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No Major Violations in Orangewood Findings : Inquiry: Part of report will be made public by the end of the month. Critics question why results were withheld for so long.

TIMES STAFF WRITER

A much-delayed audit of psychiatric medication practices at Orangewood Children’s Home--finally received by the county last week--found no evidence of serious violations requiring reports to law enforcement or licensing authorities, Orange County Supervisor William G. Steiner said.

But suspense--and suspicion--remains over the audit that was ordered by the supervisor a year ago.

Steiner, who received a briefing from county health officials on the independent auditors’ findings, said most of the details will not be released publicly because the county counsel’s office has determined they involve confidential “quality assurance” issues.

The auditors’ final recommendations, however, will be made public by the end of the month as part of overall suggestions for improving the county’s mental health system, he said.

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“I am satisfied that the welfare of the children currently in the home is not being jeopardized,” Steiner said.

But critics who pressed for release of the audit over the past year said they expected something more.

“We want to know the methods by which they came to these conclusions,” said Zaida Ramos, a former mental health supervisor at Orangewood whose complaints led to the audit. “What is it that they have to hide? If they had nothing to hide, they would release everything.”

Steiner, a former director of the county-run home for abused and neglected youngsters, called for the probe last year after Ramos complained that a psychiatrist there was over-medicating young patients, mixing prescriptions improperly and giving the children adult dosages.

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The report was delayed for months--first by the turmoil engendered by the county’s bankruptcy and then, after the lead auditor, a Torrance psychiatrist, refused to hand over her findings because she feared being sued for defamation. Dr. Melinda Young, who headed the three-person audit team including another psychiatrist and a pharmacologist, finally was persuaded to turn over her portion last week.

A community civil rights group contends that withholding the findings after such a long delay can only lead to doubts about the quality of the probe.

“We are relieved that there are no findings of gross mismanagement,” said Amin David, chairman of Los Amigos of Orange County. “However, we must have a bit of reservation on the quality of the audit if it was held in abeyance such a long time,” he said. “The entire audit” should be released, he said. “That will certainly clear the air and allay any grounds for suspicion about the worthiness of the audit.”

Steiner said he would like the whole report to be released as well, but the county is legally bound to respect the rules of peer review, under which a doctor’s practices are reviewed confidentially. The idea is to encourage reviewers to speak freely, without fear their findings will be made public.

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“It has always been my preference to have full disclosure and deal with any perception of impropriety, as well as to have closure on this issue, but I have been preempted by the county counsel,” Steiner said.

Steiner referred questions about the legal issue to Deputy County Counsel James F. Meade, who said last week he was unfamiliar with the matter and would look into it.

Before the end of the month, Steiner said, the county will release 24 recommendations to improve the county’s mental health system, touching on services provided to both adults and children.

The recommendations will be taken from the reports by the three Orangewood auditors as well as a state inspector who examined the county’s entire quality assurance system, he said. County health officials also will release their response to those suggestions.

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Meanwhile, the Orange County Juvenile Justice Commission is continuing its probe of mental health care received by children who are wards of the county courts.

Bruce Malloy, the commission’s administrative officer, said his agency may subpoena the reports of the Orangewood auditors as part of its “big picture” investigation. The commission’s findings are expected to be released by early next year.


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