Wyden targets poor care at youth residential treatment facilities

Sen. Ron Wyden, D-Oregon, and state Sen. Sara Gelser Blouin, D-Corvallis, speak on Wednesday, June, 12, 2024, in a press conference about oversight of youth residential treatment facilities. Wyden's Senate Finance Committee released a report about abuse and neglect in facilities. (Screenshot)

U.S. Sen. Ron Wyden wants to hold youth residential treatment facilities accountable when children endure harm while in their care.

Youth residential treatment facilities are often a last resort in the foster care system, serving children with behavioral challenges or who cannot be placed in foster homes. Many of the young people who end up in residential treatment facilities have experienced abuse, neglect and rejection.

In the worst circumstances, abuse continues at residential treatment facilities, with children experiencing physical and sexual abuse, the use of restraints and seclusion rooms and medical neglect. In recent years, the Oregon Department of Human Services has faced scrutiny and litigation for sending foster children to out-of-state facilities with inadequate oversight that have abused children.

“Unfortunately, it seems that more often than not, abuse and neglect is the norm at these facilities, and they’re set up to let this happen,” Wyden said Wednesday in a hearing of the Senate Finance Committee, which he chairs. “The system is failing, except the providers running these treatment facilities, who have figured out exactly how to turn a profit off taxpayer-funded child abuse.”

The Democratic Oregon senator’s committee on Wednesday released a 136-page report summing up a two-year investigation into some of the largest providers of youth residential treatment facilities in the nation. The report found a range of problems, including unsanitary facilities, poorly trained or unqualified staff and abuse with a lack of adequate oversight and accountability.

Some cases mentioned in the report have ties to Oregon, including a 9-year-old who was chemically restrained and locked in a seclusion room of a now-shuttered Montana facility. A 14-year-old Oregonian with an intellectual disability was sent to a Utah facility and physically restrained and chemically sedated over 30 times in a four-month period.

State lawmakers in 2020 passed legislation to raise the bar for out-of-state placements and require facilities outside Oregon to meet the same standards as in-state facilities.

Litigation also has prompted action. In May, the Oregon Department of Human Services settled a federal class-action lawsuit filed by advocacy groups on behalf of foster children. As part of the settlement , the state agency agreed to work with a neutral expert to make improvements that include the rate at which children re-enter the foster care system and receive adequate access to medical, dental and mental health care.

On the federal level, Wyden said he’s committed to stopping federal funding for facilities that fail to provide good care.

“ In order to get a dime from Medicaid or any other program in my jurisdiction, all of these facilities are going to have to start providing actual care,” he said. “Systemic failures at even a handful of these facilities is an indictment of the whole model.”

Wyden said he plans to introduce legislation to hold youth residential treatment facilities accountable with increased health and safety standards, oversight and investments in community services that reduce the need for residential treatment.

He said he invited Marc Miller, the president and CEO of Pennsylvania-based Universal Health Services – the largest provider nationwide – to speak at the committee meeting and he declined.

“His company’s conduct – and the entire (residential treatment facility) business model – is simply indefensible,” Wyden said.

In a statement to the Capital Chronicle, Universal Health Services called the report “incomplete and misleading” and said it creates a false narrative. The company said it provided 12,000 pages of records to the committee and made staff available to answer questions in a separate meeting that lasted for more than four hours. The company said it takes caring for residents seriously and responds with remedial action in cases when residents are harmed.

People share personal stories

The stories of survivors – and the families of those who have died – are central to the issue. In a press event before the hearing, they shared their stories.

Kayla Muzquiz, a former foster youth from the Rio Grande Valley in Texas spoke about her journey through 18 youth residential treatment facilities in Utah, North Carolina and Texas.

“All of these programs were thousands of miles away from everything that I knew and everyone that I loved,” she said. “So I consider it being trafficked because I was very isolated, not only away from people that I knew in my community.”

Inside the facilities, she said, she was physically restrained. She was also restrained with chemical injections.

“They will pull your pants down and inject you right where your thigh meets your butt,” she said. “And patients in there call that booty juice. This is normal in those facilities, and I felt like I was a lab rat most of the time.”

At 14, she started to have fainting spells. Staff said she was an attention-seeker and she didn’t get medical attention until she gained nearly 20 pounds in less than a month. An endocrinologist diagnosed her with an untreated fourth-stage thyroid condition that will require medication for the rest of her life.

“I’m disabled for the rest of my life, and I’m dependent on medication just to produce a hormone so I can function correctly,” she said. “The medical neglect in foster care is real. I almost died, and it was very scary having to go through that by myself.”

State Sen. Sara Gelser Blouin, D-Corvallis, who has pushed for reforms in the Oregon Legislature, also spoke.

“What you will find when you read the report is that it validates what youth and survivors have been telling us, not for weeks or months or years, but for decades,” Gelser Blouin said. “My hope is that this is the first step in people saying ‘enough.’ Enough spending our money to abuse children. Enough sending kids to places just to warehouse them. Enough holding kids to the ground and silencing them, both literally and figuratively.”

Gelser Blouin said states and child welfare programs need to aggressively investigate abuse in facilities and invest in more community mental health services that keep families together and help young people.

“Every child, every youth, is filled with tremendous potential,” Gelser Blouin said. “It’s time for us to stop stealing that through abusive facilities.”

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