Finance
Senate Finance Committee Releases Excoriating Investigation of Abuse in At-Risk Youth Industry
After years of facing criticism for wrongdoing and mistreatment of patients, the at-risk youth industry was blasted in a report released on Wednesday by the U.S. Senate Finance Committee.
The report and communications from the committee chairman, Sen. Ron Wyden (D-Ore.), conclude that systemic harm and abuse are “routine” parts of the at-risk youth industry. It delves into specific incidents at facilities owned and/or operated by some of the industry’s most prominent players: Universal Health Services (NYSE: UHS), Acadia Healthcare Co. Inc. (Nasdaq: ACHC), Devereux Advanced Behavioral Health and Vivant Behavioral Healthcare.
“The harms, abuses, and indignities children in [residential treatment facilities] have experienced and continue to experience today occur inevitably and by design: they are the direct causal result of a business model that has incentive to treat children as payouts and provide less than adequate safety and behavioral health treatment in order to maximize operating and profit margin,” the report states.
The presentation of the report also enlisted the support of socialite and media personality Paris Hilton, a staunch critic and self-described survivor of the at-risk youth industry. The Senate Finance Committee also hosted a hearing on Wednesday to discuss the report’s findings.
Hilton, Wyden, the report itself and several others call on Congress to act.
“Providers will continue to operate this model because it’s good business, unless there is some bold intervention,” the report states.
Wyden’s Republican counterpart, Senate Finance Committee Ranking Member Mike Crapo, also called for reforms. In a statement, Crapo said that the report’s findings were “deeply disturbing” and that “chronic patterns of failure must not go unnoticed or unaddressed.”
The report finds that understaffing, restraints (both physical and chemical), poor care and a general lack of oversight within and of residential treatment facilities were typical for the industry.
The action contemplated by the report and the Senate Finance Committee centers on elevated scrutiny of the industry and the role of government payers supporting these operations. The report and proceedings focus on what they call residential treatment facilities, which focus on providing care to children on a long-term basis.
The Senate Finance Committee report’s recommendations are summarized into three points: ensuring safe and dignified treatment in home-like settings, government prioritization of community-based services and more effective oversight of standards of and funding for facilities. These three specific recommendations should be taken up by Congress, the report states.
It calls on state governments to use existing authority to favor community-based services, calling many states’ historic reliance on residential treatment facilities inappropriate, and to “ramp up their oversight capabilities for youth in both in-state and out-of-state facilities.”
The report also calls on the U.S. Department of Justice to enforce Title II of the Americans with Disabilities Act to ensure that violations of so-called “Olmstead” standards are addressed within the at-risk youth industry. These provisions require that people be treated for severe conditions in the least restrictive setting possible.
“After reading it (the report), I honestly have never felt so seen and heard: it validates everything that I’ve been fighting for over the past four years,” Hilton said in a video statement released Wednesday morning. “As a survivor, please do something. I am begging you to protect your constituents before it’s too late.”
The committee meeting featured subject matter experts who testified before the Senate Finance Committee. Wyden said during his prepared remarks that Marc Miller, the CEO of UHS, was invited to participate in the meeting and that UHS was invited to engage with the committee’s investigators. UHS and Miller declined to do so; Miller was listed as a witness in notices for the meeting but did not attend.
On top of the recent public pillorying, Acadia Healthcare and UHS have seen substantial financial ramifications for abuses recognized by the courts at their facilities.
In July 2023, a jury ruled against Acadia Healthcare in a civil lawsuit involving sexual abuse of a minor at a now-defunct facility that totaled $405 million. In October 2023, Acadia agreed to pay $400 million to settle three cases related to abuse at the facility.
In April, a court ruled against UHS to the tune of $535 million over an incident involving a child sexually abusing another child at a facility in Champaign, Illinois.
The report adds what some call “headline risk” to a modality of care that is replacing wilderness therapy. For example, Chandler, Arizona-based Embark Behavioral Health, a sizable care provider in the at-risk youth segment, is abandoning wilderness therapy altogether in hopes of transitioning these businesses into residential treatment facilities and investing more in outpatient offerings.
