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Showing posts with label Medicare - Medicaid. Show all posts
Showing posts with label Medicare - Medicaid. Show all posts

Violent sex offenders strain S.C. mental health agency


There are two more articles following this one, see "read more" below.

11-13-2011 South Carolina:

COLUMBIA — Violent sexual offenders are placing a growing burden on South Carolina’s mental health services.

“The sexual predator program, frankly, is getting out of hand,” S.C. Department of Mental Health director John Magill told a Senate subcommittee Wednesday.

When Sen. Thomas Alexander, R-Oconee, asked what lawmakers could do to address the problem, Magill pointed to other states’ programs, which allow offenders to receive mental health treatment during their prison sentence.

South Carolina’s Sexually Violent Predator Treatment Program, which began in 1998, is based in Columbia within the state prison system’s Broad River Road Correctional Institution. In South Carolina, when a violent sex offender has completed his prison sentence, he is committed to the mental health agency’s care until treatment providers believe he is unlikely to re-offend the public.

The mental health agency provides security and medical and mental health treatment for 103 violent sexual offenders at the Broad River Road prison, 32 others at the Columbia Regional Care Center in northeast Columbia, and has a growth rate of about two new offenders per month, according to agency staff.

Minnesota Bill would pay insurance for disabled state hospital staff


3-27-15 Minnesota:

A worker at a state psychiatric hospital who is permanently disabled by an inmate would get the state portion of their health insurance paid until age 65, when they qualify for Medicare, under a bill from Mankato Sen. Kathy Sheran.

The state has a responsibility to treat injured hospital workers like the nation treats wounded veterans, she said.

"We ask people to work in dangerous situations," she said of state workers. "We know ahead of time it's dangerous."

The bill passed unopposed Wednesday through a Senate judiciary committee and now heads to a finance committee.

Embattled sex offender agency director quits


5-2-2014 Texas:

AUSTIN - Allison Taylor, the embattled director of the state agency that supervises high-risk sex offenders after they finish serving their prison sentences, resigned Thursday to take a job at another state agency.

Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission, confirmed that Taylor was joining her agency's inspector general's office as a Medicaid investigator effective immediately. Her annual salary will be $70,000.

Taylor, an Austin resident who had headed the state Office of Violent Sex Offender Management since 2003, could not be reached for comment Thursday.

The agenda for a Saturday meeting of her agency's three-member governing board includes an item regarding possible termination of Taylor. With her departure, the board now is expected to discuss, and possibly appoint, an interim replacement.

Whew! Arizona State Hospital keeps certification


3-16-2014 Arizona:

The Arizona State Hospital is finally meeting federal standards and will not lose its certification -- and millions in federal dollars.

In a letter to state health officials, Rufus Arther of the Centers for Medicare and Medicaid Services said his agency is scrapping its plans to terminate the certification of the mental health facility. He said the latest survey done by an independent inspection unit of the state Department of Health Services for the federal agency shows the hospital is now complying with all the requirements to participate in the Medicare and Medicaid programs.

A copy of the March 10 letter was obtained Friday by Capitol Media Services.

The move comes four months after Arther, manager of survey, certification and enforcement for the federal agency's non-long-term-care division, removed the hospital's status as a provider considered to be meeting the required standards.

Arther said a September inspection found violations of regulations dealing with patient rights and nursing services. He said that review found deficiencies that "substantially limit the hospital's capacity to render adequate care to patients, or are of such a character as to adversely affect patient health and safety.

Failure to comply with CMS standards comes with a risk: Cutoff of federal dollars. And that federal cash makes up about a fifth of the $30 million budget for the hospital's 120-bed civil commitment unit. (More below)

Arizona State Hospital: Feds return to state mental hospital after failed inspection


1-31-2014 Arizona:

PHOENIX - Inspectors returned to Arizona’s state mental hospital this week to determine if the facility has corrected serious deficiencies that put the lives of patients at risk.

The Centers for Medicare and Medicaid Services (CMS) is threatening to pull the Arizona State Hospital’s certification after failing a September inspection that was triggered by an ABC15 report. If the hospital loses certification, it will also lose millions of dollars in federal reimbursements.

Multiple sources confirmed that CMS was at the hospital. The visit comes after releasing a scathing 46-page report about their last inspection.

