Amid celebrity fanfare and rare bipartisan support, long-awaited federal legislation calling for better oversight of youth residential treatment centers was introduced in both chambers of Congress today.
The Stop Institutional Child Abuse Act pledges greater accountability and data transparency from the network of residential facilities under mounting pressure to reform due to revelations of rampant physical, sexual and emotional abuse of children.
“When it comes to institutional care, we discover that too often oversight, love and compassion are in short supply, that in far too many facilities, institutional care has become institutional abuse,” bill author Sen. Jeff Merkley (D-Ore.) said at a press conference introducing the legislation.
Celebrity heiress Paris Hilton, who has publicly shared her experiences with the “troubled teen industry,” joined Merkley, Republican senators and co-authors John Cornyn and Tom Tuberville, and other congressional leaders to announce the bill’s introduction. Prominent youth advocates as well as young people referred to as “survivors” testified alongside the lawmakers.
“Even though I entered the foster care system because I was a victim of abuse, I was treated more like a criminal in these places,” said Kayla Muzquiz, who entered institutional care through the Texas foster care system.
Youth residential care has been the focus of excoriating reports by the media and disability watchdog groups, following the 2020 death of 16-year-old foster youth Cornelius Fredericks at Lakeside Academy in Michigan. The facility, run by the for-profit company Sequel Youth & Family Services, came under harsh scrutiny after video footage revealed Cornelius was suffocated during a 12-minute face-down restraint involving seven staffers who piled on top of the boy. His misdeed was throwing a sandwich in the cafeteria.
“Far from Home, Far from Safe,” a 2020 investigation by The Imprint and The San Francisco Chronicle later revealed California children sent to facilities run by Sequel had been slapped, choked and punched by staff members.
The coverage and other investigations fueled lawsuits, state level law changes, and the shuttering of dozens of Sequel facilities.
Business tycoon Hilton has led her own campaign for change, working with the offices of Merkley and California Democrat Rep. Ro Khanna. Reform legislation has been in the works since 2021, when the lawmakers first indicated that a bill would be forthcoming. Progress appeared to stall last year, however, and Merkley’s office said at the time that the coalition was working to gather bipartisan support. Several Republicans from both chambers are now signed onto the bill, including Sen. Susan Collins from Maine.
“This issue is deeply personal for me,” Hilton said at today’s press conference. “I’m speaking up because this industry profits by silence, and those who need the most help are taken advantage of instead.”
Lawmakers framed the bill as both a moral and fiscal imperative. Merkley noted that $23 billion in public funds is funneled annually to the scandal-ridden institutions each year, through Medicaid funding and contracts with state child welfare and juvenile justice agencies. Roughly 60,000 children are sent to these troubled institutions, Merkley said, including 35,000 placed through foster care and 25,000 sent by parents struggling to meet behavioral or mental health needs at home.
“They cost about what it cost to go to Harvard,” Tuberville said. “But most of them look like something that came out of a Charles Dickens movie. Gloomy, dark. It’s not something you’d want to be proud of.”
The Stop Institutional Child Abuse Act would create a work group tasked with developing recommendations to minimize the use of residential care and improve treatment of youth sent to live in such settings.
The group would create a national database documenting residential care — including lengths of stay, outcomes, and the use of physical restraints and isolation practices.
Citing an increasingly apparent mental health crisis among American children and teens, Cornyn pointed to residential care as an important component in meeting treatment needs for some youth, and said the database would be a tool to make them safer.
“Many of these facilities do great work, but just one child harmed in their care is too many,” Cornyn said. “In order to hold bad actors accountable, we need to be able to look behind the curtain.”
The group would publish a report every two years with policy recommendations focused on ensuring best practices, developing risk-assessment tools, and eliminating the use of restraints and seclusion, with a shift toward “positive behavioral interventions” and trauma-informed de-escalation. The reports would also recommend strategies to prevent residential placements by increasing access to community-based alternatives. These might include crisis intervention; outpatient mental health and substance abuse treatment; and better access to local education for students with disabilities or behavioral challenges.
The work group would include representatives from several federal agencies: the Administration for Children and Families, the Justice Department and the Department of Education, among others. The group would have to consult with former residents of the institutions in question, as well as experts and advocates in the field.
The bill would also commission a study by the National Academies of Sciences, Engineering, and Medicine on the state of youth living in residential care, to be completed within three years.
Hilton described the horrors of the restraint and seclusion practices the bill addresses, and the deception often perpetrated against parents who send their children to such facilities for treatment.
“What if you thought your kid was receiving treatment, but was actually locked in a solitary confinement cell?” Hilton said. “What would you do if you found out that your child was being restrained by multiple staff members? How would you feel if you found out later that your child was being injected with sedatives that made them numb for days at a time?”