Washington becomes latest state to ditch Sequel

Washington state will stop sending children to treatment centers run by Sequel Youth & Family Services following a review of the company that raised concerns about the treatment of kids at two facilities. 

The for-profit company, which operates more than two dozen treatment centers around the country for children with behavioral problems, was the subject of an APM Reports investigation published in September. Washington is the fourth state to end its relationship with Sequel this year, joining Minnesota, Oregon and Maryland. Next week, Ohio is scheduled to hold a hearing to revoke Sequel’s license to operate there. 

The yearlong APM Reports investigation found that Sequel had pursued profit and expansion by taking in some of the most traumatized and difficult-to-place kids in the nation while trying to keep expenses low. APM Reports found dozens of cases of abuse at Sequel facilities around the country.

The Washington Department of Children, Youth, and Families said it was halting referrals to Sequel because of the inappropriate restraint of a child at a treatment center in Illinois and “concerns regarding the supervision of youth” at a facility in Idaho. The state is not immediately bringing home the five Washington foster kids currently living at Sequel facilities. 

In October, a coalition of organizations, including the Washington chapter of the ACLU and Disability Rights Washington, demanded the state sever ties with Sequel, citing the APM Reports investigation. 

The state’s most serious concerns centered on Sequel’s Northern Illinois Academy in suburban Chicago, which accepts children as young as 6 with a combination of mental illness, autism and developmental delays. 

Washington officials found that staff there placed a child in an “inappropriate restraint” and refused to turn over surveillance video documenting the incident. The company argued the video was not an “incident report” and wasn’t covered under its contract with the state, according to the state report. Washington is contemplating legal action against the company to force it to release the recording. 

Sequel has historically accommodated such requests from government regulators, records show, but the company has been under intense pressure following the public release of a video showing the restraint in April of 16-year-old Cornelius Fredrick at Lakeside Academy in Michigan. Fredrick lost consciousness and died two days later. 

The video of a Black teenager held to the ground by those in authority presaged the police killing of George Floyd a month later, and it turned Fredrick’s death into national news. Prosecutors charged three former Sequel employees with child abuse and involuntary manslaughter in connection with Fredrick’s death. Sequel shut down its Michigan operations under pressure from Gov. Gretchen Whitmer. 

The company did not respond to an interview request.

Northern Illinois Academy has a history of citations for excessive force by staff, according to local, state and federal records. In January, a former employee was charged with the aggravated battery of a child there. That same month, federal regulators cited the facility for violations related to physical restraints, deficiencies it deemed “so serious they constitute an immediate threat to patient health and safety,” according to federal records. 

When Washington began its review in September, the state had three children placed at Northern Illinois Academy. One child reported not feeling safe there, according to state records. A review of documents also showed two occasions when the facility reported it had insufficient staffing. The state removed the two children in its custody from Northern Illinois Academy this fall. The remaining child is in the custody of a Washington Indian tribe, which decided to leave the child there in spite of the state’s concerns, according to the report. 

The review also found instances of lax supervision at Sequel’s Mountain Home Academy in Idaho, where a child reported staff were on their phones when they were supposed to be looking after residents. The report also noted a case in which residents engaged in sexual contact due to “issues of supervision.” 

While troubling, inappropriate physical restraints and staff distracted by cell phones are relatively routine transgressions at residential treatment centers — both at Sequel and in the industry generally. In isolation, such incidents typically wouldn’t lead a state to end referrals to a care provider. But for Washington, they were the last straw with Sequel. 

Two years ago, the state pulled children out of Sequel’s Clarinda Academy in Iowa after Disability Rights Washington released a report criticizing the treatment and use of restraints there. Then in 2019, Sequel closed a school in Utah where Washington had several kids after an investigation by Utah officials found “numerous accounts of mistreatment, abuse, acts of violence and overall disrespect toward residents.” 

Yet Washington continued to send kids to Sequel until this September, five months after Fredrick died in Michigan. And while the state has vowed to stop sending kids to Sequel facilities, it still has five children living at the company’s treatment centers in Idaho, Iowa, Utah and Illinois.

For the past two years, Washington has been working to reduce its reliance on facilities in other states, and it has made significant progress. It used to have more than 80 foster kids living in out-of-state treatment centers. That number is now down to 13. 

The Department of Children, Youth, and Families says it wants to bring all those children home but needs more funding from the Legislature to do that, because the state doesn’t have enough foster care beds, especially for children with complex mental health and behavioral problems. 

Treatment options for children with inappropriate sexual behaviors are particularly lacking due to inadequate state reimbursement rates, the department said. 

During its two decades in business, Sequel has become a national magnet for some of the most vulnerable children in the foster care, mental health and juvenile justice systems. Many states turned to the company’s network of facilities when they couldn’t find treatment options for children in their communities. 

As of 2019, Sequel said about a quarter of its 2,000 residents had to cross state lines for treatment, including children from more than 40 states. The company has been closing facilities at a rapid clip since then. In the past two years, it has shut down eight treatment centers. Many of the closures occurred amid abuse scandals. Today, it operates 29 residential treatment centers spread across 15 states. 

“I hope that this is the end of this chapter,” said Susan Kas, a staff attorney for Disability Rights Washington. “It’s definitely a step forward.” 

Kas is still concerned about the five children from Washington who remain in Sequel facilities and urged the state to bring them home. She also expressed concern that the state was looking to add beds in institutional facilities as part of its solution. She said the focus should be placing children with families and bringing services to them in their home communities. 

“The problem isn’t that it’s out of state,” Kas said. “The underlying problem is that it’s very difficult to provide a nurturing, stable home in a congregate care setting. And that’s what children need to be well, and grow up and be healthy.”