EAST PROVIDENCE, R.I. (WPRI) – When a child or teenager is admitted to the adolescent program at Bradley Hospital, they typically stay for six to nine days.
But at least 20 people affiliated with Rhode Island’s child welfare agency have been living at the East Providence psychiatric and behavioral care facility for much longer – sometimes for months – in part because state officials say they can’t find anywhere to send them after treatment. And while stuck in limbo, the student-aged children receive no formal education, meaning some go months without school.
“It’s inhumane,” Paul Chaput, a behavioral health specialist in the hospital’s adolescent program, told Target 12.
“We’re talking about kids’ lives and futures here that are at stake,” he said. “If they’re not getting educated, they’re going to fall behind their peers and the likelihood that they’re going to have a better future decreases.”
Children stuck at Bradley without education isn’t anything new, Target 12 discovered after multiple interviews with hospital workers, administrators, advocates and local school district superintendents, along with state officials at the R.I. Department of Children, Youth and Families.
For years the adolescent program has been a place where DCYF teenagers have had to live for extended periods of time while awaiting placements. But state officials claim the situation has grown worse during the coronavirus pandemic, because openings in foster families and group homes are even scarcer than usual.
“Children who are admitted to Bradley Hospital receive the necessary treatment for their acute conditions until a safe discharge plan is available,” DCYF spokesperson Sean McFarland told Target 12. “During the COVID-19 pandemic, several youths have been ready for discharge from the facility but are awaiting appropriate discharge placement.”
‘Locked in a facility’
Bradley was founded in 1931 as the nation’s first psychiatric hospital exclusively for children, and today it’s recognized as a key community resource for Rhode Island children and teenagers in need of mental health care.
But Chaput argues the facility wasn’t designed to house DCYF-affiliated children who have completed their treatment programs and need to move on with their lives. Many of the teenagers and children in the adolescent program — some as young as 11 years old — have been there since September or October, but a few have been there longer.
At least a couple have been there since the beginning of the year, he said.
“There’s no reason why a kid should be locked in a facility for that long,” Chaput said. “These kids need to move on with their lives so they can be successful.”
Chaput, who’s been employed at the facility for about a decade and now works on a per diem basis, said he’s concerned nobody is advocating for these children, so he raised the issue with both DCYF and Gov. Gina Raimondo earlier this year. He also contacted the R.I. Office of the Child Advocate.
“Would you want to keep your child locked up in a hospital facility for between 1 and 11 months?” Chaput wrote to the governor in a letter dated July 4. “Would you not educate your child for 1 to 11 months?”
His call for action evoked some response. Chaput said DCYF officials met with him to hear his concerns. But he said the discussion was filled with excuses and finger-pointing, and the inaction that followed spurred him to speak out publicly.
“The kids have to have a voice,” Chaput said.
R.I. Child Advocate Jennifer Griffith, whose office oversees DCYF operations, said the state is aware of every child who’s in the hospital and all issues are being addressed as they arise.
“We are aware of the issue, we are dealing with it and we are trying our best in this challenging time to assess how education has changed dramatically over the last nine months,” Griffith said. “It’s a challenge.”
She pointed to soaring demand for psychiatric and behavioral treatment among children during the pandemic, as the public health crisis has taken an increased toll on the mental health of Rhode Islanders across age groups. The heightened demand, she said, makes post-treatment placement more challenging.
Griffith also disagreed with the characterization that children were getting “stuck” at Bradley, though she described the pattern of children having to live at the hospital after treatment as “not ideal.”
The placement challenges complicated by the pandemic were echoed by Kathleen Hart, a spokesperson for Bradley parent company Lifespan, who said demand for Bradley services is always high.
“Patients with severe or acute needs may require a high level of support or specialized services that, if unavailable, can delay discharge, and in some cases the COVID pandemic has exacerbated this challenge,” Hart wrote in an email.
DCYF declined a Target 12 request to interview the children under state custody currently living at the hospital, saying it isn’t allowed in part because of “confidentiality requirements.”
When asked whether any of the children are receiving education, McFarland didn’t answer, saying instead local school districts bear that responsibility. Pressed for an answer about whether it was DCYF’s job to ensure the children receive education – regardless of who provides it – McFarland again pointed elsewhere.
“Actually, the hospital has the responsibility of working with the education advocate (the parent or appointed advocate) and the school district to arrange for tutoring while the child is in the hospital,” he said, adding that “not all youth in the hospital are clinically able to have tutoring or to take part remotely in schooling.”
‘We are now aware’
The 22 children at Bradley either under DCYF custody or participating in agency programs as of last month came from at least 16 different school districts across Rhode Island.
Target 12 reached out to the superintendents in each of those districts to ask whether they knew their students were at the facility and why they weren’t receiving any formal education.
Only six responded, and all but one declined to comment on the placement of their students. In Providence, where the R.I. Department of Education took over the school system last year to attempt a turnaround, a spokesperson said the district became aware it had students at Bradley after being contacted by Target 12 and is now making educational accommodations.
