State of­fi­cials held in con­tempt

Judge or­ders beds opened for pris­on­ers in men­tal hos­pi­tals

Baltimore Sun - - FRONT PAGE - By Pamela Wood

A Bal­ti­more cir­cuit judge is hold­ing Mary­land’s act­ing health sec­re­tary and other top Health De­part­ment of­fi­cials in con­tempt of court and or­der­ing them to open dozens of beds at state psy­chi­atric hos­pi­tals by the end of the year.

Re­tired Judge Gale Rasin ruled Thurs­day that act­ing Health Sec­re­tary Den­nis Schrader and his top staff had failed to fol­low court or­ders to place crim­i­nal de­fen­dants in state psy­chi­atric hos­pi­tals.

In some cases, Rasin said, men­tally ill de­fen­dants have lan­guished in jails for weeks wait­ing for a bed to be­come avail­able at a state hos­pi­tal.

“Sec­re­tary Schrader: I say, ‘ Fix this prob­lem and do it now,’ ” Rasin said from the bench.

She said the De­part­ment of Health, which is re­spon­si­ble for treat­ing men­tally ill de­fen­dants, hasn’t been do­ing its job.

“It has failed mis­er­ably to meet its re­spon­si­bil­ity,” Rasin said. She said the eval­u­a­tion and treat­ment sys­tem for po­ten­tially men­tally ill de­fen­dants is “in a sham­bles.”

Schrader told The Bal­ti­more Sun that Rasin is ig­nor­ing steps he is tak­ing to add 95 psy­chi­atric beds in a va­ri­ety of lo­ca­tions.

“I don’t agree with it and it’s in­ac­cu­rate,” Schrader said.

Asked what was in­ac­cu­rate in the rul­ing, he re­sponded: “She’s stuck in the past. I’ve got to be wor­ried about the fu­ture.”

In a blis­ter­ing 42-page or­der, Rasin sys­tem­at­i­cally picked apart ex­pla­na­tions given by Schrader and his staff for the

de­lays in get­ting de­fen­dants into hos­pi­tal beds.

Rasin wrote that state health of­fi­cials had failed to heed warn­ings of a need to ex­pand state hos­pi­tals as far back as 2012, when Martin O’Mal­ley was gover­nor and a con­sul­tant rec­om­mended “a very sig­nif­i­cant in­crease in hos­pi­tal beds.”

Sub­se­quent re­ports and prom­ises of ac­tion have fallen short, she wrote.

Rasin said the de­part­ment’s con­fus­ing es­ti­mates of wait­ing lists and wait times rep­re­sented “a sort of shell game” that im­peded progress.

“If the De­part­ment lacks im­por­tant data, it has been a con­scious and in­ten­tional choice not to gather it,” she wrote.

Rasin said Schrader seemed to be “dis­con­nected from the process.”

“Mr. Schrader seems to lack a ba­sic ground­ing in the is­sues, and clearly mis­ap­pre­hends what­ever has been re­ported to him,” she wrote.

Schrader said that he is wor­ried about how crit­i­cism of the de­part­ment will af­fect the staff, but that he is not tak­ing it per­son­ally.

“I’m a big boy,” he said. “I can take the crit­i­cism.”

In or­der to lift the con­tempt find­ing, Rasin said, Schrader and his deputies must fully staff 20 beds that were added re­cently to the Clifton T. Perkins Hos­pi­tal Cen­ter in Jes­sup and open and staff 20 more beds in a new ad­mis­sions unit there, and open and staff 20 more beds in a new ad­mis­sions unit at Spring Grove Hos­pi­tal Cen­ter in Ca­tonsville.

That group of new units must be opened and staffed by the end of De­cem­ber, Rasin said.

In her con­tempt or­der, she named Schrader, Bar­bara J. Bazron, the deputy health sec­re­tary; Erik Roskes, di­rec­tor of foren­sic ser­vices for the de­part­ment’s Be­hav­ioral Health Ad­min­is­tra­tion; Ina Taller, clin­i­cal di­rec­tor of Clifton Perkins Hos­pi­tal; and Danielle Robin­son, clin­i­cal di­rec­tor of pre­trial ser­vices at Clifton Perkins Hos­pi­tal.

