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NATSAP Letter
To Congressman Miller
June 1, 2005
Congressman George Miller
2205 Rayburn House Office Building
Washington, DC 20515
Reference: Legislation to Curb Child Abuse in Residential
Treatment Programs
We appreciate the intent of the introduction of this legislation,
but are concerned the excellent work being done by a large
number of residential treatment programs will be impacted
negatively if their interests are not considered.
The National Association of Therapeutic Schools and Programs
("NATSAP") was established in 1999 as a trade organization
with a mission to serve as an advocate and resource for innovative
schools and programs, which devote themselves to society's
need for the effective care and education of struggling young
people. NATSAP is now a thriving and growing organization
with 142 member programs serving nearly 10,000 youth annually.
Our programs are located in 31 states throughout the country
and employ more than 5,000 adult staff, many with professional
backgrounds and degrees, and all trained to care for troubled
youth in ethical and responsible ways.
One of the primary reasons our programs came together to
form NATSAP was to exchange ideas and come to agreement on
reasonable and necessary standards of operation that would
allow diversity of approach and yet provide the basic ethical
position and framework of operation that would protect children
and their families. Since NATSAP programs are located throughout
the country and serve primarily private paying families, they
fall under diverse licensure laws and regulation.
Our organization felt the need to establish a national consensus
of ethics and standards that would define programs that offer
quality care for children. To this end we have established
Ethical Principles, Principles of Good Practice, Supplemental
Principles of Good Practice for Therapeutic Schools, and Standards
for Behavior Support Management. We have enclosed a copy of
each of these principles and standards. They can also be reviewed
on our website www.natsap.org/overview/asp. All NATSAP programs
are required to subscribe to these principles and standards
as a condition of membership, and we provide ongoing discussion
and education about ethics and operations at our national
and regional conferences.
In addition to membership in NATSAP, the majority of our
members are licensed or accredited either by a state licensing
board or by a national or regional accrediting agency. The
national accrediting agencies include the Joint Commission
on Accreditation of Healthcare Organizations (JCAHO), the
Commission on Accreditation of Rehabilitation Facilities (CARF),
and the Council on Accreditation (COA). We have found that
there is great diversity in the structure and operations of
programs throughout the country, and so it is important to
allow for a variety of methods to assure that programs comply
with high standards of care.
We also recognize that there are programs that are unaware
or chose to ignore basic ethical standards and practice principles.
We feel that such programs represent a minority of the many
fine programs who serve troubled youth. However, such programs
are, of course, a risk to families, children, and to all of
us who operate quality programs. NATSAP hopes to raise awareness
for such programs, and try to include and educate such operators
to improve their program quality and safety.
NATSAP programs, however, have legitimate concern that it
would be very dangerous for either the federal or any state
government to create prescriptive regulations without input
and representation from our member programs. For example,
our organization is quite concerned about your proposed legislation
in SECTION. 303. Eligibility (b) (3) that states "In
the case of each child who is a resident of the facility and
whose domicile is another State, the facility meets the standards
of such other State for the operation of such a facility,
including any licensing standards". Given the vast array
of administrative rules in different states such a clause
would create an unreasonable administrative nightmare, and
in effect allow the most restrictive rules in all states to
dictate treatment standards for every state. We urge you to
omit SECTION 303 (b) (3), and furthermore ask that you meet
with representatives from our organization to discuss a variety
of issues with your proposed legislation.
Programs that serve the private market are, of course, in
need of clear operational standards, but such standards are
in many cases quite different from those required for publicly
funded programs in which the state has a fiduciary responsibility
for both the expenditure of funds and often for the care and
guardianship of the affected children. In the private pay
market, parents retain the ultimate control to authorize,
pay for, and select the type of treatment they feel most appropriate
for their child. Both parents and children in such situations
still need assurance that the programs they choose and work
with represent themselves honestly, and have practice standards
that are within the range considered safe and appropriate
by the profession. It is in this spirit that NATSAP members
have worked to create our Ethical Principles and Practice
Standards.
NATSAP would like to offer our resources to work with you
on ways to approach the problem of defining the proper role
of government and regulation for the private pay market. We
support an approach that does not suppress the diversity of
legitimate methods in our profession and yet protects the
interest and concerns of parents and children enrolled in
our programs. We would like to open a dialogue with your office
in order to assure that any laws or regulations that you sponsor
are crafted in a way that protects the legitimate interest
of ethical programs as well as safeguarding the interest of
the children and families we serve.
Thank you for your consideration.
Sincerely,
Jan Moss
NATSAP Executive Director
John Santa, Ph.D.
NATSAP Board President
Copyright ©
2005, Woodbury Reports, Inc. All Rights Reserved.
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