Health and Safety of Participants Attending Wilderness Therapy Programs or Residential Treatment Programs for Troubled Youth on Public Lands

UNITED STATES DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
WASHINGTON, D.C. 20240

June 25, 2008

In Reply Refer To:
2930 (250) P

EMS TRANSMISSION 07/01/2008
Instruction Memorandum No. 2008-141
Expires: 09/30/2009

To: All Field Officials

From: Assistant Director, Renewable Resources and Planning

Subject: Health and Safety of Participants Attending “Wilderness Therapy Programs” or
“Residential Treatment Programs for Troubled Youth” on Public Lands

Program Area: Recreation – Special Recreation Permits

Purpose: The purpose of this Instruction Memorandum (IM) is to ensure that wilderness therapy or residential treatment programs for troubled youth operating under Special Recreation Permits (SRP) are appropriately using the lands and waters managed by the Bureau of Land Management (BLM); are adequately providing for the protection, health, and safety of children participating in the programs; and are in compliance with state licensing or registration requirements.

Policy/Action: Currently, there is no standard definition for wilderness therapy programs.
The Government Accountability Office (GAO) in their October 10, 2007 testimony, GAO-08-146T, before the Committee on Education and Labor, House of Representatives describes residential treatment programs for troubled youth as entities that call themselves “… wilderness therapy programs, boarding schools, academies, behavioral modification facilities, and boot camps, among other names” and which “…provide a range of services, including drug and alcohol treatment, confidence building, military-style discipline, and psychological counseling for illnesses such as depression and attention deficit disorder.”

Based on this information and lacking a standard definition, the BLM defines wilderness therapy programs as those programs intended to provide a less restrictive alternative to incarceration or hospitalization for youth who may require intervention to address emotional or behavioral challenges. These programs are directed toward youth under age 18 with a variety of behavioral and emotional problems including substance abuse, addiction, physical/mental disabilities, learning disorders, criminality, psycho/social and sexual issues. Participants may pose a risk to themselves or others.

Additionally, these programs generally:

Provide an individualized treatment plan, based on the diagnosis of a mental or physical health issue, with specific behavioral and emotional goals for clients or patients;
Serve adjudicated or at risk youth under age 18 who have a variety of behavioral and emotional problems including substance abuse, addiction, physical/mental disabilities, learning disorders, criminality, psycho/social and sexual issues;
Serve clients or patients who are not typically participating of their own free will, cannot leave the program on their own accord, and participate in the program as part of an intervention, treatment or adjudication requirement or mandate; and
Involve long-term residency in the outdoors, typically lasting a month or more.
The BLM definition for wilderness therapy programs excludes the more general outdoor recreational and educational programs, classes, courses and activities offered to youth by churches, outdoor schools, environmental and wilderness education programs, colleges and public or private accredited schools, summer camps, youth groups, and adventure travel and adventure-based organizations.

Authorization of wilderness therapy or residential treatment must be performed according to the requirements of Chapter 1 in Handbook H-2930-1, Recreation Permit Administration. Also, given the sensitive nature of these programs, it is imperative that adequate monitoring and performance evaluations be conducted to ensure compliance with all permit stipulations.

