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Advocates press for greater oversight of state's psychiatric center for children

Hartford Courant - 12/27/2018

Dec. 27--When a child with a mental illness enters the state's Solnit South psychiatric hospital in Middletown, she slips beyond the framework of safety inspections in place in nursing homes, general hospitals, group homes and even the private treatment programs that have contracts with Solnit's operator, the Department of Children and Families.

State facilities aren't licensed, and the state doesn't hold itself to the same standards it demands of private programs. That's a regulatory defect, say advocates and some lawmakers, and it cannot be allowed to persist, lest the dangerous conditions found during emergency inspections at the Solnit center in the spring and summer of 2018 be repeated.

A draft report on social-service priorities for Gov.-Elect Ned Lamont, completed in mid-December, includes an initiative to license and regularly inspect state facilities that serve children. Sarah Eagan, the state's child advocate, first proposed it in September during a legislative hearing following a suicide and a string of suicide attempts at the Solnit center.

Asked then what a licensing and inspection program at Solnit should measure, Eagan said, "Ask yourself what a mother or guardian would want to know about the place that is supposed to be taking care of her child."

Also, a private company called Beacon Health Options, which has a contract to help the state coordinate its mental-health services, has offered a plan that it says would boost oversight and accountability at Solnit.

Joette Katz, DCF's outgoing commissioner, said the agency sends emails on all critical incidents to the child-advocate's office and other professionals, but Eagan has said those notifications pale in comparison to the narratives that follow state inspections of nursing homes and disciplinary actions against doctors, nurses and other professionals. Eagan added that a parent looking for a child-care provider can obtain a provider's compliance history and inspection results from the Office of Early Childhood, with much of the information available online.

DCF officials cite confidentiality laws that surround child-welfare records, but program reviews and physical inspections that don't reveal the identify of children are not confidential.

"The time has long passed that we can rely on DCF to police itself," said Miriam "Mickey" Kramer, the assistant state child advocate. She said DCF is capable of addressing problems in the short-term, "but there is little trust that they can sustain it."

For that reason, the state "has an obligation to ensure continuous external oversight at Solnit," said Faith Vos Winkel, an associate state child advocate and child-fatality investigator.

It was a year of tragedy at the Solnit center, the state's primary psychiatric hospital and residential treatment program for children with dire psychiatric illnesses. In late June, a pregnant 16-year-old committed suicide in her room at Solnit, and in separate incidents before and after her death, a total of seven children attempted suicide.

While the state Department of Public Health doesn't routinely inspect Solnit, state and federal Medicaid officials were concerned enough about several suicide attempts in the spring that DPH was dispatched to the Middletown campus.

In what became a string of back-to-back inspections, DPH found that Solnit was repeatedly placing patients in jeopardy.

The public-health agency lifted that designation after DCF made changes, but the additions were so fundamental -- more nurses, more life-saving equipment, better communication, better emergency protocols, more supervision -- that advocates were wondering how the Solnit units could have been allowed to function without them.

Eagan has said that DCF does evaluate its internal programs "but the public doesn't see the results."


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