For help, call 1-888-373-7888 or text *233733 for the 24/7 National Human Trafficking Hotline, a national, toll-free hotline.

When she was a 10-year-old foster child, T Ortiz often rode a public bus around the San Francisco Bay area, alone.

She’d frequent a bus stop by a barber shop. Little by little, the barber, who was 15 years older, befriended her, she said — buying her snacks and meals, giving her attention, gaining her trust. It wasn’t too long before he started selling her on the street and taking explicit photos of her to post online.

Ortiz wasn’t a stranger to abuse: She’d first been sex trafficked by her birth mom when she was 5 years old, and she was abused by foster parents throughout her childhood, she recalled.

Ortiz was in state custody and sex trafficked through age 17. She doesn’t remember how many group and foster homes she was placed in — she stopped counting at 14 homes. As she moved from one to another, the barber said he’d protect her from abusive foster parents. “You’re nothing more than a paycheck to them,” he’d tell her.

“He was the most consistent person in my life,” said Ortiz, who is now a 34-year-old advocate and policy adviser who travels the nation, working with nonprofits to help survivors and to train and educate people about human trafficking and how to prevent it.

Ortiz went missing from her foster homes dozens of times, sometimes for days or even weeks, as she was trafficked around California and across state lines in Nevada, Oregon and Washington. But caseworkers never properly screened her to uncover that she had been raped, she said.

Foster care children are especially vulnerable to sex trafficking, and a 2014 federal law requires state authorities to screen missing children when they are found to determine whether they were sexually exploited. But a federal audit suggests that some states are failing in that duty, missing opportunities to connect kids with help and prevent further harm.

“Many kids across the country still go under the radar due to screening models across states that lack uniformity, consistency,” said Ortiz, who testified before a U.S. House panel in favor of the federal law. “The push from the top, from government and state officials, needs to ensure that it happens.”

The report last year on five states (Illinois, Massachusetts, Minnesota, Pennsylvania and Texas) by the Office of Inspector General at the U.S. Department of Health and Human Services found no evidence of a screening in 65 percent of the 413 case files of returned children between 2018 and 2019. The auditors selected those states because they reported the most runaway or missing children in 2018.

When caseworkers did screen children who had been missing, according to the audit, the workers sometimes relied on the kids themselves to say whether they had been victimized — a practice deemed unreliable because children often don’t disclose or even understand what they’re experiencing.

To conduct a screening, child welfare workers typically use a questionnaire or a checklist designed to detect exploitation. The screener should seek to determine, for example, whether the child has met with online acquaintances; if there has been prior abuse or trauma; and whether the youth is on edge or hypervigilant. New tattoos might be a trafficker’s way of “branding” the child as property.

Pennsylvania, Massachusetts, Minnesota and Illinois showed documented screenings for just 15 percent, 18 percent, 19 percent and 32 percent of children, respectively.

Overall, “states lacked a mechanism to ensure that screenings were conducted,” said Brian Whitley, Health and Human Services regional inspector general. He called the findings “alarming.”

Case files showed children received money from strangers, used or sold illegal substances, or got pregnant while missing, yet there was no evidence that caseworkers screened these same kids for sex trafficking when they were found, according to the audit.

Texas, which since 2015 has been under various court orders to improve its foster care system, had the highest documented screening rate at 83 percent. The federal auditors say the state might have scored particularly well because it has special investigators who conduct most trafficking screenings.

Pennsylvania’s Department of Human Services said it has taken steps to address child trafficking since the inspector general collected the data for its report, including implementing an agency screening policy for use by counties statewide.

“Pennsylvania takes seriously its responsibility to protect our most vulnerable children and youth and is committed to providing proper screening, assessment, and services to those who are at risk for, or are victims of, sex trafficking,” the agency wrote in a statement to Stateline.

The Illinois Department of Children & Family Services said leaders from the agency met with Health and Human Services to “better determine areas of improvement and act on them.” The agency also said it consulted with federal and state experts to develop a new screening tool, which is set to launch before the end of the year “accompanied by a training for all relevant staff and partners,” the agency said in an email.

Massachusetts said it is updating its information technology system to better document cases and has retrained staff on screening practices. The state also conducted its own audit and asserts higher screening rates than the inspector general’s findings, saying it found evidence to support screenings in 82 of 89 sample cases.

“Our systems need more checks and balances and definitely more investment,” said Zozan Kucukaydin, anti-human trafficking services coordinator with the Pennsylvania Coalition to Advance Respect, a sexual assault victim advocacy group.

