Monday, March 29, 2010

Disability rights watchdog group looks into alleged sexual abuse at Wisconsin mental health center

From the Milwaukee Journal-Sentinel:


A state-designated watchdog agency has launched its own investigation into patient sexual abuse allegations at the Milwaukee County Mental Health Complex.

The agency, Disability Rights Wisconsin, has made a sweeping demand for records at the complex and will interview staff, patients and their guardians to find out the scope and seriousness of the abuse, Barbara Beckert, Milwaukee office manager for the agency, said Friday.

Beckert said the probe was prompted by news accounts in the Journal Sentinel, which told of a federal investigation that had found multiple instances of patient sexual abuse at the county complex. A federal inspection in January found staff inattention to various patient care rules, including nurses and nurse assistants who were unaware the hospital had a policy of no sexual contact between patients.

A 22-year-old woman at the complex was discovered pregnant in August, after repeated sexual contact with another patient, according to federal reports. A male patient was identified in the report as having a history of sexual aggression and responsible for sexual contact with four women patients at the Mental Health Complex. Under state law, any sexual contact with a mentally ill person is considered assault.

County officials, meanwhile, said they were confident the county would be cleared of any federal sanctions over patient sexual assaults.

The disability rights organization is designated under state law as its protection and advocacy agency for people with mental illness or other disabilities. In that role, the rights group has broad investigative powers, including access to institutions and records. In cases where there is strong evidence of patient abuse or neglect, the rights agency's authority is greatest.

Beckert said the agency will issue a report in about a month detailing its findings and recommending changes.

"We are deeply concerned about the recent reports of assaults and other citations at the Milwaukee Mental Health Complex and possible systemic failures, which may include neglect of vulnerable people by staff," Beckert said in a prepared statement. "This is intolerable."

Her agency regularly advocates on behalf of patients at the complex, "but clearly there are additional patients whose rights are being violated and are in need of advocacy services," said Beckert.

John Chianelli, administrator of the county's Behavioral Health Division, could not be reached Friday. He said earlier that he was confident federal sanctions and threats of withholding millions of dollars in Medicare and Medicaid payments to the county would be lifted. The county expects to get $60 million of its $185 million budget for the Mental Health Complex this year from Medicare and Medicaid.

The federal Center for Medicare and Medicaid Services found the county out of compliance with federal rules governing patient care. One federal order threatening a funding cut was lifted in late January, but a second order remains in force, a spokeswoman for the federal center said Friday. The county was given an April 21 deadline to fix problems.

Timothy Schoewe, a deputy county corporation counsel, said the county had received verbal assurances that the federal sanctions would be lifted. Elizabeth Surgener, the federal spokeswoman, said no such assurances had been provided by federal officials. It's possible such assurances were given by state officials, said Seth Boffeli, spokesman for the state Health Services Department.

State inspectors conducted the review of the Mental Health Complex under contract with the federal agency. Although both state and federal health agencies have oversight authority over the county hospital, separate state sanctions for the same problems would be unusual, Boffeli said.

A county "corrective action plan" prompted by the assaults promises improved training for staff at the county's psychiatric hospital, better documentation of patient care records and improved recovery plans that address patients' tendencies toward sexual violence or vulnerability to sexual abuse.

All staff members at the Mental Health Complex are getting training on required patient risk assessments for sexual behavior when patients are admitted, the plan says.

The county plan also promises more thorough documentation of physical exams of patients. The federal inspection found that the exam done on the patient who became pregnant was incomplete. The county's plan was filed with the federal Medicare and Medicaid Services and obtained through an open records request with the state.