Governor to enact treatment facility reform

South Dakota News Watch image

Gov. Kristi Noem has ordered the state Department of Social Services to enact a series of wide-ranging reforms intended to improve the safety of youths sent to privately run treatment facilities across South Dakota.

The governor’s announcement came in response to an investigative report published June 5 by South Dakota News Watch that uncovered a decade-long pattern of physical, sexual and psychological abuse of youths at Aurora Plains Academy, a privately run, government-funded intensive residential treatment facility in Plankinton.

“As a mom, it deeply saddens me to read the stories of these kids. Regardless of whether a situation happened 10 years ago, 10 months ago or 10 days ago, abuse is never OK,” the governor wrote in a statement to News Watch. “I hope we can learn and take corrective action where it is needed to protect our most vulnerable population.”

Noem said she has ordered DSS, which has regulatory authority over youth treatment facilities including Aurora Plains, to review and reform licensing and inspection processes of the facilities, to seek ways to improve safety for children, to increase transparency of neglect or abuse complaints and corrective-action plans, and to push state agencies to do more unannounced inspections (only one annual, pre-announced inspection of each facility is done by the state now.)

“In light of the stories of abuse these people have shared, I have asked the Department of Social Services to produce a full analysis on the processes for licensing and inspecting these private facilities and fully evaluate the department’s role in ensuring the wellbeing and safety of these children,” Noem wrote. “If there are ways to improve our systems – whether that’s through added resources, increased oversight, or legislation – we must act. We must do better.”

Six-month investigation

The six-month News Watch investigation included a review of public records and independent injury investigations, as well as a dozen on-the-record interviews with former academy residents and employees and the parents of residents. The report showed that 400 child abuse or neglect complaints were filed against Aurora Plains over the past 10 years, but that the state investigated only 39 of those complaints and issued four corrective-action reports during that time. The report further showed that some employees were needlessly rough with residents, that some employees used illegal restraints and holds, that residents were bullied and taunted by some employees, and that a culture of secrecy and protectionism within the facility allowed the abuse to continue unabated. Several residents were left with physical injuries including injured limbs, bruising and rug burns on their faces. Some female residents reported being touched sexually or having their breasts pinched to the point of bruising.

Noem, a first-term Republican governor, said Aurora Plains was placed under a corrective-action plan by the state from 2012 to 2014 that required improvements in reporting protocols, the proper use of physical restraints on residents, the supervision of youth, the management and training of staff, and emergency procedures. She said the number of complaints filed against the facility fell after those steps were taken.

“Facilities such as Aurora Plains Academy play a critical role to a very vulnerable population,” Noem wrote. “My team and I remain committed to protecting kids in this facility and helping these private facilities administer the best care for youth.”

In an earlier email to News Watch, Noem wrote that improvements were required and have been implemented at the Black Hills Children’s Home, a privately run residential youth treatment facility in Rockerville operated by the Children’s Home Society. That facility in February lost track of 9-year-old resident Serenity Dennard, who ran away and has not been found and is presumed dead by authorities, who continue to search for her.

The president of Clinicare Corp., the for-profit Wisconsin firm that operates Aurora Plains, said in a statement that the News Watch investigation was incomplete, and “distorted” the role of academy employees in allegations of improper care.

“Because of regulatory and legal requirements regarding confidentiality … we are not in a position to publicly address such allegations,” company president David Fritsch wrote in response to a series of questions sent to him by News Watch. “That said, the reporting of several allegations misrepresents the scope of the alleged incidents with incomplete accounts that distort the response by staff members.”

Fritsch declined an interview request. But in his statement, he noted that Aurora Plains employees were trained in late 2018 on a new form of physical restraint known as Safe Crisis Management, which emphasizes de-escalation and collaborative problem solving.

By state regulation, academy employees are allowed to physically restrain residents only when they are a danger to themselves or others. Former academy residents and employees told News Watch that some employees often used holds or sometimes tackled them to the ground or mashed their faces into walls or the floor. Hard restraints were done for minor violations such as not following orders, talking out of turn or failing to take medications, they said. Some employees would goad residents into acting out so they could restrain them and would then falsify reports to place the blame on residents for causing their own injuries.

Aurora Plains is an intensive residential treatment center licensed to house 66 people ages 10 to 20, with 48 beds for males and 18 for females, according to the facility website. The site refers to its clientele as a special population “characterized by high levels of verbal, physical and sexual aggression.”

State Sen. Joshua Klumb, a Republican from Mount Vernon whose district includes Aurora County, where Aurora Plains Academy is located, said he knows and attends church with several academy employees who he said are fine people.

“I don’t really believe there is a problem,” said Klumb, who noted that he sits on a community advisory board for Aurora Plains Academy.

Klumb said it’s likely that people who have alleged abuses at the academy are “disgruntled,” and that he feels state oversight of the facility has been adequate. “I think we’ve got two sides of the story there and I have to go with the people I trust,” Klumb said.

State Rep. Paul Miskimins of Mitchell, a Republican whose district includes Aurora County, said he also knows good people who work at Aurora Plains but added that it is clear mistakes were made and that abuse of some youths did occur.