Sharon Bo­gins Eber­hart, a pub­lic de­fender who rep­re­sents de­fen­dants who were await­ing men­tal health treat­ment, called the rul­ing a good start to­ward fix­ing the prob­lem — if the state com­plies.

“If they were to do it, it would be a tremen­dous step for­ward,” she said.

Del. Erek L. Bar­ron, who at­tended the hear­ing Thurs­day, said the rul­ing could be the mo­ti­va­tion the state needs to fi­nally solve the prob­lems.

“I wish this would have come sooner,” the Prince Ge­orge’s County Demo­crat said.

He is a mem­ber of the com­mit­tee in the House of Del­e­gates that over­sees the state hos­pi­tals.

Bar­ron said the De­part­ment of Health has been “fla­grantly ig­nor­ing” court or­ders to put peo­ple in treat­ment.

He said that the gover­nor should be able to find the money to com­ply with the judge’s or­der.

“Money comes fly­ing out of ev­ery­where when it’s a pri­or­ity of his,” he said.

“It’s a shame we can find money and re­sources for con­stituen­cies that can be a squeaky wheel, but for the voice­less? For the marginal­ized groups? Who is go­ing to stand up for them? “Fi­nally we have a judge who has.” Ho­gan spokesman Doug Mayer said the state has in­creased the bud­get for psy­chi­atric hos­pi­tals.

“Heated and mis­lead­ing rhetoric won't help those in need,” Mayer said.

Mayer de­clined to com­ment on the case or the judge’s or­der.

Univer­sity of Bal­ti­more law pro­fes­sor Kim­berly Wehle said Rasin’s or­der could be a “shot across the bow” aimed at forc­ing the state to get de­fen­dants into men­tal health treat­ment.

In con­tempt cases, Wehle said, judges usu­ally have a va­ri­ety of op­tions for en­forc­ing their or­ders, in­clud­ing fines, jail time, re­quir­ing progress re­ports or tak­ing an ac­tive role in man­ag­ing the agency, Wehle said.

She said fin­ing or jail­ing a govern­ment of­fi­cial would be “ex­tra­or­di­nary.”

Wehle sug­gested there may be an el­e­ment of pub­lic sham­ing be­hind the judge’s or­der.

“It’s re­ally em­bar­rass­ing and she knows that,” Wehle said.

Schrader out­lined a plan to open 95 men­tal health beds across the state, in­clud- ing 18 at Po­tomac Cen­ter in Hager­stown, 40 at Clifton Perkins Hos­pi­tal and 24 at the East­ern Shore Hos­pi­tal Cen­ter in Cam­bridge.

He said an­other 13 beds will be pro­vided by Bon Se­cours Hos­pi­tal in Bal­ti­more and Wash­ing­ton Adventist Hos­pi­tal in Takoma Park.

Those plans don’t meet Rasin’s or­der to add beds at Perkins and Spring Grove.

“We are go­ing to do what is med­i­cally nec­es­sary and clin­i­cally in­di­cated, OK?” Schrader said.

Schrader has been em­broiled in a separate con­tro­versy over his ap­point­ment as sec­re­tary.

He has been work­ing with­out pay since July.

Schrader was not con­firmed by the state Se­nate, as is re­quired for Cab­i­net sec­re­taries.

Ho­gan with­drew Schrader’s nom­i­na­tion and then re-ap­pointed him af­ter the Gen­eral Assem­bly ses­sion in April.

The Assem­bly put lan­guage in this year’s bud­get say­ing un­con­firmed nom­i­nees could not be paid. Schrader is chal­leng­ing that in court. An­other Cab­i­net nom­i­nee in the same sit­u­a­tion, Wendi Peters, was moved last week from act­ing sec­re­tary of plan­ning to a role as spe­cial sec­re­tary of smart growth, which does not re­quire Se­nate con­fir­ma­tion.

Den­nis Schrader is the act­ing sec­re­tary of the Mary­land De­part­ment of Health and Men­tal Hy­giene.

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