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NH’s Child Advocate says recent bill is critical in getting more protection for children in residential care

Office Of The Child Advocate / Issue Briefing

The exterior of the Bledsoe Youth Academy in Tennessee

A bill in the New Hampshire House aims to strengthen oversight of children placed in out-of-state residential facilities.

The proposal follows reports filed last year by the Office of the Child Advocate that detailed abuse and neglect at Bledsoe Youth Academy, a Tennessee facility where two New Hampshire boys were placed, then removed, by the state.

NHPR’s All Things Considered host Julia Furukawa spoke with Child Advocate Cassandra Sanchez about the bill and what it could mean for New Hampshire children.


Cassandra, we have residential facilities here in New Hampshire, but children are placed out of state sometimes. Why is that?

A multitude of reasons. We always try to exhaust all services here, first. Ideally, we would love to see all of our children remaining in the community and receiving those community based services and not needing that higher level residential. But when they do, they're referred first to our in-state programs.

What that child's unique needs are can absolutely be a reason why they may need to be sent out of state. There are some program-specific treatments that we don't have in New Hampshire, and so we may have to go out of state looking for that.

It can also be bed availability. Currently, what we've been seeing for quite some time now, since COVID, is staffing struggles in our residential facilities. [Such as] having empty beds while they wait to hire additional staff. And so that leads to them, if they can't fill their beds, where else are our children going to go? They're going to start going out of state.

Let's talk about your visit to this residential facility in Tennessee. What did you see there?

It was horrifying. It really was. Just seeing the way in which the staff interacted with the children. It was not playful. It was not uplifting. It was not supportive in any way. Children really were quite reserved, quiet, following orders of staff that were directing them. It just, it wasn't like anything I had ever seen before, and especially to be able to meet with children from New Hampshire who I had met prior and seen them in another setting, it was a very different presentation. You could really see the fear in their eyes, the worry to speak to us. And we did work to ensure that we could find a confidential space to speak with them so they could share with us openly. But even initially, when sitting down with them, there was a lot of hesitancy to open up.

How does this bill address your concerns and what you saw when you visited the facility?

What this bill does is it enhances the oversight of our agency that certifies these facilities. So the ones that should be going in and looking at the physical space, the programing, [and] asking questions of the director, the treatment team.

And what we learned, in coming home from Bledsoe and sharing our concerns with the state, was that they hadn't been there in person. So they had some of these conversations virtually. They collected materials such as resumes and brochures from the facility, but they weren't there in person. They weren't there to walk around the facility to talk with children themselves, to experience what it is like a day in the life of a child in that facility. As well as, [they didn’t do] what they would typically do during a certification visit, [which] would be to pull some files, take a look at what treatment looks like for a child, what incident reports look like, [and] get a better understanding of that.

We went there blind. We weren't getting any incident reports from them. If we had received reports from there, we would have had those red flags sooner, and we would have brought this concern forward to the agency before even stepping foot out there.

What else needs to be done?

For us, it either needs to be spelled out explicitly in this bill, or there needs to be some clarity from DHHS [Department of Health and Human Services] around who is the entity that will be holding facilities accountable.

We're not looking to shut down facilities. We're not looking to take our kids out of all of these facilities—a facility like Bledsoe, absolutely—but the facilities in our state that have some room for improvement, we're looking for them to make those improvements.

And so, that's a core piece for us, that we're looking to DHHS to say, how can you support them, but also ensure that our residential facilities are providing adequate care for our kids and if not, coming up with a plan to address it? So we're not just talking about the same problem years down the line.

Michelle Liu is the All Things Considered producer at NHPR. She joined the station in 2022 after graduating from Northwestern University with a degree in journalism.
Julia Furukawa is the host of All Things Considered at NHPR. She joined the NHPR team in 2021 as a fellow producing ATC after working as a reporter and editor for The Paris News in Texas and a freelancer for KNKX Public Radio in Seattle.