Coalinga State Hospital: A Work in Progress  

Coalinga State Hospital



 
 
Administrative Directive 818 Alleged Underground Regulations

 Office of Administrative Law - Re: CTU 2008-0314-01 - Response

Contact:
Michael G. St. Martin CO #000414-3
Coalinga State Hospital
P.O. Box 5003/Unit #10
Coalinga, CA 93210-5003

Email:   michaelst.martin@hotmail.com

http://www.voicesofthegulag.com


 
MAJOR ELECTRICAL FIRE AND EMERGENCY AT COALINGA STATE HOSPITAL

July 11, 2009: 

It was reported from Coalinga State Hospital (CSH) today that there was a complete power outage for the entire hospital. 

The cause is reported to be a main transformer which caught on fire and did major damage to the electrical distribution system, and the emergency power switch-over system. Several fire trucks were required to contain the fire.

Since the emergency power system was also damaged and failed to function. It took over two hours to restore a modicum of emergency power to limited areas, mainly lighting and air circulation in the hallways.

The patients were kept on lockdown status for over four hours under intolerable conditions.

There is presently no lighting or air circulation in the housing area rooms and dorms. 

There is no power available for the culinary areas to cook food or for the refrigeration systems to properly keep food, nor is it likely power will be restored to that area anytime soon. A significant amount of spoilage is expected. The culinary workers are attempting to prepare sack meals to feed the patients.

For over two hours the facility was pitch black, as it did not have a functioning emergency backup lighting system. Some staff had flashlights which were used within the units.  The water pumps were also off and there was no water in the bathrooms or for drinking. Some water was restored after over two hours had passed.

Flashlights are now being propped on chairs in the bathrooms to provide some lighting for that function.

The facility’s main phone system and computer systems were also knocked out by the power failure. It is being reported that the parts to repair this damage are not readily available, and the hospital will be lucky if power is restored sometime next week.

The question is being raised as to whether or not the State of California presently has enough money available to pay the necessary vendors to repair the extensive major damage caused by this transformer and resulting fire.

Tom Watson



UPDATE

July 12, 2009, 09:00 update:

On July 11, Coalinga State Hospital officials contacted several private companies about making repairs to the damaged electrical system. It is reported that the companies asked the question, “Are you paying for this with state vouchers?” The hospital officials said, “Yes.” All of the companies refused the work as none of them were willing to accept California vouchers.

PG&E was then contacted and agreed to do the work. Being a public utility, there is apparently some obligation involved.

PG&E crews worked throughout the night and were able to restore limited power around 2:00 am.

As of approximately 9:30 am all power had been restored in the facility. It was a slow process, as crews had to go to each area and reset systems.

The patients expect to be fed a regular meal at lunch time today.

Major flaws were exposed in the “state-of-the-art” system. There is essentially no redundancy in the emergency power back-up system.

A major problem was exposed in the medication dispensing system known as “Med Select.” Without power, the hospital was unable to dispense medications to patients. Only a pharmacist has access to the medications when the machine is inoperative, and there was no pharmacist available.

For a substantial period of time, there was no power whatsoever available in the medical units which are required under the law to have emergency power available for life support systems and the like.

The emergency back-up deficiencies exposed by this event are expected to result in extensive costs through retrofitting this so called “state-of-the-art” facility. Retrofitting that will be required to bring the facility up to the licensing standards for hospitals under state and federal laws.

Tom Watson



BREAKDOWN

Turmoil replaces treatment at Coalinga hospital
A state facility meant for sexually violent predators gets low marks after two years.
By Scott Gold and Lee Romney
Los Angeles Times Staff Writers

November 15, 2007

   [More pictures at link above latimes.com.]
COALINGA, CALIF. — One in a series of occasional articles on California's troubled mental health system.

-- Two years after California opened the nation's largest facility designed to house and treat men who have been declared sexually violent predators, Coalinga State Hospital is described by both patients and staff as an institution in turmoil.

Convinced that they stand little chance of being released and angry about perceived deficiencies at the hospital, patients are engaged in a tense standoff with administrators, according to interviews with more than 40 patients and staff members.

Almost all of the detainees at Coalinga have served time for serious sexual offenses. But instead of being released after completing their sentences, they were transferred to the state hospital system under a 1995 law that allows the state to declare certain high-risk sex offenders mentally ill and commit them to psychiatric facilities.

Detaining someone under the law is constitutional provided that the patient receives treatment. But today, significant treatment at Coalinga is rare. Administrators acknowledge that three-quarters of the hospital's 600-plus detainees refuse to participate in a core treatment program, undermining a central piece of the $388-million hospital's mission.

Some patients have also declined to eat for days at a time to protest alleged inadequacies in psychiatric and medical care as well as less important issues, including limited access to phones. Many have boycotted educational and improvement programs that include anger management workshops, computer training and Spanish classes -- a protest known inside the hospital as a "strike."

A severe staff shortage has further impeded treatment, patients and staff members say. As of last week, 26 of the hospital's 37 budgeted staff psychiatrist positions were vacant. On many wards, hospital police officers fill roles assumed by clinicians at other hospitals.

"We've got guys who camp out, waiting for clinicians to show up," one staff member said.

Staff members describe feeling overworked and harassed by patients who bang angrily on the nursing station glass if technicians or hospital police officers are a few minutes late to escort them on smoke breaks.

