Inside a taxpayer-funded treatment center for adoptees, tales of abuse, neglect and little oversight

LAKE OZARK, Mo. (AP) — A facility deep in rural Missouri promises relief for desperate parents whose adopted kids are struggling — a lakeside, summer camp-like academy where kids can heal by bonding with golden retrievers, and where caring employees “create joy.”

The company that operates the place known as Calo Programs says it exists “to serve the hardest-to-treat cases — the students and families the broader system has given up on.”

But an Associated Press investigation paints a more complicated and less idyllic picture.

Law enforcement is often called to Calo to investigate assaults or track down runaways. State agencies that pay to send kids there have questioned its operations, training and transparency. Parents and former employees say there is minimal treatment and barely any schooling, with only young, poorly trained staff to supervise the kids. Two mothers described it as something out of “Lord of the Flies.”

The price is steep and taxpayers often pick up the tab. Also known as Change Academy at Lake of the Ozarks, Calo has charged up to $20,000 a month to treat adopted children. Some stay for years.

It is part of the so-called troubled teen industry, a sprawling network of loosely regulated, for-profit residential centers, boarding schools and wilderness programs that have been quietly institutionalizing adopted children at extraordinarily high rates — adoptees are as much as 10 times more likely to be sent away than the general population.

A deep dive into Calo’s practices — how it makes money, and what happens to kids under its watch — offers a window into a larger phenomenon: Some youth treatment centers, backed by private equity companies, share a business model that depends on government funding, despite limited oversight and few consequences for negligence.

The AP obtained troves of state data and documents through public records requests and interviewed young adults who recently attended, parents who sent their children there, former employees and lawyers who are engaged in more than a dozen lawsuits against the company.

In emailed statements, Calo denied allegations of wrongdoing and said student outcomes prove the strength of their approach and innovative treatment.

“Over and over again, parents across the country have come to us in their moment of need, and we are proud of the track record we’ve established helping treat their children and return them to their families with the skills and tools they need to get ahead.”

Hundreds of pages of Camden County Sheriff’s Office reports documenting calls to the facility from 2020 to the fall of 2025 show that children in Calo’s care have been alleged victims, witnesses and perpetrators.

There was the free-for-all last summer when escaping girls ran toward the woods and jumped into the lake to swim away, employees chasing them and returning them, only to see them escape again. (Calo said none of them were injured.)

Just before that, sheriff’s deputies wrote that two kids had reportedly gotten high on methamphetamine that a Calo employee brought in her purse. (Calo said the employee was fired and the substance was never confirmed to be meth.)

Not long before that, deputies called to Calo were told staffers were outnumbered as teens “stormed” a room to attack another student. One boy climbed onto the roof, jumped, landed on rocks below and had to be airlifted to the hospital. (Calo said altercations happen among troubled kids, staff followed protocol in calling for help, and the boy who jumped sustained a sprained ankle.)

Stacy Roberts, who runs the local juvenile detention center, said his agency is frustrated by Calo and processes as many as a dozen cases each year involving Calo kids who live out of state.

Many families have decried the conditions at Calo as jail-like. Roberts rejects that comparison — because traditional juvenile detention centers like his are held to a higher standard, he said. Unlike Calo, Roberts answers to the public, a judge and the juvenile justice system, which monitors children’s stays within his facility.

“It’s a business,” Roberts said. “They’re not doing this because they want to help. They’re making money off these kids.”

Selling hope at a vulnerable time

Calo opened in 2007 with 40 beds and has expanded greatly since, with a capacity of 144 this year. It specializes in adoption trauma and says 90% of its clients are adopted.

Many are diagnosed with a rare condition called reactive attachment disorder, which experts say has been misapplied to many adoptees who struggle with the trauma of being divorced from their birth families and, for foreign adoptees, their country and culture.

The company says it’s treated thousands of young people ages 9 to 20 from more than 30 states as one of the nation’s largest for-profit centers of its kind, popular for out-of-state placements.

Critics ranging from advocacy groups to local law enforcement say serving faraway families has allowed places like Calo to avoid dedicated oversight and strict regulation.

Calo said it responds to serious incidents as required by law, and it “operates under rigorous, continuous external oversight” from governments that fund its students, some of which visit the campus annually or monthly.

And it defends its marketing efforts aimed at families in distress.

“It is a common misconception that for-profit entities are more expensive or less ethical than non-profit organizations,” Calo said in a statement. “Reaching them through thoughtful outreach and advertising helps break down the mental health stigma that keeps people from seeking treatment …”

Nationally, the need for youth mental health services has skyrocketed, along with its cost.

