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HHS: Regional center incident Thursday an anomaly

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BY CORY MATTESON AND NANCY HICKS / Lincoln Journal Star

Friday, May 09, 2008 - 12:22:23 am CDT

Two Sarpy County Sheriff's deputies left a 19-year-old man, deemed incompetent to stand trial, at the Lincoln Regional Center on Thursday, handcuffed to a chair.

Center officials told the deputies at noon there was no room for him at the facility.

Three hours later, following a judge's orders, the deputies left the man at the center, handcuffed to a chair in the lobby.

State moves people around to make room at LRC

Over the past several weeks, the state has played musical chairs to make room for people waiting in jails for beds at the Lincoln Regional Center.

It moved eight people from the Lincoln Regional Center general population to the Norfolk Regional Center. They all were originally from the Norfolk area and were nearing the end of their treatment, said Scot Adams, director of the Behavioral Health Division with the Department of Health and Human Services.

The state then moved seven people from the Security Building - home to the most dangerous people - to the general population.

That freed up space in the Security Building for nine people held in jails, Adams said in a telephone interview Thursday.

“That got the list (of people waiting in jail for treatment at LRC) back into what we considered to be normal range,” Adams said.

People go to the regional center from jail for two reasons: Either they were found not responsible by reason of insanity; or the court determined they were not able to participate in their defense and were “ordered to treatment so they can be be restored to sanity,” Adams said.

Often, they’ve been in jail six to eight months before they are ordered to the regional center.

And it normally takes another four to six weeks for a center spot to open, he said.

But that had stretched to a nine- to 10-week period before the state “took the unusual step of moving people to Norfolk,” he said.

Using the Norfolk Regional Center was a one-time occurrence, Adams said.

The backlog began in January, when the Security Building stopped taking new people for about three weeks while employees made security improvements suggested by national accreditation inspectors, he said.

The backlog became public in April after a York County inmate had waited more than two months for a bed at the Lincoln Regional Center. A district court judge said he might order top state officials into court for an explanation.

The man was moved to Lincoln in late April.

- Nancy Hicks

The series of events that unfolded Thursday is anomalistic, said Scot Adams, director of the Nebraska Health and Human Services Department's Division of Behavioral Health.

The frustration that brought them about is not, several officials said Thursday.

"It brings to the (forefront) the plight of the individual and the plight of the system," Sarpy County Attorney L. Kenneth Polikov said Thursday evening.

There is a waiting list at the regional center for prisoners and other mentally ill people who need to be in the state’s care.

The backlog has left officials in holding patterns when dealing with people who are in serious need of help. On Thursday, a court order Adams called “out of protocol” was used to bypass the wait.

Deputies were ordered by Sarpy County Judge Robert Wester "that the defendant is hereby forthwith committed to Lincoln Regional Center," Sarpy County Lt. Steve Grabowski said, reading part of the court order over the phone.

Grabowski said the judge told him that his deputies were to leave the man at the regional center even if the center refused to admit him. If the deputies didn't, Grabowski said Wester would send the lieutenant to jail.

So when the regional center refused to admit the man, deputies left him there.

"We were pretty shocked at the unfortunate behavior that left a man handcuffed to a chair in a lobby," Adams said. "Most of the time, everybody does their best to work together and make this work."

Dean Settle, director of Lancaster County's Community Mental Health Center, which oversees  Lancaster County's Crisis Center, said in general the system has had a "major disruption."

The Crisis Center is full, and he said he has three women who are already committed and waiting for inpatient service at the regional center.

He said he also has five people waiting for final rulings on their competence from the state Mental Health Board, because the board members know there is no room at LRC. 

Grabowski said he and other law enforcement agencies are frustrated nearly every time they pick up somebody who needs to be placed in emergency protective custody — people who are a danger to themselves or others and who are supposed to receive mental care immediately.

"Our average time for an EPC is six hours," Grabowski said. "That takes one of my cruisers off the street for six hours."

That's a long time not only for the county to be down one patrol vehicle, but also for people who desperately need mental health, he said.

