Missing Elements in Child Welfare Systems of Care

This paper describes conclusions from an expert report prepared for litigation against the Office of Refugee Resettlement (ORR) with relevance for all children at risk for placement in restrictive settings. The claims that ORR refused to release unaccompanied immigrant children to appropriate custodians, improperly retained children in restrictive placements, and placed children with behavioral, mental health, or intellectual and/or developmental disabilities in restrictive facilities because of their disabilities rather than their needs have universal relevance to systems of care for children. These conclusions could be used by regulators, funders, advocates, family members, and others to improve decision-making about the management of children at risk for placement in restrictive settings. 1. Children can often be safely maintained in least restrictive settings with effective, individualized, community-based services and behavior management strategies. 2. Services must be based on adequate, evidence-based evaluation of children's needs. 3. Criteria for placement of children in more restrictive settings must include a specific determination that each child could not be maintained safely in a lower level of care, and the specific basis for that determination. 4. Effective systems of care require internal mechanisms to evaluate decisions and promote best services in the least restrictive setting.