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DESERT HILLS CENTER FOR YOUTH AND FAMILIES —
EVEN UNDER INVESTIGATION, ABUSES CONTINUE
Desert Hills Center for Youth and Families came
under investigation for the February 1998 restraint death of
15-year-old Edith Campos. Medical examiners confirmed that Edith had
died of asphyxiation after being restrained. Senator Elaine
Richardson (D-Tucson), has now called for the treatment facility to
be shut down following recent allegations that two teenage girls
were sexually molested by an employee who was supervising them.
“While they (Desert Hills) are still being
monitored and investigated, these allegations are still happening,”
Richardson said. “If they are happening while they are being
monitored, what’s happening when we don’t have their feet to the
fire?”
“These children are placed in the facility for
rehabilitation, learning, treatment and to become prepared to enter
society from [sic: a] safe environment,” Richardson wrote. “Instead,
they have been exposed to violence, illegal conduct, serious
mistreatment and even death. I feel there is no alternative at this
time other than to close this facility and cause no more harm to
these troubled children.”7
IS THERE A MONETARY INCENTIVE BEHIND THE USE
OF RESTRAINTS?
Kenneth Clark, M.D., a Harvard College graduate
and psychiatrist, stated that patients were placed in restraints
because this then justified their placement in a Psychiatric
Intensive Care Unit, which gives a higher rate of reimbursement.
“Regarding reimbursement rates for patients
placed in restraints — know that if they say a patient is
uncontrollable the patient is then transferred to the Psychiatric
Intensive Care Unit (PICU). The daily rate is higher, so there is a
rate increase when the patient is in restraints as the patient
obviously needs more intensive care. I know there were instances
where the patient was aggravated or provoked to justify the use of
restraints and this placement.
“The staff at the hospital where I worked
referred to the practice as ‘Mayhem Therapy.’ I don’t have exact
figures but I do know that it cost more than a thousand dollars a
day for a patient for this. This estimate is probably on the low
side.”1
One psychiatric facility lists their rates for
various programs and services. Intensive Care for both adults and
adolescent patients costs more than standard services:
Inpatient Hospitalization Programs
*Adult Standard — $550.00 per day
*Adolescent Standard — $575.00 per day
*Intensive Care (Adult & Adolescent) — $650.00
per day.2
Psychiatric Intensive Care Units do include the
use of restraints and seclusion in their treatment of patients as
noted in the information in the promotional materials of one
psychiatric hospital that provides this service.3
Psychiatric hospitals are not the only
facilities that get a higher reimbursement rate for patients who are
labeled as being more agitated and/or a problem. In an excerpt from
an interview with a former residential treatment facility employee
from Texas, the claims of Dr. Clark were echoed:
“You keep up the incident reports because the
insurance company wants to know the progress. You have a ‘Catch-22’
in that the insurance won’t keep the client there if there isn’t
some progress, so you have to show some progress, and then if you
have a lot of agitation, then you can say that because he has become
more difficult, his care has gone from $5,000 to $9,000 per month.
That was done.”4
A news article that ran in the Charlotte
Observer April 5, 1999, discussed the fact that state officials were
once again questioning the effectiveness of treatment at an upstate
psychiatric facility where they had twice previously removed
children after incidents of little care, given drugs they did not
need and, in one instance, the sexual assault of a 14-year-old. How
much does all of this cost the state?
The state pays $252 per day to the facility for
each child covered by Medicaid. From July 1 to March 1, the state
paid a total of $642,424, compared with $216,493 during the previous
12 months, according to the state Department of Health and Human
Services.5
In March of this year, 9-year-old Timithy
Thomas became the latest child to die of asphyxiation after being
physically restrained. The facility where Timithy Thomas was placed
charges $172.00 per child per day — which comes to over $5,100 per
month.6
1 Statement from psychiatrist Kenneth Clark, 6
April 1999. On file with CCHR International.
2 Schedule of Rates effective July 1, 1996
through June 30, 1997, “Program Fees” for Chestnut Lodge Hospital.
Internet website address http://www.chestnutlodge.com/Rates.htm
(accessed 6 April, 1999).
3 Acute Assessment and Treatment Program and
the Psychiatric Intensive Care Unit. Internet website address
http://www.bcmhs.bc.ca/aatp.htm
4 Excerpt from CCHR Texas interview done on
2/12/98. On file with CCHR International and CCHR Texas office.
5 The Charlotte Observer, “Therapy questioned
at kids’ hospital” April 5, 1999.
6 The Charlotte Observer, “Report: Boy’s death
caused by asphyxiation,” Saturday, March 13, 1999 and Grandfather
Home for Children, Inc. “Answers to Frequently Asked Questions” from
their internet website at http://www.grandfatherhome.org/faq.htm
7 The Arizona Daily Star, “Sen. Richardson
wants Desert Hills shut down,” Tuesday, 6 April 1999.
http://www.cchr.org/index.cfm/10657
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