"Just trying to find a bed for someone is hard to do," he said. 

In Lincoln, Police Chief Tom Casady said officers used to drive around for hours with a mentally ill person in the back of the cruiser, waiting for a bed to open at a local hospital or the Lincoln Crisis Center.

Now he said he has told his officers not to put anyone in a cruiser unless placement for that person is guaranteed.

As for EPCs, Adams said the 64-bed Lasting Hope Recovery Center in Omaha, which opened last month, will help ease the burden of law enforcement officers when people with mental health problems are placed in their care.

He said the center is expected to be running at full capacity by the end of June.

But the man who was handcuffed to a chair Thursday was not classified as an EPC. He had been jailed at the Lincoln Correctional Center.

In April, York County officials told the Associated Press that they were frustrated that a man who had been committed to LRC two months earlier was still in their jail.

At the time, the backlog of people awaiting treatment was nine or 10 people, Adams told the AP. That was because the center was revamping security to remain nationally accredited.

Typically, Adams said, up to four people are on the waiting list to receive care at LRC, and they are  on the list for about four to six weeks. They all have court orders to receive care.

That was the case Thursday, when the deputies brought in the man they left handcuffed to a chair.

Adams said HHS attempted to contact Wester Thursday, but could not.

The Journal Star could not reach him Thursday night.

Polikov said he believed the judge was trying to make a point, that local officials are frustrated when somebody in their care would best benefit from being attended to by the state.

"I think it got somebody's attention," he said.

He said officials at all levels are trying to do what's best for the individual, and that he is surprised that more funding, and more care, isn't available for people with mental health problems, even though it is a concern that affects everybody in the state.

"I suspect there will be a lot of conversation, and I predict there will be progress," Polikov said.

"We will continue to evaluate and move forward the best we can," Adams said.

As for the man who was left at LRC, the deputies left the key to the handcuffs. Adams said he could not comment on the man's admission status.

"We are caring for this individual, giving him respect, nourishment," he said.

Reach Cory Matteson at 473-2655 or cmatteson@journalstar.com.


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Thanks Mike Johanns wrote on May 9, 2008 5:23 am:
" Thanks to our ex-governor and senate hopeful for closing all those acute beds in the regional center system and moving those people into the community. Now we have to hand cuff Nebraska's mentally ill in the LRC lobby? And it looks like Bill Gibson, the CEO of all three regional centers (two which were to close?? What happened to that plan?) is trying to play musical beds to meet the needs. The system has been ruined by a political opportunist and a bean-counting CEO. That is mental health reform in Nebraska folks! "

abby wrote on May 9, 2008 7:07 am:
" My oh my. I would rather have enough beds for people who need them so they can get the help they need than to have them on the streets making poor decisions and getting in trouble. "

Hal wrote on May 9, 2008 7:27 am:
" Mr. Adams said " Most of the time, everybody does their best to work together and make this work."Anybody in law enforcement knows that this isn't true. There is no "working together", we call looking for a bed and we are told they are full. The only thing done together is the phone conversation. I can't tell you how many times I have had officers have to sit their entire shift with a suicidal person. Or they spent their entire shift at LGH waiting for them to evaluate the person.
"

dealt with but not seen wrote on May 9, 2008 7:41 am:
" Why were those beds successfully closed? Because not enough people told the administration "no, don't do that." Who speaks for the mentally ill and those people who need the services of the Regional Centers or other state services? All too often the general citizenry hope that the problem will be dealt with, but without their input. Most of society expects someone else to do the work or make the effort to solve a problem.

