Saturday, December 14, 2024

Perspective | Tax-funded youth treatment centers are ‘warehouses of neglect,’ report finds

Perspective | Tax-funded youth treatment centers are ‘warehouses of neglect,’ report finds


“Your tax dollars at work” was never meant to include child abuse.

But that’s the odious image presented in a new Senate report, whose title describes numerous youth residential treatment facilities (RTF) that receive federal funding as “warehouses of neglect.”

Bipartisan oversight legislation is now planned, following a Senate Finance Committee hearing last month on the two-year congressional investigation into facilities caring for children with a range of issues — emotional, mental, behavioral and occasionally criminal. Instead of getting the care they need, according to the report, in too many cases the children are injured, psychologically and physically — at times fatally — while the government pays the bill.

Committee Chairman Sen. Ron Wyden (D-Ore.) accused a number of facility operators of “profiting off rampant abuse” while “American tax dollars are funding this abuse.”

The committee’s investigation found treatment facility residents “suffer harms such as the risk of physical, sexual, and emotional abuse at the hands of staff and peers, improperly executed and overused restraint and seclusion, inadequate treatment and supervision, and non-homelike environments.”

Industry representatives reject the broad allegations, although documented cases are chilling.

A particularly egregious example in the report was the 2020 death of 16-year-old Cornelius Frederick, who, as a video shows, was killed by staffers at Lakeside Academy in Kalamazoo, Mich. After he threw a sandwich at other youth in the cafeteria, he was knocked to the floor by a staffer and multiple employees piled on. Two staffers pleaded no contest to involuntary manslaughter. Another pleaded no contest to third-degree child abuse.

More than 100 former residents of the facilities, and their family members, attended the hearing and a preceding news conference, while others submitted statements to the committee with their personal horror stories.

Sasha Oates’s statement said she was placed in a Utah facility when she was 14 because of mental health and self-harm issues.

“I was sexually assaulted by a staff member, restrained in a violent manner that led to multiple injuries, isolated in a concrete room without clothing or my eyeglasses or even a bathroom, gassed by mixed cleaning chemicals that caused permanent scarring in my lungs to the point I was taken to the hospital,” she recalled. “I was called a number, 316, instead of my name. I was dehumanized and forced to stand or sit in stress positions. I was forcibly tube-fed, one of the worst experiences of my life multiple times. I was overmedicated, including chemical restraint, and forced through conversion therapy. This treatment had a profound negative impact on me, including nightmares, chronic asthma from the scars in my lungs, severe PTSD, and a loss of self.”

Christina “Chrissy” Clark-Atkins said she was assigned to a facility where she received “no real mental health care” for severe emotional and psychological stress. After being called a liar by staff, then refusing their instructions, “I, at 16 and 95 pounds, was suddenly yanked off my bed and thrown face down and laid on by 3 adults. Then more came piling through the door,” Clark-Atkins wrote. “I had about 5-6 adults by the end fully holding me down and pressing their collective weight on me. Then, I was suddenly stuck with a needle and injected with something into my hip, which I later found out was likely Thorazine, to sedate me.”

Government Accountability Office and finance panel staffers could not provide the amount of taxpayer money going to the facilities, but the committee estimated the tab is in the billions, and Wyden said some RTFs receive more than $1,200 per day per child from Medicaid.

“We’re talking about child welfare dollars,” Wyden said during an interview, as he complained that “federal oversight has significant gaps and deficiencies.”

He expects his legislation, which he has not yet introduced, to seek improved health and safety standards, oversight, enforcement and more resources for community-based services.

When Wyden cited several companies in his opening remarks, he singled out Marc Miller, president and CEO of Universal Health Services (UHS), for refusing the committee’s invitation to testify. In an email to The Post, UHS — which operates facilities around the nation — said the committee’s report “is incomplete and misleading and provides an inaccurate depiction of the care and treatment provided” by extrapolating “certain incidents and survey reports into a false narrative. … We vehemently dispute this characterization of our facilities.”

In a letter to Wyden declining the invitation, a UHS lawyer said the company provided 12,000 pages of documents responding to committee requests. UHS was concerned, the letter added, the panel was creating “an incomplete picture” and that the hearing “will not provide the opportunity to fully respond to complex situations.”

But the report found that it is “overwhelmingly … clear that the operating model for these facilities is to warehouse as many kids as possible while keeping costs low to maximize profits. This means intentional understaffing with people who have zero experience or qualifications to provide the care these children need. … It also means facility conditions are often unsanitary and dangerous, and feel more like a prison than a safe place to help a child get through a difficult time. In these conditions, children can’t get the care they need, like high-quality and individualized treatment.”

Shawn Coughlin, president and CEO of the National Association for Behavioral Healthcare, a trade group for the facilities, supported his member companies, saying “the comprehensive information, statistics, and insights they provided were not reflected at all in the Committee’s one-sided report. The report describes all residential treatment facilities (RTFs) as the same, and it fails to acknowledge that our members’ RTFs offer clinical treatment programs and educational services that have helped thousands of kids who need behavioral health care services — and, in many cases, saved lives.”

Wyden does not claim all operators are equally guilty.

“The industry is a multibillion-dollar sector … and they get billions of taxpayer dollars in Medicaid, child welfare,” Wyden said. “These kids ought to get good quality care. And yet in too many instances … not in every facility, but in too many instances, they’re getting abuse rather than good quality care.”



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