"We're calling it the Titanic State Hospital," said a psychiatric technician who, like most other current employees, spoke on condition of anonymity, fearing reprisal from administrators. "We've lost control. I've been saying for a couple of months now that the monkeys are running the circus."

Patients, meanwhile, are despairing.

"It's hopeless," said Robert Bates, 41, who was sent to Coalinga after serving a 10-year prison term for committing a lewd and lascivious act. "This is a therapeutic setting, supposedly. But it's nothing more than a mock-up prison. They can call it what they want. But it's prison."

State officials acknowledge the unrest, though they say there hasn't been as severe a disruption as patients and some staff members contend. They say they are doing the best they can with an unusually challenging patient population.

"When you undertake something of the magnitude of Coalinga, there is a growing and learning experience," said Stephen W. Mayberg, director of the state Department of Mental Health. "Where we are right now is certainly, I think, moving in the right direction."

Mayberg said the hospital can't force patients to take part in treatment.

"Am I disappointed that so many folks choose not to participate? Yeah. Do I think that's indicative of their illness, or their condition? Yes, I do," he said.

Coalinga opened in September 2005 amid promises of a new era, both in protecting the public and in treating sex offenders. Even empty, the facility stood out; its sleek architecture and tidy topiaries presenting a jarring contrast to the tumbleweeds and dust devils that dominate the surrounding landscape.

But the operation of Coalinga -- the only mental hospital built in California in half a century -- was never going to be effortless.

Sex offenders are a notoriously difficult group to treat. More than half the men confined at Coalinga are pedophiles, and many have had numerous victims. And sex offenders tend to be manipulative and charismatic, traits that helped enable some of their offenses in the first place.

Most Coalinga patients don't have mental illnesses that can be treated with medication, and there is no sure-fire way to rid the men entirely of their impulses. Many psychologists do not believe that hard-wired sexual deviance can be "cured"; instead, officials focus on what they call "relapse prevention."

From the start, Coalinga patients rejected their confinement, calling it unconstitutional. Then, last fall, California voters overwhelmingly approved Proposition 83, a tough crackdown on sex offenders.

Jessica's law, as it is known, made it easier for authorities to designate someone a "sexually violent predator" and hold him indefinitely, and to put restrictions on patients' ability to challenge their confinements.

Staff members say that because such a wide spectrum of sex offenses qualifies people for post-prison commitment, decisions about who is released and who is detained are largely random. Some staffers question whether all the patients at Coalinga belong there.

Michael Feer, a psychiatric social worker with more than three decades of experience, worked at Coalinga for a year before leaving this spring. He now works in San Diego County with recently paroled sex offenders, men who in some cases committed the same crimes as those at Coalinga but who are being released into the community, he said.

Feer said that although all Coalinga patients qualify as violent predators on paper, he believes that more than a third of them would pose no threat if released.

"They did their time, and suddenly they are picked up again and shipped off to a state hospital for essentially an indeterminate period of time," Feer said. To get out, he added, "they have to demonstrate that they are no longer a risk, which can be a very high standard. So, yeah, they do have grounds to be very upset."

The hospital, Feer said, "is a setup" -- ostensibly a treatment hospital but one built with a wink to a public that has little compunction about locking up sex offenders forever.

Coalinga administrators insist that there is still a clear path to release, provided a patient completes the hospital's exhaustive treatment program.

"I wouldn't be working in this field if I thought it was a scam," said Deirdre D'Orazio, director of program development and evaluation services at the hospital. "I don't believe that there are any wastebasket cases, individuals who are so abnormal that they can't learn to put aside their deviant impulses."

The core sex offender treatment involves such activities as a "psychological autopsy," a detailed accounting of decisions that preceded an offense.

Patients offer a variety of reasons for declining to participate. Some believe they can overcome deviance on their own. Others believe, mistakenly, that mere participation could be viewed as their first public admission of guilt. But many patients shun treatment because they have become convinced -- not without reason -- that no matter what they do, they are never going to win their freedom.

As of August, two years after Coalinga opened, not a single patient had been released because of completion of the treatment program. Of the more than 600 sexually violent predators who'd been committed to the facility as of August, the latest figures available, 17 patients had been released, all of them after petitioning in court.

Hospital administrators argue that patients should participate in treatment not just because they want out but because they want to acknowledge and address their problem.

"They need to say, 'My freedom is less important to me than never creating another victim,' " D'Orazio said.

Coalinga patients are keenly aware that they are not a sympathetic crowd. So they have tried to sell their cause -- to hospital administrators, healthcare reformers and advocates for the mentally ill -- as a matter of governmental responsibility.

"They've sold this as a wellness-and-recovery program," said patient Greg Peters, 49, a former studio percussionist who served a five-year prison term for raping two adult women before being routed into the mental health system. "But they are deceiving the public. You guys are out there paying taxes for this."

Like most patients at Coalinga, however, Peters said he harbored little hope that he will ever get out. He says staff shortages have resulted in a failure by the hospital to monitor and document patients' progress, an important part of convincing a court that they are ready to be released.

The staffing shortage stems in part from the decision by state officials to build the hospital 60 miles southwest of Fresno, in an isolated, dusty pocket of California's Central Valley otherwise dominated by huge almond farms, hardly the stuff of recruitment posters.

