Name

Unit/Position

HEAL SPECIAL REPORT:

FOUR CIRCLES RECOVERY CENTER

ENROLLMENT AGREEMENT REVIEW

HEAL has found multiple problems with Four Circles Recovery Center's enrollment agreement including apparent unconscionable terms and/or contradictory terms leaving us to believe that Four Circles Recovery Center is running a money-making scam on families in need of assistance.  We will be alternating between "quoted text" from pages of Four Circles Recovery Center's (Four Circles/Four Circles') enrollment agreement (as was downloaded from fourcirclesrecovery.com on October 7th, 2010) and HEAL's questions/concerns.  HEAL will not repeatedly link to the enrollment agreement in full throughout this review, and, we advise readers to scroll back and/or open the enrollment agreement in a new window while reviewing our work for accuracy or if additional contextualization is preferred.  This is an independent review and if you are in need of legal assistance or advice, please consult with an attorney. 

Enrollment Agreement (Page 1)

"Please List Any MEDICATIONS that you are CURRENTLY taking and bringing or indicate NONE.  All Medication "MUST" include a Prescription & be in the correct Containers.  All medications (including Vitamins & Acne Creams) must include clear doctor's prescriptions, or they will not be dispensed."

"Do you have a History of refusing to take Medication?"

"Please list any major illness or physical injury that was suffered by your child previously:"

HEAL's Questions/Concerns

It is reasonable that a drug rehabilitation facility would require any medications to be prescription only and dispensed/controlled by personnel given the nature of the supposed purpose of the treatment. 

Will Four Circles Recovery Center force residents to take medications they are opposed to taking?  If so, what methods are used to enforce such a rule?

It is strange that this program is for adults ages 18 to 28 years old, but, that the third question noted above seems to be aimed at parents as opposed to an adult seeking treatment.  There are a few places in this enrollment agreement that contradict each other in regards to whom is applying for, seeking, and funding this "treatment".  This will be addressed below.

According to NCcareLink.gov, Four Circles Recovery Center is not a recognized substance abuse treatment program in North Carolina.  Four Circles Recovery Center appears to be licensed as a limited liability company and a day treatment center only.  It appears based on the public documents available at the "Four Circles" link in the previous sentence that this program was formerly known as Appalachian Trails Recovery, LLC and changed names in 2006.  Four Circles is licensed as a day treatment center for substance abuse and is not licensed to provide residential treatment.  This is a serious concern as they are operating a residential program without being properly licensed to do so.  The state of North Carolina appears to draw a very clear distinction between day treatment (being part-time--a few hours a day, a couple of times per week) and residential treatment.  The licensing requirements for these services are different and it appears that Four Circles is not being honest in its operating practices.

Enrollment Agreement (Page 2)

"I hereby authorize Four Circles Recovery Center to release to( names) the below specified information and release the above named organization(s)/individual(s) from all legal liabilities that may arise from this situation."

"To release personal/healthcare information to Four Circles Recovery Center, and release the above named organization(s)/individual(s) from all legal liabilities that may arise from this situation."

"I understand that information regarding my alcohol and/or drug treatment is protected by federal law under the Drug Abuse Prevention, Treatment, and Rehabilitations Act and the privacy provisions of the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), and their implementing regulations...I understand that my health information specified above will be disclosed pursuant to this authorization, that the recipient of the information may re-disclosed the information and it may no longer be protected by federal law under HIPAA...I understand that I may revoke this consent in writing at any time except to the extent that action has been taken in reliance on it, and that this consent will expire in one (1) year unless otherwise specified below."

HEAL's Questions/Concerns

The good news is that Four Circles is licensed, at least as a day treatment provider, by the Department of Health and Human Services in North Carolina.  The Department of Health and Human Services would be charged with the task of enforcing HIPAA and insuring HIPAA compliance.  So, at least in this instance, Aspen Education Group appears to be somewhat forthright regarding being subject to HIPAA regulations.  This is not the case, from our understanding, for most Aspen programs.

Regardless, Four Circles requests a release of liability in the event private information obtained from or shared with others is improperly disclosed.  And, it is the release of liability that is a concern given the practices at Aspen to use protected health information (PHI) for promotional and marketing purposes.  So, this is a concern.

Enrollment Agreement (Pages 4-6)

"Under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Aspen Education Group and its affiliated entities (collectively, "Aspen") must take steps to protect the privacy of your "protected health information" (referred to in this Notice as "PHI" or "health information")."

"In addition, these entities, sites, and locations may share health information with each other for treatment, payment, or health care operations purposes as described in this notice."

