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Justice Department to probe Napa State

Medical care, treatment of patients will be focus of probe, hospital speculates

Sunday, January 25, 2004

By DAVID RYAN
Register Staff Writer

The U.S. Department of Justice is due to launch a probe of Napa State Hospital's practices, according to Gov. Arnold Schwarzenegger's office. But neither the Governor's office nor hospital officials have details about what investigators want to look at or when they'll conduct their investigation.

Charles Miller, a spokesman with the Justice Department, said it was the government's policy not to comment on investigations. San Francisco U.S. Attorney's Office spokesman Tim Credo said he couldn't confirm whether the office was investigating anyone, but Napa State Hospital officials said they anticipated a visit from the Department of Justice because of a July 2002 probe of the Metropolitan State Hospital in Norwalk that has yet to be resolved.

Napa State Hospital spokeswoman Lupe Rincon speculated the government would investigate Napa State Hospital's treatment services, including the way it restrains patients, provides medical care and runs its day-to-day operations.

Nora Romero, spokeswoman with the state Department of Mental Health, said the DOJ has yet to get back to Metropolitan State Hospital regarding its adult services program, and the DOJ hasn't responded to a plan of correction the hospital issued about is child services program.

"Since we haven't heard from them yet we don't know where they're going," she said. "But since they reviewed Metro(politan), we thought they might be going to the other hospitals."

Cathy Bernarding, Metropolitan State Hospital spokeswoman, said the institution had no knowledge of what the Justice Department investigation focused on.

"With the Department of Justice, they don't talk about why they're coming," she said. "That's typical. They took a look at a few things and left."

Napa State received a score of 89 out of 100 possible points in a 2002 survey by the Joint Commission on Accreditation of Healthcare Organizations. At the time, the survey noted the hospital needed to improve ways it assessed its staff's competence and used medication. It received the best available score for patients' rights. The hospital came into full compliance with the commission's standards by May 2003.

Romero said it's easier for hospitals to meet the guidelines of the commission than the Justice Department.

"Their standards are pretty well set out and you know what you have to do to meet those standards," she said. "The difference is the DOJ requires you to meet standards, but those standards are not posted anywhere."

The National Governors Association drafted a policy position stating they wanted Congress to "require DOJ to develop standards and promulgate rules" implementing the Civil Rights of Institutionalized Persons Act.

"Governors believe that there sometimes must be a balance between (institutionalized people's) freedoms and rights and the interest of the states in managing institutionalized populations," it said.

The Justice Department doesn't see a need to develop specific standards. Spokesman Jorge Martinez said the only standards the hospitals need to follow are already set down in writing.

"First of all it's not our standards, it's the law," he said. "People need to follow the law. Our authority is not to create standards, it's to enforce the law ... these facilities are or should be knowledgeable of the law."

Napa State has a medical contingent of 89 people providing psychiatric and medical care to about 1,100 patients on 411 acres just south of Imola Avenue in southeastern Napa. Other county substance abuse programs occupy other parts of the total 1,356 acres of hospital land.

Rincon said patients are referred to the hospital by either the courts or county mental health agencies. The hospital cares for patients if they're found not guilty of crimes by reason of insanity or are deemed incompetent to stand trail in court.

Other patients are referred to the hospital because they have severe mental illness that prevent them from caring for themselves properly or because they become a danger to other people.

Systemwide, Romero said 80 percent of the patients in the state's mental hospital system were referred by the criminal courts and 20 percent are referred by counties.

The state's mental hospitals include Napa, Metropolitan, Atascadero State Hospital near San Luis Obispo and Patton State Hospital in southwestern San Bernardino County. Atascadero and Patton are high-security facilities, exclusively serving patients referred by the criminal justice system. Napa State serves a mix of patients.

Despite its good ratings with the commission, the hospital has had some trouble in the past few years keeping patients from committing violent acts. In recent years at Napa State Hospital, some patients have killed themselves, other patients or assaulted doctors.

On June 3, 2003 45-year-old patient Wafa Farag died after hanging herself. The next month 56-year-old patient Raymond Uphoff died in the same way. Another patient, 39-year-old Anthony Gore, was charged with killing his roommate at the hospital on May 3, 2002. He pleaded not guilty and is still awaiting trial.

Timothy Cameron, 35, assaulted a doctor at the hospital in December 2001, later being sentenced to five years and four months in state prison. On Christmas night 2000, patient John Reed was strangled to death by another patient, Orrin Patrick, who later plead guilty to voluntary manslaughter. Patrick will spend the rest of his life in mental institutions.


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