Children Suffer ‘Routine’ Abuse at Residential Treatment Centers, Senate Finds

The U.S. Capitol building in Washington on June 12, 2024. Madalina Vasiliu/The Epoch Times

Children receiving behavioral health care at residential treatment facilities operated by four major providers are subjected to “routine” physical, sexual, and emotional abuse, a Senate committee reported on June 12.

“There are endless examples of sexual, physical, and verbal abuse, improper restraint and seclusion of young children, unsafe and unsanitary conditions, and even a total lack of provision of behavioral health care,” said Sen. Ron Wyden (D-Ore.), chairman of the Senate Finance Committee investigating the allegations of abuse.

“Unfortunately, it seems more often than not, abuse and neglect is the norm at these facilities. And they are set up in a way that makes it happen.”

In 2022, after repeated accusations of abuse and neglect, the committee opened an investigation into youth treatment centers run by Universal Health Services, Acadia Healthcare, Devereux Advanced Behavioral Health, and Vivant Behavioral Healthcare.

At a committee hearing, Mr. Wyden described the panel’s findings as “shocking.”

Over the course of the investigation, committee members reviewed 25,000 pages of company documents, interviewed dozens of experts, and toured the facilities in person. In a 136-page report, the committee concluded that the operating model of such businesses incentivizes the prioritization of revenues and profit margins over patients’ well-being.

“Overwhelmingly, it’s clear that the operating model for these facilities is to warehouse as many kids as possible while keeping costs low in order to maximize profit,” Mr. Wyden said. “That means intentional understaffing with persons who have zero experience or qualifications to provide the care these children need.”

Reported Abuse

Children may be placed in residential treatment centers for a variety of reasons, from behavioral health concerns to a lack of local resources or a propensity for criminal behavior. But according to the report, many of those children fall prey to “rampant civil rights violations,” including the overuse of medication for sedation or as a “chemical restraint.”

Federal law prohibits the simultaneous use of chemical restraint and seclusion. Yet in 2018, at an Acadia facility in Arkansas, staff were found to have been “regularly pairing” the two interventions on patients.

Other cases outlined in the report detail the misuse of physical restraint. For instance, at a United Health Services facility in Georgia, a 19-year-old with autism died after staff reportedly “sat on the teen’s midsection and back and he ‘choked on his own vomit’ face down.”

The report is also rife with accounts of sexual abuse. In one instance, a female staff member at a Universal Health Services facility in Oklahoma admitted to having a sexual relationship with a patient. She also reportedly shared with a co-worker plans of having “a more intimate relationship” with the girl once she turned 18 and left the facility. After the allegations surfaced, the woman was assigned to another unit, although she continued to stand outside the patient’s window every night. She was later terminated.

Federal Funding

To provide care for minors, residential treatment facilities rely on Medicaid and other government funding. That means taxpayers are bankrolling the abuse, senators noted.

“Hardworking taxpayers should not be funding anything less than superior care,” Sen. Mike Crapo (R-Idaho), the committee’s top Republican, said. “Our child welfare and behavioral health systems have made a lot of progress in improving the quality of congregate care settings, but clearly, gaps remain.”

Mr. Crapo pointed to “bureaucratic challenges” as a roadblock to states’ implementation of the Qualified Residential Treatment Programs (QRTPs) that Congress established under the Family First Prevention Services Act as a behavioral health option for children in the welfare system.

QRTPs include a trauma-informed treatment model meant to help children with emotional or behavioral disorders.

“One of the goals of Family First was to reduce inappropriate placements for children in congregate care settings,” Mr. Crapo noted. “To meet that objective, we must ensure that residential treatment interventions are a placement of last resort, with a focus on integrating patients back into the community as soon as is clinically possible.”

The senator added that facilities caring for vulnerable children should be subject to “routine and reliable” oversight.

Drawing on the bipartisan concern for the issue, Mr. Wyden said he wanted to work with Republicans to “shut off the firehose of federal funding” for residential treatment facilities such as those the committee investigated “to put an end to this cycle of abuse.”

“In order to get a dime from Medicaid or any other program in our jurisdiction, all these facilities are going to have to start providing actual care,” he said.

Providers Push Back

In a statement emailed to The Epoch Times, Universal Health Services said the committee’s report was “incomplete and misleading” and did not accurately depict the company’s treatment of its patients or their safety.

“The report attempts to extrapolate certain incidents and survey reports into a false narrative regarding the treatment provided, environment of care and regulatory compliance at our facilities. We vehemently dispute this characterization of our facilities,” the statement reads.

The company acknowledged past incidents in which patients suffered harm at its facilities but said those incidents were not representative of its policies.

“Incidents of staff failing to follow our training, policies, procedures, and protocols are an extreme exception and not the norm,” the company said.

Mark Miller, CEO of Universal Health Services, declined an invitation to testify before the committee.

Meanwhile, Leah Yaw, a senior vice president at Devereux, said it was “categorically untrue” that children at Devereux facilities are subjected to abusive or unsanitary conditions. She said that as a nonprofit, the organization “does not operate with for-profit motivation.” She also said that Devereux’s use of medication is “extraordinarily careful” and in line with best practices.

Acadia and Vivant did not respond to requests for comment by publication time.