Oregon slow to deal with troubled facilities for troubled kids

From the Oregonian, December 20 2008

Authorities knew of problems at two institutions that house Oregon’s most troubled children: Kids getting the wrong medication; workers with criminal records; a teen with a broken collarbone after a fight with staff; and unsupervised mentally ill youths.

Pendleton Academies Board of Directors Top Row (right to left): Justin Burns, Albert Baxter, MD, Leo Stewart Bottom Row: Tim Mabrey, Daniel Marier, MD, Susan Neal, Laurie Drop

Pendleton Academies Board of Directors Top Row (right to left): Justin Burns, Albert Baxter, MD, Leo Stewart Bottom Row: Tim Mabrey, Daniel Marier, MD, Susan Neal, Laurie Drop

But instead of closing the institutions, state licensing officials spent several months warning the Kirkland Institute near Burns and the Pendleton Academies in eastern Oregon.

It was only after authorities feared that children were in danger that they cracked down and blocked new admissions. At Kirkland, for instance, another teen in state protective custody was taken to the emergency room after a run-in with staff. At Pendleton, a 17-year-old was charged with raping a 13-year-old girl.

Why did the state wait months to act?

The answer is complicated and may be considered by the Legislature next year.

Few places in Oregon — especially rural Oregon — will take in kids with severe behavioral or mental health issues, and officials worried there would be nowhere else for these children to go.

Also, Oregon has only two licensing specialists to oversee 240 so-called private child caring agencies — a category that includes everything from boarding schools to mental health treatment centers.

Erinn Kelley-Siel

Erinn Kelley-Siel

Erinn Kelley-Siel, interim director of the state’s Children, Adults and Families Division, said she’s considering asking the 2009 Legislature to allow the state to levy fees in order to hire more staff and to grant the legal authority to impose civil penalties at the first sign of trouble.

“Short of suspending their license, we have no alternative kind of remedy,” Kelley-Siel said. “I think this could make a big difference in the lives of hundreds of kids.”

Typically, group homes, mental health treatment centers and other state-licensed child care agencies get a visit from a licensing specialist once every two years.

Rejected boys

It was during one of those visits that licensing coordinator Monika Kretzschmar discovered serious problems at the Kirkland Institute for Child and Family Study, where the Oregon Youth Authority sends boys and the Department of Human Services puts teen boys who have been rejected by family foster homes or other group placements.

Kretzschmar learned that some on Kirkland’s staff had criminal histories and others lacked the qualifications for their job. Neither the state nor Kirkland would discuss the specifics of those criminal histories with The Oregonian.

She also found medication logs indicating the boys did not receive their prescribed meds, were given another boy’s pills or, in one instance, a teen was taken to the hospital because staff gave him an accidental overdose.

Kretzschmar followed with a letter listing 19 corrective actions Kirkland must take to retain its license. A few weeks later, Kirkland named a new executive director.

“We’re trying to do everything we can,” Rich Streeter, Kirkland’s newly hired executive director told The Oregonian. “You’re talking about some of the most difficult kids in Oregon, and some of the most difficult to place. We’re making sure we’re providing them with a safe, secure environment when they’re here.”

But problems continued.

In September, the state received a report that a Kirkland employee broke a teen’s collarbone while trying to subdue him. An investigation by the state Office of Investigations and Training found that the actions taken by Kirkland staff constituted child abuse.

On Sept. 19, Erin Fultz at the Oregon Youth Authority e-mailed her supervisor: “I just feel uncomfortable with our youth staying there since there have been so many red flags over the last several months.”

Just before Thanksgiving, the state received a report of a Kirkland teen taken to the emergency room after a run-in with staff. That’s when state authorities closed Kirkland to new admissions and began finding places to move the 22 teens who were there.

A rare licensing move

It was a rare step. State licensing authorities said they’ve closed admissions on only half a dozen programs over the past five years.

The last boy was moved out of Kirkland on Thursday, Streeter said.

Kirkland is working with the state so that it can once again accept new admissions, he said.

Meanwhile, in Pendleton, the state Addictions and Mental Health Division informed Pendleton Academies on Nov. 17 that it intended to revoke the institution’s certification to provide psychiatric treatment.

Pendleton Academies treats girls and boys ages 5 to 18 who suffer from bipolar disorder, psychosis and other severe mental disorders.

State officials say they’ve worked with Pendleton to iron out problems since 2005. But last August, they warned Pendleton Academies it needed to improve in eight areas or lose its certification.

Among those areas: ensuring that children receive appropriate treatment for their psychiatric symptoms and that children get adequate supervision.

State officials said they were alarmed that police responded to at least 56 calls at the institution in the first six months of this year.

“Many of the incidents requiring police intervention involved child-to-child assaults resulting in an injury to one or both of the children,” notes an Aug. 20 letter from state officials.

The Pendleton Academies board replaced the executive director with Terry Edvalson, and state officials allowed the institution to continue operating.

“The staff has done a significant job in helping turn this place around,” Edvalson said.