"RESPONSIBILITIES OF ASPEN EDUCATION GROUP AND ITS AFFILIATED ENTITIES"

"Make sure that health information that identifies you is kept private (with certain exceptions)"

"Follow the terms of this Notice that are currently in effect"

"We may use or disclose your protected health information without your authorization as follows in relation to health care operations: --To administer and support our business activities or those of other health care organizations (as allowed by law) including providers and plans."

"We may use or disclose your protected health information without your authorization as follows in relation to health care operations: --To other individuals (such as consultants and attorneys) and organizations that help us with our business activities. (Note: If we share your health information with other organizations for this purpose, they must agree to protect your privacy.)"

"We may use or disclose your protected health information without your authorization for legal and/or governmental purposes in the following circumstances: --Military activity and national security--To the military (if you are a member of the armed forces), and to authorized federal officials for national security and intelligence purposes..."

"We may also use or disclose your protected health information without your authorization in the following miscellaneous circumstances: --Facility directory information-Unless you object, we may use and disclose your name, the location at which you are receiving care, your general condition (e.g. fair, stable, etc.), and your religious affiliation in our facility directory...-Research-For research purposes provided that certain steps are taken to protect your privacy.  For example, a research project may involve comparing the health and recovery or all patients who receive one medication to those who received another, for the same condition..."

"USES AND DISCLOSURES OF YOUR PROTECTION HEALTH INFORMATION BY ASPEN THAT REQUIRE US TO OBTAIN YOUR AUTHORIZATION...Except in the situations listed in the sections above, we will use and disclose your health information only with your written authorization."

HEAL's Questions/Concerns

The above goes into additional information regarding to whom or with whom Aspen/Four Circles can disclose or discuss your private mental and medical health information without your authorization.  It is important to notice that the terms apply "that are currently in effect".  This language implies that there may be terms not in effect. 

The sixth segment above begs some questions be asked of Aspen: "What do you mean by "support our business activities"? Does Aspen use client information in studies that result in financial benefit to Four Circles Recovery Center or Aspen Education Group?  If my child is included in a research study conducted by Aspen, will we or our child be compensated and informed as to the dangers of participation in such a study?

Regarding the seventh segment, can families expect the same treatment of their privacy from other organizations with whom Aspen shares information as Aspen treats said privacy?  Meaning, if enough independent organizations signed confidentiality or privacy agreements, could your private information end up in the hands of someone you would not wish to have that information? (i.e. an employer)

The eighth paragraph is a concern as many of the practices (i.e. forcing children to "wipe" with frozen snow/ice packs in freezing cold conditions as occurred at Adirondack Leadership Expeditions, another Aspen program) may be considered a form of torture.  Does Aspen run "intense interrogation" tactics in order to research "effective" practices for dealing with POWs?  Is this a possible and/or probable explanation for this clause?  Generally, schools and other institutions do not need to disclose information to the military or national security and if truly needed, would not need to be disclosed in a contract.  This is what leads us to believe that the research at Aspen programs may be something highly unethical and unsuitable for children.

Is it appropriate to include so much personal information about participants in a facility directory?  And, is it appropriate to do so without the consent of participants?

HEAL did not include every instance in which Aspen claims it can and/or will disclose your protected health information (PHI) without your consent.  See the enrollment agreement in full for more information.

Enrollment Agreement (Page 7)

"Our Notice of Privacy Practices is subject to change.  If we change our Notice, you may request a copy of the revised notice by accessing our web site...or contacting our organization."

HEAL's Questions/Concerns

Our primary concern with the above segment is that Four Circles does not take pro-active action to notify inmates or families of changes to privacy practices that may effect their decision to remain in the program.  This is a concern.  Part of this policy should include that notification of a change in this policy will be sent to all parties affected by the change.  Putting the burden on families and/or clients to request a copy of updated privacy practices and/or changing these practices without notification is a concern.

Enrollment Agreement (Page 9)

"Parent Authorization and Consent for Electronic Communications"

"I/we authorize Four Circles Recovery Center to transmit personal communications from my child to me by facsimile."

"I/we understand that errors sometimes occur in the transmission of personal communications between client and parents.  I/we release Four Circles Recovery Center from any and all liability for error's in the transmission of personal communications between my child and myself."

HEAL's Questions/Concerns

HEAL reminds readers that this program is for adults ages 18 to 28 years old.  It is a concern that there is a lack of privacy in communications allowed between an adult and his family.  In addition, it is a concern that this form requires the signatures of the parents only.  Above, we see a mingling of participant responsibility as an adult seeking treatment with parental authority/responsibility.  This is repeated directly above in the sections from page 9.  And, in this section, the authority in regards to communications appears to be the program and the family, not the adult client.  This is an additional concern.