Why are all the Regional Centers in eastern Nebraska? Believe me, Hastings and Norfolk are eastern Nebraska when you live in Scottsbluff or Chadron. There are people in western Nebraska so why not have a facility in the west and ease some of the demand on the eastern centers? There are surely some empty hospitals or nearly empty hospitals that could be converted to a facility. "

Tim wrote on May 9, 2008 8:14 am:
" Just keep playing pass the buck, err, patient? Well patients have to be handcuffed to chairs in lobbies but hey we have a cool arch by Kearney, the money pit of the "Antelope Valley Redevelopment", and coming soon throwing away millions to move the state fair to Grand Island. Way to go Nebraska! Keep those priorities in line! "

hh wrote on May 9, 2008 8:30 am:
" no comments regarding the judges action. He should be off the bench! "

The only way wrote on May 9, 2008 9:15 am:
" As much as I hate to say it... This may be exactly what the system needed. It's unfortunate that this person had to sit handcuffed in the lobby, but the rash actions of this judge and the deputies have brought this issue to the public eye where maybe it will now be dealt with properly. To read these comments above would indicate that Johanns decision to close the Hastings and Norfolk regional centers was a dumb one! "

Anya wrote on May 9, 2008 10:02 am:
" I wonder if Scott Adams has ever visited the Regional Centers? There are more than two reasons why men are sent to the Lincoln Regional Center. They are sent for evaluations to determine whether they are competant to stand trial. The Forensic Mental Health Unit is also chock-full of sex offenders! Send THEM to prison! They are not violent, as a rule. If they were gone, that would free up a LOT of beds for men who are actually in need of secure care, and not just therapy! "

come on hh wrote on May 9, 2008 10:08 am:
" Why throw the judge off the bench for enforcing? Where is all the behavioral health money? When they closed the centers the money was to be given out to support these folks. Lets send them to the streets or the shelters where we are not trained to take care of them so they can get into trouble and know they will get meds and squares. Wake up Nebraska - we can not close our eyes to this population, they are not going any where and we do not have enough pairs of handcuffs to pin them all down. "

FOPRES wrote on May 9, 2008 10:22 am:
" One correction on what Mr. Adams said. The client was NOT ahndcuffed to a chair. He was left in the lobby with legirons and handcuffs on his hands and feet. Again NOT to the chair. THanks HAL for reinforcing the plight of Nebraska's Law Enforcment Officers and EPC.s "

ED wrote on May 9, 2008 10:35 am:
" Where are all those 30 bed facilities, now that Hastings Regional Center is basically closed?

Where's the recall petition on a judge who makes an order that is thoroughly tying the hands of law enforcement. Let's hope the nebraska Bar looks into this. "

Nurse wrote on May 9, 2008 10:40 am:
" Being an ER nurse, I experience the same issues. We are always told there is no room to transfer a mentally ill patient or suicidal patient. We waste much of our time just sitting with these patients so they don't harm someone or themselves. We definitely need more facilities! "

MH Worker wrote on May 9, 2008 11:14 am:
" THIS IS WHY MENTAL HEALTH REFORM IS SOOOO CRITICAL!!! I work in the MH field. Region V which includes all counties from Saunders, Polk, Richardson, Thayer and all of the counties inbetween. We have 35 beds. THATS it... so everyone else who needs MH help is given to community services workers.
WHY are we builing a new jail when 80% of those incarcerated are either mentally ill or addicts. ???
Lets free up the jail for actual criminals and put addicts in to residential treatment facilities and those with mental illness in
regional hospitals....
I am forced to get clients out of the Regional center that sends chills up my spine... but they tell me to release them and get them set up in the community as they need the beds.
I try my best but I cant make people take there meds or go to therapy like a residential setting could.

Its a

"

York_curmudgeon wrote on May 9, 2008 11:29 am:
" There would be room at LRC had the Hastings Regional Center not been gutted "

Cindy wrote on May 9, 2008 1:31 pm:
" Handcuffing a person in need of mental health services to a chair and leaving him to make a point is ABUSIVE! It will not magically make more beds appear either. That judge should be removed by the end of the day and charged with abuse or negelect of the man who was left. SHAME ON YOU JUDGE WESTER!!!!!!!! "

frustratedconcerned wrote on May 9, 2008 2:15 pm:
" this whole scenario is a tragedy.

