[House Hearing, 110 Congress]
[From the U.S. Government Publishing Office]
CHILD ABUSE AND DECEPTIVE MARKETING
BY RESIDENTIAL PROGRAMS FOR TEENS
=======================================================================
HEARING
before the
COMMITTEE ON
EDUCATION AND LABOR
U.S. House of Representatives
ONE HUNDRED TENTH CONGRESS
SECOND SESSION
__________
HEARING HELD IN WASHINGTON, DC, APRIL 24, 2008
__________
Serial No. 110-89
__________
Printed for the use of the Committee on Education and Labor
Available on the Internet:
http://www.gpoaccess.gov/congress/house/education/index.html
______
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COMMITTEE ON EDUCATION AND LABOR
GEORGE MILLER, California, Chairman
Dale E. Kildee, Michigan, Vice Howard P. ``Buck'' McKeon,
Chairman California,
Donald M. Payne, New Jersey Senior Republican Member
Robert E. Andrews, New Jersey Thomas E. Petri, Wisconsin
Robert C. ``Bobby'' Scott, Virginia Peter Hoekstra, Michigan
Lynn C. Woolsey, California Michael N. Castle, Delaware
Ruben Hinojosa, Texas Mark E. Souder, Indiana
Carolyn McCarthy, New York Vernon J. Ehlers, Michigan
John F. Tierney, Massachusetts Judy Biggert, Illinois
Dennis J. Kucinich, Ohio Todd Russell Platts, Pennsylvania
David Wu, Oregon Ric Keller, Florida
Rush D. Holt, New Jersey Joe Wilson, South Carolina
Susan A. Davis, California John Kline, Minnesota
Danny K. Davis, Illinois Cathy McMorris Rodgers, Washington
Raul M. Grijalva, Arizona Kenny Marchant, Texas
Timothy H. Bishop, New York Tom Price, Georgia
Linda T. Sanchez, California Luis G. Fortuno, Puerto Rico
John P. Sarbanes, Maryland Charles W. Boustany, Jr.,
Joe Sestak, Pennsylvania Louisiana
David Loebsack, Iowa Virginia Foxx, North Carolina
Mazie Hirono, Hawaii John R. ``Randy'' Kuhl, Jr., New
Jason Altmire, Pennsylvania York
John A. Yarmuth, Kentucky Rob Bishop, Utah
Phil Hare, Illinois David Davis, Tennessee
Yvette D. Clarke, New York Timothy Walberg, Michigan
Joe Courtney, Connecticut [Vacancy]
Carol Shea-Porter, New Hampshire
Mark Zuckerman, Staff Director
Sally Stroup, Republican Staff Director
C O N T E N T S
----------
Page
Hearing held on April 24, 2008................................... 1
Statement of Members:
Altmire, Hon. Jason, a Representative in Congress from the
State of Pennsylvania, prepared statement of............... 57
McKeon, Hon. Howard P. ``Buck,'' Senior Republican Member,
Committee on Education and Labor........................... 5
Prepared statement of.................................... 8
Additional submissions:
Statement of Madeline McGrotha, alumni of New
Horizons for Young Women........................... 6
Statement of Kelsey Snoke, Kaysville, UT............. 7
Miller, Hon. George, Chairman, Committee on Education and
Labor...................................................... 1
Prepared statement of.................................... 4
Questions submitted to witnesses and their responses:
Dr. Bellonci......................................... 90
Ms. Brown............................................ 91
Mr. Kutz............................................. 93
Mr. Martin-Crawford.................................. 99
Ms. Whitehead........................................ 100
Additional submissions:
Compilation of testimony from Community Alliance for
the Ethical Treatment of Youth (CAFETY), Internet
address............................................ 58
Letter from Brew and Libby Hagood.................... 58
Abuse at a troubled teen ``faith-based'' program
using physical restraint by a ``chemical straight
jacket,'' by Doug Hoover........................... 59
Letters received concerning residential programs for
teens.............................................. 65
Platts, Hon. Todd Russell, a Representative in Congress from
the State of Pennsylvania, Department of Justice reports
for fiscal years 2004, 2005, and 2006, Internet address.... 44
Statement of Witnesses:
Bellonci, Christopher, M.D., child/adolescent and adult
psychiatrist, medical director, senior clinical consultant,
Walker School.............................................. 22
Prepared statement of.................................... 24
Brown, Kay, Director, Education, Workforce and Income
Security, U.S. Government Accountability Office............ 26
Prepared statement of.................................... 29
Kutz, Greg, Managing Director, Forensic Audits and Special
Investigations, U.S. Government Accountability Office...... 10
Prepared statement of.................................... 12
Martin-Crawford, Jon, former program participant at the
Family Foundation School, member, board of advisors, CAFETY 17
Prepared statement of.................................... 20
Whitehead, Kathryn, former program participant at Mission
Mountain School, founder, CAFETY........................... 12
Prepared statement of.................................... 15
CHILD ABUSE AND DECEPTIVE MARKETING BY RESIDENTIAL PROGRAMS FOR TEENS
----------
Thursday, April 24, 2008
U.S. House of Representatives
Committee on Education and Labor
Washington, DC
----------
The committee met, pursuant to call, at 10:03 a.m., in Room
2175, Rayburn House Office Building, Hon. George Miller
[chairman of the committee] presiding.
Present: Representatives Miller, Kildee, Scott, McCarthy,
Kucinich, Wu, Bishop of New York, Sestak, Loebsack, Hirono,
Altmire, Hare, Shea-Porter, McKeon, Petri, Platts, and Kline.
Staff present: Tylease Alli, Hearing Clerk; Tico Almeida,
Labor Policy Advisor; Jody Calemine, Labor Policy Deputy
Director; Sarah Dyson, Investigative Associate, Oversight;
Patrick Findlay, Investigative Counsel; Ruth Friedman, Senior
Education Policy Advisor (Early Childhood); Ryan Holden, Senior
Investigator, Oversight; Lloyd Horwich, Policy Advisor for
Subcommittee on Early Childhood, Elementary and Secretary
Education; Lamont Ivey, Staff Assistant, Education; Brian
Kennedy, General Counsel; Danielle Lee, Press/Outreach
Assistant; Sharon Lewis, Senior Disability Policy Advisor;
Stephanie Moore, General Counsel; Alex Nock, Deputy Staff
Director; Joe Novotny, Chief Clerk; Rachel Racusen, Deputy
Communications Director; Margaret Young, Staff Assistant,
Education; Michael Zola, Chief Investigative Counsel,
Oversight; Mark Zuckerman, Staff Director; Stephanie Arras,
Minority Legislative Assistant; James Bergeron, Minority Deputy
Director of Education and Human Services Policy; Robert Borden,
Minority General Counsel; Cameron Coursen, Minority Assistant
Communications Director; Kirsten Duncan, Minority Professional
Staff Member; Alexa Marrero, Minority Communications Director;
Susan Ross, Minority Director of Education and Human Resources
Policy; and Linda Stevens, Minority Chief Clerk/Assistant to
the General Counsel.
Chairman Miller [presiding]. The Committee on Education and
Labor will come to order for the purposes of conducting this
hearing on ``Child Abuse and Deceptive Marketing by Residential
Programs for Teens.''
Last October, this committee heard from the parents of
three children who died in private residential programs as a
result of abuse and neglect they experienced at the hands of
staff members. The stories these parents told left everyone in
this room stunned, heart-broken and angry.
Bob Bacon testified that program staff members mocked his
son Aaron when the 16-year-old boy asked for medical help,
calling him a faker. For weeks, the staff deprived Aaron of
adequate food and water, even when his weight loss became
frighteningly apparent.
Cynthia Harvey told the committee that program staff
members waited 45 minutes before summoning appropriate medical
care for her daughter Erica, who had collapsed and was having
difficulty breathing.
Paul Lewis testified that program staff members ignored his
son Ryan's obvious signs of emotional distress, denying him the
psychiatric care that could have saved his life.
In each of these cases, it was clear from the parents'
testimony that the deaths of their children were preventable.
Untrained, uncaring staff, reckless management and
irresponsible operating practices permitted these horrible
tragedies to occur.
Sadly, the deaths of Aaron, Erica and Ryan are not isolated
cases. The Government Accountability Office found thousands of
allegations of abuse and neglect in private residential
programs for teens between 1990 and 2007.
The abuses included staff members forcing children to
remain in so-called ``stress'' positions for hours at a time;
to undergo extreme physical exertion without food, water or
rest; and to eat their own vomit.
The purpose of today's hearing is to gain a better overall
understanding of the industry in which these types of abuses
have been allowed, in many cases, to continue almost unchecked.
Specifically, we will learn more about where these programs
operate, the loose patchwork of state laws that govern them,
and how they market themselves to parents.
We will also discuss legislation that Congresswoman
McCarthy and I have introduced to keep kids safe in these
residential programs.
Residential programs for teens, which come in a variety of
forms, including therapeutic boarding schools, wilderness
camps, boot camps and behavior modification facilities, have
sprung up in greater numbers since the 1990s.
As we will hear today, a number of these programs use
deceptive marketing practices to appeal to parents. They claim
to be subject to independent inspections that never happen.
They claim to offer services that they don't, like schooling
with transferable education credits. They assure parents that
health insurance will cover the cost of their services when, in
reality, it won't.
Programs are aided in these deceptions by their
relationships with ancillary service providers, like referral
services. While referral services purport to offer independent
advice to parents about which programs would be best for their
children, the truth is that at least some of the referral
services operate with significant conflicts of interest.
This tangled web of deception, fraud and conflicts of
interest makes it extremely difficult for parents to judge
whether any of these programs offer a safe, professional, high-
quality environment for their children.
We know that there are many programs and many people around
the country who are committed to helping improve the lives of
young people and who do good work every day, but it is
difficult for parents to tell the good programs from the bad.
And that difference can be lethal.
Making matters worse, some of these programs operate free
of minimum standards of care. It is estimated that hundreds of
these programs operate nationwide, with anywhere from no
regulation whatsoever to some regulation.
Even the information that states collect on many of these
programs is limited. Indeed, in a survey conducted by the GAO,
state agencies in 45 states could not say whether or not a
death had occurred at exclusively private residential programs
for teens in 2006.
The legislation that Congresswoman McCarthy and I have
introduced will end the federal government's longstanding
failure to address this nightmare of abuse and neglect. The
goal of our legislation is simple: We want to keep the children
safe.
This legislation will require the U.S. Department of Health
and Human Services to establish minimum standards that all
programs must meet, including prohibitions on the physical and
mental abuse of children and requirements that programs provide
children with adequate food, water and medical care.
These standards will also include new training requirements
for program staff members, including how to identify and report
child abuse. The legislation will require Health and Human
Services to set up a hotline for people to call to report abuse
at these programs.
It will also require Health and Human Services to create a
Web site with information about each program, so that parents
can look to see if substantiated cases of abuse have occurred
at the programs they are considering for their kids.
The legislation will require Health and Human Services to
enforce these standards by inspecting program facilities and,
when there is a violation, by issuing civil penalties up to
$50,000 per violation. Within 3 years, the legislation would
call upon the states to take up this role of setting standards
and enforcing them.
We have an obligation to keep kids safe no matter what
setting they are in, and this legislation would take the first
steps toward finally ending the horrific abuses that have gone
on for far too long in some of these private residential
programs for teens.
We must treat this issue with the urgency it demands by
acting on this legislation quickly.
Individuals who have themselves lived through this abuse
are in the hearing room today, as are family members of abuse
victims. I want to thank all of them for being here to remind
us why this issue is so important.
And I wanted to thank our witnesses. We appreciate that you
took the time to be with us today, and we look forward to
hearing your testimony.
At this point, I recognize Congressman McKeon from
California, who is the senior Republican on the committee. And
then we will turn to the panel of witnesses for your testimony.
Congressman McKeon?
[The statement of Mr. Miller follows:]
Prepared Statement of Hon. George Miller, Chairman, Committee on
Education and Labor
Good morning. Welcome to today's hearing on ``Child Abuse and
Deceptive Marketing by Residential Programs for Teens.''
Last October, this Committee heard from the parents of three
children who died in private residential programs as a result of the
abuse and neglect they experienced at the hands of staff members.
The stories these parents told left everyone in this room stunned,
heartbroken, and angry.
Bob Bacon testified that program staff members mocked his son,
Aaron, when the 16-year-old boy asked for medical help, calling him a
``faker.'' For weeks, the staff deprived Aaron of adequate food and
water--even when his weight loss became frighteningly apparent.
Cynthia Harvey told the committee that program staff members waited
45 minutes before summoning appropriate medical care for her daughter,
Erica, who had collapsed and was having difficulty breathing.
Paul Lewis testified that program staff members ignored his son
Ryan's obvious signs of emotional distress, denying him the psychiatric
care that could have saved his life.
In each of the three cases, it was clear from the parents'
testimony that the deaths of their children were preventable. Untrained
and uncaring staff, reckless management, and irresponsible operating
practices permitted these horrible tragedies to occur.
Sadly, the deaths of Aaron, Erica, and Ryan were not isolated
cases.
The Government Accountability Office found thousands of allegations
of abuse and neglect at private residential programs for teens between
1990 and 2007.
The abuses included staff members forcing children to remain in so-
called ``stress'' positions for hours at a time; to undergo extreme
physical exertion without food, water, or rest; and to eat their own
vomit.
The purpose of today's hearing is to gain a better overall
understanding of the industry in which these types of abuses have been
allowed, in many cases, to continue almost unchecked.
Specifically, we will learn more about where these programs
operate, the loose patchwork of state laws that govern them, and how
they market themselves to parents.
We will also discuss legislation that Congresswoman McCarthy and I
have introduced to keep kids safe in residential programs.
Residential programs for teens--which come in a variety of forms,
including therapeutic boarding schools, wilderness camps, boot camps,
and behavior modification facilities--have sprung up in greater numbers
since the 1990s.
As we will hear today, a number of these programs use deceptive
marketing practices to appeal to parents.
They claim to be subject to independent inspections that never
happen.
They claim to offer services that they don't, like schooling with
transferable education credits.
They assure parents that health insurance will cover the cost of
their services when in reality it won't.
Programs are aided in these deceptions by their relationships to
ancillary service providers, like referral services.
While referral services purport to offer independent advice to
parents about which programs would be best for their children, the
truth is that at least some of the referral services operate with
significant conflicts of interest.
This tangled web of deception, fraud, and conflicts of interest
makes it extremely difficult for parents to judge whether any of these
programs offer a safe, professional, high-quality environment for their
children.
We know that there are many programs and many people around the
country who are committed to helping improve the lives of young people
and who do good work every day, but it is difficult for parents to tell
the good programs from the bad.
Making matters worse, these programs often operate free of minimum
standards of care. It is estimated that hundreds of the programs
operate nationwide, with anywhere from no regulation whatsoever to some
regulation.
Even the information that states collect on many of these programs
is limited. Indeed, in a survey conducted by the GAO, state agencies in
45 states could not say whether deaths had occurred at exclusively
private residential programs for teens in 2006.
The legislation that Congresswoman McCarthy and I have introduced
will end the federal government's longstanding failure to address this
nightmare of abuse and neglect.
The goal of our legislation is simple--we want to keep children
safe.
The legislation will require the U.S. Department of Health and
Human Services to establish minimum standards that all programs must
meet, including prohibitions on the physical and mental abuse of
children and requirements that programs provide children with adequate
food, water, and medical care.
These standards will also include new training requirements for
program staff members, including how to identify and report child
abuse.
The legislation will require HHS to set up a hotline for people to
call to report abuse at these programs. It will also require HHS to
create a website with information about each program, so that parents
can look to see if substantiated cases of abuse have occurred at a
program that they are considering for their kids.
The legislation will require HHS to enforce these standards by
inspecting program facilities and, when there are violations, by
issuing civil penalties of up to $50,000 per violation. Within three
years, the legislation would call upon the states to take up this role
of setting standards and enforcing them.
We have an obligation to keep kids safe no matter what setting they
are in, and this legislation would take the first step toward finally
ending the horrific abuses that have gone on for too long in private
residential programs for teens.
We must treat this issue with the urgency it demands by acting on
this legislation quickly.
Individuals who have themselves lived through this abuse are in the
hearing room today, as are family members of abuse victims. I want to
thank you all for being here to remind us why this issue is so
important.
I also want to thank all of our witnesses. We appreciate that you
took the time to be with us today and we look forward to hearing your
testimony.
Thank you.
______
Mr. McKeon. Thank you, Chairman Miller. And good morning.
We are here today for our second hearing on residential
treatment facilities for teens. I know I speak for all my
colleagues when I say that I was deeply troubled by the
testimony we heard last year.
Many of these facilities have been established to serve
children who are deeply troubled. Whether they are suffering
from drug addiction or severe emotional or behavioral problems,
many of the youth who enter these facilities are placed there
by parents as a last resort.
Yet no parent, no matter how serious the troubles their
child may face, would knowingly send their child to a place
where they may be abused or neglected.
Today's hearing builds on our findings from last year by
examining the marketing practices of residential treatment
facilities. Once again, I expect we will hear of some worst-
case scenarios in which parents may have been deliberately
misled.
Our witness panel also includes former participants in
these types of programs. I want to take a moment to thank these
witnesses for offering their testimony today, when I know they
have faced some very difficult experiences.
At the outset of today's hearings, I think it is important
that we ask the same questions that we asked last year: How
pervasive are these problems? What safeguards are in place to
protect against them? And what are the best practices in the
industry so that we can encourage broader adoption of their
practices?
The facilities we are examining today receive no federal
funding under the Juvenile Justice Programs this committee has
been working to reform over the past year. Nonetheless, I
understand that Chairman Miller has introduced legislation that
would establish a federal regulatory structure and mandate
state regulatory systems.
I am eager to work with him on our shared effort to stop
instances of neglect, abuse and death. At the same time, we
must be mindful of the ramifications of any new federal
intervention, in order to ensure these issues are addressed in
the best, most appropriate and most effective possible manner.
The question of the scope of the problem will be important
as we continue to examine the possibility of federal
legislation. Although even one instance of child abuse and
neglect is too many, we cannot provide an effective response
until we understand whether the problems are a few isolated
incidents or part of a larger pattern.
We also need to understand how these facilities are being
regulated under state and local laws. The last thing we hope to
do is create a patchwork of confusing regulations that would
undercut our ability or the ability of states to protect young
people and their families.
One area I think deserves greater attention in our
deliberations is the question of what works. We are right to
focus on cases where children have been harmed or parents have
been misled. But the picture would be incomplete without also
examining the stories of those young people who have been able
to turn their lives around thanks to this type of intervention.
Mr. Chairman, I request that two pieces of testimony be
included in the record in order to broaden and enlighten the
discussion. This testimony comes from two young women who had
positive, life-changing experiences at residential treatment
facilities.
Chairman Miller. Without objection, they will be made part
of the record.
[The information follows:]
Prepared Statement of Madeline McGrotha, Alumni of New Horizons for
Young Women
I honestly believe I am alive today as a result of the wilderness
program that I attended. I attended a wilderness program by the name of
New Horizons for Young Women located in Maine from March 1st, 2006
until May 1st, 2006. It was the best and most rewarding experience of
my life and I am truly blessed to have been given the chance to
experience the help that I received at New Horizons.
Beginning in middle school I spun into a deep depression.
Throughout the years it developed into something worse and worse. At
the age of 16 I dropped out of high school and didn't see any reason
for myself to keep living. I hated myself, my family, and the world.
People had tried to help me in any way that they could, but I was
extremely defiant and not receptive to any of the help that was being
offered to me. I had been to numerous therapists, tried many different
prescription drugs for my depression, but nothing seemed to work. I
needed something more, something that I couldn't get in the environment
that I was in.
Wilderness took me out of my normal environment. It removed me from
my family problems, a harmful boyfriend, and a crowd of people that I
didn't need to associate myself with. It allowed me to focus on myself
for the first time in my life. I was surrounded by people who cared
about my well being and showed that to me in every possible way they
could.
While I was in the wilderness program I gained so much confidence
through completing the day to day activities that we had to do. In the
program we lived in tents in the woods of Maine. Before this experience
I had never even been camping before, so living in the woods for two
months is a huge accomplishment for me and something that I am very
proud of. I learned to saw down small trees, make a fire without a
lighter, cook my own food along with many other things I would have
never thought I would be able to do. We hiked during the day and even
though it was physically hard sometimes, it wasn't anything too
strenuous and it was actually very therapeutic. On these hikes it gave
me time to really think about things, most importantly to me, the
relationship with my mother and father which had become so damaged and
destructive over the past couple of years. It also gave me a chance to
talk in a non threatening environment with the counselors about the
thoughts I was having. Wilderness in my experience was in no way a boot
camp and after the first week it was apparent that this was not
punishment but a tool to help me grow into the person that I
unknowingly wanted and needed to be.
I want to personally make sure that every person is able to
continue to get the help that they so desperately need from these types
of programs. These programs save lives and I can't stress enough how
important that is. I truly feel like my success is a direct result of
the program that I attended. I graduated on time from a traditional
boarding school in Texas called San Marcos Baptist Academy and
currently am studying psychology at the University of North Florida. I
am also involved in a sorority on campus, Kappa Delta. Another huge
accomplishment is the mended relationships that I have developed with
my mother and father, which is extremely important to me. After my
experience I learned to successfully function in society and I feel
that none of this would have been possible without my life changing
experience in my wilderness program.
______
Prepared Statement of Kelsey Snoke, Kaysville, UT
My name is Kelsey Snoke and I am 18 years old. I am writing this to
give you a brief feel of my story.
When I was in about eighth grade I started having bad mood swings,
depression, and anxiety. When I was feeling down, I started cutting and
burning myself to forget about what I was feeling. It never got any
better, just worse.
I started going to a therapist regularly. It was hard because I
couldn't find one that I connected with. The end of my ninth grade was
the beginning of the worst of the problems I was having. I started
going to day treatment during the day and at night would go home. I
also spent two separate weeks in acute treatment. After I was finished
with these programs, I was doing well for a few months and then fell
back into the same behaviors. My parents and I began to realize that it
was only a short term fix and didn't really do much for me long term. I
started hating school and refused to go any more. I was way behind on
my work and honestly never thought I would ever finish high school.
Things started getting severely out of control. My parents weren't
sure how to help me anymore and started looking for other options. I
knew I needed help and agreed with my parent's decision to find a long
term residential program. They researched the different options and
found a program in Spanish Fork Utah called New Haven.
The three of us were able to visit the campus to take a tour and
got to meet with some girls that were in the program. I knew right then
that it was a place that could help me. My parent's took me to New
Haven right after Thanksgiving in 2006 to start the program and I ended
up staying for nine and a half months.
It was very difficult at first being in a new place and not being
able to see my family every day. I was very nervous and didn't want to
participate in activities and groups. I soon realized that I needed to
open up and start working on my issues. There was a lot of work
involved in progressing in the program that included me and my parents.
There were many group activities such as tasks for recreational
therapy, equine therapy, as well as group therapy on specific topics
that helped me learn to trust my peers and people around me.
Every six weeks New Haven held a family weekend for parents to come
and participate with their girls in activities around campus. On the
second family weekend, some things happened that was a turning point in
my treatment.
There was a rope course in the field that was about thirty feet
high with a rope and log ladder and a suspended log beam at the top. I
always looked at it and hoped I would never have to do any activities
with it. When it was our family's turn for rec. therapy, the therapist
told me I needed to get over my fear and climb the rope course. I was
overwhelmed and scared to death. They helped me put on a harness and
other equipment and then we got started. I was to climb the ladder that
was swaying with each step and had to say something that I am capable
of with each step. It was very difficult and scary, but I did it! At
the top I walked across the beam and stood there reflecting on what I
had done before I came down. I was very proud of myself for
accomplishing this task. This is only one of the many things I did that
taught me that I can do anything I put my mind to do.
New Haven has been a very positive experience for me. I don't know
where I would be in my life if I hadn't completed this program. I have
learned so many things. I can go to my family when there are problems
and need support. I have learned to build positive relationships. I
have learned to be independent and do things on my own. I have learned
to accept responsibility for my actions. I'm finishing my senior year
of high school and will be graduating on time. I can do things I never
thought I could do. But most of all--I learned to love myself!
______
Mr. McKeon. Once again, I want to thank Chairman Miller for
his leadership on this issue, and I want to thank each of our
witnesses for being here to explore this important issue.
I expect that we will proceed thoughtfully, cautiously and
deliberately on this issue in the coming months in an effort to
ensure youth and their families are protected.
And I yield back.
[The statement of Mr. McKeon follows:]
Prepared Statement of Hon. Howard P. ``Buck'' McKeon, Senior Republican
Member, Committee on Education and Labor
Thank you Chairman Miller, and good morning. We're here today for
our second hearing on residential treatment facilities for teens.
I know I speak for all my colleagues when I say that I was deeply
troubled by the testimony we heard last year. Many of these facilities
have been established to serve children who are deeply troubled.
Whether they are suffering from drug addiction or severe emotional or
behavioral problems, many of the youth who enter these facilities are
placed there by their parents as a last resort. Yet no parent, no
matter how serious the troubles their child may face, would knowingly
send their child to a place where they may be abused or neglected.
Today's hearing builds on our findings from last year by examining
the marketing practices of residential treatment facilities. Once
again, I expect we will hear of some worst case scenarios in which
parents may have been deliberately misled. Our witness panel also
includes former participants in these types of programs. I want to take
a moment to thank these witnesses for offering their testimony today,
when I know they faced some very difficult experiences.
At the outset of today's hearing, I think it's important that we
ask the same questions that we asked last year: how pervasive are these
problems? What safeguards are in place to protect against them? And
what are the best practices in the industry, so that we can encourage
their adoption?
The facilities we are examining today receive no federal funding
under the juvenile justice programs this committee has been working to
reform over the past year. Nonetheless, I understand that Chairman
Miller has introduced legislation that would establish a federal
regulatory structure and mandate state regulatory systems. I am eager
to work with him on our shared effort to stem instances of neglect,
abuse and death. At the same time, we must be mindful of the
ramifications of any new federal intervention in order to ensure these
issues are addressed in the best, most appropriate, and most effective
possible manner.
The question of the scope of the problem will be important as we
consider the possibility of federal legislation. Although even one
instance of child abuse and neglect is too many, we cannot provide an
effective response until we understand whether the problems are a few
isolated incidents or part of a larger pattern.
We also need to understand how these facilities are being regulated
under state and local laws. The last thing we hope to do is create a
patchwork of confusing regulations that would undercut our ability, or
the ability of states, to protect young people and their families.
One area that I think deserves greater attention in our
deliberations is the question of `what works'. We are right to focus on
cases where children have been harmed or parents have been misled. But
the picture would be incomplete without also examining the stories of
those young people who have been able to turn their lives around thanks
to this type of intervention. Mr. Chairman, I request that two pieces
of testimony be included in the record in order to broaden and
enlighten the discussion. This testimony comes from two young women who
had positive, life changing experiences at residential treatment
facilities.
Once again, I want to thank Chairman Miller for his leadership on
this issue, and I want to thank each of our witnesses for being here to
explore this important issue. I expect that we will proceed
thoughtfully, cautiously, and deliberately on this issue in the coming
months in an effort to ensure youth and their families are protected. I
yield back.
______
Chairman Miller. Thank you.
The chair notices the presence of a quorum. And before
introducing our witnesses, let me briefly lay out how we will
proceed in today's hearing.
Because of the importance of this issue, I am exercising
the right to extend the 5-minute rule for myself and Mr.
McKeon. Following the witnesses' testimony, we will each have
15 minutes apiece for questioning.
It is our intention to yield 5 minutes of our time to the
chairwoman and senior Republican of the Subcommittee on Healthy
Families and Communities, Ms. McCarthy and Mr. Platts.
Following the expiration of extended questioning, all of
the members will be recognized for 5 minutes.
And, with that, let me introduce our witnesses.
Our first witness will be Mr. Gregory Kutz, who is
currently the managing director of GAO's Forensic Audits and
Special Investigation unit. Mr. Kutz has testified and written
investigative reports about the federal government's handling
of Hurricanes Katrina and Rita, military pay problems at the
Department of Defense, and smuggling of nuclear materials
across our nation's borders, among other important issues.
He is accompanied by Andy O'Connell, the assistant director
of investigations at GAO.
Kathryn Whitehead is a former program participant at
Mission Mountain School, where she spent 18 months as a
teenager. She currently works for the Mental Health Association
of New York City's Coordinated Children's Services Initiative,
working toward keeping struggling youth in their communities.
Ms. Whitehead is also a co-founder of the Community Alliance
for the Ethical Treatment of Youth, an advocacy organization
whose mission is ending human rights abuses of youth in
residential programs.
Jon Martin-Crawford is a former program participant at the
Family Foundation School, where he spent almost 2 years as a
teenager. Jon is currently working toward a double master's in
English and secondary education, and is also working with the
Community Alliance for the Ethical Treatment of Youth, hoping
to shed light on the troubled teen industry.
Dr. Christopher Bellonci is the board-certified child/
adolescent/adult psychiatrist, who has worked in residential
treatment in school consultation since completing his child
psychiatry training at McLean Hospital in 1993. He is currently
the medical director and senior clinical consultant at Walker
in Needham, Massachusetts, working with children experiencing
severe emotional and behavioral disorders secondary to major
mental illnesses, trauma and developmental disorders. Dr.
Bellonci is on the Mental Health Advisory Board of the Child
Welfare League and is a board member of the American
Association of Children's Residential Centers.
Kay Brown is the director of GAO's Education, Workforce and
Income Security team and has more than 20 years' experience at
GAO. She is responsible for GAO's work related to child
welfare, child support, domestic nutrition assistance, among
other social programs. Throughout her career at the GAO, Ms.
Brown has managed projects that focused on improving
governmental performance and services to children and families,
disability and retirement benefit delivery, and customer
service and program integrity.
She is accompanied by Cindy Ayers, assistant director for
Education, Workforce and Income Security at the GAO.
And, Mr. Kutz, we will begin with you. And I believe under
our arrangement, you will be allowed 10 minutes. As you know,
there will be an orange light when there is 1 minute left and
then a red light, and we hope that you will be able to wrap up
your testimony, but we clearly want you to be able to complete
your thoughts in a coherent fashion.
Welcome to the committee, and thank you for your work.
STATEMENT OF GREG KUTZ, MANAGING DIRECTOR, FORENSIC AUDITS AND
SPECIAL INVESTIGATIONS, U.S. GOVERNMENT ACCOUNTABILITY OFFICE
Mr. Kutz. Mr. Chairman and members of the committee, thank
you for the opportunity to discuss residential programs for
troubled youth.
Last year I testified that negligent practices contributed
to the death and abuse of troubled youth. Today's testimony
responds to your request that we continue our work in this
area.
My testimony has two parts. First, I will discuss cases of
death and abuse. Second, I will discuss industry marketing
practices. I will also play excerpts from telephone calls we
made to certain programs while posing as fictitious parents
with troubled youth.
First, we took an in-depth look at eight cases of youth
that died or were allegedly abused at private programs. It is
important to note that we did not evaluate the benefits of
these programs. In addition, the results of case studies cannot
be projected to all programs.
For these cases, we found that untrained staff and
ineffective management contributed to the death and abuse of
youth. Human restraint also played a key role in several cases.
The following examples will provide more detail.
First, one group became lost and spent several additional
hours hiking when the reported heat index outside was 120
degrees. A 14-year-old boy, weighing 250 pounds, had problems
breathing, but was encouraged by the staff to continue. When he
returned to the camp, he collapsed against a tree and fell to
the ground. Staff believed that he was faking it until he
vomited, became unresponsive and ultimately died.
A 17-year-old male jumped off of a building in a suicide
attempt and severely broke his left arm, with the bone exposed.
Despite this severe wound, the boy was punched, slammed against
walls and rolled in the dirt. He was beaten so severely that he
forgot who he was and he became unconscious. These beatings
continued for 2 weeks before he was finally given medical
treatment.
A 16-year-old boy having trouble breathing and walking was
tortured and humiliated for days. One staff member told the boy
that he deserved an Academy Award for faking it. He died later
that day. An autopsy report for this boy showed 71 contusions
and abrasions from head to toe.
Another 16-year-old boy with asthma was placed in a face-
down restraint by three staff members before he died. Another
boy was restrained more than 250 times, including two times for
more than 12 hours each. A 12-year-old boy, weighing 87 pounds,
was placed in a face-down restraint with a staff member lying
on top of him until he died.
And a staffer referred to as the ``drill instructor''
trained his pitbull to bite people in the crotch on command. A
17-year-old boy experienced this painful abuse.
Other kids in these and other programs also experienced
disturbing abuse. For example, boys at one boot camp were
required to stand with bags over their head and a hangman's
noose around their neck. The rope on this noose was tightened
to simulate a hanging. The individual responsible for this told
officers that this was an appropriate form of discipline.
Another boy was forced to lie face-down on a red ant hill
and was not allowed to brush the ants off of his face or his
body. In a separate incident, this boy was required to lie on
his stomach for 10 hours. He was only allowed to get up to
vomit, and then he was required to clean up his vomit before he
got down on the ground again.
And finally, the posterboard shows the picture of a horse
in Canada. This horse was starved, as you can see by the
protruding ribcage. Neglect also resulted in the problems with
the hoof that you see on the picture.
You are probably wondering what this has to do with today's
hearing. Here is the interesting answer to that question: This
horse belonged to the owner of one of our case-study programs.
This owner was convicted in Canada for cruelty to 39 horses and
seven Golden Retrievers.
Although he received a lifetime ban from taking care of
animals in Canada, he was allowed to take care of teenagers
here in the United States, and the results should not be
surprising. He and his wife were cited in Utah for, among many
things, use of profane language to humiliate youth, improper
seclusion, and rat infestation.
Let me move on to my second point of my testimony here.
Posing as fictitious parents with troubled teenagers, we called
a number of programs and referral services to see what they
would tell us. What we found were examples of deceptive and
other questionable marketing practices. Let me describe a few
of these cases for you.
First, one program told our fictitious parent that they
must apply to have their child admitted to the program.
Although we never actually applied, the posterboard on my right
shows that our fictitious child, Devon, was approved for
admission to this program.
One fictitious parent was also told that membership in a
trade association was like a Good Housekeeping seal of
approval. One program went so far as to tell us that site
inspections were performed by this association. The reality is
that this association simply collects dues but does no due
diligence of any programs.
And one referral service told our fictitious parent that
the boot camp they recommended feeds the child a whole-grain
diet and that, along with exercise and rest, ``the bipolar, the
depression, those kinds of things, they just go away after a
while.''
Our fictitious parent heard other deceptive and
questionable information during our undercover calls. Issues
related to taxes, reimbursement of health insurance, and
education provided.
One explanation for these shady marketing practices relates
back to the root cause of many problems: money. These programs
aren't cheap. Costs for the programs that we called ranged from
$2,800 per month to over $13,000 per month.
In conclusion, we, as a country, judge other countries
harshly for their human rights violations. Yet, at the same
time, we found torture and abuse of youth across the United
States. I can't tell you how widespread this problem is, but if
the only horror stories are the ones that I have described for
you, then isn't that enough?
Mr. Chairman, I want to commend you for your continued
oversight of this matter. We support the committee's efforts to
put a framework of oversight and control in place over these
programs. Although the youth we are talking about today are
troubled, that shouldn't be an excuse for anybody to torture
and abuse them.
I now want to play the excerpts I mentioned at the
beginning of my statement here of some of the phone calls we
made, posing as fictitious parents with troubled youths. And
what you will see on the screen, assuming it works, is the
transcriptions of these conversations on the monitor while you
listen.
[Audio clip played.]
Mr. Kutz. Mr. Chairman, thank you for being generous with
my time, and that ends my statement.
[The statement, ``Residential Programs: Selected Cases of
Death, Abuse, and Deceptive Marketing,'' may be accessed at the
following Internet address:]
http://www.gao.gov/new.items/d08713t.pdf
______
Chairman Miller. Thank you.
Ms. Whitehead, welcome again. You will be given 5 minutes.
And at some point, there will be an orange light in front of
you, and that will give you an idea that there is about a
minute. But, again, we want you to complete your thoughts in a
manner that you are comfortable with.