Enrollment Agreement (Page 11)

"This agreement ("Agreement") is entered into, by and between Four Circles Recovery Center, LLC, (hereinafter "Four Circles Recovery Center"), a Delaware limited liability company, operating a residential drug rehabilitation program which is described in the program materials..."

"In consideration of mutual promises set forth in this Agreement, Four Circles Recovery Center and Participant (hereinafter the "Parties") mutually agree as follows:"

"In entering into and performing under this Agreement, Four Circles Recovery Center is relying on all representations and promises of the Participant contained or expressed in this Agreement and all other documents and information sheets from Participant to Four Circles Recovery Center, and Participant expressly warrants the truth and accuracy of the same."

"Assuming the Participant is accepted into the Program, the term of this Agreement shall be a minimum of 42 Days beginning with the Participant's arrival in Horse Shoe, North Carolina, as the case may be, now anticipated on...(the "Arrival Date")."

"The Participant is accepted with the expectation that the Participant will complete the entire Program.  Unless otherwise set forth in Exhibit "A", the Program fee is $465 per day, plus professional fees."

"At the time of admission, private pay Participants shall pay the full initial amount of the Participant's scheduled stay plus the enrollment fee."

HEAL's Questions/Concerns

Four Circles Recovery Center is a limited liability company.  This was mentioned in previous segments of this review and we included the above to highlight in the agreement where this information is explicitly identified.

In this portion of the enrollment agreement, the focus is on the participant or adult residential client as the consumer with Four Circles as the service provider.  In this section, we see Aspen reverting back to the adult client as the focus, while in other segments the parent/sponsor is the focus for responsibility.  The language and documents involved in this section are unclear and not friendly to consumers who are unfamiliar with the law.

Prospective clients/participants and their families should inquire as to what the average length of stay is at this program and what the longest enrollment period has been for their most "challenging" client(s). 

Exhibit "A" agrees that the Program fee is $465 per day.  The enrollment fee is $2000 and is included on "Exhibit "A"" or page 18 of the enrollment agreement, discussed below.  With a minimum stay of 42 days, that makes the initial payment due at date of enrollment, $21,530.  It appears that "Exhibit A" contradicts the above and requires a payment for the first 28 days along with the enrollment fee at time of arrival/enrollment.  This contradicts the above terms and leads to further confusion regarding the meaning of the contract and the expenses expected to be incurred by participants and families.  Also, it appears that therapeutic/mental health services provided by qualified professionals comes at an extra charge.  These are concerns.

Four Circles Recovery Center does not provide the program materials/details online or with the enrollment agreement.  HEAL does not currently have the program details for Four Circles Recovery Center.  However, Four Circles is an Aspen Education Group program and being that the contracts are so similar, we feel that the program details for Aspen Ranch and our analysis of the same should provide a guideline for families and researchers investigating the methods employed by Aspen Education Group programs.

Enrollment Agreement (Pages 27 & 28--Aspen Ranch)

"Aspen Ranch Program Details"

"In order to maintain a safe environment for students and staff, we will conduct a thorough intake which includes a strip search and search of all belongings upon admission and upon return of all off-campus visits with parents."

"Your child will be provided most of the items he or she will need at Aspen Ranch."

"Other family members can write letters later in the child's treatment as he or she moves through the level system.  Students can only receive letters from friends in the final stages of treatment and only with parental approval."

"Typically, the first eight weeks in the program are a time of orientation and emotional adjustment for the student and family.  Our experience has indicated that it is more productive when family and student have made this adjustment separately.  Therefore, parent visits can be set up with the therapist after the eighth week in treatment."

"The student will be present for at least one family session via teleconference each month after the blackout period."

"The minimum time that a student can complete the program is nine months.  For most students, completion of the program will take longer than nine months."

"A minimum of (2) parent education workshops and Family Enrichment is required."

"We retain the services of a psychiatrist who visits the Ranch once a month...We also retain the services of an Family Nurse Practitioner who visits the Ranch once a week."

"Students who attain Rider or Wrangler are eligible for off campus trips that may include hikes, visits to National Parks, snowboarding, river rafting and trail rides.  These are privileges that students must earn.  Typically, students are not able to earn this level and these privileges until they've been in treatment for at least 6 months."

"Aspen Ranch is a Residential Treatment Center...For a child to be successful in all aspects of the program, the parent's attitude needs to embrace all aspects of the program."

"Aspen Ranch is accredited through the Northwest Association of Accredited Schools...Aspen Ranch offers a college preparatory track, but does not offer Advanced Placement options...Students may take a foreign language through a correspondence course available through Brigham Young University.  Parents are responsible for the extra fee that this incurs."

