Push is on to save Cascadia mental health
Nonprofit - Multnomah County officials hold meetings to keep services going
From The Oregonian - May 01, 2008
Multnomah County leaders were scrambling Wednesday to craft a last-minute plan to keep mental health services operating as the state's largest provider moved closer to collapse.
Cascadia Behavioral Healthcare learned in the late afternoon that its bank was collecting on a long-standing $2 million debt due this week, a development that the nonprofit company previously warned would likely force it to declare bankruptcy.
County officials held a series of tense emergency meetings from early morning into the night to come up with a plan to keep the system going. Participants said they couldn't disclose details of the discussions, which included officials from the state, Cascadia and other mental health service providers.
"We're going to do everything we can to keep the services alive for clients," said Joanne Fuller, head of Multnomah County's Department of Human Services. Spokesman Jim Clay said Cascadia's 90 facilities in Multnomah, Clackamas, Washington, Lane and Marion counties would "absolutely" be open for business this morning.
With a $58 million budget, Cascadia provides housing, treatment and crisis response services to 23,000 people each year for ailments ranging from depression to alcohol abuse to schizophrenia.
Multnomah County urged current clients to attend scheduled treatment today and to call its mental health information line at 503-988-4888 with any questions.
Employees will still be paid, Clay said. "If that changes at any time, we would let employees know," he said.
County officials first learned the scope of Cascadia's financial problems about a month ago, when the company approached them with a request to guarantee millions in loans. County Chairman Ted Wheeler denied that request -- as did the state Department of Human Services -- but launched an ongoing audit of Cascadia's finances and began planning to stabilize the mental health system in case the company failed.
Cascadia executives have said the company lost millions switching to a new billing system, worsening an already shaky bottom line.
Wheeler hoped that Capital Pacific Bank would provide Cascadia more time to allow that work to continue. Capital Pacific CEO Mark Stevenson said the bank has spent "enormous amounts of time" trying to reach a solution, without success, but remains open to negotiating.
Clay said Cascadia managers were busy working on survival plans. "They spent more time talking about the clients than they did about their own paychecks," he said. "Everyone knows the consequences here."
Arthur Sulzberger: 503-221-8330; arthursulzberger@ news.oregonian.com
©2008 The Oregonian
Cascadia battered by financial storm
Mental health agency seeks help from Multnomah County and state
From the Portland Tribune, April 24, 20008
Running out of time to pay off mounting debts, the nonprofit lynchpin of Multnomah County’s mental health system is seeking millions of dollars in financial assistance from the county and the state Department of Human Services.
Cascadia Behavioral Healthcare owes its bank, Capital Pacific, a payment on a $2 million line of credit by the end of the month.
Cascadia’s chief executive officer, Leslie Ford (pictured), resigned Wednesday, and its chief operating officer, Judy Watson, resigned earlier this month. Cascadia’s board of directors has appointed psychologist Derald Walker as the new CEO. Walker previously served as a vice president at the agency.
Cascadia is working with its bank to refinance the loan, Walker told the Portland Tribune in an interview on his first day on the job.
“We’re optimistic,” he said. “We’re talking with the bank and with our partners at the county and the state about how to solve this problem.”
Walker emphasized his commitment to stabilize the agency and reassure its clients that it will continue to provide “solid, available, consistent” services.
With an annual budget of $60 million, Cascadia provides services to about 23,000 mentally ill clients across the state, running the gamut from professionals with gambling problems to shoeless schizophrenics wandering the streets of Old Town.
It provides crisis intervention, treatment, walk-in clinics, housing, counseling, case management, outreach and other critical services at scores of sites scattered throughout the Portland area, in addition to operating janitorial and landscaping services.
Staff hears a warning Last week, Ford warned Cascadia employees to brace themselves for a round of layoffs, benefits rollbacks and cuts in services.
“Cascadia is grappling with many critical issues which impact both our operational and financial health,” she wrote.
Meanwhile, Ford approached officials at Multnomah County to help Cascadia weather the impending financial storm by loaning the agency $4 million. Multnomah County Chairman Ted Wheeler denied the request, according to Jana McLellan, the county’s deputy chief operating officer.
Cascadia then requested that the county accelerate roughly $2 million in payments due to the agency for services already provided. In response, Wheeler has dispatched a forensic auditor, Darrell D. Dorrell of Financial Forensics in Lake Oswego, to inspect Cascadia’s accounts and report back to the county board of commissioners.
The term “forensic auditor” may raise eyebrows, but officials say it refers simply to an expert who scrutinizes an organization’s financial records with an eye to its ongoing viability.
“We have no indication that there’s been fraud,” said county auditor LaVonne Griffin-Valade, who is overseeing the audit. “We simply want to get an accurate snapshot of Cascadia’s financial situation.”
Effects could be widespread The county commissioners would have to approve any additional payments to Cascadia, which holds about $20 million in county contracts.
The big question hanging over the discussion is what will happen to Cascadia’s clients, many of whom literally depend on the agency for their sanity.
“The services Cascadia provides are terribly important to the mentally ill folks in our community,” county Commissioner Maria Rojo de Steffey said. “What happens to our clients if Cascadia goes under?”
One mental health professional, speaking on condition of anonymity, called the situation “alarming” and noted that any interruption of services would have negative impacts not just on clients and other mental health providers, but on hospital emergency rooms, the criminal justice system and the state of the homeless in Portland.
