When Mental Health, Safety, Politics Collide

Photo by Phil Grout

See more at: Covering a small town can be more active than what you think.

I learned this when I was thrusted in covering a controversial change at a state mental hospital in town, Springfield Hospital Center. The center has a long history with the town and many residents either work there or knows someone who does.

They understand the hospital’s mission and care. But a change in policy led residents to be uneasy as those who battle mental issues that have committed crimes, some violent, would be transferred to Springfield. The Muncie Building on the campus, shown above, was renovated to house these patients awaiting trial.

Links to full coverage are at the bottom, for as long as the Sun maintains the archive.

Court-ordered center slated for Sykesville

Facility will house some relocated Rosewood patients

By Charles Schelle, cschelle@patuxent.com

Posted 7/16/08

A building renovation is progressing on the grounds of Springfield Hospital Center in Sykesville in preparation to house a court-involved program for residents with developmental disabilities.

The Sykesville Secure Evaluation and Therapeutic Program is set to open in October, and will partially replace the Rosewood Center in Owings Mills, according to Michael Chapman, director of Maryland’s Developmental Disabilities Administration.

“Our goal is to help people assume responsibility of the nature of their crime and to be reintegrated into the community,” Chapman said.

Security at Rosewood has been under scrutiny of late, as a resident of the center escaped for the second time in five years and was found July 8 in New Hampshire, according to an account in The Sun.

“Our first concern is the safety of the individual and the safety of our staff that work there,” Chapman said. “And our utmost concern is the safety of the community.”

The administration is working with New York-based security consultants to ensure safety of residents and the community, he said.

Gov. Martin O’Malley (D) announced in January that Rosewood would close June 30, 2009, in favor of a more secure center.

The state is renovating the nearly 40-year-old Muncie Building on First Street within Springfield. The renovation will cost an estimated $250,000. The operating budget was estimated at $5 million as of February, according to John Hammond, spokesman for the Department of Mental Health and Hygiene, but that figure will likely change when the program opens in October.

The Sykesville center will house a maximum of 22 people, 11 of whom would be the court-involved patients from Rosewood.

Other Rosewood patients will be relocated into other areas through a community placement program, such as group homes, Hammond said. The program being housed in Sykesville is not considered part of the Springfield Hospital Center system, Chapman added.

“This is not a prison,” he explained. The people housed at the Sykesville center are awaiting trial and have been deemed by the courts incompetent to stand trial, he said.

“People have allegedly committed a crime, but there is not a way to prove that because they are standing for trial,” Chapman said.

Part of the requirements include therapeutic programs to help the patients resume normal life, he said.

“The issue here is: Where is the best place to treat people?” he said. “Here we’re going to treat them within a safe environment.”

The center will employ about 65 people, Chapman said.

Questions arise over center in Sykesville

Krebs, Kittleman eye Rosewood transfers

By Charles Schelle, cschelle@patuxent.com

Posted 7/23/08

State Sen. Allan Kittleman (R-9) and Del. Susan Krebs (R-9B) are raising questions about plans for a court-ordered center in Sykesville for residents who have developmental disabilities.Kittleman and Krebs wrote a letter to Gov. Martin O’Malley (D) questioning how secure the Sykesville Secure Evaluation and Therapeutic Program will be — and why Sykesville was chosen.

“I’m concerned that this ground is being moved prematurely,” Krebs said.

In addition, Kittleman on Monday called for a hearing on how security is implemented at sites such as the Sykesville center (see box, at right)

The program, to be located in the Muncie Building on the grounds of Springfield Hospital Center, will house people who are accused of various crimes, but are deemed incompetent to stand trial until evaluations are completed. The residents are sometimes called forensic residents.

The center is scheduled to open in October.

Krebs and Kittleman are questioning security, citing a report of a man who escaped from a similar program at the Rosewood Center in Owings Mills twice in five years. The man faced murder, attempted murder and carjacking charges in 2000, but was found incompetent to stand trial.

“The other patients who may be treated (on the grounds of Springfield) may not have the history of violent crime, and I think that’s what’s different from this,” Kittleman said. “When you hear the story of someone who escapes and has killed someone, you don’t ignore it.”

But Kittleman and Krebs said they do not understand how plans changed from 2004, when no mention of Sykesville was made.

