Mialissa Florez was sent from San Diego to the Youth for Tomorrow residential facility in rural Virginia in 2018. / Photo by Adriana Heldiz

A May 11, 2020, press release from San Diego County’s probation department announced that two teens, one of whom had tested positive for COVID-19, were being returned to San Diego from a Michigan treatment program and placed temporarily in a juvenile detention facility. 

The Michigan program, unnamed in the press release, had been deemed “no longer a viable placement option for youth under the jurisdiction of the San Diego County Probation Department.” 

What it didn’t say is that on April 29, staff at the Michigan program had restrained a young man, 16-year-old Cornelius Fredericks, until he stopped breathing. Fredericks had thrown a sandwich in the cafeteria. Fredericks, who was from Michigan, died two days later. 

His death sparked chaos at the facility, Lakeside Academy in Kalamazoo, including what officials described as “a race riot.” Roughly a quarter of the kids at Lakeside, operated by the Alabama-based, for-profit residential treatment provider Sequel, tested positive for COVID-19. 

San Diego was one of at least seven California counties that scrambled to bring kids home from Lakeside. Seven months later, they’d be told that they needed to bring all youth who’d been sent out of state — some of the county’s most difficult cases — back to San Diego amid a massive decertification of treatment programs that had been found to be abusing their young clients. But state records and interviews with youth and experts raise the question of whether these kids needed to be sent away in the first place. 

Following Fredericks’ death, The Imprint — an independent news outlet focused on child welfare and youth justice systems — and The San Francisco Chronicle started looking into incidents of abuse that children suffered or witnessed in privately-run, out-of-state facilities, revealing that the California Department of Social Services knew of reports that youth at Sequel-run facilities had been slapped, punched and choked by staff. 

On Dec. 9, presented with reporters’ findings about conditions at the facilities, the California Department of Social Services ordered all children placed out of state to be returned to their home communities. The department also decertified all out-of-state programs, regardless of the provider. The swift action gave county probation and child welfare agencies 45 days — amid the harrowing winter coronavirus surge — to find new homes and treatment programs.

Problems were seemingly everywhere. The facilities violated dozens of rules, inspection reports showed, creating environments that were more punitive and jail-like than therapeutic, with restrictions on everything from phone calls with loved ones to using the restroom.  

Last month, Gov. Gavin Newsom signed legislation that banned out-of-state placements and provided counties with more than $100 million to develop locally based programs. 

‘Placements of Convenience’

Before it became unlawful, California officials sent hundreds of vulnerable children each year to residential treatment programs as far-flung as Wyoming and Florida. 

They were kids who the courts, social workers and probation officers decided were too troubled to place in family foster homes or in local group facilities. Their behaviors were so unsafe and mental health issues so severe, local officials determined, their needs could not be met anywhere in the state, which has some of the nation’s most innovative social services. 

By the end of this past January, more than 130 children, including 13 from San Diego, had been brought back to California from out-of-state programs. More than three-fourths of these children — who had previously been deemed impossible to treat in California — ended up in local treatment programs or the homes of relatives or foster families, according to figures published by the Department of Social Services.

The largest share of youth who returned from other parts of the country, roughly one-third, were placed in state-licensed and regulated short-term residential treatment programs. The local facilities are a step down from in-patient psychiatric hospitals, providing around-the-clock supervision and treatment for mental and behavioral health issues. 

“There were some young people that never needed to go to another state,” said Ken Berrick, founder and CEO emeritus of the Oakland-based Seneca Family of Agencies, which serves thousands of California foster youth. “There were resources in the state that could have accommodated them, but they got sent out of state for less than optimal reasons.” 

Jennifer Rodriguez, executive director of the San Francisco-based Youth Law Center, wrote in a May letter to Gov. Newsom and legislative leaders that kids had been sent out of state as “placements of convenience.”

This is precisely how Mialissa Florez feels about being sent from San Diego to the Youth for Tomorrow residential facility in rural Virginia in 2018 — that she was shipped away for being “one of the bad kids” who repeatedly ran away from local group homes. 

“It has nothing to do with the treatment that they offer elsewhere, and it’s like it has everything to do with the kid themselves,” Florez, who’s now 20, said in an interview. 

At Youth for Tomorrow in Bristow, Va., where Florez spent a year, state documents show that staff relied on “improper” discipline, which included requiring youth to submit to random drug testing to participate in activities, and cancelling home visits “as a punishment to modify behavior.” California officials found that unwarranted physical restraints lasted longer than permitted and that the methods were deployed at times with excessive force that caused injuries and bruising.

