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Completed by:
The Unsilenced Policy Team
Nevada Legislation Report
2022
2022
Introduction
The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.
Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.
Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.
An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.
It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.
Introduction
The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.
Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.
Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.
An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.
It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.
Nevada Legislation
| General Oversight and Transparency | Chapter 432A - Services and Facilities for Care of Children |
| Oversight Agency | Division of Public and Behavioral Health |
| Which state agency oversees investigations? | Division of Public & Behavioral Health: Child Care Licensing Unit and Washoe County Human Services Agency: Child Care and Early Childhood Services |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes |
| Is a list of licensed facilities available to the public? | Yes |
| Are regulations only applicable to facilities receiving public funds? | No |
| Can complaints be filed online? Is the reporting portal easy to find? | Yes |
| Does the state conduct unannounced site visits? How many per year? | Yes. Annually |
| Are background checks required, including volunteers? | Yes |
| Is a full-time licensed clinician required to be on staff? | No |
| Does the state require a guardian's consent to all treatment received? | Yes |
| Does the state require that the guardian be notified of an emergency involving their child within 24-hours of the incident occurring? | Yes |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | Yes |
| Is a licensed clinician required to perform a mental health evaluation upon intake? | No |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | Yes |
| Does the state require medical response training for all staff working with children in residential settings? | Yes |
| Does state require 1:4 staffing ratio or higher? | 1:13 |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | No |
| Are the guardian & admitted child required to be informed of their their rights? | No Information |
| Does the state define institutional abuse and neglect? | Not Specifically |
| Are there civil penalties for violations of institutional child abuse and neglect? | Yes |
| Does the state prohibit mail censorship? | No Information |
| Do the youth have unrestricted access to guardians, legal counsel, welfare advocates, religious clergy, friends and family via telephone? | No Information |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No Information |
| Is the facility required to provide an individualized treatment plan? Is the plan reviewed regularly? | No Information |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | Yes |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No Information |
| Are youth provided with access to advocacy services and representation? | No Information |
| Does the state require a guardian's consent to all treatment received? | No Information |
| Is a grievance procedure required for youth and families? | Yes |
| Is youth consent required for all treatment received? | No |
| Does the state have zoning and occupancy requirements for structures being used to house youth in residential settings? | No Information |
| Is there regulation for physical restraint? | Yes |
| Is there regulation for chemical restraint? | Yes |
| Is there regulation for mechanical restraint? | Yes |
| Is there regulation for seclusion? | Yes |
| Is there a Bill of Rights for youth in care? | No |
| General Oversight and Transparency | Chapter 432A - Services and Facilities for Care of Children |
| Oversight Agency | Department of Health and Human Services |
| Which state agency oversees investigations? | Department of Health and Human Services |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes. The Bureau of Health Care Quality and Compliance - Child Care Licensing |
| Is a list of licensed facilities available to the public? | Yes |
| Are regulations only applicable to facilities receiving public funds? | Yes |
| Can complaints be filed online? Is the reporting portal easy to find? | No |
| Does the state conduct unannounced site visits? How many per year? | No Information |
| Are background checks required, including volunteers? | Yes |
| Is a full-time licensed clinician required to be on staff? | No Information |
| Does the state require a guardian's consent to all treatment received? | No Information |
| Does the state require that the guardian be notified of an emergency involving their child within 24-hours of the incident occurring? | No Information |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | No Information |
| Is a licensed clinician required to perform a mental health evaluation upon intake? | No Information |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | No Information |
| Does the state require medical response training for all staff working with children in residential settings? | No Information |
| Does state require 1:4 staffing ratio or higher? | No Information |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | No Information |
| Are the guardian & admitted child required to be informed of their their rights? | No Information |
| Does the state define institutional abuse and neglect? | No Information |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the state prohibit mail censorship? | No Information |
| Do the youth have unrestricted access to guardians, legal counsel, welfare advocates, religious clergy, friends and family via telephone? | No Information |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No Information |
| Is the facility required to provide an individualized treatment plan? Is the plan reviewed regularly? | No Information |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | No Information |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No Information |
| Are youth provided with access to advocacy services and representation? | No Information |
| Does the state require a guardian's consent to all treatment received? | No Information |
| Is a grievance procedure required for youth and families? | No Information |
| Is youth consent required for all treatment received? | No Information |
| Does the state have zoning and occupancy requirements for structures being used to house youth in residential settings? | No Information |
| Is there regulation for physical restraint? | No Information |
| Is there regulation for chemical restraint? | No Information |
| Is there regulation for mechanical restraint? | No Information |
| Is there regulation for seclusion? | No Information |
| Is there a Bill of Rights for youth in care? | No |