“The community would pay for it in the end,” the professional said.
Mental health officials have been scrambling to come up with a plan to ensure continuity of services for those clients.
“The bottom line is to make sure folks have access to services,” Karl Brimner, the director of the county’s mental health services, told a hastily arranged meeting of mental health providers Thursday morning.
Cascadia has grappled with several challenges over the past year. A computer glitch last summer accidentally choked off almost $1 million of reimbursements from Medicaid, the government insurance program for the poor, triggering a cash-flow crisis.
Money was so tight that the nonprofit suspended direct deposit for employee paychecks, received shut-off notices from utilities and at one point owed $325,000 to its own health insurer, Kaiser Permanente.
Meanwhile, a combination of high caseloads and sagging morale sparked a union drive among some frontline staff, who are trying to persuade their co-workers to sign up with the American Federation of State, County and Municipal Employees.
Finally, Cascadia is in ongoing discussions with the state Office of Payment Accuracy and Recovery over a Medicaid audit that identified $2.7 million in overbilling (down from an initial estimate of $3.4 million). Medicaid billing is a highly sensitive issue for the agency; filling out paperwork is time-consuming and distracts staff from spending time with clients.
At the same time, several Cascadia employees have told the Portland Tribune that they feel pressured to “fudge the numbers,” as one employee put it.
Anyone with questions about mental health services can call the county’s call center, 503-988-4888.
James Chasse discussed on OPB's Think Out Loud
LISTEN TO "Policing the Mentally Ill" (24MB MP3) - broadcast March 17, 2008
In September of 2006, a schizophrenic man named James Chasse died in police custody, sending shockwaves throughout Portland and the state. At the time, Mayor Potter promised an overhaul of the system that failed Chasse.
A year and a half later, the Mental Health Association of Portland is working on a documentary to make sure we never forget James Chasse, and Portland police are well into a training program designed to help avoid any repeat incidents. The Crisis Intervention Training program, which used to be voluntary, is now required for all current officers and a new law this year made this sort of training mandatory for all new police officers statewide.
Is this enough? What else needs to be done to ensure the inevitable interactions between law enforcement and the mentally ill are as positive as possible?
GUESTS:
Jason Renaud: Volunteer with Mental Health Association of Portland and former executive director for local National Alliance on Mental Illness chapters
Raul Ramirez: Executive Director of the Oregon State Sheriff's Association
David Zeiss: Coordinator of White Bird Clinic's "Crisis Assistance Helping Out on the Streets" (CAHOOTS) program
Help a Good Filmmaker Do Some Good
By Shawn Levy, The Oregonian, February 18, 2008
One of the greatest and most inspiring surprises for me last year was “Finding Normal,” a gripping and moving documentary by local filmmaker Brian Lindstrom, who went deep into the world of recovering addicts and turned up an amazing fly-on-the-wall portrait of the addicts and the peer mentors who help them find a new path in life through a downtown Portland program.
Well, Lindstrom has set his sites on another story set on the local streets: the case of James Chasse, a troubled 42 year old who was effectively beaten to death in September, 2006, in broad daylight on a Pearl District corner by three Portland cops. The Chasse case has been a real lightning rod for critics of the training and technique of police officers, particularly in their encounters with the disenfranchised and/or disturbed. (You can read details of the incident and the shockwaves it produced here.)
Lindstrom has begun work on “Alien Boy,” a documentary about Chasse’s life and death and the issues his killing has raised, and, being a virtual one-man show operating on a not-even-shoestring budget, he could use a hand. It seems to be a perfect marriage of artist and subject matter, and you could feel pretty good about yourself if you visited the film’s web site and donated money or support or even helped tell other folks about the project.
The word you’re looking for is mitzvah.
Welcome From the Inside Out
The Mental Health Association of Portland is proud to announce its new association with the Portland-based theatre company, From the Inside Out.
From the Inside Out has been providing interactive theatre productions for the past two years focusing on issues important to people with mental illness.
Interactive theatre comes from a method taught by Augusto Boal (pictured) in his Theatre of the Oppressed, which invites spectators into the play to solve problems and respond emotionally to the content presented by the actors.
The Mental Health Association of Portland will act as a fiscal agent for From the Inside Out to assist in raising funds and awareness for the program.
You can learn more about From the Inside Out on their web page.
Upcoming presentations by From the Inside Out will be listed on the EVENTS page of this web site.
Film will examine Chasse's life, death
Documentary - "Alien Boy" deals with the case of James Chasse Jr., who died in police custody
From The Oregonian
The Mental Health Association of Portland will be working with a Portland filmmaker to produce a documentary about the life and death of James P. Chasse Jr.
The title, "Alien Boy," refers to a song written by a friend of Chasse, Greg Sage, the lead singer of The Wipers band. As a young teenager, Chasse described The Wipers as "my fave local band" in a magazine he wrote called "The Oregon Organism."
Sage dedicated the lyrics from his 1979 song "Alien Boy" as a memorial to Chasse, a 42-year-old man who died in police custody Sept. 17, 2006. Chasse, who suffered from schizophrenia, died of broad-based trauma to his chest after police struggled to take him into custody in the Pearl District.
Sage's lyrics are: "Go and grab your gun; Got him on the run; Cause he's an alien; They hurt what they don't understand."
The association will work with Portland filmmaker Brian Lindstrom to make the film, and follow the family's civil case against the city and police.
