Boston Globe, June 29, 2020

More than 8 percent of children living in Department of Children and Families group homes and similar settings have contracted the coronavirus, a figure that far outstrips the rate among young people elsewhere in the state.

The first case of COVID-19 in so-called congregate care surfaced in early April, according to DCF officials, and similar to other corners of Massachusetts, the virus has proliferated since. Of the roughly 1,700 children in state custody living in group homes or residential school settings, 144 have so far contracted the virus.

State officials have not reported any COVID deaths among children in DCF group care, and none of those who tested positive are believed to have been hospitalized, said Maria Z. Mossaides, the head of the state’s independent Office of the Child Advocate.

All but one child has recovered as of June 23, the last time state officials updated their weekly disclosure of cases at various state facilities.

But the share of children who’ve become infected stands in stark contrast to the virus’s apparently scant spread among young people statewide. Of the state’s nearly 109,000 confirmed and probable COVID-19 cases, about 5 percent were under the age of 20. And those roughly 5,800 cases account for less than 0.4 percent of the nearly 1.6 million people living in Massachusetts who are 19 years old or younger.

The data offer what officials say is another example of how congregate living situations, such as nursing homes or independent living centers, can be ripe for spread. They also note that children in group homes may be subject to more testing than the general population.

But among some of the state’s most vulnerable children, it also underscores another concern, advocates say: the outsized impact the virus has had on people of color. Hispanic and Black people made up 47 percent of minor children in congregate care, according to DCF’s most recent annual report, even though they account for just 19 percent of the state’s total population.

White people made up 41 percent of those in congregate care, where children live under 24-hour supervision in group settings.

State officials have released little publicly on the children in group care who have tested positive, including their age, race, or gender — information that is regularly collected and disclosed on other COVID cases statewide.

And the information that is regularly released on DCF group homes, which are run by outside vendors, is limited: It doesn’t include the number of cases among staff members, nor does it show the location of the group homes that have reported cases.

The thin disclosures have frustrated child advocates and attorneys, who say that despite formal state guidance for group homes on navigating the pandemic, they’ve heard anecdotal reports of protocols varying widely in settings where quarantining children — who often share rooms and bathrooms — is already difficult.

“It’s demonstrative that congregate care is an inherently dangerous environment,” said Cristina Freitas, an attorney and member of MA Child Welfare COVID-19 Coalition, a collection of roughly a dozen advocacy groups, law firms, and others. “They’re not built to support that type of social distancing [recommended by health officials] and a lot of these facilities, especially with DCF, only have one or two bathrooms.”

Freitas said she and her law partner and sister, Debbie Freitas, have filed public records requests seeking more information since April, only to face a tangle of responses from DCF; the state Department of Early Education and Care, which licenses group homes; and the state Department of Public Health, which handles the overall COVID data reported by the state. Each agency said it didn’t have in its “custody or control” the demographic data, or couldn’t say who did, Cristina Freitas said.

That lack of information on nearly 2,000 children in state custody points to what Debbie Freitas called a “constant struggle of transparency” within DCF, which has long released what advocates say are incomplete or delayed data.

“It’s about releasing data to save lives, not reputations or egos,” Debbie Freitas said.

State officials defended their handling of congregate care settings. They said the department’s leaders have held weekly or biweekly calls with group home providers in addition to offering mobile testing at homes starting April 10.

State officials last updated a 19-page set of guidelines for group homes on April 14, included telling homes to exclude any staff members who test positive from returning to work for at least seven days until after they were tested. The state also requires that all staff be screened before entering a facility, to further guard against potential spread.

“Child protection is the first and foremost priority of the Department of Children and Families,” said Andrea Grossman, a DCF spokeswoman. “Throughout this unprecedented pandemic, the Department has maintained close communication with providers to triage and respond to issues as they arose, such as helping providers source personal protective equipment for children and staff. We are pleased that the vast majority of children who tested positive have clinically recovered.”

Mossaides, the state’s child advocate, said within many of DCF’s 250 congregate care facilities, it’s inherently difficult to separate children. Getting a hold of personal protective equipment early in the pandemic was also challenging, and while the state allowed for emergency sites for those who have tested positive — DCF secured 21 beds across four sites — officials tried to avoid moving vulnerable children unless absolutely necessary, Mossaides said.

But she otherwise praised the steps DCF and state officials took, both in offering testing and including DCF’s medical director in decision-making on children’s cases.

“The idea that only one child is currently diagnosed with COVID-19 is a testament to what policies were implemented,” said Mossaides, who previously was executive director of Cambridge Family and Children’s Service, which manages two group homes.

Mossaides said the vast difference between the infection rates among children in group homes and children statewide could be attributed to both the cramped setting of a group home and the level of testing to which the children are subjected.

“I think we’ve done a lot more testing with this population,” she said. “I can say, literally in the first couple days and weeks thereafter, I was involved in daily briefings: ‘What do we need to do? Are we doing enough?’ In that sense, I think there was an immediate response.”

Even before the pandemic, officials have identified other worrisome trends in group homes. A state’s Child Advocate report released in November found that at least 184 children were neglected in such settings during fiscal year 2019 — a 55 percent increase over the previous year. More than 10 percent were 11 years old or younger, the report found.

Five group homes had three or more reports of abuse or neglect, Mossaides said at the time, and her office found a common thread of issues: problems with recruiting, training, and retaining sufficient staff.

With the pandemic, however, she said she’s confident the homes have the tools to be responsive.

“People are much clearer on what you need to do to make sure the environment is safe as it can be,” Mossaides said.

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