Compounding the staff shortage, an ongoing salary dispute makes it possible for many of the people hired there to make more money doing the same job elsewhere. And many of those who do go to work at the facility leave quickly.

Between November 2006 and October 2007, the hospital hired 468 people, but 147 left.

Extraordinary turnover isn't limited to rank-and-file employees; state officials are conducting a national search for the hospital's fifth executive director -- including people who have held the job on an interim basis -- in 18 months.

A single clinician is often left to supervise a unit of more than 50 patients. Mandatory overtime is routine, as is burnout, according to staff members.

"It's a miserable place to walk into," said one psychiatric technician. "Morale is horrible."

A growing sense among patients that they have been effectively railroaded into a life prison term formed the seed of discontent during the summer and fall.

Administrators have since challenged the patients' account of the "strike," saying the percentage of people participating has been far lower than patients and some staff members contended. They said, however, that they did not have attendance figures for educational and improvement programs.

But both patients and staff acknowledged that in the highly charged environment at Coalinga, even the most trivial of disagreements had ballooned into full-fledged disputes over civil rights.

In August, for instance, according to staff members, a group of patients taped small protest fliers to their hospital-issued identification tags. Most read: "When injustice becomes law, resistance becomes duty." Hospital officials ordered patients to remove them.

"They said they were defacing government property," a clinician said. "But they were just making this up as they go."

It did not end well; officers eventually hauled away one patient who refused to take off his protest flier.

"They made a martyr out of him," the clinician said. "The next day, patients had bigger pieces of paper taped to them that said: 'Please don't hit me because I'm wearing this piece of paper.' "

Patients, meanwhile, have developed a list of complaints and concerns. They say, for example, that the hospital drags its feet before allowing them outside the walls for specialized medical care.

The hospital denies having a problem, though a former employee familiar with the hospital's medical operation acknowledged that patients weren't seeing necessary specialists. The employee said the issue was complicated by the fact that physicians in nearby communities refuse to contract with the facility.

"Nobody can decide what we are," said Niles Carr, 38, who was routed into the mental hospital system in 1998 after serving time for molestation. "But as long as we're stuck here, we need to be treated properly."

Some of the patients' demands -- such as Internet access -- aren't likely to gain much traction with the public.

Others, however, have gained the attention of a congressionally charged, federally funded group that advocates on behalf of people with physical and mental health disabilities. Protection & Advocacy Inc. attorney Sean Rashkis said the group was investigating patients' concerns.

"They have done their time and have moved into a civil commitment which is based on treatment," he said. "Some of the patients argue that that's not what they are getting. It may be the case. We'll have to see."

scott.gold@latimes.com

 leora.romney@latimes.com
 
 


COALINGA STATE HOSPITAL: 
A WORK IN PROGRESS








Everyone at Coalinga State Hospital ("CSH") has become intimately familiar with the administration's favorite phrase, have patience "its a work in progress." Be that as it may, it is obvious to the most casual observer that CSH was nowhere near ready to open when the first patients arrived in September of 2005.

Much of the infrastructure was not in place, and still is not. While the facility has great potential, it is for sure a work in progress as that potential appears to be years from becoming fulfilled.

There are many, what would normally be, minor problems that simply have not been solved. For example, while there are now over one hundred patients, the hospital has no means to make minor repairs to prosthetics, such as replacing a nose pad, on eyeglasses, or repairing dentures. There is no dentist. There is no optometrist. There isn't even a live body with a simple set of jeweler's screwdrivers to make minor repairs. Those are but just a couple examples of the many available.

There are many design flaws, to be put more bluntly - bad designs:

The area designed for "blood draws," the taking of blood for lab work, for example, was designed with an approximately four foot wide counter in the space between the patient and the medical staff. A nearly impossible distance making the actual blood draw extremely difficult. This problem, after three months of being worked on, is being rectified through reconstruction at some unknown expense to the taxpayers.
The windows through which regular medications are dispensed are another example of a poor design. The slot through which the medications are handed is low down, it is small, and it is constructed in a manner in which neither party can see what is coming through the window. The patient cannot see the item being passed through the window in order to accept it from medical staff without almost kneeling down on the floor.

There is a store for patients to make small purchases. It is very small and only two patients may enter at a time. While this may work for the one hundred patients presently at the hospital, it will most certainly be inadequate when the hospital has all 1500 beds filled.

There is a main courtyard which would be crowded with 100 patients. What do they expect to do with 1500 patients who want to use that courtyard?

Metal lockers were mounted on the walls in each patient housing unit room. These locker are approximately two feet (2') by three and one half feet (3.5') by twelve inches (12") deep. Whoever decided to mount them on end certainly never tried to use such an arrangement. Such end mounting resulted in each locker having four approximately 12 inch square areas upon which to store all of their personal possessions. In other words, after placing one layer of possessions on each flat area, the rest of the space is unusable unless one is happy with living with everything in a deep pile. Out of the approximately six and one half square feet of actual area, there is, maybe, two square feet of usable space.

There is no place provided for patients to hang their clothes, so clothing is piled on the floor.
There is no place for patients to hang their clothing in the shower room, so clothing is piled on every available flat surface while the patients are showering.