A January 2004 Health and Mental Hygiene report included an interim plan to close Rosewood and build a 54-bed center at Clifton T. Perkins Hospital in Jessup to house the Rosewood forensic residents.

In January of this year, the governor announced the Rosewood Center would close June 20, 2009, and a maximum of 22 residents would be housed in Sykesville — 11 from Rosewood.

The decision to house the program in Sykesville was made this spring, said Arlene Stephenson, deputy secretary for Public Health Services in an e-mail.

The Sykesville location is considered temporary, Stephenson said, and the department is looking to build a larger facility in the future, though he did not specify when.

The Muncie Building “had the best space for programming for the residents, and was able to support other needs for the program such as dietary, laundry, etc,” Stephenson said. “It is our best option at this time.”

Krebs said she was first told in April that a Sykesville program was in planning stages and that she would be contacted when plans progressed, but that never happened.

She said she found out that the program will be in Sykesville through accounts in The Eldersburg Eagle and The Sun.

“The lack of communication has been problematic,” she said.

Additionally, Springfield’s staff had to reshuffle and locate to another building, Krebs said. “It creates a domino effect.”

Not alarmist

Springfield Hospital, the drug treatment centers and the Central Laundry Facility minimum security jail have been good neighbors, Krebs said, but her gut instinct tells her the new program doesn’t mesh with the rest of the campus, especially the Warfield Commerce and Cultural Center.

“This isn’t compatible or not well thought out, or else it would have been part of the recommendation when they made the recommendation,” she said.

Shaun Adamec, deputy press secretary to O’Malley, said Monday in an e-mail that “The governor is aware of the concerns of the delegation, and the Department of Health and Mental Hygiene is working with the members of the delegation to address those concerns.”

Regardless of where the patients will be housed, they need taken care of, Kittleman said.

“We have a population that we have to deal with,” he said. “We can’t pretend they’re not there.”

Krebs said she is concerned that the Rosewood patients are being shuffled around, since she’s not sure if the Sykesville program is permanent or temporary.

She said she’s not trying to be an alarmist to scare businesses away, but the communication about the program and security measures needs to be addressed.

The Muncie Building will be locked and will have a fenced courtyard, Stephenson said. Other features include secure doors, windows that cannot be broken out, security cameras, guards and a risk assessment of each resident, she said.

The center will employ 65 people and renovations are estimated at $250,000. The operating budget was estimated in February at $5 million, but is likely to change, according to John Hammond, spokesman for the department.

Kittleman and Krebs are scheduled to meet with Department of Mental Health and Hygiene officials in early August to learn more about the center.

Said Kittleman, “It’s important that we understand what their plans are for the future and that they are going to ensure the residents of Sykesville and the residents of Eldersburg that this will be safe.”

 A state Department of Health and Mental Hygiene official says that Springfield Hospital was the best fit for a new center to house residents who are developmentally disabled and have a criminal history — in part because the state doesn’t have time to house them somewhere else.”We determined we needed to plan for these individuals (from) Rosewood, so we didn’t have a large time frame,” said Arlene Stephenson, deputy secretary for Public Health Services. “We had to go somewhere.”

Gov. Martin O’Malley (D) announced January that Owings Mills’ Rosewood Center would close June 30, 2009.

Some of Rosewood’s residents will be housed at the Sykesville Secure Evaluation and Therapeutic Program, which will open in October. The state decided in the spring that the Muncie Building on the grounds of Springfield Hospital Center would be the best location for the residents.

Del. Susan Krebs (R-9B) of Eldersburg and Sen. Allan Kittleman (R-9) of West Friendship are set to meet Friday, Aug. 8, with state health department officials at Springfield.

The Rosewood center houses people who are developmentally disabled and are deemed incompetent to stand trial for crimes. Its residents with a history of violence were initially slated to go to Clifton T. Perkins Hospital Center, which is a maximum-security psychiatric hospital in Jessup, according to a 2004 state health department report.

The report also outlined alternatives such as moving residents to the Potomac Center in Hagerstown and selling some of Rosewood’s land to generate revenue for a new building.

But that plan has now been replaced with the Sykesville project.

Sykesville had not been mentioned as a possible alternative back in 2004. But John Hammond, spokesman for the state’s health department, said in an e-mail that Springfield was not included because it was at capacity in 2004. The hospital has freed up space since then, he added.