The G7 Leaders’ Summit took place in Évia
Why financing matters for forest restoration
Over the past several years, Armonía and local communities have made significant progress restoring parts of the Tunari protected area. To date they have planted 1.25 million trees, with more than half of these planted in the Tiquipaya municipality. Community wildfire brigades have been strengthened, reservoirs built to secure water, and new systems created for communities to participate in watershed management.
One of the most important actions was strengthening the structure and function of a watershed governance body, known as Organismo de Gestión de Cuencas (OGC). This coordinates restoration activities and helps design sustainable development strategies for the communities living in the park, helping rebuild trust between them, park authorities and conservation organisations. Women leaders have played an important role in shaping this work.
However, a major challenge was highlighted – restoration takes decades, but most conservation funding arrives through short-term projects. Without stable long-term financing, restoration gains are difficult to maintain.
How the financing model would work
The proposed PES mechanism would collect small contributions directed into a transparent trust fund with independent governance. Resources would then be invested in three main areas:
- Forest restoration and protection – Communities would receive incentives for protecting existing forest and payments tied to successful restoration outcomes.
- Community sustainable development – Investments would support livelihood activities that reduce pressure on the forest, such as sustainable agriculture, water management and local enterprises.
- Strengthening park management – Funds would help support ranger capacity, wildfire prevention and long-term monitoring within Tunari National Park.
For communities, the system recognises their role as custodians of the watershed. For urban residents, it offers a practical way to support the ecosystems that provide their water. For public and private partners, it creates a transparent structure for long-term investment in landscape restoration.
Once fully implemented, the mechanism could generate an estimated £3 million per year for watershed protection and restoration.
Designing a Payment for Ecosystem Services mechanism
Over the past two years, Armonía has worked with municipalities, communities and regional institutions to explore how a PES mechanism could work in the Cochabamba region.
The PES concept is straightforward. Communities living in the upper watershed protect and restore forests that provide essential services such as water regulation, erosion control and biodiversity conservation. Downstream users who benefit from these services contribute financially to support that stewardship.
Through the Accelerator process, Armonía undertook studies, assessments and consultations across the Cochabamba metropolitan area’s seven municipalities. Many residents recognised that protecting the forest is directly linked to their water security. Based on these encouraging results, Armonía and their partners are developing a regional trust fund.
Building the institutions behind the mechanism
The financing system is only one piece of the puzzle – strong governance and community participation are also essential. With FIA support, Armonía is now helping communities develop ten-year sustainable development strategies that identify restoration priorities and income opportunities. A multi-stakeholder platform will oversee the initiative and guide decisions, while the park administration is also receiving support to strengthen monitoring, prevent wildfires and improve co-ordination.
A new model for watershed protection
The work underway in Tunari is about more than planting trees. It’s about building a durable system that links ecological restoration, community leadership and long-term financing. Once the mechanism is operational, it could transform how the Tunari watershed is managed. Instead of relying on intermittent projects, the region would have a locally supported financing system that rewards stewardship and protects the Kewiña forests that has supported life in the Andes for centuries.
Implementing the “Future of Finance Academy”
KPMG in the UK worked with CCEP to co-create a comprehensive learning program for senior managers and associate directors in its finance function. We began by developing a strong understanding of the unique business context in which the company and its finance team operate.
This also helped us determine the best mode of delivery for its globally distributed finance function and identify opportunities to stretch CCEP’s ambitions further.
For example, the KPMG team proposed turning the final module of the course into a showcase presentation. Trainees applied what they had learned to real business challenges and presented their solutions to the board in a business pitch-style competition. Although this added to finance leaders’ already demanding workload, it proved to be one of the course’s most successful elements, enabling participants to put their new skills into practice.
Before work on the Academy began, KPMG developed a detailed plan setting out how the two teams would work together, ensure consistency across the learning modules, maintain quality assurance, and manage changes to scope.
KPMG professionals then collaborated closely with CCEP to co-create bespoke learning content, with CCEP’s senior finance leaders acting as subject matter experts alongside our own finance specialists.
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