"Parents should understand that academic progress waxes and wanes relative to therapeutic progress."

"Students must complete the program in order to receive transitional services.  If you elect to terminate your child's care prior to his/her completion of the program, you forfeit the $7,982.50 pre-paid fee for transitional services."

"Monthly tuition covers room and board, supervision, therapeutic care and academics.  In addition, parents will pay for miscellaneous expenses including: escort fees, clothing & hygiene products, minor school supplies, birthday cakes, activities and SAT/ACT testing."

HEAL's Questions/Concerns

HEAL has amply covered the issues regarding the strip searches conducted by Aspen.  We include it again above as a reminder that body cavity searches are included and conducted on all children in the program regardless of the child's needs or history.  This is a serious concern and an apparent violation of the child's rights.

What necessities are not provided by Aspen?  Why are children deprived of any item they need while being under the control of Aspen?  Deprivation of needs would suggest blatant child neglect.  Neglect is a serious child abuse issue.  These and other abuses are described in detail on HEAL's Teen Rights' page at www.heal-online.org/teenrights.htm.

It is one of HEAL's primary warning signs of an abusive program that they deny or severely limit contact with the outside world.  Denying children the right to speak with parents by phone, and vice versa, during the first few months of "treatment" is a sign of an abusive program.  See www.heal-online.org/warn.htm for more warning signs and questions you should ask any program you consider. 

How long is the blackout period?  Does it ever last more than two months?  What is the longest period a child has been denied contact with the outside world (including parents) while in the program?

What is the average length of stay in the program?  How many years of "Harvard tuition" will be sucked up by Aspen's scam?  How many vacations or homes will be forfeited as a result of the extraordinary costs of this program?

Are the seminars included in the cost of the program?  Are the seminars and other parenting materials to be purchased separately by the family? 

For what purpose does Aspen retain the services of a psychiatrist?  Why does the psychiatrist only visit once per month?  Is the psychiatrist's sole purpose to prescribe psychoactive drugs to children?  Is the sole purpose or primary purpose of the nurse's weekly visit to monitor the effects of psychoactive drugs on children?  Are any legitimate professional therapies provided by Aspen?  They do not appear to be.

Are children held within the confines of Aspen Ranch on location for 6-months or more without any interaction with the outside world?  If so, this seems like a blatant violation of the child's civil rights.  See www.heal-online.org/provocases.htm and www.heal-online.org/legalarguments.htm for more information.

Again, we have Aspen demanding parents support the program without question.  This is a serious concern as many reported practices of Aspen appear to violate the rights of children.  These include practices that may be considered child abuse by authorities.  This is a serious concern.

For information on issues with accreditation agencies, see www.heal-online.org/accreditation.htm.  It is HEAL's understanding that the NAAS allows self-evaluations as the primary basis for accreditation.  This is in no way effective oversight.  Also, a foreign language taught by correspondence course is not going to benefit the child in understanding the language or culture of the language's origin.  This is a serious concern.  Also, since most colleges require foreign language as a pre-requisite for acceptance, this may hamper a child's future.  Why does Aspen charge extra for providing a lame correspondence course?  Greed?!

Are children denied access to an educational curriculum/academic services at any point of the program?  What does Aspen mean by "academic progress waxes and wanes relative to therapeutic progress"?  In many programs, the right to an education is deprived during certain phases of the program.  This is a serious concern.  What does Aspen mean by "therapeutic"?

Why are parents expected to pay for minor school supplies, activities, and academic testing?  Shouldn't these costs be included in the steep tuition cost (more expensive than Harvard University)? 

Readers may notice that the program description does not describe the program, the level system used, the definitions imposed by the program in regards to privileges/disciplinary actions/etc., or any detail that would suggest the program is providing a legitimate service.  Since this is the only description included of the program, the overall contract appears to be illusory, void/voidable, unenforceable, and amounting to nothing more than a scam that defrauds families and injures children, emotionally, psychologically, and/or physically.  Aspen Education Group should be immediately shut down by regulators and/or the Department of Justice and penalties should be imposed and victims should be provided with refunds and/or compensation for any and all injuries.  (end of excerpts from the Aspen Ranch review)

Enrollment Agreement (Page 12, Four Circles Recovery Center)

"A cancellation received less than seven (7) days prior to the arrival date will result in a 50% refund.  The amount retained by Four Circles Recovery Center may, if deemed appropriate by Four Circles Recovery Center, be used as credit against any future enrollment of the Participant."

"If Participant withdraws before expiration of the minimum period of enrollment without the recommendations of the Program Director, an early withdrawal fee (See Exhibit A)."