Perkins ruled out

The Perkins transfer died because a lawsuit determined each patient would need a legal hearing to be moved to another state facility and because disability advocates raise concerns that the move to a maximum-security facility would violate patient rights, said Michael Chapman, director of the state’s Developmental Disabilities Administration.

O’Malley’s announcement did not leave time to go through the state’s capital budget process for a new facility, so the state started looking for an alternative, Stephenson said.

“We did not have time to build anything because we had to find existing space,” she said.

The department picked Springfield’s 40-year-old Muncie Building because the campus is familiar with patients who have disabilities, the building had some security features and it had space to accommodate the number of residents, she said.

Stephenson said the Sykesville relocation will be temporary “until we obtain funding to develop a larger and more appropriate space for someplace else,” Stephenson said.

That could take years, she added.

Krebs said she’s concerned about communication of the project because she thought it was in the planning stages in April and has not been contacted since.

Stephenson said she’s not sure if there was miscommunication or a misunderstanding.

“I thought the communication back in the spring was that we were moving to Sykesville,” she said. “I shared that with (Krebs) and the courts at the time.”

Reporter Bryna Zumer contributed to this story.

Official acknowledges lapse in communication on Rosewood

Citizen meeting about program at Springfield planned, but no date set

By Charles Schelle, cschelle@patuxent.com

Posted 8/20/08

Arlene Stephenson, deputy secretary for the Maryland Department of Health and Mental Hygiene, last week apologized for what officials described as communication problems concerning the transfer of residents from Owings Mills’ Rosewood Center to the Springfield Hospital Center in Sykesville.

The Sykesville Secure Evaluation & Therapeutic Program is set to open in October in Springfield’s Muncie Building and will house people who have developmental disabilities, have a criminal record and are incompetent to stand trial.

Del. Susan Krebs (R-9B) of Eldersburg said she had requested to be kept up to date about plans for patients being moved to Sykesville, but never received word — until after it was approved — that the program was definitely coming to Sykesville.

For that, Stephenson apologized.

“The Delegate requested ongoing information from an employee of (Developmental Disabilities Administration) who had agreed to provide it,” Stephenson wrote in an e-mail. “DHMH leadership was not aware of the request and the employee neglected to follow through.

“We apologized and requested that if that should ever happen in the future that information is always available through our Office of Governmental Affairs,” she added.

The discussion stems from an Aug. 8 meeting that Krebs of Eldersburg and State Sen. Allan Kittleman (R-9) of West Friendship had with Health Sec. John Colmers, Stephenson and others concerning the Sykesville move.

Sykesville residents will have a chance to ask questions and learn more about the program in a community meeting, said John Hammond, spokesman for the department.

A time, date and location has not been set. Krebs said last week it will likely be in September.

Gov. Martin O’Malley (D) announced in January that Rosewood would close June 30, 2009. Some Rosewood residents would be transferred to the Muncie Building in October.

“I’m still not convinced that Springfield is the place to go,” Krebs said, but added that she understands a lot of the decision-making was based on a shortage of time, money and availability of space.

“This is sort of pulled up as OK, it’s the quickest solution, but it’s not necessarily the best way to do business,” she said.

The October transfer could be pushed back because the state has not begun preparing for increased security measures at the Muncie Building, Krebs said.

Regulating the center

Security of the Sykesville program is a focal point because of Rosewood’s track record with escapees since 2000, Krebs said.

“What’s to make me be comfortable — and my community — that the program is better here than it was there?” she said.

The way regulations are written, security features may be put in place, but don’t have to be, and are based on budgetary constraints, Krebs said.

State Department of Health officials are open to working with Krebs and Kittleman on possible revisions to the regulations, Stephenson wrote.

To create the Sykesville program, the state has to create, and a General Assembly committee must approve, regulations that outline its purpose and policies. Kittleman sits on the Joint Committee on Administrative Executive & Legislative Review and questioned the regulations.

He has requested a hearing on regulation 08-156-P, which would essentially create the Sykesville program.

Though the regulation passed 10-2, Kittleman is allowed to request a public hearing and said he hopes to change some of the guidelines. A date for that hearing has not been announced.

Kittleman is unsure if the committee will be able to convene over the summer, he said.

Regulations also stipulate that the program’s residents will first be sent to the Clifton T. Perkins Hospital Center in Jessup to be evaluated for 90 days, then sent to Sykesville.

“I can’t understand why it’s OK to house them (in Perkins) for 90 days and it’s not OK to send them there for long-term,” Krebs said.

