[Congressional Record Volume 154, Number 105 (Tuesday, June 24, 2008)]
[House]
[Pages H5949-H5953]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STOP CHILD ABUSE IN RESIDENTIAL PROGRAMS FOR TEENS ACT OF 2008
The SPEAKER pro tempore. Pursuant to House Resolution 1276 and rule
XVIII, the Chair declares the House in the Committee of the Whole House
on the state of the Union for the consideration of the bill, H.R. 5876.
{time} 1557
In the Committee of the Whole
Accordingly, the House resolved itself into the Committee of the
Whole House on the state of the Union for the consideration of the bill
(H.R. 5876) to require certain standards and enforcement provisions to
prevent child abuse and neglect in residential programs, and for other
purposes, with Ms. McCollum of Minnesota in the chair.
The Clerk read the title of the bill.
The CHAIRMAN. Pursuant to the rule, the bill is considered read the
first time.
The gentleman from California (Mr. George Miller) and the gentleman
from California (Mr. McKeon) each will control 30 minutes.
The Chair recognizes the gentleman from California (Mr. George
Miller).
[[Page H5950]]
Mr. GEORGE MILLER of California. Madam Chairman, I yield myself such
time as I may consume.
I rise today in strong support of H.R. 5876, the Stop Child Abuse in
Residential Programs For Teens Act of 2008. Last year, a 17-year-old
boy in a Maryland residential program for teens became unresponsive
after he was physically restrained by staff members. According to the
press reports, prosecutors alleged that the staff members waited 41
minutes to call 911 because they thought the boy was faking. The boy
died. A 15-year-old boy in a wilderness camp in Colorado died in May
2007 from a staph infection. According to the press reports, State
authorities said the boy showed observable signs of infection that were
neglected by the camp staff members.
Tragically, these recent deaths are not isolated cases. The
Government Accountability Office has thousands of cases and allegations
of child abuse and neglect stretching back decades in teen residential
programs, including boot camps, wilderness camps and therapeutic
boarding schools.
The Education and Labor Committee has closely examined a number of
these neglect and abuse cases, including cases that resulted in the
death of a child. We have heard stories about program staff members
forcing children to remain in so-called stress positions for hours at a
time, to stand with bags over their heads and nooses around their necks
in mock hangings, to eat foods to which they were allergic, even as
they got sick, or to eat their own vomit. We have heard from parents of
children who died preventible deaths at the hands of untrained,
uncaring staff members.
{time} 1600
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
though his weight loss became frighteningly apparent. When Bob and his
wife Sally went to the mortuary to see their son, they found scars of
abuse and dried skin stretched taut over Aaron's bones.
Cynthia Harvey told the Education and Labor 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 psychiatric
care that could have saved his life.
In addition to wrenching stories like these parents told, the
Education and Labor Committee has also heard from adults who attended
these programs as teens. They too were victims of physical and
emotional abuse and witnessed other children being abused.
Madam Chairman, these abuses have been allowed to continue unchecked
because of the weak patchwork of State and Federal regulations
governing teen residential programs.
An exhaustive 18-month study by the Government Accountability Office
showed that State licensing programs may exclude certain types of teen
residential programs, and thus place children at higher risk of abuse
and neglect. In some States, inconsistent licensing enables programs to
define themselves out of the licensing altogether. According to the
GAO, in Texas a program that calls itself a residential treatment
center would be required to obtain a license; but if that same program
were simply called a boarding school, it would not require a license.
Even when licensing exists, GAO found that there may not be minimum
standards to effectively prevent child abuse and neglect.
Parents often send their children to these programs when they feel
they have exhausted all their alternatives. Their children may be
abusing drugs or alcohol, attempting to run away--or physically harm
themselves--or otherwise acting out. Parents turn to these programs
because of the promise that staff members will help their children
straighten their lives out. And surely there are many cases in which
programs do provide families with the help they need. In far too many
cases, however, the very people entrusted with the safety, health, and
welfare of these children are the ones who violate the trust in some of
the most awful ways imaginable.
