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WASHINGTON - Teens were beaten, tortured and denied food and water. Some were forced to eat their own vomit. One had to clean a toilet with a toothbrush and then clean his teeth with the same tool.
This may sound like human-rights violations in a Third World country, but it took place in the United States, much of it in the deserts of southern Utah, according to Greg Kutz, an investigator with the Government Accountability Office.
Kutz studied abuse accusations in wilderness therapy programs for troubled youth as part of an ongoing congressional probe into this loosely regulated industry. He presented his findings - thousands of cases of abuse or deaths since 1990 - to a House committee Wednesday. He also presented details of 10 deaths, five of which took place in Utah, one of the nation's leaders in wilderness therapy.
Committee Chairman George Miller, D-Calif., called the findings "absolutely astonishing" and "outrageous."
"The federal government has completely failed to grasp the urgency of this situation," he said.
Miller says Congress needs to wade into the oversight of these programs, though some of his Republican counterparts and the program owners want to see regulation remain at the state level.
The only Utah representative on the committee - GOP Rep. Rob Bishop - did not attend because he was at another hearing.
For family members of these dead teens, Tuesday's hearing was an emotional triumph.
Cathy Sutton's daughter Michelle died of dehydration in a Utah program in 1990, which led the state to start regulating wilderness therapy groups. The state has closed three programs since then, but teens have continued to die.
While Cathy Sutton still remains a bit skeptical, she said she has never been so full of hope that the government would rein in bad programs.
But any congressional action will move slowly. The GAO expects to release a broader study early next year and more hearings are planned.
The GAO report released Wednesday could not determine the frequency of abuse or deaths because no organization compiles such data. After scouring court records, state investigations and news accounts, the best investigators could say is that thousands of complaints have been alleged.
Kutz acknowledged many programs are above-board but he also said abuse is "widespread" with "negligent" program owners manipulating desperate parents with false advertising.
The 10 cases he highlighted showed a disturbing pattern of medical neglect, with counselors repeatedly assuming the teens were making up their symptoms.
"It seemed that the only way program managers would believe they were not faking it is if they stopped breathing or did not have a pulse," Kutz told the committee.
That appears to be what happened to Aaron Bacon in 1994. He was taking drugs and running with a bad crowd in high school, so the 16-year-old's parents enrolled him into the North Star Expeditions' nine-week program in Utah's Escalante Wilderness Area.
He died a month later, having lost a fifth of his body weight. His body was covered in bruises, rashes and open sores. His father, Bob Bacon, told the committee that his son was a "grotesque skeleton."
Journals kept by Aaron and counselors shows he received no food for 14 of 20 days and when they did let him eat it was small quantities of "undercooked lentils, lizards, scorpions, trail mix and a celebrated canned peach."
Aaron Bacon, complaining of major stomach pain, wanted to go to a doctor. Counselors refused until they found him without a pulse. He died of a perforated ulcer. They thought he was acting sick to get out of the program. North Star Expeditions is no longer in business.
After Aaron Bacon's death, Utah beefed up regulations, as it has after wilderness therapy deaths since then.
Hikes can't take place when the thermometer tops 90 degrees. Each teen has to have six quarts of water a day. Medical personnel must check out each teen every two weeks.
"There are a lot of good rules in place and we keep making them better every year," said Carol Sisco, spokeswoman for the Utah Department of Human Services, which regulates the therapy programs.
But that isn't enough, said Bob Bacon. "Regulations by themselves won't do anything."
Utah lacks the resources to provide constant oversight, he said. And the state can't do anything about problem owners moving from state to state.
Bacon wants to see federal mandates for training and for on-site medical personnel. He wants to see the government go after people who market themselves as experts when they have no actual expertise. And he wants the federal government to create a data clearinghouse to help regulators and parents alike.
Right now, it is all up to the states and some have no rules and no oversight.
It usually takes a tragedy for a state to revoke a company's license, Kutz said.
Ken Stettler, the director of Utah's licensing office, said the only meaningful federal role he sees is a requirement that states have a standard set of regulations. After that, he said, state regulators are in a better position to keep an eye on the outdoor programs.
The parents and members of the committee also expressed frustration that in many of these cases no criminal charges are filed and in those that do go before a judge, the punishments appear to be minimal.
"There is really no teeth behind the investigations," Kutz said. "There is really no action on the criminal side here."
The Aaron Bacon case was one of the few exceptions, but even in that instance the punishment was not severe. Seven North Star staffers were charged with some form of child abuse.
One was convicted of a felony and served two months in jail. The others pleaded to lesser charges and received probation.
15, of California, died May 9, 1990, from altitude sickness, dehydration and heat exhaustion while hiking south of St. George with Summit Quest. Sutton's death led the state to start regulating wilderness therapy groups.
16, of Florida, died June 27, 1990, of heatstroke on a hike in Kane County with the Challenger Foundation program of Escalante. Owner, Stephen Cartisano, was charged with negligent homicide but a jury acquitted him.
16, of Arizona, died March 31, 1994, of peritonitis and a perforated ulcer, while on a wilderness trek in Garfield County with North Star Expeditions of Escalante. Supervising counselor Craig Fisher was sentenced to a year in jail.
16, of Virginia, died Jan. 13, 2002, three weeks after she fell about 70 feet into a crevasse while hiking with Redrock Ranch Academy of St. George in Washington County. No charges were filed. Lank's parents sued and settled for an undisclosed amount.
14, of Texas, died July 13, 2002, of heat exhaustion while hiking with Skyline Journeys program in the Sawtooth Mountain area west of Delta. Owner, Mark Wardle, the parent company and a staffer were charged but the charges were later dismissed.
Susan Pinson, Ian August's birth mother, reflects on his death nearly one year after he died in the Sky Line Journeys wilderness program in Utah.