But a lawsuit determined that housing patients at Perkins would be too restrictive, since it is a maximum security hospital, and that a legal hearing would be needed for each patient.

Krebs said the state is using that one lawsuit as the basis for the Sykesville decision, when it could be different for other patients.

“What they should have done is taken each of these cases through the process,” she said.

The lawsuit has no bearing on people being evaluated at Jessup’s Secure Evaluation and Therapeutic Program, Stephenson wrote. She said the lawsuit dealt with the transfer of residents from Rosewood to Jessup.

“No individuals who currently reside at Rosewood will move to Jessup SETTP — only individuals who are newly-referred for short-term evaluation,” she said.

Sykesville will host its own meeting on Rosewood transfers

Community invited to Sept. 22 discussion

By Charles Schelle
cschelle@patuxent.com

Posted 9/10/08

Sykesville’s mayor and Town Council on Monday announced that they will host a community discussion at the next council meeting regarding the transfer of residents from Owings Mills’ Rosewood Center to Springfield Hospital Center’s Muncie Building.

The meeting will be held at 7 p.m. on Monday, Sept. 22, at the Town House, 7547 Main St. Residents of the town, and adjacent communities, are invited.

“We haven’t been asleep at the wheel,” Mayor Jonathan Herman said at Monday’s council meeting. “There have been a lot of things going on and conversations that need to take place and a little bit more education on our part with the powers that be.”

Gov. Martin O’Malley (D) announced the closure of Rosewood in January, and the state Department of Mental Health and Hygiene plans to move “forensic patients” — those who are being held on criminal charges but are deemed incompetent to stand trial — in October to Sykesville.

The Muncie Building would host the Sykesville Secure Evaluation & Therapeutic Program, which will house a maximum of 22 forensic patients, with about 12 coming from Rosewood.

The program will be operated by the state Developmental Disabilities Administration, and not the Springfield Hospital Center.

After Monday’s council meeting, Town Manager Matt Candland made it clear that the Sept. 22 will not be the community meeting that Del. Susan Krebs (R-9B) of Eldersburg announced she and the state’s Department of Health and Mental Hygiene plan to have this month.

That meeting has not been scheduled as of Monday of this week.

Candland said if the town receives feedback that residents of Eldersburg wish to attend the Sykesville meeting, the town might move the Sept. 22 discussion to Sykesville Middle School to accommodate a larger crowd.

Herman said he plans to invite experts to attend the meeting to help field questions.

“We hope to talk about it in terms we hope that will bring some clarity to this issue,” he said.

State Sen. Allan H. Kittleman (R-9) of West Friendship, Krebs and some Warfield Development Corp. members have scrutinized the transfer, and have expressed concerns about security, communication and other issues.

The 100-acre Warfield complex is where Sykesville, the state and county are partnering to develop an employment campus and cultural center.

The WDC is a board made up of local business people, residents and officials to help develop Warfield. The group is in the final stages of negotiation with Washington-based developer Cafritz Interests to announce a deal and overall plan for the property.

Michael Chapman, Developmental Disabilities Administration director, said the move would benefit the patients currently at the aging Rosewood Center.

“Maryland residents with disabilities and involved with the court system will receive those services and supports necessary to prepare them for community life as a productive/contributing member of their home community,” he said in an e-mail.

“Additionally, in the event an individual admitted to the unit requires mental health interventions, the immediate access to the staff expertise at Springfield would significantly enhance the therapeutic process,” Chapman said.

Not right for Rosewood transfer?

By Charles Schelle
cschelle@patuxent.com

Posted 11/19/08

Consultant study says Springfield building ‘not well-suited’An analysis of Springfield Hospital Center’s Muncie Building has found the space is not a good fit for the impending Sykesville Secure Evaluation and Therapeutic Treatment program.

“The Muncie Building is not well-suited for use as a secure, intensive treatment program for individuals with mental retardation or developmental disabilities who have histories of significant involvement in the criminal justice system or serious offending behaviors,” wrote consultant John W. Finn of Voorheesville, N.Y.

The state Department of Health and Mental Hygiene contracted Finn to review the Muncie building for the SETT program.

The program, run by the state’s Developmental Disabilities Administration, is for people who are mentally impaired and have committed a crime and are either found incompetent to stand trial or not criminally responsible for their crimes.

