Senator Ron Wyden (D-Oregon), chairman of the committee, said: They accuse the facility operators of “profiteering from rampant abuse” and saying “this abuse is being paid for with American tax money.”
The commission’s investigation found that residents in treatment facilities “are subject to harms including risk of physical, sexual and emotional abuse by staff and peers, inappropriate and excessive restraint and seclusion, inadequate treatment and supervision, and a non-homely environment.”
While the documented cases are horrifying, industry representatives deny the widespread allegations.
One particularly egregious example cited in the report was the death of 16-year-old Cornelius Frederick, who was killed by staff members at Lakeside Academy in Kalamazoo, Michigan, in 2020. As seen on video, Frederick hurled a sandwich at other young people in the cafeteria before being thrown to the floor by staff members and several others mobbed him. Two staff members have pleaded not guilty to manslaughter; the other has pleaded not guilty to third-degree child abuse.
More than 100 former residents of the facility and their families attended the hearing and a press conference that preceded it, and others provided written statements to the committee about their terrifying personal experiences.
According to a statement from Sasha Oates, she was committed to a facility in Utah at the age of 14 for mental health and self-harm issues.
“I was sexually assaulted by staff, violently restrained resulting in multiple injuries, isolated in a concrete room with no clothes, glasses or a toilet, and permanently scarred my lungs with a mixture of cleaning gases before being rushed to the hospital,” she recalled. “They called out the number 316 instead of my name. I was dehumanized, forced to stand and sit in stressful positions, force-fed through a tube, one of the worst experiences of my life. I was overmedicated, including chemical restraints, and forced into corrective therapy. This treatment had a significant negative impact on me, including nightmares, chronic asthma due to scarred lungs, severe PTSD, and a loss of sense of self.”
Christina “Chrissy” Clark-Atkins said she was placed in a facility where she was unable to receive “real mental health care” despite experiencing severe emotional and mental stress. After staff called her a liar and refused to follow instructions, “I was suddenly pulled off my bed (16cm tall, weighing 95lbs) and placed face down by three adults as more poured through the door,” Clark-Atkins wrote. “Finally five or six adults had me completely pinned down and pressed their entire body weight against me. Suddenly, I was stabbed with a needle and given an injection in my lower back that I later found to be possibly the sedative Thorazine.”
While the Comptroller’s Office and Finance Committee staff could not disclose how much tax money goes to the facilities, the committee estimates the cost is in the billions of dollars, and Wyden said some RTFs receive more than $1,200 per child per day from Medicaid.
“We’re talking about a child welfare budget,” Wyden said in an interview, complaining that there are “significant gaps and deficiencies in federal oversight.”
He is looking forward to the bill, which he has not yet introduced., It calls for improved health and safety standards, oversight and enforcement, and increased resources for community-based services.
Wyden named several companies in his opening remarks, specifically pointing out Mark Miller, president and CEO of Universal Health Services (UHS), who declined to be called to testify by the committee. In an email to The Washington Post, UHS, which operates facilities across the country, said the committee’s report “is incomplete, misleading, and provides an inaccurate portrayal of the care and treatment provided” and “extrapolates specific incidents and investigative reports into a false narrative. … We strongly dispute this portrayal of our facilities.”
In a letter to Wyden declining the invitation, lawyers for UHS said the company had submitted 12,000 pages of documents in response to the committee’s request. The letter added that UHS was concerned the committee was creating an “incomplete picture” and that a public hearing “would not provide an opportunity to fully address the complexities of the situation.”
However, the report concludes that “it is overwhelmingly clear that the operating model of these facilities is to house as many children as possible while keeping costs down in order to maximise profits. This means they are deliberately understaffed, with no experience or qualifications to provide the care these children need. … Conditions in these facilities are also often unsanitary and unsafe, feeling more like a prison than a safe place to help children get through a difficult time. In these conditions, children are not receiving the care they need, including quality individualised therapy.”
Sean Coughlin, president and CEO of the National Behavioral Healthcare Association, the facilities’ trade group, supported member companies, saying, “The comprehensive information, statistics and insights they provided are simply not reflected in the commission’s one-sided report. The report describes all residential treatment facilities (RTFs) as the same and fails to acknowledge that our member RTFs provide clinical treatment programs and educational services that have helped thousands of children in need of behavioral health services, often saving their lives.”
Wyden is not arguing that all operators are equally guilty.
“This is a multi-billion dollar industry that receives billions of taxpayer dollars in Medicaid and child welfare funding,” Wyden said. “These children deserve quality care, but in too many cases, not in every facility, children are being abused instead of quality care.”