| General Oversight and Transparency | For the residential part, there is none. For the education, oversight is provided under the Private Elementary and Secondary Education Authorization Act. This states that private schools must be licensed according to minimum criteria established by the Board of Education - VNRS 394.075. |
| Oversight Agency | Board of Education |
| Which state agency oversees investigations? | Board of Education |
| Are investigations and outcomes visible to the public online? | No |
| Is this type of program required to be licensed by the state? | No |
| Is a list of licensed facilities available to the public? | No |
| Are regulations only applicable to facilities receiving public funds? | No |
| Can complaints be filed online? Is the reporting portal easy to find? | No |
| Does the state conduct unannounced site visits? How many per year? | No |
| Are background checks required, including volunteers? | No |
| Is a full-time licensed clinician required to be on staff? | No |
| Does the state require a guardian's consent to all treatment received? | No |
| Does the state require that the guardian be notified of an emergency involving their child within 24-hours of the incident occurring? | No |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | No |
| Is a licensed clinician required to perform a mental health evaluation upon intake? | No |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | No |
| Does the state require medical response training for all staff working with children in residential settings? | No |
| Does state require 1:4 staffing ratio or higher? | No |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | No |
| Are the guardian & admitted child required to be informed of their their rights? | No |
| Does the state define institutional abuse and neglect? | No |
| Are there civil penalties for violations of institutional child abuse and neglect? | No |
| Does the state prohibit mail censorship? | No |
| Do the youth have unrestricted access to guardians, legal counsel, welfare advocates, religious clergy, friends and family via telephone? | No |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No |
| Is the facility required to provide an individualized treatment plan? Is the plan reviewed regularly? | No |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | No |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No |
| Are youth provided with access to advocacy services and representation? | No |
| Does the state require a guardian's consent to all treatment received? | No |
| Is a grievance procedure required for youth and families? | No |
| Is youth consent required for all treatment received? | No |
| Does the state have zoning and occupancy requirements for structures being used to house youth in residential settings? | No Information |
| Is there regulation for physical restraint? | No |
| Is there regulation for chemical restraint? | No |
| Is there regulation for mechanical restraint? | No |
| Is there regulation for seclusion? | No |
| Is there a Bill of Rights for youth in care? | No |
| General Oversight and Transparency | Chapter 432A - Services and Facilities for Care of Children |
| Oversight Agency | On the federal side, Bureau of Land Management. For the state side, The Bureau of Services for Child Care and the State Board of Health |
| Which state agency oversees investigations? | Division of Public and Behavioral Health - Child Care Licensing Unit |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes |
| Is a list of licensed facilities available to the public? | Yes |
| Are regulations only applicable to facilities receiving public funds? | No |
| Can complaints be filed online? Is the reporting portal easy to find? | Yes |
| Does the state conduct unannounced site visits? How many per year? | Yes. Annually |
| Are background checks required, including volunteers? | Yes |
| Is a full-time licensed clinician required to be on staff? | No but they must be accessible |
| Does the state require a guardian's consent to all treatment received? | Yes |
| Does the state require that the guardian be notified of an emergency involving their child within 24-hours of the incident occurring? | No Information |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | Only over age 18. NRS 432A.175 |
| Is a licensed clinician required to perform a mental health evaluation upon intake? | No Information |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | Yes |
| Does the state require medical response training for all staff working with children in residential settings? | Yes to an extend. NRS 432A.410 |
| Does state require 1:4 staffing ratio or higher? | Yes to an extend. NRS 432A.480 |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | Yes. A medical exam, interview, and treatment plan. NRS 432A-440 |
| Are the guardian & admitted child required to be informed of their their rights? | No Information |
| Does the state define institutional abuse and neglect? | No Information |
| Are there civil penalties for violations of institutional child abuse and neglect? | Yes |
| Does the state prohibit mail censorship? | No Information |
| Do the youth have unrestricted access to guardians, legal counsel, welfare advocates, religious clergy, friends and family via telephone? | No Information |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No Information |
| Is the facility required to provide an individualized treatment plan? Is the plan reviewed regularly? | No Information |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | Yes |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No Information |
| Are youth provided with access to advocacy services and representation? | No Information |
| Does the state require a guardian's consent to all treatment received? | No Information |
| Is a grievance procedure required for youth and families? | Yes |
| Is youth consent required for all treatment received? | No Information |
| Does the state have zoning and occupancy requirements for structures being used to house youth in residential settings? | Yes |
| Is there regulation for physical restraint? | Yes |
| Is there regulation for chemical restraint? | Yes |
| Is there regulation for mechanical restraint? | Yes |
| Is there regulation for seclusion? | Yes |
| Is there a Bill of Rights for youth in care? | No |
| General Oversight and Transparency | NRS 63 & NRS 62B.200 These are State Facilities |
| Oversight Agency | Department of Juvenile Justice |
| Which state agency oversees investigations? | Department of Health and Human Services |
| Are investigations and outcomes visible to the public online? | No Information |
| Is this type of program required to be licensed by the state? | No Information |
| Is a list of licensed facilities available to the public? | No Information |
| Are regulations only applicable to facilities receiving public funds? | No Information |
| Can complaints be filed online? Is the reporting portal easy to find? | No Information |
| Does the state conduct unannounced site visits? How many per year? | No Information |
