Troubled kids, troubled system
Oversight of private treatment programs for troubled teens moves to DPHHS
By Cameron Evans • Originally published on May 3, 2019
The oversight of private residential treatment programs for troubled teens in Montana no longer rests in the hands of program owners who, for the past 12 years, have regulated the same programs they operate.
On Friday, Gov. Steve Bullock signed a bill into law that terminates the Private Alternative Adolescent Residential or Outdoor Programs (PAARP) board and moves licensing of programs under the state health department.
“I would say it’s one of the first steps toward regulation,” said Sen. Diane Sands, a Democrat from Missoula, who carried the Senate Bill 267.
“This is not the last step. It’s the beginning of a process of paying very focused attention to both the implementation of that law but to other potential activities that will bring these programs into compliance with every other residential treatment program,” Sands said.
The board has been criticized as “the fox guarding the henhouse” because the 12 years since its creation have seen 58 complaints against programs, yet the board has not issued any significant sanctions, a yearlong investigation by the Missoulian found.
Under the move to Department of Public Health and Human Services’ Quality Assurance Division, which oversees more than 70 similar facilities, more complaints against programs will be public.
The Department of Labor and Industry, which oversaw the PAARP board, and the board chairman both conceded that the board lacked the resources to properly oversee programs and supported the shift to DPHHS.
“I do think that DPHHS is probably better set up to offer the kind of oversight and regulation than is the Department of Labor and Industry,” board chair John Santa, who co-founded Montana Academy in Marion, told the Missoulian.
Santa said he feels confident in the move because “DPHHS has indicated they would be cooperative with us in creating regulations that meet the kinds of levels of care that we represent and that we’ve been operating under for the last 10 years.”
The health department has yet to establish new rules for standards of care at private alternative residential treatment programs.
The original version of SB267 included language specifying minimum standards of care, but that language was removed in an amendment by Rep. Bob Brown, R-Thompson Falls.
Brown, who previously worked at the now-closed program known as Spring Creek Lodge where a student died by suicide in 2004, said he proposed the amendment because language in the bill could hinder programs’ ability to exist.
“The fact that those things could be a barrier to these programs operating, how is that not a huge warning sign?” said Tamara Cherwin, who attended Montana Academy from 2010 to 2011.
“If you can’t operate with minimum standards of care and qualified staff, I don’t think you should operate at all,” Cherwin said.
Cherwin said she’s grateful the bill passed but still feels that it’s “not enough” and that she still deals with PTSD that she was diagnosed with from her time at the program.
“When I think of the state of Montana, I should think of huckleberries and hiking and Glacier Park,” Cherwin said. “Instead, I think of the worst two years of my life.”
Santa said he has some concerns about the rules that DPHHS could create, but declined to specify examples that would hinder a program’s ability to operate.
“They could create regulations that would make it impossible for the levels of care we offer, and that would not be a good thing because it would close a number of businesses throughout Montana and it would also take away levels of care that are very important,” Santa said.
Carter Andersen, the administrator for the Quality Assurance Division at DPHHS, expressed an interest in working to accommodate programs’ needs in a February PAARP board meeting.
Andersen is currently responsible for the oversight of residential treatment programs in the state, including a program where he was formerly the CEO called Acadia Montana, which has been criticized recently by the state of Oregon for its use of “chemical restraints” and other practices.
The rules governing Acadia Montana and other residential treatment programs for youth remain unclear, as The Montana Standard reported.
Sands said her efforts to bring increased oversight to programs isn't done. She said she remains interested in following the programs' transition to the health department.
Sands also said she intends to continue to bring up religious programs in the interim between legislative sessions. Those programs are allowed to operate unregulated if they claim ties to a religious organization. Currently, if children at religious programs are sexually assaulted or psychologically or physically abused, the state's child protection system can move the child to safety but can do nothing to the program or its employees.
House Bill 222, which would have regulated religious programs, died in committee, adding to a history of failed attempts to bring religious programs under licensure.
However, Sands found success with another bill which made it illegal for staff and therapists at private residential treatment programs to have sexual relationships with the teens they treat — even if those clients are 16, the age of consent in Montana.
All three of the bills in the 2019 legislative session to increase protections for youth in residential treatment programs were met with emotional testimonies from former program participants.
"It’s the courage of people to come forward in all of this that makes a difference," Sands said