Thank you.
STATEMENT OF KATHRYN WHITEHEAD, FORMER PROGRAM PARTICIPANT,
MOUNTAIN MISSION SCHOOL
Ms. Whitehead. Good morning, Chairman Miller, Ranking
Member McKeon and distinguished members of the committee. Thank
you for this opportunity to testify before you today. I
appreciate your leadership and efforts to help protect youth
from abuse and neglect by convening this hearing.
I am here to share the tragic experience of myself and
family at an unregulated facility in Montana called Mission
Mountain School, a NATSAP member program where the headmaster,
John Mercer, served on the board of directors for several
years.
I will also speak on behalf of a youth survivor advocacy
group, the Community Alliance for the Ethical Treatment of
Youth, to the general concerns of youth placed in private
residential care.
At the age of 13, I was diagnosed with chronic depression
following a suicide attempt and hospitalized at a local
psychiatric hospital. When I was discharged, lacking any
community-based support, my family sought to identify services
outside of my community and found Mission Mountain School at
the recommendation of a hired educational consultant.
Mission Mountain School held great promise, as it was sold
to us as a small, family-like therapeutic environment for girls
ages 12-18 with above-average intelligence. I packed my
treasured belongings, reminders of home, and my mom and I flew
out to Montana.
I felt hopeful that maybe this special school for kids like
me would help, as they claimed to have the ability to treat any
myriad of serious psychiatric issues, such as bipolar disorder,
eating disorders and depression. Sadly, this couldn't be
further from the truth.
Upon arrival, I quickly encountered the punitive and
invasive interventions which would come to define my 18 months
at Mission Mountain School. My mom left me shortly after we had
arrived, and most of my belongings were taken from me.
I never received any explanation of the rules of the
program, though the rules quickly took shape during the series
of group sessions held daily. Everyone was called out in group
when they first arrived. Every infraction was framed as an act
of dishonesty. We were all labeled liars and manipulators upon
arrival.
Often there were punishments when we were thought to have
been dishonest, euphemistically called ``consequences.''
Consequence always involved some type of physical punishment:
forced labor, exercise, labor such as ice-picking, rock-
picking, and chopping wood. More serious rule-breaking would
result in what was called an ``intervention,'' which was work
crew all day long, with breaks only during group chores and
mealtime.
There were personal interventions and group interventions.
Sometimes the group was put on interventions which would last
weeks, if not months, and during this time no contact was
allowed with the outside world--in contrast to our already
monitored and censored contact under usual conditions.
It was generally understood that we were being exhausted
for the purpose of making us more truthful, whatever that meant
to those in charge. Exercise was a rigorous daily requirement.
Slowing down from exhaustion only resulted in more exercise or
getting yelled at. Staff would often use profanity.
I was not allowed to speak with my family for months after
I arrived, and calls thereafter were monitored. Any criticisms
were labeled as ``manipulative,'' and my phone call was
promptly disconnected, followed by punishment.
The most powerful figure at the facility was a headmaster
with no formal training in mental health and whose group
therapy sessions were particularly bizarre and frightening. He
was often confrontational or would smirk and laugh.
He would attempt to unearth repressed memories and
encourage regressive states. I recall on multiple occasions my
friends speaking as if they were toddlers, recounting alleged
instances of abuse. Hours would be spent with girls reliving
their traumatic experiences at the unqualified hands of the
staff.
Intensive group sessions sometimes lasted all night.
Bathroom use was prohibited. Any allegations of abuse discussed
in group therapy were never reported by staff to proper
authorities.
Because all the founders were members of A.A., it seemed to
them that everyone was an addict of sorts. I was deemed an
alcoholic and a sex addict. A close friend was deemed a sex
addict. She had never had sex in her life and denied the claim.
And as a result, staff forced her to carry six large rocks on
her back at all times for several months, naming them issues
like ``sexual abuse'' and ``sex addiction,'' causing bruising
along her spine.
At other times, inappropriate and humiliating interventions
were used, such as forbidding youth from talking for several
weeks, forcing youth to wear gloves because it was thought they
were masturbating, or tying two girls together because they
didn't get along.
When I got caught with a plan to run away, I was placed on
a personal intervention, where I had to rock-pick for a week, 8
to 10 hours a day, and at one point dropped off 25 miles from
school and forced to hike back. This was all done in the name
of therapy.
Education was nearly nonexistent; claims of illness taken
as manipulative. We had no access to advocates, no rights
whatsoever.
Then one day, 18 months later, I was told I was to be
discharged. I had visited home maybe twice while there and was
ever more grossly ill-prepared to function in the world. My
nights were filled with a reoccurring nightmare of being chased
by the founders and brought back to the facility, despite
protests that I was healthy now.
In the end, all Mission Mountain School gave me was more
confusion, increased anxiety and depression, and made social
functioning after discharge ever more difficult.
The work I have done since then I anticipate will speak to
the broad pattern of atrocities Dr. Pinto commented on in her
testimony at the hearings in October 2007.
As co-founder and executive director of the Community
Alliance for the Ethical Treatment of Youth, I have heard from
over 1,000 survivors and understand that, in most instances,
parents remain unaware of the abuse their children have
experienced and often firmly believe the program saved their
child's life.
To me, this is the saddest repercussion of these
facilities. At once not only is the trust between parent and
child broken, but the truth is further hidden behind the facade
promulgated by deceived parents.
What I am hoping to convey----
Chairman Miller. Ms. Whitehead, I am going to ask you to
wrap up, if you might.
Ms. Whitehead. What I am hoping to convey today through my
testimony is that numerous residential facilities that are in
operation are stripping youth of their basic human rights to
dignity, respect, to least restrictive care, appropriate mental
health treatment, to education and parental contact, to freedom
of thought and opinion, and ultimately to freedom from
censorship and torture.
The legitimate practice of therapeutic intervention is
being injected with a perverse form of social control,
including inhumane treatment practices, which defy the ethical
principles upheld by peer-reviewed mental health practices.
I believe this bill to be a promising and important first
step in curbing such draconian methodology and applaud Chairman
Miller for introducing the first piece of comprehensive
legislation to that end.
Thank you.
[The statement of Ms. Whitehead follows:]
Prepared Statement of Kathryn Whitehead, Former Program Participant at
Mission Mountain School and Founder of Community Alliance for the
Ethical Treatment of Youth (CAFETY)
Good morning Chairman Miller, Ranking Member McKeon and
distinguished members of the Committee. Thank you for this opportunity
to testify before you today. I appreciate your leadership and efforts
to help protect youth from abuse and neglect by convening this hearing.
I am here to share the tragic experience of myself and family at an
unregulated facility in Montana called Mission Mountain School. I am
also here to tell you about the patterns of mistreatment and abuse of
youth in residential programs across the country, which I have become
aware of through my work with the youth advocacy group, Community
Alliance for the Ethical Treatment of Youth. Finally, I will offer my
perspective on the ways in which legislation could help to increase
protections and at long last bring an end to the atrocious mistreatment
of American youth in residential facilities across the country.
My story is one of a youth battling mental illness, a group of
Montana residents taking the liberty to assume that their own
experience as recovering alcoholics was qualification enough to operate
a facility for struggling youth, and parents operating from a place of
gullible desperation, willing to spend upwards of $70,000 to fund a
fictitious therapeutic milieu that amounted to little more than
humiliation, deprivation and abuse--leaving in its wake a family torn
apart and a traumatized 15 year old.
At the age of 13 I was diagnosed with chronic depression following
a suicide attempt, and hospitalized at a local psychiatric hospital.
When I was discharged, lacking any community based support, my family
sought to identify services outside of my community and found Mission
Mountain School at the recommendation of a hired educational
consultant.
Mission Mountain School held great promise, as it was sold to us as
a small family-like therapeutic environment for girls ages 12-18 with
above average intelligence. It was located in picturesque Condon MT.
Though I felt unspeakable grief at leaving my family and all that was
familiar to me behind, I knew I needed help. I packed my treasured
belongings, reminders of home, and my mom and I flew out to MT. I felt
hopeful, that maybe this `special school' for kids like me would help
me, as they claimed to have the ability to treat any myriad of serious
psychiatric issues, such as bipolar disorder, eating disorders and
depression.
Sadly, this could not be further from the truth. Upon arrival I
quickly encountered the punitive and invasive interventions, which
would come to define my 18 months at Mission Mountain School.
My mom left me shortly after we had arrived and my belongings were
taken from me. I never received any explanation of the rules of the
program, though the rules quickly took shape during the series of
groups sessions held daily. Everyone was called out in group when they
first arrived--every infraction was framed as an act of dishonesty. We
were all labeled ``liars'' and ``manipulators'' upon arrival. Our daily
diaries were read, and compared to the detailed life histories that we
were forced to write soon after arrival, which were required to include
details of every sexual encounter we had experienced in our short lives
to ensure accuracy.
Often there were `punishments' when we were thought to have been
dishonest, euphemistically called ``consequences.'' Consequence always
involved some type of physical punishment--forced labor, such as ice
picking, rock picking, and chopping wood. More ``serious'' rule
breaking would result in what was called an ``intervention,'' which was
work crew all day long with breaks only during group, chores and
mealtime.
Sometimes the group was put on ``interventions'' which would last
for weeks if not months, and during this time no contact was allowed
with the outside. It was generally understood that we were being
exhausted for the purpose of making us more truthful--whatever that
meant to those in charge. Exercise was a rigorous daily requirement.
Slowing down from exhaustion only resulted in more exercise or getting
yelled at.
I was not allowed to speak with my family for months after I
arrived, and calls thereafter were monitored. Any criticisms were
labeled as ``manipulative'' and my phone call was promptly
disconnected, followed by punishment. If at some point we ``advanced''
enough in the program to not require such monitoring, that just meant
that by that point, we were no longer expressing our concerns because
we knew our parents wouldn't believe us anyway.
The most powerful figure at the facility was the headmaster who has
no formal training in mental health and whose group therapy sessions
were particularly bizarre and frightening. He was often confrontational
or would smirk and laugh. He would pit friends against friends, and
force us to say mean things to one another. He would attempt to unearth
repressed memories and encourage regressive states. I recall that on
multiple occasions my friends speaking as if they were toddlers,
recounting alleged instances of abuse. Hours would be spent with girls
reliving their traumatic experiences at the unqualified hands of the
staff. Intensive group sessions sometimes lasted all night. Bathroom
use was heavily regulated. Any allegations of abuse discussed in group
``therapy'' were never reported by staff to proper authorities.
Because all of the founders were members of AA, it seemed to them
that everyone was an addict of sorts. I was deemed an alcoholic and sex
addict, a close friend was deemed a sex addict. She had never had sex
in her life, and denied the claim and as a result, staff forced her to
carry 6 large rocks on her back at all times for several months, naming
them issues like ``sexual abuse'' and ``sex addiction,'' until she
conceded to staff that each issue was true, detailing traumatizing
experiences supportive of that claim. When I got caught with a plan to
run away I was placed on personal intervention where I had to rock pick
for a week, eight to ten hours a day, at one point dropped off 25 miles
from school and forced to hike back. This was all done in the name of
therapy.
At other times inappropriate and humiliating interventions were
used such as forbidding youth from talking for several weeks at a time,
forcing youth to wear gloves because it was thought that they
masturbated, or tying two girls together because two girls didn't get
along. Claims of illness were framed as manipulative.
Education was non-existent; schooling a joke. We would have
schooling maybe a few hours a day a couple days out of the week. I
taught myself algebra, and uncertified teachers taught English and
Spanish. We weren't allowed any information about the outside word such
as newspapers or news magazines. I learned next to nothing. It wasn't
until I was nearing graduation from Mission Mountain School that I
underwent testing outside of the facility and was diagnosed with a
learning disability.
We had no access to advocates, no rights whatsoever. Groups of
educational consultants would come in on occasion for a visit. They
were always impressed by our manners and ability to be so forthcoming.
None came to the facility unannounced. None asked us for our honest
opinions of the program * * * although even if they had, given the
insidious fear-based environment, it's doubtful I would've spoken--it
wasn't long before I was broken down and I came to believe what I was
told: that Mission Mountain School was to be the only place that could
save me from myself or I'd end up in ``jail, insane or dead''. The
cumulative effect of the program was losing all sense of self.
Then one day, 18 months later, I was told I was to be discharged.
None of it made any sense to me--though I was told I had been given the
tools to live, I found it difficult to reconcile their claim with my
internal landscape. My nights were filled with a reoccurring nightmare
of being chased by the founders and brought back to the facility,
despite my protests explaining that I was healthy now. In the end, all
Mission Mountain School gave me was more confusion, increased anxiety
and depression, and made social functioning after discharge evermore
difficult. It wasn't until 10 years later that I came to recognize the
damage done and sought change.
I'd like to speak about the work I've done since then, which will
hopefully speak to the broad pattern of atrocities Dr. Pinto commented
on in her testimony at the hearings in October 2007. As co-founder and
Executive Director of the Community Alliance for the Ethical Treatment
of Youth, I have heard from over one thousand survivors and understand
that, in most instances, parents remain unaware of the abuse their
children have experienced and often firmly believe the program saved
their child life. To me, this is the saddest repercussion of these
facilities. At once not only is the trust between parent and child
broken, but the truth of the youth is further hidden behind a facade
promulgated by deceived parents. In my communications the majority of
folks I've been in contact with have reported first hand with regards
to:
Trauma due to use of escort services
Communication and privacy rights violations such as mail-
monitoring, call-monitoring and filtering, restricted or interrupted
correspondence.
Inappropriate Seclusion and Restraint
Inhumane Treatment such as:
Forced labor
Restricted access to the bathroom
Scare tactics
Exposure to harsh elements
Excessive exercise
Food/nutritional deprivation
Sleep deprivation
Physical punishment
Emotional, physical or sexual abused by staff
Education and Mental Health Treatment
no individualized plan
dissatisfaction with the training background of the staff
members who were providing education, therapy,
support and/or care
What I am hoping to convey today through my testimony is that
numerous residential facilities that are in operation today are
stripping youth of their basic human rights to dignity, respect, to
least restrictive care, appropriate mental health treatment, to
education and parental contact, to freedom of thought, opinion and
association, and ultimately to freedom from censorship and torture. The
legitimate practice of therapeutic intervention is being injected with
a perverse form of social control, including inhumane treatment and
practices, which defy the ethical principles upheld by peer reviewed
mental health practices.
As a nation it is our obligation to hold places of care accountable
to their claim. A nation with the best interest of the child in mind
must be in the position to assure this is occurring. For this reason it
is critical that oversight is stringent enough for this to occur, it is
questionable that youth safety can be assured if visits occur once
every 2 years. Quality assurance is paramount--if a place claims to be
a place of healing a facility must be able to back up such claims. It
is our nations responsibility to families to ensure not just that abuse
is not occurring, but that therapy is never used as justification for
the violation of the human rights of youth. Consistent with such
commitment, every youth ought be entitled to the least restrictive care
possible. Facilities must be held accountable to claims that deceive
parents into thinking that no alternative exists and that years of
imprisonment are a necessary therapeutic intervention. Of concern are
misinformed families who lack community support and feel they have no
alternative but to choose institutionalize their child (unnecessarily)
at the behest of programs concerned with their interests over that of
the youth.
I strongly believe this bill to be a promising and important first
step in curbing such draconian methodology this industry has been
founded upon and applaud Chairman Miller for introducing the first
piece of comprehensive legislation to that end.
______
Chairman Miller. Thank you. Thank you very much.
Mr. Martin-Crawford?
STATEMENT OF JON MARTIN-CRAWFORD, FORMER PROGRAM PARTICIPANT,
THE FAMILY FOUNDATION SCHOOL
Mr. Martin-Crawford. First, I would like to thank the
chairman and the committee for the opportunity to present my
side of this story.
After watching the hearing back in October, I was truly
inspired by the clear case of morality that brought together
both sides of the aisle on this discussion.
We have been called noisy complainers, and we have been
called manipulating troublemakers, but after over 10 years, I
finally have my chance to speak.
My name is Jon Martin-Crawford, and I was locked up at a
NATSAP-affiliated program, The Family Foundation School, in
Hancock, New York, from 1995 to 1997.
My life at home was anything but stable, causing me to seek
my own release from it all. I created a persona for myself, the
troublemaker at school, always looking for attention I didn't
get at home. I was involved in drugs by the age of 13. I was
lost, constantly in fights, legal run-ins and more. My parents
were at wits' end. My only release was my music, my writing and
my skateboarding.
After being expelled from public school and one private
school for marijuana use and writing an underground newspaper,
my parents were told to send me to The Family shortly
thereafter, thinking it would give me what I needed.
Once I arrived at The Family, I knew I was there until I
was 18. I went through what seems like the ritualistic
stripping of identity almost all of us survivors faced. I was
stripped; my clothes were taken and thrown away. My music, my
art, my skateboard all destroyed. What I didn't have with me my
parents were told to destroy as well. I was left with only a
letter from my mother for the next 3 months.
I had been to some in-patient settings before, but this one
was different. Other places allowed phone calls, mail and peer
communication. Here, I wasn't even allowed to call home the
first few months. Even after that, I only got that one phone
call home a week, nothing more--no access to CPS.
Here I was only allowed to talk to staff and kids that had
been there more than 6 months. I was told I was denying the
extent of my drug use, and I was confused as to just how I
would ``get better'' enough to see my family. I sat and watched
and learned to play the game of lies necessary to get
privileges and eventually get out. I was lucky and figured
these rules out quickly enough not to endure what I saw many
kids endure.
But I witnessed it all, including staff punching students
in the face while restraining, not once but several times.
Typical restraint procedures were wrapping kids up in duct tape
and blankets. Kids were not let out of this wrap, even to use
the bathroom, for feminine hygiene, or just to move around a
little bit and extend their limbs.
Restraints were not only done by faculty, but students as
well. Usually, this was even more brutal and was often done in
front of all other students to show what will happen if you act
out. Kids were forced to eat food they were allergic to and
keep eating even if vomiting as a result.
We were forced to attend daily religious services and A.A.
meetings and share personal stories with the outside world.
Kids as young as 12 being taken out of school to carry out
pointless manual labor, such as shovel manure, carry
wheelbarrows of rocks, sweeping the roof, shoveling numerous
things, for days on end.
When kids tried to run away, it was again not only staff
but students told to chase, tackle, restrain and bring them
back.
Many things were heard from staff, berating kids with high
levels of verbal abuse, often of a highly derogatory and sexual
nature, at times regarding sexual orientation. An admitted sex
addict was one of the high-up faculty and counselors, as well
as a dorm monitor living above the boys' dorm.
The rules I learned to avoid many of these problems were as
follows: I made up a horrible past to cure myself of. Our moral
inventory was nearly always fabricated to make our problems
seem worse and the program seem like salvation. Tell on
yourself and your peers for things you may have never done to
give the illusion you are getting better and working the
program.
If you have certain gifts, you can find a way to skate by.
For me, I was their golden boy with my pen. And at my
graduation speech, as well as for others, our speeches were
used as propaganda as part of the family day for all the
parents to hear their message of goodwill.
Under no circumstances were we to tell our parents or
prospective parents the truth about what we saw. I was
fortunate enough to go home after a while, but I quickly
learned that if I told my parents the truth about what I saw, I
would only be explained as a manipulation and lose more
privileges.
While I had been fortunate enough to miss out on these
horrors personally, I gave many tours to prospective parents,
always omitting the details of restraints, punishments, and any
lack of communication against the abuses that took place.
As a dorm leader, I was told to wake up one of the kids in
my dorm with the lamp that only had a floodlight as a bulb,
burning his retinas. I participated in the restraining and took
part in the barrage of verbal attacks, just as did many of my
peers.
I am not proud of this, but we had no choice. If we did not
conform, we were being negative and subjected to the same
treatment and lack of privileges as everyone else.
Once I left, I saw that I was now in the real world with
real problems again, and the school had never helped me with
those problems. After nightmares of The Family led to a
relapse, I was soon out of Vassar College and into the
military. The training in the military, although viewed by some
to be harsh, was a cakewalk compared to the hell endured at The
Family School.
My trust issues were never resolved after leaving The
Family, and the nightmares remain. Ultimately, these
psychological issues and flashbacks led to the need for my
discharge from the Army, something I regret to this day.
For years, I thought all this was my fault. While the
nightmares and anxiety never wore off, getting high at least
made it go away again.
I will not blame others for my choices and my mistakes; I
take responsibility for those. What I blame The Family for is
stripping me of my childhood. I still have nightmares of being
locked up and told I am ruining my life. I still read their
monthly paper of lies and get nauseous remembering what we
witnessed.
The only thing I can say to temper my disdain for these
types of schools or at least for The Family is this: While the
programs, as they are, have little positive effect long term, I
do believe that kids in my position need some sort of help. I
believe there can be a safe solution, as some staff are
genuinely decent and caring people. We need oversight and
regulation of these facilities, with swift and severe penalties
for those who stray from the standards.
What must be remembered through all of this is that these
success stories that these places put out tend to fall in the
1-to 2-year range after leaving such programs and are usually
the opinions of parents.
A true statistic? Of the 25 kids from my graduation class
and the one prior to mine, maybe four remain sober.
While many can now say they live successful lives, it came
anywhere between 5 and 10 years after leaving the program and
figuring out life on their own with psychiatric help.
Unfortunately, this cannot be said for all.
The programs are quick to take credit for a successful
story and are just as fast to claim that anyone that doesn't
make it just didn't work the program. The truth? The nightmares
and psychological scars of being dragged from your home to a
place in the middle of nowhere, restrained in blankets and duct
tape, assaulted, verbally and physically--those scars and that
trauma never go away.
For my friends who have since died from suicide because of
the nightmares or those who still suffer the nightmares, our
time and our voice will not be in vain. There comes a time for
every man to make amends and right their wrongs. This is a
lesson all these programs preach, and it is a lesson they
should now follow.
[The statement of Mr. Martin-Crawford follows:]
Prepared Statement of Jon Martin-Crawford, Former Program Participant
at the Family Foundation School and Member of the Board of Advisors for
the Community Alliance for the Fair and Ethical Treatment of Youth
I would like to thank the Chairman and the Committee for the
opportunity to present my side of this story. After watching the
hearing back in October, I was inspired by the clear case of morality
that brought together both sides of the aisle in this discussion.
We have been called ``noisy complainers'' we have been called
``manipulating troublemakers.'' After over 10 years, I finally have my
chance to speak. My name is Jon Martin-Crawford. I was locked up at the
NATSAP affiliated program, The Family Foundation School, in Hancock,
NY, from 1995 to 1997.
My life at home was anything but stable. This caused me to seek my
own release from it all. I created a persona for myself at school, the
troublemaker, always looking for the attention I didn't get at home.
Involved in drugs by the age of 13, I was lost. My only release was my
music, my writing, and my skateboarding. After being expelled from
public school and one private school for marijuana and writing an
underground newspaper, my parents sent me to The Family shortly
thereafter.
Once I arrived at The Family, I knew I was there until I was 18. I
went through what seems like the ritualistic stripping of identity
almost all of us survivors faced. My clothes were taken and thrown
away. My music, my art, my skateboard all destroyed. What I didn't have
with me, my parents were told to destroy as well. I was left with only
a letter from my mother for the next 3 months.
I had been to some inpatient settings before, but this one was
different. Other places allowed phone calls, mail, and peer
communication. Here, I wasn't even allowed to call home the first few
months. Even after that, I only got that one phone call home a week * *
* nothing more * * * no access to Child Protective Services. Here I was
only allowed to talk to staff and kids that had been there more than 6
months. I was told I was denying the extent of my drug use, and I was
confused as to just how I would ``get better'' enough to just see my
family. I sat and watched, and learned to play the game of lies
necessary to get privileges, and eventually get out. I got lucky and
figured these rules out quickly enough to not endure what I saw many
kids endure. But I still witnessed it all.
Including:
Staff punching students in the face while restraining. * *
* not once but several times
Typical restraint procedures were wrapping kids up in Duct
tape and blankets. Kids were not let out of this wrap, even to use the
bathroom, feminine hygiene, or just to move around and let the body out
of the confinement, while in an isolation room (the 6X6 library room)
Restraints were not only done by faculty, but many senior
and junior members of students. Usually, this was even more brutal and
was often done in front of all other students to show ``what will
happen if you act out''
Kids forced to eat food they were allergic to, and keep
eating even if vomiting as a result.
Kids as young as 12 being taken out of school to carry out
pointless manual labor such as shovel manure, carry wheelbarrows of
rocks, sweeping the roof, etc. for days on end
When kids tried to run away it was again, not only staff,
but many students told to chase, tackle, restrain, and bring them back.
Many things heard from staff, berating kids with high
level verbal abuse, often of a highly derogatory and sexual nature, at
times regarding sexual orientation
An admitted sex addict was one of the high-up faculty and
counselors, as well as a dorm monitor living above the boy's dorm
The rules I learned to avoid much of these problems were as
follows:
make up a horrible past to ``cure yourself of''* * * our
moral inventory was nearly always fabricated to make our problems seem
worse, and the program seem like salvation
Tell on yourself and your peers for things you may have
never done to give the illusion you're getting better
if you have certain ``gifts'' you can find ways to skate
by. Me, I was the school's golden boy with my pen and my graduation
speech, as well as others were used as propaganda at graduations as
part of ``family day'' for all parents to hear.
Under no circumstances tell your parents or prospective
parents the truth about what you see happening.
Yes, I was fortunate enough to go home once a month after a while.
All I wanted for those weekends at home was to sleep, relax, and watch
television. I quickly learned that telling our parents the truth about
what happened at The Family would only be explained away as
manipulation and we would lose our privileges.
While I had been fortunate enough to miss out on most of the
horrors personally, I unfortunately gave many tours to prospective
parents, always omitting the details of restraints, punishments, and
lack of any sort of communication or safeguards against the abuses that
took place. As a dorm leader, I was told to wake up one of the kids in
my dorm with the light from the lamp * * * that only had a flood light
as a bulb * * * burning his retina. I participated in the restraining,
and took part in the barrage of verbal attacks just as did many of my
peers. I am not proud of this, but we had no choice in any of this. If
we did not conform, we were ``being negative'' and subject to the same
treatment and lack of privileges.
Once I left, however, I saw that I was now in the real world with
real problems again, and the school had never helped me with those
problems. After nightmares of The Family led to a relapse, I was soon
out of Vassar College and into the military. The training in the
military, although viewed by some to be harsh, was a cakewalk compared
to the hell endured at The Family School. My trust issues were never
resolved after leaving The Family, and the nightmares remained.
Ultimately, all these psychological flashbacks led to the need for my
discharge from the Army, something I regret to this day.
For years, I thought all this was my fault. While the nightmares
and anxiety never wore off, getting high made it go away again. I will
not blame others for my choices, my mistakes. I take responsibility for
those. What I do blame The Family for is stripping me of my childhood.
I still have nightmares of being locked up and told I'm ruining my
life. I still read the monthly paper of lies the school puts out and
get nauseous remembering the stuff we witnessed.
The only thing I can say to temper my disdain for these types of
schools, or at least for The Family is this:
While the programs, as they are, have little positive effect long
term, I do believe that kids in my position need some sort of help. I
do believe there can be a safe solution, as some staff are genuinely
decent and caring people We need oversight and regulation of these
facilities with swift and severe penalties for those who stray from the
standards.
What must be remembered through all of this is that the ``success
stories'' of programs tend to fall in the one to two year range after
leaving such program * * * and usually are the opinions of parents. A
true statistic? Of the 25 kids from my graduating class and the one
prior to mine, maybe 4 remained sober. While many can now say they live
successful lives, it came anywhere between 5-10 years after leaving the
program and figuring out life on their own with psychiatric help.
Unfortunately, this cannot be said for all.
The programs are quick to take credit for a successful story, and
are just as fast to claim anyone that doesn't make it just ``didn't
work the program'' The truth? The nightmares and psychological scars of
being dragged from your home to a place in the middle of nowhere,
restrained in blankets and duct tape, assaulted, verbally and
physically. * * * those scars and that trauma never go away.
For my friends who have since died from suicide, and still suffer
the nightmares, our time and our voice will not be in vain. There comes
a time for every man to make amends and right their wrongs. This is a
lesson these programs preach, and it is a lesson they must now follow.
______
Chairman Miller. Thank you.
Dr. Bellonci?
STATEMENT OF CHRISTOPHER BELLONCI, M.D., MEDICAL DIRECTOR AND
SENIOR CLINICAL CONSULTANT, WALKER SCHOOL
Dr. Bellonci. Mr. Chairman and members of the committee, I
am pleased to be here in support of your proposed legislation,
the ``Stop Child Abuse in Residential Programs for Teens Act of
2008.''
As a child and adolescent psychiatrist who dedicates his
career to the treatment of youth with mental health disorders,
I am frankly horrified to hear about these accounts of latent
abuse in the name of treatment or therapy.
Nothing that I learned in medical school or my clinical
training could ever justify such treatment. The behavioral
interventions you have heard described have no role in the
appropriate treatment of mental or substance abuse disorders.
As you are hearing, this is trauma-inducing and not trauma
treatment.
Let me start by saying that treatment for a child or
adolescent with serious emotional disturbance should be in the
least restrictive environment, and preferably with their
family. However, there are many children that cannot
effectively be treated and managed in a home or community
environment safely and need more acute, intensive treatment.
I am here today to talk about Walker and the specific needs
of children and adolescents being treated in residential
centers.
Walker is licensed in Massachusetts through our state's
Early Education and Care agency. As an accredited school, we
are also approved by our state Department of Education. We are
accredited by the Council on Accreditation, a national
accrediting body originally affiliated with the Child Welfare
League of America.
Our licensing and accrediting agencies all require frequent
renewal and on-sight visits by representatives of these various
regulatory bodies. We also adhere to reporting requirements
that are consistent with those proposed in your legislation.
EEC has clear guidelines for adherence to civil rights that
would prohibit restriction of access to mail, family visits or
phone calls. We do not utilize wilderness programming or boot
camp experiences. We would never allow other children to
restrain other children.
Our staff undergoes a minimum of 2 weeks of pre-service
training, including instruction in Cornell University's
Therapeutic Crisis Intervention, with a focus on de-escalation
strategies and techniques that are individualized to the unique
strengths and needs of the children we work with.
Staff is cleared by the Massachusetts Criminal Records
search process before they are allowed unsupervised contact
with children. During orientation, staff also receives training
regarding mandated reporting laws, first aid and CPR.
Walker has explicit policies outlining unacceptable forms
of discipline, consistent with those outlined in your proposed
legislation, that would never allow the sorts of treatment that
you are hearing described today.
We also have clear policies regarding notification of
adverse outcomes, both to parents and guardians, as well as our
state child protective service, our licenser, and funding and
referral sources.
We strive for transparency in our work and view parents as
essential allies in the complex treatment of children. We have
an open campus and invite and encourage parents to visit and be
an active part of the treatment milieu.
Increasingly, we have been serving children and families in
their homes, schools and communities. We actively partner with
our state's child welfare and mental health departments in
advancing best-practice principles and provide consultation and
program review and development to over 35 school districts in
Massachusetts.
We take our commitment to family-driven practice seriously
and, in the last year, have hired our first parent liaison
coordinator, who is a parent of a child formerly in residential
care at Walker. For over 5 years, we have had a current parent
serving as a voting member of our board of directors. We also
have an active parent council and run parent support groups for
all interested families.
I work directly with most of the children served in our
residential program, providing psychiatric treatment. It is
against my ethical and licensing requirements to make a
medication change without first discussing the risks and
benefits of the proposed treatment and obtaining informed
consent.
In this regard, I am frankly concerned that your
legislation may not go far enough, as it calls for notification
to parents within 24 hours of a medication change, after that
change has already been made, when it is quite clear standards
of ethical practice require the informed consent to be obtained
prior to any removal or addition of a medication except in
emergency situations.
The goal of this legislation is to ensure that children are
not abused in these treatment settings, not to limit access to
appropriate, regulated and licensed residential care for
children who are in need of these services.
Licensing creates a baseline of expectations to which all
programs within a state can be held accountable. Effective
licensing requirements help promote client rights, staff
competence, quality improvement, and consistent practice. They
provide the constants, the solid ground from which innovative
and transformative practice can be launched. They also provide
a degree of safeguard against the potential of harm to
children, events of a type that can undermine efforts to create
meaningful change.
All of us working in licensed residential centers should
support this goal. All residential treatment programs should
provide for all of the child's developmental needs, including
mental health care, physical health care, and education needs;
be licensed within the states where they practice and adhere to
national standards; encourage parents to be active parts of the
treatment teams for their youth; and employ a well-trained,
multidisciplinary, culturally competent staff.
Thank you for raising this important issue. And when it is
appropriate, I would be happy to take questions.
[The statement of Dr. Bellonci follows:]
Prepared Statement of Christopher Bellonci, M.D., Child/Adolescent and
Adult Psychiatrist, Medical Director, Senior Clinical Consultant,
Walker School
Mr. Chairman and members of the committee, my name is Christopher
Bellonci, M.D. and I am pleased to be here in support of your proposed
legislation, the ``Stop Child Abuse in Residential Programs for Teens
Act of 2008''. I am a board-certified child and adolescent psychiatrist
and the medical director at Walker, a multi-service agency in Needham,
Massachusetts that offers residential treatment as one of a range of
programs in our service array. I am a member of the American Academy of
Child and Adolescent Psychiatry who paid for my travel to be here
today. I co-wrote the Academy's Practice Parameter on The Prevention
and Management of Aggressive Behavior in Child and Adolescent
Psychiatric Institutions with Special Reference to Seclusion and
Restraint and am a board member of the American Association of
Children's Residential Centers.
First let me start by saying that treatment for a child or
adolescent with serious emotional disturbance should be in the least
restrictive environment, preferably with their family. However, there
are many children that can not effectively be treated and managed in a
home or community environment safely and need more acute intensive
treatment. I am here today to talk about Walker and the specific needs
of children and adolescents being treated in residential centers. We
are licensed in Massachusetts through our state's Early Education and
Care (EEC) agency. As an accredited school, we are also approved by our
state Department of Education. We are accredited by the Council on
Accreditation, a national accrediting body originally affiliated with
the Child Welfare League of America.
Our licensing and accrediting agencies all require frequent renewal
and on-sight visits by representatives of these various regulatory
bodies. We also adhere to reporting requirements that are consistent
with those proposed in your legislation. EEC has clear guidelines for
adherence to civil rights that would prohibit restriction of access to
mail, family visits or phone calls. We do not utilize wilderness
programming or boot camp experiences. Our staff undergo a minimum of
two weeks of preservice training including instruction in Cornell
University's Therapeutic Crisis Intervention with a focus on de-
escalation strategies and techniques that are individualized to the
unique strengths and needs of the children we work with. Staff are
cleared by the Massachusetts Criminal Records search process before
they are allowed unsupervised contact with children. During orientation
staff also receive training regarding mandated reporting laws, first
aid and CPR. Walker has explicit policies outlining unacceptable forms
of discipline consistent with those outlined in your proposed
legislation. We also have clear policies regarding notification of
adverse outcomes both to parents and guardians, as well as our state
child protective service, our licensor, and funding and referral
sources.
We strive for transparency in our work and view parents as
essential allies in the complex treatment of children. We have an open
campus and invite and encourage parents to visit and be an active part
of the treatment milieu. Increasingly, we have been serving children
and families in their homes, schools and communities. We actively
partner with our state's child welfare and mental health departments in
advancing best practice principles and provide consultation and program
review and development to over 35 school districts in Massachusetts.
We take our commitment to family-driven practice seriously and in
the last year have hired our first parent liaison coordinator, a parent
of a child formerly in residential care at Walker. For over 5 years we
have had a current parent serve as a voting member of our Board of
Directors. We also have an active parent council and run parent support
groups for all interested families.
I work directly with most of the children served in our residential
program providing psychiatric treatment. It is against my ethical and
licensing requirements to make a medication change without first
discussing the risks and benefits of the proposed treatment and
obtaining informed consent. In this regard, I am concerned that your
legislation may not go far enough as it calls for notification to
parents within 24 hours of a medication change when it is quite clear
standards of ethical practice require the informed consent to be
obtained prior to any removal or addition of a medication except in
emergency situations.
