November 22, 2011

In wake of sex abuse allegations, new rules for state hospitals

11-22-2011 Texas:

Staffers accused of sexual abuse at the state's psychiatric hospitals must now be transferred or put on emergency leave while they are being investigated, according to new rules issued last week by the Department of State Health Services.

The new rules come in the wake of allegations that Dr. Charles Fischer , a former child psychiatrist at Austin State Hospital, sexually abused patients at the facility. While the state investigated him, he continued to work in the same hospital unit where the abuse is said to have taken place.

The mandate is among more than a half-dozen new rules outlined in a memo written last week by Mike Maples , assistant commissioner for mental health and substance abuse services. The memo, which was sent to the superintendents at all 10 state hospitals, laid out changes on how staffers conduct themselves around patients and how they deal with sexual abuse complaints.

The department is also reviewing any past or present allegations of sexual abuse levied against employees and is looking for patterns of repeated investigations.

"We have a responsibility and duty to ensure a safe treatment environment for patients and staff," Maples wrote in his memo. "Recent events have identified opportunities to provide additional protection for both patients and staff."

Fischer has not been charged with a crime by any law enforcement agency. The Austin Police Department is investigating, and the Travis County district attorney's office says it is preparing several cases for the grand jury. Officials say the state received at least eight allegations against the psychiatrist over the past decade.

Fischer's attorney, Tony Cobos , has said that they "categorically and vehemently deny any allegations of misconduct."

Fischer, 59 , was fired Nov. 14 , three weeks after the Department of Family and Protective Services told hospital officials that the psychiatrist had been involved in two instances of sexual abuse with at least one patient.

During the five-month investigation into the accusations, Fischer continued to work at the hospital.

But Department of State Health Services spokeswoman Carrie Williams said Austin State Hospital Superintendent Carl Schock placed multiple restrictions on Fischer's interaction with patients. Among other things, he was ordered not to have patients in his office or other isolated areas with the door closed; not to conduct individual therapy sessions beyond the hours of 8 a.m. and 5 p.m.; and not to touch a patient in any way unless assisting in an emergency situation or procedure.

On Friday — two days after the Austin American-Statesman reported the allegations against Fischer — Maples distributed a memo outlining new procedures to be implemented in all of the hospitals. Among them:

• Staffers may not provide unplanned individual therapy outside usual times unless two staff members are in the immediate vicinity.

• Therapy or treatment room doors may not be locked during sessions.

• Staff may only provide individual treatment services in rooms with windows or other locations where they can be directly observed by other employees. If windows are not available in therapy rooms, staffers can leave the door open or take patients to other campus locations, such as a picnic table or park bench.

• All Class I abuse allegations — which includes sexual abuse or very serious physical abuse — must be reported to Maples' office immediately.

"With the benefit of hindsight, we're looking at what we could do differently," Williams said. "We can always do more. We always want to be looking for ways to make our patients safer and reduce risk for abuse."

The Texas Youth Commission, which went through an agency shake-up after a sex abuse scandal in 2007, changed many of its comparable procedures directing how staffers behave around juvenile offenders, spokesman Jim Hurley said . For instance, in recent years, Youth Commission facilities have installed more than 12,000 digital cameras so that no area is unwatched.

"If we get an allegation, we can go immediately to the cameras," Hurley said. The images can be viewed immediately by facility superintendents, agency inspectors and administrators, even if they're located miles away in Austin.

In addition, all solid wooden doors have been replaced with doors with windows, and offenders entering psychiatric counseling sessions are observed through the windows by a correctional officer, Hurley said. The only time a juvenile offender would be expected to meet after-hours with a staffer would be "for a crisis only, and not just with a single person," he said.

Finally, "if there is an allegation of sexual abuse, and we can't immediately confirm or deny it, then the accused staff would be reassigned until the investigation is done," Hurley said.

Austin Child Guidance Center , a nonprofit group that provides mental health services for youth and their families, follows the same kind of procedures.

Executive Director Russell Smith says there are no after-hours sessions, staffers have to treat patients on-site and at least two people have to be in the immediate area during treatment.

"I don't think our therapy room doors even have locks," he said. ..Source.. by Andrea Ball and Eric Dexheimer, AMERICAN-STATESMAN STAFF

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