The federal lawsuit, pending in U.S. District Court in Portland, contends that the officers involved violated Chasse's civil rights and that the city has a pattern of failing to discipline officers involved in use of deadly force.
Lindstrom has made two other documentaries, called "Kicking," about drug detoxification in Portland, and "Finding Normal," about recovery from drug addiction, also made in Portland.
"Our hope is to create a film powerful enough to persuade other cities to make the changes Portland did after James died -- before someone like James in their hometown dies," said Jason Renaud, a friend of Chasse's and a volunteer board member of the mental health association.
The film's Web site lists the following positive changes made since Chasse's death: the requirement that all Portland officers complete 40 hours of crisis intervention training; Multnomah County's call for a sub-acute center to treat people suffering from a mental health crisis; and changes to the Portland Police Bureau's Use of Force policy that encourages officers to use the "least force reasonably necessary."
More information about the film can be obtained at the Web site: www.alienboy.org. All donations to the Mental Health Association of Portland this year will go toward the production of the film.
"Only a full, public account of who James was and what happened to him can prevent another tragedy," the film's Web site says.
Milwaukie faces $300,000 suit
Court - Advocates for the disabled say the city broke laws by blocking plans for a group home
From the Oregonian
Neighbors hailed Milwaukie leaders as heroic for subverting plans to open a group home for mentally ill criminals, but advocates for the disabled called the actions illegal and are suing the city for $300,000.
When city officials maneuvered behind the scenes to buy property proposed for the home, they not only broke fair housing laws, but they also delivered an unkind message, said Bob Beckett, executive director of Columbia Care Services. "They said: 'If you're disabled, you're not welcome here.' I don't think that's how most of the citizens of Milwaukie feel."
Beckett said Oregonians should care about the case because it tests whether a city can prevent people with mental disabilities from living where they choose.
The lawsuit alleges violations of the Federal Fair Housing Act and the Americans with Disabilities Act. In addition to asking for money, the suit asks the court to order the city to sell the property to Columbia Care or, if that's not feasible, to pay the additional expense for Columbia Care to purchase another property.
Milwaukie Mayor Jim Bernard (pictured above) said the city acted legally and will win in court. He and other city officials declined to comment further except to add that the city supports people with disabilities, has fought for them in the past and had no intention of offending them.
The case arises from 2007, when Columbia Care, then known as Oregon Regional Behavioral Services, planned to buy a residential property at 2808 S.E. Balfour St. to build a 15-bed group home. Prospective residents could include people found guilty except for insanity of crimes that could range from trespass to murder. The home would be locked and staffed 24 hours.
Columbia Care officials and advocates for the mentally ill said the facility was safe and would not reduce property values.
But neighbors were skeptical, and some were upset, calling the proposed home a threat to themselves or their children. More than 150 people attended an Ardenwald-Johnson Creek Neighborhood Association meeting in November to discuss the project.
READ - Columbia Care County V City of Milwaukie, lawsuit filed by Oregon Advocacy Center (PDF)
County Boss Soul Searches on Mental Health Center
From The Portland Mercury - 1/24/2008
County Chair Ted Wheeler met with 60 mental health advocates last week to confess his disappointment over the county's ongoing failure to reopen Portland's sub-acute facility for people in mental health crisis.
Since the closure of the crisis triage center in 2003, cops have had no option but to transport people in such crises to jail or, if they've hurt themselves, to an emergency room.
Reopening a sub-acute facility was the number-one recommendation of Mayor Tom Potter's Mental Health/Public Safety initiative formed in the fall of 2006, following the death in police custody of James Philip Chasse Jr., a 42-year-old schizophrenic, in September of that year.
Since then, Potter has funded crisis intervention training for all the city's police officers to the tune of $500,000, and Police Chief Rosie Sizer has overhauled the cops' use-of-force policies to hold officers more accountable over allegations of excessive force. Meanwhile Wheeler, who took over from Diane Linn as county chair in early 2007, hasn't held up the county's end of the public safety bargain.
Chasse's parents sat intently in row six of a 60-strong audience last Friday evening, January 18, at the Trinity Episcopal Cathedral on NW 19th. Wheeler, half-protected by a modest wooden lectern, faced the crowd, which included three county court judges, the head of the state's psychiatric review board, and the heads of two local mental health treatment centers.
He began by justifying his decision last October to vote against a proposal to fund the sub-acute facility by diverting $4 million of county subsidies from Gresham, County Commissioner Lisa Naito's idea ["Less Than a Crisis?" News, Nov 1]. Wheeler said the Gresham money is used to fund essential police services there, and that he did not believe in solving one crisis by creating another.
He also announced plans for an experimental, county-funded Mental Health Court, beginning some time in late spring. The court, which was explained to the group by Multnomah County Circuit Court Judge Julie Frantz, will aim to offer a choice of treatment to those with psychiatric needs who are caught up in the criminal justice system.
In the first year, the Mental Health Court aims to divert up to 100 people into treatment, according to the county's director of mental health and addiction services, Karl Brimner. Brimner insisted the treatment services for those people are funded and ready to go, although he faced doubt from the audience about the on-ground availability of those services.
Then the tough questions started. Wheeler was asked how satisfied he is with the state of mental health services in Multnomah County, right now. He responded by mentioning the county's new crisis hotline—a 24-hour phone service for people to call a mental health responder if they're worried about someone in crisis. But he confessed to frustration with the state legislature's refusal last spring to fund the ongoing cost of running the sub-acute center to the tune of $3 million a year—despite his promise to build it with $2 million of one-time county money.
