Evidence on who should be held accountable for violent attacks by patients on Hawaii State Hospital workers will be presented during Senate committee hearings to begin this week, said one of two lawmakers holding the briefings.
The Senate committees on Health and on Judiciary and Labor will begin the first of several informational briefings Tuesday.
"The information we have received so far has not been positive as it relates to the behavior of certain supervisors at the facility," Sen. Clayton Hee, chairman of the Senate Committee on Judiciary and Labor, said by telephone Saturday. "That will come out on Tuesday because we have transcripts of recordings, and we have reports that strongly suggest that the administration needs to take proactive decisions with respect to supervisors at the facility."
Workers have submitted smartphone recordings of conversations with supervisors, Hee said.
The briefing’s purpose, according to the agenda, is to provide an update on the state of violence against hospital workers, explore staffing patterns and plans to create a safe workplace, and receive information about the spectrum of patients, including violent offenders.
"Ultimately the goal is to find ways to protect the workers from being assaulted by patients," Hee said. "Also, we’re keeping in mind that the patients need to be kept safe and that the administration needs to become proactive in providing policies and directives to be a part of the solution to prevent the ongoing assaults to protect workers."
In November, Sen. Josh Green, Senate Health Committee chairman and a Hawaii island doctor, said the whole system may need to be overhauled.
An assault on a hospital worker occurs every three days, Hee noted.
Psychiatric technicians have spoken out publicly that they have experienced mental and emotional damage in addition to physical damage from the patients at the Kaneohe hospital.
One man said he was kicked in the head by two patients fighting in August and suffered a concussion, as well as post-traumatic stress disorder and memory loss.
A woman was slammed into a wall and suffered a dislocated jaw in 2009 after she tried to get help for another worker who was getting punched. She said she suffered panic attacks when she tried to return to the hospital and was diagnosed with PTSD.
One underlying problem with the assaults is in the interpretation of the law.
If an individual is ruled insane by the courts, there is no standard "order to treat" such a patient with medication, despite the patient’s irrationality and violence, Hee said.
The hospital takes a position that it requires a court order.
Hee said he has been working to clarify the statute with a state Judiciary administrator who is revisiting the statute and discussing it with the circuit judge in charge of orders to send people to the Kaneohe facility.
Hee said that the profile of the criminally insane has changed over time.
"Many are psychotic because of drug abuse, and many of the males have a background in mixed martial arts, so the workers would assert the population is violent," he said.
Senate President Donna Mercado Kim has asked to the committee chairmen to consider a resolution to be passed by the Senate to allow the investigative committee to subpoena individuals to protect them if they testify, Hee said.
Another issue that is being investigated is workers’ complaints that their workers’ compensation claims are not being processed.
One union official contends a lack of staffing and training to deal with criminally insane patients is part of the problem, and said a separate facility for the court-committed patients that provides adequate treatment and appropriate security is needed.
Hee agreed "there needs to be a separate facility for the most dangerous mentally ill individuals who are sent to the state hospital" and added that that had been the case in the past and the adminstration will explain Tuesday why it was discontinued.
Dr. Mark Fridovich, who oversees the hospital as chief of the Adult Mental Health Division, said in November the rate of assaults has not increased, but hospital officials are concerned about the number of staff members assaulted and that assaults are evidence treatment is not progressing. He said the staff-to-patient ratio was good.
Hospital officials said employees are adequately trained, but a review of the program will be conducted to see whether there is room for improvement.
"While I hope federal oversight will not be the result of this, if that is what it takes to get the administration in order and get the administration providing safety for patients as well as workers, that’s also an option," Hee said.