"In addition to the Program fee, Participant agrees to pay for the following expenses: transportation from the Participant's current residence to Horse Shoe, North Carolina as the case may be, and return transportation to the Participant's current residence; food and lodging expenses for any holding period before commencement of the Program and/or after completion of the Program; all medical, dental, hospital, and related expenses incurred by or for the Participant and all required personal items specified in the Participant Clothing List.  Participants are also responsible for any additional escort fees required for transporting Participant to and/or from the Program to another location (i.e. airport, doctor's appointment or special event).  Participants are responsible for the cost of any psychiatric evaluations performed by a psychiatrist."

"Participant agrees to accept full responsibility for (1) the repair or replacement of any property damaged, defaced, or destroyed by the Participant, whether owned, leased, or controlled by Four Circles Recovery Center or any third party, and (2) any personal injury to any Four Circles Recovery Center personnel, other Participants or third parties caused, in whole or in part, by the Participant; and to promptly reimburse Four Circles Recovery Center for any costs and expenses, including legal fees, it may incur in connection therewith." (section ends on page 13)

HEAL's Questions/Concerns

The early withdrawal fee is $5000.  This is on top of the accrued per diem and the enrollment fee.  It is a penalty clause and likely would be considered illegal, unconscionable, and void as a matter of public policy.  It is a concern that such a term would be included in this contract.

It is a concern that the "therapeutic" services of the program are optional and appear to come at an additional cost.  This too is contradicted.  In the 3rd segment above, Four Circles states that Participant will be charged additional fees for psychiatric and psychological testing and services.  If it is a residential treatment program, legitimate therapeutic services should be included in the cost.  This means services provided by qualified and licensed mental health professionals in good standing.

The fourth segment is reasonable, or would be reasonable, if Four Circles' program does not intentionally provoke or cause violent or extreme outbursts by the very nature of their methods.  It is reasonable for Four Circles to demand Participants accept liability for their own actions resulting in damage to people or property.  But, only with that caveat that Aspen is providing a nurturing environment and not provoking angry outbursts through humiliation or physical assault of the Participant.  Since it has been reported that such outbursts are intentionally provoked by Aspen staff at other Aspen programs at times, this clause may raise concern for families and Participants.  Four Circles should insure against such incidents through good business practice and proper insurance that would be required of any properly licensed residential program or facility.  It is wrong to solely place liability with the Participant when the program may share or be primarily liable for the circumstances resulting in damage or harm.  And, families/participants should require an investigation into any incidents of this nature to insure that they are not being stuck with a bill that is not their own or their son's/daughter's.

Enrollment Agreement (Page 13)

"Four Circles Recovery Center is not liable for any loss of or damage to any of the Participant's property.  The Participant is fully responsible for the same at all times."

"Participant agrees and consents to Four Circles Recovery Center subcontracting certain services to be rendered under this Agreement to persons or entities deemed by Four Circles Recovery Center to be properly qualified to provide said services, at no additional cost to Participant unless otherwise agreed to by both parties.  Four Circles Recovery Center is not responsible for the services provided by such third-party contractors and is hereby released from any liability arising from such services.  All clinicians furnishing services to the Participant, including any psychiatrists, psychologists, mental health professionals, or internists or the like, are independent contractors with the client and are not employees of Four Circles Recovery Center.  The Participant is under the care and supervision of his/her attending clinician and it is the responsibility of the Participant's clinician to obtain the Participant's informed consent, when required, for medical, surgical, or psychiatric treatment, special diagnostic or therapeutic procedures, or other services rendered the Participant under the general and special instructions of the clinician."

"If the Participant's condition is such as to need the service of a special duty nurse, it is agreed that such must be arranged by the Participant.  Four Circles Recovery Center shall in no way be responsible for failure to provide the same and is hereby released from any and all liability arising from the fact that Participant is not provided with such additional care."

