Montana Academy Addresses Congressman Miller

I write to ask you to consider writing to your representatives and senators to oppose HR 5876, which rep George Miller is in a rush to pass in the House. [Under separate cover John Santa and I will send you a letter draft that might save you time, and we will also send you "instructions" from NATSAP to help you locate your reps and senators.] Put succinctly, we have been disquieted by congressman Miller's rush to "prevent child abuse" by suddenly ("within 9 months") creating a federal bureaucracy to regulate private programs and therapeutic schools like Montana Academy.

Here's what worries us. This congressman has for years conducted a crusade against educational consultants, wilderness programs and alternative therapeutic schools. We really don't know why-an influential upset constituent? a troubled son or daughter? It has been impossible to find out. I have tried repeatedly to meet the congressman. So have others. My friend Craig Van Dyke, Chairman of Psychiatry at University of California (San Francisco), has recently written to Miller, not officially as a professor or chairman, but as a constituent in Miller's Berkeley-Richmond district, to express concern about "collateral damage" to innovative programs like Montana Academy and to ask for a meeting to discuss the issues and to introduce me, so as to help him become informed. Three times Craig has written to Miller-in both California and Washington-and three times the congressman has not had the courtesy to reply. This rudeness has left both of us baffled. If he were serious about helping teenagers certainly we ought to be able to be a help to him in any number of ways. After all, we actually know something. And Craig is Chairman of Psychiatry at arguably the best medical school in the nation.

Since the Democrats took over the House, however (with my help, I cringe to add), Miller's party membership and seniority abruptly made him Chairman of the House Committee on Labor and Education. In this year he has gaveled two hearings that were forums for accusation and ambush, not calm fact-finding. He held them without notice. He did not bother to invite knowledgeable speakers from the National Association of Therapeutic Schools and Programs (e.g., John Santa, PhD, past president, who created a national consensus on standards of care and ethical principles for NATSAP). Instead Miller ordered the GAO to find "examples" (scandals). To this end the GAO Report (available, if you want to read it) assembled 8 cases from past years in which teenagers had been injured or killed after incompetent treatment, criminal abuse or simple bad luck. On the strength of these examples of "abuse," the congressman proposes immediate federal regulation.

However, the committee has no basis for making this momentous decision. In those cases in which abuse was alleged, state regulators already had investigated the facts, and there already has been criminal or civil court review. These were "closed" cases. The GAO report does not address problems for which there are not already agencies or courts to provide a legal remedy. Moreover, a few "examples" do not provide a responsible committee with the proper basis for making a decision as to whether federal regulation is needed or not. The GAO report (and public testimony) failed to survey the experience of abuse across the nation; failed to estimate incidence or prevalence; and failed to show in which states or in what kinds of programs such abuse might be concentrated.

Is this paucity of facts a problem? It is. Consider the practice of medicine-in California, let us say. California's medical licensure board regularly reports physicians' disciplinary problems-a report that makes for harrowing reading. It names specific doctors who have been disciplined for showing up drunk, for having sex with patients, for doing procedures ineptly, for negligent practices, for fraud, and for criminal mishandling of controlled substances. These "examples" are certainly ugly, even scandalous. But they do not prompt sensible persons to suggest immediate federal regulation of medicine in California. Why? Because California has a medical board to address these problems; because such problems are better monitored locally; and because such problems are no more common in California than in Chicago or Copenhagen. There are licensure procedure in place already. In fact, California's regulation is considered exemplary.

Is it the same for private programs for teenagers? Who knows?-the committee has not yet examined current state regulation. The chairman rushes to pass his bill although the GAO merely has promised to survey extant state regulation "later." The committee has not heard from experts on alternative programs or from program leaders or from parents of troubled kids helped by these innovative programs. Although the GAO report notes this information gap, congressman Miller is already marking up his bill. Our association's (National Association of Therapeutic Schools and Programs) attempts to advise the committee has been greeted with bullying and blame, as if committee members imagined NATSAP somehow were responsible for licensure and regulation-and so had been complicit in the 8 awful cases the committee heard about.

I have no idea what this congressman is angry about. But his hearings served only to arouse indignation about "private programs," even though we know the "thousands of complaints" the GAO report imprecisely cited are almost all from government-sponsored programs and boot-camps for (court-ordered) treatment of adjudicated (criminal) youth. The two populations-adjudicated youth in public programs and non-criminal youth sent to private programs-differ in almost every way. Moreover, government-contracted programs for delinquent or gang youth are explicitly excluded from HR 5876. The bill only covers "private" programs. In short, the GAO report cites complaints about oranges to justify federal regulation of apples.

It is hard to know what reasonable people should do to protect the reputable programs and schools they built and take pride in. No one knows better than I that what MA provides is not available elsewhere in conventional medical psychiatry. Yet it is awkward to oppose a bill that offers to "prevent child abuse." Perhaps it would be fine if we could trust Miller's motives and talk reasonably with him. But past versions of his bill required alternative programs to demonstrate that they meet all the state regulatory requirements of every state from which enrolled teenagers hail from. As MA accepts teenagers from 30 states, this would become a potentially impossible undertaking-at best requiring we meet regulations of states hostile to programs for teenagers. This seemed the point: to close down private programs, to make it impossible for programs like Montana Academy to treat teenagers without having to demonstrate compliance with regulatory standards of, say, Rhode Island, or states where programs like Montana Academy do not and cannot exist. We have come reluctantly to suspect that congressman Miller, for reasons best known to himself, has camouflaged with noisy indignation about child abuse his ambition to shut down alternative programs like Montana Academy. We have no idea why he might want to do so.

