‘We’re On The Front Lines Too’: N.H. Youth Residential Facilities Prep For Pandemic | New Hampshire Public Radio

‘We’re On The Front Lines Too’: N.H. Youth Residential Facilities Prep For Pandemic

Apr 10, 2020

Nashua Children's Home is one of 13 residential facilities that contracts with the state to care for children involved with DCYF.
Credit Courtesy of Facebook/Nashua Children's Home

The state’s residential facilities and detention center for youth are modifying operations in response to the coronavirus pandemic, but some advocates say change isn’t coming fast enough.

As of April 1, about 350 young people were in residential facilities operated by 13 different providers across the state. About half of the youth are involved in the juvenile justice system; the rest were placed by child protective services.

State orders review of cases to send children home

Congregant care facilities are at a higher risk for COVID-19 transmission and outbreaks because of the close quarters shared by residents, and the challenge of quarantining sick staff and residents.

In March, the Division for Children, Youth, and Family, or DCYF, instructed residential facilities to shift nearly all in-person visits from DCYF staff, attorneys, and families to video and phone.

DCYF director Joseph Ribsam also directed staff to review all juvenile justice cases and determine whether children can go home, though the department has not issued any formal written guidance to this effect.

In the last three weeks, nearly 20 children have been discharged, and about 10 have returned home for extended visits.

The Sununu Youth Services Center, the state’ sole detention facility for youth, released five of its 20 youth this week.

Ribsam says this rate is slightly higher than normal, but the majority of court-involved youth will likely remain in facilities.

“Some of these youth have treatment issues that are just not remediated to have them safely return to the community without putting themselves and others at risk,” he said, “[The pace of discharge] is not incredibly fast because these decisions are hard to make, and we have to make sure that if youth are going home, they’re going to be safe there.”

Advocates ask for written guidance and updated safety measures

Some advocates say the state is not dealing with the risk in residential facilities with enough urgency.

“For better or worse, COVID-19 has changed our assessment on a number of things, and the health risks of close confinement in these facilities is legitimate and well-documented," said Robin Melone, president of the N.H. Association of Criminal Defense Lawyers, which sent a letter in March asking the state and courts to work to decrease the population of youth in residential facilities and at the SYSC.

 

“While it is true that children are largely not widely experiencing the lethality of COVID-19, we don’t want them sick when that can be avoided,” said Moira O’Neill, the director of the Office of the Child Advocate. “They also serve as vectors increasing risk to the staff in facilities that already struggle to keep adequate staff. The adequacy of staff implicates the safety of children on any given day.”

O’Neill says DCYF is “working hard” to ensure children’s safety, but she is still awaiting clarity on how juvenile justice cases are being reviewed. In some cases, she says, attorneys have reported “reluctance” from DCYF staff who are supposed to review a juvenile’s case.

Coronavirus gear and protocols vary by facility

DCYF has directed all residential facilities to follow CDC guidelines, but safety protocols for staff vary at residential facilities. At the Spaulding Youth Center in Northfield, incoming staff get their temperature taken at the beginning of every shift. All of them wear masks.

But at Nashua Children’s home, staff are still trying to get enough masks donated, and there was no procedure for temperature checks. Staff with symptoms were told to stay home.

In many facilities, some youth require intensive one-on-one support because of behavioral and developmental needs; for cases where youth need help eating or going to the bathroom or threaten harm to others, social distancing for staff and residents is impossible.

“There are many front lines. It’s not just the hospitals,” says Susan Ryan, the CEO of Spaulding Youth Center, which has 43 youth who live and go to school on campus. Some are court-involved; others are placed by school districts or child protective services.

“We’re on the front lines too. We don’t have a choice; most of my staff can’t work from home. When they’re picking up a child to toilet them and feed them, they’re not socially distancing.”

‘It’s taxing emotionally, physically and mentally on the best of days’

Staffing at residential facilities was a concern prior to the pandemic. Now, some worry that without good safety measures and higher pay, recruiting and retaining staff will become harder.

DCYF recently expedited a plan to increase rates to over half the state’s residential facilities. Susan Ryan used that to help pay for a $2/hour rate increase for employees during the pandemic. Still, she worries some may have to leave if they or loved ones become infected.

“What happens when we have a catastrophic staffing shortage?” she asks. “If I don’t have enough staff to do the work, what then? I’ll be begging for help and I don’t know what that help will look like.”

Spaulding runs a school on campus, but other facilities typically send kids to local public schools. Now, those facilities are tasked with overseeing remote learning.

At Nashua Children’s Home, which houses 36 kids who go to school in nearby districts, each residential counselor is now overseeing remote learning for about four kids, many of whom have learning disabilities.

“It's probably the challenge that a lot of parents have - residential counseling staff aren't teachers, and they're certainly not special education teachers,” director Dave Villiotti says. “[Their job] is taxing emotionally, physically and mentally on the best of days, and now even moreso.”

State and facilities developing quarantine procedures for incoming and infected youth

Since early March, the number of newly opened juvenile cases and facility placements has plummeted.  Ribsam says this is in part because courts aren’t hearing as many cases during the state of emergency, and because some police are less likely to bring charges during the pandemic.

Credit Courtesy of N.H. DHHS

But Ribsam says residential facilities and the Sununu Youth Services Center should expect to receive new residents before the pandemic is over.

Some facilities – including Easterseals’ Gammon Academy, Spaulding Youth Center, and the Sununu Youth Services Center – are developing a space to quarantine residents upon arrival or if they become infected.

But not all facilities have space to do so. Ribsam says the state is looking at how to stand up a facility that would serve youth in need of quarantine from a group home, or when transitioning from their family to a facility. He said this space would not be located in the secured wing of the Sununu Youth Services Center in Manchester.

Ribsam said this new quarantine facility should be a last resort and might be unnecessary if DCYF and the court system continue sending kids home.

“We want to make sure there’s flexibility and ensure there’s room in the system for kids who really need it,” he says. “Kids who maybe can be safe at home – we [should] take advantage of that and move kids from residential facilities to their homes.”