Reports of abuse and neglect have increasingly rang alarm bells about the lack of oversight of children in residential behavioral health facilities. 

A new report from the Office of Inspector General (OIG) found that almost one-third of states fail to collect the information that could identify patterns of maltreatment among foster children in residential facilities. 

The other two-thirds of states, while able to report some information about maltreatment, often did not clearly indicate that they routinely monitored for patterns of maltreatment in residential facilities.

“This is the latest of several investigations – including my own – underscoring the failures of a system that is doing more harm than good,” Senate Finance Committee chair Ron Wyden (D-Ore), said in a statement. “The rampant abuse and neglect at youth residential treatment facilities will only continue until meaningful action is taken to strengthen oversight, raise the floor for standards in these facilities, and refocus federal dollars into community-based services.”

States also lack awareness about maltreatment across residential facility chains that operate in multiple states. Fourteen states could not provide data on maltreatment occurring among chains of facilities, resulting in limited oversight of these facilities. 

“​​Some of the States that did track patterns of maltreatment across chains of facilities reported taking actions including increasing monitoring activities, implementing corrective action plans, and reducing or ceasing placements in facilities within the chain, as necessary,” the report read. “In one case, a State reported that it terminated its contract with the parent company, ending the relationship with all facilities owned by that chain.”

Without increased tracking, states are unable to make changes to address systemic issues, the report noted.

While the report’s data pertains to residential facilities of any kind, many residential behavioral health facilities have been accused of systematically taking advantage of foster children.

The analysis comes less than a year after the publication of Mother Jones’ groundbreaking article detailing how Universal Health Services (NYSE: UHS)-owned North Star Behavioral Health and other residential facilities profited off of foster children by unnecessarily keeping them in the system for months or years. 

The article found that $611 million had been spent on the care of foster children at UHS psychiatric facilities. Mother Jones reporter Julie Lurie found several factors contributing to the lack of oversight, including the fact insurers do not closely surveil behavioral health services.

The OIG made several recommendations to increase oversight of foster children in residential programs, including that the Administration for Children and Families (ACF) should provide guidance and technical assistance to states on how to monitor maltreatment in residential facilities.

The report also recommended that the ACF take steps to improve monitoring of residential facility chains and improve inter-state communication to protect children placed in out-of-state facilities.