A few of the key findings:
The hospital has “systemic problems” with nursing care. Inspectors found there was a “failure to ensure that the number of RNs and other personnel met the facility’s pre-determined staffing requirements to provide for patients’ safety and care needs for 9 of 9 patients who sustained self-inflicted injury, assaulted others, or were assaulted by other patients.”

The hospital “endangers” the lives of patients. In the past several months, inspectors discovered the state hospital failed to properly care for six patients, who all required constant supervision. One of those patients was Chris Blackwell, who died after the hospital failed to prevent him from swallowing dangerous objects and then didn’t give him proper medical care.
Click here to see the full inspection report.

In November, state officials filed an official plan of correction. A federal spokesperson told ABC15 that CMS has accepted the hospital’s plan but will make unannounced visits to “ensure the promised improvements have been made.”

The ABC15 Investigators have learned of several recent safety and security lapses that cast serious doubt that some of the most serious deficiencies have been corrected.

On January 17, a patient was able to steal an employee’s badge, use it to get out of his unit, get past security checkpoints and enter another wing of the hospital where he violently assaulted another patient, sources said.

The attacked patient was supposed to be under constant watch by two staff members to protect him from himself and others.

The patient who escaped his unit also assaulted a second patient in November. That assault sent the victim to the hospital for almost two weeks with serious injuries.

Both incidents highlight deficiencies the hospital was supposed to fix.

State health and hospital officials have not gotten back to ABC15 with details about the January 17 incident. They’ve also declined to comment about the ongoing CMS inspection case. .Source.. by Dave Biscobing

Arizona State Hospital update: Lawmaker introduces bill to require full audit of AZ mental hospital


1-19-2014 Arizona:

PHOENIX - The state’s house minority leader introduced a bill this week that would require a full performance audit of the Arizona State Hospital.

Rep. Chad Campbell, D-Phoenix, is sponsoring HB2357 . He’s asking for an audit of the state’s only publicly run psychiatric hospital because of a series of ABC15 investigations.

“It seems like this whole ship is broken, and they need to right the ship,” Campbell said.

The ABC15 Investigators have been investigating the state hospital for more than a year. Our reports have exposed an alarming number of escapes , a shocking level of violence and a lack of treatment and care for patients.

A patient also died in September because the hospital didn’t properly monitor him or provide adequate medical care, records show.

ABC15’s reports also triggered a federal inspection , which the hospital failed. If officials don’t correct “serious deficiencies,” the hospital could lose certification and millions of dollars in federal Medicare reimbursements.

Read the full inspection report

After watching ABC15’s stories, Campbell met with top hospital officials. He said he was misled about conditions at the hospital.

“They gave us this rosy picture that everything was great, everything was fine,” Campbell said.

The last time an audit was conducted at the Arizona State Hospital was in 1999. Auditors discovered staffing shortages, a failure to provide adequate therapy for patients and a lack of ability to intervene in patient disputes.

The hospital wasn’t due for another audit until 2019.

State health and hospital officials said they won’t comment on pending legislation.

HB2357 has not yet been scheduled for a hearing. ..Source.. by Mark LaMet

Federal agency threatens to pull certification for Arizona State Hospital


11-21-2013 Arizona:

PHOENIX — A federal agency is threatening to revoke the certification of the Arizona State Hospital, saying it found violations of regulations dealing with patient rights and nursing services.

In a letter to hospital chief executive Donna Noriega, the Centers for Medicare and Medicaid Services, said deficiencies inspectors identified in a September visit “substantially limit the hospital's capacity to render adequate care to patients or are of such character as to adversely affect patient health and safety.” Ruth Arther, manager of survey, certifications and enforcement for the agency's non-long term care division, said her agency is immediately removing the hospital's status as a provider considered meeting requirements to participate in — and get reimbursed — by Medicare and Medicaid.

Arther said if sufficient corrections are not made, Medicare payments will cease on Feb. 12. Those federal dollars make up about a fifth of the $30 million budget for the hospital's civil commitment unit.

Both CMS and the Department of Health Services say the actual inspection report detailing the problems is not subject to public review until January.

Health Director Will Humble said the inspectors — who actually are health department employees — did find various instances where procedures were not followed and patients were injured. But he said that, in some of the cases, procedures were followed but hospital personnel failed to document what they had done.


Humble said he intends to send a corrective plan to the federal agency today.