That demand, coupled with free-flowing public funds, has attracted investors. It’s estimated that the broader industry taps billions of dollars annually from government sources, including health programs, child welfare agencies, school districts and juvenile justice systems.

Calo was acquired around 2011 by a private equity firm led by the Stanford-graduate Alex Stavros, who over the next 13 years expanded the business by merging with other treatment centers to become the parent company Embark Behavioral Health. Stavros, who stepped down in 2024, did not respond to The Associated Press for comment.

Stavros claims in his LinkedIn profile that he built Embark to 38 programs across 20 states and achieved a remarkable 40-fold increase in revenue, to $180 million. Under his leadership, Calo shifted its business model “from entirely private pay to majority third party reimbursed,” including both private health insurance and Medicaid, and a range of government programs.

This is so integral to Calo’s business model that Nicole Fuglsang, its current CEO, once led a presentation at an industry conference on how to diversify revenue. The 2014 session was titled: “Show me the Money — An Innovative Approach to Finding Funding for Families.”

In the thick of the Covid-19 pandemic, as residential programs struggled with enrollment, Calo kept admissions humming.

Among the residents in 2020: a 9-year-old boy adopted from Haiti. Illinois education funds paid for his stay there. He later told his mother he was bullied. Other kids used racial slurs against him and defecated and urinated on his bed, his mother said. When she took him out, he woke up screaming for weeks, she said, before finally telling her that he’d been sexually assaulted there by an older boy.

Calo officials later told law enforcement that they couldn’t substantiate the sex abuse claim and that the bullying was mutual, according to the incident report.

His mother, who the AP is not naming to protect the identity of her son, said she reported what happened to him to everyone she could: law enforcement, Illinois state authorities and Calo’s parent company. She felt that no one cared. Though they told her they investigated, she said she watched as Calo continued business as usual.

“The almighty dollar will prevail once again,” she wrote to the Illinois State Board of Education, “and Calo will grow in wealth from school systems and cause harm to young children like my son.”

A month after her son arrived at Calo, Embark called on dozens of industry people to talk business strategies. “DOING EPIC SH$T” was printed on the cover of the August 2020 “Embark Academy Sales & Marketing Conference” handbook. It featured a session on how to “overcome objections” with sales tactics to “build your client base and keep your pipelines full!”

Attendees were urged to touch hearts to help “assure a doubting child or resentful spouse.” In a session that touted admissions as a vital part of the treatment team, the handbook noted: “The admissions person sells hope when the family is at their lowest and most hopeless, scary, and vulnerable time.”

At Calo’s request, the AP called families who the company recommended and said had good experiences. Several said they believe the facility helped heal their children.

Bill Hayden said his daughter, who was adopted from Russia, was never harmed during the 15 months she was at Calo, starting in 2016. A retired doctor, Hayden believes Calo changed his daughter’s life, and said that his daughter agrees.

“I felt that they were dedicated professionals who were trying to do their best with about the toughest group of kids you could probably ever house,” Hayden said. “We were content that things were going as well as they could with kids with extraordinary problems.”

Reported abuse, little accountability

A New Hampshire family said they paid about $100,000 for their adopted daughter’s 10-month stay, beginning in June 2023, when she was 10-years-old. The New Hampshire state government provided additional funds.

The girl had already suffered so much before her adoption — in-utero drug exposure, violence, sexual abuse and extreme neglect, her mother said. In her new home, she still struggled with mental health problems and increasingly explosive behavior.

Her mother remembers the red flags she ignored — how dirty the facility was and how unhappy the children looked. Her daughter woke up screaming during a visit months into her stay. Her mother found a disturbing journal entry: “I had a vision that (she) attacked me but not just a few scratches,” her daughter scrawled, naming the assailant. “I had blood dripping everyw(h)ere.”

Late one night weeks later, the mother’s phone rang. It was another mom whose daughter had been at Calo. The woman, from Illinois, told her both of their daughters had been molested by another girl.

The AP is not naming the mothers or their daughters because it does not typically identify people who say they are victims of sexual assault.

The mothers say they both reported their concerns to the same therapist who treated their daughters, and allege Calo covered up the assaults.

The Illinois mom said her adopted 11-year-old daughter was sent to Calo after struggling with thoughts of suicide. In February 2024, she told her mom that a girl in her preteen program had months earlier touched her genitals while lying next to her and had threatened to beat her up if she told anyone about it.

Such incidents of abuse were rampant at Calo, the girl said to her mom: “(She) touched me, but (she) touches everybody. Everybody knows that.”