| Are background checks required, including volunteers? | No Information |
| Is a full-time licensed clinician required to be on staff? | No Information |
| Does the state require a guardian's consent to all treatment received? | No Information |
| Does the state require that the guardian be notified of an emergency involving their child within 24-hours of the incident occurring? | No Information |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | No Information |
| Is a licensed clinician required to perform a mental health evaluation upon intake? | No Information |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | No Information |
| Does the state require medical response training for all staff working with children in residential settings? | No Information |
| Does state require 1:4 staffing ratio or higher? | No Information |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | No Information |
| Are the guardian & admitted child required to be informed of their their rights? | No Information |
| Does the state define institutional abuse and neglect? | No Information |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the state prohibit mail censorship? | No Information |
| Do the youth have unrestricted access to guardians, legal counsel, welfare advocates, religious clergy, friends and family via telephone? | No Information |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No Information |
| Is the facility required to provide an individualized treatment plan? Is the plan reviewed regularly? | No Information |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | No Information |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No Information |
| Are youth provided with access to advocacy services and representation? | No Information |
| Does the state require a guardian's consent to all treatment received? | No Information |
| Is a grievance procedure required for youth and families? | No Information |
| Is youth consent required for all treatment received? | No Information |
| Does the state have zoning and occupancy requirements for structures being used to house youth in residential settings? | No Information |
| Is there regulation for physical restraint? | No Information |
| Is there regulation for chemical restraint? | No Information |
| Is there regulation for mechanical restraint? | No Information |
| Is there regulation for seclusion? | No Information |
| Is there a Bill of Rights for youth in care? | Yes |
| General Oversight and Transparency | NRS 449.001 & NRS 433 |
| Oversight Agency | Division of Public and Behavioral Health |
| Which state agency oversees investigations? | The Bureau of Health Care Quality and Compliance |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes. NAC 449:414 states that a person or a public or private facility shall not operate or provide the services of a psychiatric residential treatment facility or represent that the person or the public or private entity operates or provides the services of a psychiatric residential treatment facility, unless the person or the public or private facility is licensed by the Division pursuant to NAC 449.410 to 449.4495, inclusive, to operate the psychiatric residential treatment facility. |
| Is a list of licensed facilities available to the public? | Yes |
| Are regulations only applicable to facilities receiving public funds? | No |
| Can complaints be filed online? Is the reporting portal easy to find? | Yes |
| Does the state conduct unannounced site visits? How many per year? | Yes. Annually |
| Are background checks required, including volunteers? | Yes to employees. No to volunteers |
| Is a full-time licensed clinician required to be on staff? | No Information |
| Does the state require a guardian's consent to all treatment received? | No Information |
| Does the state require that the guardian be notified of an emergency involving their child within 24-hours of the incident occurring? | No. NRS 433.494 Individualized plan of services for consumer.The plan must be kept current and must be modified, with the input and participation of the consumer, the parent or guardian |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | No. Monthly. NRS 449.485 |
| Is a licensed clinician required to perform a mental health evaluation upon intake? | No Information |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | No |
| Does the state require medical response training for all staff working with children in residential settings? | Yes. NRS 449.194 |
| Does state require 1:4 staffing ratio or higher? | No Information |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | Yes. NRS 433.471 grants rights concerning admission and discharge of consumers |
| Are the guardian & admitted child required to be informed of their their rights? | No Information |
| Does the state define institutional abuse and neglect? | No Information |
| Are there civil penalties for violations of institutional child abuse and neglect? | Yes. NRS 433.554 |
| Does the state prohibit mail censorship? | Yes. NRS 433.482 Personal rights. to mail and receive unopened correspondence |
| Do the youth have unrestricted access to guardians, legal counsel, welfare advocates, religious clergy, friends and family via telephone? | No Information |
| Does the state require that children be allowed visitors in private during normal visiting hours? | Yes |
| Is the facility required to provide an individualized treatment plan? Is the plan reviewed regularly? | No Information |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | No Information |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No Information |
| Are youth provided with access to advocacy services and representation? | No Information |
| Does the state require a guardian's consent to all treatment received? | No. NRS 433.494 Individualized plan of services for consumer Be developed with the input and participation of: (1) The consumer, to the extent that he or she is able to provide input and participate; and (2) To the extent that the consumer is unable to provide input and participate, the parent or guardian |
| Is a grievance procedure required for youth and families? | No Information |
| Is youth consent required for all treatment received? | Yes. NRS 433.484 provides rights concerning care, treatment |
| Does the state have zoning and occupancy requirements for structures being used to house youth in residential settings? | No Information |
| Is there regulation for physical restraint? | Yes. NRS 433.5486 Use of physical, mechanical or chemical restraint on consumer by facility authorized in certain circumstances |
| Is there regulation for chemical restraint? | Allowed |
| Is there regulation for mechanical restraint? | Allowed |
| Is there regulation for seclusion? | No Information |
| Is there a Bill of Rights for youth in care? | No |
Additional Information
Unsilenced Program Database: Nevada Programs
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