The bathroom stall doors are a gravity type hinge, which if installed properly would automatically cause each door to seek the closed position. However, they were not. The bathroom stall doors will not remain closed. The hospital, rather than making the contractor fix the problem has spent the last three months attempting to come up with a velcro type closure system which has still not been installed.
These are but just a few of the basic design flaws. In general, the hospital's resources and infrastructure appear to be wholly under designed in respect to the number of beds expected to be filled.

The ergonomics of many of the patient use items is poorly designed or not even considered. It is as if no one actually tried using these things before purchasing them. For example, each patient unit has a typewriter available for patient use. This typewriter was first set up on a computer table and worked fine. However, the computer table apparently was only temporary and was recently replaced with a very nice looking solid oak typewriter table. While it is very nice, and would make an excellent night stand next to ones bed, it is ergonomically poor for typing. It is too low causing one to bang his knees. It places the typist at in uncomfortable position, and it is too small leaving no space for other papers such as the copy one is typing from.

Since CSH is a locked facility, there are many security procedures needed. Rather than develop its own, CSH went to another locked facility, Atascadero State Hospital ("ASH"), and obtained the procedures known as Administrative Directives ("AD") from there. However, this was obviously done early in the design and construction process of CSH as the ADs obtained were so old that they had been replaced some four years earlier at Atascadero. At the time CSH placed these old ADs into effect in its new facility they were long outdated. In other words CSH, the highest tech such facility in the state, opened its doors with outdated and obsolete Administrative Directives purloined from another state facility.

When the first patients were moved from their previous facility, ASH, to CSH, they were told before transfer that CSH would be better. That everything they possessed at ASH they could also possess at CSH. However, in reality, due to the antiquated ADs CSH utilized when opening , those patients stepped back four year in time. Many of their possessions from ASH were simply not allowed at CSH. The most glaring example was tennis shoes. While many of the patients wore their tennis shoes while being transferred, they had them confiscated upon arrival at CSH. The problem was shoe laces. Although ASH had allowed shoes with shoe laces for several years, the antique ADs first adopted by CSH had no such provision.

While this sort of problem should have been relatively simple to fix, in practice it was not. Due to the multiple layers of bureaucracy, it took over three months to repair this one issue.

There are many many more such issues, and with the numbers of meetings and staff hours required to make the necessary changes it must be a very expensive process for the taxpayers to be paying for all of this poor planning.

While CSH is a nice new facility with a lot of potential, it is a long way from achieving that potential. The line level working staff is doing everything within their power to make it all work. However, there is a huge bureaucratic stumbling block in the way of this "work in progress" that has bogged down the efforts of both the patients and low level staff who are attempting to make this work.

Eliminating this huge bureaucratic stumbling block should have been the first order of business so that this "work in progress" can actually begin working in a smooth and efficient manner. Particularly since smooth and efficient would correlate with saving the taxpayers money that is otherwise being wasted on inefficient procedures. However, to date, it appears that the inefficiency which is part and parcel of bureaucracy and red tape is the one thing that remains firmly entrenched.

Tom Watson December 17, 2005

[Original Article - by Tom Watson]
Patients Demonstrate at Coalinga State Hospital

Strike by Patients at Coalinga State Hospital Nets Promises of Change



Mental Facility Staffing Called a Peril
Report by Coalinga State Hospital police objects to minimal supervision by licensed caregivers. Head of the complex says it's safe.
By Lee Romney
Times Staff Writer

April 6, 2006

In a scathing report, high-ranking police officers at the state's newest mental hospital condemned as dangerous the plan to house most patients in units with minimal supervision from licensed caregivers. 

"It would border on negligence to sustain the idea of the proposed minimum staffing levels," the police sergeants assigned to Coalinga State Hospital warned in their report last fall as the hospital began accepting patients from overcrowded Atascadero State Hospital. 

"The reality is that patients that harbor a propensity toward violence or propagate illegal activities would 'slip through the cracks' and immediately recognize the extreme weakness in staff's span of control."

The analysis was requested by administrators at the Coalinga facility, which was built to house sexually violent predators who are confined to the state's mental hospital system beyond their prison terms. 

But the hospital's management, which has struggled to recruit staff, declined to make use of the analysis, submitted in October.

The state mental hospital — the first constructed in half a century — has drawn criticism for its low staffing levels. Mental health officials secured an unprecedented change in state law last summer that suspended the required staff levels at Coalinga. The criticisms come at a time when the state system is under scrutiny by federal officials concerned with patients' rights and by staff concerned with unsafe working conditions. 

Hospital Executive Director Tom Voss said that the decision to lower the licensed staffing levels had already been made and that the police sergeants were asked to help implement it, not criticize it.

"It was not at all what they were supposed to have done," he said.

Administrators initially refused to release the report to union negotiators, who contend that the unarmed officers are forced to perform duties outside their contract. But the hospital released the report this week in response to an unfair labor practice charge.

The report calls for measures such as security locks on patient doors and surveillance cameras, saying that the $388-million complex was designed to be a "staff-intensive treatment facility" and that without more caregivers it is unsafe. The "warehousing style of housing" is unlikely to provide effective treatment, the report added. 

The abridged report contains a cover sheet stating that officials from the hospital and state Department of Mental Health disregarded its findings because it "contains numerous inaccuracies." 