The goal of this legislation is to ensure that children are not
abused in these treatment settings, not to limit access to appropriate,
regulated and licensed residential care for children who are in need of
these services. All of us working in licensed residential centers
should support this goal. All residential treatment programs should:
1. provide for all of the child's developmental needs including,
mental health care, physical health care and education needs,
2. be licensed within the States where they practice and adhere to
national standards,
3. encourage parents to be active parts of the treatment teams for
their youth,
4. and employ a well trained, multidisciplinary, culturally
competent staff.
The Board of the AACRC is equally concerned about the growing
number of unlicensed residential programs. We believe that residential
care in licensed and accredited facilities is an important and
necessary part of an organized system of care and believe that all
residential providers should be licensed within the States where they
practice. In fact, all members of the AACRC are licensed and this is a
condition of membership. We also strongly encourage residential centers
to seek accreditation which hold the standards they must adhere to even
higher.
As an organization representing agencies committed to working
collaboratively with families and youth, we were disturbed by the
concerns raised in this committee's previous hearing about children and
youth experiencing harm in residential settings. We support the
initiatives of this committee and its proposed legislation and believe
that residential treatment is an appropriate placement for some
youngsters and that there are high quality programs being administered
by committed and competent staff.
The AACRC's mission is to support the professional development of
this committed and competent workforce. The AACRC looks forward to
working alongside this committee and state and federal agencies in
ensuring that standards are in place for residential centers.
Licensing creates a baseline of expectations to which all programs
within a state can be held accountable. Effective licensing
requirements help promote client rights, staff competence, quality
improvement, and consistent practice. They provide the constants, the
solid ground from which innovative and transformative practice can be
launched. They also provide a degree of safeguard against the potential
of harm to children, events of a type that can undermine efforts to
create meaningful change. AACRC requires licensure of its members and
is concerned about the variability of practice that can occur in
unlicensed settings, which can lead to adverse outcomes for children
and their families and criticism of the field. AACRC encourages
organizations to work with their state authorities to create meaningful
and reasonable licensing frameworks for residentially based services.
Accreditation is not an effective replacement for licensing, as the
accountability it yields is less stringent than that which typically
occurs through licensing and regulation. Nonetheless it is an important
accompaniment to licensure. Accreditation standards encompass emerging
knowledge and evidence in the field and come together to define
clinical and managerial practices that result in high quality and
effective care.
Agency-developed standards, policies, and procedures build upon the
framework of licensing and accreditation, creating unique, mission-
driven structures as the foundation for care and innovation.
Establishment and measurement of desired outcomes and performance
indicators helps each organization assess the degree to which it is
fulfilling its own objectives and creates the possibility of comparison
or benchmarking with other similar entities on key aspects of care
identified through accreditation and licensing.
Compliance with accreditation standards, particularly in
conjunction with adherence to licensing and regulatory requirements and
a quality improvement infrastructure, provides the foundation of safety
and best practice that can infuse transformational change, elevate
practice, and improve outcomes. AACRC supports efforts to establish
licensure requirements and encourages agencies to pursue voluntary
accreditation, as part of implementing a transformation agenda.
In the last two decades, the thinking about family involvement
across the child serving systems has begun to change. The Child and
Adolescent Service System Program (1985) envisioned a central role for
families in community systems of care for children with mental health
problems. Wraparound, family decision making, and parent-professional
partnerships have emerged in child welfare, education, medical, and
juvenile justice arenas, as well as in mental health. Such service
configurations have recently been supported by research and heralded in
salient mental health public policy studies, including the Surgeon
General's and the President's New Freedom Commission reports. Research
specific to residential care has also consistently identified improved
child outcomes when parents and families are more involved. The
response from the field to these developments has been slow but not
insignificant, as residential centers across the country increasingly
design processes and practices for more inclusion of parents and family
members in the care of their children. The result has been improved
outcomes for children and families.
Parents and families provide important information and feedback. An
approach that engages them equally creates a shared responsibility for
growth and change. It provides the opportunity for staff to work
together with parents and to utilize family members' experience and
expertise. This yields an increased ability to understand the child
within the context of his/her family, culture and community, and to
develop realistic expectations, plans, and supports. The family is
affirmed in having their strengths recognized and valued; the staff
benefit from having support and assistance and from being relieved of
the implicit, at times self-imposed, responsibility to be the ones who
will ``fix'' the child. Family-driven care is a partnership.
Parents are strong and effective voices, advocating in pragmatic
and realistic ways for the needs of children on quality improvement,
planning, and governance bodies. As political partners with
professionals, parents are powerful advocates for the full continuum of
care, inclusive of residential, and for efforts to meet the needs of
children and families in local communities. The research in residential
treatment consistently shows that the processes and outcomes of care
improve in correlation with the degree of family involvement.
At the governance level parents are valuable members of Boards of
Directors, and offer critical input into strategic planning and
resource allocation. At the system level parents can have important
voices on advisory committees and interagency collaboratives. Parents
understand the importance of a full array of services and, in telling
their stories, have a powerful influence on policy makers.
Such multi-level partnerships can help establish and reinforce a
culture of family-driven care. They are more readily supported if the
organization has made the leadership commitment to become family driven
and can dedicate budgetary resources to supporting parent travel,
paying stipends, or hiring parents as paid staff. The Board of
Directors and CEO can ask themselves a series of key questions in
assessing readiness to move in this direction, for example:
Do the staff of the organization act, speak, and interact
in ways that truly welcome, support, affirm, and incorporate the
perspectives and wishes of parents?
Do parents have to be ``invited'' into the organization or
is it a baseline assumption of staff that parents are reciprocal
partners?
Is the organization committed to redefining itself as
providing an intervention within a community continuum rather than as a
placement of last resort?
Does the organization believe that sharing decision-
making, leadership, and power with parents yields better outcomes for
children and youth?
Is the organization willing to implement training and
other practices that culturally reinforce the importance of parents and
families in day to day actions, discussions, and care planning?
The responses to these questions can drive strategic planning and
practice innovation. Changes in practice, even incremental, can and do
lead to positive results.
The American Academy of Child and Adolescent Psychiatry is
currently working on a Practice Parameter defining best practice for
residential treatment and once available, AACAP would be happy to share
it with the committee. Many of my remarks are taken from Position
Papers developed over the last 5 years by the AACRC.
Thank you for the opportunity to present these comments to the
Committee.
______
Chairman Miller. Thank you.
Ms. Brown, you will be recognized for 10 minutes, as
promised you.
STATEMENT OF KAY BROWN, DIRECTOR, EDUCATION, WORKFORCE AND
INCOME SECURITY, U.S. GOVERNMENT ACCOUNTABILITY OFFICE
Ms. Brown. Chairman Miller and members of the committee,
thank you for inviting me here today to discuss our work on
residential programs for teens.
This morning, you have already heard a number of heart-
wrenching examples of individual cases of abuse and death in
residential facilities. Now I would like to try to shed some
light on what we know about the national picture.
To clarify the difference between our work and the case
studies that you heard, my remarks are based on our ongoing
work. Over the past year, we conducted national surveys of
three separate agencies in each state: child welfare, health
and mental health, and juvenile justice. Each of these state
agencies may place youth experiencing behavioral and emotional
challenges in residential facilities. In our survey, we asked
about a broad range of facilities, including the types that you
have heard about today. We also visited four states.
Today I will discuss what we know about the extent of youth
maltreatment in these facilities across the nation, what states
are doing to protect youth in these facilities, and what
federal agencies are doing to oversee state efforts.
In summary, youth maltreatment and fatalities occurred in
both government and private facilities all across the nation.
However, we don't know the full extent of the problem because
many states either don't collect or don't report data for all
residential facilities.
Regarding oversight, we identified gaps in state activities
that leave youth in some facilities at greater risk of
maltreatment or death. We identified similar gaps in federal
activities.
Regarding the extent of the problem, in one year 34 states
reported to HHS more than 1,500 incidents of youth maltreatment
that were committed by facility staff. As you can see,
hopefully, from the graphic above, the proportion of incidents
related to physical abuse was 24 percent; to neglect or
deprivation of necessities, 44 percent; and sexual abuse, 9
percent.
Officials in the states we visited cited factors such as a
lack of experienced staff, insufficient training or lack of
appropriate supervision as causes.
In addition, in our survey, 28 states reported at least one
death in residential facilities. This next graphic shows that
16 states reported deaths due to accidents, nine due to
suicide, and fewer states to homicide and the use of seclusion
and restraint. I should mention here, though, that deaths
related to seclusion and restraint may also be categorized as
accidents in some cases.
It is important to note that these data are not complete.
The number of adverse incidents is very likely more numerous
and more widespread than reported, for a number of reasons.
For example, in many states, officials said they lacked
authority under state law or regulation to collect data on
private facilities that do not receive government funds. And
the HHS database I mentioned earlier tracks fatalities that
result from maltreatment but not from suicides or accidents,
both of which may be an indicator of neglect or other problems.
Regarding my second topic, state oversight, as you know,
under the current structure, states are primarily responsible
for ensuring the well-being of youth in residential facilities.
To do this, they have a range of tools at their disposal,
including licensing, standards, monitoring, and enforcement
when violations are found.
All states in our survey reported having some licensing
processes. However, the types of facilities licensed and the
licensing requirements varied from state to state, and we found
gaps in the licensing activity.
Most notably, state agencies often exempted certain types
of facilities from licensing and, in particular, private
residential schools and academies. This is worrisome because
owners can self-identify the type of facility they operate.
Therefore, a facility could bypass state requirements by
identifying itself as a type of facility not subject to
licensing.
In addition, for those facilities that states did license,
they used standards that addressed many but not all of the
primary risks to youth well-being that you have heard about
today. Almost all states reported that licensed facilities are
required to meet basic standards, such as the safety of the
physical plant. However, about a third of state Child Welfare
and Health and Mental Health agencies reported that they do not
require written suicide-prevention plans.
Once a facility is licensed, regular monitoring helps
ensure that licensing standards are taken seriously and that
risks to youths' well-being are addressed quickly. However,
officials in three of the four states we visited were unable to
meet their goals for conducting regular site visits for
monitoring at residential facilities. They were also unable to
conduct unannounced site visits, which can reveal conditions
that might not be seen during your regular announced visit.
These officials cited fluctuating levels of resources and large
workloads as factors limiting their visits.
There are also other approaches to overseeing facilities.
For example, some states required accreditation either in
addition to or instead of licensing, as a condition of serving
youths under state care.
Finally, turning to federal oversight of state efforts, the
Departments of Health and Human Services, Justice, and
Education all have certain processes in place through their
grant programs to hold states accountable for the well-being of
youth in general.
However, as with the states, we found gaps in their
oversight related to residential facilities. For example, under
current law, federal agencies do not have the authority to hold
states accountable for youth well-being in private residential
facilities unless those facilities serve youth in programs that
receive federal funds.
For those facilities that are under federal purview,
federal requirements did not always address the primary risks
to youth well-being. HHS, Justice, and Education all reported
that they do not have authority to require that states have
suicide-prevention plans as a condition for receiving grants
that they administer.
Similarly, with one exception, federal programs also do not
require that states ensure the proper use of seclusion and
restraint practices in residential facilities.
Federal agencies did not always include residential
facilities in their oversight visits and have not used all of
the enforcement tools available to them, such as financial
penalties.
In conclusion, the results of our ongoing studies show that
the current federal-state oversight structure is inadequate to
protect youth from maltreatment and death at a time when they
are most vulnerable. Given the wide variety of facility type
and the variation among state laws, there are no simple
solutions.
Without meaningful data, state and federal agencies don't
know the extent of maltreatment in their jurisdictions, so they
cannot accurately assess the risk to youth in facilities or
best target their oversight resources. And licensing alone
holds no guarantees without clear standards, regular monitoring
and a full array of enforcement tools.
The comprehensive results of our work will be included in a
report to be released next month. This report will provide
options for action that states, federal agencies and Congress
may want to consider in any restructuring effort. We also
anticipate that our report will contain recommendations for
action that federal agencies can implement now under the
existing structure.
Mr. Chairman, this concludes my statement. I would be happy
to answer any questions you or others on the committee would
have.
[The GAO statement, ``Residential Facilities: State and
Federal Oversight Gaps May Increase Risk to Youth Well-Being,''
may be accessed at the following Internet address:]
http://www.gao.gov/new.items/d08696t.pdf
______
Chairman Miller. Thank you very much.
Thank you all for your testimony. As disturbing as it is,
it is important that this committee hear it and, hopefully,
this Congress hear it.
I have been involved with the attempt to protect children
in out-of-home placement for over 30 years. And I guess I am
saddened by the fact that, 30 years later, we still see this
number of children put in these positions of jeopardy while the
government looks on because of the patchwork and incomplete
system that we have here, so that we can have simple but vital
information about these programs, as Ms. Brown has pointed out.
You know, the last time this country witnessed somebody
with a bag over their head and a noose around their neck, the
world was horrified, the nation was embarrassed, and it was at
Abu Ghraib.
To be told by this committee that this is considered a
valid therapy, I guess, or a practice by somebody in the care
of somebody else's child, and putting the noose around their
neck with a bag over their head, that this was acceptable, I
think would horrify this nation again. But, unfortunately, we
don't have a picture of that. We just have the sad results of
it, with what happened to that young person.
It is hard to believe. It is hard to believe that people
would do this to somebody else's child.
Mr. Kutz, in your testimony you describe eight programs
where children were abused and a number of cases involving
misleading marketing practices by programs and referral
services.
To the extent that you can, can you identify these programs
and services that either abused these kids or used misleading
marketing practices?
Mr. Kutz. Would you like me to name for the record the
ones--there are eight----
Chairman Miller. If you can, yes.
Mr. Kutz [continuing]. For the death and abuse, and then
there is the table we had of the misleading marketing----
Chairman Miller. Yes. Yes.
Mr. Kutz. All right. Let me go through those with you.
The names of the facilities, the first four were death
cases, and that was the Arizona Boys Ranch, Lonestar
Expeditions, Star Ranch, and Summit Quest Academy. Those were
cases one through four.
The other four cases, which were abuse cases--three of the
first four also were abuse cases. Cases five through eight were
Kids of North Jersey, Bethel Boys Academy, Whitmore Academy,
and Royal Gorge Academy.
So those are the eight cases of death and abuse.
With the marketing, some of the 10 in there are multiple
hits, if you will. So I will go through those.
Case number one was the C.S. Landre Foundation, and that
was one of the cases you saw in my opening statement on the
monitor, of the tax scheme where people were asking others to
make donations for their children.
The second case was Spring Creek Lodge Academy. Cases
three, four and five were Lonestar Expeditions, which was the
same as our case number two, the death case.
Cases six, seven and 10 were Teen Path, and that is a
referral service. And cases eight and nine were Parent Help,
and that is also a referral service.
Chairman Miller. You know, if your child applies to
college, they ask a lot of questions about your child when you
finally get to the final steps; they want a lot of information.
To what extent did--you played this series of tapes about
representations about these programs. And you are not a mental
health professional, and I understand that.
But to what extent was there any attempt to delineate the
information about the child, in terms of what maybe pre-
diagnosis had been, other placements of that child, what other
determinations were made by mental health workers or
psychiatric health workers that that child might have been
exposed to? In many instances, these are not the first
placements of these children.
Was any effort to develop that history and then inform
those parents what would or would not be available that was
aligned with that?
Mr. Kutz. I made some of the calls myself, actually. And
for the cases that I called, I called five of them, and four of
them didn't ask any questions at all about my fictitious child.
The fifth one did ask a lot of interesting and good questions.
We made, in total, 30 or so calls. And in most cases, the
focus was on the marketing, not actually extracting information
on the child and whether the child would be a good fit for that
program. So I think that is kind of--do you want to add to
that, Andy?
Mr. O'Connell. Yes, most of the conversations centered on
cost----
Chairman Miller. Would you just identify yourself for the
visual record?
Mr. O'Connell. Andy O'Connell from GAO.
Chairman Miller. Thank you.
Mr. O'Connell. Of the 30 phone calls that we made, the big
pitch was about the program itself and not about your child. It
mostly centered on the cost and how you could finance the cost
to pay to go to these schools.
Chairman Miller. Ms. Whitehead and Mr. Martin-Crawford,
after you arrived at your programs, was there any attempt to
take your personal history, to discuss that with you, and then
to tell you what the plan of treatment would be?
I am not going into the validity of the treatment, but just
if those acts were engaged in.
Ms. Whitehead. Well, when I first arrived, actually, there
was no real set of treatment plan established, but we were
required to write out our life history and our sexual history
in detail. And that was how they gathered information, or they
would read our diaries from home.
But we were never notified of any kind of treatment plan or
goals or anything like that.
Chairman Miller. Mr. Martin-Crawford?
Mr. Martin-Crawford. Likewise, anything that we had
actually been asked, as I mentioned earlier, when it came down
to our past or, you know, any plan of treatment, it was really
what we did. And then if we came with a list, you know, say, I
smoked pot a couple times, that wasn't good enough, and we had
to say that we were doing cocaine and crack in order to speak
with our families.
So any type of writing down what we needed help on was sort
of--they told us what we needed help on, whether we did or
didn't.
Chairman Miller. Mr. Kutz, in one of the narratives in your
report--and correct me if I am wrong--but I believe that, in
fact, drug tests were administered to one of the students
repeatedly. The drug tests were negative, and they were
reported as positive to the parents. Is that correct? Including
the initial test?
Mr. Kutz. That is correct. And, also, what was just
described here, we did see evidence where kids were forced to
confess to things far worse than they had actually done. That
was significant, and not just the kid we looked at, but a
number of kids in that program were forced to do that at the
admission process.
Chairman Miller. And those confessions were then used how?
Mr. Kutz. Well, then they had to keep repeating them during
the counseling, that--I guess it is called the M.I.
Is that correct?
Mr. Martin-Crawford. Yes, it is called the moral inventory.
Ours were used not as much for the counseling as for
parents. So when we had a group----
Chairman Miller. Those were then told to parents, that
progress----
Mr. Martin-Crawford. Right.
Chairman Miller. Again, I don't want to put words in your
mouth. But those were used to tell the parents what?
Mr. Martin-Crawford. That way, when my parents came and I
was saying, oh, yeah, well, by the way, I was smoking crack and
shooting people or something, that way they thought that they
did the right thing in putting me there and that I really
needed to be there and this would, you know, save my life.
Chairman Miller. Those admissions were viewed as progress
being made.
Mr. Martin-Crawford. Or at least as good enough reason for
me to be there, so it made them feel better. Like, if I had
just told them the truth, that I had smoked marijuana a few
times, it wouldn't seem as though I really needed to be there
as much.
Chairman Miller. Dr. Bellonci, I could give you an hour,
but I am only going to give you about 2 minutes, to tell me
what, as a professional and in your experience, what your
impression is of this. And I will come back to you in a second
round, but I have got to move on to other members.
Dr. Bellonci. It makes me ill, hearing it, frankly. And to
think that this is being done in the name of treatment is
abhorrent to me.
You know, just to clarify, the difference between the
programs that you are hearing about and my facility, we don't
advertise. Children are referred to us by their public school
or by the state of Massachusetts child welfare or child mental
health agencies. Our admissions office is run by a licensed
clinical social worker----
Chairman Miller. I understand that, but let me explain. You
know, the marketing here is to desperate parents who have gone
through much of that before. I don't want to compare it to your
program, at this point. I just want your professional
impressions of this.
Dr. Bellonci. It is abuse. There is nothing about what you
are hearing that can be construed as treatment, therapeutic,
intervention, care. I had the same association you had to Abu
Ghraib when I was hearing this.
This is no way to treat anyone, particularly someone who is
already struggling with depression, substance abuse, mental
health issues. It is only going to exacerbate the problem and
not lead to treatment.
So there is no way that I could begin to defend any of the
practices that you are hearing as anything remotely appropriate
or acceptable.
Chairman Miller. Thank you.
Mrs. McCarthy, recognized for 5 minutes.
Mrs. McCarthy. Thank you, Chairman Miller.
This is actually the second hearing that we have put
together on this. And I thank the chairman for following
through and his long work on this issue.
Mr. Platts and I, when we had this hearing, going back last
fall, and we had the parents speaking and telling their
stories, it was heart-breaking.
With that being said, the legislation that was introduced
yesterday to try to make a difference, as with anything down
here, you know, we saw the hearing pushed back immediately. And
I find it hard, mainly because when we are trying to do
something so that there are standards that children are not
abused, I don't understand why there is a push-back. When we
are looking at how possibly these schools or treatment areas
can have some standards to take care of the children, I don't
understand why there is a push-back on that.
I don't understand, if you are dealing with children that
already have some problems, why we shouldn't be doing
background checks on those that are supposed to be helping
them. So I have a real hard time understanding a lot of that.
But with that being said, I need to ask some questions.
And, Ms. Brown, your testimony said there is not a single
Web site, federal agency and other entity that collects
nationwide data on incidents in these programs. Our bill calls
for a central Web site which will have data on these facilities
and their operating systems, and requires marketing materials
to include a link to this Web site so parents can see
information for themselves.
Would you think that this would actually help parents make
a decision on exactly what they are putting their child into?
Ms. Brown. I think that that Web site has a number of
advantages that it offers.
The first and most important one would be to give parents
information that would help them make an informed decision.
This is assuming that incidents of abuse and facility names and
that kind of thing were all contained on the Web site.
There are also a couple of other advantages. In the hearing
in the fall, we talked about facilities that, if they were shut
down in one state, move to another state. And a Web site like
this could help try to prevent that kind of activity.
And then the third piece is, in our surveys and in our
state visits, we learned that state agencies--the officials in
state agencies that place children in residential facilities
don't always share information with each other in the way that
they should. And so sometimes one agency may have decided that
they didn't really want to place their children in a facility
because of problems they knew and they didn't tell the other
agencies.
So, if this Web site could be constructed in a way that it
had all of the information that you have in the bill, I think
it would be helpful to the agencies, as well.
Mrs. McCarthy. The other thing I wanted to follow up on--
with a lot of the issues that we deal with here on the
Education Committee and the research that we do on certain
bills, I have found that when we pass a law here, you know, and
we put it out to the states, we really are not getting the
information that we need to make the correct decisions. So I
really become some person of--I like data. I like a lot of data
now.
And, with that being said, there is only one database that
collects some of this information, the one operated by HHS
called the National Child Abuse and Neglect Data System. The
federal government provides funds to states for reporting abuse
and neglect to this organization, but a lot of the states
aren't putting that data in there. We found that with some of
the educational standards.
How would you feel about having a--why doesn't HHS get more
comprehensive data from states on the number of incidents of
youth abuse and death? And how can we improve on that?
Ms. Brown. Well, you are absolutely right that the quality
of the data in that system is only as good as what the states
provide. And, as I said, there are a number of different areas,
particularly related to private facilities, that states don't
necessarily collect information on.
There are also problems with the way that some of these
systems are constructed, so that even though they may be
reporting the data, it is impossible to isolate those incidents
that happened at residential facilities versus other areas or
within a child's family.
One of the things that we have recommended in our report
that will be coming out soon is that HHS does step up and try
to work with the states and figure out what some of the
problems are and how they can improve that data reporting for
that system. Because it is used in HHS widely.
And I think that there might be a loophole in the law right
now, where states are expected to report these data that says
``to the maximum extent practicable.'' And that does, I think,
give a little bit of leeway. That I think it has been long
enough that these states have reported this data, that it might
be fair to expect them to report it more completely now.
Mrs. McCarthy. I agree.
I want to thank the whole panel for the testimony, and for
the parents that are here that testified in the past. And,
again, hopefully we can get a handle on this and get this bill
onto the floor and passed and hopefully prevent abuse to many
of the children that are out there and help the parents.
Thank you. With that, I yield.
Mr. Kutz. Mr. Chairman, could I just add one real quick
thing to that? It will take just a second.
What we found at the case-study level, too, is that a lot
of the abuse and torture and things like that never gets
reported to the state. So that is just another point, that even
if the states aren't reporting it, they are not getting it from
the programs. A lot of the programs we looked at were cited for
not reporting abuse, and most abuse maybe never gets reported
in the first place.
Chairman Miller. Mr. McKeon will now be recognized for 15
minutes. And thank you for your patience.
Mr. McKeon. Thank you, Mr. Chairman, for yielding.
I want to begin by thanking all the witnesses for their
testimony here today.
I strongly believe that the instances of neglect and abuse
and death at these facilities that we have been talking about
over the last few months are totally unacceptable and must be
stopped. That goes without--probably should go without even
needing to be said.
I still don't feel, though, that the committee has a full
grasp on the extent of the problem or possible solutions. As
you just said, a lot of these things are not even reported.
So I am glad this hearing has been convened today to learn
more about these facilities and give members an opportunity to
ask questions about them.
Mr. Kutz, you talked about eight instances of death. Has
there been any prosecution on those deaths that you are aware
of?
Mr. Kutz. Yes, there was one case of a criminal conviction
for third-degree assault and false imprisonment, and that
person served 1 month. There was also a plea, but there was no
time served.
On all the other ones, there were no criminal prosecutions
or charges.
Mr. McKeon. So murder is okay now. I mean, listening to
just what you said about it, I can't even understand how we
don't have eight people in jail for murder in those instances.
How do you possibly not have----
Mr. Kutz. I agree with you. It is very difficult to look at
this and wonder why there is not more criminal aggressive
effort in this particular case. There was a lot of civil
activity, lots of civil settlements, but that doesn't fix the
problem with the people who were doing the abuse.
And the real issue, I think we talked about at your last
hearing, these people are moving around. So who knows what
program they will move to next, and----
Mr. McKeon. But you have----
Mr. Kutz [continuing]. There is no trail then.
Mr. McKeon. I mean, you know of a death.
Mr. Kutz. Yes.
Mr. McKeon. The police don't find out about it? Or they
just shrug it off and write traffic tickets, or what? I just
don't even understand this.
Mr. Kutz. It may be that it is difficult to prove in a
court of law. I mean, I can't really explain it fully.
Mr. McKeon. To prove how the death occurred, or that there
was a death? I mean----
Mr. Kutz. There was clearly a death and there was clearly
abuse, in some of the cases we looked at. And why there was no
more criminal on that, I just can't explain it for you fully.
Mr. McKeon. I just don't understand that.
Ms. Whitehead, Mr. Martin-Crawford, both of you seem to be
doing quite well now--apparently not as a result of your stay
in these institutions. But how did you get your lives turned
around?
Ms. Whitehead. Well, I think primarily just doing the work
that I have been doing, in terms of advocacy. I mean, it really
took a good 10 years for me to, kind of, get through all of the
depression stuff and the anxiety. And----
Mr. McKeon. It just happened, or did you have some
professional----
Ms. Whitehead. Well, no, I had some therapy around it,
and--but really it was about not really understanding my
experience, not really framing it as abuse, and speaking with
Dr. Pinto at length and understanding that there is some
legitimacy to my claim and finding a place to put that.
So I think that, you know, it was that confusion and that
internal battle that took so long, you know, the nightmares and
understanding where that came from, and then understanding that
it wasn't therapy.
Mr. McKeon. What I am trying to get at is you apparently
had some problems, which is why you were sent to this place.
And if you could just block that out, how did you get the
problems that got you to that point in the first place, how did
those get taken care of?
Ms. Whitehead. Therapy.
Mr. McKeon. After you----
Ms. Whitehead. Oh, after, yes.
Mr. McKeon [continuing]. Came back home.
And was your experience the same?
Mr. Martin-Crawford. My experience, for the most part, when
it came down to the issues that got me into The Family--
marijuana use, things like that--most of it really just came
out of maturity. At some point I just realized that doing the
right thing--going to school, getting a degree, and, you know,
becoming a teacher--meant more to me than hanging out and
getting high.
And as much as I hate to say it, this testimony here,
because of the thorough background checks that certified
teachers get, could be problematic for that. But it is worth
the risk. I mean, I guess my certification means more to me
than these people's.
Mr. McKeon. Thank you very much.
Dr. Bellonci, in your testimony you seem to have pretty
extensive knowledge of the legislation that was introduced last
night?
Dr. Bellonci. Yes.
Mr. McKeon. When did you see the legislation?
Dr. Bellonci. Tuesday of this week.
Mr. McKeon. Tuesday of this week?
Dr. Bellonci. Yes.
Mr. McKeon. Today is Thursday?
Dr. Bellonci. Yes.
Mr. McKeon. Okay.
I have some questions I would like to direct at all the
witnesses. Can you tell me how many private residential
treatment programs or boot camps there are nationwide?
I guess that is a no?
Ms. Brown. I think it is safe to say the answer, from our
perspective, is no, we don't know.
Mr. McKeon. And so, if we don't know how many there are, we
probably would not have numbers to break them down by state?
How many different types of treatment programs----
Chairman Miller. Let the record show the answer appears to
be no again. [Laughter.]
Ms. Brown. The answer is no.
Chairman Miller. Yes, thank you.
Mr. McKeon. How many different types of treatment programs
are there in the country?
Mr. Martin-Crawford. I believe that would depend on what
they call themselves. That goes anywhere from emotional growth,
residential treatment, wilderness--I mean, there are so many
different names that it is almost impossible to tell. Because
if we listed 20 names right now, there would be 21 tomorrow.
Dr. Bellonci. If I may, I mean, I think part of the problem
in even beginning to get the scope of the issue is that there
is no agreement on the terms to define these programs. And I
think one of the things that we really need from the national
level is a definition of the range of out-of-home care options
that exist, and then clear standards to correspond to each of
those definitions of care.
Mr. McKeon. Okay.
One of the solutions that has been suggested is some sort
of federal oversight. And I am curious about the capacity that
would be required to regulate these programs on a federal
level.
Can any of you talk about the manpower, expertise and
funding that is going to be needed to establish and then to
monitor these programs by a federal agency?
If this doesn't----
Ms. Brown. I was trying to think if there was anything I
could contribute to that. And I guess the only thing I can say
is, in our options that we lay out for Congress to consider,
one of them is direct regulation, which is the first part of
the bill that relates to asking HHS to monitor the facilities.
And we don't know the cost of that or the capacity.
When we looked at that option and other options, we
considered the fact that there are really three factors that
need to be weighed against each other, or traded off. And one
is cost. And the second is the federal reach, how far you want
the federal government to be involved in this. And the third is
the extent of protection that children would receive or how
wide the net would be.
Mr. McKeon. Where would the federal government get the
jurisdiction to be----
Ms. Brown. For direct regulation?
Mr. McKeon [continuing]. Directly involved in this? Yes.
Ms. Brown. Well, according to our counsel, that would come
from the issue of interstate commerce. And there are two ways
that that could be applied. The first one is through the
marketing practices that we talked about today and those
occurring throughout the government. And the second one is
related to the number of youth that are actually placed across
state lines.
Mr. McKeon. Okay, so if you have a state that had an
organization within the state that did not cross boundaries,
that only had students coming from within their state, where
would the federal government have the ability to get involved
in this program?
Ms. Brown. Well, and that--the question there of, if they
don't accept or place children in other states, would be, what
are their marketing practices, and did those have a wider
reach? I know that many of these facilities----
Mr. McKeon. But the ones that are just done within a state,
where would the federal government have the ability to
intervene?
Ms. Brown. The way that the federal government, in those
cases, has influenced that and would be able to in the future
would be through the use of federal funds. If you were to----
Mr. McKeon. But if they are not receiving any federal
funds, as I understand these programs aren't, where would the
federal government have the ability to intervene, according to
the Constitution?
Ms. Brown. I have to tell you, first of all, I am not a
legal or a constitutional expert, so----
Mr. McKeon. Do we have any on the panel?
Okay. That would probably be better to address somewhere
else then.
Ms. Brown. Right.
Mr. McKeon. Okay. At this time, I yield to Mr. Platts for
my remaining 5 minutes.
Mr. Platts. Thank you, Mr. McKeon. And I want to thank the
chairman and the staff of the committee for their important
leadership and work on this issue.
And certainly thank all of our witnesses here today,
especially Ms. Whitehead and Mr. Martin-Crawford, for your
efforts to try to take the trauma that each of you suffered
through not to be repeated against others, and your willingness
to be here, not just in testifying, but your advocacy for the
rights of other children that are still in these programs.
I tell you, as a parent sitting here today as well as in
our last hearing, it is truly sickening to hear of the care
given to children entrusted to adults to help better the lives
of those children, and instead have resulted, as we have heard,
in some instances, in the deaths of those children. And as a
nation, we certainly have a moral responsibility to do our best
to not allow this to happen.
Mr. Kutz, I would like to start with your comments. First,
in the four cases where there were deaths, are any of those
facilities still operating today? Or, as to the best of your
knowledge, are any of the individuals associated with those
facilities still operating under, perhaps, different names?
Mr. Kutz. The answer is yes. Cases two and four are still
open under the same name and same individuals involved. Numbers
one and three are closed.
Mr. Platts. And under cases two and four, are those
institutions or facilities ones that there were legal actions
of any kind brought against them?
Mr. Kutz. There was an investigation of case four by the
state. And for the other one, there was a civil settlement, but
no criminal.
Mr. Platts. All right. As Mr. McKeon stated, it is hard to
understand that scenario and that there is not more scrutiny
and action, given the circumstances that you have shared with
us.
You reference in your testimony that, in three of the eight
cases you looked at, the victim was placed in the program by
the state or in consultation with state authorities.
To the best of your knowledge, was there any follow-up,
site visits, interviews, you know, investigations by the state
authorities or entities that placed those individuals to make
sure that the child being placed was receiving the care that
they were intended to?
Mr. Kutz. Not until it was too late, until it was a
problem, and then there was lots of investigative activity. And
that gets into the whole issue here, hopefully that the
committee's focus here is on preventing these things from
happening. And that is really what I would say you should focus
on, because once you get to the investigative phase, it is too
late. And, as we are hearing here, oftentimes there are no
consequences.
But we are talking, also, about Medicaid money. Several of
them had Medicaid money. And then one of them had money from
the juvenile justice system also. So there were various types
of money, either paying for part or all the tuition, even
though it was a private program.
Mr. Platts. My focus is not the investigation after
allegations of abuse, but if a state is saying, we are placing
this child in your custody, at state direction, as to your
knowledge, there is no, ``And we will be back in a month to see
how that child is doing, how you are operating, how you are
caring''? To the best of your knowledge, that did not occur
again until it was too late?
Mr. Kutz. I can't say that for sure, but if it was, it was
ineffective oversight. And it may not have been random,
unannounced visits, which is something I know that has been
discussed, and that may be an element of your bill, I believe.
But that would be something that I would suggest, no matter who
is responsible, that random, unannounced visits would be
something that could help this.
Again, if it is a wilderness program, that would be
difficult, because you would have to parachute into the
wilderness to do a real unannounced visit. But, otherwise, some
of the physical structures, you could do a random, unannounced
visit.
Mr. Platts. Probably a necessity, to truly get an
understanding.
In your testimony, you also talked about--you say, ``A
number of states do not license or otherwise regulate certain
types of private programs.'' Do you know how many states do
regulate in some fashion private residential facilities?
Mr. Kutz. I will let Ms. Brown answer that more so. I mean,
with respect to our case studies, some were licensed and some
weren't. That was true last fall also.
Mr. Platts. Okay.
Ms. Brown. I think one of the issues there is for private
facilities whether they are receiving government funds or
whether they are not. And all of the states that we heard from
licensed some types of private facilities.
The issue is that there are some that are exempt from
licensing. In some cases, it might be, as I mentioned,
academies and boarding schools are the ones that are most often
not licensed. And then there are also examples like faith-based
facilities that would also be exempt from licensing. There are
six states that do that.
Mr. Platts. Just a quick follow-up on that, is there a best
example of a state that you would point to that does regulate
private facilities?
Ms. Brown. I wish I could give you a simple answer to that
question. We have an idea of what we would like to see the
oversight and regulatory structure look like. But as we looked
at the states, none of the states that answered our surveys,
which was all but one, had the complete package.