"Participant acknowledges serious hazards and dangers, known and unknown, inherent in the Program, including but not limited to ranch, agricultural and vocational activities, emotional and physical injuries, illness or death that may arise from strenuous hiking, climbing and camping in a natural environment, exposure to the elements, plants and animals, running away from the Program, "acts of God" (nature), the ropes course, stress, involvement with other Participants, self-inflicted injuries, and transportation to and from the Program's field location(s), and agrees to assume and does knowingly and voluntarily assume all of the risks inherent in the Participant's participation in the Program and all of its related activities, and the risks associated with the Participant's unique medical, physical, mental and/or emotional limitations; and Participant acknowledges that Participant has had adequate opportunity to ask Four Circles Recovery Center any questions Participant may have about the Program and its inherent risks, and gives Participant's informed and unqualified consent thereto; and Participant agrees to fully release, hold harmless and indemnify Four Circles Recovery Center, and any and all of its officers, directors, employees, agents and subcontractors from and against any and all liabilities, claims, damages, fines, losses and expenses, including legal fees, that may arise or be incurred as a result of the Participant's participation in the Program and related activities.  In addition, Participant agrees to release, indemnify and hold harmless Four Circles Recovery Center, its employees, agents and subcontractors from and against any and all liabilities, claims, damages fines, losses and expenses, including legal fees, that may arise or be incurred, directly or indirectly, as a result of their actions taken pursuant to the authorizations, agreements, warranties and representations set forth in this Agreement or the application forms."  (section ends on page 14)

HEAL's Questions/Concerns

Four Circles is free to steal from you as a result of the clause freeing them of liability for lost or damaged property.  Theft of personal property at programs is fairly common.  Theft of personal property at elderly-care facilities are equally as common.  It is always a good idea to keep any items of pecuniary or sentimental value safe at home, this includes you.

In addition, Four Circles demands control of what "independent contractors" will be utilized and granted the fees charged for their services.  However, Four Circles does not take responsibility for the care provided by the contractors they deem "properly qualified".  And, since they are asking you trust their judgment in regards to choosing said independent contractors, they would arguably be liable for faults found with their judgment in the event harm or other violations occur.  But, they demand you hold them harmless if there is a problem with the subcontractor.  And, they put full responsibility on the outside or "subcontracted" clinician for the supervision and care provided to you, and, they likely give permission in your stead with your permission protecting everyone else from any liability for any and all harms done to you while in Four Circle's program.  An additional concern is that in the general release of liability covered in the next paragraph, the program demands that these "responsible" subcontractors be released from liability as well.  This seems to be an unconscionable contract with many unconscionable terms.

The above also states that risks of emotional (i.e. psychological) and physical harm are inherent to the program.  This may be true of physical harm given that exploring wilderness with limited supplies and/or improper supplies for warmth/hydration/etc. is likely to result in physical harm and is a semi-reasonable assumed risk when adventuring in such conditions.  However, psychological and emotional harm should not be an inherent risk and stating that it is reveals the harmful nature of the Four Circles program. 

Enrollment Agreement (Page 14)

"All costs and expenses incurred for these services shall be the sole responsibility of the Participant.  Participant also authorizes Four Circles Recovery Center to arrange for a physical examination (including a drug screen/blood test, at Four Circles Recovery Center option) and any psychological assessments of the Participant deemed necessary by Four Circles Recovery Center prior to the Participant's beginning the Program."

"Participant hereby acknowledges and agrees that Four Circles Recovery Center personnel may search the person and personal effects of the Participant at any time, including a "strip search."  In connection with such search, Four Circles Recovery Center may, in its discretion, require Participant to remove all of his or her clothing and may search Participant's entire person.  Four Circles Recovery Center is further authorized to confiscate any and all items deemed by Four Circles Recovery Center to be contraband or counterproductive tot he Participant's successful completion of the Program.  The disposition of all items confiscated by Four Circles Recovery Center shall be left to the sole discretion of Four Circles Recovery Center."

"Participant hereby acknowledges and agrees that Four Circles Recovery Center personnel may physically restrain, control and detain the Participant by the exercise of necessary restraints when deemed necessary by Four Circles Recovery Center, for purposes including but not limited to preventing the Participant from jeopardizing the Participant's own safety or the safety of others."

"Participant hereby authorizes Four Circles Recovery Center to use data from the Participant's records, tests, and assessments for purposes of ongoing research, provided that the Participant's name and identity will be kept confidential and not used in any published materials."

HEAL's Questions/Concerns

HEAL thinks it is important for families and participants to understand the indemnity clauses placing them in the position to take full responsibility in the event of serious injury or death of their loved one/him/herself in the program.  Many families have lost their loved ones in programs similar to Four Circles Recovery Center and some of these deaths occurred in Aspen programs.  At least two children died at Aspen's SageWalk program in Oregon before it "voluntarily" suspended operations as the death(s) are investigated by authorities.  These risks are very real and both participants and parents should think if the worst happens and Aspen's methods are responsible, how they will feel with nowhere to turn for justice.  Be careful and always seriously consider what you are agreeing to in signing any contract.  Again, this is not legal advice.  If you would like legal help, please consult an attorney.

