Panel to begin work
regulating youth homes
By JOHN STROMNES of the Missoulian
October 24, 2005
Is solitary confinement in an isolated “hobbit
hole” appropriate behavior-changing therapy for a troubled, defiant
Are leg restraints appropriate when bringing
such teens to Montana against their will (but at their parents'
insistence) to live in a private boarding school?
Who is responsible when an untrained youth
“counselor” seduces teenagers half his age while they're in his care
at a church-based residential facility?
These are some of the questions facing - but
unlikely to be quickly answered - by the state's newly formed Board
of Private Alternative Adolescent Residential or Outdoor Programs.
The board will take its first baby steps toward
self-regulation of the unregulated - and burgeoning - “behavioral
health-care industry” in Montana on Wednesday, with a public hearing
in Helena on proposed administrative rules that will govern board
procedures and the establishment of fees to register existing
The board was established by the 2005
Legislature as an alternative to a state Department of Health and
Human Services measure that would have regulated the programs as
health-care providers, as are similar facilities for youths confined
by court order.
The push for regulation came about because of
much-publicized concerns about the mistreatment or neglect of youths
whose parents have enrolled them in behavior-modification programs
in Montana, Utah, Arizona, the Caribbean, Mexico and even Central
Many of the programs operate without government
registration or regulation, and abuses have occurred. In
well-publicized cases from some “wilderness experience” programs,
youths attending by parental order have even died.
Government and private therapeutic treatment
programs for youths committed because of delinquency or crimes are
intensively regulated in Montana. Many states also regulate the
nonjudicial alternative programs, where the youths in custody are
turned over by their parents. But in Montana, these private-pay,
private-enroll programs are called “substitute-care providers” and
are specifically exempted from state regulation.
In 2003, Montana's Department of Health and
Human Services published a report, “Unregulated Youth Residential
Care Programs in Montana,” to provide background information on the
need for regulations.
In 2005, the sought-for legislation - which
would have registered and ultimately regulated the programs - was
proposed by DPHHS and would have been administered by the
department, said Mary Dalton, director of the DPHHS Quality
The agency already regulates 380 residential
facilities and 629 child day-care providers.
But the industry quickly mustered its forces -
one program spent $34,000 on lobbying - and proposed its own bill.
“When it became evident that the state would be
moving in this direction (toward regulation), the programs wanted to
be willing participants and ahead of the curve rather than being
dragged along on a leash,” said Rep. Paul Clark, D-Trout Creek, who
sponsored the industry's bill and himself works for two smaller
wilderness-based adolescent programs in western Sanders County.
The industry bill differed in a number of
crucial ways from the DPHHS proposal.
First, it put the entire registration and
regulatory proposal under the auspices of the state Department of
Labor and Industry, through a board mainly composed of industry
representatives, instead of the health-care professionals in DPHHS.
Second, it exempted any faith-based or
religious private behavioral therapy programs; at least seven of the
30 programs in Montana are faith-based.
Third, it would be self-supporting through fees
and not cost taxpayers any money, as the DPHHS regulation presumably
The Legislature weighed its options and quickly
favored Clark's bill, which passed both houses easily. The DPHHS
bill died in committee.
Dalton said the fact that Clark, a respected
legislator who works in the industry, sponsored the industry bill
and helped secure its passage. Clark said the fact that his proposal
cost taxpayers nothing was “a big issue” to many legislators.
“The programs themselves, not the state, are
paying for it. That was a big issue - $40,000 and $50,000 for the
two years,” he said.
The first step in the approved process is to
establish rules by which the board will operate and register
existing programs. That will be the topic at Wednesday's meeting in
Helena. The rules also propose how site visits will be made. A
week's notification in advance must be given to the program, under
the proposed rules.
Programs that are exempt include any that are
already regulated, or recreational programs, or boarding schools or
residential schools that focus on academics, or sports-oriented
Specifically exempt are alternative residential
programs that are adjunct to any organized church, such as Pinehaven
near St. Ignatius.
The new board is composed of five members -
three from various segments of the industry and two interested
members of the public. Serving on the board at present are Clark, as
representative of small programs; Michele “Mickey” Manning,
principal at Spring Creek Lodge Academy west of Thompson Falls, with
500 students perhaps the largest such boarding program in Montana,
and the largest employer in Sanders County; Mary Alexine of
Chrysalis Inc., near Eureka, representing medium-sized programs;
Carol Brooker of Plains, a Sanders County commissioner; and Maureen
Neihart of Laurel, a licensed clinical child psychologist.
The board must meet at least twice a year for
two years to examine the benefits and drawbacks of licensing and
registration. To do so, it will conduct an extensive survey of
current standards and other issues.
It will report back to the 2007 Legislature and
either recommend further legislation, or recommend the board be
disbanded with no further action advisable.
The law asserts that “necessary licensure
processes and safety standards for programs are best developed and
monitored by the professionals that are actively engaged in
providing private alternative adolescent residential care.”