Wheeler was asked when the sub-acute center would be open.
"I think it would be irresponsible to state a date," he said.
He was asked whether he would have failed as county commissioner if the center does not open by the time he's up for reelection in 2010.
"No, I don't think I'll have failed as county chair," he said. "We've done a lot of talking about the importance of this center, but it's not just about me. If we're still talking in three years about how we're going to fund the biggest gap in mental health, that's not just a gap for me, it's a failure for the entire community. There's going to be a lot of disappointment to go around."
While continuing to lobby Salem for the money to run the center—alongside mental health advocates and representatives from Washington and Clackamas Counties—Wheeler is also considering putting a public safety levy on Portlanders' election ballots this November.
Such a tax would require three votes from Wheeler's board of county commissioners and a public hearings process. Voters approved similar levies for schools and libraries last May, but his office will delay a decision on the new tax until late spring.
"Multnomah County voters have shown a willingness to support well-planned ideas," says Wheeler's communications director, Rhys Scholes. "I think that a lot of people understand the depth of this problem."
In the meantime, there's still no sub-acute center, but advocates are hopeful.
"Wheeler is ambitious, optimistic, dynamic, and has a strong personality," said Jason Renaud of the Mental Health Association of Portland, after the meeting. "The question is, can he get enough people on the bus with him to Salem to make the difference?"
READ - DEPT OF JUSTICE INVESTIGATION OF THE OREGON STATE HOSPITAL (PDF 2.6 MB)
Feds: Oregon State Hospital violates patients' safety, rights
From The Oregonian - 1/15/2008
Care and conditions at Oregon State Hospital violate patients' safety and their constitutional right to good care, said a U.S. Department of Justice report released Wednesday, Jan. 16. Federal reviewers documented widespread problems after visiting Oregon State Hospital campuses in Salem and Portland in November 2006.
Issues included patient-to-patient assault, repeated suicide attempts by patients who were supposed to receive one-to-one monitoring, and questionable use of restraint and seclusion to control violent or suicidal behavior.
READ THE DOJ INVESTIGATION OF THE OREGON STATE HOSPITAL (2.6 MB PDF)
Other problems, the report said, included improper medication and disease control procedures and inadequate planning that delayed patients' recovery and discharge.
The director of the state Department of Human Services and the president of the Oregon Senate characterized the findings as damning.
"This is the worst report I have ever seen regarding any state program or services -- without a doubt," said Senate President Peter Courtney, D-Salem. He announced that he will chair a legislative oversite committee to determine whether conditions at the state hospital are safe for patients and staff to remain.
The Justice Department warned state officials that the U.S. Attorney General "may initiate a lawsuit" to correct deficiencies. But it also says the feds would prefer to "resolve this matter by working cooperatively with the state."
More on the DOJ report on the Oregon State Hospital
EXTRA - Report reveals horrors, EastOregonian.info, January 18, 2008
EXTRA - Federal report blasts psychiatric hospital, Salem Statesman Journal, January 17, 2008
EXTRA - Feds slam state hospital safety, Oregonian, January 17, 2008
EXTRA - Bungled drugs, inadequate treatments, Oregonian, January 17, 2008
EXTRA - Health, safety violations cited at state hospital, AP, January 17, 2008
PR SPECIAL - State hospital one step away from gold standard seal of approval, Bend Weekly, January 8, 2008
Cascadia nailed by Medicaid audit
from the Portland Tribune, December 28, 2007
Overbilling questions, county format change among financial woes
Cascadia Behavioral Healthcare, the biggest provider of mental health treatment services in Oregon, may owe the government up to $2.7 million for overbilling Medicaid, the health insurance system for the indigent and disabled.
Investigators at the Oregon Department of Human Services identified the potential overbillings in a preliminary audit, and now are engaged in negotiations with Cascadia over the precise amount to be repaid, according to DHS spokesman Ken Palke.
At press time, no one at Cascadia was available to discuss details of the audit, which was performed by the state Office of Payment Accuracy and Recovery. But Palke confirmed that the nonprofit is on the hook for as much as $2.7 million unless it can persuade state regulators that its Medicaid billings were proper.
The Medicaid audit is the latest in a series of financial blows for Cascadia, which suffered through an acute budget shortfall this fall.
Money was so tight that the nonprofit suspended direct deposit for employee paychecks, received shut-off notices from utilities, and at one point owed $325,000 to its own health insurer, Kaiser Permanente.
In the scramble to stay afloat, Cascadia slashed dozens of positions and halted new client intakes. Several high-level executives departed.
“We did go into a cash-flow crisis,” Cascadia CEO Leslie Ford (pictured here) said last week in her Northeast Portland office, her desk swamped with paperwork. “We sweated making payroll.”
Nonetheless, Ford said, the agency managed to survive the autumn crunch without cutting services, thanks to a cash infusion from Multnomah County totaling nearly $500,000.
Cascadia, which has an annual budget of $60 million and some 1,400 employees, provides a wide range of mental health services in Multnomah County. It maintains a walk-in clinic and provides housing, case management and outreach services.
Last year, Cascadia served 23,000 clients statewide, and it is by far the biggest such provider in Multnomah County, treating 75 percent of the county’s low-income residents who have mental illness.
