Stirling Calls for Closure of Hospital in Hillcrest

Assemblyman Larry Stirling (R-San Diego) urged Wednesday that the state immediately close San Diego County’s embattled mental health hospital in Hillcrest, saying recent investigations by four state agencies indicate that patients there are “being subjected to life-threatening danger . . . on a daily basis.”

Stirling, who for months has been a dogged critic of the county’s Health Services Department, which administers the hospital, said he took the “major step” of calling for the closure after reviewing 40 “deficiency reports” from an investigation by the Licensing and Certification Division of the state Department of Health Services.

Stirling made his recommendation in a letter to Gov. George Deukmejian.

Many of the deficiency reports involved improper filing of reports and work practices, but others were more serious, Stirling said, upon releasing copies of the documents. One said “acceptable standards of care” were violated when a patient was restrained in a supine position for almost eight hours. At least one other case of physical abuse of a patient by a staff member was cited.

The assemblyman also hinted that unnamed workers at the hospital and within the county Health Services Department would be singled out in the state investigations. “We do know that both investigations involve specific personnel at County Mental Health that have long been protected by the corrupt management of the county health department,” Stirling said.

State officials were not available to comment on the documents.

David Janssen, San Diego County’s deputy chief administrative officer, said he was “not wild about” the assemblyman’s remarks and declined further comment.

Stirling said he expected “the county to fight all the way on this. They won’t want Hillcrest closed, but there are no other alternatives at this point.”

The deficiency reports will be incorporated in a yet-to-be-published report by the Health Services Department. The state auditor general in June completed a report critical of Hillcrest’s practices, and additional reviews by the state Department of Mental Health and state Board of Medical Quality Assurance are due to be released soon.

Investigations into Hillcrest began last year when a supervising psychiatrist at the hospital charged that three of four recent deaths of patients housed there could be traced to poor judgment by the medical staff. In June, the county grand jury concluded an eight-month investigation that was harshly critical of the hospital’s administration.

The grand jury said it found instances of patients being inappropriately released or refused admission to the mental health hospital and said doctors on late-night shifts improperly slept while on duty. It also said unlicensed employees had worked at the hospital, and that Hillcrest’s administrative practices were sloppy. In addition, there were allegations of sex involving patients at the hospital.

In response to those charges and the findings of its own internal reviews, the county has begun to reorganize the Health Services Department’s mental health division. A program manager at the hospital who was found to be working without a proper license--one of the deficiencies contained in the documents Stirling released Wednesday--was fired. Dr. Warren Higgins, who served in top management positions at the hospital for almost 20 years and who has been blamed for many of the hospital’s problems, was transferred.

In July, county supervisors approved a $678,000 budget increase that county Chief Administrative Officer Clifford Graves said was needed to help end ongoing problems at Hillcrest. The money is to go toward hiring 24 staff members at the Hillcrest hospital and the county mental health facility at Loma Portal. Those include two doctors, four psychiatrists, two psychiatric social workers, a vocational nurse and six nurses’ assistants.

But the plan has yet to be completed, in part because the changes in job classifications and salaries have been hung up in the red tape of the county’s civil service system.

On Tuesday, the Board of Supervisors ordered outgoing Graves to hire an independent consultant to investigate the management and organization of the Health Services Department.

Stirling praised Supervisors Paul Eckert and Brian Bilbray for initiating the consultant’s investigation, but he said the county’s actions to improve Hillcrest had been largely insignificant, and that the “situation has grown worse in the last month. It is very sad indeed that the primary response to date of the county’s entrenched bureaucracy has been to dismiss, ignore, sidestep and call for more studies. . . .

“This is government bureaucracy at its worst. We have no choice but to close down County Mental Health before more helpless and unprotected mentally ill patients are killed because county government has neither the will nor the commitment to act decisively.”

Stirling said there would be no shortage of mental health beds in county hospitals caused by the closure of the 61-bed Hillcrest facility.

Times staff writer Daniel M. Weintraub contributed to this report.