June 12,2024

Crapo Statement at Hearing on Residential Treatment Facilities

Washington, D.C.--U.S. Senate Finance Committee Ranking Member Mike Crapo (R-Idaho) delivered the following remarks at a hearing entitled “Youth Residential Treatment Facilities: Examining Failures and Evaluating Solutions.”

As prepared for delivery:

“Thank you, Mr. Chairman.

“Three weeks ago, the Senate Finance Committee held a hearing to celebrate the child welfare system’s progress resulting from enactment of the Family First Prevention Services Act.

“We heard from witnesses about the importance of investing in preventive services, and that children are best served when they receive care within their homes and communities.

“While more work is needed to provide states with a diverse array of evidence-based programs to meet the needs of their communities, the Chairman and I are committed to rigorous engagement with the Administration for Children and Families to fulfill our shared commitment of prioritizing familial placement whenever possible.

“One of the goals of Family First was to reduce inappropriate placements for children in congregate care settings.

“To meet that objective, we must ensure that residential treatment interventions are a placement of last resort, with a focus on integrating patients back into the community as soon as clinically possible.

“When home and community-based services fall short of a child’s needs, families deserve access to high-quality residential treatment facilities that provide medically necessary treatment in safe, therapeutic environments.

“Anything less risks causing further harm, and escalating an already tragic and difficult situation.

“To the victims in the audience and around the country who suffered abuse and neglect in a residential treatment facility, your experience is entirely unacceptable.  Facilities entrusted with caring for our most vulnerable youth should be held to the highest standards, and subject to routine, reliable oversight.  Chronic patterns of failure must not go unnoticed or unaddressed.   

“The incidents highlighted in Chairman Wyden’s investigative report are deeply disturbing.  

“Many of these facilities are reimbursed with federal Medicaid and Title IV-E dollars, making these deficiencies even more concerning.  Hardworking taxpayers should not be funding anything less than superior care.

“Our child welfare and behavioral health systems have made a lot of progress in improving the quality of congregate care settings, but it is clear gaps remain. 

“As we consider reforms to remedy inadequacies, we must recognize the different forms of residential treatment facilities, the essential role they play in the care continuum and the regulations and requirements that are unique to each setting.

“For example, Congress established Qualified Residential Treatment Programs, or ‘QRTPs,’ as a high-quality, clinically-informed treatment option for children in the child welfare system with behavioral health needs.  Unfortunately, bureaucratic challenges have prevented many states from implementing this model.

“Additionally, psychiatric residential treatment facilities are subject to federal health and safety standards as a condition of participation in the Medicaid program.  Congress and the Administration should ensure these requirements are patient-centered, informed by best practices and promote access for those who require more intensive services.

“I look forward to a productive conversation with our witnesses today about how to improve care quality and increase accountability of youth residential treatment facilities, including by empowering states to establish QRTPs and other treatment models that best serve children.

“Again, I thank the advocates for being here and Chairman Wyden for his important work on this issue.

“Thank you, Mr. Chairman.”