But state officials said they could not overlook what occurred Oct. 27, when a 17-year-old male is accused of coercing a 13-year-old girl to have sex.

Employees had been told not to allow the two within 15 feet of each other, yet records indicate the boy and girl were unsupervised.

“The people who were responsible for supervision are no longer with us. They were fired,” Edvalson said.

Pendleton Academies can appeal to the state to be allowed to continue to operate. In the meantime, Edvalson said earlier this month that his staff was looking for suitable places to send the kids.

“You just don’t pull the plug,” he said. “Our kids are very fragile, and we need to get them out of here as carefully as we can so we don’t do them damage.”

Since the state DHS finally brought attention to these agencies, the front page of the Pendleton Academies web site has been pulled down, but the remaining pages show who is responsible for tanking this state and federally funded social service agency.

Here is a recent list of board of directors of Pendleton Academies from their web site.

J. Albert Baxter, M.D. (Board President) – �Psychiatrist, Private Practices

Susan Neal (Board Secretary/Treasurer)� – Community Volunteer

Justin Burns� – Attorney, Burns Law Office, LLC

Laurie Drop� – Executive Director, Bethphage

Tim Mabry – �Businessman and Family Representative

Daniel Marier, M.D.� – Internist, Pendleton Internal Medicine Specialists, P.C.

Mary Moore-Suever� – Executive Director, Pendleton Academies

Michelle Sitz� – March of Dimes Eastern Oregon Division Director, Community Volunteer

Jackie Smith, L.C.S.W. (Ex-President) – �Community Volunteer, Retired Social Worker, Eastern Oregon Psychiatric Center

Leo Stewart� – Confederated Tribes of Umatilla Indian Reservation (CTUIR) Board of Trustees Vice-Chairman

Here is a recent list of staff members of Pendleton Academies from their web site.

J. Albert Baxter, M.D. – Board President
Dr. Al Baxter, a psychiatrist in private practice, is the president of the Pendleton Academies Board of Directors. He is the Medical Director of the Eastern Oregon Alcoholism Foundation, psychiatric consultant to the Yellowhawk Clinic and the Eastern Oregon Correctional Institution, and is on the medical staff of St. Anthony Hospital.

Mary L. Moore-Suever, M.Ed. – Executive Director
Mary provides leadership, supervises directors and administrative staff, ensures compliance with current state and federal regulations and mandates, manages fiscal matters, and executes board policy and directions.

David Conant-Norville, M.D. – Medical Director
Dr. David Conant-Norville provides the overall direction for the treatment of all children at Pendleton Academies. He is a board certified child psychiatrist who serves as a clinical team leader during reviews for all children at Pendleton Academies. He practices in Portland, Oregon and is on the faculty of the Oregon Health Sciences University.

Gannett L. Pitkin, Ph.D. – Clinical Program Director
Dr. Gannett Pitkin is Pendleton Academies� Clinical Program Director. He is responsible for admissions for residential care and oversees and coordinates the entire clinical program, including the assignment of children to clinical staff and monitoring of the effectiveness of therapies He also coordinates the treatment elements of the education program with the therapeutic school staff.

Barry J. Grant, M.S. – Residential Director
Barry is responsible for assessment and stabilization admissions; overseeing residential care; and recruiting and training children�s treatment families.

Pat Blanchard, M.S. – Chief Financial Officer
Pat oversees the administrative support staff and the development of financial reports, and advises the Executive Director regarding financial and fiduciary matters. She also oversees the management of the Academies� data system.

Barbara Ceniga, M.Ed. – School Director
Barbara directs and oversees therapeutic school staff and operations, including the professional development of school staff, the oversight of curriculum, and the academic progress of Pendleton Academies’ students.

Terry Edvalson, M.S. – Project Development Director
Terry assists the Executive Director in carrying out the Board of Directors� capital and program improvement mandates and with other matters to ensure the financial stability of the organization.

Vincent Brunning, M.A. (Oxon), M.A., LPC – Cultural Coordinator & Psychotherapist
Vincent ensures every child�s cultural background is honored and cultural values and rituals are incorporated into their treatment plans.

Joey Bechtal, M.S.W. – An Employee of Umatilla County Department of Health and Human Services
Joey Bechtel is a knowledgable and talented social worker with the Office of Development Disabilities. represents an outside agency on the Pendleton Academies Leadership Team.

The board and staff at Pendleton Academies received significant technical and clinical assistance from the Beaverton-based child and family psychiatry clinic, Mind Matters, PC. Their partner physicians include Robert A. George, MD, David O. Conant-Norville, MD, Mary-Lynn Theel, MD, Marvin Rosen, MD, and Stewart S. Newman MD.

EXTRA – Restraint and Seclusion Data for Youth, 12 11 2008
EXTRA – Pendleton Academies site review by DHS, June 2006
EXTRA – America’s Mental Health: More than a State of Mind, by Mary Moore-Suever, former executive director of Pendleton Academies
EXTRA – Pendleton Academies Provide Rural Mental Health Care, OPB.org, March 2008
EXTRA – Mind Matters, PC