Parents should require residential treatment centers to tell them details about their auto and liability insurance coverage, educational and therapy programs. As well as accredidation and licensing information. 

The decision to place a child in a Residential Treatment Center (RTC) is fraught with emotional turmoil and significant financial investment. Parents, desperate for help, often find themselves in a vulnerable position, reliant on the representations of RTC staff. 

However, ensuring the safety and well-being of their child requires parents to be diligent and assertive in seeking comprehensive information from these facilities. 

If an RTC discourages or refuses to answer a parent from asking questions about those basic items, a parent should skip consideration of that RTC and move on to another more professional facility if at all possible. 

This article outlines the critical disclosures that RTCs should provide to parents, empowering them to make informed decisions and hold these institutions accountable.

1. Insurance Information: A Non-Negotiable Right to Know

The assertion by some RTCs that their insurance details are “private” and not subject to parental scrutiny is unacceptable, particularly in cases involving accidents or potential liability. Parents have a fundamental right to know the specifics of the RTC’s insurance coverage for several compelling reasons:

• Adequacy of Coverage: RTCs engage in activities that carry inherent risks. Whether it’s equine therapy, or adventure programs with ATV’s, UV’s, and boats, or interacting with livestock, or simply transporting students, accidents can happen. Parents must ascertain whether the RTC’s insurance policies, including general liability and auto liability, provide sufficient coverage to protect their child in the event of an injury.
• Financial Responsibility: In the unfortunate event of an accident resulting in significant medical expenses or long-term care needs, parents need to know that the RTC has the financial capacity to meet its obligations. Inadequate insurance can leave families facing devastating financial burdens.
• Verification of Compliance: Requiring proof of insurance ensures that the RTC is operating legally and responsibly. It demonstrates a commitment to transparency and accountability.

Specifically, parents should demand the following insurance-related disclosures:

• General Liability Policy: Documentation verifying the existence and limits of general liability coverage, including per-occurrence and aggregate limits, and any exclusions that may apply to specific activities (e.g., equine therapy, use of all-terrain vehicles).
• Commercial Auto Liability Policy: If the RTC transports students, parents must see proof of a commercial auto liability policy, with details on coverage limits and any restrictions. This is especially critical when transporting multiple students, as in the example of an RTC transporting six girls in a vehicle.
• Professional Liability Insurance: Information on professional liability coverage, particularly important for RTCs providing therapeutic services.

1.1 What is Considered Appropriate Liability Coverage?

Determining “appropriate” liability coverage is complex and depends on several factors, including the specific activities of the RTC, the number of residents, and the potential severity of injuries. However, some general principles can guide parents:

• General Liability:

  • Per-Occurrence Limits: These limits should be substantial enough to cover the potential costs of a serious injury. In situations involving activities with a higher risk of severe injury (e.g., equine therapy with horses, interaction with livestock like bulls, use of ATVs), $1 million or more per occurrence is highly advisable. Given the RTC’s activities, it’s clear that the risk of serious injury is elevated. The RTC’s refusal to implement safety recommendations, further highlights the need for robust liability coverage.
  • Medical Expense Limits: The $20,000 per person limit found in some policies is often grossly inadequate for serious injuries. Consider that a severe head injury, spinal cord injury (as seen in Christopher Reeve’s equestrian accident), or burn injury can easily exceed this amount in initial treatment costs alone. Higher medical expense limits or a separate excess medical payments coverage is preferable.
  • Aggregate Limits: These limits define the total amount the insurer will pay for all claims during the policy period. This should also be high enough to cover multiple incidents.

• Auto Liability:

  • Bodily Injury Liability: This coverage should be high enough to cover serious injuries to all occupants of the vehicle and any third parties involved in an accident.
    
    • In the scenario where an RTC is transporting six students in a vehicle, the potential for multiple serious injuries is significant.
    • Recommended Coverage: In such cases, a combined single limit of $1 million or more is strongly recommended. This means that the policy will cover up to $1 million for all bodily injuries and property damage resulting from a single accident. Alternatively, split limits (e.g., $250,000 per person, $500,000 per accident for bodily injury, and $100,000 for property damage) may be acceptable, but the overall coverage should still be substantial.
    • Medical Payments: In addition to bodily injury liability, it’s beneficial to inquire about medical payments coverage, which can help cover immediate medical expenses regardless of fault.
  • Property Damage Liability: This covers damage to other people’s property. Limits should be sufficient to cover the cost of replacing expensive vehicles or other property.

It’s important to note that these are general guidelines. Parents should consult with an insurance professional or attorney to determine what constitutes adequate coverage in their specific circumstances.

2. Educational Program Details: Ensuring Academic Continuity

For adolescents, maintaining academic progress during their stay at an RTC is crucial. Parents must receive detailed information about the facility’s educational program to ensure their child’s academic needs are met:

• Accreditation: Is the RTC’s educational program accredited by a recognized agency? Accreditation by organizations like Cognia (formerly AdvancED), Middle States Association of Colleges and Schools (MSA-CESS), or similar agencies ensures that the program meets specific quality standards and that credits earned are more likely to be transferable.
• Curriculum: What courses are offered? Are they aligned with state standards? Can the RTC accommodate students with special education needs?
• School Affiliations: Does the RTC have agreements with local schools or online programs? How are credits transferred?
• Teacher Qualifications: What are the credentials and experience of the teachers or educational staff?
• Instructional Approach: What is the student-to-teacher ratio? What teaching methods are used? What support services are available?

