Notorious Psych Ward at Miami-Dade Jail Finally Shuttered

From this report in the Prison Legal News Website

In a historic culmination to decades of “horrific” living conditions and a pattern of constitutional violations, the Miami-Dade County Jail in Florida has finally closed the “Forgotten Floor” – the notorious ninth floor at the facility that was used to house mentally ill prisoners, often for months and years at a time, with levels of care so abysmal that prisoners routinely died.

“It is thrilling on one level but kind of sad that it has taken so long,” said Miami-Dade Judge Steve Leifman of the December 23, 2014 closure of the jail’s ninth floor. “A lot of people have been hurt or died up there.” Leifman, as chair of the 11th Circuit Mental Health Project, has been a long-time advocate for the mentally ill.

In 2013 alone, three mentally ill prisoners housed on the ninth floor died. On August 26, Joseph Wilner, 59, was found “unresponsive” in his cell; jailed for driving on a suspended license, he was in the unit reserved for the most acute mental cases.

In July 2013, Leifman was informed of the death of wheelchair-bound prisoner Joaquin Cairo. An employee with the jail’s diversion program told the court that Cairo said “someone propositioned him while in custody and when [he] declined they threw him against the bed and against the floor.” Cairo suffered a broken pelvis and died from internal bleeding.

“The neglect was despicable. Despicable,” Leifman said. “He should have been taken to a hospital immediately, and there is absolutely no excuse.”

Three months earlier another psych ward patient, Juan Matos-Flores, who was considered a suicide risk, died after jailers found him unresponsive on the floor of his cell. When staff tried to call 911 they were unable to do so because the phones on the ninth floor were programmed to block outgoing calls. Instead, employees were forced to call another floor to get help.

“It’s a floor that is specifically designed for people who are ill. It’s absurd,” Leifman said after learning of the telephone debacle.

When the ninth floor at the Miami-Dade County Jail closed, some 400 prisoners were transferred to six newly-refurbished wings at the Turner Guilford Knight Correctional Center, where the telephones allow 911 calls and cameras monitor prisoners in every cell.

[...]

The Miami-Dade County Jail, the nation’s eighth-largest, has been under federal monitoring since the U.S. Department of Justice concluded a three-year investigation in 2011 that found a “pattern and practice in constitutional violations” of prisoners’ rights due to deplorable living conditions.

Leifman was more blunt, calling conditions on the Forgotten Floor “horrific.”

“It was not built to be a psychiatric facility. It was built as a jail [with a cell] for one person, and here two and three people [were placed] in there that are very psychotic,” he said.

The public got its first glimpse of the infamous floor in 2006 when Leifman invited a television reporter and camera crew to document conditions as he guided a tour. “Human beings should not be treated like this. No blankets, no beds, no mattresses. We sleep on the floor,” one prisoner told CBS4 chief investigative reporter Michele Gillen, who found the faucets in cells were not working and prisoners were drinking water from the toilets. Leifman credited Gillen’s reporting with stirring public outrage which, in turn, prompted action.

“We have finally closed the ninth floor, thanks to you,” Leifman told Gillen in an interview. “I don’t think the public ever would have understood how horrendous the situation was, but for your reporting. And it led to where we are today.”

Fairfield psychiatrist charged with fraud. They submitted bills that added up to them seeing patients 24 hours a day.

The state attorney general is suing a Westport couple for Medicaid fraud, charging they submitted bills that added up to them seeing patients 24 hours a day.

Attorney General George Jepsen announced Thursday morning that Dr. Ashwini Sabnis, a psychiatrist, and her husband Saurav “Sam” Mohanty, co-owners of Brighter Concept, Inc., 2000 Post Road in Fairfield, allegedly filed false claims under the Connecticut Medical Assistance Program. The couple also operated a Brighter Concept office in New Haven.

Jepsen said he is seeking triple damages under the state’s False Claims Act for actions that occurred between January, 2010 and December of last year, including billing for services that garnered higher reimbursement levels than the services they actually provided. Jepsen alleged that the couple overbilled the state Department of Social Services by $768,171 during the four-year period.