Some had much more developed oversight standards, but they
didn't reach very far, as far as the number of programs, the
types of programs they covered. Some had much more broader
coverage, but their standards and oversight were only this
deep. So it is hard to pick one out.
Mr. Platts. No one perfect example to point to.
Ms. Brown. No, sir.
Mr. Platts. Thank you, Mr. Chairman.
Chairman Miller. Thank you.
Mr. Scott?
Mr. Scott. Thank you, Mr. Chairman, and thank you for
holding the hearing. We are going to be dealing with this
subject, if we don't deal with it directly, at least indirectly
through the reauthorization of Juvenile Justice and Delinquency
Prevention. So it is an important issue as we deal with
juveniles.
I would like to ask Ms. Brown, you know, we know what we
are trying to cover. You, kind of, know it when you see it. But
I was wondering if you had looked at the definition that we
have in the bill to see if it covers everything that needs to
be covered and doesn't leave anything out.
It, for example, does not cover government-run programs.
Should government-run programs be covered?
Ms. Brown. In our survey, we looked both at government-
operated facilities and then private facilities, those that
were exclusively private and those that received government
funds. And we found very similar problems with the government-
operated facilities.
The organization in the Department of Justice that
investigates civil rights abuses for institutionalized persons
in public facilities has an annual report that provides
detailed information on different cases that they have
investigated that sounds very similar to the case studies that
Mr. Kutz reported on.
Mr. Scott. Are there any other programs--that the
government programs ought to be considered. Any other programs
that would not be covered by this definition that ought to be
covered?
Ms. Brown. The issue of----
Mr. Scott. If you are not prepared to answer that now, if
you could think about it and get back to us, that would be
helpful.
Ms. Brown. Yes, I would be happy to.
Mr. Scott. Mr. Kutz, I have seen studies that suggest that
boot camps just don't work, if it is just a disciplinary
program. However, if you have boot camp plus a significant
education component, then it does work. And then it occurs to
me, if you have an education component without the boot camp,
it would probably work anyway.
How do we deal with the question of whether boot camps
work, as we try to regulate them?
Mr. Kutz. The ones we looked at--and I can only speak to
the case studies we looked at, and I am not an expert on this.
The ones we looked at had very little educational program. It
was more a discipline, more of a military style to, I guess,
help youth that maybe had trouble with discipline or whatever
the case may be.
But I didn't see a lot of education in the case studies we
have looked at, so I can't really address how effective----
Mr. Scott. Well, did they accomplish a goal?
Mr. Kutz. Again, I haven't looked at them all. The ones
that we looked at, there was some more severe abuse, I would
say, of kids at the boot camps. They had more of a difficult
environment for the kids.
Mr. Scott. Well, if they weren't abusing them, did the
underlying program work?
Mr. Kutz. Again, in the case studies we looked at, I would
say no. But, again, I can only speak to a few case studies of
that, so that is probably not a fair look at all of the boot
camps.
Mr. Scott. Dr. Bellonci, if you are having this physical
activity, would it help if you required the students to have
physical exams before they signed up?
Dr. Bellonci. Absolutely.
Mr. Scott. Should the staff be certified in CPR?
Dr. Bellonci. Yes.
Mr. Scott. Ms. Brown, we have in here that you ought to
have standards. For example, there ought to be a medical
emergency plan. But it doesn't say what is in the plan.
Who should decide what specifics are in the plans? Should
that be a state-level certification, or should the bill include
specifically what should be in the plan?
Ms. Brown. I haven't looked at the bill in that amount of
detail, to be able to comment section by section on that.
I know that there is something to be said for having broad
standards that are agreed upon at a very high level that
everyone can be expected to meet. When you get down to the
details of what should exactly be in a medical plan, that may
vary depending on the type of student that is being served.
Mr. Scott. Well, maybe Mr. Kutz or somebody else could
comment too. We have, staff shouldn't be convicted felons,
particularly in child abuse areas. Should there be minimum
standards for staff in these things? Education level?
Mr. Kutz. Well, I would say yes. I mean, I am not, again,
an expert on it, but I would say----
Mr. Scott. Okay. Then who ought to set the standards?
Mr. Kutz. I don't know who should set the standards, no,
sir.
But I think you mentioned something else in your comment.
There are background checks too, because we did see certain
programs do background checks, other ones don't do background
checks. We had instances where prior felons were involved with
these programs. We have seen that before. So that is something
that is quite important, I believe.
Mr. Scott. Well, if you are trying to accomplish a goal,
there ought to be some minimum education requirement, some
qualifications for staff, if you are trying to accomplish a
goal. Who ought to set the standard?
Well, Mr. Chairman, I guess that is something we need to be
looking at. I yield back.
Wait a minute. I think we might have an answer.
Dr. Bellonci. I don't know if it is an answer. It is a
recommendation.
I think there are a number of accrediting bodies, there are
a number of training programs that set their own standards,
particularly around behavior management. And to expand on my
earlier question of just yes to needing CPR training, there is
so much that must go on before you even get to that point.
And even then, I don't think that most of the interventions
that you are hearing about are justifiable from a clinical
treatment modality. It is just not clinical treatment.
But even when you are a good program that is licensed and
accredited and have highly trained and qualified staff, bad
things can still happen. And so, having a rubric that you
follow, that does meet some baseline platform of licensure and
regulation, I think is at least the place to start to try to
clarify, when bad outcomes happen, what you can learn from that
so that it doesn't happen again.
Mr. Scott. Mr. Chairman, my time is expired, but I would
hope that somewhere along the lines we would consider what the
goal of these programs might be, what outcomes they are trying
to get, and the regulations really ought to be consistent with
that. Just having plans and this kind of thing, at some point
some of these programs are working, some of these methodologies
are working, and some don't.
Chairman Miller. Oh, I think that is part of the problem we
have encountered here. Because there are some which are
considered successful by parents and others and maybe even by
those operators, the suggestion is, because some are good, you
can't look at the bad.
And I think we have to delineate these programs, because
there are clearly practices here that have been designed over a
period of years. And after various incidents and run-ins with
various agencies, these people have learned to navigate the
gray areas between federal, state regulation, definitions and
all the rest of that.
And this has not emerged by accident; this is designed.
There have been numerous ones of these programs that are the
most troublesome are third and fourth iterations of various
problems and third and fourth career opportunities for people
who were engaged in previous and serious offenses. So this is
not an accident, that this industry has sprung up in the manner
in which it has.
Ms. Shea-Porter?
Ms. Shea-Porter. Thank you, Mr. Chairman. And I really have
more of a comment.
First I would like to say how sorry I am that you have
experienced what you have. As a former social worker, I am
absolutely horrified. I can't imagine why there wasn't any
oversight, why nobody stepped in. And so, I say I admire both
of you for being here and sharing your story and making a
difference.
And I would like to thank the chairman and those who worked
on this to make sure that we have the changes.
I would also like to say, the federal government does step
in. They step in, they can provide money to states to help them
license and oversee. So I see it as an appropriate role of the
federal government. Indeed, you know, we have some groups that
support animals that would have had more clout than some
organizations had to help you.
The other comment I wanted to make, simply was a question,
I know that on the Web site one of the proposals would be that
they would have access, that they could take a look. But do you
know another way, from your own experience, to help families
recognize the pitfalls of an organization? How would you go
about it? Is there something else you could add to this
discussion about how to warn families before they put their
children in bad treatment facilities?
Ms. Whitehead. Well, I think, sort of, what Dr. Bellonci
was speaking to, in terms of accreditation. I think that, you
know, regulation is important, absolutely, but anybody can open
up a facility and call themselves a therapeutic location and
yet use these aversive methods that are causing more harm than
any benefit.
So I think, you know, that would be a recommendation,
accreditation, as well as a facility with an open campus. I
commend the Walker School for opening up their school to
parents. Because the facility I attended and a lot of the
facilities I hear about, the campuses are closed, no
unannounced visits. People have to call. Parents aren't allowed
to come in, and so nobody really knows what is happening.
So those are primarily the recommendations--and close to
home. I mean, families shouldn't have to be torn apart to heal.
Mr. Martin-Crawford. I would say even with the distance
from home, even if kids were sent away, one of the main things
that any parent should look for is, does your child have
absolute access to Child Protective Services and to calling
home to their family? Keeping those two things away, you are
just looking for trouble.
The other thing for parents that are just browsing Web
sites and not really doing research, if that is the case, a lot
of this is--you will see success stories that are, you know,
``I just graduated.'' And it is really people that graduated
this year or last year, you know, at the most 2 years, saying
how the place saved their lives and all that.
You look a little further down the road, and these kids--I
mean, it took me probably about 4 or 5 years to start seeing
it. And, you know, it progresses, as time goes by, to now, I
even have my friends' parents that are telling me how much they
hated the experience that their child went through. Because it
takes a long time to really get over the brainwashing and the
scars that you really go through.
So, I mean, look at the Web sites and all the success
stories that they tout out, from the parents to the students,
graduation speeches, whatever the case may be--you know, try to
be realistic. If you are only getting stuff that is within the
last year, chances are it is because other people have stopped
talking to them for some reason or another.
Ms. Shea-Porter. Thank you.
Thank you, Mr. Chairman.
Chairman Miller. Thank you.
Mr. Platts?
Mr. Platts. Thank you, Mr. Chairman.
Ms. Brown, a follow-up to when I asked about the best
practices and you talked about a lot of these states have good
aspects but no one state, kind of, had the whole package.
And I don't expect you to have it here today, but you could
follow up with us what you have identified what you believe to
be the whole package, you know, of this state's good
attributes, standards, this state's. But what would, from your
investigations and research, be that whole package? If you
could follow up to the committee in writing with that, that
would be helpful.
Ms. Brown. Certainly.
Mr. Platts. Thank you.
In your testimony, you referenced the Civil Rights of
Institutionalized Persons Act and the authority of the attorney
general to bring actions. And this relates to state and local
facilities, public facilities.
Are you aware of, in, say, the last 5 years, how many
investigations and/or actions have actually been initiated by
the attorney general of the United States under this act?
Ms. Brown. The first thing to say is that the officials
from this organization told us that they get more referrals
each year than they can handle. But they do issue an annual
report. And I am stalling right now, because I am hoping that--
--
Mr. Platts. The attorney general's office gets more
referrals than they can handle?
Ms. Brown. Yes, this special litigation division that deals
with the civil rights of institutionalized persons.
And, okay, so in 2006 they investigated over 175 facilities
in 34 states. And their report does contain quite a bit of
detail about the problems that they saw.
Mr. Platts. Mr. Chairman, if we could have the report
included as part of the record and we receive copies of that,
that would be wonderful.
Chairman Miller. Without objection.
[The three CRIPA reports for fiscal years 2004, 2005, and
2006, respectively, are accessible at the following Internet
addresses:]
http://www.usdoj.gov/crt/split/documents/split--cripa04.pdf
http://www.usdoj.gov/crt/split/documents/split--cripa05.pdf
http://www.usdoj.gov/crt/split/documents/split--cripa06.pdf
______
Mr. Platts. Thank you, Mr. Chairman.
So it sounds like they are trying to be dutiful in their
responsibilities but perhaps don't have the resources to be--
did they give any indication of, if they did, I think, 170-some
investigations, was it twice that they received, so 50 percent
they didn't get to? Or that wasn't shared?
Ms. Brown. Well, they get many, many more referrals than
they can investigate. How many of those would be valid ones
that they should actually be pursuing, I don't know.
Mr. Platts. Okay.
Ms. Brown. I can tell you that, in our upcoming report, we
are making a recommendation that relates to trying to encourage
the other federal agencies to work closely with them so that,
if they find information about problematic facilities, they get
that referral over to the Department of Justice so they can
follow up.
Mr. Platts. Excellent. Because the more coordination and
communication, the more likely we can get the bad apples
identified and pursued.
Mr. Kutz, a follow up. In your testimony, you talked about
the referral services. I mean, clearly, it seems like false
advertising. In Pennsylvania, we have an unfair trade practices
act that would seem to govern some of this.
Are you aware of any actions at the state level--or
federal, but more likely at the state level--to pursue any of
these entities that has engaged in the type of advertising or--
you know, fraudulent or apparently misleading information?
Mr. O'Connell. Andy O'Connell from GAO, just to follow up
on that question.
We are in dialogue with the FTC regarding our work. And I
don't know what they are doing right now; you would have to ask
them. But we are----
Mr. Platts. You have shared your results with the FTC, for
them to----
Mr. O'Connell. Yes, we have.
Mr. Platts. Okay.
Mr. O'Connell. And on the one tax scheme that you saw in
our----
Mr. Platts. Yes, on the 501.
Mr. O'Connell [continuing]. We are making a referral to IRS
on that.
Mr. Platts. Great. Thank you.
Mr. Kutz, I know you investigated these eight specific
cases. What is the youngest age of any child, that you are
aware of, that has been placed?
Or if anyone else would want to answer that, as well.
I have heard 12, a number of times 12-year-olds. Are there
children younger than 12 in these facilities?
Mr. Kutz. Of our cases, 12 is about the youngest. But there
is evidence that there are kids under 10 years old in these
programs, yes.
Dr. Bellonci. My program actually works with children
between the ages of 5 to 13 in our residential setting.
Mr. Platts. How about in any of the wilderness or boot
camp-type facility? Anyone----
Mr. Martin-Crawford. At ours, as well, the youngest was 12
years old. I think 6th, 7th grade was pretty much where their
cut-off was at that point.
But, I mean, there were kids that stayed there, although
they were family members of staff members that ended up then
being students later on. So they were there all the time.
But the only ones whose parents actually admitted them, the
youngest was about 12 years old, a kid that pretty much just
had ADD and, while he was there, did develop the behaviors that
most of the people pretended to have and that was actually shot
last year as a result.
Ms. Whitehead. I know of a facility in Utah called Majestic
Ranch that admitted youth as young as 7.
Mr. Kutz. At the other end of the spectrum, we had one
program where kids were held beyond their will after 18, which
is the other end.
Mr. Platts. And that was one of your cases you referenced?
Mr. Kutz. Yes. There were several kids--one was held there
over 13 years.
Mr. Platts. My time has expired. I don't know if we will
have another round or not.
Chairman Miller. We will.
Mr. Platts. Thank you.
Chairman Miller. Mr. Kutz, again, in a number of the case
studies--I would like you and then maybe Ms. Whitehead and Mr.
Martin-Crawford would want to respond also. But in a number of
instances, we have students participating in physical actions,
maybe abusive actions, against other students.
Can you outline that or tell me what you know about that?
And then I will ask the other two to respond from their
experiences.
Mr. Kutz. Yes, we saw students being involved in abuse and
torture of other students, typically at the direction of some
of the staff or owners. But, yes, kids, typically against their
will, being responsible for that and being told to carry
somebody around, kick them, beat them, whatever the case may
be. And we saw that last time, too, the 10 cases from last
fall, the same type of things, where kids were involved.
One of the programs, the actual staff were people who had
been program participants. So they went through the program,
and their qualifications to be the staff were that they had
been in the program.
Chairman Miller. Ms. Whitehead?
Ms. Whitehead. My facility didn't use any kind of physical
intervention, you know, among students. But what we did, we
were required to--it was called ``called out'' in group by
other students. And, sort of, to deflect attention away from
one student, we would have to call another student out on
behavior, vague notions of dishonesty, and then they would get
subsequently punished and have to do work crew for the day or
rock-picking, things like that.
Chairman Miller. Mr. Martin-Crawford?
Mr. Martin-Crawford. The same was the case in my program.
The students did actually have to physically restrain students.
We had to chase them, bring them back.
The first few times that a student would do it, if you had
just become a senior member, you were told by staff, ``Okay,
you are a senior member. You should go and chase them now.''
And then, after a while, it sort of becomes second nature. It
is almost just a reflex, at that point, because you know that
you are expected to do it.
Chairman Miller. When you discussed wrapping students up in
restraints, that was done by other students?
Mr. Martin-Crawford. That was usually initiated by the
faculty, but the students assisted. Like, a faculty would say,
``Wrap them up,'' and then the students were the ones that were
forced to do it. The faculty was then the one that would say,
``Put them in the isolation room,'' and a student would
observe.
So, occasionally, we would let the kids out of the blankets
if we thought we wouldn't get in trouble for it, if nobody was
looking, but it was something that, if anybody was around, we
had no chance of doing.
Chairman Miller. Dr. Bellonci, what is your impression of
this?
Dr. Bellonci. Once again, I am horrified. There is no
justification for having youth-on-youth interventions like
that.
Chairman Miller. Is there in, I don't know, what I would
call a normal practice, is there a discussion of this within
the profession of whether this is advised or ill-advised?
Dr. Bellonci. Yes, I think it is very clear in the
profession that this is ill-advised and unaccepted practice.
You know, one of my comments, as I was listening to what
could be helpful, you know, and what a parent might want to
ask, I would want to know whether or not--you know, what were
the professional qualifications of the staff. I would want to
know if there was on-site medical involvement and oversight and
an administrative capacity. I would want to know what the
training guidelines were for the staff. I would want to know
what the history of abuse claims were against the agency.
In my state, you can find out more about a restaurant by
doing a Web search for their health standards than you can
learn about these kinds of programs that are caring for
America's youth. And that is an outrage.
Chairman Miller. Mr. Bellonci, I, I guess like many
members, know of families and have been involved with young
people and older people and their families--my wife does a lot
of mental health work--with bipolar. I know the struggles and
the difficulties, both for the individual suffering from
bipolar problems and their families.
Ever any suggestion that oatmeal--and I am not being flip
here; I am very serious--any suggestion that oatmeal and
exercise itself would cause bipolar to go away?
Dr. Bellonci. I have never heard that. You know, it is a
serious disorder. It needs to be taken seriously. There are
treatment interventions that are successful, that are well-
studied in double blind placebo control trials. I have never
seen an oatmeal study to show any kind of an outcome.
There are some research studies looking at dietary
interventions for ADHD. But, again, I don't believe that they
have shown any significant positive outcome in double blind
placebo control trials.
That is not to say on a case-by-case basis I haven't
anecdotally heard stories of reducing sugar content or caffeine
benefiting children, particularly adolescents, but nothing
regarding your statement.
Chairman Miller. And, as I understand it, Mr. Kutz, this
was held out as, in fact, a cure that would be offered, since
this ``parent,'' this interviewer was told that this would make
it go away.
Mr. Kutz. That was one of the marketing pitches you heard
in the opening statement, yes.
Ms. Brown. An oatmeal diet?
Mr. Kutz. Whole-grain diet, but I guess----
Chairman Miller. Oh, excuse me, whole-grain. Let me correct
the record: whole-grain diet.
Again, what bothers me is that, again, a fair amount of
experience with a lot of these parents and families, you get to
your wits' end with a very difficult child, and a difficult
child that you have tried different alternatives to help, and
with school districts and all of what it entails for some of
the clientele of these facilities. And to then suggest things
that just aren't based in fact, science or otherwise, that this
will all, sort of, come true, I really believe it is just
preying, and in a very unethical fashion, preying on the
anxieties and the stress that exists in these families.
The repercussions, you know, of the families engaged in our
first hearings and, I assume, many of the families that had
their children either abused or died in this hearing,
repercussions within those families are long-lasting and
sometimes very devastating for the adults who later find out
maybe that they had participated in this and how badly they
feel about it, in some cases, or, as we discussed, in cases
where they voluntary had their children kidnapped from their
homes and then realized what had taken place when, certainly,
later the child was tragically killed in those programs.
So the idea that this is a harmful intervention at many
levels I think is very dangerous for us as policy-makers to
consider. Again, you know, we don't want to paint with a very
broad brush here, but the fact of the matter is, we are
starting to see emerge here some programs that are very
dangerous, that are very reckless, with respect to the health
and welfare of the children that they have in their custody.
And, you know, they have gotten that custody, I think, under
very suspect representations and conditions to those families
and to the parents.
Mr. Kutz, if I might--and I have a little bit of time
left--these financial connections--you know, we went through a
long scandal here on colleges referring people to certain
student loan lenders and you might not have gotten the best
interest rate. But here you have a referral service that may be
financially connected, I assume through either fees or
commissions for the referral of these patients. And so, again,
you have no sense that you are getting informed, independent,
ethical representations from the phone calls you made.
Can you tell us about this or what you know about the
financial arrangements that may create a conflict of interest?
Mr. Kutz. I would say one case was worse than that. You had
a husband-wife team claiming to be independent. One was the
referral service; one was the actual program. We called the
referral service three separate times, as three separate
parents with three different, very different, kids, and each
time we were referred to the same program. And it is because it
was a husband-wife connection.
Chairman Miller. But they hold themselves out as being
independent referrals?
Mr. Kutz. Well, they didn't disclose that to us, as the
parents. So I don't know if they hold themselves out as that,
but there was no evidence anywhere on their Web or anything
they told us that, ``Yes, we are related to this program, and
no matter what your problem is, we are going to put you to the
same program,'' which appeared to be the reality of the
situation.
And there were other issues where I think the referral
services are certainly getting money, in many cases, from the
programs for the referrals. And those are undisclosed types of
situations, typically.
Chairman Miller. Excuse me, I lost you. Do you know that as
a fact, or----
Mr. Kutz. Yes, we have cases of that.
Chairman Miller. Oh, I see.
Mr. Kutz. Yes, absolutely. The one was the worst case,
where you had the husband and wife. But you have other
situations where you had undisclosed to the parents that the
referral service was getting money for each referral they made
to the program, or a vacation or--there were other things like
that they were getting paid. So there was a financial
relationship between them.
Chairman Miller. A lot of these programs appear to have a
28-day or 30-day--there was a time, and I don't know if it is
relevant in this case, where that was related to insurance
payment, that you got an insurance benefit that, sort of, had a
30-day cut-off on it for mental health or treatment.
Is that operative in this situation, with respect to
placement of these young people?
Mr. Kutz. I don't know.
But with respect to health insurance, we were marketed by
some of the programs, one in particular saying that you might
be able to get money back from your health insurance. But what
they told us was, ``Don't tell them in advance because,'' I
think the word was, ``you will be up a creek.'' So they said,
wait until the end. Well, you know most insurance programs
require pre-approval for substantial disbursements.
And so you advise a parent not to talk to the health
insurance company, get them to believe they are going to get
money at the end of the day. I believe they would be up a
creek, probably, because most health insurance companies--even
for hospital stays, you have to get pre-approval for health
insurance. So, for something like this that is even possibly
not covered at all, to give parents that advice is very
misleading.
Chairman Miller. Dr. Bellonci, do you know of that?
Dr. Bellonci. Yes, absolutely. I think the point is that
most health insurances would do the due diligence and not fund
programs that were unlicensed or unaccredited. So I don't think
most health insurances would actually support these programs.
Health insurances also want to know that they are getting a
return on their investment for treatment. And they would know
that these are not programs practicing evidence-based practice
or care, and, therefore, they would not allow payment to these
programs.
And I think that your point is essential, about the
desperation that these families are finding themselves in as
they are searching for appropriate treatment and intervention.
I think it is a very large issue. It has to do with access to
appropriately licensed, regulated, accredited programs. It has
to do with the shortage of child psychiatrists in this country.
It has to do with the limitations on health care, particularly
behavioral health. And it has to do with mental health stigma.
Chairman Miller. Thank you.
Mrs. McCarthy?
Mrs. McCarthy. Thank you again, Mr. Chairman.
I was just wondering, as I was listening to the testimony,
where a lot of these particular facilities are. I was just
wondering, Ms. Brown, when you were looking at all this if
there was a correlation between where these facilities are and
maybe that particular state being extremely weak in child
protective cases, you know, those states that might be weak or
didn't have the finances to be able to do what they need to do,
just even through, say, foster care of anything that had to do
with children.
Ms. Brown. We did see some correlation between a lack of
oversight in some states and types of facilities, Utah being
one that had a very large number of--a disproportionately large
number of boot camps. Now, they have since started to make some
changes in their laws in oversight. And we don't know how that
has affected the number of facilities there.
I think Mr. Kutz's team actually has a map that outlines
where some of the different facilities and types are.
Mr. O'Connell. Mr. Chairman, if I could add--Andy O'Connell
from GAO--we have found that most of these boot camps,
wilderness programs, residential treatment centers exist in
about 48 states today.
Chairman Miller. Yes. The map, I think, is page 22 or 23 in
the GAO testimony, where they demonstrate where their case
studies, where the student came--what state they came from to
what state they went to the program.
Mrs. McCarthy. Okay. You know, the more I keep hearing this
testimony--some of us are old enough, going back to the 1960s
and the 1970s when, unfortunately, children that had some
mental illnesses were in these particular facilities that were
supposed to be hospitals or treatments for them until
investigations like yours were done to expose that these
children were living under conditions that were totally
unacceptable to the majority of people of the world.
And I think that, you know, by having a hearing like this
and trying to expose the issues that we are facing with,
unfortunately, young people and parents who want to do the
right thing for their children are led down this path, as Mr.
Miller has said--you know, these parents want the best for
their kids, and sometimes they do come to the end of the line.
But I think that I do believe the federal government has
the right and certainly we should be able to work it out,
whether it is, you know, putting standards to protect children.
Your facility--we are not concerned about facilities that are
treating our young people at an early age. But in this day and
age, I mean, it breaks my heart to hear about these particular
facilities. You would think we would have grown or certainly
gotten past on what we should be doing for our children and our
young people.
So hopefully we will go forward. Hopefully a hearing like
this will educate those parents that might be having a problem
with their young person now to really go out and--that is why I
just think collecting the data and having a place to go for
parents to really check out what it is, maybe even working with
every D.A. in this country, to set up something with them so
that we can put that data in that also, and really start
collecting the information for more information for those
parents.
You know, today is the world of the Internet, today is the
Web site. You know, put out the ones that are there, you know,
that are the good ones, or even the bad ones, so parents can
make an intelligent decision.
But I do believe the federal government has a role, because
obviously the states haven't done their job. And I think that
is what we are seeing here.
With that, I yield back.
Chairman Miller. Thank you.
Mr. Kildee?
Mr. Kildee. Mr. Chairman, under general leave, I will
submit questions in writing.
Chairman Miller. Thank you.
Mr. Platts?
Mr. Platts. Thank you, Mr. Chairman.
Before questions, if I could move that we keep the record
open for 14 days for additional testimony and for some of the
documentation that we have requested?
Chairman Miller. That is fine, without objection.
Mr. Platts. Okay, thank you, Mr. Chairman.
Dr. Bellonci, to follow up on your testimony, you talk
about the membership of the American Association of Children's
Residential Centers and that any member of the association has
to be licensed and you encourage additional accreditation as
well.
Am I correct in understanding that, first, the license is
by the individual state, wherever the facility is located?
Dr. Bellonci. Correct.
Mr. Platts. Are you aware, to be licensed, does it involve
any--or does it mandate on-site visits of the facilities, to
have those licenses?
And then, also, does it involve or require any follow-up
interviews with individuals who have gone through the
facilities after they have left them?
Dr. Bellonci. I think that is an excellent question.
I can't speak to every state, because what you are hearing
is there is really a patchwork of state licensing and
regulation.
Mr. Platts. Right.
Dr. Bellonci. I can speak to Massachusetts, where they do
come on site. They are authorized to come unannounced.
There are actually multiple levels of oversight and
regulation that my facility comes under. So Department of
Education can come from the state. Child Welfare can come from
the state because they have children placed in our program.
Department of Mental Health can come from the state. Our
licenser, which is EEC, can come.
And whenever there is an allegation of abuse or neglect
against our facility, they do on-site visits. They would meet
with the staff. They would talk about the incident. We would
provide them the data.
We do our own internal investigation. We have a very low
threshold. Even though we are serving children as young as 5,
if a child makes an allegation against a staff person, we
investigate that, and we do, at times, even report on
ourselves.
And there is a whole division of Child Welfare/Child
Protective Service that has institutional investigational
capacity.
But I can't speak to whether or not----
Mr. Platts. The other states.
How about in Massachusetts, to your specific state, any
follow-up with individuals after they have left your facility
or other facilities, in other words, to get that feedback after
they are no longer on site?
Dr. Bellonci. It is a real problem, the follow up after
youth leave programs.
There have been times--and I have been at the agency 13
years now--that I have heard about youth making an allegation
against a staff person after they have left. And that would be
also investigated, within the capacity of gathering the data,
finding the staff that are probably no longer even there, to
try to track down what occurred.
Mr. Platts. But there is no--what I am really after was
more like any random sampling, of just randomly picking--not
because an allegation was made, but just a random, we would
pick this patient or individual to follow up with, with the
parents, with the individual.
Dr. Bellonci. Not that I am aware of. We do try to do our
own outcome studies, and we have staff that call 6, 12--we are
trying for even further--months out, just to see, are we doing
what Congressman Scott asked, can we have data to show that our
intervention is yielding results. And it is a real challenge,
but we are trying to do the best we can to gather data to show
that it is a treatment worth the state's investment.
Mr. Platts. Great. Thank you.
I guess, to any of our witnesses, our focus has really been
on the medical side or behavior modification, but an important
part of any of these facilities, as the Committee on Education
and Labor, is the education that is provided.
And through some of our testimony--Ms. Whitehead, I think
in your testimony you talked about it really didn't exist, that
you taught yourself algebra and that you really didn't have an
education aspect, even though you were there for a long period
of time.
What, to the best of your knowledge, each of you, education
standards are adhered to or, you know, enforced, given that we
have national standards, what we expect of our states to do for
children? Whether it be in a public or private setting, we
want, you know, a minimum level.
What kind of oversight occurs, to the best of your
knowledge, regarding education standards?
Mr. Martin-Crawford. As far as education, that is the only
thing that I can give The Family School credit for. We did
actually have a decent education. Most of us--some of us have
gone--a few people went to American University; I went to
Vassar College. We had a bunch of decent graduates coming out
of it.
Whether or not these teachers were certified or not to
teach the classes is a different question. We did have some
that were qualified enough that they could have been certified,
but I don't believe they were.
At the same time, we also have no time to do anything but
do homework. So, in that nature, our grades were obviously
going to be improved. But, at the same time, it is the only
thing that the school actually has credentials for. They do
give out a New York state Regents Diploma that is actually an
official New York state Regents Diploma, unlike a couple of
other----
Mr. Platts. So you took the Regents Exam?
Mr. Martin-Crawford. I took the Regents Exams. I took A.P.
college--not A.P., but college credits while I was a senior.
You know, I was able to get into a relatively decent school.
That is not the case with all programs and definitely not
the case with some of them; it is completely the opposite. But
when it comes down to misleading aspects of it, that is the
only thing that I could say that they probably told my parents
the truth about.
Mr. Platts. And, Ms. Whitehead, yours was probably one of
those opposite--or, from your testimony, not a very good
standard?
Ms. Whitehead. Right. I mean, my facility was accredited. I
don't know what kind of documentation they needed to prove
that. But what I can tell you is that we had schooling maybe a
couple hours a day. And then we had one certified teacher that
taught everybody both history and science. And then there was
an uncertified teacher, the headmaster's wife, that taught
English, which was pretty minimal.
So, overall, maybe we had, I would say, 12 hours of
schooling a week, maybe. And some of our field trips were
considered schooling. You know, we would look at the trees and
identify the leaves and things like that. But when I left the
facility, I was far behind in everything. You know, I barely
knew how to write a paper, and I was in 10th grade.
Mr. Platts. Okay.
Dr. Bellonci. If I may?
Mr. Platts. Yes.
Dr. Bellonci. Our students follow the same Mass Curriculum
Frameworks. We have data to show that they have educational
attainment. We actually do quite well with a very disabled
population, particularly in terms of learning disabilities.
Most of our children are gaining a year for a year in reading.
We are struggling more with math, as the nation is.
They have to take the MCAS, which is our state annual
exams. So we have to meet all the same criteria. They are on
individual educational plans, and we meet with the school
district annually to update those.
Mr. Platts. Okay.
Mr. Kutz. I would add a couple things here for us.
We saw some examples of schools that said they were
accredited, and they weren't. So that has been something out
there.
And we had one kid, in our case study number five, who was
there for 4 years and he got no education.
Mr. Platts. Ms. Brown, did you----
Ms. Brown. From the oversight perspective, I can tell you
that in our survey of the states, when we asked about what
aspects state agencies monitored, they presence of educational
programming and also, in particular, the quality of educational
programming were the least likely to be monitored.
Mr. Platts. Of, kind of, a cross-section.
Ms. Brown. Of other things, like physical plants, staff
issues, use of seclusion and restraint.
Mr. Platts. Okay. Thank you.
Thank you, Mr. Chairman.
Chairman Miller. Thank you.
Mr. Kutz, on your case number five, on page 15, you write
about in the report the interaction between the parents and the
placement facility. And you talk about, when the victim's
father, the victim of this abuse, refused to attend therapy
meetings for the fear of losing his job, the program told him
to quit. When he would not quit his job or miss work to attend
the meetings, the victim said the program convinced his mother
to leave her husband. After the parents separated, the program
would not allow the victim to contact his father. The victim
said the program never told the victim's family that all of the
drug tests they performed--and we referred to this earlier--
were negative results, including the initial one.
I mean, I just don't understand this pattern of therapy,
where this much trauma can be activated within the family. I
don't quite get this. I have never heard of----
Mr. Kutz. It is an incredible story, actually. It was
almost like a cult-like organization. And they brainwashed a
lot of the parents, it appeared from what we saw, and they
became part of the process.
And actually kids were going home at night sometimes to
other people's parents' houses and staying, and there was abuse
going on, in some cases, at other parents' houses.
So it was a very bizarre thing, Mr. Chairman. There is a
movie about it. ``Over the G.W.'' it is called. I mean, it is
just an incredible story.
And this was one of the ones that accepted Medicaid money.
That is how they were primarily funded, millions and millions
of dollars from Medicaid.
But the parents became, kind of, sucked into the program.
And there were apparently split marriages and things involved,
because one parent might get sucked in, the other one didn't,
and that caused pretty significant issues.
Chairman Miller. Dr. Bellonci, you are----
Dr. Bellonci. You know, we have learned a lot about the
treatment of mental health disorders for children and youth in
this country. There are established, evidence-based protocols
and practices, largely funded by the federal government. The
Substance Abuse and Mental Health Services Administration,
National Institutes of Mental Health have funded studies to
show what works and what does not.
This is absurd that this is being done in the form of--or
in the claim of treatment. And to think that federal dollars
are being spent in this abuse is unconscionable to be and,
certainly, not anything that any child psychiatrist, any
medical professional, any mental health professional should be
condoning or participating in.
You know, it is not like we don't know what works. And the
fact that we are not utilizing what is known is, I think, the
greatest sin.
Chairman Miller. Thank you.
Mr. Kutz, you have, several times in your testimony this
morning, used the word ``torture.'' And we have some discussion
about the use of restraints and--I am sorry----
Ms. Brown. Seclusion and restraint?
Chairman Miller. Seclusion and restraints. Could you
comment on this and why you used the word ``torture''?
Mr. Kutz. Yes. I would say two things.
Torture would be, for example, in case number one, where
the boy couldn't walk, was having trouble breathing, yet they
were forcing him to exercise. They were actually picking him up
and dropping him on the ground as a push-up. In other words, he
couldn't do a push-up, he was ready to die, and they were
picking him up and dropping him on the ground. And I understand
the last word he breathed was ``no.'' And so, that is an
incredible case.
But you are talking about the human restraint here too, and
we saw human restraint in many forms. The ones that caused the
death were typically the face-down restraint. And, again, some
of those were done contrary even to the program's policies and
procedures, where there were either three people on top of a
child or one. And one of the boys, in fact, had asthma, and the
staff had not been told that, and they did a face-down
restraint, and he died.
Some of the other restraints were, you know, it was called
three-point, four-point, five-point; three-point being three
people holding down limbs or the head. The five-point restraint
would have been one person on each arm, one person on each leg,
and one person holding the neck or the head still, many times
for hours.
And so, I would say that that is pretty severe abuse,
bordering on torture. I mean, I am not sure what the
distinction is between abuse and torture, but certainly I think
that in some of the cases I would define it as torture, what we
saw.
Chairman Miller. I just wanted to make sure you weren't
casually using the term. You are using it based upon the case
studies that you examined.
