STATES CONSIDER NEW RULES FOR THERAPEUTIC BOARDING SCHOOLS

Volume 28, Issue 484 February 5, 2007

Anna C. Spencer

Following complaints by students and parents about physical and verbal abuse, unsanitary living conditions and medical and nutritional neglect—including a handful of cases that resulted in student deaths—state and federal policymakers are taking a closer look at therapeutic boarding schools. Utah strengthened an existing law (SB 107) by requiring licensure of all programs providing residential care to youth, and the federal Government Accountability Office plans to launch a study of them in February 2007.

Since the 1990s, residential care facilities have flourished. These boarding schools, which promise desperate parents a last-ditch stop to reform out-of-control youth, are highly structured programs that combine education, strict behavior management and psychiatric help.

While many of the schools succeed in helping youth to turn their lives around, critics charge that others provide questionable treatment. A significant proportion of private residential care facilities are unregulated and unlicensed by state entities, which puts vulnerable youth at risk, according to a study to be published this summer in the American Journal of Orthopsychiatry.

Utah: The Model State

While states have the authority to license mental health facilities, the disparate nature of youth residential care centers means that many fall under regulatory exemptions, said Gary Blau, chief of the Child, Adolescent and Family Branch at the Substance Abuse and Mental Health Administration. The facilities may be excluded from state oversight if, for example, they don’t take public money or if they receive a certain percentage of their funds from a religious organization.

In 2005, the Utah Legislature amended a law already on the books to expand the scope of licensure requirements for youth treatment facilities. Frequently cited as model legislation, the updated law (SB 107) requires programs that provide services to minors—including temporary child placement, day treatment, outpatient treatment, residential support, residential treatment, intermediate secure treatment and outdoor youth programs—to obtain a license from the state Office of Licensing.

The licensing office seeks to ensure that a “minimum standard of treatment” is followed by all programs within the state. Programs must meet health and safety standards, and employees must be screened to work with youth. Youth treatment programs are licensed annually with periodic visits from a licensing specialist to ensure compliance with the Core and Categorical Rules of Treatment that govern programs and facilities throughout the state.

The law allows certain efforts to be excluded from licensing, including programs owned by the federal government and those operated by the Department of Corrections. Also excluded are individual or group counseling sessions provided by a licensed mental health professional, hospital or other health-care facilities, and boarding schools. The statute clearly distinguishes boarding schools from therapeutic schools by defining the amount of therapeutic interventions provided, the purpose of the school and the reasons for recruitment of students.

Montana Considers New Rules

This session, Montana Sen. Trudi Schmidt sponsored a bill to encourage licensing of all private residential and outdoor programs (Sen. Schmidt also introduced legislation in 2005, but the bill failed.) SB288 would require all residential treatment facilities to register with the State Department of Labor and to obtain a license by Dec. 31, 2007. The bill also would mandate background checks for personnel and set minimum health and safety standards.

Sen. Schmidt has already received a “considerable amount” of support for the bill, she said, particularly from industry members and from members of the public who learned about the schools from media coverage. “There are quite a few treatment programs that want to be licensed, and want to separate themselves from those that don’t [want a mandate for licensure],” she said.