3. Accreditation and Licensing: Verifying Standards of Care

RTCs should be fully transparent about their accreditation and licensing status:

• Accreditation: Accreditation by organizations like The Joint Commission or CARF International signifies that the RTC has undergone rigorous evaluation and meets specific standards for quality of care, safety, and service delivery.
• State Licensing: RTCs are typically licensed by the state in which they operate. Parents should verify that the RTC has a current and valid license and inquire about any past or pending disciplinary actions. In Utah, for example, the Department of Human Services, Division of Substance Abuse and Mental Health (DSAMH) licenses and regulates these facilities.

4. Safety Record and Incident Reporting: Transparency is Paramount

Parents have a right to know about the RTC’s safety record and how it handles incidents:

• Incident Reporting Procedures: How does the RTC document and report incidents such as injuries, altercations, or runaways?
• History of Violations: Has the RTC received any formal complaints, citations, or sanctions from licensing agencies or regulatory bodies?
• Safety Protocols: What specific safety measures are in place to prevent accidents, ensure supervision, and protect residents from harm? This is particularly important in RTCs with activities like equine therapy, where specific safety protocols should be present. RTC’s that don’t implement safety recommendations (e.g., “Keep Out” of dangerous area signs, require helmets) pose significant red flags. 

5. Treatment Philosophy and Approach: Aligning Values

Understanding the RTC’s treatment philosophy is essential for parents to determine if it aligns with their values and their child’s needs:

• Therapeutic Modalities: What therapeutic approaches are used (e.g., cognitive behavioral therapy, dialectical behavior therapy, family therapy)?
• Behavior Management Techniques: How does the RTC address behavioral issues? Are the methods evidence-based and ethical? Are there any restrictions on communication with family?
• Staff Qualifications: What are the credentials and experience of the clinical staff (e.g., therapists, counselors, psychiatrists)? What is the staff-to-resident ratio?

What Constitutes “Private” Information?

While transparency is crucial, some information may legitimately be considered the RTC’s private business and parents should NOT expect them to disclose such as:

• Proprietary Business Information: Details about the RTC’s financial operations, marketing strategies, or internal business practices, unless directly relevant to resident care or safety, are generally considered private.
• Specific Staff Information: Individual staff members’ personal contact information or detailed salary information is typically private, unless it involves staff credentials or qualifications directly related to their interaction with residents.

Legal and Ethical Obligations

While the extent of legally mandated disclosure may vary by jurisdiction, ethical considerations and emerging legal trends strongly support the need for RTCs to provide comprehensive information to parents.

• Duty of Care: RTCs have a legal and ethical duty of care to the residents in their charge. This duty includes providing a safe environment, adequate supervision, and appropriate treatment. Transparency about insurance, safety practices, and treatment approaches is essential to fulfilling this duty.
• Informed Consent: Although parents or guardians typically provide consent for treatment, true informed consent requires that they have access to sufficient information to make a knowledgeable decision.
• Consumer Protection: Parents are, in essence, consumers of the RTC’s services. Consumer protection principles suggest that they have a right to accurate and complete information about the services they are purchasing.
• State Regulations: Some states have specific regulations regarding disclosures that RTCs must make to parents. For example, Utah regulations may outline specific requirements for licensing, reporting of incidents, and client rights. Parents should familiarize themselves with the regulations in the state where the RTC is located.

Conclusion

Parents placing their child in an RTC face a daunting task. By demanding comprehensive disclosures and understanding their rights, they can better protect their child’s safety, well-being, and future. RTCs must recognize that transparency is not only an ethical imperative but also a critical component of building trust and ensuring accountability. 

The need for adequate insurance coverage, particularly auto liability with sufficient limits to cover multiple serious injuries, and transparent safety practices cannot be overstated, as these are fundamental to ensuring the safety of vulnerable youth in their care.

References

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2. Alliance of Nonprofits for Insurance. (2025). Commercial General Liability Coverage Declaration.
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4. Alliance of Nonprofits for Insurance. (2025). Social Service Professional Liability Coverage Declaration.
5. Insurance Services Office, Inc. (2004). U.S. Treasury Department’s Office of Foreign Assets Control (“OFAC”) Advisory Notice to Policyholders.
6. Insurance Services Office, Inc. (2012). Commercial General Liability Coverage Form.
7. Insurance Services Office, Inc. (2012). Liquor Liability Coverage Form.
8. Insurance Services Office, Inc. (2007). Nuclear Energy Liability Exclusion Endorsement.
9. Nonprofits Insurance Alliance. (2025). Member Criteria.
10. Nonprofits Insurance Alliance. (2025). Policy Information.