Mr. Kutz. Not just the case studies. Other kids in these
programs had the same thing done to them.
Chairman Miller. On page two of your long testimony, you
explained how you selected these cases. ``We limited our cases
to closed criminal cases and, thus, did not include ongoing
cases from the last several years.''
Can you tell us how many ongoing cases there were?
Mr. Kutz. There is a lot. And we actually had more cases we
looked at. We didn't include them in the testimony because they
had some sort of ongoing litigation, or there may have been
some other reason we excluded them.
But, as I mentioned before, there are other big civil cases
with hundreds of plaintiffs involved that are out there right
now that have some of the similar types of things we have
talked about here, that your two former victims, I will call
them, sitting at the table here have described, the same types
of things. So there are hundreds of cases out there of
individuals involved with these.
Chairman Miller. That is abuse you are----
Mr. Kutz. Yes, those are abuse because the kids are still
alive for that particular----
Chairman Miller. Or, I don't know if there were families,
but what about in--were there other cases of death?
Mr. Kutz. Yes. Yes, there were others. Suicides and other
types of cases of death, yes.
Chairman Miller. Can you supplement your testimony for the
committee with those numbers?
Mr. Kutz. We can provide other information based on the
other cases.
Chairman Miller. Do you know those numbers?
Mr. Kutz. We don't have any broad numbers, again, as Ms.
Brown. I think just no one knows how many. But we can submit
other information on what we know, yes.
Chairman Miller. So these cases were selected from a larger
number----
Mr. Kutz. Absolutely.
Chairman Miller [continuing]. Of cases either of death and/
or abuse.
Mr. Kutz. Yes. And given another couple years, we could
have used some of those other cases as they became closed, et
cetera, yes.
Chairman Miller. Yes.
Ms. Brown, you know, very often this Congress has reacted
very, very quickly to the question of background checks,
certainly around the care of young children or the teaching of
children, people working with children. We have criminal
background checks. We are worried about sexual predators. We
worry about all those kinds of things. In many cases, we have
enacted statutes to require that of states or agencies or of
programs.
How do these programs fall within those kinds of background
checks?
In the first round of hearings, I think in a number of
instances, we found very questionable characters working in
these programs but no requirements for background checks. I
don't know, again, what your survey told you about the
background checks.
And Mr. Kutz has alluded to, in a number of cases, where
students were sexually preyed upon by some elements of these
programs. What can you tell us about that?
Ms. Brown. Well, according to what was reported to us,
state agencies are saying that they do require background
checks when they are funding facilities. Now----
Chairman Miller. If the facility is required to be licensed
by the agency.
Ms. Brown. Correct.
Chairman Miller. But if their facility is not required, as
a number of these apparently were not, that would not apply.
Ms. Brown. Correct.
Chairman Miller. There is no generic state law with respect
to that for a business?
Ms. Brown. There may be some generic state laws. I don't
know if we know the full answer to that.
But certainly there are facilities that are exclusively
private that are not under the purview of state agencies that
would not be monitored for their background checks. Even if
they were required to conduct them, there was no oversight, no
one would know whether they had actually conducted them and
what the outcomes were.
Chairman Miller. Mr. Kutz, in any of your interviews the
GAO did of prospective programs, was there any discussion about
background checks, about staffing?
Mr. Kutz. Yes. And sometimes they had been done; sometimes
they hadn't.
But remember what we talked about here earlier. A lot of
these people were never convicted of anything. So even if you
did a fingerprint background check on a lot of these people,
they might come up clean, but they could have been involved
with the cases of torture and abuse we have been talking about
here.
But I still would support a fingerprint background check as
being one of the potential standards here.
Chairman Miller. Mr. Platts, do you have any further
questions?
Mr. Platts. Thank you, Mr. Chairman.
No other questions. Just, again, my thanks to each of you
for your testimony.
And, Mr. Chairman, also to echo your sentiments on the
abuse that occurs to the youth, the children in these programs,
and also the psychological, probably, ramifications to the
parents who are probably in desperate situations, seeking what
they think is help and trusting others to be giving assistance
when, instead, they are not, and the long-term consequences
within the family dynamics of the abuse that occurs in these
facilities.
I think that is an important aspect of the oversight you
are leading and the efforts to reform it. So, again, my thanks
for your leadership on the issue.
Chairman Miller. Thank you. I want to thank you and Mrs.
McCarthy for all your cooperation and your input in this
matter. And I look forward to continuing to work with the whole
committee on this.
And I certainly want to thank GAO for all your work. I can
tell you how much we appreciate it. I think you have given us a
much better idea of the scope of the problem that we are
confronting, some of the difficulties that we are going to have
in trying to deal with it, given the patchwork of regulations
and the creativity of some of these organizations.
Tragically, you have also given us a pretty good idea of
how dangerous and reckless some of these programs are, with
respect to the students that have been assigned to their care
by their parents.
And maybe even more astonishing is almost the predatory
nature of some of these programs, in preying on both the
students when in their care and preying on these families prior
to their surrendering their children to the care of these
programs.
Again, this is not an indictment of this entire industry.
But clearly these reckless and dangerous programs should not be
able to hide behind those who are doing the responsible thing
with respect to the care of these children, in many instances,
who are, in fact, very, very difficult problems and, as Dr.
Bellonci pointed out, cannot be cared for in their own homes.
They require some other kind of treatment outside of their
homes.
Ms. Whitehead and Mr. Martin-Crawford, thank you very much
for publicly coming forward and talking about your experiences.
And, obviously, I think every member of this committee wishes
you the best in your continued endeavors. I am quite amazed,
given your stories, to see where you are today, and you should
be very proud of that.
And, Dr. Bellonci, thank you for giving us a compass here
of where we should be thinking about and some standards of what
we should be thinking about, with respect to the program you
are involved in but also the state's regulation of that kind of
program.
So thank you all. I am sure we will be back in touch with
you in rather short order, because I think the hearing has
raised some issues that we want to continue to clarify from
both sides of the aisle. But thank you for your cooperation.
And, with that, the committee will stand adjourned. Thank
you.
[The statement of Mr. Altmire follows:]
Prepared Statement of Hon. Jason Altmire, a Representative in Congress
From the State of Pennsylvania
Thank you, Chairman Miller, for holding this hearing about child
abuse and deceptive marketing by some residential programs for teens.
This is our committee's second hearing about residential treatment
programs for teenagers and I commend you for your dedication to
protecting teenagers and for your diligence in investigating these
programs.
Last October, this committee met to discuss cases of child abuse
and neglect in residential treatment facilities. Since then, the
Government Accountability Office (GAO) has continued to investigate
instances of child abuse and deceptive marketing by some of these
programs. Today, I am interested to hear about the results of the most
recent GAO study and to learn about what role Congress may be able to
play tin ensuring the safety of children at these facilities.
Thank you again, Mr. Chairman, for holding this hearing. I look
forward to continuing to work with you on this important issue.
______
[Additional submissions of Mr. Miller follow:]
[Compilation of testimony from Community Alliance for the
Ethical Treatment of Youth, Internet address follows:]
http://cafety.youthrights.org/wiki/index.php?title=Submit--Your--
Testimony
______
------
Abuse at a Troubled Teen ``Faith-Based'' Program Using Physical
Restraint by a ``Chemical Straight Jacket''
This is a case of physical abuse, of chemical restraint by illegal
medicating of our daughter and other children using illegally obtained
prescription medications without the child's or parents' knowledge, and
what appears to be a local government cover up or simply repeated lack
of actions by Public Servants that followed.
This is our family's statement concerning our run-in with an
unregulated ``religious'' teen program known as Mountain Park Baptist
Church and Boarding Academy in Patterson Missouri. This program was
owned by Bobby R. and Betty Sue Wills and operated by Samuel L. and
Deborah Gerhardt.
On or around January 15, 2003 my wife Katrina mentioned that she
had called around to some of the local Baptist churches in our hometown
of Lewisville, Texas. Katrina was looking for a boarding school for our
daughter Erika. Katrina felt that Erika was falling away from God with
some of the behaviors of adolescence that were starting to show needed
a change in direction before the behaviors escalated. Erika was not a
bad kid, or a troubled teen. She was starting to show how head strong
she could be at times.
My wife Katrina in her teen years had, herself, been enrolled in a
boarding school in 1983 to 1984 in Mississippi called Bethesda Home for
Girls. Katrina, from what she remembered, had a pleasant experience and
felt Erika could gain from her own experience at a bible-based boarding
academy.
The first time my wife Katrina mentioned sending Erika away to a
boarding school I had the usual fears that any parent would have. I
wanted to make sure our daughter would be taken care of properly and
could grow both mentally and spiritually.
Katrina said that a church staff office worker at Temple Baptist
Church in Lewisville, Texas had a name and number to a Baptist boarding
school in Missouri. Katrina had called and talked to Brother Sam
Gerhardt and realized during the phone conversation that Sam Gerhardt
also had run Redemption Ranch for Boys in Mississippi. Katrina had
remembered that it was the boy's academy owned and operated by Bobby R.
Wills and Betty Sue Wills, and who also ran the Bethesda Home for
girls.
Katrina was excited to say the least she reflected on many of the
good times she had while she attended Bethesda. She spoke highly of
``Papa and Mama Wills'' (Bob and Betty Wills). Katrina told me of the
bus tours they would take going around to different churches and
singing for the church's congregations. With Katrina's memories of the
good times she had while attending Bethesda, along with her fond
memories of the Wills, and with the recommendation of a local church, I
felt that I would need to take a leap of faith and go along with
Katrina's decision to send Erika to a boarding school.
January 18, 2003 we enrolled our daughter Erika in Mountain Park
Baptist Boarding Academy in rural Patterson, Missouri.
I understood from what was represented to us that Mountain Park was
firm in discipline, and would be a good Christian environment that
Erika would be involved in. When we were driving back to Texas from
dropping off Erika we felt confident that, although Mountain Park
Baptist Boarding Academy would be tough at first for Erika, it would
ultimately be a good experience for her.
Looking back this first impression was the furthest from the truth
and only the beginning of a bad nightmare.
For the first few weeks everything seemed like it was going well.
Then Katrina came home from her Wednesday night church program at
Northview Baptist Church in Lewisville, Texas with a folder from a
church member by the name of Elaine Dawson. Elaine had asked previously
which Boarding Academy Erika had been sent to. Katrina told her. Elaine
went on the Internet and found several websites and articles concerning
Mountain Park and the owners. Elaine gave Katrina the folder and told
her to view it with an open mind. Katrina gave me the folder and asked
if what was in it could be true. I read through the articles from the
websites www.mountainparksurviors.com, www.mountainparkhorrors.com, and
copies of lawsuits and bankruptcy concerning the Wills and Gerhardts. I
was shocked at what I saw.
If even an ounce of what was contained in the folder was true, I
knew I did not care to be associated, nor have my family members
associated with the Wills and Gerhardt clan.
The next day I called to have our DSL Internet connection hooked
back up so I could do my own research. One of the forum posts concerned
a mother who tried to remove her daughter from Mountain Park Academy
and was arrested for kidnapping.
I told Katrina that when she spoke to Erika or the staff at
Mountain Park Academy not to let on that we felt something was not
right. My greatest fear at that time was for Erika's safety and to see
what had to be done to remove her as soon as we could.
Mountain Park required a Power of Attorney, and since access to our
daughter was limited and from what I understood at that time concerning
papers we signed, we could not just drive up and demand custody of our
daughter. I now know different. Their power of attorney was not limited
as it stated or even legal, although Mountain Park Academy
Administrator/Principal Samuel L. Gerhardt presented that it was. The
contract papers are illegal, according to Missouri Laws concerning
``take it or leave contracts.'' Mountain Park Boarding Academy clearly
had the upper hand as far as the contract agreement was concerned.
As soon as the DSL was re-connected I started researching for
myself. I have researched the stories of abuse, neglect, reaching back
in to the early 1970's and also found that they had connection to
Lester Roloff and his brand of discipline that gave me alittle more
insight into how they operated.
I decided then that we had to get Erika out of there as quickly and
as safely as we could. I was torn because I wanted to confront Samuel
and Deborah Gerhardt for the lies that we had been told, but I was
concerned that if they were confronted over the phone something bad may
happen to Erika. It was a tough decision, but we decided not to tip
them off that we knew things weren't as they the Gerhardt's represented
them to be. As parents we had to play along with Mountain Park's stupid
manipulation game with their requests to help ``re-establish our
authority as Erika's Parents.''
The whole time they were trying to make it seem as if they were
helping to re-establish our relationship with our daughter they were
actually working to destroy the relationship.
I knew in order to get Erika out safely it was a possibility that
we would have to wait until our first ``four month family visit''
unless an opportunity arose before that.
I knew that according to a copy of the Power of Attorney that had
been posted on Mountain Park Survivor's website and comments that were
with it, we needed to draw up a Revocation of Power of Attorney to
remove any supposed parental right Mountain Park thought they had. I
contacted a few attorneys and others for suggestions. I found out what
the form needed to say and to whom to submit, etc. I found a generic
version on the Internet and modified it. We would also have to have it
signed, before a notary, and make sure it was also filed as certified
in Wayne County, Missouri, where Mountain Park was located, before
going for our visit.
Meanwhile, on or around the first part of April 2003 Erika had
mentioned that her tooth was cracked and she needed to see a dentist.
We told her that she needed to tell the staff at medicine call so they
could make arrangements for an appointment. It took close to two
months, and only after Katrina made several calls to Debbie Gerhardt,
for Mountain Park Academy to finally get Erika to their dentist. First
they would use the excuse that Erika couldn't go to the dentist until
her four-month family visit. Then the next excuse was that the dentist
could not see her for a few weeks. Normally for emergency dental work
it should be a few days at most, not a few weeks. That was pure neglect
on Mountain Park's side. For them to allow a child that was suffering
with a cracked tooth to continue to suffer until it was finally made an
issue with the repeated requests by the parents. I guess Mountain Park
realized that we as parents still had some authority. Or they noticed
that we as parents would not allow our child to suffer as they would.
Erika's tooth was repaired by sub-standard dental work to say the
least. We had to take her to another dentist once she was set free from
their Gulag to have a dentist repair the sub-standard work Mountain
Park's dentist had done. We paid $144.00 for Mountain Park dentist,
(because in Mountain Park's and their dentist words Erika had a huge
cavity) and then another $351.00 to have the cracked tooth and crappy
dental work corrected after she was out.
While it took well over a month for Mountain Park get around to
taking our daughter to a dentist of their choosing after our repeated
requests, it took less than a week for them to send a notice that ``we
as the parent of Erika needed to replenish her medical account.'' In my
opinion Mountain Park's greed played a part since the coffer was not
full to the rim.
My wife Katrina had started requesting ``our first family visit''
around mid to late April. First Sam Gerhardt told her that request
couldn't be made over the phone it had to be in writing. So Katrina
hand wrote a request and sent it. Next the request came back, with a
note saying that request had to be made on the request form that was
contained in the PARENT/student handbook. So Katrina filled out the
correct form and sent it. The next week we received it back with
another note stating that the dates Katrina had chosen WOULD NOT work
because that was the week of graduation.
So Katrina, being a little peeved by this time, called up Mountain
Park and asked Mrs. Harper (Mountain Park's Secretary) to please get a
message to Sam Gerhardt that we will be there to see Erika on May 16,
2003 for our family visit.
Time was growing very near and although we didn't realize, at that
time, the real reason that Mountain Park was trying to stall us on our
visit. I now feel we caught them off guard alittle when we arranged our
visit a week before graduation instead of two weeks after graduation.
(explained later)
On May 15, 2003 we left Texas for the long 10-hour drive to
Missouri for Our First Family visit. On Saturday May 16, 2003 instead
of going directly to Mountain Park Academy, we made a detour to the
County Court House to file the revocation of Power of Attorney papers
with the county clerk.
Shortly after filing the papers we proceeded to the sheriff's
office. There we asked to see Sgt. Handy. Another Deputy was on duty
(Deputy Fox) and said that Sgt. Handy was off that day. We spoke with
him and told him that we were going to Mountain Park to retrieve our
daughter. I asked him if he was familiar with the Boarding School and
he said ``Oh yes, we here of all kinds of things going on out there.''
Deputy Fox asked if we needed an officer to go with us. At first we
said yes but when he said that we needed to wait a little while until
he called someone. I decided that I wasn't going to take a chance of
wasting time, since I didn't know just how well he knew them and what
if any his connection was. I knew through researching Mountain Park
Academy they had a maintenance guy with the last name of Fox and I was
not going to wait to find out if they were related. I told him that we
go alone and if we needed them we would call.
We drove straight to the Mountain Park Compound we arrived shortly
after 9:00 am. Of course the front door to the office was locked. (They
would not want any of their golden geese escaping.)
My wife called from their front porch phone so we could gain access
to the office. There we met Debbie Gerhardt. She asked who we were and
allowed us in to the office.
Katrina was allowed to go back into the dorm to get Erika. From
what Katrina has told me, she grabbed Erika's bag and started filling
it as fast as she could. Katrina said that the student guide that
escorted her back to the dorm had an odd look on her face like she knew
something was awry.
While Katrina was getting Erika, I stayed in the front office
making small talk with Debbie. She asked me where we would be staying
for our visit and what sights did we plan on seeing while we were on
our ``family'' visit.
That was the longest ten minutes of my life, standing there
listening to someone that I knew was an out-and-out liar and a fraud.
And worst of all using religion as a tool to take advantage of people
and their family in need.
As soon as Erika had entered the office I started making a beeline
for the front door. Debbie wanted to continue the small talk but at
that point I really had one thing on my mind and that was to get Erika
out of there.
We exited the office and headed straight for our vehicle. On the
road out of the Mountain Park Compound I turned to Erika and told her
that I hoped that she got everything she wanted (as far as clothes and
personal items) because if she didn't she would not be seeing them
again. She had the most puzzled look on her face. And said ``Sir?''
Katrina repeated what I had said. I told Erika then that she was out
and was not coming back so what ever she left she will not see again.
I wasted no time getting out of Missouri; we drove as fast and as
hard as we could to get back to Texas and away from Mountain Park's
Culpable Regime.
On the drive home Erika had complained that her right arm hurt and
that she had three spots that looked like burns. Katrina asked Erika to
pull up her shirtsleeve to see the spots. I didn't see them real clear
until we got home. One spot was on the inside near her wrist, one spot
was inside of her arm near her elbow, and the other spot was located on
the inside of her upper arm.
As soon as we arrived home I emailed Attorney Oscar Stilley, whom
we had previously been in contact, to let him know that we filed the
revocation of power of attorney and that we arrived home with Erika
safely. I mentioned to him in the email that Erika had three spots on
her arm that appeared to be possibly burns and she didn't know how she
got them. I also asked him what, if any, repercussions should I expect
from Mountain Park as far as Mountain Park expecting full payment of
tuition.
We spent the rest of the weekend enjoying the time with our family.
On Sunday night around 5:00 PM CST, I stayed close to the phone
expecting Mountain Park to be calling wanting to know if we were lost
and why Erika was not back at the Academy.
That call never came. I guess once again that Mountain Park has
shown that they were not concerned about our daughter, or our family.
They never even bothered to call to check up with us on her status.
Of course, it might also be possibly someone in Wayne County
informed Mountain Park administrators that we had filed the Revocation
of Power of Attorney.
On Monday morning Katrina faxed a copy of the filed revocation
Power of attorney, just so if Mountain Park didn't already know they
would then be notified that we did not plan on bringing Erika back to
them.
On Tuesday around 11:40pm CST, I receive an email from Oscar
Stilley (a reply to the one I sent him on Saturday night) Oscar dropped
a bombshell in that email. One I never in my wildest dreams thought
would happen. In that email he mentioned that he and others suspected
that Mountain Park Administrators/Owners/Staff may have been illegally
medicating the children in their custody. Without a Doctor's
prescription, without the knowledge of the children, and without the
knowledge of the parents. He didn't know exactly what drug was used but
asked if I would be willing to have Erika tested for a class of
medications. He thought it was rather strange that Erika had burns on
her arm but she didn't know how she got them. I printed a copy of
Oscar's email with the list of drugs to test for and the following
morning (Wednesday) I took Erika to our family doctor to have drug
tests done.
We spent another week in turmoil not knowing what the results would
show. We would let all the abuse (burns on her right arm), and the
neglect (dentist incident) pass as something to learn from and to never
again take a leap of faith no matter how innocent and well-meaning
people seem to be on the surface.
But then the three-page tests results came back. The first page
(urine test): ``none detected.'' I thought well good may be Mountain
Park was abusive but not cruel and inhumane as other people on the
Internet had portrait them to be. Then the following day I got a call
from the nurse at the doctor's office. ``Mr. Hoover it would appear
that the results I gave you yesterday were not complete there are two
more pages that came in today and it shows that Erika tested positive
for chlorpromazine in the serum (blood) test, which goes by the brand
name Thorazine and traces of Mellaril.'' The test results on the third
page clearly show that Erika was drugged with Thorazine at a level of
198ng/ml.
Horrified * * * ! Damn right. How dare they. * * * Mountain Park
Boarding Academy states that they don't believe in Behavior
Modification drugs. The BASTARDS were going against their own policies
and violating the law by secretly medicating the children in their
care.
Looking back this would explain the complete change in Erika's
headstrong attitude. When we picked her up from Mountain Park Academy
she was overly submissive.
It was not God, it was not Mountain Park's Miracle ``Religious''
Message and Discipline practices. It the simple fact that they were
chemically restraining children that refused to conform.
For the record, I do not know how many other children over the 30
years that Wills and the Gerhardts claim to of been helping troubled
teens were or may have been restrained chemically, but there are other
children with positive serum tests and positive hair tests. Our
daughter was not the only child to fall victim to these predators; we
are not the only family that knows this to be true.
Also for the record, based on my daughter's positive test results,
I contacted the Wayne County Sheriff's Department about abuse of my
child. I also called the Missouri child abuse hotline and complained.
As a result, the Sheriff's Department and a unit of the State Highway
Patrol went to Mountain Park, took urine samples from kids and drinks,
and collected pills, and apparently hair samples to test for illegal
drugs. But either the lab never received the samples, the samples were
never tested, or the test results were lost or destroyed, because
according to a state investigative letter sent to me almost 2 years
later, they could not substantiate my claims because the Department
could not get the Sheriff's Office or the Highway Patrol to give them
results.
On the surface it would appear to the general public that Mountain
Park Baptist Boarding Academy is using religion to help bring change in
the lives of children in their care. In reality it is not religion that
this Clan (Bobby Ray and Betty Sue Wills and Samuel L. and Deborah
Gerhardt, who are related by marriage, and any of the other family
members of their staff) at Mountain Park Baptist Boarding Academy &
Palm Lane Baptist Boarding academy were using to ``help troubled
teens.'' Religion is simply the cloak that is hiding their abusive
practices.
These Faith-based programs need regulated as well as the other teen
programs. If researched, you will find that many of the ``faith-based''
programs have a network behind the scenes.
Some of the very referral services and non-profit corporations have
the very people that run these programs sitting on the board of the
non-profit corporations. The fox minding the hen house, so to speak.
These non-profit corporations are believed also to be using the
``Associations of Christian Child Caring Agencies'' that have been set
up in several states: Texas, Florida, Missouri, and many other states.
These agencies use referral services to transfer children from state to
state. In some cases, even to out of the country and/or off-shore
programs. The Founder of FACCCA is Bobby R. Wills. Michael Palmer was
also on the board of FACCCA, as well as the corporate board of Palm
Lane Baptist Boarding Academy in Florida, which the Wills also owned.
Michael Palmer, who owned Genesis Ministries, as known as Victory
Christian Academy, is believed to have transferred students out of the
country to Palmer's Genesis-by-the-Sea Academy in Mexico, which was
raided several years ago for abusive practices.
When Mountain Park Baptist Boarding Academy in Missouri and Palm
Lane Baptist Boarding Academy in Florida finally shut their doors,
Mountain Park Boarding Academy's Principal Sam Gerhardt was quoted as
saying, ``We've been in some battles for the last couple of years. It
is just time for us to do something different.''
My belief is that although we were unable to get these criminals
charged, as they should have been, we got to close to what was actually
happening. They were caught with their hand in the cookie jar. Instead
of them standing on their religious soapbox much like they had done so
many times in the past they instead closed the academies and fled to
another state: first to Newport and now Knoxville area of Tennessee.
Mountain Park Academy's Owners/Administrators/staff were likely
illegally obtaining prescription medications to control, dominate, and
warehouse the children under their care so they could fleece the
parents of the tuition monies. And they were making quite a profit for
their ``church''--only a rough estimate of well over $4 million a year.
Of course the IRS may need to check to verify the actual amounts they
claimed.
To further add insult to the injury it would appear that they are
using the profits of tuition money, along with donated mission funds to
defend them in court and provide them with a nice retirement nest egg
and to buy political favors along the way.
I have screamed loud and I have screamed long and still in today's
America I cannot get the civil servants of Missouri to do their jobs. I
called and wrote all levels of local, state, and federal agencies,
including the governor's office and the FBI. Sure Missouri Family
Services investigated but never followed through. Instead they sent a
letter dated April 18, 2005, stating, in part, the following:
Incident Number 03209148 and 03217038
``This case was pending until the results came back from the MSHP
Division of Drugs and Crime Control. As of April 18, 2005, there are no
results of these tests. The Wayne County Sheriff's office reportedly
forwarded the evidence to MSHP Division of Drugs and Crime Control for
testing, however, there is no report in the Wayne County Sheriff's
Office in reference to this. Numerous attempts were made to obtain this
information from Wayne County Sheriff's office and the MSHP Division of
Drugs and Crime Control.''
--Rick Engelhardt (by Dea Nobis, OHI Field Supervisor).
My question is this: Why and how could a case be closed as
unsubstantiated when the results have not been received?
The federal court in the Eastern district of Missouri is clearly
not impartial. Justice in America is not blind, in my personal opinion,
it is being bought. If a person was to review the case Woods v. Wills a
person would clearly have to reason that the premature summary
judgments, along with rulings by the Judge were not impartial they were
biased to the defendants. The issue of was Mountain Park using drugs on
the children in their care never even was allowed in to the trial. The
parents' portion of the complaint concerning fraud by Mountain Park
Academy was also not allowed in. How is this happening?
Please keep in mind that when we realized what Mountain Park
Boarding Academy Owners and Administrators were using illegally
obtained prescription medicine, and illegally medicating children in
their care, we did everything in our power to get criminal
investigation and charges to be brought against them before any civil
actions were taken. The civil court actions were only brought against
them after no criminal actions were taken. We have cooperated fully
with the Government Agencies that are supposed to stop this type of
Illegal activity. We will continue to cooperate fully if and when any
criminal actions are finally brought against these religious frauds.
Too many people in power positions mysteriously are turning a blind
eye to what is happening.
Finally, the Federal Government is looking into the physical abuses
and the deceptive practices used by Owners and Administrators of
programs in the troubled teen industry.
Although the Hearing held on April 24, 2008 covered and made public
the physical abuses, deaths, it covered a few of the deceptive
practices in only a few programs. I heard mention of physical
restraints used against several of the children in these programs, but
what was not mentioned was use in these programs of chemical
restraints.
From the research, I have done it clearly shows the effects of
chlorpromazine is a chemical restraint also known as the ``Chemical
Straight Jacket.'' In Mountain Park Academy's use of this chemical
straight jacket it achieved for them what physical abuse could not.
With chemical restraints there are no outward signs of abuse, but it is
no less dangerous. There are many side effects from the use of
chlorpromazine some that will not appear until years down the road. I
hope that Erika will be fortunate and any adverse effects will not
affect her in the future.
In closing I would like to thank the Committee for allowing our
statement to be included into the records.
I hope that the committee, lawmakers, and the general public will
see that this issue is not an isolated incident. In researching
Mountain Park Boarding Academy, the only regulation through the state
of Missouri was an annual fire inspection. What a joke. I hope that
regulating the programs will promote the safety and well being of our
children and to stop the abuse and torture that has existed for many
years. It is well past time to regulate these programs.
It has been shown that these programs are either unable or
unwilling to self regulate for the safety of children these programs
have placed profits above the well being and safety of children.
Thank you,
Doug Hoover.
______
Letters Received Concerning Residential Programs for Teens
Beth Goldberg,
Gloucester, MA, May 7, 2008.
To Whom It May Concern: My son attended the Family Foundation
School from January 2003 until December 2004.
After many interventions, which included school counselors,
doctors, therapists, drug counseling and two psychiatric hospitals he
was sent to Family Foundation School
Prior to his being accepted as a student, I was required to visit
the school, speak with admissions directors, get a tour of the campus,
and participate in a family lunch. At that time, I determined that this
was the place that my son needed to be to address his addiction issues.
My son was heavily involved in drugs and alcohol, was abusive both
physically and verbally, stole, lied, cheated and was sexually
promiscuous. He punched holes in walls, broke doors, snuck out at
night, refused to go to school, and was completely out of control. He
had no respect for himself or anyone else. No matter what interventions
were put in place here at home, it became painfully clear that they
were not working, and that he was in need of long term rehabilitation.
I felt completely hopeless, and without any viable options to help my
son.
I heard about the Family Foundation School from a parent whose son
had attended the school, and was then attending Northeastern University
after completing the Family School program. A year later my son was
enrolled at the school. He was sixteen years old.
Today, my son is a senior at Binghamton University and is slated to
graduate in a matter of weeks. He has been sober for five years. The
tools he received at the Family Foundation School were far beyond
anything I could have imagined.
Not only did he learn the tools to become a responsible, caring and
sober adult, but he experienced many educational opportunities which
included taking college credit courses while at the school,
participating in national debate competition in Salt Lake City, Utah,
and found his voice in Family Foundation School's award winning chorus
and theatre productions. He was a contributing editor of ``The Family
Times'' newspaper and surrounded by caring adults who encouraged him to
be the very best he could be. My son also learned the value of giving
back, and has returned to the school to work part time while attending
college.
There are no words to express my gratitude to the Family Foundation
School. I believe that my son is alive today because of his attendance
there. He went to the school as a defiant, irresponsible, drug and
alcohol addicted teen and left the school as a caring member of this
world with a sense of how to use the tools he was given to maintain a
sober and healthy life. He has a strong sense of community and of the
importance of helping others. There is no doubt he gained these
important convictions as a result of his stay at the school.
The Family Foundation School also works very closely with parents
to help them understand addictions and encourages participation in 12
step programs, as well as offers family meetings to address specific
issues. Parents are given many insights and opportunities to gain tools
to move into the future as a healthier parent. The healing that
occurred as a result of my son's attendance at the Family Foundation
School has been felt though out our family system. I have an honest,
loving and open relationship with my son today and he has healed
relationships with his brother and father as well. I will forever be
grateful to the caring and talented staff at the school.
If you have any questions, please feel free to contact me at the
address and phone number above.
Sincerely,
Beth Goldberg.
______
January 14, 2008.
Re: Education and Labor Full Committee Hearing ``Cases of Child Neglect
and Abuse at Private Residential Treatment Facilities'' (10/10/
07)
Dear Representative: As leaders in the private outdoor behavioral
healthcare industry, we were instrumental in obtaining regulations in
our state and would like to offer our expertise and experience to you
as you consider drafting legislation for programs such as our own.
Unfortunately, we recently received negative attention at the Education
and Labor Full Committee Hearing ``Cases of Child Neglect and Abuse at
Private Residential Treatment Facilities.'' We hope that you will take
the time to look beyond what was conveyed, listen to the other side of
the story, and to consider our recommendations for regulation.
Twenty years ago, Catherine Freer Wilderness Therapy Programs was
founded on the belief that combining therapy and outdoor experiences
would offer troubled teens and their families a valuable treatment
option. Since 1988, our program has helped thousands of adolescents
address the issues that are causing them to struggle. These youth, as
many will attest, would most likely still be abusing drugs and alcohol,
alienated from their families, in jail, or worse if their parents
hadn't intervened and sent them to our therapeutic wilderness program.
(Enclosed please find letters from clients and their parents discussing
their experiences at our program.) We currently hold multiple
licensures in the State of Oregon and are accredited by the Joint
Commission on Accreditation of Health Care Organizations (JCAHO).
Catherine Freer Wilderness Therapy Programs serves 300 adolescents
per year and helps middle class youth whose parents have run out of
options for saving them from self-destruction. These are kids that
haven't found success in outpatient treatment, have not yet become
enmeshed in the criminal justice system, and who don't qualify for
federally or state funded programs. These working families often fall
through the cracks and can do little to help their children with
emotional and behavioral issues. We strongly believe that these
families deserve to have options for their children. With our licensing
and accreditation, 70 percent of our families are able to receive some
third party (insurance) reimbursement for their treatment, which is a
critical factor for most of our clients. Taxpayer dollars are not used
to run our program.
Our program was mentioned in the Government Accountability Office's
testimony due to the tragic loss of life of one of our participants
(Refer to GAO-08-146T--Case 8). Even with licensing, accreditation and
regulation, incidents can happen as our program has learned to our
great sorrow. With all of the information before them, the
investigating authorities came to the conclusion that this young
woman's demise was not the result of abuse and neglect. (Her
dehydration was later found to be caused by the use of a prescription
drug for which no FDA warnings existed at the time of her treatment
with us.) It is unfortunate that not all the details were brought forth
in the GAO's testimony regarding this incident. We also suffered the
unrelated loss of a participant that died from a falling tree limb and
a client who died of natural causes while sleeping. In all of these
cases, we reached out to the authorities, asking for them to thoroughly
examine and review these incidents. And, in each case, neither abuse
nor neglect was found.
We firmly believe that well-crafted and thoughtful regulation can
raise the bar for outdoor therapy programs and other privately funded
therapeutic programs. These programs offer effective approaches to
treatment for families. At Catherine Freer, we have invested heavily in
outcome research to verify that our treatment is helping families.
Following is some of the data gleaned from multiple studies:
Long-Term Outcome Research Program
A study by the Outdoor Behavioral Healthcare Industry Council
(OBHIC) and the University of Idaho Wilderness Research Center of 850
parents and adolescent participants indicates that clients entered
wilderness programs with about the same level of dysfunction as
adolescent patients entering psychiatric hospitals. At graduation their
average scores were slightly above the normal adolescent range. Another
phase of this study suggests that a large majority are doing well 24-
months after treatment. More than 80 percent of parents and over 90
percent of graduates contacted believed that their wilderness treatment
experience was effective two years after the process. (Enclosed please
find detailed information on the research and a summary of other
research from 1999-2006.)
Catherine Freer Customer Satisfaction/Outcome Study
This study found that 90 percent of parents said they would
recommend the Catherine Freer program to others. The average
satisfaction score for their children being treated with dignity and
respect was 2.84 on a three-point scale. On a four-point scale (one
indicating an ``extremely serious problem'' and four indicating ``not a
problem''), parents rated their children on 13 behavior items with an
average pre-program score of 1.81, a one-month post-program score of
3.38, and a one-year post-program score of 3.45.
As this research clearly indicates, outdoor therapy is a proven
solution for troubled youth. Our industry is helping serve families in
need and deserves attention and regulation, not censure. Presently
there are 102 outdoor behavioral healthcare programs. Ninety percent of
these programs are licensed by state agencies, and more than 60 percent
are nationally accredited by the Joint Commission or the Council on
Accreditation (Russell, K. C. [2007], Adolescent Substance Use
Treatment: Service Delivery, Research on Effectiveness, and Emerging
Treatment Alternatives. Director, Outdoor Behavioral Research
Cooperative, College of Education and Human Development, University of
Minnesota.) We believe that the risks to adolescents participating in a
licensed and accredited private therapeutic wilderness program are not
significantly different from the risks to adolescents in the general
population. Unfortunately, there are some programs that are not
licensed and have created both service quality and risk problems for
some families and their children.
Understanding the importance of regulation, we strongly advocated
that Oregon develop regulatory rules for outdoor therapy programs
operating within the state. We had the honor of consulting on
legislation and participated actively in helping craft the regulations.
Oregon created a good process, with clear assignment to Child Welfare
for both writing and enforcing the regulations, while including both
program stakeholders and outside parties as consulting participants. We
believe the result could serve as a national model for regulation of
outdoor therapeutic youth programs.
