UC Irvine Medical Center Ousts Group Foster Home

A group home for troubled teenagers is being forced off the grounds of UC Irvine Medical Center in Orange and castigated by government regulators after the alleged sexual assault of one boy and a series of other disturbing incidents.

The operators of Research and Treatment Institute have agreed to leave their quarters in a faded building not far from the hospital’s emergency room by late June at the request of medical center officials, who said children in the facility were poorly supervised and “out of control.”

In just the first eight months of the home’s existence, UC Irvine police were called to it more than 200 times, usually for runaways and fire alarms, but also for assault and battery, vandalism and disturbing the peace. In any setting the trend would have been unsettling, but this unfolded on the grounds of a bustling medical center.

Yet despite the home’s turbulent history, the case is not a clear-cut one. For while one branch of the state bureaucracy is moving to revoke its license in Orange County, another is deciding whether to let Research and Treatment Institute reopen a bigger facility in Azuza, at the foot of the San Gabriel Mountains.

All the conflicting pressures and deep ambivalence of the child welfare system are laid bare at such facilities:

County social workers desperate to create a place for society’s most difficult foster children; neighbors and landlords rebelling at the prospect of living with adolescents who throw tantrums, set fires, hallucinate and attack their caretakers; and state officials pressured to license homes to meet a growing demand, while attempting to enforce minimum standards of care.

Child welfare officials often don’t agree on how to respond. Orange County social workers stopped placing children at the home in February, but Los Angeles County sent at least three more children there even after the sexual assault had been reported.

“We are trying to respond to the needs of social workers and counties, who really, really need a place for these difficult kids,” said Martha Lopez, head of the state Community Care Licensing division. “As long as the homes are safe and healthy and have a good program, there is reason to try to salvage them.”

But determining what is safe and healthy is open to interpretation.

The saga of Research and Treatment Institute is detailed in a series of documents obtained by The Times--confidential reports from Los Angeles and Orange county child welfare officials, internal medical center memos and state licensing documents.

The crisis point arrived in early February, when a mentally disabled 13-year-old boy allegedly was sexually assaulted by other residents. The reported attack touched off a series of investigations and only reinforced a decision by the home’s landlord--UC Irvine--to evict it, officials said.

The university medical center had complained for months that children were poorly tended. Campus police were called 206 times between July 1996 and Feb. 26 of this year. There was also a dispute over nearly $100,000 in back rent. In sum, the home created an “intolerable” disruption, said Medical Center Director Mark R. Laret.

The founders and operators of Research and Treatment Institute--which has two other group homes in Covina that reports show are in compliance with state regulations--say that they absolutely do not condone violent or sexual acts by their clients. But they say university and government regulators do not understand that, regardless of the care these adolescents receive, they are bound to act in potentially dangerous ways.

“We were clear to everyone [before the home opened] that for the first six to nine months we were going to rock and roll,” said Chuck Leeb, the clinical psychologist who founded Research and Treatment Institute. “All the literature and practical experience shows this will happen with a new facility.

“These kids have long histories of this kind of behavior,” said Leeb, referring to runaways and angry outbursts that have prompted much of the police attention. “Then they come here and do the behavior they have always done and . . . suddenly we are the bad guys.”

But Patrick T. Smith, the state licensing official who oversees the home, said: “I never buy the statement that kids exhibit their pathology and you can’t do anything. I don’t buy that as an excuse.”

Responding to an Acute Need

Leeb and partner David Morrison, an educational psychologist, said they formed Research and Treatment Institute in 1991 to treat the expanding population of severely emotionally disturbed adolescents. The next year their nonprofit company opened a home for disturbed preteens in Covina that would eventually grow to 24 beds.

There has been an acute need for homes that treat the most difficult children, called “Level 14s.” In the child welfare bureaucracy, the term refers to the highest level of compensation allocated to group homes--more than $60,000 a year per child.

In Orange County, for example, only one other home cares for teenagers in this category. It has just six beds, although county officials say they could use at least up to 50 more. In Los Angeles County, private operators have spots for 153, but need about 200 more.

It was at the urging of officials in the Orange County Department of Children and Family Services that Research and Treatment Institute brought its program south in July 1996. It was designed to treat boys and girls, ages 12 to 17, rejected by many other homes. UC Irvine welcomed the program, Laret says, because it filled a need in the community and augmented the medical center’s psychiatric programs.

By December, the home settled into its permanent 34-bed quarters in an abandoned three-story psychiatric building.

Employees complained that the university failed to properly prepare for their clientele. Fire alarms were left manually operated, not retrofitted for keys. And the empty third floor was accessible to the teenagers, who lived just a floor below.

Medical center officials say they had concerns early on that the teenagers were not properly supervised. Among the scores of police calls, more than 100 were for runaways, while 42 were fire alarm reports and false 911 calls. But there also were more serious calls: six for assault and battery, two for assault with a deadly weapon and one for a stolen vehicle.

Since then, with a decreased client population and increased staffing ratio, incidents have dwindled significantly, campus police said.

The fallout from the alleged sexual assault in early February, though, continues to reverberate. It started with an anonymous complaint to state licensing officials.

According to state and county reports, five residents made their way onto the unoccupied third floor of the facility one afternoon. There, a 13-year-old Orange County boy, with an IQ of about 70, was surrounded by four other boys about his age. His pants were pulled down and he was sexually abused by one boy and then urinated on while he futilely screamed for help, according to a report by Orange County officials detailing the incident.