We have learned a great deal from the Government Accountability
Office about programs' irresponsible operating practices that put kids
at risk and about the deceitful marketing practices that programs use
to lure parents desperate for help for their children. The Government
Accountability Office also found examples of the shady network that
programs sometimes relied on, such as referral service providers that
claim to offer independent services to parents but that actually have
close financial or personal ties to the very programs that they are
``independently recommending.''
We know that there are many programs and people around the country
who are committed to helping improve the lives of young people and who
do good work every day. But, unfortunately, it has become extremely
difficult for parents to tell the good programs from the bad. And I
would remind you again that very often these parents seek nothing but
the best for their children, children who are extremely difficult to
handle, who have failed in other efforts and other programs to deal
with their problems. So these parents have exhausted most of their
options, and then they run into some of these programs which then
endanger their child even though the parent is seeking the best for
their child.
The legislation before us today, H.R. 5876, would help keep children
safe in residential programs and help ensure that parents have
information they need to make safer choices for their kids. The
legislation requires the U.S. Department of Health and Human Services
to establish minimum standards for private programs to enforce those
standards.
With children's health and safety at risk, this Federal rule is a
necessary recognition that we are dealing with an emergency and we
cannot wait for the States to act. These abuses have been going on for
years. States have had time to act and in many instances they have
failed to do so.
Ultimately, however, States will be primarily responsible for
carrying out the work of this bill. The legislation calls for States
within 3 years to take up the role of setting standards and enforcing
them on all programs, both public and private.
The Health and Human Services Administration and the State standards
would include prohibitions on physical, sexual, and mental abuse of
children. The standards would require that programs provide children
with adequate food, water, and medical care. They would require that
programs have plans in place to handle medical emergencies. They would
also include new training requirements for program staff members,
including training on how to identify and report child abuse.
The legislation requires Health and Human Services to set up a toll-
free hotline for people to call to report abuse in these programs.
As you can see, Madam Chair, these are minimum requirements for the
health and the safety of the children that have been placed in this
care.
It also requires Health and Human Services to create a Web site with
information about each program so that parents can look and see if
substantiated cases of abuse have occurred at a program that they are
considering for their children.
Finally, the legislation helps prevent programs from using deceptive
marketing tactics to target parents. Among other things, it requires
programs to disclose to parents the qualifications, roles, and
responsibilities of all current staff members, and requires programs to
notify parents of substantiated reports of child abuse or violations of
health and safety laws.
The legislation has the strong support of the American Association of
Residential Centers. One of the association board members, Dr.
Christopher Bellonci, testified in support of the legislation earlier
this year. He said, and I quote, ``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.''
Madam Chairman, we have a responsibility to keep children safe no
matter what setting they are in, and today we
[[Page H5951]]
are taking an important step towards finally ending the horrific abuses
that have gone on far too long in residential programs for teens.
I want to thank Congresswoman McCarthy of our committee for her hard
work on this legislation, and I want to thank Congressman McKeon for
his effort. And we will be offering a manager's amendment later that I
think will help make this bill bipartisan and helps deal with some of
the concerns that people had with the legislation. So I want to thank
Congressman McKeon and his staff.
I reserve the balance of my time.
Mr. McKEON. Madam Chairman, I yield myself such time as I may
consume.
We are here today to consider a bill that will help protect the
thousands of young people enrolled in residential treatment facilities.
Although we don't know exactly how many such facilities exist, it is
estimated that hundreds of them have been established all around the
country. We will hear a lot about boot camps today, but there are a
range of residential treatment programs, both public and private,
ranging from wilderness therapy to boarding schools.
Many of these programs are successful, helping troubled teens
overcome addiction, emotional struggles, and other challenges in order
to turn their lives around. We are here today not because of the
success stories, and there are many, but because of cases where these
programs have harmed the young people they are meant to heal.
Over the last several years, the Government Accountability Office has
been conducting a series of inquiries into reports of child abuse,
neglect, and even death at residential treatment programs for teens.
