Multnomah County mental health whistleblower sues

READ – Monaco v. Multnomah County, Legacy Health + DBA Unity Center, and Chris Farentinos (PDF)

READ – Multnomah County’s termination letter to David Hidalgo, March 27 2019 (PDF)

Multnomah County mental health whistleblower sues

Greg Monaco, told to shut up about reports of patient abuse at Legacy’s Unity Center, is now suing.

From the Portland Tribune, April 2, 2019

A former Multnomah county investigator who was told to shut up when he alerted his bosses to reports of patient abuse at a new regional psychiatric emergency ward has sued the county for $1.1. million.

The suit by Greg Monaco, a longtime county mental health investigator, says county managers subjected him to “intolerable” working conditions due to his raising of concerns about patient safety at Legacy’s Unity Center for Behavioral Health, “pressuring” him to take early retirement — which he did in July 2018.

The lawsuit was filed shortly after the county fired two top mental health managers, one of whom is named in Monaco’s suit alleging whistleblower retaliation.

Some parts of the suit are familiar. They allude to the findings of patient abuse at Unity Center detailed by a scathing state report released in response to a Portland Tribune records request. They also echo a August 2018 Tribune article detailing how ,after Unity complained about him, Monaco’s managers had told him more than a year before to stop raising concerns of patient mistreatment and neglect at Unity Center, which began operations in 2017.

But the suit also goes into more detail about the pressure that led him to retire two years early, such as his boss asking him, “When are you going to retire?”

David Hidalgo, the recently fired head of the mental health division, initially told the Tribune last August he had no knowledge of Monaco’s complaints and appeared to dismiss them, saying “context is everything.” He claimed the county lacked authority to investigate the complaints.

This, county officials realized, turned out not to be true, documents and interviews show. Chair Deborah Kafoury eventually ordered a full investigation of the county’s handling of complaints, including whether county managers had acted unlawfully.

That investigation, headed by the Multnomah County District Attorney’s office, is ongoing. In December the Tribune first reported that a preliminary review found 16 reports of patient abuse at Unity Center should have been shared by county managers with police for criminal investigation, but were not.

Now Monaco’s suit details how he’d visited Unity Center shortly after it opened in January 2017 and “observed significant problems with the facility in areas including structure, staffing, staff training, and other areas threatening patient safety. From the time of opening and continuing thereafter, Monaco heard Unity nurses raise complaints about understaffing, poor management, inappropriate injections, and safety concerns, as well as a culture of retaliation against any nurses who complained about health and safety risks faced by patients and staff. Nurses related to Monaco how no positive action appeared to be taken by Unity in response to internal staff complaints.”

After receiving similar complaints from Unity employees, state investigators at first found the facility’s poor design, management and staffing presented such a hazard to patients that it might have to be shut down.

But later in the year the state and federal regulators concluded that Legacy’s safety improvements at the mental health facility were adequate to allow it to remain in operation.

Monaco’s suit says he had repeatedly urged county managers to address similar concerns, only to be told that Unity was “too big to fail.”

On March 27, the county issued letters of termination to Hidalgo and quality assurance manager Joan Rice, who’d both been on leave pending the investigation.

“I have determined that your continued employment is no longer in the best interests of Multnomah County,” wrote Marissa Madrigal, the county’s chief operations officer, in the letters.

On the same day, the county named the mental health division’s deputy director, Ebony Clarke, to replace Hidalgo.

Former Multnomah County Mental Health Investigator Files Whistleblower Lawsuit Against the County, Legacy Health

Greg Monaco raised concerns about conditions at the Unity Center, a new psychiatric facility. He was ignored.

From Willamette Week, April 2, 2019

In the latest of a long string of dominoes to fall, a former Multnomah County mental health investigator filed a whistle-blower lawsuit April 1 in Multnomah County Circuit Court.

For more than 25 years, Monaco worked for the Multnomah County Mental Health and Addiction Services Division as a pre-commitment investigator, evaluating whether patients should be hospitalized.

That work placed him deep inside the workings of the public and private sector mental health systems within the county.

In early 2017, with support from OHSU, Kaiser and Multnomah County, Legacy Health opened a specialized facility called the Unity Center for Behavioral, which was aimed a coordinating and improving the delivery of services to people facing psychiatric crises, who were often left untreated in hospital emergency rooms or the streets.

But in his lawsuit, Monaco says from the beginning, staff at the Unity Center, where he often went to evaluate patients, shared concerns with him.

