[Congressional Record (Bound Edition), Volume 154 (2008), Part 10]
[House]
[Pages 13503-13507]
[From the U.S. 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).
  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

[[Page 13504]]

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 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

[[Page 13505]]

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 
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.

[[Page 13506]]

  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. 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.
  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.

[[Page 13507]]


  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.

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