Beginning last fall, the Education and Labor Committee heard
testimony from the GAO on its findings. We also heard directly from
victims of abuse and from the families of teens who lost their lives.
The stories we heard were devastating and the response was
unequivocal: Someone needs to take responsibility for regulating and
monitoring these programs and enforcing strong protections for the
young people they enroll. However, even though we know the need to
regulate these programs is clear, we are faced with many obstacles in
determining the best approach.
The threshold challenge we face is to determine exactly what
facilities we are talking about. Even the GAO, which has spent years
investigating these programs, cannot offer a precise count or even an
estimate of how many such programs exist and where they are located.
There is also the question of protecting against abuse while still
allowing effective programs to serve families. As I mentioned earlier,
in addition to stories of neglect and victimization, our inquiries into
these programs also brought to light numerous success stories. We heard
from young people who suffered from drug addiction, emotional and
behavioral troubles, and other self-injuring behaviors. They credited
residential treatment programs with turning their lives around.
Balancing these and other challenges, and after a process of review,
analysis, and cooperation, I am pleased that we have developed a
bipartisan proposal that will ensure the effective regulation,
monitoring, and enforcement of these programs by the States, with the
Federal Government playing an appropriate oversight role.
I appreciate Chairman Miller's willingness to work with our side of
the aisle throughout this process, and particularly over the last
several days as we were able to forge a compromise that achieves our
shared goal of protecting young people without creating the type of
parallel and conflicting dual-regularity structure envisioned in the
original bill.
As with any piece of legislation, this bill is not yet perfect. I
remain concerned about potential conflicts between State child abuse
laws and the new definitions and interpretations established here at
the Federal level. I also think we need to consider whether linkages to
the Child Abuse Prevention and Treatment Act will be sufficient to
ensure States are fulfilling their duties to protect the young people
in these programs. But on the whole, I am pleased with the progress we
have made to develop a strong bipartisan bill that will help put an end
to the cases of abuse, neglect, and death in these facilities.
Madam Chairman, I reserve the balance of my time.
Mr. GEORGE MILLER of California. Madam Chairman, I yield 3 minutes to
the gentlewoman from the District of Columbia (Ms. Norton).
Ms. NORTON. I thank the chairman for yielding and I thank him and I
thank the ranking member as well for a bill that is, I think, very
important to the country.
This is a matter of State regulation and will remain and should
remain a matter of State regulation. But the fact is that there are
many jurisdictions like my own which, because of the nature of the
mental or the emotional or the behavioral problem of a particular child
and the attempt to match that with the child's needs, may be required
to send the child out of State. That is more likely to be the case if
you are in a city, a medium-sized city like the District of Columbia
which of course, does not have State facilities, but it is true of
every State. We have learned of instances where I think even with the
best efforts of the city, and the city has been to blame some of the
time, there would have been very little that the city could have done
unless there was a monitor on the spot. And understand, it costs
hundreds of millions of dollars to send these children out of State.
This is very expensive to do, but you do it for a young child, in the
hope that you can help this child and bring this child back.
We had a situation recently, Madam Chair, where the city was sued,
this city, the District of Columbia was sued for a hefty amount because
the city had sent a child to a clinic in Pennsylvania and the child was
raped by a very trusted counselor.
Now, perhaps the city should have been sued, so I am certainly not
here to say whose fault it was, and I know nothing of the regulations
of the State of Pennsylvania. I do know this: That if there are not
minimum standards across these United States, no city or jurisdiction
which sends children to another jurisdiction can be confident that
every day, everything is going to happen as expected.
There is a monitor of child welfare matters in the District of
Columbia, and she recently reported that, for example, that some
District children that were being treated in Florida like ``garbage.''
And the only way the District of Columbia knew was they read it in the
newspapers. Now, what were they supposed to do, have somebody down
there looking every day at what they were doing? Perhaps it was their
fault. But we do not know if there were standards, such as the chairman
and the committee have proposed here.
