Is D.C. Neglecting Neglect? Why the District keeps sending vulnerable kids to a troubled treatment facility

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Illustrations by Daniel Fishel

M arrived at intake covered in scars.

He was a big kid, but the wounds were self-inflicted. For the staff at The Pines residential treatment center, the marks up and down his arms and legs should have been warnings signs about his ambitions.

This March, less than two months into his stay, M dug into his own arm with a plastic spoon. He was supposed to be watched. He wasn’t. The spoon was all he needed to rip himself a primitive bloody hole. “It takes a bit of psychosis for him to cut himself with a piece of plastic as deep as he did,” recalls a current employee.

In interviews, two staffers familiar with M’s case recall him saying he didn’t want his arm anymore. Another said he was suicidal. But he was nonetheless able to hurt himself repeatedly. Staffers recall multiple E.R. trips. “Each time he ripped a staple or stitch out, did no one see that he was doing it?” asks a former staffer, who, like colleagues, declined to speak on the record due to the sensitive nature of the incident. “And why didn’t they try to stop him?”

It’s easy to see how M could get lost. From March to mid-April, according to incident records from the facility, there were 50 fights or assaults among kids—sucker punches, biting, outright brawls. There were also two suicide attempts and 15 incidents of self-harm. At the end of March, two boys, ages 8 and 9, confessed to engaging in oral and anal sex.

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With three sprawling campuses in Virginia’s Tidewater region, The Pines is the biggest for-profit residential treatment center in the state. It’s a complex operation that sustains itself on the idea of accepting just about any kid. The sexual predator, the orphan, and the gang member all occupy The Pines’ fortress of smash-proof glass and sky-blue cinderblock.

But in the past three years, The Pines has faced more abuse and neglect allegations than any other RTC facility in Virginia, according to a review of state records. Its campuses have been under constant scrutiny, threats of sanctions, and state orders to correct problems. One staffer described M’s unit as a “dog pen.”

Officials from The Pines, which changed ownership late last year, declined repeated requests to discuss specific incidents turned up in this investigation, saying new management was making changes. “All of the Pines Campuses are safe,” explains a statement sent by Kathy Parker, director of business development for Universal Health Services, its parent company. “We take the safety and well being of each resident very seriously…The Pines management team is continually reviewing clinical programming, procedures and staff training to enhance the provision of safe, effective, and patient-centered treatment.”

As it happens, this story from the far side of Virginia should matter to D.C. residents. Every year, the District spends tens of millions of dollars sending its most troubled children to distant RTCs—and The Pines has benefited like few others. Between 2009 and 2010, the city’s Department of Youth Rehabilitative Services nearly doubled the number of kids it sent there. Several other city agencies that tend to troubled kids also use The Pines.

Why keep using the place? City officials were aware of some problems, according to hundreds of emails and monitoring reports obtained through Freedom of Information Act requests. But those same documents demonstrate a cozy relationship between the city and the facility, one that persisted despite the countless warning signs.

Other governments moved more quickly. In early spring, well after the management change, North Carolina announced that it had begun the process of yanking its own kids out of The Pines. D.C. agencies, though, have been confused on just how to respond. On May 16, after repeatedly defending the placements in interviews for this story, DYRS announced plans to pull them. “Based on discussions with our partners in the District and the licensing authorities in Virginia, we believe it would be easier for The Pines management to deal with some of their operational and administrative challenges with a smaller population,” says DYRS Chief of Staff Christopher Shorter.

At least one other city agency, though, still has kids at the Pines. And the story of why that is explains a lot about how D.C. cares for troubled kids.


If Virginia officials had their way, D.C. would never have sent so many kids to The Pines. In spring 2009, an agreement with Virginia officials stipulated that the facility would improve its care and work toward “decreasing the number of Out-of-State residents, particularly those with very serious histories of violence or gang activity.”

