About 200 children, nearly 15 percent of the 1,554 Philadelphia youths removed from their homes this year, live in residential facilities outside of Pennsylvania.

All of them need mental-health therapy, many because they have been abused or neglected. Some are kids pulled out of unsafe homes by DHS; others are juvenile offenders sent by the courts.

The city places children in out-of-state centers, sometimes hundreds or more than a thousand of miles away, because many facilities in Pennsylvania turn away deeply troubled or violent youths, Evans said.

For this, the city pays millions of dollars each year, as much as $112,000 per year per child, according to DHS figures.

Since Leach's death last summer, Evans said, DHS has been looking to bring kids home. "We're absolutely not OK" with the number of children in out-of-state institutions, he said.

But, he said, good alternatives are hard to find.

"You don't want to cause more trauma by pulling children from a facility and sending them to a place that's not a good fit," Evans said.

The same problems have shown up inside Pennsylvania; by far, most of DHS's clients are housed here. More than 20 city children have died in those institutions in the last decade, according to the state Department of Public Welfare.

But experts say the problems of oversight are exacerbated when regulators have to try to evaluate care from hundreds or more than a thousand of miles away.

Jeanne Milstein, the child advocate for Connecticut, has a theory why cities settle for substandard care.

"States and cities go into facilities with their hands over their eyes," she said, "because they're so desperate to place kids."

Richard Gelles, dean of the University of Pennsylvania School of Social Policy and Practice, said he understood there were too few beds and too many children.

But states can't use that as an excuse for keeping kids in a facility months after another child has been killed, he said.

"If you were a parent who had five kids and the babysitter killed one, would you say, 'That's the only babysitter I have?' "

Trouble far from home

Files show some facilities used by DHS were troubled almost from the day they opened. But DHS relied on them to care for scores of children, overlooking problems until tragedy forced its hand.

One such facility, the High Pointe juvenile treatment center in Oklahoma City, was willing to take on the hardest cases. DHS had plenty.

But Philadelphia kids placed there routinely ran away. Some were caught robbing people in the city, others turning tricks at truck stops, according to Oklahoma regulators and DHS reports.

Helena Costello was a wild 15-year-old when a Philadelphia judge took her from her Frankford home and sent her to High Pointe in 2001. In an interview, she said it had been just as easy to get in trouble there; drugs were easy to get, she said, and she had sex with male and female staff members.