Also, parents/participants should understand that in the first segment quoted above they are giving Four Circles permission to seek and obtain psychiatric, mental health treatment, and medical treatment for their child/him/herself and at the sole discretion of Four Circles.  The clinician and/or other mental health professionals will be contracting with Four Circles on behalf of you/your child and will likely report solely to Four Circles in regards to the care of you/your child.  Four Circles' control and ability to deny you access to the records of such services is an additional concern.  In the likely event you/your child is harmed, how will you begin to determine who should be held accountable?  Who can be held accountable when the waiver extends to "volunteers" and "community organizations" with which Aspen contracts?  Please consider these issues seriously.

Strip-searching without probable cause is a violation of the civil rights of the Participant.  Assuming every Participant, with or without a history of drug use, is in need of a strip-search is unreasonable.  Searching Participants at "any time" suggests such searches are used as a form of humiliation as opposed to being done for any legitimate purpose.  And, this is a serious concern.

Using restraint to detain and control an adult, who should be free to leave the program if enrolled voluntarily, while in the program also shows that the program is not "voluntary" for the Participant once enrolled and that the Participant is forced to participate in the program through physical force.  Congress is working on legislation (HR 4247, the "Keeping All Students Safe Act of 2010") to stop these misuses of restraint in programs and schools that often result in serious injury and death.

Again, Four Circles references the use of your data in "ongoing research".  What is this research and will you be made privy to all studies in which your private information will be used?  If not, why not?  Informed consent to participate in any research includes knowing the purpose of the research and the projected risks involved in participating.  This again suggests possible violations of the Nuremberg Code (International Human Rights Laws). 

Enrollment Agreement (Page 15)

"In the event that Four Circles Recovery Center elects to terminate the Participant pursuant to the terms of this paragraph, Participant understands and agrees that Participant forfeits all monies pre-paid to the program."

"Participant agrees to attend educational seminars conducted by Four Circles Recovery Center during the Program, if any, and to give Participant's full cooperation to Four Circles Recovery Center personnel throughout the Program, in order to maximize the benefits of the Program for the Participant.  Participant also agrees to read any educational materials and watch any video programs sent to Participant by Four Circles Recovery Center, and to fill out and return to Four Circles Recovery Center any interactive educational materials, while the Participant is in the Program."

"If an escort is required to bring the Participant to North Carolina for the Program, Participant agrees that any escort or escort service used by Participant, whether or not Participant is referred to the escort by Four Circles Recovery Center, is in all respects an independent contractor contracting directly with Participant.  Participant agrees that Four Circles Recovery Center bears no responsibility of any kind for any such escort service or the negligence or failure thereof."

"Participant warrants that the Participant is not a minor, both by age and as a matter of law."

"Any controversy or claim arising out of or relating to this contract, except at Four Circles Recovery Center's option the collection of monies owed by Participant to Four Circles Recovery Center, shall be settled by binding arbitration conducted in the State of California, County of Los Angeles, in accordance with the rules of the American Arbitration Association.  Judgment upon the award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction for purposes of executing upon the award."

HEAL's Questions/Concerns

The entire agreement appears unconscionable in one respect or another.  It is a serious concern that the program is not more explicit about the methods used or civil rights abuses entailed and yet will happily lay claim to all monies pre-paid for a program that subcontracts out any and all legitimate services and claims no liability for any harm caused by its ineffective and harmful methods.  This is a serious concern.  Most individuals and families would not expect to lose over $15,000 if choosing against a service after having been exposed to it briefly caused harm or serious concern.  Coupled with the additional and outrageous "early withdrawal" penalty fee of $5,000, it is seriously disconcerting. 

HEAL recommends that Participants ask what Four Circles means by "full cooperation".  If you witness abuse and try to prevent said abuse in opposition to the protocol of Four Circles' program, will you be in violation of the "full cooperation" clause?  This is likely how Four Circles sees it.  And, anyone who demands full cooperation and/or unquestioned authority over others is not acting in the best interest of that individual or family.

Since Four Circles chooses to conduct business in and enroll individuals from other states, including North Carolina, they should be able to be sued from the home-state of their dissatisfied clients.  If they do not wish to assume the risk of litigation outside of the state(s) of their choice, then they shouldn't accept enrollment from other states.  This will be developed in the next section.

Enrollment Agreement (Page 16)

"In the event that either party is found in default or material breach of any specific promise, term or condition expressly set forth in this Agreement by an arbitrator(s) or a court of competent jurisdiction, said party shall be liable to pay all reasonable attorneys' fee, court costs and other related collection costs...Participant agrees to compensate Four Circles Recovery Center for all reasonable attorneys' fees and costs incurred by Four Circles Recovery Center in connection with those matters concerning which Participant has agreed to pay or indemnify Four Circles Recovery Center herein."