That promise had no effect on The Pines’ business with the District. A Pines worker was even given a desk in 2009 in DYRS’ offices, according to three current and former city workers. Sources say she handled the heavy paperwork load for the city’s many dealings with The Pines. “She was actually really good—on the business side,” recalls one former official. The in-house Pines staffer left last summer after other RTCs asked for space, and the city decided it couldn’t accommodate all of its contractors.

Our Readers Say

Everyone who was involved in monitoring the Pines from D.C. ought to be ashamed of themselves. And that goes for Tommy Wells who should have done more to protect kids like M.

I have applied to the Pines several times. I also know people that have they have never heard anything from the agency. I applied over 2 months ago. If the staff were not few and far bewteen as they have said in the media maybe the kids can be watched more closely. I worked in a sex offender facility for male adults for over 18 months so I do have that experience.
Great story Jason & Washington City Paper! Thanks for having the bravery to print the truth. It's about time the media started giving this hidden issue some national attention. Facilities owned by Universal Health Services are having these same problems all over the United States because they all follow the business pattern of UHS, "Profits over People!" The disabled children in their care suffer and the states and localities are requiring accountability by UHS. UHS/The Pines states that they accept the kids nobody else will take, dangerous children with severe, complex problems. Ha! This article shows UHS/The Pines also take lots of children, young children, who are guilty only of not having a placement available, not because they have done anything horrendous. Many of them are foster children. But when 8 & 9 year old children are raping each other they will certainly be developing problems soon enough. UHS / The Pines is a holding pen and huge money maker for Universal Health Services. UHS / The Pines doesn't take just the kids nobody else wants, they take any kid that can make it through the door. And if the child can't make it to the door, UHS / The Pines is happy to go get them from wherever and drag them kicking and screaming through the door. Crossing the threshold is the only requirement for acceptance into UHS / The Pines. Thankfully, starting July 1, 2011, the Virginia DBHDS will be posting all the investigations and inspections for residential facilities on line and everyone will be able to see for themselves the horrible things that happen in residential facilities in Virginia, especially those owned by Universal Health Services / Psychiatric Solutions Inc. To see all the stories now, got to "Keep An Eye On PSI!" (And UHS!) on Facebook. http://www.facebook.com/home.php?sk=group_326364429203
Ooops .... and the states and localities are NOT requiring accountability by UHS! Look here for the pitiful amount of licensing information listed about UHS / The Pines on the Virginia DBHDS licensing website. (Search for The Pines under T ) http://www.dbhds.virginia.gov/LPSS/LPSS.aspx

Without better accountability, how could anyone know how poor a job UHS / The Pines is doing and how often the children there are abused, neglected, raped, and almost killed?

And how embarrassing that the Virginia DBHDS still lists facilities as licensed for children with "mental retardation." When will Virginia crawl out of the dark ages?
Glad to see the CityPaper is still doing stories about things that really matter. Thanks Jason. This is heartbreaking.
As a previous employee of the Pines, I can say it is not just the staff for monitoring the residents. In late 2009 & beginning of 2010, that particular campus reduced the amount of staff per unit, thus reduce the ratio staff per resident. At the time, staff and residents argued for the safety of the children, as well as staff on the more violent units and sexually acting units. Administration excuse at the time was that teachers were also part of the count (ratio) and can do just about the same as staff was qualified for. I witnessed first hand, when altercations and codes let out on the unit and school, very few to respond to them were teachers. I worked on a sex offender unit with 11-12 young male residents w/ one other female staff. Luckily we were a strong team, but in the mornings teachers who were suppose to be in ratio with us would either not show up or be late. When reported to management, their only suggestion is to tell the principal (their boss) of the lack of duties. I've worked there for 2 yrs, during that period it had a lot to do with Administration and management. As staff, we come in and did our assigned jobs with little or no support from them. Granted there are few bad apples that come in and sit around for an easy paycheck, but the staff who do work hard are the ones who get shitted on the most! Staff who are protected on the Pines' umbrella come in as late as they want to, not caring about ratio and relieving those who worked 8 to 12 to double shifts. They can put their hands on residents and as long as everyone's on the same page, does not get reported, only documented. Sure staff gets a slap on the hand, but after a week is back on the floor doing other careless things. The staff that come in, do their job right, and keep their mouth shut are the ones being pushed over by management. It's like they want disgruntle staff to work their units and say they're doing a sucky job.
Cases like M, the doctor, nurses, Administration all knew he was on 1:1 for suicide attempt but that unit and other units in that same situation do not get the proper amount of staff scheduled for that type of monitoring. The excuses, they didn't know he was a 1:1 or shortage of staff. Basically, lack of/NO communication and, of course, if something did happen staff is to blame even after pleading with management that they would need extra staff on that particular unit, especially if it was the most hostile unit on campus.
There's a resident who has a history of punching or assaulting female staff. Supposedly charges get pressed, but that boy is stlll there. Pines can't afford to lose the big bucks!
So it's not about watching the kids more closely. When I worked there, I did what I can with what I had. If there were 2 staff to 11 residents, best believe all of them would be sitting in eye view. My best days were with my residents and when management would stay the hell out of my way! They're the laziest bunch of bastards!
Thats the problem there are to many comments and not actions. Take action. How many of these children for real have been neglected from not recieving family support services and assitance. Take some of these selfish, cheek eating case managers out of the system an put people in the system that care. Some things are not about a check.

