The U.S. Department of Justice (DOJ) Civil Rights Division and the U.S. Attorney's Office for the Eastern District of New York announced that the City of New York has entered into agreement to correct conditions of confinement at the Kings County Hospital Center's (KCHC) psychiatric emergency room and psychiatric in-patient units located in the borough of Brooklyn, N.Y.

The DOJ had filed suit against New York City, the New York City Health and Hospitals Corporation, and KCHC under the Civil Rights of Institutionalized Persons Act (CRIPA) which authorizes U.S. Government investigations of confinement in state or local government-run institutions or institutions run on behalf of governments. Institutions can include psychiatric hospitals, nursing home, residential facilities, and various correctional facilities. The agreement, in the form of a consent judgment, was approved by U.S. District Judge Kiyo A. Matsumoto.

The allegations concerning conditions at KCHC arose from investigative findings, detailed in a letter from Acting U.S. Assistant Attorney General Loretta King. The letter characterized the conditions at KCHC as particularly disturbing, noting that "Substantial patient harm occurs regularly due to KCHC's failure to properly assess, diagnose, supervise, monitor and treat its mental health patients." Particularly troubling was an incident where a woman, Esmin Green, died face down on the floor after a 23 hour wait to be seen, while staff ignored her condition.

King also detailed how KCHC had problems in protecting patients from a significant level of patient-on-patient aggression and protecting patients with suicidal ideation. The conditions were highly dangerous and necessitated immediate attention, King's letter said. The investigation also found inadequate care, inadequate emergency responses, inadequate supervision and monitoring, poorly trained personnel, use of drugs restraint and transfers rather than treatment, failure to provide adequate and individualized discharge planning and follow-up services, falsification of patient medical records, and failure to respond promptly to medical emergencies.

Under the provisions in the consent judgment, New York City will work to ensure that patients at KCHC have a safe and humane environment and are protected from harm. In addition, policies and procedures implemented for prevention and management of aggressive behavior, anonymous reporting of destruction, modification or falsifying of records, investigation of serious incidences, review of environmental safety hazards, ensuring that patients receive accurate, timely and complete assessments and care, as well as several other provisions.

"Jurisdictions have a responsibility to protect the constitutional rights of individuals in their care and to protect those individuals from harm. We have worked cooperatively with New York City to craft an agreement that will benefit the lives of persons with disabilities at Kings County Hospital Center," said Thomas E. Perez, Assistant Attorney General in charge of the Civil Rights Division, in a DOJ press release. "We commend Mayor Michael Bloomberg, the Hospital Center, and the New York City Health and Hospitals Corporation for their willingness to work aggressively to remedy these problems."

U.S. Attorney Benton J. Campbell of the Eastern District of New York stated in the same release, "This consent judgment is designed to improve the quality of psychiatric care provided to some of our district's neediest and most vulnerable residents. We thank the city for its cooperation in achieving this important goal."

Adapted in part from a Department of Justice press release.

Link: http://www.justice.gov/opa/pr/2010/January/10-crt-013.html

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