From our experience, some of the issues that should be addressed
through regulation include management issues, following the JCAHO
model: how policies are created, monitored and enforced; outside
oversight on those processes; and how incident reports are analyzed and
then utilized to alter policies and to provide staff training. In
addition, intake procedures, medication management, and staff
qualifications and training should be considered in the regulation
process.
We humbly request to join you at the table to help create
regulations that would protect families, while at the same time
preserving viable options for children in need. We also ask that there
be a serviceable level of appropriations allocated to fund this
regulation and abuse and neglect prevention. We would be happy to
discuss approaches to regulation creation with you and your staff and
be helpful in the future in any way that we can.
Sincerely,
Robert Cooley, Ph.D.,
Executive Director.
Paul Smith, MA,
Program Director.
______
Cody W. Traub,
Kalama, WA, January 9, 2008.
Dear Congressman Miller: It has come to my attention that you are
working on some legislation to regulate outdoor wilderness programs.
Putting restrictions and capping these programs would be a mistake.
In 2002 I attempted to take my own life. I was only an 8th grade
student. I suffered severely from depression, behavior and family
issues. Many times I thought there was no hope for me. My parents also
felt similar at times.
I was in and out of different behavioral treatment centers in the
Portland, Oregon area. Nothing worked. I came home to the same
destructive environment and fell back on bad behavioral habits. It
seemed as if I was lost and had nowhere to go.
I had little aspirations in my life. After being stuck in different
facilities and coming home to the same issues, I found hope. Catherine
Freer Wilderness Therapy Programs answered my call for help.
One March day in 2002, my parents picked me up at a behavioral
health center in Washington State. They transported me to the offices
of Catherine Freer Wilderness Therapy Programs in Albany, Oregon. I was
terrified. As I was in all of the facilities I went to.
After having a group meeting with other families and participants,
my journey began. I said goodbye to my parents, as I would not see them
for the next twenty-one days.
The group of complete strangers left for an unknown location in the
Oregon Cascades. We arrived in the unknown location and began our trek
through the Oregon wilderness. The next three weeks would be the
hardest and most influencing events of my life.
After completing the three week trek through the Oregon wilderness,
I was a new person. I left the trek and spent a day with my parents in
Bend, Oregon. A day later, my parents transported me to Burns, Oregon
where I stayed on a mule ranch with a well structured family.
I stayed on the ranch for two months. I was stripped of all of my
materialistic items and lived a simple life working on the ranch. This
experience helped shape me.
Overall, my experiences with Catherine Freer Wilderness Therapy
Programs were phenomenal. I would not have the drive, personality and
sense of humor I have today without this experience. There is the
possibility that I could have taken a different path in my life. I
could be a criminal or even dead today without this program.
I went from a depressed, self destructive middle school student to
a mature young man that made history in his small town. In high school,
I served on the Washington Association of Student Councils as the
President and held the office of President on my high school student
council. I had the opportunity to meet with several Washington
legislators, Governor Chris Gregoire and U.S. Congressman Brian Baird.
My teachers and principals described me as a history maker and dream
student.
I started working at the age of fifteen years old for the City of
Kalama, Washington as a Computer Network Manager and Administrative
Assistant. In January 2008, I started working full time for the City of
Kalama with my old position and in a new position at the Kalama Police
Department as a limited authority law enforcement Community Service
Officer. I am also currently enrolled in the Associates in Criminal
Justice program at the University of Phoenix.
Without Catherine Freer Wilderness Therapy Programs, I would have
never made those accomplishments. I would not have the sense of humor I
have nor would I have the motivation and morals I do today.
Please do not put a cap on outdoor and in-patient therapy programs.
These programs are life changing for many people and it would be a
devastating event to see the programs botched because of government
regulations.
Best wishes,
Cody W. Traub,
Kalama, WA.
______
January 4, 2008.
To Whom It May Concern: I am writing to express my support for
wilderness programs. It has been five years since I first participated
in a Catherine Freer Wilderness Expedition and five years now that I
have been sober. I owe my sobriety to Catherine Freer Wilderness
expeditions. Without the program's support, I would not have had the
motivation to drop my addiction to drugs and alcohol and return to
values that I once knew were important. In all honesty, I would have
ended up dead or in prison without the intervention the Catherine Freer
program offered.
The program was effective because it took place in the wilderness.
The wilderness offered the necessary space to evaluate my life and an
important reminder of what is necessary to survive in this world--food,
water, shelter, clothing, and friends--and what is not--drugs and
alcohol. Catherine Freer used the wilderness to make me responsible for
my own life. In the wilderness, I was responsible for wearing the best
clothes for the weather, eating enough food, and making sure my water
was clean. These skills demonstrated how good life is when I do the
right things and how miserable it can be when I do not. With the
support of my Catherine Freer Wilderness expedition and the lessons
learned from the wilderness, I was able to rekindle a relationship with
my family, return to school, and take advantage of opportunities not
before available.
One of the opportunities that I took advantage of was being a field
staff for Catherine Freer. With the perspective of being both a field
staff and a client, I know Catherine Freer takes the necessary
precautions to create safe experiences for their clients. As a client,
I always felt safe and cared for by the staff leading me through the
experience. As a staff member, I learned that my trust in those staff
that led me through the wilderness was not blind.
I would like to think that Congressman Miller's intent is good, but
I am worried about the type of legislation he may propose. Miller has
capitalized on the misfortunes that have occurred in the wilderness
programs while overlooking the success these businesses have in saving
lives. I therefore believe that Miller's proposal will hinder
wilderness programs' success. Congress should not restrict Catherine
Freer from being able to effectively change destructive behavior. I
applaud Catherine Freer for being safe and humane, and I find Miller's
proposals unnecessary.
I would not have been awarded three years in a row Academic All-
American in college or have continued to pursue a love for the
wilderness with my father as a companion if it had not been for
Catherine Freer. I urge you to think about the good that this program
has had for me and the many others and balance it against the risks
those must take to effectively participate in a wilderness program.
Please let Catherine Freer and the other businesses in the industry
provide their services without restricting or hindering them.
Sincerely,
Chas Biederman,
South Haven, MS.
______
January 10, 2008.
To Whom It May Concern: I am not sure where I would be right now if
it weren't for the Catherine Freer Wilderness Program. I am actually
frightened when I think about it. My life was on a road to disaster,
and I had refused the help of my loved ones, close friends, and
professionals who tried to stop my self destructive behavior. I felt
angry, lost, and alone, and the only comfort I could find was in drugs
and alcohol. If it weren't for my father enlisting me in this program I
most surely would be in serious trouble today, if I were around at all.
My mother died when I was very young and, despite therapy and
support from my family, I self-medicated with drugs and alcohol. I felt
as though nobody could really understand what I was going through, and
I longed to get away and be on my own with my friends who also used. I
attempted to run away from home several times, and went on binges that
sometimes lasted several days. I was fifteen years old.
By the time my drug use was at its worst I had experimented with
cocaine, ecstasy, methamphetamines, and prescription drugs. I was also
a regular user of alcohol and marijuana. Although these drugs made me
feel better while I was using, I was destroying my relationships with
everyone around me, most importantly my father. I feel so guilty when I
think of what I put him through during that time. I am so lucky to have
family that cares about me so much, and even though they did everything
they knew how to help me, I was destroying their trust and abusing
their help.
My father tried so many ways to reach me. He sent me to several
counselors, which I manipulated into thinking that I was fine by
blaming everything on him. We tried to ease my depression with drugs
such as Zoloft and others, but it didn't help. I was still using,
lying, sneaking out in the middle of the night, and getting in trouble
with the law. It seemed like nothing was working. I didn't want to
stop. Then my dad found out about the Catherine Freer Wilderness
Program.
He heard about it from the parent of one of my friends that I first
started using with. He had sent his daughter on a trek to try and
change her destructive behavior and drug use. Although it seemed
extreme, it was like a last hope. So one day my dad woke me up early
and took my brother and me to the Catherine Freer office. It was there
that I met the other kids who I would be sharing this experience with
and their families. Everyone had a chance to tell their stories, and I
realized that even though our situations were different we all had a
lot in common. It was heartbreaking to here everyone's families share
the effect that their child's and sibling's actions had on them.
Everyone cried. I was scared, because I knew that we were about to be
sent away.
At first I resisted, as I am sure most kids do, but after a week or
too out there in the wilderness things started to become more clear.
The Catherine Freer staff was so amazing; you could tell that they were
really there to help us. It was hard to open up in group every night,
it's hard to be so vulnerable with people you hardly know, but over the
period of three weeks I learned more about myself than I ever had. I
knew I wanted to change my life. I knew that I had to make things right
with my family and loved ones. I made the decision to change and, in a
way, it was scarier than being on trek. It was very emotional,
physically challenging, and eye-opening. I learned important tools to
stop my addiction and become the person I want to be. These tools have
helped me tremendously to this day, and will continue to help me
throughout my life.
After trek was over I had the opportunity to stay in a transitional
home. It was there that I learned even more tools to help me overcome
addiction and rebuild the damaged relationships with my family. The
Catherine Freer staff was still very much involved with my progress,
making phone calls to the home to see how I was doing, and planning
weekend retreats for the people in the transitional homes. I felt very
cared for and valued by these people, and I still do. I have received
multiple emails and phone calls from members of the Catherine Freer
staff even years later.
When I left the transitional home and returned to my home town
things were not easy. But with the help of those people who had
supported me for the last couple of months I became active in AA and
NA. They encouraged me to communicate with my father and use the tools
I had acquired to rebuild our relationship. Now we are closer than we
have ever been. I learned how to communicate my true feelings and have
conversations in a way that I had never had before with my family.
My senior year of high school I applied for my small communities'
royalty court for the Strawberry Festival. It might not seem much to
people that have never been to the Strawberry Festival, but for my town
it is huge. I couldn't believe it when I was accepted onto the court
and went on to win the title of queen. It was a great honor, and an
experience I will never forget. It was so rewarding to share with the
Catherine Freer staff this accomplishment, because I give them a lot of
credit for my success, as I mentioned in my newspaper article when I
was on the court.
Since the Catherine Freer Program worked with my school I was able
to earn credits for the time I was away, which helped me to graduate on
time. Since graduation I have gone on to attend Western Oregon
University, where I am well into my third year. My inspiration to
become a teacher came from the woman who tutored us at the transitional
home. Somehow she was able to get us to actually care about our
education, and she allowed me to take on extra credits which helped me
to graduate. It was her dedication and compassion for our learning that
really inspired me to teach. It couldn't have been an easy job, we were
a group of girls with many behavior issues, but she didn't give up on
us. I want to have that impact on my students someday. I want to show
them that I care about them as people, and I want them to succeed.
I have been living on my own know for about three years. My first
year I spent in the dorms on campus at Western, and now I live in an
apartment close by with a roommate that I met in the dorms. I have been
spending my summers working at a grass seed research farm in Albany,
and for a little over a year I have also been working at Target in
Salem, Oregon. I am supporting myself and continuing my education, and
I am very happy. I have many friends who do not use, and I am very
close with my family.
I still read my journals that I wrote while I was on trek from time
to time to remind me how far I have come. Whenever I am frustrated or
upset I think about all of the good things I have in my life because of
the changes I have made. I cannot thank the people at Catherine Freer
enough for this opportunity to be a whole, happy, and healthy person,
and for caring enough to keep in contact with me years later. If it
were not for completing this program when I was 16 years old I probably
would not have even completed high school. I owe so much to them, and I
hope they are able to continue helping troubled kids for a long, long
time. Thank you for reading my story.
Sincerely,
Erin Van Atta,
Montana Academy.
______
May 4, 2008.
Dear Chairman Miller and Ranking Member McKeon: After studying your
proposed bill, I write to include my reactions in the public record. I
applaud your intentions and efforts to improve the safety of private
programs, but I strongly oppose H.R. 5876 as written.
I am an owner of a private therapeutic program that would fall
under regulation with the proposed bill. I agree that we must place
safety and appropriate care of children as the foremost priority in all
residential care, in both public and private settings. I also agree
with the general safety requirements outlined in Section 3 with the
possible exception of section E (access to telephones must in many
cases be supervised to ensure that access is restricted to parents and
a child abuse reporting number). Unrestricted access to telephones has
great potential to corrupt treatment with calls to undesirable and
unsafe contacts.
However, I strongly disagree with the suggestion that the law turn
over authority for regulation of these basic safety principles to the
federal government. Federal authority to regulate will override and
conflict with the many states that have worked for years to understand
and create regulations responsive to this level of treatment. Federal
regulation in all fifty states will also create a costly, inefficient,
bureaucracy that largely duplicates state and county agencies that are
already in place to provide on-sight inspection and assurance of
compliance with safety standards. It would also be impossible for the
federal government to create well informed and reasonable regulatory
rules and enforcement procedures within the ninety day period allowed.
Appropriate regulation can only derive from a careful and diligent
attempt to examine and understand these programs and the need they
fill.
The mandate from your committee to the GAO was simply to
investigate and document any evidence of abuse in private programs. The
investigation did indeed document a few clear incidents of abusive
practices. They made no attempt to compare these incidents of abuse to
the incidence in the public at large, or in public residential
programs. However, it should be noted that the GAO's suggestion that
they uncovered ``thousands of allegations of abuse in residential
programs'' came directly from the Department of Health and Human
Services NCANDS data base, a data base that derives almost entirely
from public, state funded, and licensed residential treatment programs.
If anything, the GAO report provided clear evidence that whatever child
safety laws are passed with regard to residential care must apply
across the board to publicly run programs, groups homes and foster
homes as the evidence overwhelmingly suggests that the incidence of
abuse is much greater in these programs than in private placements in
which parents have complete authority over making and terminating the
placement.
What was lacking in the mandate was any effort to understand and
report on the important care that is now given to thousands of children
in private residential treatment facilities. Tens of thousands of
families are paying out of pocket to place their children in private
residential programs each year because of inadequate and failed
treatment in their community settings. Virtually all of the children in
our private therapeutic programs have tried and failed to respond to
conventional outpatient therapies, community based psychiatric
facilities, and medication. And yes, there are a few remaining programs
that are highly disciplinary in nature, the so called ``boot camps'',
but they have nothing in common with virtually any of the private
programs that would fall under the regulation of this law. In fact, the
vast majority of military and boot camp programs are run by state
correctional facilities which are not covered by your bill.
The problem for most troubled adolescents in private residential
care is that they are grossly immature, and have failed to develop a
personality structure sufficient to handle the stress and demands of
being a teenager in a culture that is loose, unstructured, and toxic.
It is extremely dangerous to be an adolescent who relates to the
demands of being a teenager with the approach of a child. Such
adolescents display a variety of DSMIV-R Axis I psychiatric symptom
clusters such as anxiety, depression, school failure, impulsivity, and
lack of morality. However, the underlying problems are primarily
failures in character development. Treatment of such problems does not
require a hospital level of care, but often does require removing
children from their locally toxic environments and placing them in
safe, nurturing, well structured programs that allow them to repair the
wounds that have led to their failures to mature.
Attempts to regulate such programs must first involve an effort to
understand them in order to establish regulations that are appropriate
but reasonable for the levels of care. Failure to take the time to
understand and be responsive to the different levels of care required
for character growth can result in eliminating these important
programs, or turning them all into inpatient hospitals, or day
treatment programs, solutions that have already been tried and failed
for these children and their families.
Most states have worked with programs for many years to understand,
and modify standards to fit treatments and yet protect children. The
federal government does not have this local level of expertise, and
making a mistake in this type of regulation that eliminates or alters
significantly these programs will put thousands of children in eminent
danger for their life.
I strongly urge you to amend your bill to provide funds for states
to meet or exceed your basic standards of section 3 within one year of
passing this law. In this way we will have strong basic standards, but
each state can demonstrate how they meet these standards for the
various types of programs that operate in their jurisdictions. You will
also greatly reduce the funding requirements of the bill, empower
states, and eliminate a costly bureaucracy.
I feel that I own and operate a high quality therapeutic school, as
do many of my colleagues. We support the intent and goals of your bill,
but are terrified that arbitrary and uniformed regulation can easily
make it impossible for us to operate our facilities that truly have
saved thousands of struggling adolescents.
Respectfully,
John L. Santa, Ph.D.,
Licensed Clinical Psychologist, Owner, Montana Academy.
______
To Whom It May Concern: I was one of those parents who had my son
at 15 escorted to The Family Foundation School on April 23, 2003. He
was escorted at 4:30 A.M. After coming home drunk and God knows what
else. He graduated on June 25, 2005 with a high school diploma, above
average grades, and many extracurricular activities. It was one of the
few times in his life he finished what he started to my amazement and
did it better than I would have ever dreamed. The experience may even
have saved his life!
But most important, he was sober for 26 months and experienced life
on life's terms and allowed his brain, (frontal lobes) to develop. Now
he is my only child, and I am here to tell you that I was a very
protective parent who hated the idea of doing this in the first place.
But it does not take a keen eye to see the spiral of drugs and alcohol
coming to a point of critical mass. I did what was right and stand by
it to this day.
Was the school tough. * * * yes? Did it brainwash my son * * * yes.
But he needed the structure and he needed his brain washed. He will
tell you for himself that he needed the structure. He watched the
testimony along with me and after he discussed it, his comment was that
he wants to go back and visit the school one day.
I would encourage you to invite parents and former students, sober
or not to tell their side of the story of their experience. Ask any
military person, West Point Cadet or grunt and they will tell you the
school was a cake walk. Go to any AA meeting and you will hear that
there is no ``easy or soft'' way of combating addiction.
Yes, the school has evolved, grown for the better made changes but
it was never the hell this kid is portraying. And regarding scars, I am
not buying it. As for the failure of his military career, what part did
he play in that? What part did he play in getting to the school in the
first place? Everyone has scars, get over it.
Did you watch the PBS program about life aboard the Nimitz, the
aircraft carrier? You will hear young kids at 18 talk about the
horrendous conditions they escaped to find that the structure in the
military was the best thing for them. Furthermore, they did not allow
their awful environment to become an excuse for any failure. They got
off their back sides and had the courage and presence of mind to do
something about it. Now my son does not walk the line as I would like
him to but I am convinced that the school planted a seed that for ever
more will stay with him.
Yes, like anything out there, there are the good schools and bad
schools for wayward youth. There are some losers that need to be shut
down or tweaked. But The Family Foundation School is not one of them.
The school is an open book.
Regards,
Gene Lysick,
Montana Academy.
______
May 6, 2008.
Chairman Miller and Committee Members: I write, after studying your
bill, to place my observations about its surface good intentions and
its deeper fatal flaws into the public record. Unfortunately HR 5876
addresses upsetting and real state-level problems with an expensive,
massively inefficient and duplicative federal solution that is likely
to do substantial collateral damage to useful, innovative,
irreplaceable high-quality programs that have nothing to do with these
incidents or flawed practices. As written it ought not to be passed. If
amended sensibly, it could serve a useful purpose.
Since my comments are critical, my motives may be relevant. Let me
introduce myself briefly. I am a democrat, who has trained and worked
as an economist. My objections to your bill are not to do with a
doctrinaire allergy to regulation, for surely some sectors of the
economy, like medicine, surgery and psychiatric programs that involve
high-risk youth, need regulatory structure and constraints. With my
colleagues I have supported sensible state regulation of therapeutic
programs for teenagers in Montana. Inasmuch as there has been
resistance to this effort in our state, your bill could help us if it
encouraged responsible state supervision for adolescent programs here.
Yet, as written, your bill seems unlikely to help very much with
Montana's own effort--and instead it overrides state regulation with
new federal bureaucracy.
I was trained as a physician--educated at Harvard College,
Cambridge University (UK), Case-Western Reserve School of Medicine
(Ohio) and in Yale's Department of Psychiatry. For 8 years I was a
professor of psychiatry at University of California (San Francisco),
where I helped direct the training of young psychiatrists. Since then I
have become experienced in private outpatient and hospital inpatient
practice with both teenagers and adults. I have led adolescent hospital
start-ups in Texas and Montana, serving as clinical or medical
director, and I have decades of outpatient office experience. In 1997,
in a break from the enforced mediocrity of managed care and unnecessary
overhead costs of inpatient units, I joined other experienced
clinicians to co-found a first-rate therapeutic school in a remote
valley west of Glacier Park--called Montana Academy. In this past
decade we hired and trained a remarkable staff: 8 PhD psychologists, 2
board-certified psychiatrists, 3 MSW therapists, 7 certified teachers,
and tens of BA-level supervisory staff, who together address the
protean serious developmental problems of 85 floundering teenagers.
In sum, in 35 years of clinical and administrative experience I
have become expert in some of the problems of troubled American
teenagers and knowledgeable about the various approaches to the
treatment of their own and their families' many troubles.
Given my involvement in an innovative, safe and well-managed
clinical and academic program, given our professional ethical
scruples--about which I may say that we need no instruction from
anyone--it is clearly in our interests to promote competent, firm
regulation and licensure. It is in our interest that sensible
regulation weed out irresponsible, incompetent programs and practices,
and expel the bad actors. For both can harm children and, when they do,
they tar our collective reputations. There is no protective motive on
your committee that we do not share, nor is there any fierce
indignation about wretched adult misbehavior or mismanagement that we
did not also feel long before your committee hearings. In fact, we know
more about what it takes to provide safe, responsible and useful
treatment than you have any reason to have learned. Moreover, most of
the measures your bill calls for--e.g., criminal background checks,
proper training of staff, prohibitions of staff violence or sadism,
adequate medical supervision, and the proper care and feeding of
growing children--already are established aspects of our routine
practice and should be enforced--by competent regulation--in any
program involving children and teenagers. We have been impatient about
the lack of enforcement of ethical standards in program marketing and
in the referral process.
Yet the values and good intentions we share do not produce great
enthusiasm for HR 5876. In fact, I have three substantial reasons to
oppose your approach to these problems--and to propose an alternative.
In brief, your hearings documented a few egregious clinical debacles
and unethical marketing practices--and, as to the latter, we could add
examples of practices more troubling than those the GAO cites. But as
egregious as those cited cases may be, the GAO report and the evidence
cited in your hearings fail to justify the solution you propose: a
massive new federal howitzer to be fired immediately and from
Washington, DC at distant private programs taking care of troubled
teenagers.
First, your data provide no reliable measure of the size of the
problem for which you propose this massive federal solution. The GAO
report claims to have ``identified . . . ``thousands of allegations of
abuse . . . at residential programs across the country'' (p. 1)--but
these data concern public programs for adjudicated youth. Those data
are not relevant to private programs for troubled teenagers. The
populations of adjudicated teenagers in public programs is not at all
the same as the population in private NATSAP programs, nor are those
programs structured or staffed in the same ways, nor are the results of
residential treatment at all comparable (Ellen Behrens, 2008). There
are not ``thousands of allegations of abuse'' in private residential
programs. And HR 5876 specifically excludes all those public programs
from its regulatory mandate, so that, in effect, the GAO report
demonstrates a substantial problem about apples so as to justify
federal regulation of oranges.
Second, a few egregious cases of abuse, incompetence and unethical
marketing practices certainly might justify sudden massive federal
intervention if there were no state regulation in place already. But in
many states, particularly in states in which most of the private
programs for troubled youth have long been up and running, there
already are regulatory rules and licensure standards, which are firmly
enforced by state authorities. In some of those states (e.g., Utah)
this structure and those nuanced regulatory practices are the result of
years of experience and expertise. State regulators know well the best
programs and best practices as well as those programs with egregious
problems, and have adjusted their regulatory practices in a nuanced way
to their local, innovative programs. Surely it would be useful for
federal pressure to push states new to regulation to learn from those
whose tested practices result from solid experience and years of data,
but to ride roughshod over those informed local regulatory agencies and
to invest massively in yet another centralized federal bureaucracy
seems another example of Washington arrogance and contempt. Moreover,
if (as implied in HR 5876) the goal is to promote state governments to
accomplish their own adequate regulation, massively funding a new
national bureaucracy for inspection and enforcement hardly seems like a
rational way to do it. To argue, as you have, that some examples of
incompetence or misbehavior justify a massive new federal juggernaut is
no different than to urge, on the basis of regularly published examples
of physician malpractice, impairment or error, that we need massive
federal regulation to over-ride, supercede and supervise California's
own medical licensure board. I expect the honorable chairman's own
state board would discover a fatal flaw in this logic.
Parental due diligence, already in place, makes the need for a new
federal bureaucracy less than obvious. Unlike teen inmates in public
programs, teenagers in private residential schools have parents
involved--at the very least to give consent and to pay the tuition. At
Montana Academy we have never enrolled a student without requiring
parents first to come to Montana themselves--to discuss their
children's problems, meet our staff, visit our school and talk
privately with other students. Moreover, the parents of every child we
have ever enrolled has been referred to us by an independent
educational consultant, who has visited our program and knows all
alternative programs in the nation.
In addition, there are independent accreditation bodies that, in
our case, make federal inspection redundant. Montana Academy's academic
program is accredited by the Northwest Association of Schools and
Colleges (NWASC), which accredits Montana's public schools. Our
clinical program--policies and procedures, safety, staff credentialing,
clinical competence--has been accredited by the Joint Commission on the
Accreditation of Health Care Organizations (JCAHO). Both academic and
clinical aspects of our program has been reviewed and accredited by the
National Independent Private Schools Association (NIPSA). The state of
Montana is putting in place a state licensure, and we must demonstrate
that we meet state fire codes. This being so, a reasonable person must
ask why--in addition to NWASC, JCAHO, NIPSA, Montana's Fire Marshall,
Flathead County Public Health Department (kitchen standards) and the MT
Department of Labor--the legitimate regulation of Montana Academy also
requires a new federal bureaucracy, located three thousand miles away,
to duplicate these requirements and inspections. At the least, it makes
sense to exempt from new federal scrutiny any program that achieves
regular, substantial on-site inspection in other ways.
Finally, neither the GAO report nor hearings before your committee
seem to have bothered to ask a representative sample of parents about
their experience--and so discover the worth of many of these private
residential programs. I can tell you, as they would, that there are no
equivalent services available within conventional psychiatric and
psychological and academic facilities. I can tell you, as they would,
that their children already had failed to respond to outpatient
therapies tried at home, brief hospitalization, and competent
prescriptions of (usually multiple) medications. I can tell you, as
they would, that they would not have some so far, or endured a painful
separation from their much-loved children, if contemporary psychiatric
remedies had resolved their many potentially crippling problems.
Yet I can find little evidence in HR 5876 to suggest that, prior to
offering this legislation, the committee has given respectful
consideration to the collateral damage this legislation could do--as it
creates a remote, federal bureaucracy and mandates unknown new rules,
regulations and costly requirements. Given the total lack of
consideration and knowledge about the unique virtues of these
alternative programs, there is a significant risk, many of us
recognize, that such a federal bureaucracy will, with the best
intentions in the world, transform our less-costly, ingenious,
innovative and effective private programs into stereotyped, massively-
costly psychiatric hospitals. That is, we fear that, out of an
imprecise picture of alternative private schools and programs, and out
of indignation at the egregious misbehavior of the few, you may destroy
something valuable for the many--innovative useful programs that have
taken us years to develop, and about which we are justly proud.
I hope that these observations and objections can get a serious
hearing from members of the committee and the Congress--and that
responsible legislators will consider the duty to which physicians must
swear an oath: first to do no harm.
Sincerely yours,
John A. McKinnon, M.D.,
Co-Founder and CEO.
______
Kristie Henley,
Bonners Ferry, ID, May 6, 2008.
To Whom It May Concern: My name is Kristie Henley (formerly Vollar,
maiden name Woodbury). I'm a graduate of Explorations Wilderness
Assessment Course in Trout Creek, MT, as well as Mission Mountain
School in Condon, MT. I graduated Explorations in 1993 and Mission
Mountain School in 1994. I am also an Affiliate member of NATSAP
(National Association of Therapeutic Schools and Programs), and a
student member of the American Psychological Association. I work at
Woodbury Reports, Inc., owner of the resource web site
Strugglingteens.com.
I'm not sure where to start, as I wasn't sure I'd be given a chance
to share my story / experience with schools and programs in the private
parent choice network. I want to thank Mr. McKeon for allowing
additional testimony from graduates who hold other views of their
program than those that were allowed to testify. No one coerced me (or
even asked me) to share my story, it is of my own free will and desire.
I initiated contact after I watched the second of Congressman
Miller's hearings on abuse in residential treatment centers, emotional
growth schools and programs, therapeutic boarding schools, wilderness
camps, etc. and saw the testimony of Kathryn Whitehead, former student
at Mission Mountain School. One reason I felt it was important for me
to speak up is because I was Kathryn's roommate at Mission Mountain
School for almost eight months. She was the first roommate I had upon
arrival. My intention here is not to poke holes in her testimony or
bash her in any way, as each of us will see things differently and each
interprets experience differently. However, I know there was at least
one inaccuracy in her testimony that I'd like to be addressed for the
record.
That inaccuracy is in the educational component of Mission Mountain
School. According to Ms. Whitehead's testimony, ``we only attended 12
hours of unaccredited education (by uncertified teachers) per week with
``extreme amounts exercise''.'' This is an exaggeration. We attended
school Monday through Friday. Classes started between 9:00-9:30 am
(after a community meeting to communicate with each other how we were
all doing) and ended at 2:30 or 3:00 pm. At 3:30 pm we had a 45 minute
aerobic exercise time, Monday, Wednesday and Friday. Depending on the
season, this was either 45 minutes of biking or cross-country skiing.
On Tuesday and Thursday, we did yoga or stretching. This exercise was
for health reasons as well as Physical Education credits, not for
punishment.
Our lunch period was an hour and a half each day. For part of the
lunch break, we did community chores * * * the same type of chores
rural families would do in a home, or people would do on a working
ranch: cooking, dishes, kitchen cleanup, taking care of pets, cleaning
horse stalls, gathering/ chopping firewood, etc. These were designed to
help the students learn work ethic, discipline, responsibility,
carrying your own weight, etc. There was a daily rotation so groups of
girls would each take turns on different chores.
Educational classes included Health, Sciences, English, Math, etc.
There were also a couple independent study programs, which provided a
variety of options. The independent study classes were a lot like being
homeschooled. One of the Sciences we did was Environmental/ Earth
Science. As part of the labs of Earth Science, we would take field
trips to the surrounding forests to identify different plant life.
We also attended 3-4 hours of standard education on Saturday
morning. The classes we took were accredited and we did receive high
school diplomas. My transcripts were fully accepted by North Idaho
College, which would not have happened if the school were unaccredited.
We even took monitored SATs, which were also accepted by my community
college. I did not have to take an entrance exam, nor did I have to
take a GED exam prior to being accepted in college.
I have written numerous articles over the years based on my
experiences in both a wilderness program and a therapeutic boarding
school, which were published in the Woodbury Reports newsletter and on
the website Strugglingteens.com. I have attached many of them to this
letter showing that although the programs I attended were not easy,
they did help me and I am grateful.
It has been 14 years since I graduated and there hasn't been one
day over the last 14 years that I felt either of my programs were
abusive or punitive. In fact, I currently work in the network of
private, parent choice, emotional growth/therapeutic boarding schools.
Many alumni do. I chose to work in this network because I believe my
programs saved my life, changed me for the better and gave me tools to
lead a very successful life and work through life's trials. I also know
how bad it can be if a mismatched placement is made, and want to help
ensure that doesn't happen.
Over the last eight and a half years of working in this network, I
have visited numerous schools and programs. I have talked with
children, out of the presence of others, under no scrutiny of the staff
or other students. I have asked them questions about their programs and
experiences, and shared my experiences with them. Although there are
bad programs and referral services out there, many programs are highly
reputable and know what they are doing. I have helped place a handful
of students in programs, based on their needs. I have written articles
about my experiences and done a lot of research on which schools and
programs work well and which don't.
In this second hearing, all the examples except one (not including
the two witnesses who attended schools) were outside the network in
which I work. Many were actually state run/ state placed facilities or
boot camps, rather than private, parent choice therapeutic boarding
schools or wilderness programs. In addition, the ``referral agencies''
the GAO contacted were not in fact Independent Educational Consultants
experienced in successful placements of children. The GAO did not for
example objectively contact my office, which is one of the largest (yet
legitimate) companies of information for parents and professionals.
They contacted us before the first hearing, where we shared with them
some of the research we do annually on schools and programs in the
private, parent choice network. They did not use any of the information
we provided. We also would like to see those illegitimate referral
agencies and programs shut down, but not at the detriment of the good
schools and programs available to help the thousands of children who
need (and succeed) in private programs.
If more information is needed, I can be contacted via email at
[email protected], via my office 208-267-5550, on my cell phone at
208-610-9831, or postal mail at PO Box 1107, Bonners Ferry, ID 83805.
______
To Whom It May Concern: I attended the Family Foundation School for
two and a half years starting in 1991 and ending shortly after
graduation from high school in 1993. During my stay at The Family I was
involved in all levels of the organization, first as a troubled teen
being admitted, then as a student, a senior member of the student body,
an employee, and eventually as a college student.
I was shocked and appalled by the allegations made by a fellow
Family School alumni, Jon--Martin Crawford, before the US House of
Representatives. I know that many of the statements made by Mr.
Crawford are untrue and feel compelled to do whatever I can to restore
any damage to the reputation of the Family School suffered as the
result of this testimony.
It is not easy for many people to understand the profoundly
positive impact The Family School has had in my life and the lives of
countless other troubled teenagers. All who have known me from my teen
years through today mark two phases in my life, before The Family
School and after The Family School. My parents, brothers, friends, and
others are still in amazement and grateful fifteen years later for the
process I went through at The Family and the results that it has
produced.
Today I own and run a rapidly growing Internet Advertising company
with over 50 employees in Lake Mary, Fl. Many of the virtues I learned
while attending The Family School are actively in place in our work
environment. Honesty, Work Ethic, Integrity, and the pride associated
with being a contributing member of society are all alive and well
within our organization. I know of many of my fellow alumni who have
made significant improvements in their lives and have benefited their
families and communities as the result.
I believe it is enormously important that everyone who heard the
testimony of Mr. Crawford learn the reality of what really happens at
The Family School. In admirably high numbers, troubled teens become top
students, athletes, painters, actors and actresses, singers, golfers,
debaters, chess players, and most importantly, positive members of
their families. All of this is accomplished in a very loving
environment that empowers people to move beyond their current troubles
and issues and ``act their way to right thinking''.
There are undoubtedly organizations that profess to change lives,
and do so under the conditions Mr. Crawford described. Like any
reasonable person * * * I am horrified that such institutions exist.
Please be assured that The Family Foundation School * * * is not such
an institution. The greatest shame that could come from this testimony
would be if legislation were passed that contained provisions which
hampered the ability of life saving organizations like the Family
School from carrying out their good work. Undoubtedly, there is a need
to protect teenagers from mistreatment at the hands of others, let's
not do so by removing the ability of The Family School to protect them
from themselves.
Most Sincerely,
Michael E. Jenkins,
Founder & CEO, MarketLeverage.
______
Michelle Funaro,
Guilford, CT, May 8, 2008.
To Whom It May Concern: After viewing the latest senate hearings on
the child abuse and deceptive practices of residential programs, I felt
compelled to write as I have a daughter who attended The Family
Foundation School in Hancock, NY from Sept. 2003 to June 2005. I will
share some of our family history with you. My daughter was a difficult
child growing up. We, her parents, always made sure she received all
the love and care that she needed. By the age of 14, she was drinking,
drugging, getting in trouble in school, stealing, and getting in
trouble with the law. By the age of 16, she was stealing credit cards,
money, the car and taking off in the middle of the night. By this time,
she would go to parties, use drugs, get drunk, and was sexually active
without use of protection. She became verbally and physically abusive
to us.
My daughter was the driver involved in a car accident that could
have taken the lives of three other girls, as well as her. By the age
of 17, she was failing in high school. The school said that they could
not provide an education for her and that we needed to find someplace
else for her to go. My daughter had been through the court system for 3
separate offenses (possession of drugs, possession of stolen credit
cards, and for physically abusing me). She was mandated by the court to
wear a monitoring device and was restricted to home, medical/therapy
appointments, and school only. She was using her therapist to obtain
medication that she then crushed and snorted up her nose, along with
the medication that she and her friends were taking from family
member's medicine cabinets or buying off the streets.