The first patients, about nine, are slated to be transferred from Owings Mills’ Rosewood Center this month. Rosewood will close by June 30, 2009, as ordered by Gov. Martin O’Malley.

Finn visited the building in April and wrote a five-page report on what’s wrong with the building.

Even with the improvements, “the use of this building as a secure intensive treatment program will be a struggle,” Finn wrote.

Finn said the state should consider using the building for “less dangerous, less high risk individuals who will not be as likely to exploit the compromises in security that are inherent in this building.”

Finn cited numerous problems at Muncie, including the use of staff that aren’t part of the program, areas that would need to be secured from residents, multi-person bathrooms that aren’t conducive to patients with histories of sexual offenses and drop ceilings that pose a security issue.

In a written response to the report, the Department of Health wrote it is confident that it can address the problems. The department said special clips are being installed on drop-ceilings to prevent removal; that it will use a close-circuit television system to monitor residents and that Springfield training staff space may be separated. While the bathrooms are not being renovated, the department said it will develop a schedule to protect residents.

The department also said it is installing a 12-foot tall security fence with a curved top around the courtyard, but a fence around the building is not needed due to “other security measures.”

The Health Department has spent about $391,562 so far on Muncie Building renovations, according to Renata Henry, deputy secretary for behavioral health and disabilities.

Cause for delay?

Del. Susan Krebs (R-Dist. 9B) of Eldersburg said the problems raised in the study must be addressed before residents move in.

“Once they move in, it’s going to very hard to turn this back,” she said. Krebs also suggested pushing back the program’s start date.

In addition to the lack of security measures, Krebs said she is worried that the environment residents are being placed in will be too restrictive, and could lead to a situation in which patient advocates could raise issues about patients’ rights.

The department still has to figure out how the patients will be allowed to work, which is what they do now at Rosewood, she said.

Krebs said recent developments of the department’s plan gives more reason that the move is hasty and irresponsible. She also said the General Assembly should investigate the missteps of the department.

“There hasn’t been clear leadership in this,” she said. “(Health officials) led us to believe that this consultant led us to the (Muncie Building).”

EAGLE EXTRA: Frequently asked questions about the Rosewood transfer to Sykesville –

By Charles Schelle
cschelle@patuxent.com

Posted 11/19/08

The following is a list compiled of questions asked by local and state lawmakers, residents and The Eagle through interviews, public forums and correspondence about the Sykesville Secure Evaluation & Therapeutic Program and Springfield Hospital Center. Answers are provided officials of Department of Mental Health and Hygiene, Department of Legislative Services and interviews conducted by The Eagle. This list will be updated as more information is available.

What’s the difference between Springfield Hospital Center and the Sykesville Secure Evaluation & Therapeutic Treatment Program?

Springfield Hospital is operated by the Mental Health Administration. Patients at Springfield have a mental illness, while most are schizophrenic. These illnesses can be treated with medication. About 202 patients, or 58 percent of the 349 patients, are considered forensic, which means they have been charged with a crime.
The Sykesville SETT program is operated by the Developmental Disabilities Administration. Patients at the program are considered developmentally disabled, also called mentally retarded. The patient must be diagnosed before 18 years old to be considered developmentally disabled. These patients have an IQ of below 70 and must show a lack of skills for everyday living, such as dressing, eating, bathing, socializing. Drugs cannot treat mental retardation.
Nine patients will be at the program first with a maximum of 22. All are considered forensic. These patients are found either incompetent to stand trial because they don’t understand the legal process or roles in the courtroom and can’t defend themselves or they are found not criminally responsible.

How does having a mental illness affect someone in terms of committing a crime?

If someone has a mental disorder and is delusional, they falsely believe someone is after them and attack in self defense.
They might know that attacking someone is wrong, but they cannot help it because of their mental state.

Who decides whether someone is incompetent to stand trial?

Competency can be raised by defendant, counsel, the state, attorneys, the judge. Court orders the evaluation, and the court can either accept or reject the opinion from the evaluation.

Can a patient gain competency?

Yes. Staff help teach patients about what they have done and understand the role of the legal system.
When the patient is found that they are no longer a danger to themselves or others, the court can grant a release on a condition, similar to probation. The process is that the treatment team decides the individual is ready, makes a recommendation to the court for discharge to the community, and then the court has to agree.

Secure Evaluation & Therapeutic Treatment Program (SETT)

How was the SETT created?