Cascadia’s earlier cash-flow problems surfaced last summer, when the county changed its reimbursement system.
During the transition, Cascadia submitted hundreds of thousands of bills that the county’s computers kicked out because they were in the wrong format, according to Karl Brimner, director of the county’s Mental Health and Addiction Services Division.
Due to a glitch in Cascadia’s computer system, however, the nonprofit did not realize those bills had been rejected.
Meanwhile, Cascadia was forced to quit accepting new clients in August because average caseloads were too high — at one point hitting 75 per caseworker, far above the government maximum of 50.
“Our concern was that the high caseloads could affect the quality of services,” Brimner says. “If a counselor has too big a caseload, they may not be able to see clients as often as they should.”
The crisis grew so acute that by mid-October the agency’s new chief financial officer, Scott Dickison, quit after one week on the job.
“I literally walked in on Monday morning and learned there was a strong likelihood they wouldn’t make payroll that week,” said Dickison, who promptly returned to his old job as an executive at Regence of Oregon.
The outlook for Cascadia brightened last month, when the county agreed to repay the agency for the bills that initially were rejected, easing the cash crunch. So far, the county repayments have amounted to $466,000, with more potentially on the way.
In addition, the agency reduced its average caseload to 50 and now is accepting new clients.
The impact of the Medicaid audit is unclear, but it clearly represents a potential setback. “I can’t really comment,” said Judy Watson, Cascadia’s chief operating officer. “We remain hopeful that we’ll be able to arrive at a solution that will work for Cascadia and meet Medicaid requirements.”
County looks for partners on triage unit
Need for subacute center is a given; who will fund it is not
Portland Tribune, 12/21/2007 - A mayor’s mental health task force early this year said it was something the community direly needs — a place where potentially dangerous mentally ill people could be taken and treated, rather than to jails and emergency rooms, where they often don’t belong.
A county public safety task force is set next month to cite the same need as dire.
But almost a year after the mayor’s task force recommendations — and almost seven years after the last such mentally ill “triage” center in Portland was closed — community leaders seem to have made little progress on figuring out how to create or pay for such a center.
Multnomah County Chairman Ted Wheeler (above) says he’s ready to take yet another run at it.
Wheeler says he’s appointing a small work group to begin meeting early next month that will move beyond the settled question of whether such a center is needed — and “hammer out a plan to get this done.”
But while the group may have a hammer, it won’t have a cash register.
And that may be a problem.
The mayor’s task force and county officials have said such a center could cost $500,000 to $1 million to set up — and $2.9 million a year to operate. Those numbers would be for a 16-bed center, where people could be treated for four to eight days or so and released.
And no one has identified which governmental entity, or combination of entities, might come up with those operational costs every year.
Police often put in middle While most local governmental mental health services are paid for by or through the county, it’s unlikely that the budget-challenged county would be able to pay for the yearly costs alone, Wheeler said. Commissioners cut millions from last year’s budget.
Wheeler said county officials are considering forwarding a public safety levy inext fall, “and it’s very possible we could include programs like this in that levy.”
But beyond that possibility, Wheeler said, “I think at the end of the day, you’re going to see a partnership between the state, the city and the county — and that’s part of the work that needs to be done.”
City officials have not been exactly forthcoming about offering help, however.
Maria Rubio, the public safety adviser to Mayor Tom Potter, said that while “it’s very important to the city that this happen,” both the City Council and the county board of commissioners are beginning their budget processes — “which will determine where it is in terms of priorities, for both.”
What no one disputes is the need for what city and county leaders are calling a mental health “subacute” center.
The problems caused by mentally ill people in medical crises — people who aren’t getting or taking the medicine they need — are seen every day by people on the street, county officials say. And police officers, especially, are being put in an “untenable position … to double as mental health service providers,” Wheeler said.
Often, police officers take the people to jail or hospital emergency rooms — places that seldom can really help them.
And sometimes, in specific cases, the underlying issue explodes into public tragedy.
The city’s mental health task force was created late in 2006 by Potter after the controversial death of James Chasse Jr., in September 2006.
Police thought they saw the 42-year-old Chasse, who had schizophrenia, urinating in public. When Chasse ran from them, they gave chase, tackled and subdued him — which some observers said they did too aggressively.
Chasse died within hours. An autopsy report attributed his death to massive internal trauma, including the fracturing of almost all of his ribs.
Chasse’s family has filed a lawsuit, asserting that police aggressiveness and later neglect led to his “inhumane and tortured death.”
More recently, in August this year, a Scappoose man who had schizophrenia died of suffocation after workers at Legacy Emanuel Hospital restrained him by forcing him onto the floor of the hospital, and held him there for at least 10 minutes.
The circumstances surrounding the man’s death were reported in the Portland Tribune earlier this month.
Center part of ‘safety net’ Mental health experts say that many potentially violent or confrontational situations could be alleviated by mentally ill people in crisis being taken to an appropriate place — such as a subacute center, where they could be given needed treatment for a few days and then released.
The county helped pay for a somewhat similar facility — the Providence Crisis Triage Center, attached to the Providence Portland Medical Center in Northeast — that closed in 2001 after the county diverted its funding elsewhere.
“Every community really needs a mental health safety net, and we have some parts of that safety net,” said Joanne Fuller, head of Multnomah County’s Department of County Human Services. “But the subacute is the part of that safety net that’s missing.”
The subacute center might not be a new or stand-alone center. Wheeler said one idea would be to attach it to an existing alcohol or drug detox center.
