Struggling to comply with a federal court order to reduce long waits in jail for mentally ill defendants, Washington state has turned to a for-profit company to operate a former juvenile-detention center.
Correct Care Recovery Solutions is to oversee treatment starting April 1 for 30 patients at a time inside the former Maple Lane School in rural Thurston County north of Centralia.
The choice of contractor and setting has raised alarms for a group whose lawsuit against the state led to the federal judge’s order.
“Correct Care had been the subject of a letter from Disability Rights Washington that demonstrated several abuses of patients,” Debra Pinals, consultant to a court monitor in the federal case, wrote in a report filed with the court.
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Disability Rights Washington has “significant concerns” with how the contractor’s parent company delivers mental health care, the group wrote in a statement to The News Tribune and The Olympian. The group also said the state can’t solve the problem of inmates languishing in jails by “shuffling them from one correctional facility to another.”
The state said the move is temporary and defended its contractor, which operates seven publicly funded residential treatment facilities in Florida, Texas and South Carolina. Some of those facilities restore criminal defendants’ ability to stand trial, the same task it would perform at Maple Lane.
“We talked to other states where they’ve provided care and got really good recommendations from all of them,” said Carla Reyes, chief of behavioral health at the state Department of Social and Health Services.
The agency has signed a contract to pay Correct Care as much as $4.27 million through June 2017, including $8,160 per day of operation.
The contract wasn’t competitively bid. The state sought information from companies and found Correct Care was the only responding company that fit its need, Reyes said.
Both the contractor and its parent company have come under scrutiny for their treatment of patients.
The subsidiary was known as GEO Care when it was part of GEO Group, the private prison contractor that locally operates the immigration detention center on the Tacoma Tideflats.
But in 2012, GEO Group jettisoned its mental-health division and it was acquired by Correct Care Solutions and renamed Correct Care Recovery Solutions. Other parts of the parent company provide medical and mental-health care in jails.
A state investigation into three 2011 deaths at GEO Care’s South Florida State Hospital found staff didn’t call a state abuse hotline to report the death of a highly-medicated man in a scalding bath after staff failed to check on him as often as required, The Associated Press reported.
State reviews also described unreported injuries at the division’s Texas facility, the Austin American-Statesman reported in 2012.
Most recently, the Tampa Bay Times and Herald-Tribune of Sarasota tied deaths at the division’s Florida psychiatric hospitals in 2013, 2014 and 2015 to staff negligence or lack of supervision. The newspapers also identified questionable deaths in hospitals run by the state without involvement by Correct Care.
“We are not at liberty to go into case specifics based on privacy and regulations that govern the industry,” Correct Care Solutions spokesman Jim Cheney said in an emailed statement, “but it’s important that we state that given any instance where our service is called into question, we are cooperative and communicate in a forthright manner to a level of detail that is within the confines of the regulatory protocol.
“Since its inception, CCRS has consistently strived to provide the best possible care for the patients in the facilities we help operate. We act in accordance with independent, nationally recognized accrediting bodies, which further enforces our commitment to quality and superior practice standards. We will uphold this commitment in our new relationship with Washington’s DSHS.”
Disability Rights Washington monitors jail conditions and said it saw problems with how parent company Correct Care Solutions provides mental-health care at a regional jail for South King County cities.
“CCS has been responsive to many of the concerns we have raised with them, and it has made improvements to its provision of therapeutic programming and psychiatric medication,” Disability Rights Washington said in its statement.
“However, DRW continues to have significant concerns with the mental health care provided by CCS to inmates with mental illness, including effective screening, a lack of sufficient mental health staff and release planning services.”
The court monitor, Danna Mauch, called attention to what she called the company’s “questionable performance record” in Pierce County.
Pierce County privatized its jail’s medical clinic through a contract with Conmed, another division of Correct Care Solutions. They parted ways and Pierce County withheld payments, according to a letter from a county official citing the company’s “deplorable performance.”
Maple Lane — and Correct Care — are in play because the state hasn’t been able to meet legal standards for treating mentally ill defendants at Western State Hospital in Lakewood.
When people are charged with crimes but are deemed incompetent to stand trial, state psychiatric hospitals try to restore them to competency. In the western part of the state, that happens at Western State.
U.S. District Judge Marsha Pechman ruled last April in what is known as the Trueblood case that hospitals must admit patients for treatment within seven days of court orders.
But Western State Hospital hasn’t come close to meeting that standard in any month since Pechman’s order. In November and December, waits averaged more than five weeks.
The Legislature called for temporary use of Maple Lane to help out. It also provided money to expand the Lakewood hospital to handle more defendants, but safety problems scuttled those plans.
“At this point the plan is, this is a short-term bridge,” Reyes said of Maple Lane. “Ultimately our plan would be that we would move those beds to the hospital, assuming two things: that we’ve stabilized the circumstances at the hospital, No. 1 — first and foremost we need it to be a safe environment — and No. 2, that we can hire the staff that we need to to operate the beds.”
Training gaps and more than 300 vacancies in staffing levels already criticized as too thin are at the root of problems identified by recent federal investigations of injuries and deaths at Western State Hospital. The state has raised pay to recruit and retain workers, and the Legislature is considering adding staff.
The contract with Correct Care calls for the company to staff Maple Lane with 22 full-time equivalent jobs, including nurses, social workers and psychologists. DSHS would supplement the contractor with more than 30 employees, including security guards and a program manager, “to make sure that we’re watching for appropriate care, safe care, appropriate therapeutic environment,” Reyes said.
The area around Grand Mound and the Maple Lane campus is sparsely populated compared to Pierce County. But Correct Care spokesman Cheney said the majority of contract employees would be local.
One nearby asset could be mental health workers who were employed at Maple Lane when it treated youths with mental illness as part of juvenile rehabilitation.
The youth lockup operated for nearly a century before falling victim to state budget cuts in 2011, eliminating or transferring roughly 280 jobs. Some workers went to nearby Green Hill School.
Last year, the Legislature revived it by slating it for possible future use by the crowded adult prison system as well as short-term mental-health needs.
“It’s a potential boom for that community to re-employ some of those people that previously worked at that facility,” said Victoria Roberts, a DSHS deputy assistant secretary.
The court monitor’s consultant, Pinals, toured Maple Lane. She identified potential dangers to patients but concluded it could be re-designed from a jail-style facility to one with a therapeutic environment, especially in comparison to a jail in Yakima that DSHS plans to use for similar treatment in Eastern Washington.
Patients would occupy a single housing unit, Cascade Cottage, on the Maple Lane campus that is ringed by a razor-wire fence. Plans call for a second fence. DSHS says it’s spending $1.6 million on renovations.
Judge Pechman could weigh in on plans for expanding outside the state mental hospitals when she decides whether to grant the state an extension on complying with her order. A hearing is set for Jan. 25.