The Department of Mental Health and Hygiene wrote regulations that created the SETT program as well as an evaluation unit at Clifton T. Perkins Hospital.
The regulations are under a new chapter of the Code of Maryland, 10.07.13.
The regulations are reviewed by the Maryland General Assembly’s Joint Committee on Administrative, Executive and Legislative Review (AELR). The AELR is charged with approving regulations for various state departments and agencies.
Sen. Allan H. Kittleman (R-9) is a member of this committee and voted against the regulations, according to the Department of Legislative Services.

How do regulations work?

State agencies can submit emergency regulations, such as the forensic residential center regulations, to the 19-member committee for approval.
If approved, the regulations can last up to 180 days.
On a parallel track, permanent regulations are also proposed and are often the same as the emergency regulations.
The permanent regulations that establishes the Sykesville program and the transfer of patients from Rosewood to Springfield were reviewed during a 30-day hold period by the committee, which ended Sept. 13.
Committee members have 45 days after publishing to request a hold, in which the committee requested.
The Department of Health could then send a letter to the committee stating that it intends to move forward with the current regulations in 30 days once that 45 day period ends on Oct. 28 unless the committee takes action.
The committee could vote in favor, or to amend or approve or oppose. If the committee opposes, that delays when the regulations will take effect. The governor will have to decide whether the Department of Health should amend, withdraw, rewrite the regulations or he could approve the regulations as written.
In the meantime, the center operates under emergency regulations, which lasts through the end of the year.

What are the Department of Health’s priorities for the Springfield Hospital Center, the Sykesville SETT Unit, and the community of Sykesville?

Provide quality care and assure safety and security for the patients/residents. Provide for the safety and security of the employees. Provide for the safety and security of the community.

When will the SETT program start?

The target was originally October, but renovations of the Muncie Building are not projected to be completed until mid-to-late November. Patients will be transferred after renovations are complete.

How long will the SETT program be at Springfield?

The location is temporary, but the Department of Health cannot guarantee when the program will leave Springfield or even if it would leave Sykesville.
The Department has made a capital budget request for a new site. The Office of Capital Planning, Budgeting and Engineering Services has determined that document is not a public document at this time. Developing a new site to serve the forensic population is a priority for the current administration. State lawmakers have said it would be difficult for the plan, which could cost at least $5.5 million to be approved in a tight state budget.

Who made the decision to move Rosewood’s forensic patients to Springfield?

Gov. Martin O’Malley signed an executive order on Jan. 16, 2008, ordering that the Rosewood Hospital Center would close by June 30, 2009, based on a recommendation made by Health Sec. John Colmers.
The fiscal 2009 budget approved by the General Assembly eliminates the direct funding of the Rosewood facility beginning July 1, 2009.

Why was Sykesville chosen?

The Springfield Hospital Center Muncie Building was chosen because it is a stand-alone building that already has in place many security provisions and only minimal need for further investment.  It is also an appropriate setting in which to provide behavioral therapy and treatment. Springfield was also able to provide the support services needed such as dietary and laundry.

Were other locations considered?

Other alternatives were considered including Spring Grove Hospital Center in Catonsville, the Potomac Center in Hagerstown, the Brandenberg Center in Western Maryland, and the Perkins Center in Jessup.
Catonsville’s Spring Grove did not have any appropriate space; using Hagerstown’s Potomac Center would have been in violation of its existing license as an Intermediate Care Facility for Persons with Mental Retardation (ICF/MR); and the Brandenberg Center in Cumberland was determined to be too far west.  Jessup’s Perkins Center does not have adequate space for an additional 22 residents and they do not have sufficient programming space.  The space that was referenced in recent newspaper articles that was available in 2004 has since been filled with Perkins’ patients.

What is this 2004 report I’ve heard about?

It is a Department of Health and Mental Hygiene’s Report to the Joint Chairman on Maryland’s Developmental Disabilities Services in regards to the Closure of a Residential Facility for People with Developmental Disabilities. It is dated January 2004.

What is it about?

The General Assembly requested the report asking the Department of Health to identify one state residential center for the developmentally disabled that it could close in fiscal 2005, along with plans and alternatives. The Department identified Rosewood Center as a candidate for closure, but was never ordered to close until Gov. Martin O’Malley ordered it to close in January 2008.

What were the plans then?