The report is drawing particular scrutiny by Gov. Jan Brewer. Aside from being the state's chief executive, she has a particular interest in what goes on at the facility: One of her sons, Ronald, has been a patient in a different unit of the state hospital for more than 20 years after being found not guilty by reason of insanity in the 1989 sexual assault of a woman.

But the governor, after being briefed by Humble, told Capitol Media Services she is confident that patients in the facility are safe.

“If the policy is followed, and it is documented, there should not be a problem,” Brewer said. “They're just as safe there as they would be anywhere else.”

The investigation is the direct outgrowth of a report by the Phoenix ABC affiliate about a patient death in September. The Maricopa County Medical Examiner's Office says the man died of complications of having swallowed multiple “foreign bodies.”

That led CMS to require state inspectors, under contract to the federal agency, to take a closer look.

Cory Nelson, the health department's chief of behavioral health services, said the report found no instances of abuse. But what it did find, he said, were situations which affected “a patient's ability to be in a safe environment.”

“The hospital works with people that have the most challenging set of illnesses and the symptoms associated with that,” he said. “We have individuals out there who have very serious self-harm issues.”

He said protocols require that some of the people be monitored closely — one staffer to one patient — with direct visual contact and at a distance of no more than six feet, but Nelson said investigators found six instances where that did not occur.

And in several of those, patients were able to harm themselves by doing things like swallowing foreign objects or using items — or even their own nails — to cut themselves.

Inspectors also found situations where there was not the level of staffing that the hospital itself had said was necessary. Nelson said while some of that was lack of documentation, there also were situations where someone did not show up at work.


Brewer said she will continue to keep a close eye on the situation.

“My ultimate goal is that the hospital is run securely and obviously very safe for patients,” she said.

The inspection was only of the civil commitment unit of the hospital. It houses 120 patients, virtually all of whom were sent there under court order because they were found to be a danger to themselves or others.

A separate 120-patient unit is reserved for those who essentially have been found “guilty but insane,” people who would otherwise be behind bars except for their mental condition.

A third unit, with between 80 and 90 patients, houses those who have served their time in prison for violent sexual offenses but are considered too dangerous to be allowed back on the streets. ..Source.. by Howard Fischer, Capitol Media Services

See further comments by a patient here


Update in nursing home assault case: Cubbage to be confined as sexually violent predator


9-30-2013 Iowa:

Sex offender William Cubbage allegedly told a state investigator that he had sexual contact with an elderly nursing home resident before the August incident that led to a criminal investigation.

The evidence of other sexual assaults surfaced during a court hearing Monday in Rockwell City. The Iowa attorney general’s office argued that Cubbage, 83, poses a threat to others and must be confined, at least for now, in a locked unit, rather than in a nursing home. After the 15-minute hearing, Judge Gary McMinimee ruled that the state had met its burden in showing probable cause to believe Cubbage is a sexually violent predator. McMinimee agreed to the state’s request that Cubbage be confined to the Newton Correctional Facility pending a trial on whether he should be re-committed to the state-sun Civil Commitment Unit for Sex Offenders in Cherokee.

Cubbage lived in that unit from 2002 and 2010, then was released to the Pomeroy Care Center in November 2010. On Aug. 21, an 8-year-old girl who was visiting the nursing home told authorities she saw a man in the room of an elderly woman with his hands between the woman’s legs. The woman was allegedly calling out, “No, no, no!”

According to the state inspectors who subsequently fined the home $10,000, the child’s allegation was supported by physical injuries sustained by the woman and by statements from workers at the home. The alleged victim told authorities, “That man keeps coming into my room and doing things.”

Calhoun County Attorney Cynthia Voorde has said she plans to file charges in the case very soon.

Cubbage was attentive and jocular during Monday’s court proceedings. When asked by an assistant attorney general whether he’d rather be sent to the Newton facility or to the civil commitment unit pending the trial, he chuckled and said, “It doesn’t make any difference. I’ve been to both of ’em. I’ll go to Newton.”

Cubbage did not testify during the hearing and declined to speak to a reporter.

During the hearing, the attorney general’s office presented the judge with a report from the state’s Medicaid Fraud Control Unit. The report summarized investigator Troy Wolff’s Aug. 29 interview with Cubbage at the Pomeroy Care, eight days after the alleged assault.

Wolff wrote that during the interview, Cubbage “made numerous attempts to avoid questions and acted like he didn’t know what I was talking about.” To gauge Cubbage’s awareness, Wolff asked Cubbage about his past. Although Cubbage claimed to have no recollection of his four past convictions for sex crimes, he did recall having lived in Muscatine and having worked as a truck driver.

