Philadelphia's Department of Human Services has been sending some of the most troubled kids in its care to Chad since at least 2001. In 2005, after a drumbeat of warnings about harsh treatment and the death of a 14-year-old girl, DHS and city courts continued to use Chad even as Tennessee and New York state pulled their youngsters from the facility.
While Leach's death prompted Philadelphia officials to start removing youngsters from Chad, eight city youths were still housed there, a city official said last night.
Before the death, Philadelphia kids made up the largest group at the facility, constituting about half the 90 youths there. Since Leach died, the city has promised to reexamine its heavy reliance on distant, out-of-state facilities.
Acting Commissioner Arthur Evans Jr. said yesterday that DHS was "deeply troubled by the homicide ruling."
As the count of Philadelphians at Chad has dwindled, Evans said, his staff has made regular visits there to make sure it was safe.
Chad is one of 110 behavioral-health facilities in 33 states owned by King of Prussia-based Universal Health Services.
Spokesman Nick Ragone said the for-profit chain had no comment on the autopsy, which was completed last month. Previously, UHS said children's safety is its first priority.
In his autopsy, Levy said he had found "multiple superficial blunt force injuries" to Leach's body in addition to the injuries to the neck muscles. Those included scrapes and bruises to both shoulders and a hip as well as a bruise beneath Leach's left eye.
Levy also noted that a contributing factor in Leach's death was his enlarged heart.
Leach - a slender 5-foot8 and 148 pounds, the autopsy found - was pronounced dead June 3, a day after his clash with Chad staff.
Tennessee child-welfare officials have already cited Chad over the confrontation, saying the facility's workers needlessly provoked Leach.
The officials said a Chad staffer should have given Leach space to calm down June 2 when Leach had retreated to a dorm after a fight with another resident.
Instead, the staffer, Randall D. Rae, 22, ordered Leach to leave the dorm, and Leach attacked him, according to investigators. The two struggled for a period. At some point, Rae turned his grip on Leach over to another aide, Milton G. Francis, 31.
Police said the aides had told them that they put Leach face-down on the floor with his hands pulled behind his back in a restraint method taught as part of routine Chad procedure. Neither Rae nor Francis could be reached for comment.
The procedure is known as the "Handle With Care" system. According to the instruction manual at use at Chad, the system is "an incredibly effective and safe restraint method."
When staffers undergo training, the manual advises them: "No death chokes. . . . Take it easy on your partner."
Leach arrived at Chad on May 2, after he was arrested in Philadelphia for stealing a car.
Chad was the last stop in a series of about a dozen mental hospitals and treatment centers that Leach had attended since turning 11.
After Linda Harris, the 14-year-old Long Island girl, died of heart failure as she was being escorted by a counselor, Tennessee and New York officials quit placing teenagers at Chad.
The state medical examiner ruled that she had died of natural causes brought on by a heart problem and asthma, aggravated by "morbid obesity." She weighed more than 300 pounds.
According to public records, Chad's workers resorted to physical force at high rates - rates experts term excessive.
Tennessee repeatedly cited Chad for failing to tell regulators about children who had been injured there. In one case, the state learned only after the victim's mother called police that three residents had tried to strangle another, records show.
The Inquirer also reported that in early 2005, a man called the Philadelphia child-abuse hotline and warned that his coworkers were using "improper and illegal" force against city youngsters.
In response, DHS dispatched an investigator to Chad - three months later. The city concluded that while there had been no "illegal physical restraints," nonetheless "some residents were being harshly and improperly restrained."
In reply, Chad said it had a "nurturing and positive environment," but would hire more staff.
Contact staff writer John Sullivan at 215-854-2473 or firstname.lastname@example.org.