The lawsuit, pursued by Jepsen and Department of Consumer Protection Commissioner Jonathan Harris, was filed in Hartford Superior Court.

"This action is being brought to seek damages, civil penalties and other relief due to a scheme that was perpetrated on a health care program intended to care for our most vulnerable citizens," Jepsen said in a statement. "Health care providers who accept taxpayer dollars must play by the rules."

The couple’s attorney, Ross Garber, declined comment.

The 42-page complaint alleges that the scheme included claims for services not rendered, as well as overbilling and filing false statements in a “systematic and persistent pattern of submitting false and fraudulent claims.” The lawsuit alleges that Sabnis and Mohanty discouraged auditors from the state Department of Social Services with claims that their computer system had crashed.

Sabnis regularly overbooked her scheduled Medicaid patients for 15 or 30 minute appointments, saw them for as little as 5 or 10 minutes, then used a reimbursement code that showed she spent as much as 75 to 80 minutes with them, the complaint said. The lawsuit alleges that there were 113 days when Sabnis billed the state for more than 24 hours of service for low-income and disabled patients.

Department of Social Services Commissioner Roderick L. Bremby praised the Attorney General’s investigation.

“Uprooting and eliminating this type of fraudulent activity requires the constant vigilance of oversight agencies,” Bremby said. “While the great majority of Medicaid-enrolled providers are professional and honest, the exceptions require aggressive action on behalf of the program’s overall integrity and the taxpayers who fund it.”

Eleven psychiatrists disciplined at Japanese hospital – fraudulent applications. Newspaper “astounded by the lack of morals”

From The Yomiuri Shimbun [Japan News] (google translate)

We are astounded by the lack of morals of people engaged in medical services at a hospital. It is vital that a thorough investigation is conducted into whether inappropriate medical examinations or treatments were carried out.

At St. Marianna University School of Medicine Hospital in Kawasaki, 11 doctors were recently found to have made fraudulent applications to the Health, Labor and Welfare Ministry to acquire the special status of designated psychiatrist. The health ministry stripped 20 psychiatrists at the hospital, including attending doctors, of the special status. It is believed to be unprecedented for such a large number of doctors to be disciplined for involvement in acquiring the special status by fraudulent means.

There are 14,630 designated psychiatrists working across the country. Through the authority of a prefectural governor or an equivalent official, these psychiatrists are allowed to decide whether mental patients should be “involuntarily hospitalized” to ensure that they do not hurt themselves or others. They are also permitted to decide on “hospitalization for medical protection” for mental patients after receiving consent from the patients’ relatives. As designated psychiatrists have the authority to restrict a patient’s movements, doctors with sufficient knowledge and ample experience in this field are designated by the health minister, on the basis of the Mental Health and Welfare Law. Seeking this status through fraudulent applications is as if the status certification system is not being taken seriously.

To apply for the special status, applicants must have at least three years of working experience as a psychiatrist and to have submitted case reports on at least eight of their patients. The 11 doctors had rewritten the reports of cases treated by senior doctors and submitted them to the ministry as if they themselves had treated the cases. This is abominable.

‘Normal’ practice

What must not be overlooked is that such methods were used so often they had become a normal practice. The hospital has admitted that the transfer of data entered in the reports was carried out by these doctors. The attending doctors also failed in their function of checking such practices. This is indeed a serious problem.

The hospital reportedly became aware of the fraudulent applications of these doctors after the health ministry pointed out striking similarities in the reports. Doctors who obtained the special status fraudulently have decided on involuntary hospitalization of four mental patients and hospitalization for medical protection of about 100 patients.

If doctors made wrong medical judgments to forcibly hospitalize patients, this would constitute a serious human rights problem. Both the Kawasaki city government and the hospital need to delve deeply into the matter to clarify the situation. A designated psychiatrist is eligible for preferential treatment in terms of remuneration for medical services. With the fraudulent acquisition of the special status by these doctors, the hospital received about ¥1.7 million more than it normally would through the treatment of outpatients. Naturally, the hospital has said it will return the money.

With the retraction of the status, the hospital has scaled down treatment in its neuropsychiatric department. As a result, local medical services have been affected.

