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.
But things didn’t get better. They got worse.
Davidson had been “phoning it in” from Bethel for much of her tenure as commissioner, an absentee overseer of her department at best.
By October, the Walker Administration was done, unable to be re-elected. Lt. Gov. Byron Mallott was shown the door for his misdeeds, and Walker elevated Davidson to lieutenant governor. She gave speeches on behalf of his campaign. But his race for re-election was spiraling out of control, and there was no effective leadership at DHSS, which by now was itself falling apart.
The Walker-Mallott-Davidson Administration had through neglect brought the institution from being a serious concern to being a full-blown crisis.
[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.
