Analysis Of New Crowd-Funded Utah Teen Treatment Database Raises Questions About Effectiveness Of Inspections
Last week, The Salt Lake Tribune and KUER released a database of documents that show how the teen treatment industry is regulated in Utah, it contains the past five years worth of inspection reports for every youth residential treatment center in the state.
The Salt Lake Tribune's Jessica Miller spearheaded the project. She sat down with KUER’s David Fuchs to talk about what her analysis of those inspection reports has revealed so far.
David Fuchs: Tell me about these inspection reports. What are they? What do inspectors look for?
Jessica Miller: State regulators go into facilities about once a year and they bring these checklists with them, and they mark off whether a facility is in compliance or not. But they don't really look at a lot of aspects related to treatment. It's a lot about whether there are broken tiles or holes in the mattresses, things like that, or if a building itself is actually safe. The only point that I've noticed where they talk about actual treatment is [where] it is required that each kid have an individualized treatment plan. If they don't have those individual treatment plans, they'll get marked noncompliant for that. But they're really not assessing whether that treatment actually works for kids.
DF: You worked for six months rounding up all of these documents. What are you learning from looking at them all together?
JM: These are just thousands of pages of inspection reports. So we wanted to do a data analysis to look at what the trends are with these inspections. In that analysis, we found that combined in this five-year period, regulators assessed more than 53,000 total items and found only about 860 deficiencies. [That] means that when inspectors are going into these places, they're finding that they're compliant 98% of the time. They hardly ever find issues in those walks through.
DF: That level of compliance seems really high. Does that just show that facilities are following the law?
JM: Not exactly. We know from reading other reports and from our own reporting that bad things do happen at these places. For example, you take one facility, Provo Canyon School. They've had incident reports detailing these concerning reports of staff hurting kids in restraints — like pulling their hair or putting them in positions that are really painful. But when you look at those inspection reports, they've only been dinged for a ripped shower curtain and an emergency door that didn't work in a seclusion room. So they haven't really found those issues when they're going through and doing these inspections.
DF: So what kind of violations do the inspections catch?
JM: The most common violations are paperwork related — maybe employees don't have the background checks on file or there's paperwork that you have to file when a kid is moving from different states. And so maybe that's missing. Most of the violations are for that missing paperwork and not so much on the safety of the kids or whether the kids are being kept safe while they're there.
DF: These inspections are carried out by officials from Utah's Office of Licensing. How has the office responded to your findings?
JM: The office has said that changes are coming, but they haven't said what those are. We just had a recent piece of legislation that passed, and so because of that new law, they say they'll have to go look at this checklist again. But they didn't say whether they'll actually change their focus to include more items geared at child safety or whether they'll move to give weight to certain items over others. Right now, a ripped van seat is weighed the same as if a kid reported that he wasn't being fed enough. And so whether that will change, they haven't really said yet.
DF: That bill that the Utah Legislature just passed will increase the number of inspections done at every facility every year. What do your findings show about how effective those additional inspections might be?
JM: What our findings show is if changes aren't made to the way these inspections are done, they might not be effective even if they're increased. But I think that the addition of unannounced inspections is really where we're going to see some of this change happen. We've been speaking with [Sen. Sara Gelser] in Oregon who's a leading voice on this industry. She's been to these places on both announced and unannounced visits and have seen the difference firsthand. It's definitely a lot different if you have a heads up ahead of time to make sure the fire extinguisher is in the right place or none of the shower curtains are ripped. But if you don't know someone's coming, that's when you really see some of those problems.
Editor’s note: This database project is part of Sent Away, an investigative reporting partnership between KUER and The Salt Lake Tribune, with support from APM Reports.