We had gotten to the point that we had to lock up our wallets/
purses/money and put locks on bedroom doors so she didn't steal from
us. We hired an attorney so that we did not violate our daughter's
rights. We went through the court system to get permission from the
courts to take her to The Family Foundation School in Hancock, NY. It
would have been her choice to go to an adult woman's prison instead of
going to a residential program. The court felt she was not capable of
making good decisions and gave me the power to make the decision for
her. The court and the school system monitored the entire time she was
at the school. Reports were supplied and I continued to go to court for
her with her attorney. She faced a mandated jail sentence if she didn't
complete her program at the school.
This was not an easy decision for us. It took research, talking to
other parents, students, visiting the school, and investigating it plus
figuring out where we were going to get the funds for this. The place
was clean, spiritual, food was good, educational standard were high,
and the staff was well qualified and caring. Some of staff members
having been former addicts themselves understood the disease. We
understood that, they could help guide our children.
I took my daughter to the school with a court order in hand. She
was under the influence of drugs. When we got to the school, she and
her belongings went into the administrative building. She was searched,
as was her clothes, toiletries, etc. They found sleeping pills hidden
in a makeup container. I was allowed to say goodbye to her, which she
refused, and I left. We were not allowed communications for 30 days,
although I was in weekly contact with the school and a staff member who
was overseeing her program and her family group.
After 6 weeks we had a meeting with other parents and staff and got
to visit with our daughter. We were also exchanging letters and
receiving phone calls each week for 10 minutes. If she acted up then
she lost the privilege of speaking to us and we did not get the call.
As her parents, we were required to go to a 12 Step Meeting. In our
case, we went to Families Anonymous, a 12 step program for people
affected by a family member or friend who was an addict or had
behavioral issues. We also attended family and parent group sessions at
The Family Foundation School. We learned how to not enable the
behaviors of our loved ones.
My daughter went to school, did chores and was expected to
participate in gym, help maintain the grounds (shoveling snow in the
winter, sweeping, garden, etc). There were some things that I thought
odd and that I questioned. My questions were answered to my
satisfaction. Medical and mental healthcare was provided as needed. She
went to the OB doctor, dentist, eye doctor and talked to the school
psychologist. She was on some medication while she was there. My
daughter was expected to participate in two extracurricular activities
(chorus, art, debate, school newspaper, yearbook, or sports). The
school has a nationally recognized 1st place chorus and debate team.
There were times that she received consequences. Sitting in the
corner, running around the building for exercise, and yes, moving
gravel size rocks back uphill to the upper parking lot when she refused
to go to class. I was always informed about what was going on with her.
I was aware that if the child was a danger to themselves and to others
that they would be separated from the group. There was no wrapping with
duct tape and blankets. There was a padded room with cameras to monitor
the child if they tried to hurt someone and were completely out of
control. At no time were they left alone or physically abused.
We visited our daughter many times, ate lunch with her family
group, took her off campus and made visits back home. The school went
on daytrips and overnight trips to competitions, historical sites, the
movies, bowling, the park and even had special programs brought into
the school. There is a spiritual aspect to this school as they run the
program with the principles of a 12 step program. Respect of other
religions and cultures was taught. The children would go on spiritual
retreats to a retreat house, in Pennsylvania, twice a year. They put on
a play for the community and the parents once a year and also a holiday
show. These children have amazing talents when channeled in the right
direction.
I would also add that the school was open to me coming there at any
time. I agreed to limit my visits to times that were best for my
daughter. Personal possessions were limited due to space and need. We
were allowed to send clothing and personal items as needed. Money was
sent at Christmas so the children could go shopping (at a mall) for
each other.
When my daughter graduated, she graduated with 30 high school
credits and 9 college credits. The school works with local colleges to
allow students to take college courses while they are there. After
graduation she went on a trip to Lourdes, France with the Dean of
Education, Father Stephen Morris, with many other graduates and staff
members. They were escorting mentally and physically handicapped women
to Lourdes for 9 days. After that my daughter remained at the school
working in a paid position in the office for the summer before
returning home.
It has taken time for things to settle down after she returned. I'm
not going to say that it was perfect, because it has not been easy. She
does have resentments at being sent away for 21 months. She tells us at
times that she was traumatized and yet I know that she had a difficult
time leaving the staff and students. I believe that I got back the same
child that I sent to that school. It's the behaviors that have changed.
She also knows that there are consequences and that we are strong
enough to follow through with them, if she returns to her old ways. She
now makes better choices, lives on her own, works, and is going to
college. She is no longer that angry, abusive child. She is turning
into a responsible adult, who still has some anxiety issues. We
continue to support her seeking counseling.
Not too long ago she said to me: ``Mom, I know someday soon that we
are going to be the best of friends.'' I know that had we not sent her
to The Family Foundation School, she would not be alive today. At the
very least, she is still alive 4\1/2\ years later. I'm sure things have
changed at The Family Foundation School even in the past 10-plus years.
I can't vouch for what happened then. I can tell you what my experience
has been over the past 4\1/2\ years. We've healed as a family. We have
gained back a daughter. We will always be grateful to The Family
Foundation School.
Sincerely,
Michelle Funaro.
______
Robert H. Kieserman,
Cherry Hill, NJ, May 8, 2008.
To Whom It May Concern: I am writing this letter to praise the
efforts of the staff and faculty of The Family Foundation School in
Hancock, New York. My son Benjamin was taken to the school on December
20, 2005 by escorts. Ben never had any substance abuse problems, but
rather behavioral issues that reeked havoc and chaos in our home for
over two years. Despite going from psychologist to psychologist to
psychiatrists, no one was able to reach Ben. He shut himself up in his
bedroom, refused to attend school, and was in jeopardy of heading down
a road of self-destruction. Finally, in desperation, we sent him to
FFS.
No words could ever describe the gratitude we have for the folks at
FFS. They devoted every ounce of perseverance they had to turn Ben
around toward a positive life direction. There were times that they
needed to be firm with him, but always in a loving manner. Ben
graduated from the Family Foundation School in December, 2007 with a
high school diploma. He now holds down two part-time jobs and just
finished his first semester of college. He lives with us, and he is a
different person than he was three years ago. FFS helped Ben look at
himself, develop the self-confidence that he needed, and provided him
the coping skills that he will have for the rest of his life.
Throughout Ben's two years at FFS, his sponsor Chris Stein along with
his co-Family leader Cindy Argiros, worked arduously with Ben and was
always available to us as well, and Chris became our dear and trusted
partner in changing Ben's life for the better. Susan Runge, Director of
Psychological Services, was also a tremendous influence on Ben and on
us, teaching us how to be better parents to an adult child. Every
member of the staff interacted with Ben, and since he has been home, we
have had many opportunities to openly and candidly discuss his life at
FFS. Ben now acknowledges that although everyone on the staff
challenged him to live up to his fullest potential as a person, they
always treated him with respect, and most importantly, with a dedicated
love. He has told us that there were times that other students were
isolated for bad behavior, but at no time, was there any concern by any
of the students that those students were mistreated. At all times,
according to Ben, discipline was administered with sternness, but with
compassion and with a parent's love.
I wish to go on record that both my wife and I strongly support the
work of the entire staff and faculty of FFS. They have created one
miracle after the next, and if not for them, most of the children who
have entered through their doors as lost souls, but have walked out as
accomplished high school graduates and better men and women, would
never have seen that transition in their lives. We will forever be
indebted to each and every member of the FFS team.
Sincerely,
Robert & Regina Kieserman.
______
Roberta M. Mathews,
New York, NY, May 7, 2008.
Dear Mr. Chairman: I am writing because I respectfully oppose the
elements of the recently introduced H.R. 5876, ``Stop Child Abuse in
Residential Programs for Teens Act of 2008''. I would like to submit to
you and the Committee that there are many residential treatment
programs for teens which are providing very high quality clinical
services and which abide by the highest ethical standards of
professional conduct and delivery of services. While a small minority
of the programs across our nation has proven to be negligent and should
be held accountable on a case by case basis, it is my opinion that
federal regulation of the many programs in our nation is unnecessary.
However, the already existing regulation and licensure by each of the
States as well as professional accreditation should continue as it has
to assure high standards and ethical delivery of services.
My own experience with these matters makes me certain of the
necessity for families to have personal choice of private treatment
options for youth which are safe, ethical, and professionally
effective. My teenage son, who has struggled for the past two years
with serious clinical depression and severe anxiety disorder, has been
receiving highly effective, professional treatment, first at a
therapeutic wilderness program and then at a small residential
treatment center and school. In both these private programs, the
treatment services are rooted in respect, dignity, expertise, and
compassion. I can assure you that many programs like the ones my son
has experienced are delivering truly life-saving services to youth.
Parents of teenagers in crisis have often first utilized all modes
of out-patient treatment in order to keep their teenager at home; but
in some cases, like my son's, the personal crisis deepens and there
needs to be a more intensive and sustained treatment intervention that
cannot be provided in out-patient therapy or even in brief in-patient
hospitalization. Parents, like me, who have searched for help through
established channels, can find very high-quality private residential
programs with the help of educational consultants who can answer all
questions about licensure, accreditation, and standards of each
program. Also, parents can go and visit the programs in person, which
is what my husband and I did before we decided on one for our son. It
is highly important to preserve the element of personal choice because
what parents and their consultant need to find is a program whose
specialized services match the individual needs and specific problems
of each teen. When parents are searching to identify that match, they
often find that the best program(s) are not in their home state. It is
a very difficult decision to send one's child out-of-state for
treatment, but my husband and I feel that it was the best decision that
we've ever made because our son has received the specialized help that
he needed so badly and which couldn't be had near home.
There have been absolutely no abusive treatment practices in the
programs that I have come to know well. Both in the therapeutic
wilderness program and at the residential treatment center where my son
still currently resides, he has been kept safe and has been met with
treatment protocols which place a priority on personal dignity and
respect. The credentialed, highly professional clinicians who have
worked with him and with our family have operated on the highest
standards of professional conduct and also have demonstrated a solid
foundation of expertise and compassion in their work with struggling
teenagers.
These private programs deserve to continue their life-saving work
unencumbered by federal regulation. It is far better for the States,
individually, to take on the responsibility of oversight and regulation
because there can be a closer working alliance between a state
government and its constituent programs to ensure that professional
licensure and the highest quality standards are upheld and enforced.
This, in turn, will best protect the necessity for families to have
personal choice of private, professional residential treatment programs
which are safe, ethical, and clinically effective.
Sincerely,
Roberta M. Mathews.
______
May 7, 2008.
RE: A Realistic Commentary on The Family Foundation School
To Whom It May Concern: My name is Sal Guarino and I have had a
close association with The Family Foundation School (`The Family') for
nearly twenty years. The following is my personal and well qualified
letter of support for a tremendous institution that has served the
desperate needs of so many so well for decades. You will find my
testimony to be fundamentally in direct contrast with the one-sided
comments offered by Mr. Martin-Crawford recently. I would like to thank
you sincerely in advance for your consideration of my words.
Having been an employee of The Family for the better part of a
decade, who was closely involved in The Family's early days of becoming
the truly exceptional haven for troubled kids and families and
academically superior school that it is today, and knowing its founders
and many of its principal architects and contributors very well, and
being acquainted with many of its alumni too, I assure you that my
assessment of this wonderful institution that has helped so many is
based on a solid foundation of a rich history of direct experience and
observation.
I have witnessed hundreds of The Family's graduates transform from
children who were typically rejected by their home schools due to
behavior problems, were underperforming academically, were unhappy and
in many cases profoundly sad and unmotivated to do much of anything,
were abusive toward their parents (by any reasonable measure of
professional or lay assessment), were putting themselves at serious
risk due to a variety of high risk behavior, such as drug use, sexual
promiscuity, illegal acts, self-mutilation and numerous other
maladaptive behaviors, who were once `good kids' from caring families
who tried in vain to help their children, only to meet blatant and
often forceful resistance from them, who had typically been treated by
numerous mental health professionals by the time they came to The
Family, with limited or no positive results to speak of, and I can
assure you that contrary to Mr. Martin-Crawford's testimony, which was
at times clearly untrue, and at other times, at best incomplete, The
Family is not only being unjustly characterized in a negative light,
but it is in fact a truly unique and remarkable place--a superior
school academically and perhaps more importantly, a refuge that offers
the safety and security that its `at risk' students and their families
need, as well as the right combination of therapeutic variables
required to address the short term needs of stability and compliance
for these adolescents and the long term development of strong, healthy
and well developed coping skills.
Upon viewing Mr. Martin-Crawford's faulty and obviously jaded
testimony, I was struck by several of his points on which I will offer
comment below. Please note that I am paraphrasing his comments:
Mr. Martin-Crawford mentioned that he suffered from
relapses after leaving The Family due to his nightmares about his
experiences there.
By even the most extreme brand of psychological analysis, one that
would already be pushing the limits of common sense, to offer the clear
causative relationship between his supposed nightmares and the relapses
that Mr. Martin-Crawford suffered subsequently is spurious. This seems
more clearly to be a casting of blame and inaccurate responsibility on
the Family for behavior that Mr. Martin-Crawford engaged in of his own
volition. The fact that Mr. Martin-Crawford, years after his successful
graduation from the Family, continues to claim it was responsible for
his ongoing personal struggles, is dubious at best.
Mr. Martin-Crawford asserts that 4 of his 25 classmates
are `sober' today. (Please note that at The Family and elsewhere,
`sober' is often the word often used as a general term to describe
someone being in a positive state of recovery from what may be numerous
negative behavior patterns.)
Whether Mr. Martin-Crawford is using the term in this general sense
or in the more literal one, suggesting that those referenced are
abstinent from alcohol, it is clearly a positive attribution to The
Family. This raises another interesting point. Presuming that this is a
correct statement and assuming that none of the other classmates have
reaped any legitimate benefits from their experience at The Family,
(another logical stretch for the point of argument here), then Mr.
Martin-Crawford is in fact asserting that 16% of his group has made a
significant positive accomplishment! If Mr. Martin-Crawford were to
further investigate the data on recovery rates and behavior change for
troubled adolescents over time, as difficult as it is to gather and
interpret accurately, he may be surprised at the success he attributed
to The Family, albeit perhaps unwittingly, in his House testimony.
Mr. Martin-Crawford indicated that he had to fabricate
stories of how poor his behavior was before arriving at The Family in
order to create the illusion that he was getting better as a result of
his stay at the school. He asserted that this was necessary in order to
appease the staff members.
While he did perhaps engage in fabrication, as he claims, it was
not in fact necessary. In viewing the dynamics of The Family, or any
other environment that is attempting to help troubled teen-agers come
to terms with their own behavior in an honest and straight-forward
manner, one is advised to consider a proposition that I suspect almost
all parents, including me, would be in accordance with. That is that
the full truth may not always be included in the initial explanations
offered by our kids! This is especially likely when the teens are in
the midst of negative behavior or other addictive patterns. Perhaps if
Mr. Martin-Crawford had spent more time and attention on examining his
own personal liabilities, which is a core tenet of The Family's and
many other therapeutic models, rather than on attempting to `beat the
system,' he would have gained further useful insight into how even the
`small' deceitful actions of word and thought may be at the root of
one's difficulties or at the least be contributors to one's problems.
There are many other drastic misrepresentations and key omissions
in Mr. Martin-Crawford's testimony. I am sure that anyone with even
minimal exposure to The Family would find the comments of Mr. Martin-
Crawford both outrageous and frankly, rather sad. As much as I dispute
his erroneous testimony, I can also honestly say that I feel bad for
John in light of his apparent state of mind at present. That he seems
to be mired in a morass of self-pity and blame toward, as they say,
`the hand that fed him' troubles me on a personal level. As The Family
suggests though, it is important to oppose someone's actions at times
but to also reach a hand out to them simultaneously. This is a
challenging call to action of course but one that I will certainly take
on regarding John. I will make myself available to him as a friend and
mentor should he wish to make that connection.
Beyond the scope of his commentary though, I would like to conclude
by suggesting that members of this great body, those in whom we as
citizens have placed our trust to do what's best with our most precious
resources, visit The Family personally. You could then experience
firsthand a place where so many thankful parents have entrusted their
most precious resources--their children--into the hands of the most
caring, wise and humble group of dedicated helpers and teachers you
will find. Taking the time to do so would likely be a welcomed and
refreshing change from the daily grind of Washington and would give you
the unrivaled benefits of direct exposure to assess its merits and
intentions. The Family School is not perfect but it has been so dearly
close enough for so many grateful parents and alumni who swear by it.
As successful as The Family has been, however, it remains very open to
constructive criticism to improve itself at every level. Its track
record clearly reflects its commitment to a constant, open-minded and
positive evolution. And by the way, it couldn't hurt to know of a great
place for a troubled teen. Perhaps someday you may need it!
Thank you again for your patient consideration of my comments. It
is deeply appreciated.
Sal Guarino,
Sanford, FL.
______
Scott Montgomery,
West Point, TX.
To Whom It May Concern: This Letter is in support of the Family
Foundation School and staff who work miracles with kids having a
difficult time finding their way. My daughter has been at the school
for 1 year and is doing extremely well compared to what she was like
when enrolled. My daughter thanks me every time I see her for saving
her life and I agree. There may be other programs out there but I was
fortunate enough to find this one and am very pleased at what my
daughter has accomplished with the care and guidance of the FFS staff.
I can actually say I am proud of her today, something I could not have
said a year ago. I am sure that what ever comes of this the staff at
the FFS will learn from it and incorporate it into the every day life
at the FFS. If you are in doubt I urge you to visit the FFS and see for
yourself what this place of miracles is all about.
Thank You
Scott Montgomery.
______
May 2, 2008.
To Whom It May Concern: The intention of my letter is to encourage
the members of the Education and Labor Committee to make therapeutic
programs (specifically wilderness and residential treatment centers)
available to struggling adolescents and their families which are safe
and therapeutically appropriate.
I write as a parent and taxpayer to communicate my experience with
two programs (the Aspen Education Group (SUWS-Idaho wilderness program)
(``SUWS'') and the New Haven Residential Treatment Center (``New
Haven'')) we used which helped save our adolescent daughter's life. The
SUWS therapeutic wilderness program took place outside Boise Idaho and
New Haven is located in Spanish Fork, Utah should you wish to look into
their programming. My daughter has successfully transitioned from both
SUWS and New Haven to a therapeutic boarding school this past year and
continues on her journey in a less structured environment.
My daughter had a traumatic childhood. In 2006 we required the
different interventions offered by SUWS and thereafter New Haven. When
we started down this path of intervention we were full of fear, anxiety
and hopelessness. SUWS (for the summer) and New Haven (the following
school year) provided us with a sanctuary of safety, compassion and
hope so that we could all develop life-strengthening skills and begin
to examine the core issues that got us to this point.
Tragically, there have been instances of abuse and neglect in
wilderness and residential treatment center programs. There is a
compelling need for states to license and regulate therapeutic programs
so that the safety and welfare of children in need of such services can
be carefully safeguarded. The U.S. House Education and Labor Committee
has convened hearings to consider allegations (some verified, some not)
of abuse and neglect within private therapeutic wilderness and
residential treatment center programs. To date, the majority of the
voices heard have condemned such programs. There are, however,
thousands of positive stories of rehabilitation and healing at many
residential treatment centers and wilderness programs. I would like to
go on record stating that our daughter's life and the life of our
family have been saved by two of these programs. We have been given a
second chance. We could not have done the work needed without this
intervention.
Programs like SUWS and New Haven have saved lives, overcome
incredible challenges, restored broken families through the
participation of family members themselves, and helped youths reclaim
their lives to become productive members of society. You should be
aware that there is a broad spectrum of available programs run
responsibly, safely and with integrity. I urge you to consider what
programs like SUWS and New Haven are doing and support their life
changing work with regulation to weed out the horror story programs.
Please share our experience with your colleagues in Congress. You have
an obligation to protect families and children by ensuring that
responsible, safe and much-needed programs like SUWS and New Haven may
continue into the future with proper regulatory oversight.
Our family has been blessed by many, many gifts we received from
the staff, therapists, and treatment personnel at both SUWS and New
Haven RTC. We hope that such services will be available to others in
the future in their time of crisis.
Sincerely,
Wendy M. Broadbent.
______
Jupiter, FL, April 28th, 2008.
Hon. George Miller, Chairman,
Committee on Education and Labor, Rayburn House Office Building,
Washington, DC.
Re: Hearing on ``Child Abuse and Deceptive Marketing by Residential
Programs for Teens''
Dear Congressman Miller: I would like to thank you and the
Committee for exposing a multi-billion dollar plus industry that has
been allowed to run amok without effective regulatory oversight,
licensing or enforcement. It is my understanding that I may submit the
following, for Congressional Record. I apologize for the length of this
letter, however to give an accurate summation of the depth of deception
and corruption that we encountered, I found it necessary.
In November of 2004, my daughter Tenley Aleksandra Ryan was
admitted to what we understood was a ``Therapeutic Boarding School''
called Hidden Lake Academy (HLA) in Dahlonega, Georgia, owned by
Leonard Buccellato. We were referred to the academy by her psychologist
who provided a brochure of Hidden Lake Academy. I visited the academy
web-site, telephoned the academy and was forwarded literature including
a ``Parent Handbook''. Up until this point, I had no idea what a
``Therapeutic Boarding School'' entailed. I was desperate to save my
daughter, as all else was failing. Hidden Lake Academy offered hope, we
were vulnerable and thus a continuing nightmare unfolded.
Hidden Lake Academy Marketing Representations as apparent in all
literature/media provided:
Licensed Therapeutic Boarding School
All peer group counselors were licensed with a Masters
Degree level or higher
All teachers were certified in their field by the State of
Georgia
Clay Erikson, ``M.D.'' Director of Addiction
Services(Addiction counselor)
24 hour RN on staff to dispense psychotropic medications
SACS accredited ( including Science lab required for
College Preparatory Credit)
No violent or court ordered children were accepted
Safe, nurturing environment
Restrictions involved light tasks such as raking and would
not be `corporal'; duration would be limited one hour, to an hour and a
half after classes.
Pre-paid tuition refunded minus last month's deposit (if
child was pulled early)
As a ``Therapeutic Boarding School,'' fees/expenditures
were tax deductible
The Truth:
Hidden Lake Academy was not a ``licensed Therapeutic
Boarding School'' ( in their attorney's own written words to Carol
Winstead ORS, ``therapeutic is a marketing term'' Quirk and Quirk P.C.,
August 8th, 2004''). HLA was marketed to other states as a licensed
TBS, accepting out-of-state IEP students and children under the ``No
Child Left Behind ACT''. No record of students transported from state
to state pursuant to the ICPC, as exempt from licensure, although HLA
accepted students nationwide for a `therapeutic' program.
All peer group counselors were not licensed by the State
of Georgia. The only licensed counselors were the owner, Leonard
Buccellato, who did not counsel children, but instead signed off on
counseling bills for tax purposes and Joe Stapp (currently new
Headmaster). For example, Kees de Ventes, Spiritual Coordinator, was
given a peer group to counsel and taught English without any
qualifications. Another counselor, Chris Grimwood lists an M.S.W.
from'' Farington University'' an on-line diploma mill.
Farington University is not accepted by the State of Georgia
Department of Education, therefore he cannot be licensed.
All teachers were not certified in their field by the
State of Georgia (cross utilized without permission from SACS)
Example:. Kees De Ventes, Spiritual Coordinator .
Clay Erikson, M.D. Director of Addiction Services was
stripped of his M.D. in the State of Washington in 1999.
R.N. was not always on staff to dispense medication,
office receptionists frequently dispensed medications. There were
dangerous mistakes made.
SACS--There was never a Science Lab on premises. HLA
counsel Quirk and Quirk wrote that ``a mobile lab was purchased'', but
HLA Director of Operations, teachers and staff later confirmed that a
mobile lab was never purchased.
Violent and court ordered children were accepted into and
attended Hidden Lake Academy. Psychiatrists later reported that Leonard
Buccellato asked them to change the children's diagnosis so the child
could meet school parameters. For example, changing a diagnosis of
Pedophilia to ODD(Opposition Defiant Disorder).
The environment was not safe, nor was it nurturing. It was
based on fear. Relentless screaming and grilling of the children
ensued. Attempted suicides, rapes, cuttings, broken limbs, zip-tying,
cold-cocking, hazing, and other egregious harms occurred that were not
properly documented or reported, and were denied by the school.
However, EMS records clearly indicate the incidents occurred, including
``life flight'' transport.
Restrictions would go as long as eight hours. Parents
requested restriction guidelines during a `parent workshop' and the
guidelines were never provided. Climbing up and down a hill for hours
at instructors pace in all weather.
Carrying logs and boulders across a field for hours in all weather.
Relentless push-ups in a Goose Laden Field, no gloves provided
Picking up Goose feces with no gloves provided
Girls were not permitted to use lavatories, but instead told to use
the ``wood-line''
Leonard Buccellato used the children as labor both at HLA,
his private home, at his mother's home and clearing land for new
stables. (OSHA)
HLA withheld pre-paid tuition monies for services not used
or provided, if child was withdrawn.
Because HLA was specifically and intentionally not a
licensed Child Caring Institution under the tax code, the fees of the
mere private boarding school were not properly tax deductible.
Nevertheless, Owner Buccellato signed off on the counseling bills, when
he never saw the children, for the unauthorized deductions taken by the
unknowing parents.
Other Abuses:
At no time, was I or other parents, informed that our
minor children would be strip searched by HLA staff, without parental
consent.
At no time were we ever informed our children would be
held at ``the Chalet'', away from the main campus, if on restrictions
when agencies or educational consultants visited.
At no time was I or other parents informed that children
would be used as informants against each other during ``fall-out''. If
a child did not oblige, there were severe negative consequences.
After much research about HLA, the following Georgia authorities
were contacted by me and several other parents regarding the
misrepresentations and abuses at HLA:
Governor Perdue; Secretary of State Cathy Cox(then); Attorney
General Thurbert Baker
Tobin McDaniel GAO State of Georgia; Department of Human
Resources--Office of Regulatory Services--Residential Child Care--CPS;
Margaret Palli DHR; Carol Winstead DHR/ORS; Nina Edidin ORS Attorney;
Tamisha Jones ORS;
Keith Bostick DHR/ORS; Sharon Dougherty ORS; Amy Murphy DHR/ORS
Katherine Wallace DHR/CPS; Cara Adams DHR/ORS/CPS; Mollie Fleeman
Secretary of State Professional Licensing Board; Georgia Medical Board
Agent: Adrienne Baker; State Fire Marshall; IRS Fresno, CA(on-line
Fraud reporting); Department of Education; GAC;
SACS--Southern Association Of Colleges--Dr. Judy Flatt
CASI--Council on Accreditation and School Improvement--Dr. Judy
Flatt
SAIS--Southern Association of Independent Schools--Tom Redmon
The Georgia ORS refused to require licensure of HLA as a Child
Caring Institution (Therapeutic Boarding School) despite years of
parent inquiries, complaints and pressure until HLA was hit by a class
action based on fraudulent business practices that brought public
attention. The ORS finally succumbed, and CPS launched an investigation
into Hidden Lake Academy in the summer of 2006. CPS investigators told
me they found that suicide attempts, rapes, cuttings, broken bones, zip
tying, cold cocking and the like were never reported to CPS by either
HLA, the Lumpkin County Sheriff's Department, Chestatee Hospital, and
other responsible institutions. Either there was no protocol in place,
or if there was protocol in place, it was not followed. The ORS knew
that psychotropic drugs were being dispensed, there was a ``Director of
Addictions,'' albeit stripped of his medical license, and many children
were given the wrong medication by a receptionist or whoever was
available to dispense meds. ORS also was aware of the lack of licensing
among the counseling staff. Nevertheless, ORS Director Keith Bostick
still refused to require HLA to be licensed as a Child Caring Facility,
until finally in December of 2006, the ORS was forced to admit that
Hidden Lake Academy had indeed been operating under the radar for 12
years as a ``Therapeutic Boarding School'', a ``Child Caring
Institution'' without proper licensure. Despite the CPS report of 2006,
ORS granted HLA two consecutive six month temporary licenses. Mr.
Bostick assured us that if HLA did comply with the regulations in the
first six months, ORS would shut them down. Nothing had changed, he did
not shut them down.
Now ORS has allowed HLA owner Buccellato to recently open a new
school, Mountain Brook Academy(MBA) on the same premises as HLA. The
ORS license shows ``Ridge Creek-Mountain Brook as a single entity,
though Ridge Creek is the `sister' Wilderness Program to HLA and a
separate entity. Mountain Brook Academy advertises itself as a
``Residential Treatment Center''. According to the Georgia Department
of Juvenile Justice (DJJ), they were told Mountain Brook ``is some kind
of wilderness program'' and Chris Grimwood of HLA called looking to
take ``base-line offenders'' initially. Mountain Brook would be a lock
down facility on the same campus as the three other non-secure schools.
ORS will oversee the residential aspect of the program, granting a
license and MHDDAD will oversee mental health. The DJJ stated ORS will
make their recommendation for application and contract of MBA to the
JDD. Mr. Grimwood assured the DJJ that facilities were separate and
apparently already has counseling in place. MBA will utilize all staff
from Hidden Lake Academy. To put it mildly, this is highly irregular.
Numerous letters and calls to SACS and SAIS were also to no avail.
Even with proof that HLA was operating at a sub-par educational level,
with hand-picked colleagues making the accreditation visit and
review(no Science lab, cross utilization of non-degreed teachers in
different fields), they all did nothing.
Attorney General Thurbert Baker's office in a phone call, suggested
``off the record'', I go to the media. I was told the AG's office
represents the ORS and the ORS has ``sovereign immunity''. I received a
letter this year from the AG's office stating that I may wish to call
``the Better Business Bureau''.
In March of 2006, I contacted Berger and Montague of Philadelphia,
September 2006, a class action lawsuit was filed. August 15, 2007,
Judge O'Kelley denied the Class Suit, without prejudice. I have since
objected to `minute' class wide settlement with prejudice, as it would
bear no responsibility for what has been allowed to transpire, not just
pertaining to Leonard Buccellato, but the ORS and all State of Georgia
agencies, entities that turned their back on our children.
In the interest of the Committee, the testimony of Dr. Christopher
Belloncini of the Walker School, may be conflicting. In the spirit of
full disclosure, the President of the Walker School is listed as
Benjamin W. Thorndike, of Bain Capital, LLC. Aspen Education was
acquired by CRC Health; Bain Capital acquired CRC Health, owning Aspen
Education. As reported on FICA:
10/27/2007--Emily Graeber, a 15 year old Missouri girl,
goes `missing' on the way back to Aspen Education Group--owned program
Island View RTC.(still missing as of 11/09/2207
06/28/2207--Brendan James Blum, a 14 year old California
boy, died of a bowel obstruction after complaining of pain, losing
bowel control and vomiting, but only given over-the-counter medicine
and being told to go to bed. He was enrolled in Aspen Education Group-
owned Youth Care RTC in Draper, Utah.
04/2007--Unidentified 16 year old attempted to hang
himself from a tree at the ranch with a shoelace. After some time the
staff found him unconscious and revived him, but he later died in the
helicopter transporting him to the hospital. This took place in Aspen
Achievement Academy in Loa, Utah.
There is far more regarding Hidden Lake Academy, but I will not try
your patience any more. I have submitted documents to Keith Steck of
the GAO and Keith is very aware of Hidden Lake Academy and Leonard
Buccellato. I hope this letter will be of some help to the Committee
and
I would be happy to address any questions you all may have and do
whatever I can to bring safety, transparency, effectiveness and
accountability to an out-of-control industry.
Thank you again, for the children.
Respectfully,
Jill Ohanesian-Ryan,
Jupiter, FL.
______
Plano, TX, April 28, 2008.
Hon. George Miller, Chairman,
Committee on Education and Labor, Rayburn House Office Building,
Washington, DC.
Re: Hearing on ``Child Abuse and Deceptive Marketing by Residential
Programs for Teens''
Dear Congressman Miller: Thank you for your dedication and efforts
regarding this matter. As a parent of two children who were abused in a
three private facilities, and who received no assistance from
government agencies, I understand the importance and necessity of this
action and legislation. I share your mission and have worked diligently
on public internet forums to expose the fraudulent nature of such
programs for the past seven years, trying to get accurate information
to parents so they might make informed choices for their children. No
child should be subjected to abuse and the risk of death under the
guise of ``therapy'' or ``treatment''.
My older son attended Harlingen Marine Military Academy in the late
90s, which had many similarities to these behavior modification
programs. He was heinously abused during the six months he attended. My
son was a plaintiff in a class action suit and received one of the
largest settlements, due to the nature of his abuse.
Four years later, my former husband enrolled our younger son at San
Marcos Baptist Military Academy which was closer to home and had a
better reputation. A week after he was there he reported his dorm
officer for molesting the children in his dorm. A repeat offender, that
staff is currently serving a 95 year sentence. Since then, there was
another incidence of sexual misconduct by staff. SMBMA promptly changed
their name to San Marcos Baptist Academy, to avoid public scrutiny, and
continues to operate. Aspen Education now has a weight loss program
operating on SMBA's sizeable campus.
Following that incident, my son was terrified and began to act out.
Consequently, he was expelled, at which time his father took him to
Hidden Lake Academy (HLA) in Ga. I was not informed or consulted, my
parental rights ignored. That is when I first learned of the private
behavior modification industry. He was 14 at the time. While I did not
enroll my son, I believe my testimony is worthy of your consideration.
I have been in contact with many divorced parents who have found
themselves in this situation and were unable to get their child out of
a program once they were enrolled. Hidden Lake Academy presented false
information to the judge, via telephone, in our family court hearing;
that swayed the judge to rule that my son would stay, consoling me with
the promise to make up my lost visitation. To that, I would implore you
to add something into the legislation that would prevent this from
happening to other divorced parents. Admittance should require the
approval and signatures of both parents.
My former husband used an Educational Consultant, as required by
HLA. When I spoke to her some time later, she knew nothing about my
son. She knew nothing of HLAs methods and policies and stated that she
referred to HLA based on the owner's reputation. I contacted the
authorities in my state to inquire as to whether she was licensed or
required to be if placing children out-of-state. In fact, such a person
is required to be licensed, but they did not pursue this because she
hadn't physically taken him to HLA. She never met him or my son, simply
spoke to my former husband by phone, and collected a significant sum of
money for a referral to a program she literally knew nothing about.
As part of this fraudulent industry, there should be stringent
requirements placed on Educational Consultants, who should also be
regulated. At a minimum, they should be required to confirm that the
facilities they refer to are properly licensed, ensure that a pre-
placement evaluation has been conducted to prove the necessity of such
an austere placement, and face adverse action if they violate
regulations. I taped, then transcribed my discussion with her and
posted it on the internet to educate prospective parents. While
kickbacks from programs to Ed Cons may be difficult to prove, HLAs
Headmaster told parents attending the workshop that while HLA couldn't
compensate Ed Cons, parents who provided a receipt would receive a $250
refund that they could do with as they pleased. His tone made his
intention clear. In a NATSAP press release it was reported that Aspen
Education granted $100,000 to the IECA--Independent Educational
Consultants Association, earmarked for training Ed Cons on placing
teens in private residential programs.
Merideth Burns PhD of HLA testified by phone at our family court
hearing. She impressed upon the judge that my son was on a ``slippery
slope'' and needed the treatment HLA offered. My son had no diagnosis
prior to attending HLA. He was diagnosed as ODD by HLA, ``based on his
father's complaints'' the day he was enrolled. I felt this to be a
conflict of interest. I went to court to ask that he be brought home
for Christmas so I could have an independent evaluation conducted to
show the placement was unnecessary. Ms Burns told the judge that his
father would loose $110,000 in pre-paid tuition if our son left the
facility. After the hearing I learned that this was false, based on the
refund policy, which is documented.
