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Details of what the Office of the Child Advocate called “horrifying” abuse and neglect of two New Hampshire boys placed by the state in a Tennessee youth facility are behind legislation that would require the state to substantially increase its supervision of the children it places and limit those placements to New England as of January 2025.

The state Department of Health and Human Services has estimated it would need 30 new positions, 18 of them case workers, to meet the requirements in House Bill 1573 at a cost of about $5 million a year. The bill would also increase court hearings, a measure the state judicial branch has estimated would require nine new positions at a cost of about $1.5 million a year.

Children in abuse and neglect cases are placed in residential treatment facilities when their needs cannot be met by family, legal guardians, or other relatives.

The bill was heard Tuesday before the House Children and Family Law Committee.

Meanwhile, the state is defending itself against a federal lawsuit filed in 2021 against Gov. Chris Sununu and Department of Health and Human Services officials by New Hampshire Legal Assistance, Disability Rights Center-NH, ACLU New Hampshire, and the national advocacy group Children’s Rights. They allege the state is systematically and unnecessarily institutionalizing older foster youth rather than placing them in homelike settings within or close to their communities. The case is pending the outcome of mediation.

Currently four children of nearly 350 in out-of-state placements are in facilities outside New England, Department of Health and Human Services spokesperson Kathleen Remillard said Tuesday. Those sites are in Missouri, Arkansas, and Florida.

Of the remaining children, 264 are in New Hampshire and 81 are in New England, she said.

Child Advocate Cassandra Sanchez said the four children outside of New England is a drop from the approximately 20 children receiving services out of state when she reported the Bledsoe Youth Academy to Tennessee child protection officials and demanded the New Hampshire Department of Health and Human Services return them to the state.

Sanchez’s allegations against Bledsoe Youth Academy in Gallatin, Tennessee, included staff offering children incentives to assault other children; cameras in bedrooms that left little privacy to change; and kids with rug burns from being restrained face-down on a carpet. The two New Hampshire boys said they were threatened with retaliation for reporting the incidents to Sanchez and her team.

When officials at Bledsoe, a facility for boys 12 to 18, learned of the allegations, they told the boys they were being sent elsewhere, to a facility where gang members would harm them and kill their families, Sanchez told the committee.

In a September report recounting her findings, Sanchez said that while the Division for Children, Youth, and Families had been checking in with the two children at Bledsoe, it had not visited in person for a facilities evaluation before awarding it certification in 2021 or recertifying it in 2023.

Sanchez’s office and the department agree on “99%” of the proposed legislation, she said. Their disagreement is isolated to the nature of the state’s legal relationship with residential placement facilities.

Sanchez wants the state to contract with each facility, something it currently does with most but not all out-of-state sites. She told committee members a contract was the only way the state could hold a facility accountable.

Morissa Henn, deputy commissioner for the Department of Health and Human Services, said the state wants to maintain the contracts in place but be allowed to require certification for those sites when a child’s needs require a level of care an existing site cannot provide. She also told lawmakers contracting is a lengthy process that could interfere with providing a child timely care.

Each have requested amendments to the bill, which its sponsor, Rep. Mark Pearson, a Hampstead
Republican, introduced Tuesday for the committee to weigh. Aside from the disagreement over how to partner with sites, their amendments are virtually identical.

Under the bill, caseworkers would be required to visit the children in and out of state monthly, during which they would have to tour the children’s living area, talk with the children, and meet with the site’s leaders and staff.

Sanchez said she learned of the conditions in the Tennessee facility by taking those steps. She said seven different case workers visited the boys, all unfamiliar to the boys, and spent too little time to uncover the abuse and neglect. She said the state’s visits to children last 15 minutes.

Henn disputed that Tuesday.

“Just to correct the record, these are not 15-minute visits, where you pick up some pamphlets, as you just heard,” she said. “These are in-depth visits. We take them extremely seriously. We check on the youth under our care, we interview them. We have critical responsibilities serving often in the role of parents and in our obligations as a department. It gives me goosebumps to imagine the notion that we would do anything but the most robust protections.”

The department would also have to visit in-state and out-of-state facilities quarterly; at least one of those visits each year would have to be unannounced.

The bill would put new requirements on the judicial branch as well.

Courts would also have to review placements more frequently, from every 90 days as is now required to every 60 days. If the child or the child’s representative does not support the qualified residential treatment program level of care, those court reviews would be required every 30 days.

Prior to those hearings, the department would have to submit evidence to the court showing the residential placement continues to meet the child’s needs and provides the most appropriate level of care; placement with family or a legal guardian could not meet those needs; and that the placement is consistent with the short- and long-term goals for the child.

Before approving a placement, the court would have to determine whether the child’s needs could be met through placement with a parent, legal guardian, legal custodian, kin caregiver, or in a foster care home. Before approving a residential treatment placement, the court would have to review the specific needs of the child, the length of stay, and input from the child and the family.

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