Arizona’s foster group homes need some checks and balances
A disturbing Associated Press investigation this week raises an important question that goes beyond the political controversy surrounding Sunshine Residential Homes:
Should the same state agency that desperately needs group-home beds also be responsible for licensing and regulating the companies that provide them?
The Arizona Department of Child Safety contracts with companies like Sunshine to house children in state custody. DCS decides what services it needs, pays the providers and depends on those companies to have beds available when kids need someplace to go.
But DCS also licenses and regulates those same companies through its Office of Licensing and Regulation.
It makes me wonder if there are enough checks and balances in the system. I think not.
The Jakob Blodgett Case
The problem becomes clearer when you look at the tragic death of 9-year-old Jakob Blodgett. Jakob had Type 1 diabetes and died in 2022 after missing two doses of long-acting insulin while living in a Sunshine group home.
According to the AP investigation, DCS later issued Sunshine a licensing violation related to Jakob’s care. But DCS didn’t suspend or revoke the company’s license. Instead, it required policy changes.
A DCS licensing official later testified that the workers caring directly for Jakob should have been trained in managing his diabetes and recognizing diabetic ketoacidosis. She acknowledged that DCS hadn’t checked to make sure every staff member had the proper training.
Here’s the rub. DCS badly needs Sunshine’s beds.
The Attorney General’s investigation into a separate controversy involving Sunshine concluded that the company had “outsized leverage” because DCS depended so heavily on its group-home capacity.
Checks & Balances Matter
Imagine being the agency responsible for finding a bed tonight for a child who has nowhere else to go. At the same time, you’re supposed to be the tough regulator who might suspend the license of one of your largest providers and take dozens of beds out of circulation.
That’s a recipe for a potential bad regulatory decision.
The Legislature should consider moving health-and-safety licensing and regulation of these residential group homes to the ADHS while leaving DCS responsible for placement decisions, contracts, payment and making sure contractors provide the services DCS is buying.
The payer can focus on buying the services people need. The regulator can focus on whether the facility is safe, without worrying about whether enforcing the rules will leave the purchasing agency short of beds.
The agency buying the beds shouldn’t also be the only agency deciding whether those beds are safe.