The Hawaii State Hospital has sent two of its most violent patients to a special facility in South Carolina which costs about half as much as keeping the patients in Hawaii. But a key state senator said employees worried about continued beatings by patients want about a half dozen others to be sent away as well.
In January of 2006, State Hospital registered nurse Terry Evans reported being attacked by Curtis Panoke, a mental patient with terroristic threatening convictions, who had threatened to kill a nurse the day before.
"All of a sudden he just got up and became angry, blew up, took a swing towards me," Evans told reporters at a news conference in 2007, as she and other hospital employees called on State Health Department officials to do something about violent assaults on staff there.
Evans suffered painful injuries: broken bones and 26 stitches around her left eye.
Sources said the State Health Department eventually sent Panoke to Columbia Regional Care Center in South Carolina, the only private detention healthcare facility in the country.
State Sen. Clayton Hee has been investigating assaults on staff and other problems at the Hawaii State Hospital for the past six months.
"It's a mystery to me why in the face of an assault every three days, more patients are not considered for transfer to South Carolina," said Hee, the Senate Judiciary chairman who co-chaired investigative hearings into the hospital with State Sen. Josh Green, a physician who chairs the Senate Health Committee.
State health officials won't reveal the names of mental patients sent out of state or when and why they were transferred, saying they are "… unable to provide or confirm any individual's involvement or treatment history related to mental illness or drug abuse due to strict federal and state laws that protect confidentiality."
Sources said another Hawaii mental patient, Michael Lawrence, was sent to the South Carolina facility after assaulting a doctor at the Hawaii State Hospital.
In 1999, Lawrence was charged with killing and dismembering Kirby vacuum salesman Melchor Tabag in Waialua. In 2002, a judge found Lawrence not guilty by reason of insanity after a panel of three psychiatrists diagnosed him as schizophrenic and delusional.
The South Carolina facility costs the state about half as much per day per patient compared to the state's only public mental hospital. The state is paying GEO Care Inc. $341 a day for non-acute care or $441 a day for acute, one-on-one care, according to a State Health Department spokeswoman, compared to the cost of about $800 a day per patient at the State Hospital in Kaneohe.
A nurse manager there has told Hee that another half-dozen or so mental patients are so violent they should be sent away as well, but health department administrators rejected one request this past March.
"The people at the front line, who really know about the patients, are asking for transferring for their safety, and the safety of their workers and patients," Hee said.
Hee said Acting State Hospital Administrator Bill Elliott and the facility's medical director, Dr. Bill Sheehan, signed off on sending a third patient from Kaneohe to the South Carolina facility earlier this year. But Hee said they were overruled by Mark Fridovich, the state's head of the Adult Mental Health Division, who was concerned the state lacked policies and procedures that allow a patient's family to object to them being sent out of state.
"DOH is not planning or preparing to move (State Hospital) patients to out-of-state facilities at this time," said Janice Okubo, the Department of Health's spokeswoman, in a statement. "Policies and procedures for transferring patients to out-of-state facilities are being reviewed within DOH at this time and after internal review will require review by legal counsel. Use of out-of-state institutions is one of many options being considered by HSH to increase the safety of patients and staff."
Okubo said state law requires that the State Hospital provide patients with the "most appropriate, least restrictive level of service." She said in some cases, patients who are restrained often for their own safety or the safety of others might get better care at a more modern facility elsewhere.
"Any placement of patients out of the state is done on a case-by-case basis and considered only when all other options have been exhausted," Okubo said.
According to its web site, the Columbia Regional Care Center is a 374-bed facility that houses prisoners and mental patients needing skilled, intermediate and hospice care for conditions such as AIDS, cancer, cardiac disease, kidney dialysis, and mental health.
Reached by phone Wednesday morning, the facility's administrator Ron Lawrenz said, "I'm unable to answer your questions." He referred Hawaii News Now to State Health Department officials who had already declined to reveal the dates, locations, circumstance and treatment of patients for privacy reasons.
"Because it appears that names have been disclosed to you, any information DOH (Department of Health) provides you could be associated with those names and we would be violating the law," said department spokeswoman Okubo in an email after consulting with lawyers and top department officials.
In the paperwork justifying a non-bid contract for GEO Care dated Jan. 27, the state Health Department said "The mainland facility offers the patient and similar patients an environment where they may be given opportunities to develop relationships based on their current behaviors versus what hospital staff expect of them based on past experiences at the (State Hospital), and either real or sensationalized descriptions or perceptions."
"It is the opinion of the hospital staff," wrote the Health Department, "that the patient and similar patients would be better managed out of the State of Hawaii in a facility specifically designed to better meet the needs of patients while creating a safer environment for other patients in the HSH, the HSH staff and the patient himself."
The current contract with Columbia Regional Care Center contract started March 1, 2014 and ends Feb. 29, 2016. It costs approximately $326,000 a year for both men.
Two other forensic correction facilities in Florida and Missouri declined one of the patients, according to the procurement document.
"Future patients that have similar psychiatric, medical, behavioral and security needs will be housed at" the Columbia, South Carolina facility, said the document requesting exemption from procurement laws that was signed by Gary Gill, who was acting health director on Jan. 24, when he approved the request.
The State Hospital had 205 patients as of Tuesday, three over its licensed capacity of 202, Okubo said. The facility was built to hold 168 to 178 mental patients.
Because of overcrowding, the state also has 40 mental patients staying at the private Kahi Mohala facility in Ewa, costing the state $750 a day per patient.
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