TAKE ACTION:
NEEDED PLACE THE PEOPLE IN CHARGE UNDER INVESTIGATION MAKE THEM ACCOUTABLE FOR EVERY CHILD FOUND TO HURT THEMSELVES OR OTHERS. CHILD ABUSE AND NEGELECT CHARGES HOW ARE THEY ANY DIFFRENT THAN THE PARENTS, TEACHERS, COACHES OR ANY ONE ELSE ACUSED.
For all of those folks who think RTC's are horrible, please give your home addresses to DYRS so they can place the kids near you in your communities. Cant have it both ways. Communities have to be prepared to embrace troubled young persons being home.
The issue of the district not having sufficient resources,but simultaneously claiming that it somehow can provide new and improved services for less,should set off warning bells for parents of very vunerable loved ones. No where have I seen this any worse than with the special needs population, particularly the autistic. Bill 2-137,allows the funding agency {DDS} to not serve that population based on the bottom line. This puts our loved ones at risk for abuse because of their autistic behavior {which often is very violent}.
Great Article,

I interned at DYRS for a year and found the over reliance on RTC's to be troubling, what I found more troubling was that DYRS upper management had no real control over or buy-in from their staff. In fact the idea of waiting out an administration was normative and low and behold there have been what three leaders of DYRS in the last two years.... or is it more. Anyway in defense of the case workers the reliance on a very small number of outside agencies for all therapeutic, vocational, educational, and monitoring services mean that they can easily worm there way out of over-site. And on another note case loads of 30 or 40 youth (who probation could not handle) is to many and way above what is considered a best practice for the industry. Good luck DYRS, there is so much room for improvement.
There is no excuse for warehousing children in RTCs, period. Even when they are not physically abusive, institutionalizing a child *is* abusing a child. And it is almost never necessary. For details see our brief publication on RTCs on our website. (Links aren’t allowed, but a Google search for “Residential Treatment: What the research tells us” will turn it up.

As for DC, while CFSA sent fewer children to this hellhole than the other agencies, it apparently was the most clueless, remaining willfully ignorant of what the place was doing to children even after the other DC agencies had to face up to it.

And that means the Roque Gerald Apologist Brigade which turned out after his recent resignation, has got some explaining to do.

Richard Wexler
Executive Director
National Coalition for Child Protection Reform
This is sad, but our youth are not being given a chance to change anything.
This is a wonderful investigative expose,and some great dialog has come. I do however,want to remind all who either have had special needs loved ones in this facility or in any of the other facilties used by the District to send vunerable disabled residents they had no clue how to serve themselves. That simply because our former mayor forced out of state placements back into the District,the system is still fraught with incompetence and greed. Both of which often lead to the very abuse we see in this case.
I worked at the Pines for over 3 yrs. It started out being a good experience but as time went on I discovered that the administration cared more about money than about the residents and the staff. Residential Treatment Centers can be helpful to troubled youth because I have seen some success stories however if the administration does not care about the well being of the residents it just becomes a housing place for troubled kids where they end up leaving with more problems then they came in with.