Wolff concluded Cubbage had the ability to recall past events accurately when he chose to do so.

When asked about the Aug. 21 incident, Cubbage reportedly told Wolff that he and the alleged victim “were just in there talking.” When questioned further, however, Cubbage allegedly admitted touching the woman. When asked if he did anything else to her, Cubbage allegedly replied, “No, sexual, no. I just felt it, that’s all.”

Asked if the woman had consented, Cubbage allegedly replied, “She didn’t reject anything.” And when asked if he had been in the woman’s room before Aug. 21, he allegedly said, “I’ve been there before,” adding, “I just touch it.”

Cubbage’s attorney, Mike Adams, participated in the hearing via telephone and objected to the state’s effort to have Wolff’s report admitted as evidence. Adams noted that Cubbage has been diagnosed with dementia, making anything he said during the interview “inherently” unreliable.

“My contention is that he is not a competent witness to give accurate information,” Adams said.

Judge McMinimee admitted the interview summary as evidence, but later indicated that he assigned the document “minimal weight” in determining there was probable cause to believe Cubbage is a sexual predator. The trial to determine whether Cubbage should be committed to the sex-offender unit on a long-term basis is scheduled for Jan. 4, 2012.

Several workers at the Pomeroy Care Center have told state inspectors it was obvious to them when Cubbage entered the facility that he posed a risk to other residents and to the children that a local school sent to the facility to visit with seniors and participate in a day-care program. The workers described incidents in which Cubbage and another sex offender who lives in the home, John Steinkamp, accosted other residents or chased after children in the facility.

After the Aug. 21 incident, the home placed an alarm on the door to the room Cubbage shared with Steinkamp. On Friday, Cubbage was taken from the home and transported to the civil commitment unit in Cherokee pending Monday’s hearing. ..Source.. by Clark Kauffman

Arizona counties ask state to return millions


5-7-2013 Arizona:

Funding diverted amid budget battle

Arizona’s county leaders have asked Gov. Jan Brewer and state lawmakers to restore millions of dollars in funding diverted during the state’s recent budget crisis.

Supervisors from the state’s 15 counties sent Brewer and state lawmakers a letter outlining three budget priorities worth $34 million to counties in fiscal 2014:

Eliminating state-imposed county payments to house and treat sexually violent prisoners at the Arizona State Hospital.

Bringing back all counties’ share of state Lottery revenue.

Restoring federal highway-user revenue funds that were diverted from counties to the Arizona Department of Public Safety.

Since fiscal 2009, the state’s cost shifts and sweeps in those three revenue sources have cost counties $137.6 million, according to the County Supervisors Association of Arizona, a research and advocacy group representing the state’s 61 county supervisors.

Counties anticipate lower property-tax revenue in fiscal 2014 because an 18-month lag in the property-valuation system requires them to levy taxes based on assessed valuations made during the real-estate crisis, when property values were depressed.

There also will be continued reductions in federal resources, particularly because of sequestration, according to the letter.

Uncertainties involving the state budget, largely driven by stalled negotiations over expanding Medicaid, also have had a ripple effect on counties’ budget-finalization processes for fiscal 2014, which begins July 1.

“Though the state and municipalities are seeing an uptick in revenues, county revenues continue to be suppressed. ... Given the financial situation of counties across the state, lawmakers should return county tax dollars so they can support local services, such as public safety and road maintenance,” Lenore Stuart, Yuma County supervisor and CSA president, said in a statement.

Supervisors and county staff have been discussing budget priorities with the Legislature and the governor throughout the session. The CSA letter was motivated by the “desire to recommunicate those priorities but particularly in the context of what the supervisors are dealing with as they go through their budget analysis,” said Craig Sullivan, the organization’s executive director.

Brewer’s budget proposal included restoring Lottery revenue for the state’s 10 smallest counties, totaling $5.5 million. Her spokesman, Matthew Benson, noted that Brewer has restored portions of highway-user revenue funds and repealed the shift of prison inmates to county jails.

“When it’s been possible, she’s taken those actions” to relieve pressures on local governments, Benson said.

There are no plans to eliminate county payments for sexually-violent prisoners or to restore highway-user revenue funds shifted to DPS this year because local governments benefit from having DPS patrols, Benson said.

