The Arizona Daily Star, March 7, 1998
Court suggests removing youths at Desert Hills
By Rhonda Bodfield
The Arizona Supreme Court yesterday morning recommended that juvenile county courts remove delinquents from Desert Hills behavioral treatment center within 30 days.
The court's administrative office also suggested a one-year ban on placing children there because of concern over the center's use of restraints and staffing levels.
Pima County Juvenile Court - the only juvenile court with youths still at Desert Hills - later announced that it will remove its 15 delinquents and state wards by early April.
The Supreme Court has oversight over lower courts, but not direct jurisdiction.
On Feb. 2, Edith Campos of San Ysidro, Calif., slipped into a coma after being restrained at Desert Hills and died two days later. A Child Protective Services report stated that a psychiatric technician lay on top of Campos, who was placed in the facility through private insurance.
Also yesterday, three state agency heads met with Desert Hills officials in Phoenix to discuss removing roughly 70 state wards - almost half of the center's patients at its two Tucson facilities.
The state officials from the Departments of Health Services, Economic Security and Juvenile Corrections decided to increase monitoring by each placing a monitor at Desert Hills every day. The stepped-up monitoring begins this weekend, with no cutoff date.
The state group decided not to remove any youths from the center, pending further review.
Some participants reported privately that it appears the state will not revoke Desert Hills' license. Instead, the agencies asked Desert Hills Center for Youth & Families to flesh out the three-page draft action plan it presented to state officials.
The plan states the company will:
The state health department oversees 22 youths placed at the center, while the juvenile corrections department has 30 inmates at Desert Hills. State agencies pay roughly between $112 and $195 per youth per day at Desert Hills.
- Provide restraint and cardiopulmonary resuscitation training to all employees.
- Conduct training on how to defuse power struggles and ``identify patient problems in conflict situations.''
- Hire three additional nurses to bolster staffing and form a medical team to review all restraints weekly.
- Review all restraint procedures and revise them if necessary.
Desert Hills officials told state officials that they have a stronger commitment to care than the previous owner, Youth Services International, which owned the center from November 1996 to November 1997.
Youth Services eliminated the training coordinator position last August, for example, but the current owner reinstated that position in December, according to the center's action plan.
The company that took over, Youth and Family-Centered Services of Texas, has started addressing ``the lack of strong management structures previously at Desert Hills,'' the draft action plan states.
The state Supreme Court's recommendation came after an independent review by a court employee, who spent two days reviewing records of juvenile court wards placed at the center.
Donna Noriega, a spokeswoman for the court, said the employee identified several concerns that made the higher court's administrative section ``uncomfortable'' with placing youth at the center.
Those concerns included:
She could not elaborate on the findings. The court employee who completed the study was unavailable for comment.
- The types of restraints used at Desert Hills.
- Failure to report injuries caused by restraints to the court or probation officers.
- Inadequate staffing levels.
- The absence of a core staff system, where employees are assigned to specific units and programs.
``We're hopeful that Desert Hills has great intentions to get additional staff on board and make the necessary changes, and we'll be happy to look at (the facility) again once those changes are in place,'' Noriega said.
Desert Hills issued a written statement saying officials were ``saddened'' by the court's decision.
``We understand the political necessity for them to take an extremely conservative position even if there is no immediate evidence of wrongdoing by Desert Hills' staff,'' said Dick Hardin, Desert Hills' new chief executive officer.
Hardin said he hopes the youths will return once the Tucson police criminal investigation into Campos' death is complete.
``Unfortunately, we are the only facility in this region capable of working with many of these children, kids who have already failed in a number of other treatment settings. By making this decision, the state could be denying vitally needed care to the children and their families.''
Hearings in Pima County Juvenile Court will begin next week to determine where to place the youths to be removed from Desert Hills.
Many of them may go to Charter Behavioral Health System of Arizona, a private treatment center in the Phoenix area, said Gabriela Rico, the Juvenile Court spokeswoman.
Of Pima County's 15 juveniles at Desert Hills, one is a 9-year-old delinquent, while the others are Department of Economic Security wards supervised by the court. Juvenile Court judges have autonomy over dependent and neglected children.
Navajo County removed its six juveniles this week after a 14-year-old Navajo County girl suffered a broken vertebra during a restraint last month.
John Clayton, DES deputy director, could not comment on the Juvenile Court decision, which effectively removes 14 of the 17 state wards at Desert Hills.
Clayton said the agency plans to make recommendations by next week on whether to remove youths placed by DES at Desert Hills. First, the agency will review Desert Hills' response to his requests for more information.
In the interim, any DES placements or their parents can ask the agency for removal from Desert Hills.
Clayton said he still has concerns, for example, that the facility does not have a strong enough patient advocate. He also said he is worried about the center's restraint procedures.
Clayton said, for example, that Desert Hills told him there were 107 restraints in January. The two facilities at 2797 N. Introspect Drive and 5245 N. Camino de Oeste house 140 youths.
In February, the month Campos died, restraints dropped to 54.
Senate Health Chairwoman Ann Day, R-Tucson, said the state action should be consistent.
``Clearly, there is a health and safety problem. How extensive it is I don't know, but . . . I clearly feel that if any children have been removed, then the others need to be removed. For the others to stay, that makes no sense.''
But Linda Palmer, assistant director of the state health department, said it is important for agencies ``to not jump the gun. Everybody really is trying to not overreact and to do what is best for the individual child.''
Palmer said that from her perspective, Desert Hills' draft action plan showed the center is being pro-active, since the department has not yet cited it for any deficiencies.
``Is Tucson going to be better off without the facility? Do we not want anyone associated with Desert Hills providing services to our children? We really need to look at that.''
Arizona Daily Star reporter Jane Erikson contributed to this story.