Perhaps you will think we are over-reacting. If you read his website you might think, as I did at first, that the man's heart is simply in the right place-that he is moved to protect teenagers who need protection from incompetence and badness. His contempt and indifference to our expertise and our own good intentions makes us wary, however. His hearings have unjustly smeared us. And we have come to think we have little to learn from congressman Miller about protecting teenagers in therapeutic programs. For Montana Academy already has been accredited by NIPSA, NWASC, the Montana state Fire Marshal and the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)-and a Montana licensure, after some years of our support, is about to become available. What constructive purpose could be served by adding on new federal regulations? We could not say. In ten years running Montana Academy has recorded 0 suicides, 0 homicides, 0 assaults and-although we let troubled teenagers ride horses, climb cliffs and enjoy camping trips and long hikes-0 major injuries or accidental deaths. Surely we have been lucky. We know that not every program has been so fortunate, and we think sensible state regulation makes sense.

But if congressman Miller were motivated only by a virtuous worry about vulnerable teenagers, you would expect this virtue and worry to make itself manifest closer to home. But I wonder. Inadvertently I have learned about troubled teenagers in Miller's district in recent months. For by chance my youngest daughter just has devoted this past academic year to Teach For America in a Richmond, CA high school in Miller's district. Worried about her safety, I flew to the Bay Area in the fall of '07 to sit in Julia's classroom, meet her students, tour the campus and attend a staff meeting. I already was sure that George Miller never had visited any of the reputable NATSAP programs for which he proposes federal regulation, but I was startled to learn that at JFK High School, too, no one could recall the last time the chairman of the House Committee on Education had stopped by.

So the congressman may not recently have site-visited JFK High. But I have. I did not like what I saw. The school looks like a prison, its bunker-like buildings soiled with graffiti, classrooms and faculty lounge without windows or sunlight. Much is missing-from minor supplies to professional support. In March the school was out of Kleenex and pencils, for example, which Julia must buy for her students. Recently she e-mailed the administrators an urgent plea for psychiatric consultation for an obviously-impaired boy who had been muttering threats "to kill them" in her classroom. Rather than expressing concern for the student, the assistant principal and psychologist called Julia to the main office to yell at her because she had cc'd the district special-ed office. One official told her if she were that worried, she should just "call 911."

Staff-student atmosphere? Uniformed armed cops guard many corridors. During a recent assembly there was a student fight and a massive, violent response from police, who maced a handful of students, knocked them to the floor and handcuffed them in front of the assembled student body. Since September, three of my daughter's students have been shot in the immediate neighborhood. Just before my visit the school secretary's 21-year-old son was shot dead on the street, and a few weeks before that an instructional aid's son also was shot and killed. Police helicopters droned above the campus. In the notoriously dangerous Iron Triangle, where many of her students live, police cruisers were pulled up to control key intersections, and the Richmond police officers standing near their cars in groups of three were wearing combat boots and Kevlar.

This spring Julia wrote privately to 50 family friends to raise $8,000 to help take 8 of her students to Washington, DC in the "Close-Up" program, which is designed to teach teenagers the workings of the federal government. Students in "Close-Up" meet with their congressman-and so Julia has managed to meet congressman Miller, even if her father has been unable to do so. Students from JFK high asked their congressman some hard questions: "How come our school look like a prison?" "How come there be no safe place to play or work out?" "How come kids in our school gettin' shot all the time?" "How come we don't have any windows?" "Why are the cops in our area not friendly with students?" and "How come El Cerrito High is getting remodeled when it was nice before, and our school is still poor, and we don't even have toilet paper in the bathrooms?" The students had a low opinion for the "lame" excuses they received.

My point? that congressman Miller is much more in a hurry to spend $250 million to create a new bureaucracy in Washington to regulate private programs for teenagers than to grapple with-or to spend federal tax dollars to solve-flagrant, more challenging and more worrisome problems for vulnerable teenagers right under his nose. Perhaps in his shoes I also would prefer to find scandals in private programs so as to rescue teenagers neglected and hurt and unhappy elsewhere rather than have to face a more inconvenient truth-about the fraud and mediocrity and fiscal short-shrift and repetitive abuse and drugs and lethal dangers lurking just outside the public classrooms and the personal homes of students at JFK High School. Much harder to "heal thyself" in Richmond than noisily to find fault in Utah and Oregon and Montana. As for students at JFK High, my daughter tells me that what many of them badly need is: "Montana Academy."

You will infer that this issue arouses my indignation. I hope to arouse your strong feelings, too. Your letters to representatives and senators (anyone know Speaker Pelosi?) may protect Montana Academy and other reputable programs from political posturing and reflexive indignation and a rush to a piled-on federal regulation that could do us harm and still not solve any adolescent problem that does not already have a simpler solution. It would be a form of collateral benefit, surely too much to hope for, a collective indignation might in a small way prove helpful to the sad, much-move-vulnerable children of John F. Kennedy High, who do not have you to protect them.