My reporting examined why New Hampshire is sending vulnerable kids far away from their homes

The image of a barbed wire fence and a sticky carpet, where kids were left to eat their lunches alone on the floor, was stuck in my head. 

In 2023, New Hampshire’s Child Advocate, an independent state agency that oversees the child welfare system, visited a residential youth treatment facility in Tennessee, where two Granite State kids were living, expecting to find a therapeutic center focused on mental health care. Instead, she found a jail-like facility where kids were publicly shamed and staff threatened to punish them for minor infractions, like an unmade bed. 

Cassandra Sanchez, the child advocate, left the building and sent an email from the parking lot back to state officials: These children needed to be brought home immediately. 

The situation at the Bledsoe Youth Academy, a private company that runs youth treatment centers across the country, made headlines across the state. Sanchez called for an end to all out-of-state placements and legislation was introduced to increase oversight on kids in residential facilities. 

I knew the two boys at Bledsoe weren’t the only children to be sent out of state in New Hampshire, but I didn’t know how many others were in similar situations, or why some of these placements spanned state lines. 

My reporting project for the USC's Center for Health Journalism’s Data Fellowship sought answers on the use of residential treatment programs nationwide and the rationale for sending kids away from home. 

Anecdotally, this was easy to understand. 

There was a story I heard repeatedly: A teenager would be removed from their parents' care, with no place to go. Annual surveys of foster families in New Hampshire reveal that many families prefer to take in younger children and infants. While 1,200 children are in the foster care system, only 450 families are currently licensed to take kids in their home. Finding a placement may be even more unlikely for children with special needs or medical requirements. 

Nearly one third of kids who are eligible for foster care end up in a congregate care facility instead as a result. 

Advocates point to research showing that children are better off in a home-like setting. Many kids in New Hampshire weren’t afforded that opportunity. 

Quantifying this, though, was trickier. 

I requested data from the state Department of Health and Human Services on the number of children in residential programs, their level of care, age, demographics and the location of their placement. I hoped for an anonymized data set that could show me individual cases, which would allow me to understand the full arc of a child’s placement and its history. 

Instead, I received aggregate counts of monthly data across a four-year period, with the exclusion of categories that had less than five children, to protect their identity. The data set told me the number of children in care at one time, but it didn’t show the trend over time analysis I was hoping for. 

The request was also arduous to fulfill. The system New Hampshire’s Department of Health and Human Services uses is archaic and long overdue for an upgrade. I was told that pulling requests was not an easy export and that state employees were equally frustrated by the limitations of their system. 

With the help of my Senior Fellow MaryJo Webster, I learned that I had to make do with what I had, but that a stronger picture would come by piecing together a number of different sources.

Each month in the New Hampshire State House, a group of policymakers, nonprofit leaders, lawyers and advocates meet for the Oversight Commission on Children’s Services. The group is composed of experts regarding the state’s system of care for children who hear from state leaders on their current practices and provide suggestions and scrutiny for improvement. 

A key piece of these meetings is monthly data reports from state agencies. The Bureau for Children’s Behavioral Health shares updates on the number of children in foster care, kinship care and residential placements. A snapshot also indicates where children are placed for these residential programs and their level of need. These meetings are not recorded nor are they made available to the public online. 

Showing up is truly the only way to find out what goes on — a strong reminder of the value of having local reporters in the room. 

These presentations unlocked specifics that the data lacked. With the use of these reports, and context from state leaders explaining their latest focus or findings, I was able to draw a better picture of the state of care for kids in New Hampshire and learn that the use of residential care is a practice they hope to wind down, but the lack of suitable foster families is a hindrance to doing so.  

The most valuable source to drive my reporting, though, was former youth in care. I talked to Brie Lamarche, who was in seven placements over a three-year period. She landed as far away as Tennessee and Missouri. 

Erin Downey watched as their mother had to make a hard choice to help her child: Should she send her to a facility in California after a series of hospitalizations in New Hampshire?

Nicole Sheaff faced the same decision for her daughter Arlen, who couldn’t find the help she needed close to home.

These deeply personal and vulnerable stories brought to life the reporting I did for the project. 

But as most things go in news, a last-minute curveball upended the final installment of the series. 

In state budget deliberations, lawmakers unexpectedly slashed Sanchez’ position as the New Hampshire’s Child Advocate. That meant the only watchdog entity in the state would be dissolved, leaving less eyes on children in care, despite a resounding call for more oversight and accountability. 

Budget cuts and the initial data hurdles reminded me that planning for a series of this scope is often met with unexpected challenges. In the end, they’re essential pieces of the final product though. 

In many meetings, lawmakers, state employees and advocates were talking about the same goals. They wanted to reduce the state’s reliance on residential care and make sure that children were served closer to home and connected to families. 

Journalists can help bring understanding to these common goals, and complicating, and sometimes competing factors. With that, the reporting on this issue is far from over.