Non-forensic patients would be cared for a private provider through community placements. Some forensic patients would be transferred to a new 54-bed building at Clifton T. Perkins Hospital Center and then the remaining would be sent to another building built on the grounds of Perkins at a later date.
The department anticipated budget problems and thought the construction of the building would not happen until 2008.
One temporary option included transferring 18 or more forensic patients to Perkins’ north wing once another new maximum-security wing was completed in 2005. Another option was to sell off the remaining 180 acres of Rosewood but lease back enough space for a new forensic residential center.

Why wasn’t Rosewood closed and those plans followed?

A legal assistance provider filed suit on behalf of the residents in a Howard County court stating that transferring the patient to a maximum security hospital at Jessup violated patients’ rights. That delayed the plan for years.

When was Sykesville first mentioned as an option?

The decision was made during spring 2008.

What type of crimes have forensic patients in the SETT been charged with?

Individual cases are confidential. However, the cases range from minor assaults to possession of illegal drugs and sexual offenses. It is not known whether any patients who have faced murder charges will be transferred. Currently, six of the nine patients slated for transfer are incompetent to stand trial, which means that they have not been convicted. Three patients are not criminally responsible.

What security measures will be put in place to secure the Sykesville SETT Unit?

The Sykesville SETT Unit will be guarded 24/7. A risk assessment of each resident is conducted at the time of admission. In some cases, a risk assessment determines if a resident requires one-to-one staffing. Muncie Building’s entrance will have two locked doors that are accessible by key card only.
All other doors are being replaced with more secure doors. Windows have a special treatment so that they cannot be broken out.
There will be security cameras to provide better view down the two hallways inside the facility. A security fence with a curved top with fine-mesh will secure the courtyard.
Two guards will be on duty 24/7.

Will the SETT patients have ground privileges or be allowed out on work release?

At the current time work release options would not be available to individuals assigned to the SETT. Ground privileges are not planned at this time for SETT patients.

Do the forensic patients at Rosewood who could be transferred have ground privileges or be on work release?

Yes.

How will that affect patients transferred to the SETT program?

Del. Susan Krebs has said that she is concerned about the patients wondering why they do not have ground privileges anymore and is working with Health Sec. John Colmers to see how to address the issue.

How will elopements be handled?

The Springfield Hospital Center has an existing elopement policy. The policy exists to identify report, analyze and prevent patient elopements.  Each patient is assessed for risk of elopement. Elopement precautions are taken for those patients determined to be at risk for elopement. The goal of the policy is to safeguard patients who are clinically assessed to be at risk for eloping.  The Springfield Hospital Center Police follow guidelines regarding community notification regarding elopements that may involve an individual potentially dangerous to the community. The SETT will also have an elopement policy and will coordinate with Springfield on elopements and notifications.

What is an elopement and how is that different from an escape?

By definition, elope means to escape.
The Department of Health defines an elopement as either a walk-off or someone who has left the campus for any amount of time then returned. A person could be late to his or her therapy and could be considered to have eloped.

How will visitations (by family members) be supervised?  In the same “secure” environment?  If so, how is the safety of the visitors ensured?

All visitors are subject to the security rules of the SETTP.  This includes inspecting for items (such as cell phones, pens, anything that can be used as a weapon) that are prohibited in the unit.  Appropriate supervision is assigned to each person depending on the guidelines established by the multidisciplinary team for each individual.

How will the facility be maintained?  How often will safety inspections occur and how will violations be reported and to whom?

The facility is licensed by the Office of Health Care Quality, and will receive surveys as necessary as deemed appropriate by OHCQ.  Staff will assess daily the security and living needs of each person on the unit.
This includes routine safety and environmental inspections.  Violations will be immediately noted for corrective action.  SETT’s program director is responsible for ensuring corrective action is taken, and that the director of the Developmental Disabilities Administration is informed of incidents and corrective action including an analysis of data as well as quality improvement strategies.

What types of parameters are in place for reporting violent incidents (among the residents)?

Incidents that involve injury are reported up through DHMH and to the court.  In addition, incidents that involve permanent injury or death are reported to the Office of Health Care Quality.

The current emergency regulations specify that the administrator is responsible for keeping the patients safe and secure.  Will the department agree to modify the permanent regulations to include a requirement to take actions to keep the community safe?

As requested, the Department is amending the regulations to include language that states the administrator of the FRC shall ensure a safe and secure setting for the individuals, staff and the public.