"This Agreement, and all matters relating hereto, including any matter or dispute arising between the parties out of this Agreement, tort or otherwise, shall be interpreted, governed, and enforced according to the laws of the State of California; and the Parties consent and submit to the exclusive jurisdiction and venue of the California Courts in Los Angeles County, California, and any qualified (American Arbitration Association-approved) arbitration service in the State of California, County of Los Angeles, to enforce this Agreement.  The parties acknowledge that this agreement constitutes a business transaction within the State of California."

HEAL's Questions/Concerns

The first segment above seems more a tool of intimidation to frighten you from pursuing legal action by having you agree to pay for Four Circles' attorneys' fees regardless of the legitimacy of your claims.  This seems unconscionable.

All disputes are to be resolved in California according to this page of the Agreement.  Throughout this contract we have seen numerous contradictory and unconscionable terms.  This appears to be an illusory contract offering absolutely no legitimate service to families while charging extraordinary fees to those families.  The families take all the risks, absolve Four Circles of its own wrongdoing, and Aspen reaps all the rewards.  This appears to be nothing more than a scam on families in crisis or whom have been convinced by Aspen and/or its co-conspirators (i.e. educational consultants/referrers) that it is necessary.

Enrollment Agreement (Page 17)

"Other than the express commitments set forth in this Agreement and the Program description, Four Circles Recovery Center gives no warranties of any kind, express or implied, to Participant concerning the Program; and Participant acknowledges that Participant is not relying on any warranties or representations of any kind other than the express commitments of Four Circles Recovery Center sets forth herein."

"The parties authorize the release of Participant's information via E-mail, Internet technology, voice mail or US mail.  While every effort will be made to maintain confidentiality, Four Circles Recovery Center accepts no responsibility for the mistransmission that could result in information becoming available to someone other than the intended receiver."

HEAL's Questions/Concerns

We included the first segment above to highlight that the contract is the entire agreement.  Four Circles has agreed to do nothing but keep an adult confined until the program decides they are ready to "graduate" the program.  Four Circles guarantees nothing and offers no warranties or other consideration for the extraordinary fees they charge.  It is truly outrageous.

Also, we again see that Four Circles/Aspen will not be liable for your private/protected health information being disclosed to unintended parties.

Enrollment Agreement (Page 18)

"EXHIBIT A"

"I/Sponsor(s) understand that the cost of Four Circles Recovery Center is $465.00 per day and a $2000.00 enrollment fee.  I/Sponsor(s) understand that there is a minimum initial payment of $15,020, due upon admission, which covers the first 28 days of the program...If participant withdraws from the program before the expiration of the period of enrollment without the recommendation of the Program Manager, an early withdrawal fee of $5000 plus the enrollment fee plus the accrued daily rate $465 will be retained."

"My signature below is a formal application to participate with Four Circles Recovery Center and an understanding of its physical demands."

"I release Four Circles Recovery Center, its employees and contractors from any and all liability resulting from our my participation and assume all risks therewith, including known and unknown risks."

"Participant's Name"

"Sponsor(s) Signature"

"Sponsor(s) Name"

HEAL's Questions/Concerns

HEAL has included the above to that Four Circles has again reverted back to contracting with the Sponsor as opposed to the Participant.  The Participant being an 18-28 year old adult.  This is a concern.  We have discussed our concerns regarding the financial aspects of this program in previous segments and will not reiterate those points here.

We point out that the financial agreement includes the name, but, does not require the signature of the Participant.  Aspen typically refers to parents or legal guardians as "Sponsors" in their contracts and that is likely who is intended by the "Sponsor" references above.  It is a concern that this program refers to escorts and the contract does not make it clear whether the program is voluntary, but, certainly suggests it becomes involuntary if someone wishes to leave.  This is a serious concern and was addressed in previous segments of this review.

"OPTIONAL PSYCHOLOGICAL TESTING" (page not numbered)

"Yes, please complete psychological testing at an additional cost of $2470.00"

HEAL's Questions/Concerns

HEAL has included the above to show that there are additional fees for both psychiatric and professional mental health services.  It is a serious concern and again shows that the program itself does not directly provide any legitimate therapy or mental health services. 

At this time, we recommend no one enroll or allow him/herself to be enrolled in Four Circles Recovery Center.  If you have a friend or relative being held at this facility, please reach them and ask if they wish to remain in the facility.  If they seem afraid or their calls are being monitored by staff, drive out and demand to see your loved one.  If you are refused, please contact local authorities and ask that you be assisted in seeing your loved one to insure they are not being held against their will and forced to participate in demeaning or otherwise harmful activities.