The mother says the Calo therapist first dismissed it as “girls playing footsie” before the company acknowledged it had lost track of the daughter’s initial report. The mother also alleges the therapist and a Calo director later told her the issue had been “handled,” assuring her that the troubled girl was gone, so everyone was safe.

The mother was frustrated, but she believed Calo’s claim that it was just an innocent communication mistake and the problem that had been remedied.

Then, weeks later, the girl told her mother that the same attacker had done the same thing to an even younger girl, the one from New Hampshire.

Both families immediately took their daughters home and notified authorities. They are now among a group of families suing Calo.

After the mothers complained, Calo said it immediately reported it to authorities, including the state child welfare agency, which looked into it and “determined the claim did not meet the requirements for a full investigation.”

“We acknowledge the delayed report due to a staff member not following the established protocols and failing to route the statement to the quality assurance team for processing,” Calo said in a statement.

The Missouri Department of Social Services has previously noted that Calo has repeatedly failed to fully report serious incidents. In 2022, for example, the state ordered them to turn in five such missing files, to which a company official “acknowledged Calo needs to change their practice as it is not currently working.”

The mothers were also the first to report the allegations to law enforcement. The sheriff’s office told AP in a statement that deputies “revealed what appears to be a mistake by Calo staff not reporting the allegations," though deputies did not investigate further.

They also contacted authorities in their home states, some of which were helping to pay the tab for the girls to stay at Calo.

The Illinois mother said her daughter’s treatment was paid by a little-known program called the Family Support Program run by the Illinois Department of Healthcare and Family Services that is designed to fund behavioral healthcare. She learned about it from Calo. She and other Illinois parents told AP that they believed the state had vetted the program because it paid for so many kids at Calo.

That agency and the Illinois State Board of Education both list Calo among approved residential treatment programs they fund. Over the last decade, the two Illinois agencies have spent more than $35 million sending kids to Calo, according to data obtained by AP.

Last year alone, the Board of Education paid more than $1.6 million to send 13 kids there for special education services. Healthcare and Family Services’ spent $1.2 million for 19 kids. Some families used money from both.

Melissa Kula, an Illinois government spokeswoman, said in a statement on behalf of both agencies that they don’t oversee Calo’s day-to-day operations or regulate the facility, and rely on the Missouri government for Calo’s licensing and approvals.

The Illinois State Board of Education said the state doesn’t have a direct role in placements — it only reimburses school districts that determine where students go. The education department said it has never set foot on Calo’s campus. The law only requires on-site visits if the facility is within 50 miles (80.47 kilometers) of Illinois state lines.

‘An effort to stonewall’

Healthcare and Family Services visited for the first time in May 2024, after multiple reports of children suffering severe harm, including the girls from Illinois and New Hampshire.

The Illinois team of five nurses and officials arrived at Calo and the report of what they found there, obtained by the AP through a public records request, is scathing.

Calo administrators insisted they attend a new employee training session, and the team was shocked by what they saw, according to the report: It “was only a drum circle,” they wrote. “There was no explanation regarding how the drum circle related to therapeutic activities nor any explanation of the purpose in training new employees.”

To the AP, the company defended the drum circle as a “therapeutic, experiential activity.”

The Illinois investigators said they were “closely controlled,” and denied free access to much of the staff and property, including reviewing records and training curriculum. The team worried there was “an effort to stonewall” their inspection.

“This, along with witnessing the drum circle’s supposed training for new staff training led the reviewers to think that an organized training curriculum and training plan does not exist,” the report said.

Calo asserts that investigators weren’t denied access to its campus but acknowledged that there was “a disagreement” over restricted records. Its employee had “an error in judgment” that the company said was promptly corrected, and that Illinois investigators were later offered full access digitally.

The Illinois team was also skeptical of claims the school made about their therapy methods, noting that staff was “not aware of any research” supporting their effectiveness. They found the facility did not seem to have a “professionally appropriate” understanding of serious mental health problems children likely suffered, such as bipolar disorder. Instead, Calo insisted that the children’s problems were always viewed as a symptom of adoption trauma.

Calo’s parent company, Embark, swooped in to negotiate changes. The Illinois investigators ultimately said they believed the company was committed to the “commendable” swift reforms it pledged, including raising salaries and lowering capacity until it could hire more staff.

“At the end of the visit, we recognized that we may have talked past each other regarding our clinical offerings — something we were able to address and resolve through subsequent dialogue with the evaluators,” Calo wrote in a statement.

Former teachers like Dustin Wood, who worked at Calo for six years as an English teacher before quitting in 2024, said when he tried to report his concerns to company leaders, Calo administrators stopped inviting him to parent retreats and started writing him up for infractions like contacting parents to discuss their children’s progress.