What if the forensic patients are found not to be rehabilitated after a certain period of time?  Will they remain in the Springfield program permanently?

Maryland statute provides for periodic reviews of the status of an individual committed as  Incompetent to Stand Trial (IST), and provides a procedure should one be found by the court as not  able to be restored to competency.  See Criminal Procedures Article § §3-106 – 3-108, Ann. Code of  Maryland.
The individual may stay at the SETT as long as the court finds the patient to be incompetent to stand trial, dangerous and restorable, or not criminally responsible and dangerous.
If a patient is found by the court to be not able to be restored, the individual will remain at the Sykesville SETT.

Would the Department of Health support legislation that would prohibit the courts from specifying the placement of forensic patients?

At this time, the department is not proposing any change to the statute.
Right now the statute states that the judiciary system can commit an individual to the Department of Health. The department has taken the position that it is in the best position to make the clinical determination of the most appropriate facility (psychiatric or SETTP) that meets the clinical and security needs of the individual.  The courts have deferred to the department’s judgment.

Springfield Hospital Center

What type of crimes have forensic patients at Springfield been charged with?

Individual cases are confidential. However, they range from cases such as public intoxication, theft, tresspassing to more major charges, including major assaults and patients transferred from Clifton T. Perkins Hospital faced more “egregious crimes.”

How many forensic patients are at Springfield?

About 58 percent of the 349 patients, which is 202.

Is it true that Springfield is receiving patients from Clifton T. Perkins Hospital in Jessup?

Yes. Patients at the maximum security hospital who are deemed stabilized can be sent to a lower level of treatment and security and Springfield has been accepting those court-ordered patients since 2004.

What types of crimes do these patients face?

More “egregious crimes” such as assaults and potentially murder.

What is considered stabilized and who determines that?

A patient’s medical staff decides whether a patient is stabilized. Stabilization means the patient is regularly taking his or her medication, the medication is effective and the patient participates in therapy.

How much security does Springfield Hospital have?

The hospital has 15 guards as its Springfield Police Department. The officers are unarmed.

Why don’t the officers carry guns?

The force is a mixture of security guards and certified police officers. Officers are unarmed because they are trained to handle without guns patients when a patient’s behavior acts up. The hospital is classified as a health care facility and not a prison, so it is a part of the Department of Health’s philosophy to support that definition by not having guns.

What security measures are put in place for Springfield’s campus?

Individuals committed to the hospital for mental health treatment will be given grounds privileges as their clinical presentation improves.  Individuals who are court ordered for evaluation or who are admitted through a detention center are not given grounds privileges.

How are the staff trained to handle aggressive patients?

Staff members are registered in the Prevention, and Management of Aggressive Behavior program at the hospital.They are taught methods to identify when patients’ behavior begins to escalate and methods to help de-escalate the patient and how to physically bring them under control. Sometimes emergency medication is prescribed for the patient.
What about elopements or escapes?

See above under SETT.

How many elopements have there been at Springfield?

Fiscal 2005: 16; all returned.
Fiscal 2006: 12; all returned.
Fiscal 2007: 13; all returned.
Fiscal 2008: 13; 11 returned; 2 had alternative placements.
YTD fiscal 2009: 1; all returned.

Statistics include both forensic and non-forensic patients.

Where were the patients eloping going?

The intended destination of all eloped patients is not known, however, the final destination of all patients is known, even if they did not return to the hospital. Here are the final destinations of the patients since fiscal 2005:

Convenience store:  19
No destination; did not intend to leave: 4
No destination; intended to leave: 16
Visit family/friends: 3
Home: 3
Baltimore: 5
Court: 3
Other hospital: 2

Statistics include both forensic and non-forensic patients.

Was anyone harmed during those elopements?

No.

Sources: Michael Chapman, Developmental Disabilities Administration director; John Colmers, secretary of State Department of Mental Health and Hygiene; Paula Langmead, chief executive officer of Springfield Hospital Center; Susan Steinberg, director of the forensics office; Arlene Stephenson, deputy secretary of public health services; and Eagle interviews.
– See more at: http://archives.explorecarroll.com/news/1287/eagle-extra-frequently-asked-questions-about-rosewood-transfer-sykesville/#sthash.2pihyEIG.dpuf

Here’s a quick rundown of the coverage involved while I wrote for The Eldersburg Eagle:

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