It was not until more than two weeks later that the alleged victim was brought to Orangewood Childrens Home by his mother, where an examiner found numerous bruises all over his body, according to the special incident report by the Orange County Social Services Agency.

Research and Training Institute’s executive vice president, David Morrison, said several attempts had been made within days of the reported assault to have the boy examined at UC Irvine Medical Center. But “he couldn’t get seen because of insurance/Medi-Cal issues,” Morrison said.

A medical center spokeswoman called the suggestion that the hospital denied medical care to the boy “absurd.” State licensing officials said in an interview that the group home was obligated to have the examination done, even if at another location.

A state investigative report included pictures of bruises mottling the boy’s back. Before the reported attack, the boy had complained he was being roughed up by other residents, according to another memo, this one written by Los Angeles County officials after the incident.

“The staff acknowledged he was an easy target, the clients said he was an easy target,” said Patrick T. Smith, a licensing program supervisor with the state Department of Social Services, Community Care Licensing division. “It’s apparent from the bruising that he needed more supervision than he was being given.”

The UC Irvine Police Department has petitioned the Orange County district attorney’s office to file lewd conduct charges against two of the alleged assailants, and prosecutors are still considering the case, said Assistant Chief Bill Miller. The district attorney’s office declined to comment.

The alleged victim was returned to his mother’s home. The two alleged assailants were removed from the group home.

But Research and Training Institute executives said the watershed incident was grossly misinterpreted by outsiders. First, Leeb and Morrison raised questions about the nature of the incident. Even outside investigators conceded that the boys were unclear about when it occurred. And a medical examiner found no physical evidence that the teenager had been sodomized.

Research and Training Institute added that the alleged victim initially did not mention sexual abuse to staff members.

Further, Morrison said, it is not clear that the boy was the hapless victim regulators have depicted him as. Morrison--who emphasized that his remarks were not to condone the alleged attack but to put it in context--said the boy had instigated many fights with other children and previously engaged in consensual sex acts, despite the home’s best efforts to prevent such behavior.

A source who has followed the case angrily denied that the child was anything other than a victim. “He was like a sheep among wolves there,” said the source, who requested anonymity, because state law requires that foster care cases remain confidential.

The incident has left the medical center and the group home squabbling over who was to blame. Morrison and Leeb say the university ignored repeated requests to block elevator access to the third floor. A UC Irvine spokeswoman acknowledged that the elevator had continued to service that floor because of construction there, but she blamed inattention by the home’s workers for the attack.

The two sides are also bickering over $96,000 in back rent. UC Irvine says it has not been paid since the home opened 10 months ago. The group home said it had an agreement to delay payments until its finances were in the black, which has never happened.

The child welfare bureaucracy, meanwhile, has been preoccupied with how to respond to the crisis. Authorities in Orange and Los Angeles counties took divergent paths.

The Orange County Social Services Agency stopped placing children at the home in late February and has just seven children remaining there, compared to 14 two months ago. Los Angeles County placed at least three children in the home after the alleged attack, before cutting off its placements.

Los Angeles officials defended their decision to send more foster teenagers to the home, saying they did so only after the two boys and one girl had agreed to go there. County officials said they believed the home had made significant strides to correct shortcomings.

Judy Tanasse, a deputy director with the Orange County Social Services Agency, explained how two counties could take disparate approaches: “This is not a black and white field. There is a lot of room for judgment and differences of opinion.”

Amaryllis Watkins, who oversees group homes for the Los Angeles County Department of Children and Family Services pledged: “We will be monitoring the situation very closely.”

Widespread Problems

Research and Training Institute’s struggles are just the latest in a litany for Southern California providers.

In just the last six months, The Times has reported how problematic teenage foster children have confounded several facilities. Pride House children’s home in Van Nuys was closed last October. Overcrowding at Los Angeles County’s lone children’s shelter, MacLaren Children’s Center, late last year triggered allegations of excessive force by staff members. And this year, accusations of overmedication and poor care led to citations against Star View Adolescent Center in Torrance.

But the demand for the facilities is only growing. One of the fastest expanding segments of the foster care population in the state is teenagers. And among foster teenagers, the number who are severely emotionally disturbed or mentally ill seems to be growing too, experts say.

Research and Training Institute is expected to remain at UC Irvine Medical Center until June 30, when the eviction takes effect. But the university’s removal of the home will not resolve a seeming paradox confronting State Community Care Licensing officials.

Analysts in the state agency’s Orange office have requested that Research and Training Institute’s permit be revoked for the UC Irvine home. But another group of analysts from the same agency, who are based in Los Angeles County, are considering a plan to move essentially the same program to a new 53-bed location, at the foot of a semi-rural canyon in Azusa.

State officials said the situation is not as unusual as it appears. In many cases, permit revocation actions are used as a tactic for increasing supervision of wayward facilities. Rather than move ahead with a revocation, regulators often will strike a compromise by imposing strict new conditions, said Martha Lopez, head of the licensing division.

“I think they have a shot of running a good program there [in Azusa],” said Smith, the licensing official in Orange, who had earlier criticized the facility. “It just requires more attention to detail and, hopefully, they have learned from these mistakes.”