Fuller suggested people can be made to feel more comfortable in subacute centers than they often are in hospitals.
“A subacute center can feel a lot more homey than a hospital,” she said. “It can feel less threatening.”
County Commissioner Lisa Naito has advocated for a subacute center for years, and she said she believes the center could pay for itself — because the county would save the sometimes $700 per day per patient payments it must make to hospitals when some people get mental health treatment there.
But, Naito acknowledged, “money is definitely an issue, and I’m concerned about that.”
Money issues could mean the opening of the center won’t be any time very soon. County officials said it could be mid-2009 or later before a financing plan for the center could be complete.
Young woman dies after jumping from DHS van
This is a press release courtesy of the Oregon State Police, 12/16/07
An 18-year old female patient from Blue Mountain Recovery Center died Thursday from injuries she received after jumping from a moving Department of Human Services van and being struck by another vehicle on westbound Interstate 84 in the Pendleton area.
On December 13, 2007 at approximately 4:50 p.m. Heather N. Williams, age 18, from Veneta, was being transported in a Department of Human Services (DHS) van westbound Interstate 84 near milepost 205. The van, driven by DHS employee John L. Jones, age 51, from Pendleton, was westbound in the right lane when Williams reportedly unsecured her safety restraints, opened the van's door and jumped out onto the left lane.
Jones immediately pulled onto the right shoulder, stopped and got out of the van. He saw Williams trying to get up and ran to help get her to safety from the highway. As Jones was getting to Williams, they were struck by a westbound 1995 Ford Explorer driven by Joseph Paul Merriss, age 50, from Beaverton.
Williams was transported to St. Anthony's Hospital where she died after arrival. Next of kin have been notified.
Jones, who was accompanied in the van by another DHS employee at the time of the incident, was transported by a DHS employee to St. Anthony's Hospital where he was treated for a minor injury.
Merriss was not injured.
The Oregon State Police is completing the investigation with the assistance of the Umatilla County District Attorney's Office. No additional details are available.
Report on Shipman Death Revealed by Portland Tribune
Terrific investigative work by Peter Korn of the Portland Tribune sourced a report from the State Department of Health and Human Services on the death of Glenn Shipman at the hands of employees of Legacy Emanuel Hospital and their contractor CareMark Behavioral Health Services.
READ - Patient dies after being restrained • Hospital says cardiac arrest; medical examiner says asphyxiation • Feds: Legacy Emanuel doesn’t meet safety rules; probe continues, Portland Tribune 12/4/07
READ - Hospitals rarely tell all - Legacy death highlights reluctance to admit medical mistakes, Portland Tribune 12/7/07
READ - REPORT ON GLENN SHIPMAN from DH&HS, completed 10/3/07 (PDF 1.8 MB)
Major Shutdown for Multnomah County Mental Health System
November 19, 2007
Dear Mental Health Provider,
In the last 4 months (July – October 2007) Adult Verity Plus claim payments have increased to the degree that we will exhaust our funding well before Fiscal Year end. Therefore, it is necessary that new authorization requests submitted as of December 1, 2007 will be limited to individuals with a Severe Mental Illness assessed at a LOCUS 3 or 4 level of clinical need. In addition, they must have just been discharged from a psychiatric hospital or correctional facility or are in danger of losing custody of their children. Re-authorizations for currently authorized members will be reviewed on an individual basis. Furthermore, Multnomah County will no longer process Verity Plus 60-day authorization requests. Adult Verity Plus authorizations are for a 12-month time period and children Verity Plus authorizations are for a 6-month time period.
As a reminder, in order to serve as many Multnomah County residents as possible, it is necessary for each provider to make an effort to get individuals covered by Medicare and/or Medicaid within the first six months of Verity Plus coverage.
We anticipate that this measure will bring our expenditures into line with the available funding at which time hopefully we will be able to expand services once again to the larger population.
This applies to Adult Verity Plus requests only and does not affect Children’s Verity Plus, which is funded by a separate and specific revenue source.
Sincerely,
Keith Mitchell
Business Manager
Mental Health & Addiction Services
Cc: Karl Brimner, David Hildalgo
Read a facsimile of this letter DOWNLOAD HERE.
Death of Scappoose man questioned
Portland police, hospital officials have been slow to explain the events leading to the cardiac arrest of Glenn Shipman
The South County Spotlight, Nov 13, 2007
Questions linger for family and friends of a Scappoose man who died while in the custody of Legacy Emanuel’s psychiatric division in August, though the mother of the man has ruled out police Taser use as a cause of his death.
“The Scappoose police, their actions had nothing to do with it,” said Elaine Shipman of Scappoose.
Elaine, 76, said she arrived at her conclusion regarding the Taser and her son’s death based on information contained within the Multnomah County medical examiner’s report.
Exactly what did happen to Elaine’s 50-year-old son, Glenn Shipman, that led to his cardiac arrest and death remains unclear.
Legacy Emanuel Hospital staff and Portland police officials have made little effort to reach out to Shipman’s mother, who began to doubt whether her son’s death was being investigated as was stated in early media reports.
When first contacted by the Spotlight in mid-October, more than a month after Glenn’s death, Elaine had not been contacted by the Portland Police Bureau, and had received only one telephone call following Glenn’s death from a nurse with Legacy Emanuel who offered to send flowers, Elaine said.
“Nobody has said anything,” she said.