We just had to take some children out of something called
``therapeutic restraint,'' Madam Chair, after we found that the
children's arms had been broken as a part of this therapeutic
restraint. Excuse me, spare me this therapy.
In this city, at least, we send hundreds upon hundreds of children to
such schools around the country. It costs the District of Columbia $210
million a year. If you are in a larger State, this child may go within
the State. Even so, there are large numbers who don't go within the
State.
I want to thank the chairman for simply creating standards, and by
the way, standards that will apply to the public sector and not only
the private sector. There is no private right of action given by this
bill. I particularly like the random inspections, because you never
know if they are going to look at you.
{time} 1615
Mr. GEORGE MILLER of California. I yield the gentlewoman 1 additional
minute.
Ms. NORTON. Madam Chairman, I like the commonsense, low-cost approach
here because we obviously are not trying to duplicate what they do in
the States. The random inspections will say to you, you never know if
they are going to come to get you, and there are States that don't do
such inspections. The fact that we are not talking about suing you,
these people know how to get lawyers to sue under the appropriate
circumstances.
In any case, we don't want to do something after the fact. We want to
[[Page H5952]]
be assured if we have to send our children to another jurisdiction,
that all will be well to the greatest extent possible. This bill, which
covers the entire country, will, I think, restore the confidence of
many parents that in fact at least the Congress has done all it can.
I thank the chair and the ranking member and the committee again for
this important bill.
Mr. McKEON. Madam Chairman, I yield 4 minutes to the gentleman from
Utah (Mr. Bishop), a member of the committee.
Mr. BISHOP of Utah. Madam Chairman, first of all, I wish to thank the
two gentlemen from California, Mr. McKeon and as much as I hate to, Mr.
Miller as well, for continuing to work on this particular bill. To say
that this bill that is before us today is vastly better than the one
that came out of the committee is definitely one of the understatements
of the century, and so I appreciate their efforts to continue to try to
make improvements on this particular bill.
I still have some problems. You know, this is the era of the NBA
draft, and every team that's involved in the NBA draft is going through
all of the data. They are going through all the pictures, they are
going through the reviews, and they are checking the schedules of all
the players. Not one of them is basing their decisions on a couple of
comments in the yearbook written in the high school year of one of the
kids.
Unfortunately, this bill is based upon a GAO report that is spotty at
best which dealt with anecdotal evidence, several deaths of teens that
were reported in this program. My office received a very emotional call
from one of those who was cited, one of the programs that was cited,
saying that the death had been found to be an accident, but GAO had
never asked them about it. In fact, the GAO investigator admitted the
eight anecdotal cases that were brought before us, only one resulted in
any kind of criminal activity which simply meant either these problems
were dealt with in a professional way or the legal system failed us
miserably.
The GAO investigator admitted not knowing how many problems existed
and the depth of the problem, if there was any, because no official
study had been done on those particular areas.
Instead, perceptions were made on these particular programs which are
designed to help troubled youth, youth in difficult situations to begin
with.
One of the studies I did see indicated that in a study that was done,
wilderness programs like this designed for troubled kids estimate about
1.1 injuries of all kinds per 1,000 days of participation. High school
football camps have 19.7 injuries per 1,000 days of participation. In
fact, even average kids living at home who have a driver's license are
estimated at 4.5 accidents per 1,000 days.
We are dealing with a situation here which is more anecdotal than
actual, and we are still coming up with a bill, much better than what
we had in committee, but still has a few problems. Subsection (J) still
insists on a sex offender registry that is yet to be up and running.
Subsection (M) deals with parental requirements in which the parent is
supposed to give information yet there is no enforcement mechanism to
ensure the parent actually gives that particular recommendation. So
there is still work that needs to be done on this.
Perhaps I can end with a quote from a parent whose daughter was
actually in the same program as one of those who testified in front of
the committee in which she said: Improvements can only happen when they
are based on reality rather than generalizations and politics.
