“When you help a child today, you write the history of tomorrow.”
- Father Edward J. Flanagan, Boys Town founder
Throughout Boys Town’s more than 100 year history, one of our most important guiding principles has been to always do what is in the best interests of children and their families so they have the greatest opportunity to find healing and success.
Boys Town believes that at-risk youth should be served in their own homes or in foster care whenever possible – currently 90% of the youth who receive Boys Town services do so in their own families or in family-like settings.
However, we also believe in and advocate for quality residential care because there will always be children who need more intensive care and treatment for the challenges they face each day. Quality residential care also provides educational and skill-building opportunities that do not exist within many communities. Research and practice demonstrate that quality residential care is an essential component for any continuum of care for at-risk youth.
But residential care has come under attack recently by some policy advocates and system reformers who argue that it should be reduced or eliminated as an out-of-home placement option for at-risk youth. These critics do not differentiate between poor-quality and high-quality residential care, and contend that residential care:
· Traumatizes children and families
· Produces poor outcomes
· Is expensive
Some of these critics also say foster care and family-based programs are better equipped to meet the needs of these children. We dispute these arguments because they are not supported by research and practice, and do not pertain to all residential care. The vast majority of the children that leave our programs graduate from school and go on to become productive citizens.
Boys Town contends that:
· High-quality residential care has been effective for youth with high needs, especially those who have repeatedly been failed by attempts to help them in less-restrictive interventions like family-based or in-home services and foster care.
· Less-restrictive approaches cannot meet the needs of all youth, particularly those with serious behavioral or emotional problems.
· Foster care disruption rates range from 28%-57% during the first 12-18 months of placement, leading to multiple placements. These placement failures require children to adjust to multiple new schools, increase emotional and behavioral problems, and can result in increased trauma.
· Although quality residential care may be costly in the short term, it results in long-term personal and economic benefits for youth, their families and society.
· High-quality residential care often has the capacity to keep sibling groups together, causing less trauma for children who had to be removed from abusive and unsafe situations.
What Is High-Quality Residential Care?
Quality in residential care encompasses a combination of criteria. There are generally acknowledged “performance standards” that any quality residential program should meet. These include:
· Safe environments for children
· Effective and evidence-based practices
· Positive, lasting outcomes
· Program elements and a clearly defined model of care
· Normative experiences such as family-style living, normal schooling and involvement in extracurricular activities
The Boys Town Family Home Program® is a prime example of quality residential care. Derived from the evidence-based Teaching-Family Model, it is also the most researched model of residential care in the United States.
The Boys Town Family Home Program includes the following elements:
· Multiple layers of safety systems
· Positive short-term and long-term outcomes
· Structured training and supervision
· Evidenced-based
· Normalized family settings
· Reunification and permanency planning
· Trauma-informed approach
For youth who successfully complete quality programs with these elements, long-term financial and social benefits include:
· 77% or more are arrest-free
· 90% or more graduate from high school (compared to the typical graduation rate of 50% in foster care)
· There is the potential to save $198 to $340 per child in long-term societal costs for every dollar spent on residential services
· 80% or more have a grade point average of 2.0 or higher while in school
Conclusion
· Quality residential care is an essential element of any continuum of care and, when needed, can be the treatment approach of choice.
· The critics ignore research that shows that quality residential care is the best option for a subset of at-risk, high-needs children whose treatment needs cannot be met through less-restrictive approaches like foster care and family-based or in-home programs.
· Eliminating or reducing quality residential care is not the answer to cutting costs, reforming the child welfare system or providing necessary care for youth with high needs. Doing so may deprive youth from receiving the services they need, at the right time, in the right way. Providing youth with the right level of care, at the right time, with quality services is what these children need and deserve in order to give them the best chance for success.
· Some residential care – just like some foster care – does not measure up to the high standards of quality we require of our programs. Such programs should be closely scrutinized to determine if they can be improved enough to achieve the quality standards needed to raise healthy and productive children or if they should be closed.
To read more about high-quality residential care, check out “Why Quality Residential Care Is Good for America’s At-Risk Kids: A BOYS TOWN INITIATIVE.”
