L.A. County to Pull Mentally Ill Residents Out of 2 Sylmar Centers

Citing numerous escapes and lapses in patient care, Los Angeles County officials on Thursday said they would not renew their contract with two private psychiatric facilities in Sylmar and must now find new quarters for 170 seriously ill patients by June.

The decision follows a months-long investigation into Foothill and Sylmar health and rehabilitation centers that county officials say showed a failure to correct problems or even to consistently report them.

Marvin Southard, director of the county Department of Mental Health, said the decision to end the 16-year relationship with the owner, Golden State Health Centers Inc., was highly unusual. It resulted from a “growing lack of confidence in the commitment of the agency to patient care,” he said.

“We decided it was in the best interest to take our patients out.”

Los Angeles County is the largest source of patients for Foothill and Sylmar, which together house 400 patients. Other patients are placed by the state of California, several other counties, and the U.S. Department of Veterans Affairs. Some counties, including Orange and Fresno, say they may reevaluate their own contracts, based on L.A.’s decision.

Officials at Golden State said they regret L.A. County’s decision and called it particularly troubling because of “the first-class mental health programs that have been provided to Sylmar and Foothill’s residents.”

“While the staff at both facilities have worked diligently to avoid any deficiencies, it is a fact of life at institutions of mental disease that issues will arise that require corrective action,” company spokesman Dan Durazo said.

For Los Angeles County officials, transferring so many residents before the contract lapses June 30 could be difficult.

Foothill and Sylmar are among 12 centers, akin to nursing homes for psychiatric patients, in Los Angeles County. Such centers house patients who, because of such illnesses as schizophrenia or bipolar disorder, need close supervision. Demand has increased markedly as state hospitals have emptied their mental wards.

Operators of similar centers in the county, called Institutions for Mental Disease, say they have little room for more patients.

“They’ll just have to work with it day by day and see what happens,” said Monica Fenton, administrator at View Heights Convalescent, which has 10 vacancies in the 99 beds in its locked ward.

After recent complaints from a labor union about conditions at the Foothill and Sylmar facilities, county officials twice extended their contracts for six months, rather than the usual three years.

It was not until March, however, after The Times began inquiring about problems at the centers, that county and state officials launched a major inspection.

The inspectors found “inconsistent reporting and an excess number” of escapes and attempted escapes at Foothill and Sylmar -- which had among the worst records in the county for such facilities.

Foothill and Sylmar together logged 64 escapes and attempted escapes in 2002, according to figures provided by Golden State. County investigators who examined the logs said some of those escapes had not been reported to authorities as required.

In addition, state regulators have fined both Sylmar and Foothill three times in recent years for patient-care violations, including a fine of $3,000 against Foothill in September for failing to protect a 33-year-old female patient from being raped by a male patient. Sylmar was fined $3,000 in March because an employee had sex with a psychiatric patient.

Golden State spokesman Durazo said Sylmar and Foothill have fewer patient-care violations per bed than similar facilities in the county. Foothill recently installed a security system to prevent escapes, and Sylmar is following suit, he said.

Golden State fired Foothill’s administrator, Rich Terrell, this week after he wrote a letter accusing county officials of singling out his center for frequent inspections and holding it to a higher standard than similar locked institutions.

County Supervisor Zev Yaroslavsky, whose district includes the centers, said he supports the decision to end the relationship with Golden State.

“When we contract with somebody ... we expect that agency to place at least as much importance on the interests of the clients as we do, if not more,” Yaroslavsky said. “That wasn’t the case here, and repeated efforts to bring this to the attention of the owners ... fell on deaf ears time and again.

“Enough is enough,” Yaroslavsky said. “We don’t owe anybody a contract. That’s what every contractor needs to know. They are privileged to do business with us. They are not entitled to do business with us.”

The state Department of Mental Health said it has no plans to relocate 20 Foothill residents accused of major crimes who have been found not guilty by reason of insanity. Agency spokeswoman Nora Romero said Foothill’s program for those residents complies with state regulations.

The state agency did, however, send Foothill a letter Thursday concluding that the facility had “an unacceptable level” of escapes and attempted escapes and asking for a plan of correction.

Orange County officials, who have 73 residents at the two facilities, said they were worried that L.A. County’s decision to remove its patients might leave the centers unable to maintain their treatment programs.

“If they cannot operate the facility appropriately, obviously we would want to move our clients,” said Sandra Fair, Orange County’s chief of behavioral health operations. “We have a great deal of confidence in the L.A. County Mental Health Department and we would want to have a conversation with them about the reasons they’re taking this action.”