The state exercises virtually no supervision over the training of workers at privately run programs for juvenile offenders such as Bowling Brook Preparatory School, where a youth died last week after being restrained by staff, state officials acknowledge.
The Maryland Department of Juvenile Services says it isn't required by law to monitor how staff are trained and does not do so, even though it places about 900 juvenile offenders housed in privately operated centers at a cost to taxpayers of about $36.4 million.
One of the offenders it referred to the school in Carroll County, 17-year-old Isaiah Simmons, died there Jan. 23 after losing consciousness while being restrained over a period of several hours, a struggle described in an incident report filed by Bowling Brook with the state agency.
"The law does not require us to identify their training, assess it, nothing," said spokesman Edward Hopkins. He said the agency checks only personnel records at private facilities to make sure staff are reported as being trained. "We have to believe they are operating in good faith in providing that training," he said.
Though the agency is not precluded by law from conducting whatever supervision it deems necessary, officials said their resources are stretched thin. "I have eight investigators to cover the entire state of Maryland, so you do the math on that," said Peter Keefer, the assistant director for the department's investigations and monitoring division.
The state pays Bowling Brook $124 a day to house each youth referred there by the Department of Juvenile Services, Hopkins said. The payments are made under a three-year contract with the nonprofit school that extends to June 30, 2008, and allows for payments of up to $3.5 million a year.
Staff at state-licensed private facilities must pass criminal background checks supervised by the state. Direct-care workers under age 21 must have an associate of arts degree, while those over 21 must have at least a high school diploma or equivalent, state officials said.
They must also have 40 hours of training, including the use of restraint techniques.
The methods used to subdue Simmons have raised questions about such practices and about the state's oversight of such programs.
Multiple witnesses to Simmons' death have independently told lawyers they saw staff members sitting on the struggling teenager until he passed out and died, according to Maryland's chief public defender, Nancy S. Forster.
Several youths have also stated in interviews with The Sun that Bowling Brook staff routinely restrained students, sometimes for hours and for what they describe as minor infractions, such as disobeying an order not to talk at dinner. They described techniques that appear to conflict with what state policies and that experts say are widely accepted as proper methods for controlling an unruly youth.
For example, one student said that he was held facedown for four hours, and that staff did not release him when he complained of trouble breathing.
Experts say that counselors who provide care to troubled youths should be carefully trained in safe restraining techniques, because children can suffer serious injury or die if improper methods are used.
In the incident report released this week by the juvenile services department, school officials said their staff handled Simmons appropriately.
Bowling Brook officials have also expressed confidence that an investigation by the Carroll County sheriff's office will determine that the school did nothing wrong.
"The staff involved in this incident was senior staff of the highest caliber with advanced training," the statement said. "Bowling Brook has an extensive training program for all staff that meets or exceeds the requirements of Maryland law, including the use of physical restraints."
The president of a firm that formerly trained Bowling Brook's staff in restraint techniques, Pennsylvania-based JKM Training, said methods described by students there are inconsistent with his company's curriculum and philosophy.
"We never [teach] a position that gets on top of somebody," said company president Joseph K. Mullen. "There's no body weight used, no pressure points used. Any time you're inflicting pain, you're walking across the line of child abuse regulations in any state you're working in."
Mullen said Bowling Brook is not a current client and declined to say when his company, which provides training in 35 states, last worked with the school.
Despite limited state oversight, most residential facilities for juvenile offenders try to provide their staff with high-quality training that meets standards recommended by national advocates for youth welfare, said James McComb, executive director of the Maryland Association of Resources for Family and Youth.
The nonprofit group, which represents about half of the 270 state-licensed private residential child care and juvenile programs in Maryland, offers its members the training services of Steve Parese of North Carolina, an expert in controlling aggressive youths.
"We make his training available to anybody who signs up," McComb said.
Parese was in Baltimore last week, putting five people through a physically rigorous four-day training program to prepare them to train others how to subdue troubled youths.
At a small hotel meeting room near BWI Marshall Airport, Parese and Damaris Bristol wrestled a struggling Rachel Eversole facedown.
Leaning over her, Parese pinned Eversole's shoulders back using a wrestling hold called a "double arm bar" and clasped his fingers across her upper back, while Bristol draped herself over Eversole's ankles. It appeared that Parese was pushing down hard on Eversole's back, but she said she had no trouble breathing. "There's no pressure on my back at all," Eversole said.
Parese pointed out that all of his 200-pound weight was distributed on the floor; his body was cradling Eversole, not pushing on her.
Eversole will take the skills learned here back to the Shining Tree Children's Home in Hagerstown, where she will teach other counselors how to physically control court-committed youths when they become dangerous to themselves or others. Bristol works at the Florence Crittenton Services shelter in Wyman Park.
To the untutored observer, the difference between a safe restraint and a potentially deadly one is not immediately apparent.
For example, in another facedown restraint demonstrated by Parese's students, it appeared that two of them were leaning on top of the third student's neck.
In fact, they were leaning into each other, using their shoulders for balance without constricting the breathing of the student being restrained.
At the end of the class, Parese gave his students printed certificates acknowledging that they had completed his "Therapeutic Aggression Control Techniques" curriculum.
Not vetted or certified
Though Parese said his techniques assiduously conform to national standards such as those recommended by the Child Welfare League of America, his curriculum is neither vetted nor certified by Maryland. "Many states require an approval process to be certified as a trainer," he said. "Maryland doesn't."
McComb said his association would welcome clearer state laws and regulations governing how restraints are used on youths, such as those regulating psychiatric care facilities.
As of yesterday, all but about 25 of the 73 Maryland youths committed to Bowling Brook had been removed or released after an emergency court hearing requested by public defenders. Just two weeks ago, it was housing 170 students, many from other states.
McComb said he hopes Bowling Brook can survive the storm of controversy over Simmons' death.
"We don't have anything better in this whole state," he said. "Bowling Brook will stack up against the best of them. This is an organization that has helped thousands of kids."