Blame falls on every Nebraskan who has let this build to shameful neglect of the mentally impaired.
Citizen or not, basic human dignity demands that we do better.
The chronic underfunding of mental health care in this state is squarely on the shoulders of the Governor, the Legislature, and the state officials who have stood by, ignoring the studies and reports and allowed this to happen. "

Stop the Madness wrote on May 9, 2008 2:25 pm:
" The honorable Judge had to get the Governor's attention somehow and more power to him. The political rhetoric in this state is appalling. It started with Johanns and continues with Heineman. It's all about saving money by closing facilities and not reallocating those funds. Community based services sound great - but instead they're putting people on the streets so local police or some underfunded agency have to babysit. But that's okay cuz the bill isn't paid by the state. How much more of this do the Nebraska citizens have to hear about before they wise up to this morally bankrupt administration? The problems at Beatrice Developmental Center, the Westroads shooter who had been in (and then dismissed from)"the state system" (no money, you know..), and closing centers all over the state without funding new beds. As MH worker states for Lincoln - that means Lancaster County has to build a $100 million jail to house people who would be better served in mental health or substance abuse facilities. So what are we actually saving, except the Gov's ability to say he cut state expenses? That's where the recall papers should be filed. "

the problem is the system wrote on May 9, 2008 10:33 pm:
" Reform has barely begun to move NE to the 21st century of mental health care. Just closing regional centers is the easy part. Actually getting the workforce up to speed on being a recovery system instead of a crisis management system takes leadership, continuing education, money in the right places not perpetuating the same old revolving door of crisis, regional center, home, crisis, ...

How to improve the situation? Remove Gov Heineman & his political cronies who do not care about actual reform, or people, just "cutting budgets" - which fails to serve the vulnerable people they are responsible for & keeps the high end, high cost, humiliating & ineffective "bed" system going. Would you want anyone you care about stuck in this system? "

angry sister wrote on May 10, 2008 9:45 am:
" its not only the mentally ill that get left. 3 yers ago i took my sister to the hospital because she was dangerously close to death from addiction. she weighed 89 pounds, was covered in sores, taking anything she could get her hands on. she told them she wanted to die and if she left the hospital she most definatly would... she was told all she needed was and i quote "T.I.M.E." to "get over her problems" and they sent her home, i detoxed my sister, i had to lock her in a room ..help her though withdrawl.. the sweats the vomiting the crying the begging me to kill her...why? because they didnt have room and she had no insurance..my sister is alive and clean thank god........if she would have died i would have sued the hell out of that hospital and the state of nebraska maybe thats what it needs to come to.!!!!!!!!!!!!! "

Helen wrote on May 10, 2008 12:27 pm:
" We have laws in the state of Nebraska about abuse and neglect. I would say that an adult, who is so mentally ill that he can't be tried in court or cared for in a Jail, would meet the criteria of a "vulnerable adult" under Nebraska Law. If any other person handcuffed someone who met that criteria to a chair in the lobby of a public building and left them there alone and uncared for, they would be charged with abuse. Why would we ever accept a judge and law enforcement officers to break this law?? They may have been trying to "make a statement", but what they did should bring charges. What if this person had been injured or died because of the abuse, what comments would then be made. We can not tolerate this type of abuse to happen anywhere in our system!! "

Idea wrote on May 10, 2008 4:03 pm:
" Here is an idea let's take the County Jail which has 237 beds and house all of the sex offenders that are taking up space in the Regional center. The new jail is going to be built no matter what us tax payers say, so lets use the old jail for some relief for the mentally ill. It could easily be made into the crisis center and part of the regional center without any problems. Just a thought?? The mentally ill/suicidal people need help and constant care. "

Darren wrote on May 12, 2008 10:13 pm:
" Mike Johanns and the current do nothing govenor should be held fully accountable for setting these circumstances in motion. Where did all the money go Mike? Oh that's right, you shut down HRC and then quit your job before you got he rest handled. You left it to dave "I've never had an idea of my own" Heineman to sweep the mentally disturbed under the rug. They don't vote so you don't care. You should both be sitting handcuffed at LRC to the judge that ordered this. "