and in east coast facilities during the time of the Louisiana Behavioral Health Partnership which ended on November 30, 2015. The most specific answer given when I’ve asked how many children were placed out-of-state was, “not very many.” I am not certain anyone is aware of an exact number. (Update 2/18/16 – Today, I learned one Bayou Health plan has Louisiana children in 4 additional states. Representatives of two Bayou Health plans have indicated they are prepared to place children out-of-state if network providers are unavailable in Louisiana.)

Montana knows – at least about Montana’s children – and knowing reduces the number of out-of-state placements. Montana’s legislature requires a public annual report of out-of-state placements.

In the past, I have shared with DHH’s Office of Behavioral Health the annual report on out-of-state placements which Montana publishes. I believe this type of reporting would make transparent Louisiana’s placement of children in other states. Louisiana’s legislature should require it and publish it.

I believe we should be building sufficient resources in our own state for our own children and their families because treatment is more effective when children are near their families. Surely, Louisiana, we can do better by our children.

Rick Wheat, President and Chief Executive Officer
Louisiana United Methodist Children and Family Services