Name/Title
Law Suit: Final JudgementEntry/Object ID
2014.2.3349 A-BScope and Content
A copy of the twenty-two page Final Judgement plus the Official Memorandum from the Missouri Department of Mental Health in the F.E., et al. v. C. Duane Hensley, No. 73 CV 43-W-1 United States District Court, Western District of Missouri, Western Division. This is found in the folder marked Law Suit.Context
A. The Memorandum
TO: Superintendents, Asst. Supt. Treatment Youth Center Directors - Prog. Coord.
FROM: Devon J. Hardy, Coordinator Children and Youth Services. Dated December 26, 1978.
RE: Final Judgement
Enclosed, please find a copy of the Final Judgement which has now been signed by the Attorney for the Plaintiffs, the Attorney Generals Office and on 12/18/78 we received notification that Judge Oliver, the United States District Judge had signed the Judgement.
As many of you are aware, this has been a class action suit pending since January 26, 1973. Although it specifically involves the Youth Center at St. Joseph State Hospital, the Attorney Generals Office has advised me that all children and youth facilities in the state should be made aware of the contents of this judgement and as applicable follow the guidelines set forth.
The Department of Mental Health is very appreciative for the time, effort and interest which Mr. Michael Boicourt, Assistant Attorney General has contributed to this joint settlement.
DJH
cc: C. Duane Hensley, Ph. D.
Dr. Beverly Wilson
Michael Boicourt
_________________________________________________________________________________________________
B. The Judgement
In The United States District Court for the
Western District of Missouri
Western Division.
F.E., et al., Plaintiffs, )
) NO. 73 CV 43-W-1
v. )
)
C. Duane Hensley, et al., )
Defendants. )
FINAL JUDGEMENT
The plaintiffs, patients at the Youth Center of St. Joseph State Hospital . . . .
NOW, THEREFORE, upon consent of the parties, it is hereby ordered, adjudged and decreed as follows:
I.
JURISDICTION
This Court has jurisdiction of the subject matter of this section . . . . .
II.
PARTIES
Plaintiffs
Each of the individually-named plaintiffs was a patient at the . . . .
Patients, involuntarily committed to the Youth Center, who are . . . . .
The Court finds that this action is properly maintainable as a . . . .
Defendants
The defendants include the present members of the State Mental Health Commission of Missouri, . . .
The Department of Mental Health is required by Missouri law to . . . . .
The Department of Mental Health has administrative control over . . . . .
The Youth Center is one of several administrative units at . . . . .
III.
PURPOSE
All parties to this action share the sincere desire that the . . . .
The entry of this Consent Judgement . . . .
Also, substantial appropriations have accrued . . . . .
IV.
LEAST RESTRICTIVE ENVIRONMENT
Admission and retention of youth at the Youth Center shall be . . . . .
The vast majority of plaintiffs' class have been admitted by the . . . . .
As is consistent with the present interpretation of the above statute, . . . . . shall act as follows with respect to the admission of patients . . . . :
1. Within thirty days of admission to the Youth Center of any . . . . .
2. With respect to a patient over which the committing court . . . . .
3. With respect to a youthful patient over which the committing . . . . .
4. With respect to the admission of patients diagnosed as mentally retarded, . . . . .
5. For admissions made on court order, the rights and responsibilities . . . .
With respect to all class members, staff shall contact the committing court
one year after commitment requesting a review of the need for commitment of
each youth.
V.
AFTERCARE
There is a consensus between the parties that the Youth Center . . . . . The aftercare provided
by the Youth Center shall include the following aspects:
1. From the day that a youth enters the Youth Center, the staff . . . . .
2. The parents or guardians of youth presently hospitalized, . . . . .
3. The attempt should be made to include the responsible aftercare . . . . .
4. Aftercare workers shall work with children prior to, and after . . . . .
5. The defendants shall continue in effect the principles of . . . .
6. The aftercare for each youth shall continue until the caseworker is satisfied that
no further aftercare is needed.
VI.
INDIVIDUAL TREATMENT PLANS
A specific individualized treatment program commemorated by written plan, . . . . .
The following policies and procedures will apply to the preparation of a individualized treatment program for each member of plaintiffs' class:
1. A comprehensive physical, psychological, educational, and social testing . . . . .
2. Each class member shall have a written individualized treatment plan . . . . .
3. Each plan shall, as a minimum, include each of the following elements:
(a) Documentation . . . .
