Ten years after new regulations were adopted, activists say for-profit private care centers are rife with problems
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SALT LAKE CITY — One memory stuck out for Spirit-Angel Conley. It was 2012, and at the age of 14 she had made it through what Diamond Ranch Academy, a private youth residential treatment center in southern Utah — a troubled-teen program — called observation and assessment.
She described it as weeks filled with mindless tasks like digging holes and carrying water buckets. She said residents were not allowed to talk to anyone but staff and were required to ask permission even to sit down or apply lip balm.
Conley remembered that one day as the girls in the program passed the boy’s side of the facility, one of the boys mooned them. Late that night, staff woke the girls and made them single out the boy who did it. After he was caught, a staff member immediately began hitting him, dragging him out of the building. She remembered his shoes still lying in the hallway.
“All you could hear is this kid screaming,” she said.
It cost her parents about $60,000 for her 10 months at Diamond Ranch, said Conley.
Diamond Ranch Academy’s lawyers adamantly deny abuse has ever occurred at the facility. They point out that their program, along with other facilities in Utah, are regulated and inspected regularly. And they are right.
After years of distressing reports on the troubled-teen industry, Utah passed a bill in 2005 requiring that facilities be licensed by the state. To keep a license, a facility must be inspected at least once a year to make sure it is abiding by state rules. For example, children ought to see a therapist at least once a week, restraints and solitary confinement may not be used for punishment, and mail is to be sent and received freely, provided safety requirements are met.
That year a federal bill, the End Institutionalized Abuse Against Children Act, stalled in Congress. It would have required federal involvement in regulating facilities and provided grants to states for inspection.
But in the 10 years since legislative attention, there have been at least half a dozen deaths in Utah alone, many avoidable, according to a list compiled by a woman who was sent to two troubled-teen programs in Utah. The families of the victims reported some of the deaths and their causes. Numerous lawsuits and claims of abuse have been directed toward some of the more than 100 residential facilities that cater to youths in Utah.
In 2007, Brendan Blum, 14, likely experienced a “violent and painful” death at Youth Care in Draper, Utah, according to a coroner, after his bowel twisted during the night and overnight staffers did not notify an on-call nurse.
In 2009, James Shirey, also 14, died of a sudden and unknown illness at Diamond Ranch. Activists put the blame on inadequate medical care at the facility.
An activist reported by that an unnamed student at Diamond Ranch hanged himself in 2012, leading to the facility’s installing collapsible shower rods.
As survivor websites proliferate where former residents post testimonies of abuse and as the online community has grown, some activists, former residents, legislators and lawyers remain unsatisfied with how the industry is regulated. In Utah, they say, laws regulating the industry have not been a cure-all.
“Utah is more regulated than most other places, but it’s only on paper,” said Maia Szalavitz, a Time magazine journalist and the author of “Help at Any Cost,” a book on the history of the industry.
“Regulations are not worth the paper they are written on if they aren’t enforced, and Utah doesn’t seem to enforce these regulations well at all,” she said.
She also noted that whenever people move back and forth in employment between industry and government, regulatory agencies may become beholden to the groups they are supposed to monitor, resulting in what is known as regulatory capture.
Szalavitz cited the example of a former Utah licensing director, Ken Stettler.
Stettler, who did not respond to multiple requests for comment, won a leadership award from the National Association of Therapeutic Schools and Programs, an industry advocacy organization, and now works in the administration of Provo Canyon School, one of the better-known facilities in the state.
Still, most people critical of the industry think having some regulatory power is better than nothing.
Jodi Hobbs, the president of Survivors of Institutional Abuse, said her organization plans to go state by state and work with community members to review current legislation and work to have bills introduced. Florida and Utah are at the top of the list, she said.
In California, Hobbs and the Los Angeles LGBT Center worked with state Sen. Ricardo Lara to introduce the Protecting Youth from Institutional Abuse Act (SB 524) to require licensing of facilities in California along the lines of Utah’s measure.
