Hospital passes muster

Changes at the state hospital make
federal oversight unnecessary,
a special report says

The state hospital in Kaneohe has improved so much that federal oversight is no longer needed at the facility where mental patients once lived in overcrowded, unsafe and unsanitary conditions, a court-appointed special master says.

The special master, U.S. Magistrate Judge Kevin Chang, said yesterday in a report that the state is in "substantial compliance" with a court-ordered remedial plan and that he is recommending dismissal of the Hawaii State Hospital portion of a lawsuit filed by the federal government 13 years ago.

U.S. District Court Judge David Ezra will consider Chang's recommendation at a hearing scheduled for Dec. 10.

Chang cited "substantial progress and dramatic change" at the Kaneohe facility since 1991, when federal oversight began.

Chang, however, is also recommending continued oversight of the state's community mental health services and an 18-month deadline extension to June 2006 for the state to comply with federal standards.

Dr. Thomas Hester, state Adult Mental Health Division chief, said the progress detailed in the special master's report represents a historic accomplishment for the state.

"I believe in some areas, Hawaii State Hospital is setting the standard nationally for state psychiatric hospital services," he said.

And with the extension, Hester said he believes the state will also set the standard for community mental health services.

The conditions at Hawaii State Hospital today stand in stark contrast to what they were when the U.S. Department of Justice filed its lawsuit in 1991. Patients were left lying unattended on concrete floors, were routinely restrained and lacked necessities such as soap, toothbrushes, toothpaste and towels. Prior to the filing of the lawsuit, a Justice Department attorney observed a patient eating paint chips and another lying in his own urine.

"To say that circumstances at Hawaii State Hospital have changed is a gross understatement and fails to comprehend the severity of the problem and the change brought about," Chang's report said.

The report includes the observations of a three-member evaluation team that visited the Kaneohe complex Sept. 13-17. Team member Gail Hanson-Mayer, a psychiatric clinical nurse specialist from Lexington, Mass., noted a culture change in how the state addresses its mentally ill patients.

"The hospital has a different atmosphere that is more amenable to fostering a treatment environment that guards the rights and privileges of patients and staff at the facility," she wrote in her report.