But those funds also can be used for other county functions, such as maintaining roads in rural counties.

Navajo County, for example, maintains more than 700 miles of roads. The lack of highway-user revenue funds has delayed road projects such as asphalt resurfacing, county Supervisor David Tenney said.

“We’ve got to have some relief there and have that funding restored, or we’re going to have a catastrophe on our roads,” Tenney said.

Maricopa County, the state’s largest and home to the Arizona State Hospital, pays the most to house and treat sexually-violent prisoners at the facility. County officials said the requirement to pay 50 percent of the program’s costs has run up a $9.6 million tab.

“We’re doing the best we can to make ends meet, and we couldn’t afford to have any more mandates pushed our way or any more budget shortfalls the state can’t meet to get handed off to the county,” said Supervisor Steve Chucri, who is on the CSA legislative-policy committee. ..Source.. by Michelle Ye Hee Lee

Violent sex offenders strain SC mental health agency


11-13-2011 South Carolina:

COLUMBIA — Violent sexual offenders are placing a growing burden on South Carolina’s mental health services.

“The sexual predator program, frankly, is getting out of hand,” S.C. Department of Mental Health director John Magill told a Senate subcommittee Wednesday.

When Sen. Thomas Alexander, R-Oconee, asked what lawmakers could do to address the problem, Magill pointed to other states’ programs, which allow offenders to receive mental health treatment during their prison sentence.

South Carolina’s Sexually Violent Predator Treatment Program, which began in 1998, is based in Columbia within the state prison system’s Broad River Road Correctional Institution. In South Carolina, when a violent sex offender has completed his prison sentence, he is committed to the mental health agency’s care until treatment providers believe he is unlikely to re-offend the public.

The mental health agency provides security and medical and mental health treatment for 103 violent sexual offenders at the Broad River Road prison, 32 others at the Columbia Regional Care Center in northeast Columbia, and has a growth rate of about two new offenders per month, according to agency staff.

The added volume brings added expense.

“The violent sexual predator program by the end of fiscal year 2013 will be at an expenditure level that will exceed the current direct line of appropriation by over $7 million,” said the agency chief.

“Somebody’s going to bear the cost, but we need to figure out a way to relieve this obligation, some of it,” said Alexander.

The agency’s latest annual accountability report, dated September of this year, says there are 3,990 full-time employees, of whom nearly 49 percent work in the community systems.

The agency also has 17 community mental health centers, including the Aiken-Barnwell MHC and Beaufort County’s Coastal Empire MHC, a handful of other facilities in Columbia, and others for veterans.

The agency received about $133 million in state appropriations and nearly $195 million in Medicaid dollars, according to Magill. He compared that with the funding from 25 years ago, when the state appropriation was about $130 million and Medicaid was accounted for about $22 million.

South Carolina’s Sexually Violent Predator Act requires the Department of Mental Health to kept all its civilly committed offenders in a secure facility away from other patients. ..Source.. by SARITA CHOUREY

North Dakota State Hospital Receives Accreditation


10-22-2010 North Dakota:

BISMARCK, N.D. - The North Dakota State Hospital, which is part of the N.D. Department of Human Services, received full Joint Commission Accreditation for its hospital and behavioral health care programs following on-site survey reviews in Jamestown, N.D., in May and August.

“The accreditation and certification for Medicare and Medicaid assures the public the State Hospital meets required standards for quality, patient safety, and the care environment,” said State Hospital Superintendent Alex Schweitzer.

He said commission reviewers commended hospital staff for the quality of care they provide daily to about 120 people receiving inpatient mental health and addiction treatment services. He said the hospital is providing treatment and evaluation services to about 59 patients in the secure services unit for civilly-committed sexually dangerous individuals, and provides addiction treatment services on-site to about 84 people who are under the care and supervision of the N.D. Department of Corrections and Rehabilitation.

North Dakota strives to serve people with disabilities in their communities. The State Hospital remains a safety-net for inpatient services for uninsured people with severe mental health and substance addiction needs.

Schweitzer said the State Hospital is the primary provider of inpatient mental health and addiction treatment services for the Devils Lake, Dickinson, Jamestown, and Williston regions of the state. Those regions do not have community hospitals that provide these important inpatient services, he said.

An independent, not-for-profit organization, The Joint Commission accredits and certifies more than 18,000 health care organizations and programs in the United States. ..Source.. by Heather Stefl, North Dakota Department of Human Services