Don Reese, a Multnomah County deputy district attorney, confirmed that it is an open investigation being headed by Detective John Rhodes of the Portland Police Bureau. Rhodes said he is currently reviewing Glenn’s medical records obtained from Legacy Emanuel through a district attorney subpoena.
“That’s where we’re kind of at, is just gathering as much information as we can about the case,” Rhodes said. “You can’t focus on anything in particular until you have the information.”
The police are handling the investigation at the request of the Oregon Medical Examiner’s Office, Rhodes said. The police report into Shipman’s Aug. 26 death is being held confidential as the investigation continues.
Elaine said that she received a telephone call from the hospital informing her Glenn had suffered a cardiac arrest nearly a day after it had occurred.
The news was shocking on several levels, including the revelation that injury had befallen her son while he was housed within the assumed safety of a hospital environment.
“That was part of how shocking it was,” she said.
Upon receiving the call, Elaine traveled to the Portland hospital with Jim Marud, a family friend.
Elaine hesitates to speculate on what might have caused Glenn’s death, and said she does not want to force the hospital or police into a defensive posture.
“We’re trying to work with the hospital, and I don’t want them to get defensive or anything,” she said.
Glenn was on life support and had no brain wave activity when Elaine and Marud arrived at the hospital.
Elaine said she and Marud spoke with the attending doctor while standing at Glenn’s hospital bedside. The doctor provided few details about the events leading up to Glenn’s cardiac arrest, she said.
“The only thing he said was that Glenn was very agitated and the security staff was called in, and then he said that Glenn had a cardiac arrest and stopped breathing and they weren’t able to revive him for 20 to 25 minutes,” Elaine said. “He didn’t give any details. Needless to say I was very stressed at the time, because they didn’t call us until practically a day had gone by.”
Elaine said that one possibility for why the hospital was slow to call was because Glenn was angry at the family for having been returned to the hospital.
A Legacy Emanuel spokeswoman said the hospital is prohibited from commenting on the cause of Shipman’s death due to restrictions outlined in the Health Insurance Portability and Accountability Act, a 2003 piece of broadly interpreted federal legislation that trumps disclosure of just about anything on anybody when it comes to medical records.
“In general, we have full disclosure about patient outcome with patients and their families,” the spokeswoman said.
History of caring, anguish Glenn, who is a diagnosed schizophrenic, had been staying at his mother’s house because of his mounting feelings of paranoia he felt while living by himself in a Scappoose apartment.
Elaine said he had started to believe his medication was poison and that he had stopped taking it. He had also stopped eating regular meals and was living on popcorn and canned soup, she said.
“I had him stay here because I just didn’t feel he was safe to be alone,” Elaine said. Marud said the illness contradicted Glenn’s outward demeanor. He was a calm, gentle soul, Marud said, and was referred to by friends and family alike as a “gentle giant.”
“He was really a gentle soul, he really was,” Marud said. Glenn had attended a Bible study class taught by Marud, though the relationship between the two was mostly one of friendship.
“I met him at the church we attend, and he was just a really neat, good guy,” Marud said. “It was really, more than anything, just a friendship that we had.”
Marud recounted stories of Glenn sharing Christmas with him and his family, and that they held a large homecoming celebration, complete with a singing quartet, for Glenn after his release a couple of years ago from the psychiatric ward at Legacy Good Samaritan Hospital.
On the basketball court, his gentle touch translated into easy shots from three-point distance.
“He was a great big guy and kind of slow moving, but he could drain them from downtown,” Marud said of the 450-pound Glenn. On the football field, his demeanor was one of protector, not aggressor.
He was also a man of intelligence, Marud said, recounting how Glenn had a special knack for electronics.
“The guy was just way off the charts brilliant when it came to stuff like that,” Marud said. “He struggled mightily, but for a person who had such mental anguish from time to time, he dealt with it maturely, I think, and very carefully.”
On the evening of Aug. 23, Elaine called for Scappoose police assistance when Glenn began to act agitated at her house.
When police arrived, they discovered Glenn threatening to turn the power off to the house. But because he didn’t pose a threat to himself or others, the police determined, there was insufficient cause to take him into custody and they left.
A case worker from Columbia Community Mental Health called for Scappoose police assistance a second time at 10:20 p.m. This time, when police arrived they discovered Glenn acting combative.
Scappoose police Sgt. Doug Carpenter fired a Taser stun gun at Glenn, who responded by yanking the Taser prongs out of his chest. Officer Shaun Barrett fired a second Taser shot into Glenn, who wavered on his feet. While he was off balance, police tackled him and took Glenn into custody.
He was evaluated by paramedics prior to being transported to the hospital in a squad car
Before departing, Elaine said she heard Glenn tell the police officer that he was sorry for causing a problem.
“I heard him say, I don’t want to hurt anybody, and the one officer said, I know you don’t,” Elaine said.
Elaine said she is hoping the truth comes out about the circumstances leading to her son’s death, not for the sake of vendetta, but to help protect others from experiencing a similar fate.
“I just want, like the lady who started MADD to protect other people from what happened to her daughter, and not so much a vendetta or anything like that, because that won’t bring him back anyway,” she said.
BREAKING NEWS: City Settles For Record Half Million Dollars In Cop Shooting Case
from The Portland Mercury November 8, 2007
The City of Portland has agreed to a record $500,000 settlement over an officer involved shooting, according to attorneys working for the dead man, Ray Gwerder’s, family.
