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Isela Perez entered the custody of Georgia's child welfare system at age 10. It happened after her father was deported and her mother left her and her brother alone in their home for two weeks, she said.

Perez estimates she moved more than 20 times among group homes, mental health facilities, and foster families.

"A lot of foster parents didn't know how to deal with my anger issues or my depression, know if adderall dose too high " said Perez, now 18 and in an independent living program in Dahlonega, Georgia.

In between those placements came nearly a dozen stays in budget hotels, including one as recently as last year, while state Division of Family & Children Services workers tried to find her a more permanent home where she felt comfortable, she said.

"I knew once I was in a hotel: 'OK, I'm going to stay in here for at least a week or two until DFCS can magically find me another placement, and then I'll be back in the hotel in about two or three weeks.'"

Like Perez, foster kids across the country — many with complex mental, behavioral, and physical health needs — end up bouncing around in their states' child welfare systems and landing in temporary placements like hotels and county or state offices. The practice is known as "hoteling."

These children already face tremendous challenges, having been given up by their parents voluntarily or removed from their homes due to abuse, neglect, or abandonment. Child welfare advocates say being shuttled between temporary placements adds trauma.

Kids end up in hotels and offices for many reasons, including a shortage of foster parents with the training and support to take high-needs children and a lack of community-based support services for families.

Long-term solutions have been hard to find. States such as Washington, West Virginia, Texas, Oregon, and Georgia have resorted to placing foster children in less-than-ideal temporary living situations for years.

There's no nationwide count of how many foster kids might be sleeping in a hotel or office. But state-level reports indicate that the disruptions of the covid-19 pandemic have made the matter worse. Child welfare agencies faced the same staffing shortages that hit health care facilities. Foster families hesitated to take in children because of heightened concerns about disease transmission. States diverted dollars and personnel to fight the public health emergency.

"Exacerbated by the COVID-19 pandemic, the placement resource crisis has only worsened," Patrick Dowd, director of Washington state's Office of the Family and Children's Ombuds wrote in a recent report. It noted 256 children spent a combined total of 2,535 nights in hotels or offices from September 2020 through August 2021.

In Texas, an independent, court-appointed panel found the number of children housed in offices, hotels, and unlicensed facilities increased 152% in the first half of last year. Since then, the panel said, "it has slowly declined but remains sizable."

One major challenge is to find foster parents prepared to take children as they transition out of inpatient treatment, said Gwen Skinner, who runs residential facilities that serve foster children in Georgia and Florida, owned by the nonprofit Devereux Advanced Behavioral Health, serving kids with severe autism, oppositional defiant disorder, and schizophrenia.

"You’ve got to have well-trained foster parents, particularly if they are going to deal with those children who are at the deeper end of the behavioral health needs — those children who end up in hotels," she said.

In two metro Atlanta counties, Fulton and DeKalb, temporary placements have been on the rise, according to a recent report from court-appointed monitors.

"There was an increased challenge with youth, mainly over 14 years old, staying in county offices more frequently and for longer durations," the report said. The monitors counted 31 office stays longer than 24 hours and 16 longer than five days. The longest recorded was 68½ days.

As of mid-May, Georgia's Division of Family & Children Services said the number of kids in temporary placements has swelled to nearly 70, up from the 30s before the omicron wave of the pandemic.

"Many providers — foster families, kinship placements, and group home facilities — had to limit how many children that they could serve due to personal health concerns or COVID-19 workforce challenges," Candice Broce, commissioner of the Georgia Department of Human Services — the parent agency to DFCS — said in a statement.

She said the agency has provided temporary staffing to help solve the problem. State lawmakers put $31.4 million into the budget to bump up payments to foster parents, child placement agencies, and caregivers who are relatives of the children. DFCS has also recently offered a one-time $5,000 payment to providers who take kids out of a hotel or office.

Broce has argued that additional money would ultimately be a better deal for Georgia than to cover what she's called the "staggering" cost of keeping foster kids in a hotel. She estimated it costs about $1,200 a day to cover food and lodging and pay for often multiple staff members for each child.

Service providers and advocates say additional money will help but won't solve the problem.

"I don’t care if you pay a foster parent $500 or $100 — it’s not going to make their skill level or what they can do any better. They have to have the support," said Sally Buchanan, CEO of Creative Community Services, a nonprofit in Norcross, Georgia.

Buchanan specializes in finding homes for children who have had multiple placements in the foster system — sometimes as many as 20, she said. Many have never received adequate treatment for mental or behavioral health conditions. But even her nonprofit has limited capacity to help.

"It’s a pretty desperate situation, to be perfectly honest," Buchanan said.

Some of those children have ended up living with Joyce Shaheed in Fayetteville, Georgia. She estimates she's fostered more than 100 kids since 2007. A handful of them have come to her from hotels or offices.

"A lot of them come in with a lot of behaviors. And you just have to figure out what this child needs," she said.

If states took fewer children into custody, fewer would end up in hotels, said Richard Wexler, executive director of the National Coalition for Child Protection Reform. Building out the social safety net and making it easier to access those support services could keep some families together, he said.

"Get the children who don’t need to be in foster care out — and back into their own homes," Wexler said.

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Posted in: Child Health News | Healthcare News

Tags: Autism, Child Protection, Children, Coronavirus, covid-19, Depression, Food, Health Care, Mental Health, Omicron, Oppositional Defiant Disorder, Pandemic, Public Health, Research, Schizophrenia, Sleep, Trauma

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