This story was originally published by The Imprint, a national nonprofit news outlet covering child welfare and youth justice. Sign up for The Imprint’s free newsletters here.
In a detailed public report released this month, Minnesota’s watchdog agency for foster youth outlined the troubling treatment of a teenager in Ramsey County custody — including failure to provide healthy food and clothing, a months-long stay in a “crisis respite hotel” designed for temporary housing and “over-use of emergency response services, including law enforcement intervention for de-escalation of trauma-based behaviors.”
The Ramsey County case is the latest in a series of investigative findings by the newly established Minnesota Office of the Foster Youth Ombudsperson. The report found that county caseworkers paid scant attention to sexual abuse the teen endured, and failed to follow the 2018 Foster Care Sibling Bill of Rights, which guarantees foster youth proximity to siblings. In two instances, according to the report, the foster youth was reported to police simply for refusing to go to school. The mistreatment came from caregivers as well, the ombuds office concluded. In one institution, the foster youth — who is not named in the report — was provided just two pairs of underwear “to avoid entitlement.”
In a recent interview with The Imprint, Ombudsperson for Foster Youth Misty Coonce said her office chose to release the report to reveal problems that are widespread, and to outline systemic fixes.
“There were enough things in the investigation that we want to lift up as examples of challenges that we’re seeing,” Coonce said. “So even though this is specific to Ramsey County, it’s not that we don’t see these types of things in other counties.”
The findings were sent to Ramsey County on Sept. 12, with several recommendations. They included providing foster youth with appropriate treatment and basic necessities, and training caseworkers, caregivers and emergency responders on the needs of survivors of child sexual abuse, as well as their behaviors stemming from trauma.
Ramsey County had 45 days to respond and did so 38 days later. In a letter of reply to Coonce, Deputy Director of Children and Family Services Bobbi Jo Potter did not dispute the findings and acknowledged the concerns. In a note of praise to the first-ever ombuds office that opened in 2024, Potter said she values the watchdog agency’s “role in ensuring accountability and improving the quality of services provided to Minnesota’s foster youth.”
Potter responded with specific measures to each concern. Her agency will update training and policies, “maintain sibling relationships across all settings,” provide “timely access to trauma-informed therapeutic services,” and “reinforce expectations that children and youth consistently have access to clothing, hygiene items, and nutritious foods through ongoing communication with caregivers and social workers.” In addition, Ramsey County will “strengthen partnerships with mobile crisis teams and community-based mental health providers to reduce reliance on police intervention,” Potter told the ombuds office.
“We recognize the importance of trauma-informed responses and minimizing law enforcement involvement,” she said.
In an email Wednesday, a Ramsey County spokesperson said the county is committed to the safety of the foster youth it serves.
“We recognize that providing safe, stable, and appropriate placements is essential, and we continue to work diligently to expand and improve the options available.”
Policing trauma
Several key concerns flagged in the teenager’s case are common, the report and interviews with child welfare experts revealed: police responding to children’s psychiatric crises and foster youth being left in inappropriate facilities.
In this teen’s case, investigators found “at least two situations involving possibly unnecessary use of police intervention and psychiatric hospitalization in response to the foster youth’s escalated behavior.” In one incident, the foster youth resisted going to class because the school locked its doors and teachers used physical holds — conditions that “reminded them of a previous placement in residential treatment.”
“At the request of the agency worker,” police and first-responders were called to calm the agitated child. But when the child continued to refuse to attend school, they were given two choices: class or the hospital.
“The youth did not meet criteria for in-patient admission and instead spent five days ‘social boarding’ before returning to the placement setting and agreeing to attend school on an ongoing basis.”
Minnesota children end up left in emergency rooms, inpatient psychiatric units or juvenile detention when there is no one else willing to care for them, said Stephen DeLong, lead mental health social worker for the Children’s Minnesota pediatric hospital and clinic system. That could be because they are acting aggressively — perhaps destroying property or threatening caregivers — or due to a developmental disorder. DeLong described the many foster youth patients who end up in his hospital’s windowless emergency rooms.
“We see kids that just have failed placement after failed placement — or they’re in short-term placements and they don’t have a longer-term placement set up — and so then they keep coming back,” he said. “Sometimes, counties are literally just bringing them to the hospital because they have no other place for them to go. We don’t want these kids on the street, but at the same time, the hospital’s not the place for them either.”
Investigators for the ombuds office acknowledged that some of the Ramsey County agency’s decisions reflected limited availability of services. But they said the lack of a deescalation plan and “trauma-informed responses from multiple adults responsible for this foster youth’s care contributed to multiple avoidable instances of law enforcement involvement and hospital stays.”
