Criticized Unit’s Chief Gets New Job

The longtime manager of a county mental health department that has come under fire for its treatment of young patients at Orangewood Children’s Home is being moved to a new job, officials disclosed Wednesday.

Dr. Bernard Rappaport, head of Orange County’s Children and Youth Mental Health Services Department, will leave his post within the next few weeks to take the newly created position of medical director, where he will serve as an advisor to top Health Care Agency managers.

Ronald DiLuigi, assistant director of the Health Care Agency, said Wednesday that the move has been in the works for some time and is not related to a derogatory report about Rappaport’s department completed earlier this year by the Juvenile Justice Commission.

In the highly critical report issued in July, the commission concluded that county psychiatrists under Rappaport’s supervision had jeopardized the health of abused and neglected children at Orangewood by prescribing powerful drugs without recording a supporting diagnosis, had failed to keep accurate charts and had changed drugs with questionable frequency.

Rappaport was not named in the report, which also criticized the Health Care Agency for not being more aggressive in addressing staff complaints about treatment practices at Orangewood, some of which date to 1995.

“This move is totally separate from that,” DiLuigi said. “Dr. Rappaport has an extensive level of experience across the board in behavioral health. He has established a track record that . . . [will be] beneficial in the new position.”

But county Supervisor Todd Spitzer, who along with Board of Supervisors Chairman William G. Steiner has pushed for reform in the wake of the commission report, suggested that the Health Care Agency only made the move after coming under fire for some years.

“It took some heat for [the Health Care Agency] to deal with this head-on,” Spitzer said. “I am pleased to see this personnel shift after all these years of criticism. I hope it will bring positive change for the kids at Orangewood.”

Following issuance of the commission’s report, the agency appointed two new administrators to oversee medical care at Orangewood to better ensure that drugs were properly prescribed to children.

Cindy Stokke, head of the Juvenile Justice Commission, said the changes have brought “many excellent improvements” at Orangewood and expressed hope that a new manager of the Children and Youth Mental Health Services would bring more improvements.

“If this move means we will see more positive impacts on the system, then we will feel good about it,” Stokke said. “With the new administrators, we can talk openly about issues we are concerned about, and they will listen. . . . It’s a major improvement over the way things were before.”

DiLuigi said the position of medical director is needed because of changes in Medicare rules that give the county more responsibility for patients who need mental health services.

Besides advising top managers, Rappaport will work with local hospitals on mental health projects.

Rappaport’s department also came under criticism in 1993 for providing better mental health services for children in South County than in other parts of the county--a charge officials denied.

Rappaport did not return calls for comment.