Sunday, July 22, 2012

Private psych hospital born of back-room deal fined, investigated

The Austin Statesman's Andrea Ball has a feature today on the GEO Group's public-private psych hospital in Montgomery County, which opens:
Sixteen months after the Montgomery County Mental Health Treatment Facility opened in Conroe, the state's first publicly funded, privately run psychiatric hospital is facing at least $53,000 in state fines for serious shortcomings in patient care.

The private operator, Geo Care, is a subsidiary of Geo Group, a private prison company that has drawn attention in recent years because of deaths, riots and sexual abuse at some units in Texas and other states. ...

Meanwhile, the facility's construction, by a different firm, is the target of a separate federal grand jury inquiry.
The new facility has been much cheaper than state-run hospitals, according to initial reports, but reviews by the Department of State Health Services has criticized the facility for problems "including unauthorized restraint and seclusion of patients, incomplete medical records, failure to show patient consent for medications and failure to report serious injuries to the state."

Grits agrees Texas needs more state mental hospital capacity, but given the company's record, the GEO Group partnering with county government would be among the last ways I'd advocate providing that extra capacity. There's a chance, though, that the GEO Group could become even more involved in managing Texas mental hospitals if the state privatizes one of its facilities:
The problems come to light as the Department of State Health Services prepares to privatize one of the 10 public psychiatric hospitals it oversees. If Geo Care bids on the ongoing privatization effort — and it has expressed interest to public officials in doing so — its work in Montgomery County could be a harbinger of what taxpayers can expect if a for-profit company wins control of a public state hospital.

This week, the agency will accept bids from contractors seeking to run one of those facilities for at least 10 percent less than the current cost, a move that could save the state millions of dollars each year. If an offer is accepted, a private company could be running a state hospital by the end of the year.
Finally, Ball reported on an investigation into possible improprieties in the Montgomery County hospital's construction:
In September 2009, Montgomery County commissioners hired Alliance Development Inc., to build the hospital. The Shenandoah-based company also constructed the Joe Corley Detention Facility, which is owned by the county and is run by Geo Group. It opened in August 2008.

Now, the construction of the jail and the hospital are part of a federal grand jury investigation. In May, the U.S. attorney's office in Houston issued a subpoena to the county, asking for records, contracts, subcontracts and other information related to the development of those projects. They also wanted to know how the county chose Alliance Development for the jobs.
The possibility of insider baseball on the contract jibes with the secretive origins of the facility. Funding was approved in 2009 as a last-minute addition to the state budget, added in conference committee even though DSHS hadn't asked for it and neither legislative chamber's budget included the measure. So this project had no public vetting by the Lege on the front end and hasn't operated up to state standards since it opened.

No doubt, Texas needs more forensic beds at state mental hospitals, but this back-room privatization deal was more about pork than policy. I'm not surprised things haven't gone smoothly.


Anonymous said...

Advocates had been warning DSHS about this prior to it opening. The response was that the contract was with Montgomery County not Geo Care. So any issues that would come up would be on Montgomery County. I personally think a lot of people got kick backs probably funneled through ALEC to get this place opened.

Phillip Baker said...

Anonymous, I think you are on to something there.

FleaStiff said...

>No doubt, Texas needs more forensic beds at state mental hospitals...
but is not willing to pay enough pork to get them!

John W Goodman MD said...

The privatizing of health care in Texas has a poor track record ... e. g., the medical services (especially the psych services) of TDCJ. UTMB-TDCJ CMC is of vague legal foundation to begin with. Quality is low enough to cause some to think that another suit of TDCJ is possible. Physicians don't apply to work there now.

Re: above comment about pork. We (Texas) have always paid pork easily. What we don't do is pay for the proper product.

Anonymous said...

What the Statesman found is wrong on so many levels.

Easy mental health commitments and criminal justice are bad bedfellows.

Privatization has proven a failure everywhere we've done it, from foster care services, to Medicaid eligibility, to Medicaid dental, to prisons and now to forensic mental health. The needs of government and the needs of private industry are exactly opposite: One must conserve taxpayer dollars, and the other must maximize income, in this case through heads on beds.

Misuse of deadly restraints, drugging without consent should be treated as assault because in fact, they are.