A cyclist bikes by the Eating Recovery Center’s Franklin Street location in Denver on Friday, June 2, 2023. (Eli Imadali/Special to The Denver Post)
Colorado’s eating disorder treatment industry will soon face tighter regulations of providers’ practices under a new state law spurred in part by former patients and providers’ accounts of punitive environments and treatment practices.
The law, passed by lawmakers this spring as Senate Bill 117, charges the state Behavioral Health Administration with issuing new rules for eating disorder treatment clinics. Those must include requirements for private and clothed medical exams, outside the view of other patients; specific accommodations for transgender and nonbinary patients; guidance for the use of restraints and other restrictions on patients; and an emphasis on obtaining consent before using feeding tubes.
Gov. Jared Polis signed the law Thursday. The rules, which the BHA must implement by Jan. 1, 2026, are in direct response to patients’ complaints about punitive practices at the Eating Recovery Center, or ERC, a national eating disorder treatment provider headquartered in Denver. Some have described those practices as traumatizing and counterproductive.
“I think it’s going to make a big difference in treatment,” said Sen. Lisa Cutter, a Littleton Democrat who sponsored the bill with Rep. Chris deGruy Kennedy and Sen. Faith Winter. “Treatment shouldn’t be worse than the disease, and this bill is going to prevent some really horrible practices and promote compassionate care that’s based in behavioral health best practices.”
Colorado is a U.S. hub for eating disorder care, in large part because ERC is based here. Amid an eruption of eating disorder diagnoses, which are among the most deadly mental illnesses, patients travel from across America to receive care in metro Denver.
But some of ERC’s patients have described a punitive environment at the company’s facilities, including allegations that feeding tubes were used threateningly, that weigh-ins were conducted using robes that could expose their bodies and that patients were not allowed outside for days at a time. Though some patients described success at the facility, others said treatment left them with new trauma and a resistance to future care.
Former providers have alleged that clinical staffing is chronically low within the company, which is owned by a private equity group. ERC officials previously told The Denver Post that they were working to address staffing levels.
A Colorado Department of Public Health and Environment investigation into one ERC facility last summer found that providers had intentionally ignored two young patients’ repeated suicide attempts, including leaving one patient on the floor in a corridor during one attempt. The investigation determined that the facility lacked oversight and had violated its own policies by failing to refer the patients elsewhere.
Top ERC officials decried the treatment identified in the report and said it violated their standards. The company has otherwise defended its approach and said that eating disorders are life-threatening diseases that require significant intervention and care.
In a statement to The Post on Friday, ERC chief clinical and quality officer Dr. Anne Marie O’Melia said the company shared the goals of the bill’s supporters.
“The elements of this bill are in line with our current practices and standards of care. We are highly regulated by and partner closely with (the CDPHE) and The Joint Commission, nationally regarded as the gold standard of accreditation,” she wrote. “With this bill being signed into law, we welcome a deeper partnership with the Behavioral Health Administration as well.”
Cutter, the bill’s sponsor, credited reporting from The Post — based on patients’ and former staff members’ experiences — with spurring action by lawmakers. Legislators first attempted to regulate the facilities last year but eventually stripped those provisions because of cost worries.
Concerns have persisted among some patients and former staff members: One former ERC provider told The Post in recent months that staffing had been too low to treat the number of patients entrusted to their care adequately, so employees were told to work while sick.
The person, who still works in the field and spoke on the condition of anonymity because of a fear of retaliation, also said the facility took patients who were too ill to treat in that setting.
Lawmakers relaunched their regulatory efforts this year, and ERC hired a lobbyist and gave tours of its facilities to some lawmakers.
Em Troughton, a former ERC patient who works for Mental Health Colorado, which backed the bill, hailed its passage into law Friday. Troughton, who uses they/them pronouns, said the law was a victory for patients — particularly for those who are transgender or nonbinary, since they are more likely both to develop eating disorders and to face challenges accessing proper bathrooms.
“I think a lot of people don’t have an understanding of the trauma that can happen within the context of these facilities, and I think this bill has the power to save a lot of people from enduring lifelong trauma,” they said. “Because of that, it’s more likely that more people will access recovery and be able to maintain that.”
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