Death freed Jamal Odum's troubled young soul in seven minutes.

That's how long he lay trapped beneath a 220-pound group home worker his last Sunday morning.

A security videotape caught the March 2003 scene at a home outside Charleston: It shows the chubby 9-year-old swat at a worker's vacuum cleaner cord, then run away.

The worker lunges; Jamal falls. A second worker -- a corrections officer moonlighting at the home -- lies across his back. The minutes tick by.

Jamal goes limp. Workers pump his chest with their hands, but it's too late.

Jamal was among 2,200 children sent to state-approved group homes or institutions in South Carolina that year to treat their emotional and behavioral problems.

Yet critics say some S.C. facilities are so poorly run that they put troubled children in greater danger.

In some homes, physical and sexual abuse go unchecked, runaways come and go at will, and children languish, advocates and six recent lawsuits say.

S.C. officials say they don't believe widespread abuse takes place in the facilities, which are desperately needed to treat children without other options. The state continues to raise standards for the homes, they say.

But recent studies suggest South Carolina's patchwork residential care system doesn't always put children first.

Those studies and interviews show roughly $57 million in taxpayer money each year feeds a system seven state agencies have a stake in, but none is accountable for.

Consider:

• No one takes a systemwide look to see whether children are making therapeutic progress in the costly homes.

• No one checks whether the system generally keeps children safe.

• The S.C. agency that licenses most homes can't fine them.

The studies call for reform.

"They know what they need to do to fix this," said Rochelle Caton, an attorney for S.C. Protection and Advocacy for People with Disabilities. "They just need the will."

Responsibility spread thin

S.C. agencies say they are following a national trend and trying to aid troubled children without taking them out of their communities.But in recent years, one study says the system has moved in the opposite direction.

A legislative study committee in 2003 noted small, community-based group homes were decreasing statewide, while large residential facilities were increasing.

"No research has been offered regarding the effectiveness of this practice," the committee warned. Caton took it a step further, saying: "That's completely contrary to the direction we're supposed to be moving."

On average, each of the roughly 90 group homes and institutions in South Carolina has beds for about 21 kids, data show. The number of homes continues to decline; 23 closed just in the past two years.

Some providers complain the state's Medicaid reimbursement rate is too low -- putting a squeeze on smaller facilities that suffer more when a bed goes empty. Medicaid is the government's health insurance program for the poor.

Oversight of the homes and institutions is complicated because so many S.C. agencies are involved.

Five agencies refer kids to homes or institutions. Two license the facilities. Two inspect them annually. One tracks Medicaid compliance and pays for treatment.

No single agency is responsible for the system as a whole.

The S.C. Department of Social Services investigates abuse or neglect complaints against the facilities. Last year, it reviewed 94 claims, substantiating 26 of them.

But no home or institution lost its license.

DSS officials say that when they find problems, they draw up a list of actions a home must take to retain its license, instead of immediately moving to revoke it. Sometimes, the home decides it's not worth the effort and closes on its own, said Jackie Kasufkin, DSS foster care supervisor.

In a few serious cases, DSS has removed children or stopped placing them at homes -- which hurts the homes financially.

But S.C. law doesn't allow DSS to fine providers outright. A bill allowing the agency to do so passed the state legislature last year, but Gov. Mark Sanford vetoed it in December.

DSS officials say the bill failed because of other provisions unrelated to fines. They are looking at putting the measure on the governor's desk again.

The S.C. Department of Health and Human Services can cut off payments to providers if violations are found. It's never done so, agency officials said.

Kasufkin said the homes play a vital role for many children. "There are some children that have such horrible experiences in their family that going to a group home that is more neutral is a positive setting for them," she said.

"All of the group homes we have have a purpose."

Jamal's case

The home where Jamal died, New Hope for Children in Jedburg, closed in September after a drop in referrals created a financial strain, said Jay Orvin, president and CEO of the home's parent corporation, New Hope Treatment Centers.

Jamal's father, Larry Odum of Virginia, sued New Hope's owners, saying they failed to properly select, train and supervise staff.

The prison worker who lay across Jamal, William Brightharp, 41, faces charges, including homicide by child abuse. Two other staff workers were charged with lesser offenses.

Orvin said that while he can't talk in detail about the incident because of the litigation, the security videotape doesn't tell the whole story.

