The findings come at the same time House Education and Labor Committee Chairman George Miller introduced the "Stop Child Abuse in Residential Programs for Teens Act of 2008," designed to create federal oversight of wilderness therapy programs, also known as therapeutic boarding schools, boot camps and behavior modification facilities.
At a committee hearing Thursday, Gregory Kutz, GAO's managing director of Forensic Audits and Special Investigations, said the most recent investigation looked at eight closed cases of abuse or death, including abuse at the Whitmore Academy in Utah in November 2004. GAO found that "ineffective management and operating practices, in addition to untrained staff, contributed to the death and abuse of youth enrolled in selected programs."
Kutz told stories of teenagers being forced to lie face down on red-ant hills, being bitten by pit bulls, being forced to endure extreme physical endurance tests in 120-degree heat and other abuse.
Kutz also said the GAO found "examples of deceptive marketing and questionable practices in certain industry programs and services" after calling 14 programs with fictitious parents looking for information for fictitious children. He played audio tapes of phone calls made to certain wilderness programs.
One excerpt included a woman at a referral service telling the GAO caller to tell his wife that this was a "college prep boarding school," because she might "freak out" if she thought the caller wanted to send his daughter to a place "where there are drug addicts and people that are all screwed up."
Another example had a referral agent recommend a particular program to GAO because "the bipolar, the depression, those kinds of things, they just go away after a while" when the participants follow a special whole-grain diet and exercise program.
There were other examples of conflicts of interest, as one referral service kept directing participants to a Missouri boot camp that it owned. Other examples showed misleading information on health insurance reimbursement or encouraging tax fraud through charitable donations.
Thursday's hearing was a follow-up to one the committee held in October at which GAO released a report outlining 10 cases where teenagers died in such programs, including five deaths in Utah.
Within the next few weeks, GAO will release a separate study looking at gaps in state and federal oversight at these camps, said Kay Brown, GAO direction of Education, Workforce and Income Security Issues. GAO found that Utah is home to more than 25 percent of registered wilderness programs in the U.S.
Miller and Rep. Carolyn McCarthy, D-N.Y., head of the Healthy Families and Communities Subcommittee, call for more federal oversight in their bill, including unannounced site visits by the Health and Human Services Department at least once every two years, civil penalties of up to $50,000 per violation and allowing parents to sue in federal court if a program violates the law.
The bill prohibits any physical or mental abuse, prohibits unneeded physical restraint and would require emergency medical-care plans. The bill also requires the programs to disclose the roles and responsibilities of all staff members, inform parents of any prior violations of child abuse or health and safety laws and give a Web site link to the Health and Human Services Department, which would maintain a database of all programs. It also would set up a hotline to report abuse.
"We have an obligation to keep kids safe no matter what setting they are in, and this legislation would take the first step toward finally ending the horrific abuses that have gone on for too long in private residential programs for teens," Miller said. "We know that there are many programs and many people around the country who are committed to helping improve the lives of young people and who do good work every day, but it is difficult for parents to tell the good programs from the bad."
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