I contacted the news and fire department and health department multiples time to report things within the facility, but I guess the Pines was putting to much money into the city for anyone to care. I can go on and on but it's probably useless. DC needs to take heed to what others are doing and utilize Foster Care and relative placement instead of the Pines. There is a reason that none of the localities surrounding the Pines send their kids there.
It is unquestionable that oversight and consequential actions need to be prioritized, not just at the Pines, but in residential institutions all over the country. It is sickening to read about the treatment that these residents receive, especially in an environment that even under the best circumstances is considered threatening to an individual's mental health. I commend states (such as Pennsylvania) which have committed to closing their institutions, and even taken state-sponsored steps to increase awareness about the downfalls and potential abuses associated with this type of placement. However, having worked in the field for many years and in many different settings, it must also be stressed that the idealism associated with community living for all is NOT yet feasible. Not enough attention nor resources have been funneled into the development of programs that provide both an integrated community placement AND the support that is so desperately needed for such programs to succeed. Even community programs that do currently exist experience their own problems, such as underpaid, undertrained and overworked staff, suffering supervision ratios, pressure to accept new clients that may not be appropriate for a specific placement, and employee turnover at all levels. A focus on the elimination of questionable and dangerous practices in institutions MUST be coupled with efforts to develop appropriate alternative programs that minimize risk. This is the only way to ensure that these consumers receive maximum benefit from the services they are entitled to receive.
"Profit over People" sums it up. If Virginian residents knew the amound of tax money spent on Licensing investigations there would be serious backlash. Most of the Pines residents come from out of state. At the very least the Pines should be fined for each investigation that the state has to perform because of their poor management, lack of supervision, and inability to hire decent caring people who refuse to look the other way because it just easier. The ones that do nothing are the worst offenders of all. I spoke out, I'm no longer there. I'm better for it. Thanks for the experience.
I was recently place in a Psychiatric ward this past month for a week. And I understand the frustration the youth go through, as I'm 25 years old, and was dated to start college that same week. My experience in community organizing tells me that we need role models in the class room, and in the community bringing alternative and extracurricular education to kids from therapeutic approach. Their behavior has been shown to change when around a culturally-familiar environment.
I blame the parents- for one you if you are jacked up and have other issues please kill or give away the child. At the same time its your job to protect your child not others. Second- in other countries things would be worse, so with that said -criminals including bad a** children, need to be locked up(with keys throw away), or killed. Parents should be responsible for feeding them as well. I'm sure half the kids in the pines -(taxpayers like me are paying for services) while the dead-beat parent seat on online b*t*h*ing and complaining. Hell it's your fault and who cares. Better yet send them to the war zone -I'm sure they won't be missed.

@james- a week in the ward- wow- if if you are that emotional jacked up @ 25, then you need to do us all a favor and take a earlier vacation.

Beat your kids at a earlier age - later in life- you won't have to visit jails, pines, or other places
I'm a former employee of the Pines. The statements in this article is extremely false. We have employees that were terminated because of abuse and neglect on the job. The Pines do not tolerate that and they will terminate you. Its those ex employees that are giving false information to the media because they were let go. The Pines is not a horrible place. They take kids no one else will take, so the kids are very bad at times and they have strong therapeutic staff.
I seem to recall an article years ago...the same organization that ran The Pines opened a treatment facility for offenders in another neighborhood. The neighborhood complained. Three kids went AWOL and ended up in trouble for stealing a car. The neighborhood again rose up and complained. The issue is that they didn't complain about the treatment of the children, they complained about THE CHILDREN being in their neighborhood. When the neighborhood won it's fight and the kids were loaded onto buses, there were tears in their eyes and they cried because they were leaving the only people that had given a damn about them...their staff.

