WEBSTER GROVES — Great Circle, one of the largest behavioral health organizations for troubled youth in Missouri, closed its residential treatment program here on Friday without fanfare. The embattled program started in 1832 as a home for orphans from the cholera epidemic.
The name and scope of the program evolved over time but was mainly known in recent history as Edgewood Children’s Center. In 2009, it merged with Boys and Girls Town of Missouri to become Great Circle, which continued to grow from there.
“We will always be proud of the legacies brought by each of the 12 organizations that joined over the years to become Great Circle — and Edgewood Children’s Center is no exception,” Great Circle, still based on the sprawling campus at 330 North Gore Avenue, said in a prepared statement. “Edgewood adjusted its name and scope of programming multiple times over the decades as it adapted to meet the societal needs of children. Now, as Great Circle, our goal is the same.”
Closing the residential program, which mainly served children who struggled to maintain placement in foster homes, was expected. A shift in federal funding is looming and several former employees have been accused of endangering clients. Among them is former CEO Vincent Hillyer, known by some in the industry as the dean of residential treatment in Missouri.
The Missouri Department of Social Services, which licensed the facility for 68 people, ages 6-21, temporarily suspended intake three times since 2019. State concerns mentioned in records ranged from medication mismanagement to failing to call emergency medical services.
Yet the campus has been one of the busiest stops for local first responders. Between March 2015 and March 2021, there were 1,300 calls for service logged by Webster Groves police. In February, federal agents raided headquarters. Two weeks before, state officials accused the nonprofit of overbilling them nearly $2 million in Medicaid claims for services.
The headlines have disturbed long-time neighbors like Cindy Herschel and others.
“Its history has been very good and very helpful for some children that couldn’t find a spot otherwise,” said Herschel, 81, a former speech therapist at the Special School District of St. Louis County. “This recent stuff … is very shocking. I’d like to see residential (treatment) available under positive circumstances.”
Great Circle, which relies heavily on government contracts, said it will continue to run four other residential treatment programs in Columbia, Marshall, Springfield and near St. James. But the firm, and others still in the field, face mounting pressure from the Family First Prevention Services Act.
The federal law strives to support families before things get so bad that children need to be removed from their homes. The law also cracks down on the use of residential treatment centers, which have long been challenged to help, not just house, children in congregant settings.
“They have drawn a very clean line in the sand that as of Oct. 1 they are no longer in the business of supporting long-term residential placement for kids,” Melanie Scheetz, executive director of the Brentwood-based Foster and Adoptive Care Coalition, said of the federal government. “So the number of children in residential care is going to decrease.”
Missouri has yet to publicly outline how these children will be served.
Typically, about 10% of the 14,000 foster children in Missouri would end up in residential treatment at some point. They tend to be trauma victims who have already struggled to maintain placement in multiple foster or adoptive homes.
Coyote Hill Christian Children’s Home in Harrisburg is one of seven firms that closed residential treatment programs in Missouri since 2020, according to state records. Coyote Hill now supports foster families that live on its property.
“The spirit of the law is positive,” Kari Hopkins, chief development officer of the charity, said of the Family First Prevention Services Act. “We believe that kids should be in families, and we will do everything we can do to keep kids in a home setting. It does mean that we need more foster parents. We need more mental health professionals, especially in rural areas, but even in a city like Columbia, that accept Medicaid reimbursements for services.”
Another provider that continues its residential treatment program said it cut back capacity because of the struggle to keep and maintain proper staffing levels, in part due to low pay rates tied to state contracts. The provider asked not to be identified. Meanwhile, there have been 19 state residential treatment license suspensions since 2019, records show.
The latest intake suspension was April 19 at Annie Malone Children and Family Services Center, 5355 Page Boulevard. Records say the program didn’t meet minimum staffing ratios, lacked sufficient supervision and “safe crisis management training.” State records say there’d already been corrective action plans in place at Annie Malone since 2020 to address inappropriate interventions with youth, medication log errors and lack of training and supervision.
The Missouri House Special Committee on Government Oversight has been recently holding hearings about the Department of Social Services response to allegations of abuse and neglect made to the Children’s Division hotline. The hearings started out exploring religious boarding homes, which are unregulated in Missouri. Inquiry by the committee has since expanded to include licensed residential treatment programs that hold state contracts.
Records submitted to the committee this week say the state child welfare agency logged 155 substantiated incidents of sexual and physical abuse and neglect, mainly at licensed residential treatment facilities, between 2015 and 2020. The records say each incident could have multiple findings. Of the 155 incidents, Great Circle had 31, followed by 18 at Piney Ridge Center and 10 at Every Child’s Hope.
Rep. Jered Taylor, R-Nixa, the oversight committee chairman, recently stumbled onto the issue.
“Our main focus so far has been on the unlicensed facilities, and we have an example that is horrendous,” Taylor said at a recent hearing. “But it sounds like we have the same exact problems, even in our licensed facilities.”
As the committee digs deeper, it becomes more familiar with a tough and reoccurring question:
How can Missouri best serve its most vulnerable children?
Indeed, some of them needed to be moved out of Great Circle’s residential treatment program in Webster Groves before it closed Friday. Many of the youth were in the custody of the state Children’s Division.
Asked if it was hard to find them placements, and where the children were sent, Rebecca Woelfel, spokeswoman for the social services department, said by email that authorities worked to find the least restrictive and most appropriate placements. Depending on the individual needs of the child, she said, that may mean moving back home with intensive in-home supports or placement in a therapeutic foster home or in a different residential treatment facility.
“Residential placement for a child in the care of the state is the most restrictive option,” Woelfel said. “It is important to try to help children be successful in family settings and only use residential treatment when necessary. In general, the Department is aware that there is increasing difficulty in the ability of families to access supportive services within their communities for children who may be struggling with mental and behavioral health issues.”