“[Legislation] does not stop the abuse from taking place, but it will help to monitor, oversee and mandate accountability for any institutional setting that could have the potential for abuse,” said Hobbs.
For Szalavitz, a big step forward would be banning corporal punishment for children.
“States that allow spanking in schools allow spanking in such programs, which basically means you can beat teenagers or use any other form of corporal punishment on them in a way you couldn’t legally do with prisoners,” she said.
The practice of regulating
The licensor for Diamond Ranch Academy, Kelly Anderson, who inspects about 10 youth residential treatment facilities, said he has been visiting the program for the last decade. Every few months, unscheduled, he said he walks their halls for a general inspection.
“The kids seem to be pretty healthy there, pretty well fed,” he said.
Anderson said he chooses six kids at random from the program’s roster and meets with them, privately, away from staff, asking them about their experience — including food, laundry, medication and safety concerns.
He said he doesn’t get very many complaints.
But Conley didn’t recall hearing or seeing any inspectors during her stay. Instead, she talked about widespread mistreatment with few avenues for recourse. She said the practice of restraining residents was used liberally, not only for trying to escape but also for cursing or refusing to do schoolwork. Counselors — who spend the majority of their work hours with the children and are required to have only a high school education and perfunctory training — would usually do the restraining.
“If you were starting to make a scene or having any of your own opinions, then, yeah, you’d get restrained,” she said.
A lawyer for the Diamond Ranch Academy, Steven Bangerter, said the program uses restraints only when students threaten the safety of themselves or others. “Restraints have never been used for purposes as punishment,” he said.
He said that the Diamond Ranch Academy does not have a notion of punishment.
“[Children alleging abuse] should have talked to their therapist. They have a right to contact the child abuse hotline,” said Anderson. “The kids have plenty of opportunities to complain.”
Frequency of calls to the child abuse hotline from facilities cannot be reported, since caller information is kept confidential.
About once every two weeks, unscheduled, Conley said she would see her therapist and would be allowed to call her parents. She said she brought up the issue of restraining — as well as there being flies in the food for a time — and was brushed off. She said she has never heard of the child abuse hotline.
Staffers read the letters she wrote, she said, and in one instance, a staff member read a letter that was critical of the person and tore it up in front of her. After that, mail from her mother was withheld for a couple of weeks, she said.
In response to these allegations, Bangerter reiterated that Diamond Ranch would not break the law to punish youths.
Thomas Burton, a Salt Lake City Lawyer, has been suing the industry for over two decades and said practices like those Conley experienced are still common despite the regulations. He said he is in constant contact with former students interested in legal action.
He is suing Diamond Ranch on behalf of a group of former students for personal injury, false imprisonment, child abuse, fraudulent misrepresentation and fraud.
“Once confined, no contact with the outside world was allowed … Any disparaging remark or complaint about Diamond Ranch Academy would be punished by isolation,” the lawsuit states.
“They were also forced to go without shoes and sufficient clothing in winter … They were often tackled and ‘taken down’ and sat upon by staff for punishment for some perceived slight,” the suit continues.
Diamond Ranch Academy’s lawyers deny the allegations.
“It is a first-class facility,” said Bangerter.
Many lawsuits against the industry are settled with the stipulation that the parties not discuss the complaints — which, activists say, results in many details of alleged abuse not being discussed.
Burton said he has settled every case he has brought so far — some 25 suits since 1990.
Now some facilities in the industry, he said, are claiming to be health care providers so they may be sued only for medical malpractice, which has a two-year statute of limitations (compared with four years for negligence) and requires a prelitigation panel, making it harder to sue. However, he pointed out, there is an upside.
“Nicely enough, I just happen to have with me the administrative code for psychiatric hospitals,” said Burton as he pulled paper from his jacket pocket.
“[It] says that you have patient’s rights. You have the right to participate in your individual treatment plan. You have a right to send and receive unopened mail. You have a right to unmonitored phone calls,” he said.