For example, Voss said in an interview, the report made "oranges-and-apples types of comparisons" to staffing levels at Atascadero, where low-maintenance patients are housed in units with acutely mentally ill sex offenders, and to the state prison in Coalinga, where inmates are deemed violent security risks. 

Voss insists that the 1,500-bed hospital — which currently houses 261 patients — is operating as it should.

"In terms of whether or not it is safe here, they've been up and going for seven months and we've had no incidents. None," he said. "I will tell you emphatically that I attribute that directly to the hospital police and the good job they are doing." 

Several Coalinga housing units have the required staff ratios: one caregiver for every six to eight patients.

But licensing requirements were waived for the remaining 50-bed dorms, which are assigned two hospital police officers and one senior psychiatric technician.

State and Coalinga hospital officials devised the new model last year, reasoning that many sex offenders do not suffer from acute mental illness and decline to participate in treatment anyway, so they do not need to be surrounded at all times by licensed professionals. 

The patients pose a challenge to the state hospital system: Courts have ruled that they can be held there involuntarily only because the facilities are therapeutic, not punitive. But most refuse treatment.

Hospital police stand by the report's concerns and say problem behavior by patients is cropping up and is being "brushed under the carpet" by administrators. 

Staffing is so thin that units are at times left attended only by officers — and no licensed staff, said Sgt. Andrew Berard, a police sergeant at Coalinga and a representative of the Hospital Police Assn. of California. 


Mental Facility Staffing Called a Peril
Report by Coalinga State Hospital police objects to minimal supervision by licensed caregivers. Head of the complex says it's safe.
By Lee Romney
Times Staff Writer

April 6, 2006

In a scathing report, high-ranking police officers at the state's newest mental hospital condemned as dangerous the plan to house most patients in units with minimal supervision from licensed caregivers. 

"It would border on negligence to sustain the idea of the proposed minimum staffing levels," the police sergeants assigned to Coalinga State Hospital warned in their report last fall as the hospital began accepting patients from overcrowded Atascadero State Hospital. 

"The reality is that patients that harbor a propensity toward violence or propagate illegal activities would 'slip through the cracks' and immediately recognize the extreme weakness in staff's span of control."

The analysis was requested by administrators at the Coalinga facility, which was built to house sexually violent predators who are confined to the state's mental hospital system beyond their prison terms. 

But the hospital's management, which has struggled to recruit staff, declined to make use of the analysis, submitted in October.

The state mental hospital — the first constructed in half a century — has drawn criticism for its low staffing levels. Mental health officials secured an unprecedented change in state law last summer that suspended the required staff levels at Coalinga. The criticisms come at a time when the state system is under scrutiny by federal officials concerned with patients' rights and by staff concerned with unsafe working conditions. 

Hospital Executive Director Tom Voss said that the decision to lower the licensed staffing levels had already been made and that the police sergeants were asked to help implement it, not criticize it.

"It was not at all what they were supposed to have done," he said.

Administrators initially refused to release the report to union negotiators, who contend that the unarmed officers are forced to perform duties outside their contract. But the hospital released the report this week in response to an unfair labor practice charge.

The report calls for measures such as security locks on patient doors and surveillance cameras, saying that the $388-million complex was designed to be a "staff-intensive treatment facility" and that without more caregivers it is unsafe. The "warehousing style of housing" is unlikely to provide effective treatment, the report added. 

The abridged report contains a cover sheet stating that officials from the hospital and state Department of Mental Health disregarded its findings because it "contains numerous inaccuracies." 

For example, Voss said in an interview, the report made "oranges-and-apples types of comparisons" to staffing levels at Atascadero, where low-maintenance patients are housed in units with acutely mentally ill sex offenders, and to the state prison in Coalinga, where inmates are deemed violent security risks. 

Voss insists that the 1,500-bed hospital — which currently houses 261 patients — is operating as it should.

"In terms of whether or not it is safe here, they've been up and going for seven months and we've had no incidents. None," he said. "I will tell you emphatically that I attribute that directly to the hospital police and the good job they are doing." 

Several Coalinga housing units have the required staff ratios: one caregiver for every six to eight patients.

But licensing requirements were waived for the remaining 50-bed dorms, which are assigned two hospital police officers and one senior psychiatric technician.

State and Coalinga hospital officials devised the new model last year, reasoning that many sex offenders do not suffer from acute mental illness and decline to participate in treatment anyway, so they do not need to be surrounded at all times by licensed professionals. 

The patients pose a challenge to the state hospital system: Courts have ruled that they can be held there involuntarily only because the facilities are therapeutic, not punitive. But most refuse treatment.

Hospital police stand by the report's concerns and say problem behavior by patients is cropping up and is being "brushed under the carpet" by administrators. 

Staffing is so thin that units are at times left attended only by officers — and no licensed staff, said Sgt. Andrew Berard, a police sergeant at Coalinga and a representative of the Hospital Police Assn. of California. 



 http://www.sacbee.com/state_wire/story/14227628p-15051303c.html

Sex offenders striking at Coalinga hospital negotiate with staff
The Associated Press
Published 9:15 pm PST Wednesday, March 8, 2006

COALINGA, Calif. (AP) - Sex offenders at a state hospital are slowly going back to their normal routine after launching a peaceful protest earlier this week over the facility's living conditions, officials said Wednesday.
The action, which started Monday and continues on a smaller level as patients negotiate with the staff, included patients holding signs, sitting peacefully in the hospital's outdoor mall and refusing to attend educational and vocational classes, said Tom Hunt, spokesman for the new Coalinga State Hospital.