Wood said all employees got the same minimal training, whether as a teacher, cook or “coach” tasked with monitoring the children 24 hours a day. They were told all the kids had something called reactive attachment disorder, but were given no guidance as to how to help them, he said.

Calo said it conducts 40 hours of training. It said it investigated and addressed “in good faith” the concerns raised by Wood and another teacher that company officials “thought were valid.”

Wood said as Calo took on more kids, sometimes younger children mixed in with older teens, without enough adults to supervise them. It grew increasingly chaotic, he said.

“There’s not a single kid,” Wood said of the students he worked with, “who left in better condition than when they started.”

‘She’s a runaway from Calo’

One day last June, Amos Pierce jolted from a nap to the sound of his Ford F-150’s engine turning over. He ran outside and saw a girl hiding inside the truck.

He’s lived within earshot of Calo for decades, and figured she was from there, partly because he was so used to constant screams, escapes and vandalism, he told AP.

Pierce said he tried to coax the girl, who was screaming and crying, out of the truck. He had a daughter about her age, he told her. He wasn’t mad and wouldn’t hurt her. Come out, he said, and we can call the police.

“I could tell that girl was so scared that she was prepared to do whatever she had to do to get away from what had her in that panic state,” he said.

He watched as she drove off, ploughing over his plants as she backed out of the drive, nearly careening into a ditch. She clearly was too young to know how to drive.

“I had tears in my eyes,” Pierce said. “I was upset, by tenfold more scared for that child than I was worried about my truck.”

The girl’s desperate escape from Calo thrust her into a tense and at times dangerous encounter with law enforcement.

Deputies spotted the truck and followed, lights and sirens blaring. Two other police departments were called in. They stretched spike strips across the highway road to puncture the truck’s tires and stop her.

After she got out of the truck, at least one officer pointed a gun at her. The girl climbed over a median to dart across the highway, running into a swamp as officers chased her, according to Lake Ozark police body camera video obtained by AP. She panted and sobbed as she was arrested face-down on the side of the road, surrounded by officers.

Did anyone know who she was? One officer said simply: “Calo does. She’s a runaway from Calo.”

The chase was also captured by the reality TV show, “Ozark Law,” which reported that she was 15 years old and going as fast as 70 mph.

Sheriff Chris Edgar said the incident was a turning point for him.

For years, deputies often visited Calo for runaways, injuries, vandalism and assaults. When the AP asked about 17 specific reports involving serious incidents during the last five years, Chief Deputy Colonel Scott Hines of the Camden County Sheriff’s Office said most were found to be unsubstantiated.

The Missouri Department of Social Services is also called to Calo. Baylee Watts, a department spokesperson, declined to comment on individual cases, citing closed and confidential records, and said its role was to respond to every report and assist law enforcement.

Hines said Calo itself has never been investigated for wrongdoing.

But Edgar, who took office in January 2025, said after the girl stole the truck, he demanded Calo officials be more accountable.

“There was a lot of cases that they would not give witness statements. They wouldn’t talk to law enforcement. In a sense, preventing us from being able to investigate stuff. And that was one of the things that I had a problem with,” he said.

Edgar said he even threatened to put them in jail if they prevented officers from going inside or interviewing kids and staff.

“They have the care, custody and control of the child, so therefore, I feel the responsibility would bear with them,” Edgar said.

Calo insisted it has a great relationship with Edgar’s office, and sent a photograph of a letter on Edgar’s letterhead supporting their business.

Edgar, whose son has worked at Calo, declined to send the letter directly to AP. He instead offered a different statement that says his office’s relationship with Calo has improved, including allowing deputies unrestricted access: “I know things were not like this in the past, but this is refreshing to know everyone is working together.”

He didn’t respond to follow-up questions.

Calo said its facility is open and unlocked, a place where “students are free to move throughout the campus rather than being confined to their rooms or a single building.” The girl who stole the truck, it said, was later sent to a facility with higher-level care, including locked doors, due to her history of running away.

“In this instance, a neighbor unfortunately left his keys in an unlocked car with doors wide open. A student who eloped took advantage of the accessible vehicle,” Calo said.

Pierce, the neighbor, told the sheriff’s office he didn’t want to press charges against the girl, but wanted Calo held accountable.

Pierce’s daughter, meanwhile, took to social media. She urged that Calo be investigated because she believed the children there weren’t safe.

In response, Pierce said, a Calo employee admonished him and his daughter for the post, pleading with Pierce to take it down. He should keep a closer eye on his child, he was told.

Pierce was aghast. He wasn’t worried about his own kid, he said. He was worried about theirs.

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