When I received the call from Mike Witherspoon at HLA stating that
my son had been enrolled, I asked by what authority he was able to
severe contact between me and my son. Was he in trouble with law
enforcement? Were they a Psychiatric Hospital? Was there a court order
stating that contact between us was not in his best interest? No. They
were a Therapeutic Boarding School, that was their policy, and his
father had agreed to abide by it. I had grave concerns, which only grew
with each passing day. Contact with his siblings, grandparents, and
extended family was also severed; for no just reason. He was totally
isolated from the outside world, and everyone who loved him. Mail and
phone calls were censored. He was, for all intents and purposes,
treated like a criminal. Tragically, a criminal who was not afforded
due process.
My son was placed at HLA in violation of the ICPC (Interstate
Compact) which at that time applied to these programs. I contacted the
ICPC office in my state. They deferred to the Georgia ICPC office's
decision that HLA was a private boarding school, therefore exempt from
ICPC requirements. I provided ample documentation to refute that ruling
and prove that they indeed met ICPCs criteria based on ``services
provided''. Neither office pursued it further. In fact, my state office
didn't even know the criteria or how to implement the ICPC. My
interactions with them are documented in emails. Yet, another failed
attempt to have my son removed from HLA. Another mishandling of our
situation by a government agency.
In case you're not aware, due to the efforts of Robin Arnold-
Williams, the ICPC no longer applies to ``parent-choice'' residential
programs. Ms Arnold-Williams was Executive Director of Utah DHS before
becoming Secretary of the Washington State Department of Social and
Health Services in 2005. As one can imagine, the industry disliked the
ICPC and sought to exempt their programs. Pre-placement proof of need
could significantly decrease profits by interfering with their ``strike
while the iron's hot'' strategy.
I first saw my son three months after he was enrolled at HLA.
Unfortunately, I don't have photo documentation, but he looked almost
as bad as Aaron Bacon did before he died. He was thin, skin was ashen
and dry. He was ill and had been for days. Our 36 hours together was
spent treating his symptoms. He explained to me the so-called treatment
he had received. I was a Counseling student at the time and was
appalled by his accounts. He cried frequently. He expressed frustration
and confusion. He didn't know how to comply because the rules were
constantly changing. They twisted his words and used them against him.
My once vibrant, confident, gregarious, son could not make eye contact
with people in public. He declined to make any decisions about where we
went or what we did. He was jittery and terrified of making a mistake
at the restaurant, and when he inevitably spilled his drink, he lost
his appetite and demanded we leave. In the car, I reached to hold his
hand. He cried and asked me not to show him affection, it was too
confusing. We both cried. What kind of treatment was he receiving? As I
would come to understand, the so-called therapy practices were not
evidence-based, but based on Synanon and est, employed by mavericks of
the Human Potential movement. Might I add, concepts that even adults
struggle to comprehend. The origins of the ``therapy'' provided by CEDU
programs and all their cloans, of which HLA is one, is well documented
and I'd be happy to provide that if it is useful to this investigation.
I believe this to be one of the most significant frauds being committed
by most programs. Parents assume, based on the advertising and cost of
the program, that their child will be receiving stellar, evidence-based
treatment.
At this juncture, I have to ask, why insurance companies are paying
for ``therapy'' that is not evidence-based? Further, why are parents
allowed to take tax deductions for travel expenses to visit their
``disabled'' child, if that child is enrolled in an unlicensed facility
which fraudulently claims to their regulatory agency to be nothing more
than a private boarding school, but all the while advertises to the
public as a Therapeutic Program? Why are school districts paying
tuition to unlicensed facilities for children with IEPs who need
specialized care, when education is typically inadequate in programs?
Citizen of the US are assisting parents in paying exorbitant money for
non evidence-based behavior modification.
During our short visit my son divulged that he had been on
restrictions for most of the time he'd been there for minor offenses
and many times for unsubstantiated claims made by others. He detailed
the diet he had consumed while on restrictions. This explained his
weight loss. The Headmaster had mentioned that we might hear about the
infamous ``Restrictions Diet'' in the parent workshop, stating that
``while sparse, the diet had been approved by the Health Dept''. He
implored parents not to be manipulated by their child's complaints, but
rather tell them that they were aware of the diet and supported what
HLA was doing. Months later, when another issue arose, I inquired with
the Health Department to confirm that they had approved the diet. They
had not approved the diet and further stated that it wasn't within
their scope of duties to do so. This is documented in emails.
The restrictions diet was not mentioned in the Parent Handbook,
just as many other punishments. My neighbor, who was the Head of the
Nutrition Dept at a local community college told me it was a starvation
diet, most likely used for submission, as in Oliver. She said that no
teen should consume that diet for more than 24 hours. She also said
that given the strenuous nature of the work my son was required to do
as punishment, that he should be consuming 3000 calories per day. This
is documented in email. My son developed a dependence on Claritin and
Flonase due to the excessive consumption of white bread and cheese
sandwiches for two meals per day, for months on end.
When my son was denied his first home visit at 7 months, under very
suspicious circumstances, I began to research the facility more
thoroughly. He was instead sent to Ridge Creek (RC), their newly opened
wilderness program. He was in the second group of kids and his
placement there was a violation of HLAs own policies at that time.
Their marketing stated that RC was not a ``boot camp'', but rather an
outdoor leadership program. The facts didn't support that. The Director
and all the staff that had daily contact with the children were ex-
military. The Director did not possess the necessary credentials or
experience to run such a program and most of the staff did not possess
credentials or experience working with youth. I have documentation of
all staff at that time and their biographies.
In my research I discovered that residential and wilderness
programs were required to be licensed in Georgia, but neither HLA nor
RC were. Meredith Burns at HLA told me that wilderness programs were
not required to be licensed in Ga and refused to have my son removed
from RC and sent back to HLA. In June 2001 I contacted Jo Cato at the
Office of Regulatory Services (ORS). I sent her ample documentation to
aid her in identifying the services provided by both facilities,
including links to their online marketing and information from the
Parent Handbook. They conducted an investigation and reported that RC
was required to apply for licensure, but they determined that HLA was
exempt due to their classification as a private boarding school. This,
in spite of the significant documentation I had sent to refute it. I
requested to be sent a copy of the final report of their investigation
of HLA through the open records act. I never received it.
When HLA discovered that I had reported them to ORS, they executed
a successful plan to label me ``adversarial''. They falsely claimed
that I was harassing staff at home and on campus. Without demonstrating
any form of proof, it was decided that I would be forbidden from
calling the facility; all calls had to be placed through their
corporate attorney. Calls were slow to be returned, if at all. I rarely
received my scheduled phone calls with my son for the remainder of his
stay, which was almost a year. They successfully severed contact
between us. It was very difficult to get a pass for my son to attend my
father's wake. HLA offered 24 hours to travel over a thousand miles,
attend the wake, and be back on campus. Their attorney overrode them
and allowed 72 hours. This is documented in email.
As for the College Prep education HLA advertises, my son was an A/B
student before attending HLA. He left there, just short of two years,
five credits behind his peers at home. He had to attend summer school
in order to graduate with his class.
Prior to my former husband withdrawing our son from HLA two months
before graduation, he was slated to attend a traditional boarding
school in the NE. This was required by HLA policy as part of their
``warranty''. If a child did not attend one of their pre-approved
boarding schools following graduation, the warranty would be void. This
is common to the industry, and it's my belief that it's designed to
keep the child as far away from their parents as possible in order to
further the illusion that the ``program worked''.
Resigning myself to the fact that no one could aid me in getting my
son out of HLA, I began to report my experience on the internet in
hopes of contacting other parents who had similar experience with HLA
and other programs. Several years later, I did meet other parents who
were displeased with their experience. We formed a group and
collectively made demands to ORS to properly license HLA, to no avail.
I'm aware that you have received detailed testimony on this issue, so I
won't reiterate all the details of our experience. Except to say that
after several failed attempts, appealing all the way up to the
Governor, HLA was finally required to apply for licensure in 2006, six
years after my first request.
Aware that scores of children had died in wilderness programs, I
was very worried about my son while he was at RC. I asked ORS amongst
others, to act on my son's behalf and remove him from HLAs unlicensed
wilderness program. He remained the full 28 days. He had been out of RC
just a few weeks when I learned that our former neighbor, Ian August,
had died at Skyline Journey in Utah. Ian was one of the GAOs case
studies in the first hearing. I closely followed that case, which was a
gross miscarriage of justice. Familiar with Utah regulations, I noted
over 20 violations based on public comments made by the program owner
and staff, and law enforcement alone. The Licensing Rep who was sent to
investigate attended the same LDS ward as the owner of SJ, and no
violations were cited. When the DA filed charges, Stettler's comment
was, ``Crud, there's got to be something''. He sent a different rep
that cited 4 violations. As you may know, SJs license was eventually
revoked but they continue to operate under the name Distant Drums.
Regarding deceptive marketing practices in general, I can provide
documentation that many of the so-called independent studies published,
touting the effectiveness of the programs, were indeed conducted by
people who formerly had or still have direct connections to programs.
One such study was prepared by Ellen Behrens and staff at ``Evidence
Based Consulting''. She was formerly the director of Aspen's Youth Care
facility where Brandon Blum died recently due to medical neglect.
Partners Smoot and Fenstermacher have connections with Aspen and other
programs. Jan Moss of NATSAP then attempted to apply that study to the
entire industry when it only included 9 Aspen programs. To my knowledge
there hasn't been one genuinely independent, third-party study
conducted to date.
Over the years, I've noticed serious problems with State Licensing.
Woodside Trails Wilderness was closed due to deplorable conditions,
resulting from an investigation by the Comptroller. The state revoked
their license and removed all state placed children. Woodside changed
their name to Eagle Pines Academy and continued to do business as
usual, as a private boarding school which was exempt from regulation.
The state was aware of this. I sent a letter to Licensing imploring
them to act, telling them that this was a common strategy within the
industry. I didn't get a response. The owner of Woodside, Bebe Gaines,
was on the first Board of NATSAP at that time that this happened.
Star Ranch's license was revoked following two deaths (restraint
and negligence) and numerous violations of abuse and neglect. While
they aren't allowed to apply for a license to operate an RTC for five
years following a revocation, they are operating with a permit as a
non-residential summer camp called Charis Hills Camp. A non-profit,
religious-based program.
Aspen Education (now CRC/Bain Capital) owns several programs here
in Texas. Excel is one of them and is not licensed. Recently a child
was taken from the facility to the county jail for a wake up call. He
was turned over to inmates who forced him to disrobe and proceeded to
smear vasoline on his back side. He was taken by the Director of Excel
and an employee of Excel who also worked for the Sheriff's department.
To this day, Aspen's Academy at Swift River remains unlicensed.
They escorted the state off their property. Why doesn't licensing take
a stronger stand? They could enter the property with a court order and
demand that ASR apply for licensure. Why aren't they motivated to do
so?
As Ken Stettler--Director of Licensing in Utah--commented, the
state is ``reactive'', not ``proactive''. That is a fundamental flaw
where states are concerned given that they have the authority and are
sanctioned to inspect programs they suspect are operating without a
license. Due to public pressure, Utah has the most comprehensive
regulations of all the states, but are still lacking. The problem in
Utah and elsewhere, solid regulations will not protect children if
Licensing doesn't fulfill their obligation to enforce them. When Ken
Stettler stated publicly that he trusted his fellow moron saints to
correct the violations found at NorthStar (prior to Aaron Bacon's
death), he should've been removed from his post and replaced with
someone who had no direct personal connections to the industry. It has
always seemed a conflict of interest that Utah licensing has articles
written by one of their employees, Carol Sisco, which promote
wilderness therapy.
I particularly appreciate that this legislation provides for a
website for the purpose of disseminating information. I hope that
advocates such as my self will be allowed to submit public information
for consideration. ISAC--International Survivor's Action Committee has
a useful format that could be considered as a model At a minimum, I
feel it would be useful to provide links to the state licensing page,
and that states be required to post all investigations of abuse and
violations of regulations that were cited during monitoring visits.
Texas and Georgia do post most inspection reports, but Utah and other
states don't post any.
One common defense used by state licensing agencies is that there
is not ample financial resource to adequately monitor these programs.
Attention should be give to that. Programs should pay a significant
permit fee and should incur stiff fines for violations of regulations.
If their record shows repeated violations, they should be put on
probation and monitored more frequently and incur the necessary expense
of this extra monitoring. Just as reckless drivers pay a higher
insurance premium. The taxpayer should not bear the burden.
I'm very pleased about the National Hotline. Careful thought should
be given to how to ensure that children and staff have access to that
phone at all times. If a program is ever found to have denied access to
or retaliated for a call placed to the hotline, that should be grounds
for immediate revocation of their permit and significant fine.
Ironically, these programs desperately need the discipline and
consequences that they purport to provide to children.
NATSAPs creation was funded by the owner of HLA. They claim that
their programs are either licensed or accredited with agencies such as
JCAHO, giving parents a false sense of security. Last I checked, only
\1/3\ of their programs were licensed. Most parents do not understand
the difference between the terms ``licensed'' and ``accredited'' and
what aspect of the program are monitored by each. Fourteen deaths at
Vision Quest and still accredited by JCAHO. Four deaths at Catherine
Freer and still accredited. Ironically, Paul Smith of CF was appointed
to JCAHOs Behavioral Health Advisory Board and CF was selected as a
test site for the purpose of ``sharpening the focus on the
accreditation process, emphasizing safety and quality of patient
care''. Considered an ``Industry Leader'', there had been 3 deaths at
CF at that time, and a fourth shortly after.
Regarding Sen McKowen's comment regarding the lack of criminal
action in these deaths, there are several reasons I believe this to be.
First and foremost, there appears to be a general feeling that these
kids deserve what they get, by some citizens, judges, and prosecutors.
On Track Wilderness, displeased with the first Medical Examiner's
stated cause of death, hired a private Medical Examiner who coined the
term ``excited delirium'' which puts the blame for a child's death
during restraint squarely on the child. Appalling, but true. This was
the Chase Moody death. If one investigates thoroughly, they will find
the reasons there are no criminal charges filed. But, that is possibly
a different investigation.
I will close there. It is very difficult, as this is but the tip of
the iceberg. I have been researching and compiling information on the
industry and the people involved for seven years. I would love to put
that information to good use, and would be happy to answer any
questions or provide further information that might assist this
investigation.
Thank you again for your time.
Sincerely,
Deborah Thomas-Vigliano,
Plano, Texas.
______
[Questions submitted to the witnesses and their responses
follow:]
U.S. House of Representatives,
Washington, DC, May 9, 2008.
Christopher Bellonci, M.D.,
Medical Director and Senior Clinical Consultant, Walker School,
Needham, MA.
Dear Dr. Bellonci: Thank you for testifying at the April 24, 2008
full Committee hearing, ``Child Abuse and Deceptive Marketing by
Residential Programs for Teens.'' Below are the questions which
Committee members have asked you to respond for the record. Please send
an electronic version of your written response the Committee staff. If
you have any questions, please contact us.
Ranking Member Howard P. ``Buck'' McKeon (R-CA) has asked that you
respond to the following questions:
1. Does the Department of Health and Human Services (HHS) have the
capacity to carry out direct Federal regulation of the variety of
residential treatment centers discussed at the hearing?
2. If not, how long would it take HHS to develop the capacity?
3. How many staff would HHS have to hire to carry out inspections
of every program and location in the country? How many staff would HHS
have to hire to investigate all reports of child abuse and neglect
reported by the states and all complaints of child abuse or neglect
received by the proposed national hotline?
4. If States were able to do a good job of regulating these
programs, would direct Federal regulation be necessary?
Thank you for your time at the hearing and in responding to these
questions.
Sincerely,
George Miller,
Chairman.
______
Follow-Up Statement of Christopher Bellonci, M.D.
Dear Chairman Miller: The Ranking Member, Howard P. ``Buck'' McKeon
has asked me to respond to several additional questions since I
provided testimony before your committee on April 24th. The first three
questions address the capacity of HHS to the goals of your legislation
entitled ``Stop Child Abuse in Residential Programs for Teens Act of
2008''. In that regard I am not prepared to render an opinion as I have
no knowledge of the functions and capacities of the HHS.
Regarding the fourth question, addressing whether Federal oversight
would be needed if States were doing a better job of regulating these
programs, I have some thoughts. I think there is an appropriate role
for the Federal government to set clear definitional guidelines of what
qualifies as a Residential treatment center, a therapeutic boarding
school, a wilderness program or a bootcamp. These terms are often used
interchangeably and add to the confusion that exists for parents and in
the field of children's behavioral health. Once definitions were agreed
to, then States could more easily enforce regulation that may already
exist or develop or amend legislation and regulation if needed.
Unfortunately, experience has shown that States have either lacked the
ability or the will to regulate and license these programs on their
own, leaving untold thousands of children, youth and families
vulnerable to predatory marketing practices as was heard during your
hearings on this topic.
I hope that this additional testimony is helpful as the committee
continues its deliberations.
Sincerely,
Christopher Bellonci, M.D.
______
U.S. House of Representatives,
Washington, DC, May 2, 2008.
Ms. Kay Brown, Director,
Education, Workforce, and Income Security, the U.S. Government
Accountability Office, Washington, DC.
Dear Ms. Brown: Thank you for testifying at the April 24, 2008 full
Committee hearing, ``Child Abuse and Deceptive Marketing by Residential
Programs for Teens.'' Below are the questions which Committee members
have asked you to respond for the record. Please send an electronic
version of your written response the Committee staff. If you have any
questions, please contact us.
Ranking Member Howard P. ``Buck'' McKeon (R-CA) has asked that you
respond to the following questions:
1. Does the Department of Health and Human Services (HHS) have the
capacity to carry out direct Federal regulation of the variety of
residential treatment centers discussed at the hearing?
2. If not, how long would it take HHS to develop the capacity?
3. How many staff would HHS have to hire to carry out inspections
of every program and location in the country? How many staff would HHS
have to hire to investigate all reports of child abuse and neglect
reported by the states and all complaints of child abuse or neglect
received by the proposed national hotline?
4. If States were able to do a good job of regulating these
programs, would direct Federal regulation be necessary?
Representative Robert Scott (D-VA), has asked for your
recommendations on oversight for programs not covered under the
definition of H.R. 5876 that you thought should be covered.
Representative Todd Platts (R-PA) has asked for a description of
the ideal oversight/regulation that should be practiced by states; and
Representative Platts also asked that you submit the CRIPA report
referenced during your testimony for the record.
Thank you for your time at the hearing and in responding to these
questions.
Sincerely,
George Miller,
Chairman.
______
Follow-Up Statement of Kay E. Brown
Dear Chairman Miller: Mr. Chairman: This correspondence addresses
questions submitted by committee Members to the GAO on May 2, 2008
following our testimony at the above-referenced hearing.
Questions Submitted by Ranking Member Howard P. ``Buck'' McKeon
1. Does the Department of Health and Human Services (HHS) have the
capacity to carry out direct federal regulation of the variety of
residential treatment centers discussed at the hearing?
2. If not, how long would it take HHS to develop the capacity?
3. How many staff would HHS have to hire to carry out inspections
of every programs and location in the country? How many staff would HHS
have to hire to investigate all reports of child abuse and neglect
reported by the states and all complaints of child abuse or neglect
received by the proposed national hotline?
4. If states were able to do a good job of regulating these
programs, would direct federal regulation be necessary?
GAO Response: We do not have the information necessary to respond
to questions regarding the capacity of HHS and the staff needed to
directly regulate residential facilities. This information is beyond
the scope of our study.
Regarding the question of whether direct federal regulation would
be needed if states were able to do a good job of regulating
residential facilities: We found that states' regulation and oversight
and the existing patchwork of federal legislation and oversight have
failed to provide needed protections to youth in some facilities.
However, in our forthcoming report to be issued in mid-May, 2008 (see
Residential Facilities: Improved Data and Enhanced Oversight Would Help
Safeguard the Well-Being of Youth with Behavioral and Emotional
Challenges, GAO-08-346), we identify actions that states, federal
agencies, and the Congress could take, either together or
independently, to address these issues, and we offer policy options for
each to consider. Options for states focus on ways to expand and
improve oversight for residential facilities. States could expand
licensing coverage to establish minimum standards for youth in all
facilities. In some cases, this would require changes in state law or
regulation. Other options include requiring accreditation for all
residential facilities that serve youth, either in addition to or in
lieu of licensing, or creating common contract provisions for all
facilities. States would need to devote the necessary resources to
support regular and effective monitoring to ensure that their new
efforts were achieving the goals.
Question Submitted by Representative Robert Scott
What are GAO's recommendations for oversight of programs not
covered under the definition of H.R. 5876 that GAO thinks should be
covered?
GAO Response: Our report showed that youth well-being was at
greater risk in all types of government operated and private facilities
that did not benefit from the full spectrum of oversight activities,
such as licensing, standards of care that address common risks to youth
well-being, and monitoring. We identified gaps in licensing for both
government-operated and private facilities--such as juvenile justice
facilities and residential schools and academies. As currently written,
H.R. 5876 covers a wide range of types of residential facilities,
including private facilities. It is important to cover all types of
private facilities to prevent facility operators from self-identifying
their program as a type that is not covered by state licensing or, in
this case, by federal oversight.
However, the bill does not cover programs that are operated by a
governmental entity. Based on our work, we have found that some
government operated facilities, such as juvenile justice facilities,
are often exempt from state licensing requirements altogether. Annual
reports prepared by the Department of Justice Civil Rights Division
document patterns of severe youth maltreatment and civil rights
violations in these government-operated facilities. Therefore, our
report results would support a comprehensive system of licensing for
all residential facilities with the common goal of serving youth with
behavioral and emotional challenges, regardless of type of facility or
whether such facilities were owned or operated by government or private
entities.
Question Submitted by Representative Todd Platts
What is a description of the ideal oversight/regulation that should
be practiced by states?
Please submit a copy of the CRIPA report referenced during the GAO
testimony.
GAO Response: Our forthcoming report describes a set of fundamental
elements that are needed for an effective oversight system. These
include:
minimum standards of care that address the primary risks
to all aspects of youth well-being;
comprehensive state licensing that covers the spectrum of
facilities with the common goal of serving youth with behavioral and
emotional challenges, regardless of ownership, operation, and type;
regular, timely, and rigorous monitoring that includes
announced and unannounced on-site visits to ensure facility compliance
with standards;
a full range of enforcement options to give oversight
bodies the flexibility to quickly address identified problems depending
on their severity;
data collection and reporting systems that can act as a
feedback loop to assess adequacy of oversight efforts, identify areas
of weakness or risk, and inform changes in oversight policy; and
disclosure of data and reports to government agencies and
the public to allow them to make informed choices about use of
facilities.
It should be noted that these elements together form the foundation
for a minimum system of oversight to help ensure the safety of youth in
residential facilities. For example, the basic standards we cover in
our in our report include requirements that facilities pass inspection
of the physical plant and have procedures in place for use of approved
seclusion and restraint techniques, among others. However, these basic
standards do not address the quality of the services provided or ensure
a facility's success in helping youth address their behavioral or
emotional challenges.
The past three CRIPA reports used in the GAO testimony for fiscal
years 2004, 2005, and 2006, are included as attachments to this
correspondence. In addition, these reports and other information on
investigations done under the auspices of the Civil Rights for
Institutionalized Persons Act can be found on the following Web site
http://www.usdoj.gov/crt/split/findsettle.htm#congrep.
We appreciate the opportunity to provide this information to you
and the committee on the issues of safeguarding youth well-being in
residential facilities. We would be happy to provide any additional
information upon your request.
Sincerely,
Kay E. Brown, Director,
Education, Workforce, and Income Security, U.S. Government
Accountability Office.
______
U.S. House of Representatives,
Washington, DC, May 9, 2008.
Mr. Gregory D. Kutz, Managing Director,
Forensic Audits and Special Investigations, the U.S. Government
Accountability Office, Washington, DC.
Dear Mr. Kutz: Thank you for testifying at the April 24, 2008 full
Committee hearing, ``Child Abuse and Deceptive Marketing by Residential
Programs for Teens.'' Below are the questions which Committee members
have asked you to respond for the record. Please send an electronic
version of your written response (in Word format) to Sarah Dyson of the
Committee staff at [email protected]. If you have any
questions, please contact Ms. Dyson at (202) 226-9403.
Ranking Member Howard P. ``Buck'' McKeon (R-CA) has asked that you
respond to the following questions:
1. Does the Department of Health and Human Services (HHS) have the
capacity to carry out direct Federal regulation of the variety of
residential treatment centers discussed at the hearing?
2. If not, how long would it take HHS to develop the capacity?
3. How many staff would HHS have to hire to carry out inspections
of every program and location in the country? How many staff would HHS
have to hire to investigate all reports of child abuse and neglect
reported by the states and all complaints of child abuse or neglect
received by the proposed national hotline?
4. If States were able to do a good job of regulating these
programs, would direct Federal regulation be necessary?
Thank you for your time at the hearing and in responding to these
questions.
Sincerely,
George Miller,
Chairman.
______
Follow-Up Statement of Gregory Kutz
Dear Chairman Miller: This correspondence addresses questions
submitted by Ranking Member Howard P. ``Buck'' McKeon to Gregory Kutz,
Managing Director, Forensic Audits and Special Investigations (FSI), on
May 9, 2008, following our testimony at the above-referenced hearing.
Questions Submitted
1. Does the Department of Health and Human Services (HHS) have the
capacity to carry out direct Federal regulation of the variety of
residential treatment centers discussed at the hearing?
2. If not, how long would it take HHS to develop the capacity?
3. How many staff would HHS have to hire to carry out inspections
of every program and location in the country? How many staff would HHS
have to hire to investigate all reports of child abuse and neglect
reported by the states and all complaints of child abuse or neglect
received by the proposed national hotline?
4. If States were able to do a good job of regulating these
programs, would direct Federal regulation be necessary?
In addition to these questions, you asked FSI to create a chart
that reflects the state and local response and outcome of any
investigation or action taken by the state for the cases of death and
abuse FSI examined.
GAO Response
In a letter dated May 8, 2008, GAO's Education, Workforce, and
Income Security (EWIS) Director, Kay Brown, who also testified at the
Committee's April 24, 2008 hearing, submitted GAO's response to these
four questions. Similar to the EWIS response, FSI does not have any
information to respond to questions regarding the capacity of HHS and
the staff needed to directly regulate residential facilities or
investigate complaints of child abuse received by a national hotline.
This information is beyond the scope of FSI's work.
Regarding the question of whether federal regulation would be
necessary if states were able to ``do a good job'' of regulating
residential facilities:
As previously cited by EWIS in their response submitted May 8,
2008, GAO found that states' regulation and oversight and the existing
patchwork of federal legislation and oversight have failed to provide
needed protections to youth in some facilities. FSI found that, in some
cases, even after action was taken against a program or staff member in
one jurisdiction, that program or staff member was able to move beyond
the jurisdiction of the admonishing court or agency and continue
working in the industry in another jurisdiction, potentially placing
additional children at risk of abuse or neglect.
GAO identified gaps in licensing for both government-operated and
private facilities. A comprehensive system of licensing for all
residential facilities is important to prevent facility operators from
self-identifying their program as a type that is not covered by state
licensing. FSI found that in some cases, even though a facility held
one type of state license to operate, it did not have the required
state license to provide the types of services it offered to the
children under their care. States allowed some facilities to operate or
obtain licensing even though they employed direct care staff not
qualified or trained to effectively deal with the risks and problems
children under their care were likely to experience, which sometimes
resulted in the abuse, neglect, and death of those children. We
reiterate that common definitions, minimum standards of care that
address the primary risks to all aspects of youth well-being, and
comprehensive licensing requirements that cover the spectrum of
facilities with the common goal of serving youth with behavioral and
emotional challenges are needed to safeguard children placed in these
facilities (regardless of whether such facilities are owned or operated
by government or private entities).
The lack of minimum standards of care and definitions common to all
facilities located in all states hinders consumers' ability to identify
the types of services a particular facility is required or even likely
to provide. Parents and guardians do not have access to information
that would help verify the qualifications or past history of the
program or its staff. And in the cases we examined, the majority of the
children were placed in programs located far from their state of
residence, presenting additional obstacles for those parents and
guardians to gain access to information.
Local or state law enforcement and state child protective service
agencies may lack the ability to investigate complaints filed against
facilities. They have cited obstacles such as being required to rely on
the cooperation of facility operators for access to staff and potential
victims; failure of facilities to report incidents or complaints of
alleged abuse received or identified by the facility; or that they
otherwise lack the authority they feel is needed to adequately
investigate complaints of abuse.
In addition to the questions addressed above, you asked FSI to
create a chart that reflects the state and local response and outcome
of any investigation or action taken by the state for the cases of
death and abuse FSI examined. This chart accompanies this letter as
Enclosure I.
We appreciate the opportunity to provide this information to you.
If you have any questions, please contact me at (202) 512-9505 or Andy
O'Connell at (202) 512-7449.
Sincerely,
Gregory Kutz, Managing Director,
Forensic Audits and Special Investigations.
Enclosure--1.
______
------
U.S. House of Representatives,
Washington, DC, May 9, 2008.
Jon Martin-Crawford,
57 Hoose Blvd, Fishkill, NY.
Dear Mr. Martin: Thank you for testifying at the April 24, 2008
full Committee hearing, ``Child Abuse and Deceptive Marketing by
Residential Programs for Teens.'' Below are the questions which
Committee members have asked you to respond for the record. Please send
an electronic version of your written response the Committee staff. If
you have any questions, please contact us.
Ranking Member Howard P. ``Buck'' McKeon (R-CA) has asked that you
respond to the following questions:
1. Does the Department of Health and Human Services (HHS) have the
capacity to carry out direct Federal regulation of the variety of
residential treatment centers discussed at the hearing?
2. If not, how long would it take HHS to develop the capacity?
3. How many staff would HHS have to hire to carry out inspections
of every program and location in the country? How many staff would HHS
have to hire to investigate all reports of child abuse and neglect
reported by the states and all complaints of child abuse or neglect
received by the proposed national hotline?
4. If States were able to do a good job of regulating these
programs, would direct Federal regulation be necessary?
Thank you for your time at the hearing and in responding to these
questions.
Sincerely,
George Miller,
Chairman.
______
Follow-Up Statement of Jon Martin-Crawford
Dear Chairman Miller: I apologize for the time it has taken to
respond to the questions asked, as I have been somewhat busy with my
educational requirements. Unfortunately, I can not answer the majority
of the questions as asked, because I am in no position to do given my
lack of understanding of the scope and necessity such a program would
entail. However, I do feel as if I can honestly, and quite helpfully,
offer my insights on the final question.
When asked if this is a problem that the states can handle without
federal intervention, the answer is clearly not as easy as we would
like. While ideally, this is a situation that all states should be able
to manage, it is clear that it is not something that has been done thus
far, while numerous states have been contacted about the abuses that go
on. Additionally, as was pointed out in the first hearing on October
10th, 2007, part of the problem with this industry is the ability for
programs to pick up and move from one state to the next, thus avoiding
reporting and penalty.
The ideal would be for all states to establish their own
regulations that are up to the same standards, or in excess of the
standards, of what has already been included in H.R. 5876. However,
until such time as the states act upon this call, it is evident that
the catalyst for such regulation must come from the federal government.
Just as was in the case with the paramount case of Brown v Board of
Ed., and other cases of integration during that important time in U.S.
History, it is clear that the federal government has an obligation in
this case to ensure proper and safe treatment for its most important
citizens * * * the children. As a nation, we are focused on bringing
evil to justice and being the leaders of a free, democratic world. We
have a responsibility to do so. Part of this responsibility starts
right here in our own home.
Many programs, already have called this legislation something that
is going to give ``drug dealers and predators'' easy access to
students. They have called for state, rather than any federal
legislation. They have repeated this empty claim for years. Jan Moss of
NATSAP sat and made the same statement, later creating a link for an
``ethical complaint process'' which has ever since been ``under
construction.'' While the need for programs to help the truly troubled
is undeniable, we must have a safety net in place to avoid the problems
that have gone on for far too long.
The proposed federal legislation is the tip of the iceberg when it
comes to what is necessary for states to adopt. While it seems to be
far reaching, the reality is that it is as loose as possible given the
scope of the problem. As such, I see no possible way for the states to
regulate such programs on their own until a federal mandate of
regulations is in place. Once each state meets such standards and is
able to self regulate in a safe and open way, perhaps the federal
legislation would be able to back off. Regardless, the suggestion of a
national reporting and statistics website is something that is useful
for the long haul, and should be implemented as quickly as possible.
Since the hearing, it is frightening how many parents have already
contacted myself and Mrs. Whitehead about such programs and their fears
of not knowing whether or not a program is safe. Without accurate
reporting parents are in the dark and childrens' lives are in the
balance. Please ensure that this bill moves quickly and efficiently
through the necessary channels. It is of the most crucial importance
for our future generations.
Sincerely,
Jon Martin-Crawford.
______
U.S. House of Representatives,
Washington, DC, May 9, 2008.
Ms. Kathryn Whitehead,
277 Starr St., Brooklyn NY.
Dear Ms. Whitehead: Thank you for testifying at the April 24, 2008
full Committee hearing, ``Child Abuse and Deceptive Marketing by
Residential Programs for Teens.'' Below are the questions which
Committee members have asked you to respond for the record. Please send
an electronic version of your written response the Committee staff. If
you have any questions, please contact us.
Ranking Member Howard P. ``Buck'' McKeon (R-CA) has asked that you
respond to the following questions:
1. Does the Department of Health and Human Services (HHS) have the
capacity to carry out direct Federal regulation of the variety of
residential treatment centers discussed at the hearing?
2. If not, how long would it take HHS to develop the capacity?
3. How many staff would HHS have to hire to carry out inspections
of every program and location in the country? How many staff would HHS
have to hire to investigate all reports of child abuse and neglect
reported by the states and all complaints of child abuse or neglect
received by the proposed national hotline?
4. If States were able to do a good job of regulating these
programs, would direct Federal regulation be necessary?
Thank you for your time at the hearing and in responding to these
questions.
______
Follow-Up Statement of Kathryn Whitehead
Dear Chairman Miller: In response to Ranking Member McKeon's
request for a response for the record, I regret I am unqualified to
comment on the first 3 questions. I would like to submit a response for
the record on question 4.
If States were able to do a job of regulating these programs, would
direct Federal legislation be necessary?
I do believe that federal regulation would play an important role
in assuring youth safety and program accountability even in the event
that effective regulation and monitoring policies were in place at the
state level. I will touch upon the 3 concerns I have surrounding the
loopholes that would remain present.
1. The history of the industry's fluidity, by which program
operators easily relocate from one state to another, suggests a need
for some type of monitoring at the federal level. Without federal
regulation, a facility may easily be shut down in one state and open in
a different state, under a different name. At the very least, the
federal government should maintain a mechanism for tracking programs
that have been closed for cause to ensure that they do not re-open in
another state. Furthermore, in the event that one state has less
stringent standards of oversight in scope and reach, parents may easily
be deceived into thinking the same protections exist in the state in
which they reside.
2. States do not maintain the same level of regulatory standards
and thus there is variability across state lines. This problem can be
addressed by setting a national level of requirements that becomes the
basis for state regulation. Youth are often sent to a state they are
not resident of. A white paper issued by the Department of Public
Health and Human Services in the state of Montana titled, ``Unregulated
Youth Residential Care Programs in Montana,'' it was estimated that
ninety to 95 % of youth placed in ``therapeutic residential schools or
programs'' are from out of state. In the best interest of youth, such
interstate commerce of minors should receive federal oversight.
3. The historical failure of the ability of families to hold
facilities accountable suggests a need for federal legislation such as
H.R. 5876, which contains the ``Private Right of Action'' clause and
will help circumvent the obstacles which have arisen when families
attempt to hold programs accountable in court for their failure to meet
the standards advertised or maltreatment of their child. By allowing
for jurisdictional expansion and for courts to award punitive damage
and costs, such as attorney fees, families will not be limited to seek
justice in a state or county with a vested interest in the promoting
the particular program accused or industry and help make cases more
attractive to attorneys.
Sincerely,
Kathryn Whitehead.
______
[Whereupon, at 12:25 p.m., the committee was adjourned.]