The patients wanted more clinical staff, a dimming of bright lights that keep them awake at night, an extension of canteen hours and a relaxation of the policy that prevented them from buying food for each other.

The canteen policies have been revised, Hunt said, and staff members are working to find a compromise on the lights, which have to stay on for the safety of patients and staff.

But the staffing request might be harder to meet, because of difficulty recruiting licensed staffers willing to move to the remote location.

The state Department of Mental Health intended the facility to relieve the overburdened Atascadero State Hospital. But so far, only 200 of its 1,500 beds have been filled.

These hospitals house sexually violent predators after they complete their prison sentences.

The setting is supposed to be therapeutic, not punitive, but because of the shortage of nurses and trained personnel, the Coalinga hospital is relying on police officers. Patients have said they're afraid that anything they say in therapy overseen by these officers can be used to determine how long they should be committed.



 http://www.sacbee.com/state_wire/story/14226760p-15050700c.html

Sex offenders at Coalinga hospital stage strike for more staff
The Associated Press
Published 5:20 am PST Tuesday, March 7, 2006

COALINGA, Calif. (AP) - Almost all of the patients at a state mental hospital staged a "strike" by refusing to participate in any organized activities to protest conditions at the new facility, patients and police said.

Monday's action was intended as a protest against a lack of licensed clinical staff, bright lights that keep them awake at night and a policy that bars patients from buying food for one another at the canteen, said patient James Rosenberg. He said the protest at the hospital 200 miles northwest of Los Angeles would continue Tuesday.

"With the exception of maybe five inmates, we have the entire population shutting down - from buying food, going to work, going to programs or the library," Rosenberg said. "We started peacefully demonstrating."

The hospital, which opened last fall, has 1,500 beds but houses fewer than 200 patients. The state Department of Mental Health has transferred only a handful of patients there from overburdened Atascadero State Hospital because it has had trouble recruiting licensed caregivers to the remote facility.

The mental hospitals house sexually violent predators who, under a 1995 law, are sent to the facilities after they complete their prison sentences. Courts ruled the practice constitutional only because the hospital setting is therapeutic rather than punitive.

To staff the Coalinga hospital, however, state officials are using hospital police officers rather than nurses and psychiatric technicians to monitor most sexually violent predators.

Patients are refusing to participate in therapy because anything they say can be used against them in jury trials held regularly to determine whether to keep them committed.

---

Information from: Los Angeles Times,  http://www.latimes.com



From the Los Angeles Times
Coalinga Patients 'Strike' for More Staff
By Lee Romney
Times Staff Writer

March 7, 2006

Nearly all the sex offenders housed at a new state mental hospital in Coalinga mounted a full-day "strike" Monday, refusing to participate in any organized activities, patients and hospital police said.

The patients were protesting the lack of licensed clinical staff as well as bright lights that keep them awake at night and a policy that forbids them from buying food for one another at the canteen, said patient James Rosenberg, who said they would continue their protest today. 

"With the exception of maybe five inmates, we have the entire population shutting down — from buying food, going to work, going to programs or the library," he said. "We started peacefully demonstrating."

The action at Coalinga State Hospital, a 1,500-bed facility that opened last fall but still houses fewer than 200 patients, coincides with concern about the shortage of trained staff there.

The Times reported Sunday that recruiting licensed caregivers to the remote facility has proved so challenging that the state Department of Mental Health has transferred only a trickle of patients from the overburdened Atascadero State Hospital. 

In order to staff the hospital, state officials secured an unprecedented change in the law last summer that allowed most of the sexually violent predators at Coalinga to be monitored primarily by hospital police officers rather than nurses and psychiatric technicians. Under a 1995 law, sexually violent predators are sent to the state mental hospital system after they have served their prison terms. Courts have deemed the practice constitutional only because the hospital setting is therapeutic, not punitive. 

But the vast majority of patients refuse to participate in therapy because anything they say can be used against them in the jury trials held regularly to determine whether to keep them committed. 


 http://ktla.trb.com/news/la-me-coalinga5mar05,0,1422009.story?coll=ktla-news-1

From the Los Angeles Times 

Coalinga State Hospital Is Sitting Nearly Empty
Remote location of the new facility for violent sexual predators makes it hard to attract staff.
By Lee Romney
Times Staff Writer

March 5, 2006

COALINGA, Calif. — The $388-million facility sprawled on the desolate outskirts of this Central Valley town was intended to answer a pressing problem: what to do with hundreds of repeat pedophiles and rapists in California who have served their prison terms but are deemed too risky for release.

This was to be a hospital dedicated primarily to such "sexually violent predators," who can be lawfully detained for mental health treatment.

It was the first state mental hospital built in more than half a century, and few amenities were spared. Shiny keyboards and drum sets now grace private music rooms. Woodworking and printing studios resemble professional shops. A Native American sweat lodge is in the works.

Treatment, however, is in short supply. 

Despite vigorous recruiting efforts, not enough nurses, doctors and technicians want to work at this remote outpost. As a result, six months after the 1,500-bed hospital opened to the speeches of lawmakers, only about 170 patients have moved in. More than 400 sexually violent predators await transfer from Atascadero State Hospital near San Luis Obispo.