Reports from other facilities where San Diego County sent kids were equally disturbing. At four Rite of Passage facilities in Nevada, inspectors found staff used restraints with “minimal or no use of de-escalation interventions,” and allowed inappropriate sexual contact between youth. At a Devereux Advanced Behavioral Health campus in Viera, Fla., violations included staff using physical force, “instigating youth to act out” and denying access to food and restrooms. Staff at Woodward Youth Corp. in Iowa were also found to have used excessive force on children that “caused injuries and bruising.” 

Probation department spokeswoman Yvette Urrea Moe said officials were not aware of the issues with the out-of-state programs.  

“We do not receive notification regarding every violation at a program, only when it concerns our youth,” Urrea Moe. “Our staff conducted monthly visits at the programs and any concerns that we may have had were addressed with the state and the facility.”

Florez said that during her stay at Youth for Tomorrow, she felt like she didn’t have an advocate. “I was so lonely, I can’t even explain how that feels. It’s just like emptiness in your chest and your stomach and you can’t do anything about it.”

Describing physical restraints, the once-a-week phone calls she was allowed, and only a few off-campus trips over the course of a year, Florez said the experience made it hard to ever again trust her caregivers. 

When Florez heard her peers were pulled from similar placements late last year, she was happy for them, but felt a surprising pang of jealousy, a feeling like, “You should’ve took me out when I was there!” 

A ‘Tremendous Success’?

According to state reports, as of Aug. 10, more than 20 percent of kids who’d returned to California from out-of-state programs ended up in juvenile detention facilities, ran away or were reported missing. Some ended up in temporary youth shelters because an appropriate placement couldn’t be found. 

Of the 13 San Diego kids, three ended up in juvenile hall. 

In April, Donnie Ryan, then a spokesman for the county probation department, said the three youth had been doing well in out-of-state programs, with their conditions improving: They’d begun engaging in therapy, were “on track” and “would have benefited from continued time in the program.”

But when they returned to San Diego County — two to their homes and one to a residential treatment program — “the negative behaviors escalated,” Ryan said, and officials decided they had to be locked up again. He added that “they were not in juvenile hall as a result of the removal from out of state but as a result of subsequent behavioral needs.” 

The rest of the kids from San Diego ended up in a residential program, foster care or with family or relatives.

In a public meeting in Sacramento in March, a state official declared efforts to find in-state placements a “tremendous success.” But local probation and child welfare officials maintain they’re still competing for scarce vacancies, and they describe the transition to keeping all kids closer to home as anything but easy. 

California still lacks treatment programs willing to accept youth with histories of physical or sexual aggression and those who’ve repeatedly run away. 

“We have seen a steady reduction of available placement resources over the last several years,” said San Diego County Deputy Chief Probation Officer Lisa Sawin. “Thus, we have occasionally depended on out-of-state placement options in the past, particularly for higher needs youth who were not successful in in-state placements.”

Sawin said counties compete for limited beds, but San Diego is “actively working to expand our list of potential care providers.” 

In recent years, reforms to California’s child welfare system have focused largely on reducing the use of group homes and placing most youth in residential settings only when they are short-term and offer quality treatment. As a result, many providers have opted to close rather than adapt to higher and more costly new standards

A recently approved statewide pilot program will create additional levels of care for California children in acute mental health crises, including those who may be dangerous to themselves and those around them — the types of children who historically have been sent out of state. The five-year project, set to launch next year, will establish “crisis continuums,” providing everything from 24-hour mobile response units to additional in-patient psychiatric beds. Regional teams of professionals will respond to youth in crisis, assigning them care and treatment staff based on individual needs. 

Berrick, the Seneca Family of Agencies CEO, helped design the program. He said it will allow for a more holistic approach rather than providers simply filling congregate care beds to cover costs. 

Though California is equipped in many ways to care for many of the youth who had, in the past, been sent far from their homes to so-called “placements of last resort,” Berrick said the state is still failing to meet their mental health needs. 

“There’s still times when we get caught flat-footed,” he said, “because we simply don’t have the resources.”

A version of this story was originally published by The Imprint, a national nonprofit news outlet covering child welfare and juvenile justice.

Kelly Davis is a freelance journalist focusing on criminal justice and social issues. Follow her on Twitter @kellylynndavis or send an email to kellydaviswrites@gmail.com

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