Just some other thoughts about the reality of licensing. I say this as someone who works for a licensing agency and is involved in program oversight, but not the actual renewal of licenses (i.e. we take complaints and investigate and involve the certification team if need be, but are not the ones doing annual inspections). And has seen first hand the practice of our own agency as well as other agencies in the state.
First of all, the relationship between provider and licensor tends to be cozy. Not cozy in an illegal, money under the table kind of way, but in the going to the same church, kids go to the same school kind of way. Licensors have more of a personal relationship with the providers than with the kids, so in the event of a he said, she said situation, who do you think they're going to be inclined to side with?
Second, and this is particularly true with child welfare agencies, but similar dynamics play out with the mental health and juvenile justice systems. Licensing agencies rely on the capacity that bad programs provide. For instance we have a private psychiatric hospital in a NYC suburb that has been under threat to be closed for at least the last 4 years, that seems to take almost exclusively foster care kids from NYC. How is that? Our foster care system can't find enough foster parents to take in kids who have special needs, so they need the hospital beds to keep them off the street or out of the shelters. As long as they're in the hospital they're not the agency's problem. The hospital does just enough to stay open, because an entire system has made the decision that it's better that a youth receive substandard care in a psychiatric hospital, then be left in the community to their own devices. If something bad happens in the hospital, it'll be the hospital that gets blamed. If something happens in the community, the foster care agency has liability.
Third, keeping in the foster care realm. I've come to the conclusion that there's a subconscious calculus that plays in the mind of child protective workers - is this a child that's more likely to be killed or harder to place. Meaning lots of minority infants who have parents who aren't necessarily abusive, but there are serious concerns they may neglect their child to death, who they feel like they can find foster placements for get placed, but teenagers getting beaten by their parents don't. Assuming they meet that threshold, as the case worker is my liability higher if I remove the child or if I keep the child in the home. Translation - (Rich white abusive parents sue when their child is taken away by CPS, poor black parents don't). The threat of a lawsuit is enough to outweigh the worry of a front page story in the New York Post.
The MBA case perfectly illustrates these realities. DHS took action that they probably wouldn't have in the first place because they didn't have any of their own youth in Mount Bachelor. But when Aspen retaliated with a lawsuit, and when Aspen got parents to threaten to sue DHS as well, DHS got cold feet and settled.
Any state licensing regime will have those realities. And there are in some cases ways to get around the lack of licensing by going to the local Protection and Advocacy organization in your state.
The solution is to have a credible enough threat so that the licensing agencies fear the exposure that you can bring to bear on them over the exposure from the programs. But to do that you have to be credible, believable, and organized, and have a very good answer for when those pro-program parents show up with their "success stories".
In my next installment I will provide specific program examples and how to structure your advocacy to be most effective.