Preying on vulnerabilities

Traffickers exploit vulnerabilities such as poverty and a lack of familial support and protection.

“You have a young person who already now doesn’t trust adults, and is not getting the connection that they need from their caseworker,” said Binley Taylor, director of system change at FosterClub, a national network of youth in foster care. “They’re not getting what they need. They are leaning more towards traffickers.”

Ortiz said the barber and her other traffickers promised her security and a sense of belonging.

“What did they not promise me?” she said. “It was simply my means to survive.”

The nonprofit advocacy organization National Foster Youth Institute estimates up to 60 percent of child sex trafficking victims are or have been in foster care. About a third of 335 youth at increased risk of trafficking surveyed by researchers in 2021 and 2022 for a federal study said running away or being kicked out preceded their first time being trafficked. Those who were trafficked were more likely to have multiple out-of-home placements and episodes of going missing, the survey found.

People of color, such as Ortiz, are disproportionately sex trafficked, according to the National Child Traumatic Stress Network.

“Overall, it’s those systemically underserved communities that have been put at that greater risk of trafficking and exploitation,” said Kucukaydin, of the Pennsylvania coalition.

Following the audit, the federal Administration for Children & Families last December issued a memorandum with recommendations for states.

But according to an analysis by the Vancouver, Washington-based sex trafficking prevention nonprofit Shared Hope International Institute for Justice & Advocacy, only 11 states (Colorado, Florida, Kansas, Kentucky, Maryland, Minnesota, Nebraska, Oklahoma, Tennessee, Texas and Utah) plus Washington, D.C., have laws mandating that child welfare agencies screen children who might have been sex trafficked. Of those, only three — Minnesota, Texas and Utah — specifically mandate screening children who went missing from foster care, according to the analysis.

All states are bound by the federal law, but the existence of a state mandate increases the chances that a child will be screened, especially since the federal law doesn’t specify what the screening should entail. Many state agencies use their own screenings, which can be part of an agency policy, though not codified in statute.

Sarah Bendtsen Diédhiou, an attorney and director of policy strategy at Shared Hope, said having statutory requirements can increase accountability for state child welfare agencies. State legislatures “could also require that the state report back on how that law is being implemented.”

Diédhiou said overall, there’s “a disconnect between what is required [by federal law] and what has actually been implemented.”

“We would argue that all states should mandate screenings for all system-involved young people. By virtue of being system-involved, a young person is at risk of exploitation,” she said. “They have the vulnerabilities or risk factors for exploitation.”

Ortiz said that because kids may be trafficked across different states, it’s critical for state agencies and law enforcement to share screening results.

Training screeners

Amy Robins, forensic services director of The Child Advocacy Center of Northeast Missouri, emphasized the importance of training screeners and professionals such as school staff, who are around children often, to recognize red flags.

Her organization offers training to local leaders to be able to spot youth potentially being trafficked.

Robins recalled a girl who was first known to the system in fifth grade. The girl, in foster care, would constantly run away. It wasn’t until she was in middle school that a school resource officer finally identified her as a trafficking victim, after the officer had attended multiple training and awareness sessions.

“She was so young. A lot of the time it was missed by schools and even law enforcement,” Robins said.

Melissa Carter, executive director of the Barton Child Law and Policy Center at Emory University in Atlanta, noted that overburdened child welfare workers often fail to even report that a foster child has gone missing.

“We have workers who are not well-trained all the time, not well-supported all the time, and may not be aware of what the policy requires,” Carter said. “Why children are so often missing from care has a lot to do with the system’s inability to promote healing.”

Experts say states also need to improve monitoring of group foster homes. Last year in Bastrop, Texas, state officials shut down a state-licensed foster care facility for girls who had been sex trafficking victims — after a court found evidence staff themselves were trafficking the children.

The lack of a “gold standard tool” that agencies nationwide can use is a serious shortcoming, according to Bethany Gilot, former statewide human trafficking prevention director at Florida’s juvenile justice and child welfare agencies. Gilot, who is chair of the National Child Welfare Anti-Trafficking Collaborative, noted that only one commonly used tool, the Commercial Sexual Exploitation-Identification Tool, has been researched and shown to be effective in a child welfare setting.

Many states use their own questionnaires, which may or may not be effective.

“I’m one of many,” Ortiz said. “If we don’t see this as an overlapping, interconnected issue, then we won’t really get to the root cause of any of it.”

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org. Follow Stateline on Facebook and Twitter.