To prevent a recurrence of fraudulent applications, the health ministry plans to speed up its efforts to make a database of submitted reports in order to determine whether reports have distinct similarities. The ministry will also investigate whether there are similar illicit activities at other hospitals.

Bronx Child Psychologist Justin Miller Accused of Trying to Meet 14-Year-Old Girl for Sex

A report from NBC TV New York

A 34-year-old child psychologist at the Yeshiva University's Albert Einstein College of Medicine in the Bronx has been arrested for allegedly engaging in sexually explicit online conversations with an undercover detective he thought was a 14-year-old girl, authorities said Wednesday.

The psychologist, Justin Miller, was arrested Tuesday in the Bronx as a result of the three-month investigation. An online profile says he has eight years of experience.

Since January, authorities allege Miller engaged in the explicit sexual conversations with the undercover detective and at what point said he wanted to meet the 14-year-old girl he thought he was chatting with for sex. Police say he admitted to engaging in the sex chats with someone he believed to be a teenager.

Miller was charged with disseminating indecent material to a minor and acting in a manner injurious to a child younger than 17, which is a felony.

An email request to Miller seeking comment bounced back, and information on an attorney for him wasn't immediately available.

Albert Einstein College of Medicine referred questions about the case to police. Miller was not listed on the college's website Wednesday.

Of course, sometimes psychologists get in on the action normally reserved for shrinks

Two psychiatrists at Terrell State Hospital resigned this week after they were accused of accepting hundreds of thousands of dollars from a pharmaceutical company

From the Texas Tribune. More information in the original report

Two psychiatrists at Terrell State Hospital resigned this week after being told they would face disciplinary action for accepting hundreds of thousands of dollars from a pharmaceutical company to promote the drug Seroquel, according to the Texas Department of State Health Services.

According to agency documents, Dr. Anthony Claxton, the hospital's clinical director, and Dr. Lisa Perdue, a psychiatrist, received large amounts of money from pharmaceutical company AstraZeneca to promote the company’s drugs to other doctors and state regulators.

Claxton and Perdue were notified Tuesday by DSHS that they had violated department rules and faced possible termination. By the end of the week, both had resigned, a DSHS spokeswoman said.

Claxton is accused of taking $231,000 from AstraZeneca for “promotional speaking and consulting services” on at least 166 occasions dating back to 2005. Perdue allegedly received $615,525 for 460 such instances since 2005. State health code forbids employees from accepting other compensation that could affect their official duties.

Chicago's West Side Hartgrove Psychiatric Hospital focus of widening Justice Department probe

Highlight/Lowlights from this Chicago Tribune article

The Justice Department's criminal probe into Universal Health Services has entered a new and more serious phase, focusing on potential wrongdoing by the corporation as a whole and not just its individual facilities.

Universal, the nation's largest behavioral health firm, had previously disclosed a federal investigation into 18 of its 190 psychiatric centers across the country.

But in late March, the department's Criminal Frauds Section notified the company that "Universal as a corporate entity" is now under scrutiny, according to a regulatory disclosure filed by Universal on Tuesday.

As federal agents examine allegations of fraudulent Medicare and Medicaid billing by the corporate office, they have highlighted one facility in particular, the company disclosure said: Hartgrove Hospital on Chicago's West Side.

[...]

The Justice Department began investigating Universal facilities in Illinois in 2008 after the Tribune documented allegations that juvenile state wards and other youths were sexually assaulted at the firm's west suburban Riveredge psychiatric hospital.

The state Department of Children and Family Services in response commissioned the University of Illinois at Chicago's psychiatry department to examine conditions at Riveredge, Hartgrove and other psychiatric facilities that serve Illinois wards.

In a 2010 report, the UIC experts described an environment of chaos, physical attacks and sexual assaults of young patients at Hartgrove, saying the West Side facility was regularly understaffed and over capacity.

Also part of the expanding federal probe is Universal's Rock River Academy, a 59-bed Rockford resident treatment center that promises intensive, round-the-clock care to female state wards who suffered abuse and neglect, as well as disadvantaged girls with mental health problems.