D.C. Mayor Gray, DOJ Strike Deal to End Federal Oversight of Saint Elizabeths
Joint Motion Cites Improved Patient Care and Treatment
dc.gov | 8/27/2014, 8 p.m.
D.C. Mayor Vincent C. Gray announced Wednesday that the District and the U.S. Department of Justice (DOJ) will file a joint motion in U.S. District Court to dismiss a settlement agreement that mandates federal oversight of patient care at Saint Elizabeths Hospital. This means that, for the first time in seven years, the District’s inpatient psychiatric facility will no longer be under federal oversight.
In June 2007, the District and the Department of Justice entered into the settlement agreement. It required Saint Elizabeths to meet 224 performance benchmarks across a broad range of clinical measures, including treatment planning and services, clinical discipline assessments, discharge planning, quality improvement, risk management, and environment of care. The agreement also required the hospital to submit bi-annual reports to DOJ about its progress, which was then independently verified through its bi-annual site visits.
“This joint motion with DOJ is a recognition that we are providing high-quality, recovery-focused treatment at Saint Elizabeths Hospital,” said Mayor Gray. “It also is one more milestone in my administration’s record of ending federal oversight of local government functions.”
“With the end of the Dixon settlement agreement two years ago, the court acknowledged federal monitoring was no longer required for our community-based public mental health services, “ said Department of Behavioral Health (DBH) Director Stephen T. Baron. DBH operates Saint Elizabeths Hospital. “The end of this settlement agreement is another indication of our commitment to quality mental-health treatment and supports for District residents.”
The settlement agreement was the result of a 2005 investigation by DOJ under the federal Civil Rights for Institutionalized Persons Act. Investigators evaluated patient care and other key areas of performance at Saint Elizabeths, including infection control, risk management, and the physical environment.
Following the settlement agreement, Saint Elizabeths undertook a major reform of patient care, operations, and the environment. The hospital significantly increased its number of clinical staff; developed robust training programs to implement evidence-based best practices; and installed a modern, electronic medical records system. In 2010, the hospital moved from multiple, aging buildings into a new, state-of-the-art facility. The hospital made steady progress, and in March of this year, DOJ found the hospital in full compliance with all 224 requirements under the agreement.
“This was a huge team effort by clinicians, administrators, and support staff. These changes benefit some of the District’s most vulnerable residents and reflect our commitment to them and their families,” said Dr. Patrick J. Canavan, Saint Elizabeths Hospital Chief Executive Officer. “We also appreciate the guidance and expertise provided by the Justice Department.”
D.C. Attorney General Irv Nathan said that his office and DBH worked collaboratively with DOJ to meet the requirements of the settlement agreement. He praised the leadership of Mayor Gray and the dedication and persistence of Director Baron and Dr. Canavan.
“The care and treatment at Saint Elizabeths have improved vastly,” Nathan said. “The end of this settlement agreement demonstrates that litigation aimed at systemic reform can achieve results beneficial to all affected parties.” He also commended the outstanding efforts of two District government attorneys who worked on the matter: Ellen Efros, Deputy Attorney General of the Public Interest Division; and Matthew Caspari, DBH General Counsel.
As part of the court filing to dismiss the settlement agreement, DOJ has requested that the parties inform the court that the District’s federally recognized protection and advocacy organization for people with disabilities, University Legal Services, will continue to monitor the hospital per its independent statutory authority and current practices. The notice serves as an important public acknowledgement by the parties of continued independent monitoring of the conditions of care and advocate for the individuals in care at Saint Elizabeths.
The end of the agreement is the latest instance of the Gray Administration regaining local control of human-services functions of the District government after they had been placed under federal oversight as a result of lawsuits and investigations – some dating back more than a decade. Since Mayor Gray took office, the District has been freed from court oversight in mental health care and transportation services for students in special education. The Gray Administration continues to take active steps towards the District's achieving an end to court oversight of its agencies, including in special-education programs, child welfare, and disabilities services.