Michigan moves forward with ongoing reform of child welfare system July 16, 2020

MDHHS issues rules to restrict restraint of youth in facilities, releases recommendations from national experts to improve oversight

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) is stepping up its ongoing efforts to reform the state’s child welfare system by introducing new measures that better protect the safety and well-being of youth in foster care.

MDHHS today announced emergency rules for restricting dangerous restraints of children in child-caring institutions while the department works toward its goal of barring restraints from facilities that serve youth in the state’s foster care system. Gov. Gretchen Whitmer concurred in MDHHS Director Robert Gordon’s finding of an emergency regarding current restraint procedures.

“Protecting our most vulnerable populations, whether it’s during a global pandemic or not, is a top priority for me,” said Gov. Whitmer. “Stepping up our efforts to protect kids in foster care will help us ensure all children in our state are treated with humanity and respect. I will continue to work closely with Director Gordon and everyone else who wants to ensure Michigan kids have the care and support they need in foster care.”

In addition to the new rules, the department released recommendations from national experts – received at MDHH’S request – that are aimed at ending the use of large-scale institutional care for children. The department’s actions follow the May 1 death of a 16-year-old child after he was wrongly and improperly physically restrained by staff at Lakeside for Children, a child caring institution in Kalamazoo.

“Restricting restraints is an important step, but the ultimate goal is to reform the system so young people get the care they deserve,” Gordon said. “The best way to improve is to learn from best practices around the country, and so I am grateful to our national partners for sharing their advice. We are listening with care.”

JooYeun Chang, executive director of MDHHS’s Children’s Services Agency, said there is no time to waste in continuing reform of the child welfare system that is already underway.

“Over the last year, MDHHS has expanded its prevention efforts to reduce the need for placing children in foster care,” Chang said. “Children should be raised by families. When foster care is absolutely necessary to keep kids safe, we have worked to place more children in family-like settings rather than in residential facilities. If we must place children in child-caring institutions, it should be for therapeutic purposes to meet the child’s individual needs, and it should be for a limited amount of time. Using restraints is not a therapeutic or caring way to address behavioral issues. It’s been overused, and it can be dangerous. That is why our goal is to eliminate this practice and put restrictions in place until we can do so.”

The rules immediately prohibit child-caring institutions licensed by the state from using particularly dangerous prone restraints – which involve placing children face-down while they are being restrained – and any other restraint that restricts breathing. The rules limit the duration of restraints and circumstances when restraints can be used, and requires timely notification to families and to MDHHS when any restraint is used.

Recommendations released today are from three nationally renowned child welfare organizations, led by the Annie E. Casey Foundation in partnership with Casey Family Programs and the Building Bridges Initiative.

Among the recommendations to improve oversight of the safety and quality of child caring institutions that serve children who are in foster care are:

• Eliminating the use of coercive restraints in child-caring facilities, replacing the practice with interventions that follow national best practices and are therapeutic – meaning that they will help children recover from trauma they have experienced. Recommendations also call for removing seclusion as an intervention for addressing behavior problems.
• Engaging youth and families in conversations about how to improve child-caring institutions.
• Improving MDHHS oversight of the facilities through its licensing and contract processes.
• Improving the reporting and management of data.

The report also says that MDHHS should limit the frequency of and lengths of stay in residential placements. “Today there are 876 children in residential settings – an 18 percent decrease from this time last year,” Chang said. “I am happy that we have made progress, but we must do better for our children and our families.”

Another area of concern MDHHS is working to address is the  overrepresentation of children of color in child-caring institutions.

“National data show that teenagers of color are much more likely than other children to be placed in institutions and group settings when they enter foster care,” said Sandra Gasca-Gonzalez, vice president for the Annie E. Casey Foundation’s Center for Systems Innovation. “It is time to walk away from outdated child welfare practices that force children and young people to grow up in facilities. Systems must move with urgency to embrace safe, equitable, family-focused approaches so young people thrive.”

MDHHS has already terminated its contracts with Lakeside and suspended Lakeside’s license while going through the legal process of revoking its license. The Lakeside youth who died was restrained by staff for 12 minutes for throwing food. Video shows staff members laying across the child’s upper torso during the restraint.

The MDHHS emergency rules and the recommendations from national experts can be found on the department’s website. Please note that the recommendations may not be posted on the website until later today.