Tuesday, December 17, 2024

An odious practice tolerated in most states – and encouraged in Oregon

Third of three parts. Read the full series here.

There is an odious practice in the “residential treatment” industry known in that industry as “creaming” – as in skimming the cream.  Here’s how it works: 

First, the residential treatment “providers” justify their existence, the enormous harm they do to children and the astounding waste of taxpayer dollars, by claiming there’s no other choice: The children supposedly are so very, very difficult and have so many problems that no family could possibly handle them – they simply must be institutionalized.  (By the way, it’s not true.) 

But then, when children come along who are, in fact, particularly hard to handle, the providers refuse to admit them.  They don’t acknowledge that they’re creaming, of course, they just say that these children “aren’t the right fit for our program” or something like that.  Then, having taken only young people who could most easily succeed without them, if their own families or foster families got the right kind of help, the institutions claim as their own whatever minimal success they may have with some small portion of those they choose to admit. 

There are two ways to try to solve this problem: the right way and the Oregon way. 

To understand how Oregon screwed up so badly we need to return to 2015, when the Portland alternative weekly Willamette Week, exposed horrific abuse by one group home provider, Give Us This Day.  They also exposed how Oregon DHS knew about it and ignored it for at least 18 months.  And part of the problem revolves around creaming.  As I wrote at the time

The Willamette Week stories note that Give Us This Day was willing to take the children deemed most difficult – children other private agencies wouldn’t touch.  But “private” agencies funded with public funds shouldn’t have a choice in the matter.   It appears that DHS does not require private agencies to sign “no reject, no eject” contracts.  That allows agencies to engage in …“creaming” …  They take the easy cases and ignore the rest.  Since the state allows this, it makes agencies like Give Us This Day among the only choices for the children deemed hardest to place. 

There are two ways to deal with this: The right way: require “no reject, no eject contracts.” Then providers are required to develop programs that are flexible enough to accommodate the children rather than making the children accommodate the providers.  And the state only signs contracts with agencies that can do it.  

Most states are too afraid of their residential treatment industry to do this.  But I am aware of no state, other than Oregon, that went to the opposite extreme: Oregon actually passed a law that penalized agencies if they didn’t engage in creaming! 

The law states that 

The director shall impose a civil penalty of not less than $250 nor more than $500, unless otherwise required by law, on a child-caring facility that assumes care or custody of, or provides care or services to, a child knowing that the child’s care needs exceed the license, certificate or authorization classification of the child-caring agency if the assumption of care or custody, or provision of care or services, places that child’s health, safety or welfare at risk. 

Happily, an otherwise dreadful piece of draft legislation includes repeal of this part of state law – though only because Oregon, which tears apart families at a rate well above the national average, has no place to dump all those kids.  But that would merely make Oregon no worse than other states – it wouldn’t demand no reject no eject contracts and providers capable of handling such contracts. 

The source for so many bad ideas 

Oregon State Sen. Sara Gelser Blouin


And, of course, that still leaves the question: Who in the world would have pushed the idea of putting a provision encouraging creaming into state law in the first place?  It’s not entirely clear, but it appears to have been at least supported by Oregon media’s favorite lawmaker, the one they love to quote demanding accountability from everyone else, but is never held to account herself. Yes, it’s one more failure from Oregon’s Senator Soundbite – Sara Gelser Blouin. 

She told The Oregonian 

… the civil penalty was created in direct response to Give Us This Day accepting children whose needs it was not equipped to meet. “The purpose of that civil penalty was to give those places a reason to say ‘no’ …” 

Yikes.  Until they finally stop institutionalizing children altogether – and yes that can be done – states need to demand institutions that can serve any child -- at a minimum without abusing the child, neglecting the child or otherwise making the child’s condition worse. Then such institutions should be required to say “yes.” 

This kind of blunder is nothing new for Gelser Blouin. I think she actually means well.  But time and time again she has set back Oregon’s few feeble efforts at reform, and generally made a bad system worse.  Consider: 

A recent study, using data from 2015 to 2019 found that in Oregon, more than 40% of all families and nearly three-quarters of  Black families – 72% - would eventually face investigation by DHS for alleged child abuse or neglect. Such investigations can, in themselves, be enormously traumatic for children.  Yet during this same time period, Gelser Blouin was getting fawning media coverage for falsely claiming that Oregon wasn’t investigating enough families.  (Details on how she took data out of context to reach that conclusion can be found toward the end of this post.)

What in the world does Senator Soundbite want? Should DHS not even wait for an allegation and just investigate every Black family in Oregon – given how close they come to that already?  Perhaps a reporter should ask her. 

● Then there was her war against “differential response” (DR). Gelser got the legislature to shut down that approach to easing the trauma of investigation in July 2017.  One month earlier, a comprehensive independent report on Oregon’s differential response initiative specifically refuted Gelser Blouin’s claims about safety declaring: 

[O]ur analyses find no evidence that DR undermines the safety of children in Oregon. [Emphasis in original.] 

The evaluation found that families receiving a differential response intervention were significantly less likely to have another substantiated report of child abuse than a matched comparison group of families who got a traditional Oregon child protective services investigation. 

So did Gelser Blouin not know about this evaluation when she moved to kill the initiative, or did she know about the report and decide to ignore its findings. Perhaps a reporter should ask her.  

● When children must be placed in foster care the most humane most stable and safest option almost always is kinship foster care, placement with a family member or close family friend.  But in 2022, Gelser Blouin said she would introduce legislation that would actually make it harder for relatives to get custody, tilting the balance in favor of what should be called stranger care.  

The idea didn’t even originate with Gelser Blouin.  It came from a right-wing group in Arizona that, ALEC-style, is promoting such legislation across the country.  Perhaps a reporter should ask Gelser Blouin about this.  

It’s not that Oregon would have a good system if every journalist covering these issues didn’t have Sara Gelser Blouin on speed dial while largely ignoring families whose children have been wrongly taken, their advocates and their attorneys.  But it probably would be less bad.