(b) A statement of the specific problem . . . . .
(c) A statement of the treatment modalities . . . .
(d) A projected time table . . . . .
(e) A stated method for measuring . . . . .
(f) A statement of the rationale . . . . .
(g) A designation of the staff . . . . .
(h) A statement of the proposed family . . . . .
(i) An explanation of the criteria . . . .
(j) A form to detail . . . . .
4. Each plan shall be continuously used as a tool to assist the staff in treating each class member.
5. A comprehensive review of each plan . . . .
6. Each patient and/or his parents or guardian is entitled to a copy of the treatment plan.
7. As a component of the individualized treatment plan . . . . . Each education plan shall include:
(a) Identification . . . . .
(b) Statement of long term goals
(c) A statement of the specific . . . . .
(d) An assessment of the least restrictive . . . .
(e) The proposed dates . . . . .
(f) Appropriate objective . . . . .
VII
MEDICATION
Medication shall be used at th Youth Center only when found to be medically necessary to the treatment of the patient. The defendants have affirmatively asserted, . . . . . .
The decision to prescribe medication for a member of the class shall . . . .
The defendants will continue the policy . . .
Each class member shall be advised as to what medication he or she is receiving and the reasons that that medication is indicated.
All medications used at the Youth Center will continue to be administered by staff . . . .
Physicians will continue to write frequent progress reports on the therapeutic effects of medicine.
As provided by the Department of Mental Health regulations, . . . .
Whenever a change in medication is ordered for a patient, the attending physician shall . . .
The behavior of all youth, . . . . shall be charted in progres notes. . . .
VIII
BEHAVIOR MODIFICATION PROGRAM
One treatment modality presently used, . . . , . . . is a motivational program . . .
Attached as Appendix A, is the most recent edition, . . . , of the point system program used at the Youth Center. . . .
IX
CLINICAL PATIENT RECORDS
With respect to each class member, the staff of the Youth Center will continue to maintain . . . . medical records. . .
Each clinical patient record shall include the following:
1. Identification data and consent forms;
2. Source of referral;
3. Reason for referral (i.e., . . . );
4. A record of the complete assessment of the child's physical, . . . , . . , . . . . . ;
5. Record of diagnosis;
6. A written individualized treatment plan together with . . . . ;
7. Medication history and record of all medications prescribed;
8. Record of all medications administered by staff, . . . ., . . ., . . . . . , . . . . ;
9. Written summaries of all clinical staffings;
10. Documentation . . . . ;
11. Periodic progress reports to be prepared every thirty days;
12. All reports of consulting mental health professionals;
13. Documentation signed by a mental health professional . . . ;
14. A written summary re any extraordinary incident or accident . . .;
15. All other appropriate information . . . ;
16. Discharge and termination summary; and
17. Plan for follow-up and documentation of its implementation.
X
DISCIPLINE
The parties are in complete agreement that, . . . , . . . The use of discipline in the Youth Center shall be governed by the following policies and procedures:
1. Physical restraints and/or seclusion are occasionally necessary . . . . to prelude a patient from injury himself, . . , . . , . . . In such cases . . . only after other alternatives have been exhausted. . . . (and) shall not be used for punishment, . . . . , . . . , . . .
2. Discipline employed at the Youth Center shall occur within a time period . . . and the discipline must be therapeutically effective.
3. Class members . . parents or guardians shall, . . . be provided copies of . . .handbooks which outline the discipline employed. . . when discipline is justified.
4. If the violation of a disciplinary rule . . . does not constitute a present threat to the physical safety . . . . or a threat of extensive property damage, no discipline shall be imposed; however, if the behavior significantly interferes with the treatment . . . that fact shall be so stated in the individualized treatment plan.
5. The use of discipline shall be sufficiently consistent . . as to the likelihood that certain behavior will result in certain discipline.
6. Physical restraints shall be defined as restricting a patient's . . . . , they shall . . . cause the least possible discomfort and no physical injury. No physical or mechanical restraints . . . unless . .approved by the D.M.H.. . . . The reasons . . . will be charted.