“It is of great concern to all the people of South Dakota,” Miskimins said. “Whether DSS needs to step up their game to protect these young people or whether ownership needs to change, I’m not in charge of that. But if nothing happens, then I think action needs to be taken.”

Miskimins said greater transparency and oversight of operations and outcomes are needed at Aurora Plains, and he suggested that improved training and screening of employees could help make the facility safer. He also called for more unannounced inspections and more thorough investigations when complaints are made.

“These allegations should be taken seriously and investigated, and probably some changes need to be made in the way things are reviewed and listened to when complaints are made because it doesn’t seem that the complaints were adequately responded to,” he said. “Those that are pinching and sexually and physically abusing, that’s wrong and everyone knows that.”

Mistreatment reported

Jessi Dillon, now 24 and a construction worker in Sioux City, Iowa, said he remains emotionally scarred by the way he and others were treated by employees of the academy.

Dillon said he saw physical or mental abuse of residents almost daily, and would frequently hear youths cry out in pain or terror either in his residential pod or from others within the campus. One morning, after a restless night where his medications prevented him from sleeping, Dillon said he tried to stay in bed. Suddenly, he said, two therapeutic-support staff members showed up and physically removed him from his bed.

“Two of them picked me up and pinned me to the wall and slammed me to the ground and drug me out with my face dragging on the floor,” Dillon said. “They pinned arms so far behind my back it made my chest so tight it was hard to breathe.”

Lauren Schroeder, the parent of a boy who suffered extensive bruising and rug burns as a result of abuse by employees of the academy in 2015, was cautiously optimistic that the governor’s directives would lead to positive change.

“I think it’s a start, and while there’s something behind words, there’s much more behind action, so we really need to see action,” said Schroeder, whose son’s injuries were documented by police in Aberdeen and at Child’s Voice within Sanford Children’s Hospital in Sioux Falls. 

Emily Mitchell, whose son Ender Murray, then 10, suffered a black eye, bruising and rug burns during an attack by an academy employee in 2013, said she appreciated the governor’s efforts to reform the youth treatment system.

Yet Mitchell remains angry over the mistreatment of her son and said that it shouldn’t have taken state officials so long to listen to and believe the complaints of abuse made against academy employees by residents and their parents.

“I appreciate her taking action, but I feel like it’s not enough,” said Mitchell, who has pushed for youth treatment reform since her son was injured six years ago.

Mitchell said her son has post-traumatic stress disorder in addition to physical and emotional scarring from the abuse he endured at Aurora Plains. “They abused him repeatedly over 24 months and stole his shine,” she said. “They left my child a shell of who he was.”

Clinicare, a firm launched in 1967, now operates Aurora Plains and similar intensive youth treatment facilities in Victoria, Minn., and in Eau Claire and Milwaukee, Wis.

The mistreatment at Aurora Plains is not the first time Clinicare has faced serious allegations of injurious treatment of youths at its facilities.

In October 2013, the Wisconsin Department of Children and Families revoked the license of the Wyalusing Academy in Prairie du Chien, Wisconsin, after a boy at the Clinicare-owned facility was left paralyzed due to a damaged spinal cord resulting from three restraints by staff.

State records showed that the boy, who had been at the home less than a week, was taken to the ground during a restraint and lost feeling in his legs. Despite his injuries, the boy was restrained two more times as he was moved to an isolation room and left to sleep without bedding on a hard floor. He was not taken to a hospital for more than 24 hours after the injury.

Private agencies

All 20 youth treatment facilities in South Dakota are privately operated, either by nonprofits or for-profit entities, said Tia Kafka, spokesperson for DSS.

Privatization of correctional and treatment centers for both youths and adults is on the rise in the U.S., with about half of youth facilities now run by private non-profit agencies or for-profit companies, according to the U.S. Department of Justice.

Some national studies and reports have shown that compared with state-run facilities, privately operated juvenile facilities see higher employee turnover rates, less employee training, decreased facility maintenance and increased injuries for both staff and residents.

Melissa Goemann, senior policy counsel for the non-profit National Juvenile Justice Network, said treatment outcomes and resident safety are lower at institutions run by for-profit, private firms than those that are publicly owned and overseen. Government oversight of private facilities tends to be lower as well, she said.

“There’s so many negative consequences that we’ve seen in private, for-profit facilities,” said Goemann, who researched studies and reports on privately run facilities for a 2015 position paper for the network. “The private, for-profit facilities in general have a much worse track record in terms of resident and employee safety and positive treatment outcomes.”

Goemann said for-profit firms need to maintain a strong, steady population of residents in order to maximize profits, sometimes taking in residents who don’t really need to be there. They also try to limit spending on employee training, resident programming and other overhead expenses in order to maintain cash flow, she said.

Aurora Plains is mainly funded through the Medicaid program, with a combination of state and federal funds. In fiscal year 2018, Kafka said, the facility was paid $7.34 million in government funds, with $4.1 million in federal funds and $3.2 million in state funds.

“The incentive as a for-profit company is to run the place as cheaply as possible, and that’s not in keeping with providing what children need for positive youth development, which isn’t always cheap,” said Goemann. 

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