I have seen first hand, some of the employees go out and purchase Christmas gifts for children who's families didn't want them at home for the holidays. I have heard for myself these children call home and their parents hang up on them and not even want to speak with them. Alot of these kids were abused at home and now these parents who couldn't care for their children and love their children want to complain about the treatment of these children?

I agree that I don't know much about the new management and things may have changed for the worse but I agree with one statement on here...you can't have it both ways. Before we shut down one facility, lets create a better one, a better place for these kids to go and get the help they need.
Things like this do happen. Kids become very, very good at hiding things from staff, and find ways to harm themselves, harm others, even escape, while staff are doing their best to watch them and keep them safe. It shouldn't happen quite so much, but it does, and that is the nature of psychiatric care. Sometimes in psych you will be sitting with a kid 1:1, looking right at them, talking to them, and not realizing right away that below the table they have managed to find a tiny piece of plastic or metal (all it takes is one dropped paperclip, or pencil with eraser) and are cutting themselves with it. Trust me, it would take a superhuman staff to make any residence or hospital 100% incidence free. Most employees are doing their best. Nobody wants an incident, not only does it result in harm to another human being but it also costs money and makes extra work. So even the most cynical employees want to avoid them.

In a case like this I have to wonder if some kids were properly placed. Maybe some of the more violent and aggressive children needed juvenile detention, and should have received their psychiatric care in that context. Maybe kids needed to be grouped separately. It could have been understaffing, it could have been policy problems, it could have been a matter of not having the right space and supplies to provide proper safety and care. Or it could be a case of exaggeration because I know these type of incidents are inherent to inpatient psych, and a lot of parents like to blame the facility for the problems they created - some parents threaten lawsuits when their child is restrained for trying to beat up staff. Parents like to project their guilt and shame for having a child with these issues onto someone. They go to lawyers, they go to the media, they go tell everyone when a child's violence and misbehavior is not miraculously fixed overnight. It takes years to create these behaviors, and no facility is likely to simply eliminate them - at least not by following current psychiatric guidelines and providing compassionate care.

Does anyone suggest we go back to the Victorian era of protein deprivation, solitary confinement, and chains? Because that would certainly cut down on incidents.

No, I didn't think so.
This is where the focus goes from helping kids to being nothing but a cash making machine. I have worked at a "for profit"level 3 facility for a couple of years and they do take cases that are not suitable for the rest of the population and/or staff ability. These kids are mixed in with kids that may just have some minor issues, so what you end up with is a chaotic environment...fights, runaway, suicide attempts, etc. Now...to be clear sometimes restraints do not go well, lets get that in the clear! There is NOTHING therapeutic about a restraint...it is simply used to keep a client or other people safe...that's it. You have to react quickly when you do them and you really have to watch what you are doing when doing them or you will hurt a kid. That being said, management should be taking in appropriate referrals to the facility...no excuses. I manage a small group home and doing referrals is very stressful. You have to take clients that do not exceed your program's capabilities..i.e. level 2 in a level 2 facility NOT level 3 or 4. I have seen a facility take level 4 kids in at a 3 just for the money and I have seen staff and clients severely hurt. BAD MANAGEMENT! When I went to a smaller program and had to make those decisions I got it. Looks like the Pines brought all of this on themselves....if you are in this profession its to make a difference to a child not money, especially since the money is not that good:)
I am a former patient. My stay at the pines was 14 years ago.Seriously what do you expect when you have a bunch of angry,abused, addicted, disturbed teens together?. They were not sent there because they were angels.. people need to understand that every system has flaws. I was restrained, I was medicated.... because I was out of control or fighting. I came from an abusive home and all I knew was violence. I had staff members that were the only family I had ever known. I was one of the kids that they bought presents for because I was a foster child and had no family to do that for me. i went thru therapy and I learned coping skills. I learned how to function as a "normal" person. I am 29 years old and I have 5 children.I don"t drink or do drugs,I have not been incarcerated and I am a better person because of the treatment I received. It is very easy to sit back and judge...
I was there at Young teen place was not a good place to get education now I am not able to function basic education it was pervert staff there

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