The reality is that there are three basic approaches to residential
placement of youth, and each has its own strengths and weaknesses and a
different route to improve each. First, there are juvenile justice
institutions; second, treatment facilities including psychiatric
hospitals and residential treatment centers; and the third general type
are those that we refer to as parental-choice schools and programs.
We can and need to do better, but a solution will come about from
reasoned discussions and step-by-step improvements that address the
real problems in each type of approach. I am dubious that the Federal
Government has the ability to improve the situation. This is partly
based on what I have seen in the committee hearings where the emphasis
was on wringing political condemnations, blurring boundaries and
appealing to ideology and biases, and partly because of chronic
problems existing in the current public-funded and controlled programs.
In short, this is an approach in which the States, especially my
State, are actually solving the problem in a better way right now. We
do not need the Federal Government to be involved in this particular
program.
The CHAIRMAN. The gentleman's time has expired.
Mr. McKEON. I yield the gentleman an additional minute.
Mr. BISHOP of Utah. I am told that one of the quirks of the system we
have right now is in the State of California. Anyone who is age 14 or
older can check him or herself out of a situation or a program, which
may be one of the reasons why programs in other parts of the country
have almost 30 percent of their residents in these parent-type choice
programs coming from the State of California. Maybe in the future we
should work on how California deals with the situation internally
instead of having a one-size-fits-all program here when the States are
close to the problem and actually have stepped up to the plate and are
doing a better job in trying to emphasize and control these programs
than anything that we can do here on the Federal level.
With that, once again I thank the chairman and the ranking member for
improving this bill from where it was.
Mr. GEORGE MILLER of California. I yield 2 minutes to the gentleman
from Washington (Mr. McDermott).
(Mr. McDERMOTT asked and was given permission to revise and extend
his remarks.)
Mr. McDERMOTT. Madam Chairman, as a child psychiatrist, I have seen
lots of these kids. I have seen them both in detention centers and in
mental health facilities and in a variety of settings in which
youngsters with really severe problems, people try to handle them. And
it is with that in mind, that is why I rise in strong support of H.R.
5876, the Stop Child Abuse in Residential Programs For Teens Act of
2008.
It was introduced by my friend, George Miller, and I am proud to be a
cosponsor of what is a very important piece of legislation that will
help protect America's kids.
In answer to the remarks of one of my colleagues just a moment ago
about whether or not maybe we ought to let California deal with their
problems, this is a problem nationwide. This is not a California
problem. There are parents all over this country who have severely
disturbed youngsters who try to find a place to place a kid in hopes
that the program that is offered will in some way help their child get
back on the track to being a successful adult. There are thousands of
these youngsters every year that look for a place, some in their
States, some outside their State. Parents know what they know. They may
not know what the rules are in various States, and in some ways it is
almost inevitable something like this, because of the transfer across
State lines, that we have a national standard by which we require
programs to operate.
They go to these programs for help in facing behavior and emotional
problems, substance abuse and sometimes elements of building self-
confidence that are known as bootstrap programs or wilderness camps or
self-help boarding schools, and they operate across the country.
Now the teenagers who come into these programs receive help.
The CHAIRMAN. The gentleman's time has expired.
Mr. GEORGE MILLER of California. I yield 1 additional minute.
Mr. McDERMOTT. But tragically, Madam Chairman, they sometimes become
the victims of child abuse and neglect. And you have heard about the
GAO study, and I think there are plenty of examples about why this is
necessary.
The bill would stop any program from restraining kids for any reason
other than safety. It would stop a program from withholding essential
food and water, clothing and shelter. It would mandate education and
training for workers. It would require operators to disclose everything
from the roles and responsibilities of their employees to confirmed
cases of abuse.
[[Page H5953]]
Now to ensure compliance, the department will be empowered to carry
out unannounced inspections and enforcement. And above all, this bill
places the safety and well-being of the child above marketing hype and
unscrupulous operators. In some cases, people have closed a program in
one State and moved to another State. These programs that truly help
children with a positive, uplifting experience will only benefit from
this legislation.