7. Seclusion shall be defined as . . . . Locked security wards, . . . shall not be deemed seclusion.
8. All uses of physical restraints and/or seclusion shall be periodically reviewed by the responsible treatment team.
9. The use of restraints or seclusion must be ordered by qualified mental health professionals. . . . Emergency use . . . for no more than thirty minutes, . . . .
10. All written orders . . . shall be effective for no more than twenty-four hours. . . . . .
11. While in restraints . . ., the patient shall be seen . . . every fifteen minutes by ward personnel . . . charting the . . . . condition every hour. . . . Bathroom privileges . . . afforded every hour and . . . bathing privileges shall be allowed.
12. All incidents . . . shall e recorded in the patient's clinical medical records, . . . shall include . . . why . . . was ordered. . . . , what alternative interventions . . . , and the duration . . .
13. Class members placed in seclusion shall be allowed to wear their own clothing.
14. The defendants shall cn\continue their policy, . . . Park 15 shall not be used for seclusion in the Youth Center.
15. . . . . temporarily lock a ward . . . because one or more patients to be dangerous to himself . . others. . or to elope. . . . , the reasons . . . will be charted. . . .
16. Whenever a patient is placed on ward restriction, the reasons for the restriction shall be chartered in his/her clinical record.
XI
PHYSICAL ENVIRONMENT
. . . . . the physical facilities . . . . should provide an environment in which members . . . are cared for and treated in a therapeutic manner.
To that end, the defendants have (secured) . . . . . appropriation from the MIssouri General Assembly . . .of $1,351,504 for the renovation of the Woodson Building. . . . to be under construction by autumn, 1978. . . .
. . . . the renovations . . will include central heating and air conditioning, division of . . . areas into . . . no more that four people per room, and renovation of toilets and shower areas. . . .
XII
STAFF
The defendants will continue to provide at least eighty square feet of living space for each class member. . . . . (and) shall continue to provide staff in sufficient numbers.
. . . . the Youth Center was authorized a staff increase of thirty-five positions with an . . . appropriation of $492. 384.00. . . . . . . Included are one psychiatrist, two clinical psychologists, ten educators, one graduate nurse, one activity aide, and ten psychiatric aides. . . . . In addition, . . . . the Youth Center has recently added three staff members to its Social Services Department.
XIII
DIET
The staff of the Youth Center have been and will continue to comply with the general and special dietary needs of each patient by the provision of properly prepared and tasty food of adequate nutrition and calorie content attractively served in a relaxed atmosphere.
XIV
STAFF DEVELOPMENT
There shall be appropriate programs of staff development and inservice training for the professional, administrative, nursing, and support personnel of the Youth Center. . . . .
Programs for staff development and service training should . . . . .
Professional and nursing staff will receive . . . .
. . . . the nursing staff will have sufficient input . . .
Training programs outside the premises . . .
XV
WORK ASSIGNMENTS
It has long been the policy of (the) State Hospital that patients not be required to perform labor which involves the operation and maintenance of the institution. . . . . however, . . certain work activities may be therapeutically beneficial to the members of plaintiffs' class.
. . . . State Hospital shall continue to operate a vocational education and . . rehabilitation program . . for the purpose of teaching marketable skills. . . . .
Appropriate opportunities for productive work experience outside the facility shall be considered. . . .
The defendants may institute a limited program of voluntary work assignments on the premises . . . Patients will be allowed to participate . . . only if they and their parents or guardians agree to their participation.
XVI
COMPLIANCE
. . . . , the defendants will provide counsel for the plaintiffs with copies of each report or accreditation survey made by the Joint Committee on Accreditation of Hospitals. . . . .
. . . , the plaintiffs shall be allowed on-site inspections of the Youth Center four times during the two years immediately succeeding the date of this final judgement, . . .
XVII
COSTS
The costs of this litigation are hereby taxed and divided equally between the plaintiffs and the defendants.
Entered this _________________ day of ______________________________, 1978.
UNITED STATES DISTRICT JUDGE
By Consent: JOSEPH A. SIMANEK
Legal Aid & Defendender Society
Attorney for Plaintiffs.
JOHN ASHCROFT
Attorney General
MICHAEL L. BOICOURT
Assistant Attorney General
Attorneys for Defendants
.Collection
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Category 08: Communication Objects