On November 4, 2005, Raymond Gwerder, 30, was “drunk and despondent,” holding a handgun in the backyard of a friend’s house where he had been staying on NE 118th, when a police officer trained in crisis intervention managed to get through to his cell phone. As Gwerder was talking with the negotiator, and about to go inside the house, he was fatally shot in the back without warning by police sniper Leo Besner.
This is the highest settlement the city has ever made in an officer involved shooting, behind $600,000 paid to the family of Damon Lowery in 2005 following his alleged asphyxiation by 6 full cans of pepper spray and a 180lb officer standing on him for more than two minutes in 1999, and $845,000 paid to a collective of protesters in 2004 following officers’ excessive force at anti-Bush protests in the city in 2002 and 2003.
The settlement now needs to pass through city council for a vote next week before being finalized.
Before he died, Gwerder, 30, was completing his final courses at PSU to earn a bachelor’s Degree in Biology. From civil rights attorney Tom Steenson’s office:
“Ray was this wonderful, sensitive, brilliant man, who was just experiencing a moment in his life where he really needed some help,” Molly Aleshire, a long time friend and roommate, says. “Ray had the kind of solid integrity where you could always trust him to do the right thing, no matter what. He was one of the most insightful, and intuitive people I’ve ever known.” Evidence from the scene of the tragedy exposed an extremely flawed police operation. Besner claimed his fatal shot at Gwerder was justified by danger to Gwerder’s neighbors, yet the police failed to evacuate nearby neighbors over the 90-minute period prior to the shooting. In addition, when Besner shot him in the back, Gwerder was in mid-conversation with the police negotiator and was calmly complying with the negotiator’s requests.
Several minutes after Gwerder was shot, a police officer at a post 100 feet away from him heard him crying out in pain, but Portland Police failed to provide him with critically needed medical attention. Files also show that police left Gwerder lying on the ground dying for 20 minutes. Although they tasered him – despite the fact that he was not moving and the gun he had possessed was in plain sight, away from his body – the police did not allow paramedics to treat Gwerder prior to his death.
More from Steenson’s office:Gwerder’s family and friends say the most disturbing aspect of the case remains the fact that officer Besner continues to work as a Portland police officer. They point out that evidence shows Besner fired the fatal shot within minutes of his arrival and without first consulting with the lead police negotiator or the police commander at the scene. The commander on the scene that day, East Precinct Cmdr. Mike Crebs, told investigators that when Besner shot Gwerder, “’The shot just came outta nowhere … . I thought we were talking to the guy.’” Previous complaints against Besner have included tasering a man who was attempting to restrain a woman who had been threatening people with a knife in 2002; pepper-spraying an anti-war protestor standing on a sidewalk with a sign in March 2003; and slamming a 15-year-old, who had been standing on the sidewalk reading a newspaper, into a wall in April 2003. Besner’s 13-year tenure on the Portland Police is known to have already left city taxpayers with settlement tabs totaling about $1 million for the cases in which he has been involved.
“While we are relieved that Portland has agreed to settle the case, there is no end to our loss,” said Bobbie Jo Clark, Ray’s sister. “We remain gravely concerned that after so many complaints about Besner and my brother’s death at his hands, Besner still not only roams the streets of Portland, but with a badge, an arsenal and apparently the unending support of his department. The continued employment of Besner by the City of Portland led to the wrongful death of my brother. We can only hope and pray that no other person will suffer the loss of a loved one in the future due to the City’s failure to terminate officer Besner.”
Besner was commended as recently as March by Central Precinct Commander Mike Reese, for taking a gun from a hostile crowd after the March 18th peace march turned ugly. Besner was working mounted patrol at the time. Police Public Information Officer Brian Schmautz says he cannot comment on litigation matters.
The mayor’s office declined comment and referred the Mercury to Linda Meng in its office of risk management. Meng was out of the office. We were told “the other person you could talk to is also out.” Deputy City Attorney David Woboril, to whom we were eventually referred, had a full voicemail box.
While it must be hard for Mayor Tom Potter to stay silent in this case with blood on his hands, it’s ultimately a financial consideration: Talking honestly would cost the city money. And true leadership, it seems, would, too.
UPDATE 1:17pm: Dan Handelman of Portland Copwatch says: “Officer Besner seems to have a propensity towards violence and he probably should not be a police officer anymore given the history of all the things we have seen here.
“Your blog post doesn’t mention Besner was involved in at least two shooting incidents in 1999. One was where a guy apparently committed suicide, Richard Lynn Smith in August 18 1999, and the other was somebody whose name was July 21 1999, Brown, but we don’t know any details about that case, unfortunately. The IPR only gave us a list of the last names of the suspects and the last names of the cops being investigated for the PARC report, but that is all we know.
“Those shootings were a few weeks apart,” says Handelman. “To me, it says Besner finds it easier to resolve situations with violence than to try to use non-violent means. And the fact Gwerder was shot while a hostage negotiator was talking to him is very disturbing.”
“In August 20 of this year, Lesley Stewart was shot at in SE Portland while on the phone to a hostage negotiator. We wrote a letter to the District Attorney after he declined a grand jury hearing, urging him to have one, but it didn’t happen, I think because the DA didn’t feel the public pressure to hold one.”
“We don’t know whether Besner is going to be fired. The police should rely less on deadly force—after all, they train these snipers to kill people.”