The report described such practices as common, extending beyond Ramsey County. It noted the “well-documented high percentage of youth who have experienced maltreatment and also ‘experience arrest, conviction, or overnight stay in a correctional facility by age 17,’” citing a 2023 Office of Justice Programs article. As a result, “child welfare workers must consider the impact of frequent law enforcement interactions over time in their decision-making for foster youth.” The ombuds office added that “pervasive racial disparities in both child welfare and juvenile justice involvement further highlight the need for trauma-informed responses.”
State data from 2023 shows that Indigenous children were 16 times more likely than their white peers to be in out-of-home care, while African American and Hispanic children and youth were both around twice as likely.
The youth was also threatened again with a call to police for their misbehavior, the report said. After the youth resisted going to school a second time, and vowed to leave a county placement to go to a relative’s home, an agency worker said the police would be called if they walked away.
“The youth expressed fear of police getting involved,” the report states. “The youth continued to refuse to go to school and the police were called by staff at the placement setting, with support from the agency worker.”
Respite ‘care’?
At this point, the teenager spent one night in a hospital, even though they did not meet the criteria for admission. An emergency placement at a relative’s home ensued. But that lasted only two months, when the caregiver called 911. Police handcuffed the teenager and again took them to the hospital, where they stayed for six weeks before being sent to a “crisis hotel respite setting.”
Coonce said crisis respite hotels have been on her office’s “radar” since it was established. The facilities are relied on by caseworkers who have sought residential treatment facilities for foster youth with challenging behaviors, and “have gotten denial after denial for that young person, and they have nowhere else to go,” she said. Children discharged from hospitals with nowhere else to go can also end up in these supervised settings — designed to be temporary — which tend to be a cluster of rooms in a hotel. The food available at the hotel was mostly fast food and bulk snack items, the investigation found, noting concerns.
“Access to healthy food is essential in any circumstance,” the report said. “It is particularly noteworthy considering the extended period of time the foster child is residing in that setting and the child’s diagnosis of pre-diabetes.”
As of Wednesday, the teenager remained in the hotel, and had been there for five months, Coonce told The Imprint.
In an emailed statement, Ramsey County spokesperson Casper Hill said “providing safe, stable, and appropriate placements is essential, and we continue to work diligently to expand and improve the options available.” Hill further stated that the county’s use of “hospitals and hotels” have different criteria, and both have been used when they are “needed and appropriate.” Since last year, approvals for “crisis respite/hotel” use have involved consultation with the Minnesota Department of Human Services.
“The county is working internally and in collaboration with other metro counties, local providers, and state partners to address gaps in the system and to better meet the complex needs of children and youth,” Hill said. “This includes exploring policy and procedural changes to reduce reliance on temporary solutions like hospital boarding and crisis respite hotels, and to ensure that every young person receives care in the most appropriate setting possible.”
Coonce described the teenager’s case as one among many examples her office has examined in the past year in which youth spend several months in hotels because there are no other placements able to meet their needs. She added that the office’s recent report “is only a very small part of what we see with this issue.”
She too said state officials are working on the issue: “there are options being looked at to hopefully better address the root cause of these settings being used more often and for longer periods of time — which is a lack of an appropriate mental health continuum of care.”
Indignities continued
The foster youth has suffered additional indignities, the ombuds office found. At one placement, they arrived with only two pairs of underwear. Though an agency caseworker raised concerns, “it is unclear how long the foster child went without appropriate supply of underwear, due to the caregiver’s intention to not provide ‘too much too fast’ to residents to ‘avoid entitlement,’ according to documentation from the agency.”
The young person, who entered foster care in 2020, had also reportedly been sexually abused by at least one adult, and investigators also described “inappropriate sexual behavior between the foster child and a sibling.”
Both children were supposed to receive a sexual abuse consultation. But the report stated that the foster youth was not given a consultation or a forensic interview — a method for gathering information from victims of abuse for law enforcement for legal purposes. The foster child had shown “unsafe behaviors” with siblings, yet for years, the agency did not explore alternative ways for them to maintain some form of safe contact. In a previous report, Coonce’s office has highlighted numerous situations where siblings in Minnesota foster care are denied their legal right to connections after being removed from home.
Coonce said the goal of her most recent investigation was not to produce a “gotcha” report on Ramsey County.
“It’s always with the focus of: What can we do to raise the standard and raise practices that positively impact foster youth?” Coonce told The Imprint of her office’s work. “So when we’re seeing gaps or challenges, that’s what our role is — to be looking for those, and then suggesting recommendations.”
