A top child protection agency in the United States said that Bermuda faced an “additional burden” in the monitoring of overseas residential programmes used for the island’s young people because of its distance from the institutions.Christine James-Brown, the chief executive of the Child Welfare League of America, added that many child protection services had tried to reduce their reliance on putting minors in out-of-home settings — a move encouraged by significant legislative reforms introduced last year.She explained that the US Family First Act was “designed to move the child welfare system to a greater focus on prevention, less treatment, and also to keep children in their own homes and families, rather than residential and foster care”.She said the belief was that more funding should be directed to avoid the removal of children from their homes.Ms James-Brown added that Bermuda was “an entity that has to rely on other entities outside of Bermuda for its children”.She said: “It creates another additional burden because who is responsible for monitoring?“How do you monitor if you’re that far away? Every entity that has to do that takes a different approach to it.”The CWLA’s website said that it was a “powerful coalition of hundreds of private and public agencies that since 1920 has worked to serve children and families who are vulnerable”.Ms James-Brown explained that the CWLA provided training, technical assistance and campaigning to inform agencies about policies and regulations to help them meet requirements, but that its own standards of excellence were “aspirational”.Ms James-Brown said that Bermuda’s Department of Child and Family Services had been a member since before she started there 12 years ago.She added: “They’re less engaged now than they used to be — some of it on their side, some of it on our side.”Ms James-Brown said: “I met the head of the department years ago, when I first started, and that’s when they were really engaged and involved.”She explained that many US states and other organisations that focused on residential treatment centres needed to scale back their involvement “because there’s so much change going on that they’re trying to manage”.The Ministry of Legal Affairs said last year that the DCFS policy included vetting overseas treatment centres and that “all therapeutic facilities are accredited by the Joint Commission National Quality Approval Organisation”.A spokeswoman for the ministry said that annual checks were carried out by the department’s assistant director, the psychoeducational co-ordinator, or both.She added: “The department is responsible for monitoring out-of-home care placements to ensure that the level of care provided by the overseas therapeutic programme is consistent with the Council on Accreditation Standards.”The spokeswoman said: “The psycho-ed programme provides children and youth with protection, care, and nurturance by licensed therapeutic overseas facilities. “The psychoeducational programme affords us the opportunity to have external input with regard to therapeutic intervention and aftercare services.”The joint commission explained on its website that accreditation helped to “organise and strengthen patient safety efforts”.It added: “Patient safety and quality of care issues are at the forefront of joint commission standards and initiatives.”The website said: “Achieving accreditation makes a strong statement to the community about an organisation’s efforts to provide the highest quality services.”It added that accreditation could mean a “competitive edge in the marketplace” and improved risk management and reduction.Jody Levison-Johnson, president and chief executive of the COA, said the organisation’s standards were available on its website.She added that standards listed for group living and residential treatment services were “most closely aligned” with the overseas facilities used for Bermudian children.The COA website explained: “Residential treatment services provide individualised therapeutic interventions and a range of services, including education for residents to increase productive and pro-social behaviour, improve functioning and wellbeing, and return to a stable living arrangement in the community.”It said that group living allowed “individuals who need additional support to regain, maintain, and improve life skills and functioning in a safe, stable, community-based living arrangement”.