“All of our students matter,” spokesperson Laura Hart said in a statement. “We do all we can to put students first, and we are committed to improving our proactive outreach so that there is minimum disruption of educational service delivery. We are now aware of two students involved with Bradley Hospital and are making provisions for them to receive educational services.”
In North Providence, special education director Cynthia VanAvery said in an email that the district wouldn’t comment on the placement of any student “or the resources they receive,” but insisted every student was receiving “free and appropriate education as required by federal and state law.”
When asked for the policy to back up her claim, VanAvery did not respond and instead repeated her original statement.
In Lincoln, Superintendent Lawrence Filippelli said the district knows when students are at Bradley, and that the district works with families and the hospital to support educational planning on a case-by-case basis. But Filippeli left the door open when asked whether anyone was actually receiving any formal education.
“At this time and to our knowledge, Lincoln has not denied any educational service to any Lincoln student in a hospital setting,” Filippeli wrote in an email. “That said, my team and I have only been in Lincoln since July 2018.”
Johnston Superintendent Bernard DiLullo offered a slightly different response, saying the district doesn’t send teachers to the facility, but rather pays the hospital to provide tutoring services. DiLullo said Johnston in April was billed for 1.5 hours of educational services at a rate of $41 per hour.
Similarly, Cranston Pupil Personnel Services executive director Michele Simpson told Target 12 the district sometimes only learns that a student is admitted to the hospital because it gets billed by Lifespan School Solutions Inc., a division of Bradley’s owner.
A Lifespan spokesperson did not respond to a request for comment on what services were billed to Johnston last spring.
When asked about it, Chaput insisted there hasn’t been a tutor in the adolescent program for multiple years. But he said some tutoring could have been provided in a separate program, as the facility has about 70 beds, and it provides services to other age groups – along with children and teenagers with no affiliation with DCYF.
Ultimately, Chaput argued, it is not the hospital’s responsibility that the children receive education, especially after the treatment is completed.
“The hospital was providing a tutor [in the adolescent program] I’d say maybe four years ago for a little bit, and since then it hasn’t happened,” he said. “But once again, it was the hospital providing the tutor, it wasn’t the school district.”
Target 12 has since confirmed that the hospital had a part-time tutor in the spring, but that the person left during the first wave of the pandemic and the position has since gone unfilled.
Among the remaining school districts with DCYF students at Bradley as of last month, West Warwick declined to comment, while the rest — Burrillville, Bristol-Warren, Central Falls, Cumberland, Newport, North Smithfield, Pawtucket, Warwick, Westerly and Woonsocket — did not respond to requests for comment.
‘This is not OK’
When asked about the responses from the school districts and state officials, Chaput said he didn’t buy the argument that the current situation can be blamed on the pandemic.
He acknowledged things have become worse over the last nine months, but he said children have been stuck at the hospital without formal education for years and action is long overdue.
“The kids’ livelihoods are worth it,” he said.
For the most part, the others interviewed for this story did not share in Chaput’s sense of urgency. But Griffith said the demand for Bradley services could become less pronounced in the coming years, pointing to a proposal in the governor’s fiscal 2020-21 budget for two new female residential treatment programs for DCYF children in need of psychiatric care.
“I think they would alleviate a lot of the issues we have right now at Bradley Hospital,” Griffith said Wednesday afternoon.
However, that proposal isn’t new. The state issued a request for information in the 2017-18 fiscal year after identifying two state-owned buildings that might serve as residential facilities for DCYF children and teenagers currently living in out-of-state group homes.
The buildings were later “deemed non-feasible,” according to budget documents, because they would have required “significant renovations,” and the state still hadn’t identified an alternative by the end of 2019.
As a result, Raimondo in January proposed $3.2 million to go toward opening a new facility by January 2021, writing in her budget that the new plan would be to “work with providers who would use their own facilities,” even though no provider had yet been identified.
State legislative leaders, who would have normally finalized the budget idea last spring, punted all decisions until this week when the House Finance Committee approved a $12.8 billion tax-and-spending plan on Wednesday night.
The lawmakers made no specific adjustments to the governor’s proposal regarding female psychiatric placements, but noted they had identified about $2.2 million in savings because placements were lower than projected through the first five months of the fiscal year, which started July 1.
Griffith acknowledged the progress toward opening new psychiatric facilities has been slow, but she remained bullish that moving the governor’s proposal forward could help the state’s child welfare agency and the children and teenagers in its custody.
“That’s no fault of DCYF that the coronavirus halted the work of the State House,” Griffith said about the length of time that’s passed since the project was proposed, noting the budget would be heard on the House floor next week. “I’m certainly hopeful that that request will be granted.”
As for Chaput, he’s hopeful that raising awareness about the situation at Bradley could help spur lawmakers into pushing for change.
“Someone has to step up to the plate and say, ‘This is not OK,’” he said. “What can we do as a community to fix the problem?”