State Agrees To Settle Class Action Lawsuit Involving The State Mental Health Institute

DENVER, COLORADO, December 20, 2002…..Holland & Hart is pleased to announce that the State agreed to settle a class-action lawsuit brought on behalf of a patients involuntarily committed to the State mental hospital in Pueblo for treatment following a finding of not guilty by reason of insanity. The plaintiff class brought this suit as a result of four key concerns: 1.) that rehabilitation of patients were inadequate; 2.) that serious understaffing made rehabilitation diffucult, 3.) that no system of progression existed to fairly allow for patients’ release when cured and 4.) that overcrowding exacerbated these problems and resulting in inhumane conditions in the facility. With the filing and settlement of this lawsuit many of these concerns will now be addressed and corrected. The plaintiff class consists of approximately 200 patients, some of whom have been confined to the Institute of Forensic Psychiatry (IFP) at the State mental hospital for more than 20 years. The case was brought to redress violations of the patients’ statutory and constitutional rights following four patient suicides over the course of 15 months in 1997 and 1998.

Plaintiffs and class members contend that, for over a decade, the conditions, care and treatment at the IFP violated constitutional and statutory standards. One of the core issues in the lawsuit was the prolonged lengths of confinement of NGRI patients in the IFP. Of the eight named plaintiffs, four have been involuntarily confined at the IFP for more than 20 years, and four for periods of time between 7 and 19 years.

The plaintiffs alleged that these lengths of stay are the result of systematic deficiencies in the conditions, care and treatment of patients at the IFP. According to Dr. Stuart Silver, who served as both the Superintendent of the Perkins’ Forensic Hospital and is the Commissioner of Mental Health in the State of Maryland for nearly 20 years, the average length of stay of NGRI patients at Perkins when he was the Superintendent was four years. Dr. Robert Keisling, another of plaintiffs’ experts, was prepared to testify that a five to six-year length of stay in a forensic hospital is the norm for NGRI patients. Dr. Keisling is the former Medical Director of the Forensic Division of St. Elizabeth’s Hospital in Washington, D.C.

In many cases, the average length of stay for NGRI patients in the IFP exceed by many years the prison time that would have been served if those patients had been convicted of the crimes with which they were charged.

According to Dr. Jonathan Olin, the former Chief of Psychiatry of the IFP, the long lengths of stay are the result of several factors, including lack of treatment staff, poor physical facilities, a conservative judiciary, lack of community placement resources, shortage of psychiatric staff, lack of family support, and sluggish recognition of the hospital’s deficiencies at the Department of Human Services. Other contributing factors to the prolonged confinement of NGRI patients at the IFP, as reflected in the State’s own documents, are the persistent overcrowding and understaffing in the IFP, the lack of objective measurable criteria for progression and movement through the hospital, the lack of an independent review of the eligibility of patients for release from the hospital, and, according to the plaintiffs’ lawyers, the arbitrary system of progression and regression at the IFP with no meaningful process for challenging such decisions.

In the settlement agreement approved Wednesday, December 18, by Marva Livingston Hammons, Executive Director of Department of Human Services and filed with the court today, the Department of Human Services and the Colorado Mental Health Institute at Pueblo agreed to make several much needed and long overdue changes to the care and treatment provided to its residents. A summary of the key terms agreement follows:

•  Maintain the IFP authorized bed capacity of 278 or below, rather than the former high of up to 318;
•  Maintain as the number one capital construction priority of the Department the construction of a new secure forensic facility in Pueblo;
•  The Department will hire two outside experts to design a system of progression that provides each IFP patient with (a) a measurable plan of care and progression, which is integrated with the patient’s individualized plan of care; (b) periodic review by an independent review board whose purpose is to determine the readiness of patients for progression or release; (c) training for IFP staff necessary for implementation of the plan of progression and individualized treatment plans; (d) an appropriate system of review for the care and treatment of any patients who are regressed; and (e) a system for implementing informed consent by patients in treatment planning and programming implementation. In addition, these experts will review the existing CMHI-P grievance process and make suggestions for any changes and will determine the extent to which it would be appropriate for the IFP to offer a short term inpatient stabilization program for conditionally released patients.
•  Make improvements to the existing maximum security building, designed to improve patient treatment, programming, therapy space, and recreation;
•  Secure and hire additional direct care staff, psychiatrists and outside experts to develop a system to provide individual patient care plans and regular assessments;
•  Complete facility improvements and maintenance on the IFP to eliminate suicide risks and other hazards of the aging facility;
•  Augment the existing aftercare program with an additional 2.5 full-time employees by January 31, 2003, including a full-time vocational rehabilitation counselor; a full-time mental health clinician; and an additional half-time social worker;
•  Establish and fund a new position for a Forensics Community Program Director, who has experience in forensic inpatient hospital care or experience in delivering community forensic services;
   Establish an intensive community placement program;
•  The Department also agrees to cooperate with community mental health centers and courts to provide state-wide community placements;

The settlement agreement provides for administration closure of the lawsuit and enforcement in the federal court through July 1, 2004 and in a separate action through December 31, 2006.

The State will pay the plaintiffs’ costs and a portion of the attorneys’ fees. Finally, the State also agrees to provide specific relief to the eight individually-named plaintiffs.

“Although the State finally has begun making several of these changes over the past year, it is clear that recent changes in treatment and programming, the hiring of additional staff and reduction in patient census were a direct result of the lawsuit we filed four years ago,” explains Steve Black, attorney at Holland & Hart. “Now, with this settlement agreement, the State will be required to make permanent improvements in the care they provide to their patients.”

The settlement agreement is subject to the approval of Chief Judge Lewis Babcock following a fairness hearing.
For more details regarding the settlement agreement, please contact one of the following attorneys:

Steve Black, Holland & Hart, 303-295-8519

David Miller, 303-298-9878

Kathleen Mullen , 303-824-0596

Thomas Quinn 303-296-2828

For additional contacts or interviews, please contact Jen Friedman at Holland & Hart, 303-295-8130.