Because of the heightened concerns about wilderness therapy or residential treatment programs for troubled youth, the following special requirements pertain to permitting their operation on public lands:
The BLM will only permit wilderness therapy programs to use public lands in states that assume primacy in the regulation and oversight of treatment plans, living conditions and health and safety of the participants and that oversee the programs through periodic inspections in the field. Because of the wide variation of state requirements for these programs, each state office must determine state licensing requirements and regulations.
In states without state licensure and regulations for wilderness therapy programs or where state oversight is either unavailable or inadequate, the BLM office should deny the application on the basis that the BLM has neither the personnel nor expertise to provide adequate oversight of residential treatment and wilderness therapy programs.
Wilderness therapy programs currently operating under permit in states without state licensure and regulations for wilderness therapy programs or where states do not provide for periodic inspections should be notified that existing permits will not be renewed upon expiration. Furthermore, when feasible, these permits should be terminated prior to their expiration.
Each BLM State Office with jurisdiction over BLM lands where wilderness therapy programs are either operating on or planned for these lands will issue a protocol for field offices to follow in dealing with permits for wilderness therapy or residential treatment programs for troubled youth.
Wilderness therapy programs must be licensed by the state where the program will be operating. The applicant shall provide documentation that all state requirements are met and that it is in good standing before the BLM office can issue the permit. The permit must further stipulate that the operator will remain in compliance with all state licensing requirements and regulations while operating wilderness therapy programs on public lands.
The applicant shall provide records and references relative to prior experience and similar operations. The authorizing officer shall review the information to determine circumstances that would recommend against granting a permit.
As with all SRPs, the applicant must provide a complete description of the scope and duration of the proposed program, including venues, dates, group size, staffing, and other operational details pertaining to licensing requirements. In conjunction with issuing a permit, the authorizing office will provide this information in writing to appropriate state and local authorities having jurisdiction over these programs with a request that all operations be monitored for compliance with their regulations and licensing requirements.
The authorizing officer should request that state and local authorities having jurisdiction over licensed wilderness therapy programs provide timely notification to the authorizing BLM Office concerning any incidents that would recommend suspension or termination of a permit for operation on public lands. If a state suspends or revokes the license or orders operations to cease; the SRP shall be suspended or revoked.
The authorizing office will provide timely notification of any suspected incidents of child abuse or neglect to the appropriate state and local authorities. Soon after this notification process the office will also consult with these authorities to determine if the program should be suspended to prevent further incidents and to protect the health and safety of the participants. Where the program is stopped on the basis of substantiated incidents of child abuse or neglect, the permit should be suspended or revoked. In these cases, timely notification will be provided to other BLM states permitting similar programs recorded in the Recreation Management Information System (RMIS).
Each office permitting wilderness therapy or residential treatment programs for troubled youth will record the information in the RMIS and take other steps necessary to ensure adequate tracking. Wilderness therapy program SRPs should be entered in the RMIS database with the new SRP primary purpose listed as “wilderness therapeutic programs – youth.” In addition, the notes section can be used to record information regarding state licenses and other relevant data. If requested, this information will be provided to responsible state and local officials and other organizations and entities having oversight and the need to determine performance of the programs.
Wilderness therapy or residential treatment programs for troubled youth operating primarily off public lands are exempt from this policy when they make short-term (i.e., one-day, overnight or weekend) visits to public land recreation areas, sites and attractions primarily for recreational purposes.
Timeframe: This IM is effective immediately.

Budget Impact: The overall impact to budget development workload is minimal.

Background: Widespread interest in wilderness therapy or residential treatment programs for troubled youth requires the BLM to ensure permitted programs are operating in compliance with state and local laws and regulations and providing for the health and safety of the participants. On January 18, 2008, the Office of the Inspector General (OIG) wrote a memo to the Secretary making two recommendations concerning the permitting and operations of wilderness therapy or residential treatment programs for troubled youth on public lands. These recommendations resulted from an independent study the OIG conducted in response to a Congressional request dated October 11, 2007, related to these programs.

The two recommendations are:
Prior to awarding Special Use or Recreation Permits to residential treatment programs, the Department of the Interior’s (DOI) bureaus must validate whether the program is licensed in the state(s) in which it operate(s) and have the program declare the full scope of the program’s activities while using DOI lands; and
Require the local field offices, park units or wildlife refuges to notify the appropriate oversight bodies, such as a local or state government office(s), in writing about the existence of residential treatment programs operating on DOI lands along with timely notification regarding any incidents of child abuse or neglect on DOI lands associated with residential treatment programs they oversee.
The OIG also noted that the BLM’s use of the RMIS distinguishes the BLM as the only DOI bureau that currently tracks commercial and organized group SRPs using a centralized data system.

The GAO, on October 10, 2007, provided testimony to Congress which notes that many individuals cite positive outcomes associated with specific types of residential treatment. However, they also outline allegations regarding the abuse and death of participants enrolled in wilderness therapy or residential treatment programs for troubled youth. The GAO’s testimony includes a report on 10 case studies concerning programs where youth fatalities occurred on Federal lands, including those managed by the BLM.

As for oversight of residential treatment programs, the GAO notes that states have taken a variety of approaches ranging from no oversight to statutory regulations that require licensing and oversight. States differ in how they license and monitor the various types of programs in terms of both the agencies involved and the types of requirements. For example, some states have centralized licensing and monitoring within a single agency, while other states have decentralized these functions among three or more different agencies. There are currently no federal laws that define and regulate residential treatment programs.

Manual/Handbook Sections Affected: 2930 Manual and Handbook – Recreation Permits and Fees

Coordination: This policy was developed with the assistance of multiple BLM Field and State Offices, WO-120, WO-170, WO-250.

Contact: For further information, contact Hal Hallett, Senior Outdoor Recreation Specialist, 202-452-7794.

Signed by: Authenticated by:
Edwin L. Roberson Robert M. Williams
Assistant Director Division of IRM Governance,WO-560
Renewable Resources and Planning