Commissioner Adam Crum speaks to the media on Friday.
(6-minute read) PSYCHIATRIC HOSPITAL WAS ON THE BRINK OF A NERVOUS BREAKDOWN
The state’s psychiatric hospital was broken and close to being decertified by federal agencies.
That emergency prompted the Department of Health and Social Services Commissioner Adam Crum to act with speed, take over control of API, and then contract with a private company to manage the hospital, in the hopes of salvaging what has become known as one of the worst psychiatric hospitals in the country. He made the announcement today at a press conference in the Atwood Building in downtown Anchorage.
Wellpath Recovery Solutions is a company that specializes in running state institutions like API. Crum and other health stakeholders hope the company can help retain the institution’s certification.
Four years of neglect by the Walker Administration, including a commissioner of the Department of Health and Social Services who disappeared to her hometown of Bethel for months at a time, left the institution in shambles. It was worse than unsafe. It was dangerous.
The announcement of a professional management team is some of the only positive news to come out of API in the past few years. In fact, good news almost never comes out of psychiatric institutions anywhere in the country. Sometimes the best news is that they have retained their accreditation. They are the places where the most violent, most mentally ill, and most despairing citizens are housed, medicated, cleaned up and, sometimes, restrained.
In recent years, patients have become increasingly violent, abusing and attacking staff and other patients. Alaska’s mentally ill population has exploded, and because of the configuration of the institution, only 45 of the 80 beds can be filled.
Today’s announcement had the support of the Alaska Mental Health Trust, the Alaska Behavioral Health Association, North Star Behavioral Health, Alaska Regional Hospital, Fairbanks Memorial Hospital and brought positive comments from legislators such as Sen. David Wilson, Senate President Cathy Giessel, Rep. Ivy Spohholz, and Rep. Matt Claman, all who expressed optimism.
Sens. Bill Wielechowski and Tom Begich took another approach, and slammed the move toward professional outside management of API; Wielechowski made a hair-on-fire Senate floor speech and Begich took to social media to criticize.
12-MONTHS OF RAPID DECLINE
Over the past year, work conditions at API had deteriorated. The institution was starting to get surprise visits from inspectors. It was taking in increasingly violent patients. Cameras were watching employees, documenting their every move, and handling a patient by using the “wrong” protocol was a point of stress for staff and management. The stress on API nurses and aides had become unbearable.
Last fall, a report by Anchorage attorney Bill Evans showed that the hospital was unsafe for the employees, as disputes raged over whether staff could use restraints on violent patients. Staff shortages were chronic and the staff were fearful for their lives and their jobs.
[Read Bill Evans’ independent report here]
In September, then-DHSS Commissioner Valerie Davidson came back from Bethel and promised things would change.
“No employee should feel unsafe when they go to work, and clearly the report indicates we do have an unsafe work environment,” Davidson said. Heads started to roll, from the top down.
API Chief Executive Ron Hale was soon replaced by Duane Mayes, who was director of DHSS’s Division of Senior and Disabilities.
Also let go were a deputy health commissioner and the director of the State Division of Behavioral Health.
[Read: API staff fearful to even call a code]
Gov. Michael Dunleavy and newly appointed Commissioner Adam Crum were left to pick up the pieces.
The new governor quickly accepted the resignations of the hospital’s chief of psychiatry and another psychiatrist. Dr. Anthony Blanford and Dr. John Bellville quickly enlisted the ACLU and are now suing to get their jobs back.
In December, federal officials were at API for an inspection. That report and the one that followed weeks later were devastating.
Duane Mayes, who was named the new CEO under Walker, left in December, taking another job within the state. He was never cut out to run a psychiatric institution.
[Read: The qualification, certification, and oversight reports here.]
Last Monday, yet another inspection was scheduled.
NURSE PLEADS FOR HELP
One nurse, who asked to remain anonymous, sent the following letter to Must Read Alaska, last week, and copied it to the State Ombudsman and members of the Board of Nursing:
“We are in crisis here at API. Tonight we walked into yet another slew of policies, paperwork, hourly reports and notifications, and documentation all without training or guidance. These requirements are removing our focus from our patients and our concentration on our med pass and patient safety. We need immediate intervention and representation here from each of you. We need you to speak with people on the floor and away from administration ASAP please. We are effectively no longer nurses but investigators and reporters, and in fear of discipline and retaliation.
“Administration failed to follow up on an actual sexual assault between patients and instead of them being accountable they are putting it on staff to hourly report things as small as psychotic statements made by patients, this is consuming our time and energy, focus, and ambition as nurses, and endangering patients. I will forward the policies.
“You will not have nurses to staff API if this madness continues. There is so much more to tell but tonight is breaking the camel’s back. People are contacting the press. Administration is not taking into account what it is like to work on the floor, not involving floor staff in decisions, and isolating all but one unit from input. There are instances of bullying, retaliation, unprofessional, and unethical behavior by the interim Director of Nursing. Statements have been prepared and more are being prepared. Morale and safety are at an all time low Fear of reprisal requires I remain anonymous, but there are many more voices you need to hear.”
Several other messages followed, describing the deteriorating situation.
Today may have been the day that API turned the corner.
Will private management improve the safety of patients and staff at API?
From information being sent to Must Read Alaska from inside the walls of the facility, things can only get better in an institution that has hit rock bottom.
Crony to the core. No-bid contracts to companies with connections and an increase in cost. Dumpster fire.
Extreme circumstances required extreme counter measures. I art laughing, you make accusations, now back them up!!!