"It is impossible to look at that videotape and tell for certain whether the restraint was carried out exactly the way the restraint should be carried out or not," he said.

Experts say restraint -- a common control technique many say is indispensable in group homes -- should never restrict breathing or be used to discipline children.

Complaints of rapes

Complaints of rapes and sexual abuse involving other S.C. facilities have triggered at least five other claims since May 2003, court records show.They include one in which a teenage girl from Oconee County said she was repeatedly abused in two group homes. The suit claims staff at the Crain House in Greenville and New Foundations in Anderson regularly fondled and had sexual relations with female teenagers.

A social services investigator once kept the Oconee girl from meeting with her parents on her birthday -- instead taking her out to dinner and to buy a nightgown, the suit says.

The girl, who isn't named, tested positive for a sexually transmitted disease and tuberculosis at both homes, the lawsuit alleges, but received no medical treatment for them. She ran away 11 times.

Last year, a Crain House worker pleaded guilty to criminal sexual conduct and assault charges, according to The Associated Press.

Crain closed in 2003 after referrals dropped off, said Nancy Jones, a vice president with home owner Raleigh-based Lutheran Family Services in the Carolinas. She declined to comment on the lawsuit, but said her group "does conduct its own investigation, and we do cooperate with authorities."

New Foundations attorney Jim Jolly said he, too, couldn't discuss the suit. "Obviously, from my client's perspective, they do not believe they did anything improper," he said.

The girl's attorneys put the claim on hold earlier last year because they weren't ready to proceed but plan to refile it this year, said Stephen Lewis, a Greenville lawyer handling the case.

DSS declined to comment on any lawsuit.

`Let's move ahead'

In an e-mail, DSS Human Services Director Mary Williams said DSS is generally satisfied the care group homes are providing troubled children.

Yet one S.C. researcher said a lack of systemwide standards made it impossible to tell how children were faring in the homes.

David Murday's 2003 study tried to track about 500 children in residential care to evaluate their well-being and progress in treatment.

He'd hoped to see whether children were free of abuse and not subject to inappropriate seclusion or restraint, among other things. He wanted to see whether children's therapeutic needs were met.

So-called critical incident reports, which document problems in the homes, were to be a key data source, said Murday, assistant director at the center for Health Services and Policy Research at the University of South Carolina.

"We assumed if it was a state-mandated function, the state would have defined what a critical incident was," he said.

"Halfway through, we found out that the state didn't want to define what a critical incident was, so each provider had their own definition," he said. "Which meant you couldn't use a critical incident as any kind of measure."

The study, which had been commissioned by state agencies, couldn't be completed as envisioned, he said.

The lack of uniformity "really was a surprise," Murday said. "And it begged the obvious question of how do we know we're helping these children?"

In fact, he said he found some providers were eager for such a measure and were frustrated to be lumped in with providers who offered lower-quality care.

Two 2003 studies strongly recommended that one entity take over the job of monitoring and licensing group homes to improve the system. But the suggestions went no further.

Murday said he's read other reports from 20 years ago that suggest fixes.

"It's time to move beyond the `Let's study and create a perfect system,' and say `What steps can we make now?' " he said.

He's now serving on a task force that is looking to create more standardization and improve the quality of care. It includes state agencies.

The health and human services agency hopes the panel will help the state learn how to serve troubled children better, said Susan Bowling, deputy director of medical services.

If it finds changes should be made, "so be it," she said. "Let's move ahead and do it."

Tackling the Problem Locally

A 2003 legislative study committee made a startling find: Some S.C. children end up in more restrictive settings than they need simply because they can't find help elsewhere.

Efforts to address that problem are under way in York, Chester and Lancaster counties.

Residential placements were so high for kids in those counties that the S.C. Department of Mental Health chose the area for an experimental program that tries to treat children without removing them from their communities.

The state won a $6.9 million federal grant for a six-year project. It will involve stationing mental health workers in schools and helping families navigate a system of services that can be confusing and invasive, said Louise Johnson, principal investigator for the project.

The goal is also to keep kids out of group homes, which Johnson says she's never been comfortable with.

"Kids will be able to remain in schools and experience those natural things other kids do, like going to prom and football games," Johnson said. "And they will stay out of trouble and out of restrictive settings."