December 18,2025

Wyden Announces Major Reforms to Youth Residential Treatment Facilities

Following Landmark Investigation Into Abuse and Neglect at Inpatient Behavioral Health Providers for Youth, Top Democrat Reveals Comprehensive Reforms

Text of the Section-by-Section Summary (PDF)

Washington, D.C. – Senate Finance Committee Ranking Member Ron Wyden, D-Ore., today released a proposal to reform youth residential treatment facilities (RTFs) after comprehensive investigations into these inpatient behavioral health providers found a persistent pattern of abuse and neglect of the young Americans, including foster youth, who turn to them for help.

“Young Americans who are struggling with their mental health or who are in foster care deserve far better than what they’re getting right now,” Wyden said. “My investigation revealed that inappropriate placements and abuse and neglect in residential treatment facilities run rampant throughout the industry while taxpayers continue to foot the bill. It’s time to invest in solutions that meet these young people where they are, and give watchdogs the tools to spot and stop abuse quickly. These commonsense reforms are urgently needed and I look forward to charting a new path forward for young Americans who need support.”

The legislation, called the “Better Results through In-community Delivery, Greater Enforcement, and Stronger Services (BRIDGES) for Kids Act,” takes a multi-step approach to improving the care of vulnerable children who have mental health needs and children in the child welfare system. The legislation focuses on investing in community-centered solutions, increasing oversight of RTFs, and improving conditions at RTFs.

Key policies include:

  • Increasing the federal Medicaid matching rate for intensive home- and community-based services for children and youth with mental health and substance use conditions;

  • Increasing federal support for children in the child welfare system placed with kin;

  • Bolstering the mental health workforce through a federal grant program to cultivate new community-based mental health providers as well as youth mental health clinician loan forgiveness;

  • Establishing a uniform reporting system for RTFs, including reporting on critical indicators of quality and safety;

  • Standardizing licensure requirements of RTFs to promote quality and accountability;

  • Ensuring oversight actors such as Protection and Advocacy Systems (P&As) have the resources and access they need to continue their critical oversight; and

  • Requiring that RTFs have at least one licensed psychiatrist, psychologist, counselor, social worker, or other mental or behavioral health provider on site for at least 12 hours a day and available for emergency support 24/7.

Last year, Wyden released a landmark investigation, revealing widespread abuse and neglect at youth RTFs around the nation. The investigation found that children in these facilities are at risk of and regularly subjected to physical, sexual, and verbal abuse; inappropriate restraints and seclusions; unsafe and unsanitary conditions; and lack of necessary behavioral health care and educational support. A follow-up investigation found that LGBTQ+ youth face unique additional harms and discrimination in these facilities.

The section-by-section summary of the legislation can be found here. The legislative text can be found here.

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