From 2020 to 2022, state officials repeatedly froze admissions to a children’s psychiatric center in Hamden following repeated reports of abuse and turmoil at the facility, including allegations of staff members kicking and spitting on a child who was under their care.
The state forced The Children’s Center of Hamden to stop admitting patients to its inpatient psychiatric facility four separate times, despite a dire need for inpatient beds.
The intake freezes lasted months, and officials cited the facility on many occasions for abuse and improper monitoring of children that led to dangerous situations, internal documents show.
The thousands of pages of emails and inspection reports reviewed by The Connecticut Mirror noted instances of staff members pushing a child into a bush, punching a child in the face and looking the other way as several children assaulted another patient in their bedroom.
As state officials questioned whether the facility was safe enough to house adolescents, including foster children under the state’s care, another question loomed: If the facility closed, where would the kids go?
The incidents speak to some of the larger issues with a mental health care system for kids in Connecticut that providers and experts say is bursting at the seams. State officials had to grapple with the tension between ensuring patients were safe and knowing that taking action would mean the state would lose desperately needed inpatient beds.
The two-year saga played out largely outside of public view during some of the worst months of the pandemic. But the episodes highlight the fragile nature of Connecticut’s safety net for children and how problems at one key nonprofit provider can have a domino effect on the entire system.
The Children’s Center of Hamden is one of five psychiatric residential treatment facilities — also known as PRTFs — in the state. They’re inpatient treatment centers for people under 21 years old who have serious mental health needs.
Its patients are among the most vulnerable in Connecticut — many are in the state’s foster care system and have experienced severe trauma. The facilities are largely funded through Medicaid reimbursements and state grants.
Since the pandemic, the number of children in need of mental health care and the severity of that need has soared. As admissions at The Children’s Center of Hamden stopped, the number of kids seeking care statewide overflowed. The Connecticut Children’s Medical Center in Hartford reported that children in mental health crises were overwhelming the emergency department.
Meanwhile, incidents at The Children’s Center of Hamden multiplied.
In January 2021, a child swallowed a screw in a suicide attempt, according to an inspection report. A staff member in May 2022 punched a child in the face. A child was given too much lithium, which is used as a mood stabilizer to treat mental illnesses such as bipolar disorder. Children ran away, and one stole a car from a neighbor at knifepoint.
“The state agencies are also prepared to pursue the closure of the facility if progress is not made,” wrote Bill Halsey, deputy Medicaid director at the Department of Social Services, in an email to other state employees on Sept. 2, 2022, nearly two years after the first incidents prompted an admission pause.
Several state agencies have a hand in overseeing the facilities, forming a complex web of regulations and inspection and reporting requirements. They’re licensed by the Department of Children and Families. The Department of Social Services oversees their Medicaid requirements. The Department of Public Health inspects the facilities. Agencies work together to conduct investigations.
The state cited the facility repeatedly for failure to properly monitor children, physical abuse from staff and improper use of restraints. They also weren’t reporting incidents correctly, according to state documents.
State officials’ concerns built up to a fear that there were inherent flaws built into the culture at the Children’s Center, and that the problems couldn’t be fixed.
“We are looking for DSS’s guidance as to next steps, as we do not believe the facility is improving or able even to maintain ongoing compliance,” Adelita Orefice, chief of staff at the Department of Public Health, wrote in an Aug. 19, 2022 email to DSS staff.
The facility faced steep challenges during the pandemic, as it navigated shifting health guidelines around COVID-19. It had leadership changes and, like many residential facilities, struggled with staff retention.
“You had the perfect storm,” said Jim Maffuid, who started as chief executive officer at The Children’s Center of Hamden in 2022. “Pandemic. Everybody scrambling and trying to figure out what to do.
“So the whole system was really challenged with lots of fast changes. At the agency here, there were also a lot of administrative changes.”
But state officials kept the trouble at the Children’s Center shielded from the public eye. Even parents who had children in the facility initially didn’t know about the admission freezes, according to officials at The Children’s Center of Hamden.
And top officials, including the commissioners of the Department of Public Health, Department of Social Services and Department of Children and Families, feared how the information would play out in public. They alerted Gov. Ned Lamont to the issues in 2020 because of “the gravity of the situation and potential media attention.”
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Publish date : 2024-08-31 22:00:00
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