Understanding Institutional Abuse

Institutional Assessment Specialist, Joey Brozek works for the Office of Children, Youth and Families Division of Child Welfare and examines child welfare practice related to institutional abuse assessment within most settings where children are being cared for outside of their homes other than schools. Joey is the chair of the Institutional Abuse Review Team, one of three citizen review panels providing oversight to ensure that all institutional assessments that have been completed are thorough. Joey has more than 20 years of experience working with young people in care including Division of Youth Services facilities, residential treatment facilities and group homes. 

Tell us more about your role and experience.

I have a good understanding of the training individuals get, what the expectations around training are as well as the impact restraints can have on an individual. Currently, I have a lot of collaboration with outside organizations including foster care providers, stakeholders and non-county partners to look at the appropriateness of county practices and how it is impacting children in care.

What is institutional abuse?

Abuse and neglect are defined within statute and Volume 7 of the Colorado Code of Regulations, and caseworkers have a process to assess whether a situation is considered abuse or neglect. Institutional abuse occurs when a child or youth experiences abuse or neglect in an out-of-home setting.

For me, this is one of the toughest aspects of child abuse and neglect, because kids are in an out-of-home setting because they weren’t safe at home and yet they have experienced it again in a situation where they should be healing. It’s tragic and unacceptable. 

We’re asking our county practitioners to look at how that individual staff or multiple staff impacted the youth during an incident. 

Unlike abuse and neglect that occurs within a family, with institutional abuse and neglect there can also be a policy violation, so there is a whole separate organization that will determine if the staff acted inappropriately per the facility’s policy.  For example, you may have an incident where an individual isn’t abusive and neglectful, but they did violate a policy, so there may be some remedial actions related to the facility with that individual. Colorado has a licensing and compliance review team that looks at licensing violations and compliance and performs licensing reviews. 

Who does institutional abuse apply to?

Institutional abuse and neglect applies to out-of-home placements through child welfare such as foster homes, residential treatment homes, certified and non-certified kinship providers, Division of Youth Services (DYS) facilities and group homes as well as child care facilities. 

Since individuals can remain in foster care or DYS facilities up to their 21st birthdays, we can access institutional abuse for individuals up to the age of 21.

Why is it called institutional abuse if it happens within a family setting? 

Much like facilities, foster families have numerous policies and expectations around supervision, documenting incidents, and locking up medication and potential safety hazards, but it shouldn’t feel like an institution.  It is important that it feels like a home as much as possible for the individuals in care.

Abuse and neglect is less likely to occur within a foster family than it is in a residential setting. Ratios of adults to kids are much lower in foster care. If I’m a foster parent, I have one or two kids to one parent, but in a large facility the ratio may be one to 12. As a foster parent, you have the ability to be more impactful on that one individual, because you’ll have the ability to spend more time one on one with a child or youth.

Is institutional abuse or neglect assessed the same way abuse and neglect within a family is assessed? What is the process for incidents?

There are some similarities. Anyone who has a concern about a child or youth’s safety, should call the Child Abuse and Neglect Hotline – 844-CO-4-Kids. 

If, within a facility or family-like setting, there is a concern about abuse or neglect,  facilities are required to complete an incident report. Next, the child welfare team where the facility or family is located will determine if this critical incident rises to the level of abuse and neglect as defined in Volume Seven.  If it does, then a caseworker assesses the safety of a child or youth just like they would for a child or youth living with their parents.  Additionally, it is also the responsibility of the county to complete a global assessment of the provider’s facility. 

Why is there a review process? 

We are looking for systemic issues and opportunities to support caseworkers in conducting safety assessments.

Really what we’re looking at is: What was the staff action? Were they negligent? Were they abusive? Did they go beyond the point of what’s acceptable in their training? Did they use inappropriate techniques? And then, did they use the least amount of force to control that incident?

When facilities have numerous concerns of abuse and neglect they have been asked to surrender their license and no longer provide care. However, that is a long process. When an individual has a founded claim of abuse or neglect they lose their ability to work with children. If they ever want to work with children again, they must file an appeal through our Administrative Review process.

When we investigate, we really want to perform a global review of the facility and of their provider, because we know in the future that these children and youth are going to be placed there, so we really focus on the provider’s impact on the children and youth. The goal is to identify any concerns that would prevent a provider from providing appropriate care in the future.

What are the trends in Colorado? 

Colorado one of our nation’s top performers in preventing maltreatment in out-of-home care. We have a low number of incidents of maltreatment in out-of-home care and are consistently under the federal standard of 8.5 maltreatment incidents per 100,000 days in out-of-home care. Colorado has a very low founded rate, a very low number of incidents that occur, compared to other states.

We’ve really looked at how we can create better lines of communication with our providers to help them get their needs met and get their training needs met so that they can be a better care provider for our kids within care.