Yeah, State employees and State managers have just covered themselves with glory at API for decades. The DHSS generally, and API specifically are where competence has gone to die. It isn’t even a Democrat/Republican thing; Republican management of DHSS has been just as incompetent as Democrat. It was an annual ritual to see DHSS troop over to the Legislature to beg for ratification of millions of dollars that they’d spent on something stupid and didn’t have any money appropriated for it. They’d whine about “the most vulnerable among us” and the Leg would dutifully give them more money for medical tourism and all the other worthwhile things DHSS pays for.
Bingo Art! API only continued it’s spiral under the Walker administration; it wasn’t created by the Walker administration. The mess has been going on for decades. You and I have been around this State long enough to know almost all the stories, but my farthest poo storm memory goes back to the 70’s. There have been a lot of Donkey’s and Elephants since this place opened in the 60’s. The State needs to step away from the mental health game. Clearly, they have failed.
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I ART LAUGHING: These are REAL PEOPLE in API. REAL LIVING AND BREATHING HUMAN BEINGS. This is now a 911 situation. When human beings are in crisis mode, you need to call in help immediately. Commissioner Crum has recognized that. There is ZERO time left to dink around. He has the authority to take charge and do something about a mess. Stop making this into something that it is not. He is trying to fix something that is broken. Connections and no-bid contracts and costs and other concocted conspiracies are fun times in your head I’m sure, but this is a down-right emergency.
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If we sat around while Sen. Bill W. and Co. hashed this one out in the legislature and put out an RFP? Are you kidding me? There are empty beds that need filling, underserved residents, staff stressed to the limit, and God only knows what else going on that gives API the moniker of WORSE in the country. It is a dangerous place on many, many levels. Where were these vocal legislators before? It is interesting that Sen. Wielechowski’s first comments were about no-bid contracts. Unreal! That is the mindset of liberals. How about this: “Thank goodness immediate steps are brought forth to ensure the safety, health and wellbeing Alaskans! Once this is stabilized…..” Even Rep. Spohnholz managed something human. But for a party that advocates for the killing of the unborn, I suppose the first thought being bidding contracts over human life emergencies is quite normal for them.
In my book I say that people with a social sciences background shouldn’t be allowed to manage anything; you simply can’t make them have any sense. I have friends in healthcare that strongly criticize Crum’s appointment, but for me a background in hospital administration is the only background a responsible executive would look for to run a social services agency. You can’t make them have any sense, but you can control how much money they spend and make them live up to measurable.
Well, there are people in the trucking business that don’t like that the Crum’s have a truck training school either but what I like too is the background in health admin. and he has taken on this appointment. He could have said no thank you. He came in knowing it was a red hot mess. Let’s hope we can keep the “triggered” out of the damn way and start making some progress.
Wow. This is one of the few discussions in the “comments” after any news or column that is rational and responsible. Politics and government are how real, imperfect human beings do their best to solve challenging problems. Cynical, baseless accusations and snide Monday morning quarterbacking may make small people feel big, but do nothing to help. The situation at API is dire, and I’m grateful Commissioner Crum is willing to to make hard choices in an effort to help.
Dan “the Stache” Saddler! Is this you? Hope you are well! Absolutely spot on. The API situation is dire. The frustration I feel from afar, as I attempt to alleviate my stress through words in a comment forum, is very real. You were smack in the middle of it in the Legislature and now in the administration. Bless your heart! The difference I try to make is at the ballot box. Hopefully the Dunleavy administration will be that difference.
Has Byron Mallott checked out of the API facility yet?
Yes, I believe he was last seen trying to do a dance at the Juneau
Convention Center. He has some new moves now! He got off easy, with no charges, and your PFD money. So, hang in there, “he ain’t done yet!”
As a person who has worked for DHSS for the past 22 years. API has been a ‘Shit Show’ for a long time. But each administration came in and placed a Band Aid on it in the hopes that everything will be good as long as they are in power. If API did not reach rock bottom I am sure this administration would have also place the Band Aid and looked the other way. But unfortunately this fester reached the point of decay and something had to be done. I have several questions to ask, where was the federal oversight agency? Where was AKOSH? when all these things were happening for the past several years. What happened to the reports and who was in charge of making sure the inefficiencies were fixed? With regards to the employees where is the Union especially when these employees state that they are in fear of retaliation? Additionally, who would want to work at API. Have you seen the wage scale the State of Alaska pays for people working at API. The State of Alaska did not do their job creating a wage scale that is equal to the going Alaska wages for such an institution. Even if one thinks the benefits and good and they receive health insurance. The wages are still poor at its best and the most qualified will never come to work in such a place when they can find a job in the private sector with the same benefits. Therefore the SOA did not really create a competitive market for API. This is the same with Pioneer Homes. The wages are poor at its best and there is a constant rotation of employees. When as any government been good at operating a business? Governments are good at taking peoples money. They do not know profit and loss. Therefore asking any Government in any State to operate a business is a crucial mistake. So now we are paying a consulting firm in the tune of one million dollars a month to operate API and help it not lose its accreditation. Why not close API down? Send all their patients local facilities that can treat them locally or out of state. These people are already on Alaska Medicaid or some other insurance. I guarantee you it will cost the SOA lesser to send the critically ill mental health patients to a better hospital in the lower 48 and it will also be better for the patient. It is time to Dry Dock API. If any legislature wants to talk about this, again I say where were you 10 years ago when this place was a Shit Show? Cathy Giessel where are you? Aren’t you a so called nurse? And as for the Commissioners picked by the Governors none of them are really qualified. They are just baby wipes that get rotated every 4 years.
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