And hundreds of other beds, which could be filled with patients with other mental disorders, remain unoccupied in a system that otherwise is badly overcrowded.

The largely empty Coalinga State Hospital embodies twin problems of the state's mental health system: its struggle to hire licensed staffers and its difficulty accommodating sexual offenders, who some experts say don't fit conventional definitions of mental illness.

Now, scores of patients are being housed in a facility that does not act much like a hospital. In most housing units here, patients are supervised largely by a skeletal crew of hospital police officers — not the clinical teams of licensed caregivers required at the other four California state mental hospitals.

The problem is complex. The state can't incarcerate people beyond their prison terms; it is unconstitutional. But it can, by virtue of a 1995 state law, keep these offenders as patients.

But the state can't make around-the-clock care available without people to provide it. Moreover, it can't force therapy on patients. In fact, historically, 80% of sexual offenders have refused it.

"What they've done is to create what they hope is a legal situation for warehousing" patients, said Ted Donaldson, a psychologist who often testifies for the defense in sexual predator cases.

"Most of these people don't have a qualifying mental illness," he added. "They're bad people and we don't like them very well, but you can't civilly commit people because you don't like them."

Even some patients distrustful of therapy complain about the lack of professional care.

"The state of California spent all this money on a 1,500-bed facility and they don't have enough staff to staff it," said Luther Evans, 56, a convicted rapist who is in one of the two licensed treatment units for a medical problem and wants to stay there. "They're disguising what they're supposed to be doing in here."

Last summer, the state Department of Mental Health secured a change in California law, suspending for six years the state's obligation to provide licensed care by nurses and psychiatric technicians in 30 of 32 housing units at Coalinga. It was an unprecedented exemption for a California mental hospital. 

The two units that have been licensed for treatment handle patients who are medically infirm or suffer from psychoses that require medication. 

John Rodriguez, deputy director of the Department of Mental Health, acknowledged that the state has made "slow" progress recruiting licensed staff for the Coalinga facility. But he said the legal change was a cost-saving measure because most sex offenders "don't need the very expensive and staff-intensive 24-hour nursing" that those with mental illnesses such as schizophrenia do.

California is not reneging on its treatment obligations, he said, because therapy targeting the men's sexual urges is available, on a small scale for now, in the central portion of the facility away from the housing units. The new law requires that patients be offered a chance for treatment monthly.

Under the 1995 law, sex offenders with at least two victims and continued predatory urges were defined as mentally ill.

Courts have since ruled that detaining offenders for treatment was constitutional only because it was therapeutic — not punitive. The state offers a five-phase therapy regimen that tries to teach them to empathize with their victims and suppress their sexual urges.

But the vast majority refuse to participate beyond the first phase because anything they say can be used against them in jury trials held every two years to determine whether to keep them locked up. Nine of 171 patients at Coalinga have gone beyond that phase.

Former Rep. James Rogan, who co-wrote the sexually violent predator law as an assemblyman from Glendale, said prosecutors seem satisfied the law is working. Its primary purpose, Rogan said, was to ensure that sexually violent predators stayed out of the community.

"The implied secondary purpose, of course — where there's any mental health need — was to try to have the resources to do whatever degree of rehabilitation can be done through medicine and psychiatric help," he said. "I regret that it's not happening." 

The efficacy of treatment for these inmates is a matter of professional debate, as is whether the men have a true psychiatric disorder. They have nevertheless been channeled into an increasingly crowded state mental hospital system. At Atascadero, they have clashed with severely mentally ill patients, exploiting them for sex, drugs and money.

Planned since 1998, Coalinga presents its own set of problems. Hospital documents show that the initial staffing plan last July was for two officers — and no professional caregivers — to monitor each unlicensed, 50-patient unit around the clock. After officers protested, the plan was changed to include at least one psychiatric technician.

The officers — relatively poorly paid and untrained as caregivers — have been directed to attend to patients' needs by passing out shaving kits, monitoring showers and writing reports on aggressive outbursts

At the other four state mental hospitals in California, such officers investigate crimes and respond to disturbances. Patients are monitored by nurses and psychiatric technicians at ratios of at least one licensed staffer to six patients.

"The officers weren't expecting to be on a unit baby-sitting these guys," said Officer Bill Muse, Coalinga's representative for the Hospital Police Assn. of California and a former Atascadero officer.

"They were under the assumption that they were going to be doing police work," he added.

So far, only the best-behaved patients have been moved to Coalinga, but some already have been caught with illegal drugs and homemade alcohol known as pruno, officers said.

"The patients are getting jacked up," Muse said, "and something's going to happen."

Just two units at Coalinga are licensed for treatment, and they are almost full already. Hospital spokesman Tom Hunt, who spends much of his time seeking recruits at job fairs and vocational schools, said the hospital can seek to have more units licensed as needed. 

But attracting skilled staff may continue to be difficult. Coalinga is not just off the beaten path; its jobs are often demanding and not that high-paying. 

"The problem is going to be if they can't find the staff and people want the treatment and they can't get it," said Daniel Brzovic, associate managing attorney for Protection & Advocacy Inc., a state contractor that advocates for mental patients' rights. "Then I don't see any justification for the hospitalization." 

Several patients said they were relieved to be away from Atascadero, where tensions with treatment staff erupted often.

