San Antonio Express-News (Sunday)
Problems are found at shelters for migrant kids
Delayed medical care, belittling by staff cited
AUSTIN — A child who tested positive for a sexually transmitted disease wasn’t given treatment for more than two weeks.
Another was left alone in a bathroom for 15 minutes, during which time he harmed himself.
One staff member showed up to work drunk, while others belittled children.
State health regulators documented those and about 150 other standards violations at more than a dozen migrant children shelters across Texas run by Southwest Key Programs.
The nonprofit grabbed national attention last week when Democratic U.S. Sen. Jeff Merkley of Oregon tried to view conditions at one of its Brownsville shelters, but wasn’t allowed inside.
The federal government pays Southwest Key to take in thousands of unaccompanied minors, but Texas state health regulators license and inspect the shelters.
Deficiencies they documented over the past two years include children given food or medicine they were allergic to, lack
of timely medical care and inadequate supervision — leading some children to harm themselves.
A Southwest Key spokeswoman said the organization is proud of its track record and has taken action when needed.
“In the last 3 years, Southwest Key UM shelter programs have been evaluated for compliance on 73,292 standards and we are proud to say that less than one percent of those resulted in a deficiency,” spokeswoman Cindy Casares wrote. “However, we take each of the deficiencies seriously by self-reporting to invite external investigations as well as performing our own internal investigations. When called for, staff have been terminated or retrained as we continue to strive for excellence in the services we provide to the children entrusted to our care.”
The Texas inspection reports offer a rare glimpse inside shelters that are taking in children being separated from their parents along the U.S.-Mexico border under the Trump administration’s “zero tolerance” policy.
In May, more than 600 families were separated at the border, the Homeland Security Department reported.
Southwest Key Programs is one of the largest operators in Texas, running 16 of the 35 shelters that contract with the federal Office of Refugee Resettlement, according to state data.
As of last month, Southwest Key shelters housed nearly 2,600 unaccompanied children. The largest, at a former Walmart in Brownsville and known as Casa Padre, held more than 1,000 kids as of mid-May, state data showed.
At Casa Padre, the shelter Merkley tried to enter, the state documented 13 licensing deficiencies over the course of 22 inspections within the last year.
In mid-September, a resident tested positive for an STD, but the medical coordinator failed to follow up with treatment and the child didn’t get care until October 3, state inspection records said. Last summer, state officials found a shelter employee “made a belittling remark towards a child in care in the presence of other children.”
Casares said Southwest Key self-reported both instances to state regulators.
“According to the Texas DFPS website, 6,655 standards have been evaluated for compliance at Casa Padre since it opened. Of those, 13 or 0.195 percent resulted in deficiencies,” she said. “While we always strive for perfection, we are extremely proud of our compliance record and use every visit as a chance to work with our licensing partners to improve our programs and practice to ensure the highest quality of care for the children we serve.”
Southwest Key operates 27 immigrant children’s shelters across Texas, Arizona and California, according to its website.
Under a four-year contract with the U.S. Department of Health and Human Services, Southwest Key is being paid more than $400 million to care for unaccompanied minors who are apprehended by federal authorities.
Once sent to a shelter, the children are then placed with relatives or put into a federal foster care system. The process is overseen by the Office of Refugee Resettlement, which did not return a request for comment.
Children who arrive at the U.S.-Mexico border often are fleeing violence or natural disasters in their home countries and have experienced significant trauma, said Jodi Berger Cardoso, Assistant Professor at the University of Houston’s Graduate College of Social Work.
“What my research has shown is that many kids, on average, are exposed to at least eight extreme traumatic events in their life,” she said. “We have found as many as 60 percent of kids are symptomatic for post traumatic stress disorder.”
The majority of unaccompanied minors who arrived in the U.S. last fiscal year were over age 15, and nearly 70 percent were male, according to data from the Office of Refugee Resettlement. On average, the children spent 41 days in a shelter last fiscal year.
Southwest Key shelters in Texas took in more than 11,110 minors during the 2017 fiscal year, which ended in September.
Since then, the organization said its Texas shelters have served more than 11,900 unaccompanied minors.
A Hearst Newspapers investigation in 2014 found that unaccompanied minors quietly suffered sexual and other abuses in shelters. A federal records request turned up 101 “significant incident reports” from March 2011 to March 2013 involving abuse allegations against staff members in shelters across the country.
Texas child care licensing investigators documented no instances of sexual or other child abuse at Southwest Key shelters over the past two years.
They did find, however, that staff gave children the wrong medicine and did not seek timely treatment. One child was given Tylenol in March, despite wearing a red bracelet showing she’s allergic. Another sustained a wrist fracture, but didn’t see a doctor until three days later.
In other cases, the state noted staff belittled children or left them without supervision.
Last year, workers at the Nueva Esperanza shelter in Brownsville wouldn’t let one youth use the restroom, even after the child asked repeatedly. In another case, “a supervisor did not exhibit prudent judgment and escalated a resident while she was having a crisis resulting in the resident self-harming.” One employee was found to be “over the legal limit of alcohol” when he showed up to work at a Southwest Key shelter last year.
Casares said the organization reported all those instances to state regulators and launched internal investigations.
In many cases involving staff deficiencies, Casares said employees “were subject to discipline, including employment termination,” while some others were retrained. She did not specify which action followed each specific deficiency.
“We take all medical errors extremely seriously at Southwest Key. After any reported medical error, Southwest Key investigates the situation as well as the relevant staff member(s) to determine appropriate next steps,” she added.
Will Francis, government relations director for the Texas chapter of the National Association of Social Workers, said staff likely need better training in social services and trauma-informed care.
“Kids who made the trek to our border have probably experienced things that are going to require medical care,” said Will Francis, government relations director for the Texas chapter of the National Association of Social Workers. “Medical needs being neglected for kids in shelters is, I think, an issue.”
The Office of Refugee Resettlement also inspects the shelters and is supposed to conduct site visits each month and at least one monitoring visit every two years, according to policy. It’s not clear what issues, if any, federal inspectors found at Southwest Key shelters.
A former U.S. Health and Human Services official said it’s important to know whether state inspection records are being relayed to federal overseers.
“The biggest questions for the ORR side are were they aware, and if so what did they do?” said Mark Greenberg, now a Senior Fellow at the Washington D.C.based Migration Policy Institute.
Earlier this year, the Office of Refugee Resettlement opted not to renew grant funding with migrant children shelters run by International Educational Services, the Brownsville Herald reported. Officials wouldn’t disclose their reasoning at the time. State inspection reports documented violations including sexual behavior and a staff member having “inappropriate contact” with a child.