There is no place in America for a program that hurts kids who are
there trying to get help. This is not a bootstrap program, it is a
dangerous program that should be changed or shut down, and I urge my
colleagues to support this.
To allow children who are unable to control their own emotions and
their own well-being to be in the hands of people who aren't thinking
about them from their safety first is really a misguided program, and
this bill will correct that.
Mr. McKEON. Madam Chairman, I yield 3 minutes to the gentleman from
Idaho (Mr. Sali).
Mr. SALI. Madam Chairman, child abuse is a horrendous evil. Such
abuse is reported on an average of every 10 seconds in the United
States. And three children die every day in our country as a result of
abuse. Any abuse in residential treatment programs is an incredible
travesty.
While fighting child abuse poses a tremendous challenge for us to
overcome, this bill is not the answer. The manager's amendment makes
great progress in improving the bill, yet there remain provisions that
are simply unconscionable for those who respect the system of
Federalism long established in our Nation. H.R. 5876 represents a
dramatic expansion of the Federal oversight role in really an
unprecedented area. Most States already have systems in place to check
the abuse that this legislation would supposedly address. Yet this
legislation would trump those systems. This bill provides a one-size-
fits-all mandate for residential treatment facilities, inflexible to
the needs of actual children and unresponsive to the local challenges
faced by such youth treatment programs.
Residential treatment programs have had a great impact on youth in my
district in Idaho. For instance, Cherry Gulch is a small, owner-
operated treatment facility located on 220 acres of pristine land near
Boise, Idaho. The ranch-style therapeutic boarding school is designed
specifically for 10- to 14-year-old boys, and has made an incredible
difference in the lives of the youth who have participated in those
programs. Yet directors of these facilities have expressed grave
concerns to me that their needs will not be met by H.R. 5876.
For instance, as one treatment program director pointed out, in a
State like Idaho where usage of drugs like methamphetamine has
exploded, giving every child the undefined right to so-called
``reasonable'' access to a telephone creates direct and unreasonable
risks. Why allow youth the opportunity to contact drug dealers when the
entire point of being put in such a facility is to overcome their
addictions?
There is kind of political hubris to this approach. The attitude of
this bill is that we here on Capitol Hill know better than people in
our home States how to address the needs of abused children. I find
that stunning. I would invite any of my colleagues to go back to their
districts and talk with the people who day in and day out work to bring
hope and healing to children victimized by abuse. I believe they will
find it, as I have, quite humbling. We don't have all of the answers in
Washington, D.C., and we certainly would be wrong to impose a top-down
system of Federal management on States and localities.
Overall, I am certain that we can agree that it is important that
children in residential treatment programs be protected. However, I do
not believe that another Federal intrusion into the affairs of all 50
States is the answer.
In Federalist No. 8, James Madison warned of the dangers of creeping
Federal powers over the States. In his words: ``Ambitious encroachments
of the Federal Government on the authority of the State governments
would be signals of great alarm.''
The CHAIRMAN. The gentleman's time has expired.
Mr. McKEON. I yield the gentleman an additional 1 minute.
Mr. SALI. When the Father of the Constitution issues such a warning,
we should listen closely. Even more importantly, the Constitution of
the United States says in the 10th amendment: ``The powers not
delegated to the United States by the Constitution, nor prohibited by
it to the States, are reserved for the States respectively, or to the
people.''
In 1941, the New Deal Supreme Court, in Darby v. United States,
commented that this amendment is mere ``truism.'' Many of us here in
this body would challenge that assertion. The authority of the States
and their right to govern their own affairs is not a trite and archaic
remark but an essential aspect of our Federal system. We diminish it to
the peril of our system of Federalism which has been vital to our
freedom as a Nation.
H.R. 5876 is not a solution looking for a problem, but it is a
solution that I will submit solves fewer problems than it will create.
{time} 1630
The CHAIRMAN. The Committee will rise informally.
The Speaker pro tempore (Mr. McDermott) assumed the chair.
____________________