"They treat you pretty decent here," said Anthony Iannalfo, 63, a three-time convicted rapist who committed his last offense 24 years ago and has declined formal treatment because so few patients have won release that way. "The officers, they seldom come out of the office, but when we ask them for something, they do it right away — when you need your hall card or you want to shave."

Though Iannalfo refuses to go beyond the first phase of treatment, he is taking a depression management class and has signed up for "relapse prevention." 

But the shortage of licensed staff members underscores these patients' strange brand of purgatory. A group in one unlicensed unit spends time building model motorcycles with paper, string, straws and the foil from potato chip bags.

For now, as patients move into unlicensed dorms with names such as Catalina and Pebble Beach, critics say California's sexually violent predator program looks more like upscale incarceration. The men mostly peruse things in the library, work out in the gleaming gym and choose from classes such as computers, history and art. A woodworking shop sits unused since a teacher recruited last fall left. 

"We've been saying all along that this isn't about treatment," Jean Matulis, a Pacific Grove defense attorney, said of the state's suspension of licensed care in most housing units. "This just confirms that." 

Copyright © 2006, The Los Angeles Times



 http://www.sacbee.com/content/news/projects/predators/story/14180844p-15008018c.html
 

Special report: Sexual predators evading treatment
Many violent molesters and rapists sent to a state mental facility are being freed with few restrictions after refusing therapy
By Mareva Brown -- Bee Staff Writers
Published 2:15 am PST Sunday, February 12, 2006

A decade ago, as California was gripped with outrage over the release of a notorious rapist from prison, the state took bold action.

James Lamb, 46, is in the last phase of therapy for sexual predators who finish their prison terms and are sent to Atascadero State Hospital for treatment before release. 
 

Legislators vowed to keep the highest-risk sex offenders locked up for years after completing their prison sentences. They were to be sent to a maximum-security psychiatric facility - Atascadero State Hospital - for a strict, five-stage treatment program.

California's solution was considered among the nation's toughest.

But the program has a fatal flaw, a six-month investigation by The Bee has found, because there is a much easier way out of Atascadero, one chosen by the vast majority of sexually violent predators housed there: Refuse treatment and bank on winning release through the court hearing each offender receives every two years.

That loophole makes California's get-tough solution in practice one of the most lenient sexually violent predator laws in the nation.

It is precisely how 54 rapists and child molesters won release through the end of 2005 from their Atascadero commitments, according to a review of court records and interviews with dozens of prosecutors, law enforcement officers and sexually violent predators in California, Oregon, Arizona, Missouri and Colorado. Only four men have completed the five-step program, and one of those was returned to custody less than two months after his release.

To be declared a sexually violent predator and sent to Atascadero, offenders must have at least two sex-crime convictions, and prosecutors must convince a court that they are likely to re-offend if released directly from prison.

But there is no guarantee that the offenders will remain in Atascadero.

Some convinced state psychiatrists that they were unlikely to commit a new offense, which obligates the state to set them free. Others won release after juries could not agree whether they should continue to be held. Still others were freed after county district attorneys did not challenge the offenders' petitions for release, judging them too old or infirm to re-offend.

None of the 54 went through the full regimen of treatment the state designed for them. More than two-thirds underwent no treatment at all.

"All they need is a doctor's slip to get out," said Harriet Salarno, president of Crime Victims United of California. "Nobody should be let out unless they're truly rehabilitated."

Instead, an investigation of the program found that in California:

* There's a built-in incentive to refuse treatment, because the few offenders who actually follow the hospital's full program find themselves not only targets of scorn inside Atascadero but subject to both tighter scrutiny and community protests upon release.

* Nearly all of the highest-risk sex offenders released from Atascadero without completing treatment have returned to society with less supervision than lower-risk sex offenders freed directly from prison.

* Members of the public have no sure way to tell if a sexually violent predator has settled in their neighborhood because the state refuses to identify them as such.

Despite that policy, The Bee found the last-known locations of all 54 sexually violent predators who were released through the end of 2005 without completing the treatment program. The search included use of court records, public documents, media archives, Internet search tools and interviews with law enforcement and county prosecutors throughout California. It also relied on cooperation from some Atascadero patients and released sex offenders, as well as California's Megan's List, the attorney general's Internet listing of all sex offenders registered with California law-enforcement agencies.

Eleven of the 54 men are back in custody, including one convicted of molesting two girls he was baby-sitting two years after his release. Two were accused of new sex-related crimes. At least 10 left the state after release, some saying that life as a convicted sex offender is easier outside California, where registration requirements and monitoring efforts can be even less stringent.

Seven have died, and three currently are in violation of their quarterly registration requirements, including one - Donald Warren Delaney - who seems to have disappeared.

Authorities say Delaney, a 77-year-old former Stockton police sergeant, has dropped from sight and may be in Mexico.

Delaney, sentenced to 24 years in prison in 1985 for lewd acts on nine children, was released from Atascadero on March 25. California's Megan's List indicates he is incarcerated, but there is no record of him in any California prison, and San Joaquin County Deputy District Attorney Stephen Taylor said he may have left the country.

One property record linked Delaney to an address in Pollock Pines that turned out to be a logging road with no homes.


 Sex Offenders a Danger Forever?

 Tom Watson Writings - Index

 Three Strikes Legal - Index

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