“On or about January 31, 2017, Unity finally opened,” the lawsuit says. “Within several days of its opening, Monaco arrived on site to fulfill his [per-commitment investigation] duties. There, Monaco observed significant problems with the facility in areas including structure, staffing, staff training, and other areas threatening patient safety.”

The lawsuit says that he shared his concerns about patient safety, including at least one death at Unity, with his superiors in the Multnomah County Health Department. They reportedly ignored his concerns, he says.

Monaco also shared his concerns with former Multnomah County Steve March and the director of the Unity Center but rather than addressing those concerns, the lawsuit says, Unity officials complained to Multnomah County that Monaco was a causing problems.

“By early 2018, Monaco continued to learn of serious problems and continuing health and safety issues at Unity, including conditions and practices dangerous to patients and staff, and a pattern of retaliatory action at Unity against whistleblowing staff members,” the lawsuit says.

“Despite a continuing policy asserted by County managers to not provide oversight over issues raised about Unity, Monaco again raised concerns about Unity to the Auditor as well as managers and leadership. When Monaco raised concerns, he faced significant pushback. This pushback included criticism when Monaco elevated reports to higher managers, and instructions that he instead report to direct supervisors who had already shown, by direct statements as well as conduct, that they would take no action on those reports.”

Eventually, after extensive reporting by the Portland Tribune which first reported Monaco’s lawsuit, state officials and later, federal officials moved in and found Monaco’s concerns were valid. That validation wasn’t enough to save his job at the county, however, according to the lawsuit. He says in the lawsuit he was pressured to leave his job and took early retirement July 31, 2018.

Multnomah County continues to investigate why Monaco’s superiors ignored his complaints but last week, the county abruptly fired its two top mental health officials.

Monaco is seeking $1.1 million in damages.

Brian Terrett, a Legacy spokesman said Legacy hadn’t seen the lawsuit yet.

“Legacy Health has not been made aware of this litigation and no chance to review it in detail, Terrett said. “It is Legacy Health’s practice not to comment on legal matters or litigation, but rather let the process occur in the appropriate venue.”

Multnomah County declined to comment.

Unity Center whistleblower sues Multnomah County, Unity for $1.1 million

From The Oregonian, April 2, 2019

The Multnomah County employee who blew the whistle on mistreatment of patients at Legacy’s Unity Center for Behavioral Health has sued the county for retaliation and is seeking $1.1 million.

Greg Monaco, who worked as a county mental health investigator for nearly 30 years, alleges he was pressured to retire early after raising numerous concerns of abuse. He is also suing Legacy Health, the Unity Center and Chris Farentinos, the center’s vice president, who resigned Feb. 1.

The suit, which was first reported by the Portland Tribune, was filed Monday in Multnomah County Circuit Court. In it, Monaco says he repeatedly told his bosses and county auditors about his concerns about understaffing, poor management and risks to patient safety at the Portland area’s main mental health facility. Monaco also informed them of what he said was a culture of retaliation against nurses who expressed safety concerns.

Monaco says superiors and co-workers pressed him repeatedly to retire early and eventually he did, retiring a year and eight months earlier than he had planned. “Monaco felt that the public interest required him to report and elevate the continuing serious health and safety issues that he learned of concerning Unity,” the suit says.

“Monaco concluded that the only way he could be free to report the dangerous and unlawful conduct at Unity and other facilities was to resign his employment.”

Due in part to his whistle-blowing, patient deaths and other adverse patient outcomes were reported by many Portland news outlets, including The Oregonian/OregonLive, and outside investigations were launched.

Federal and state investigation of Unity ultimately revealed that two people died in preventable ways while at Unity as well as other instances of violence, sexual assault and poorly trained staff.

The top two Multnomah County officials overseeing Unity, including a safety official Monaco spoke to directly, have both been replaced. County officials refused last month to say whether they had been fired.

Monaco is being represented by Thomas Doyle of Bennett, Hartman, Morris & Kaplan, a firm that often represents labor unions and their members.

Whistleblower Sues Multnomah County, Unity Center For Retaliation

From The Lund Report, April 2, 2019

A former Multnomah County employee is suing the county and a psychiatric emergency center that the state investigated last summer after several patients died, suffered sexual abuse or were exposed to hazardous conditions.

Whistleblower Greg Monaco alleged in the complaint that he faced intolerable work conditions and was ultimately forced to resign after reporting patient health and safety issues at the Unity Center for Behavioral Health. He said the county failed to investigate his complaints for two years. The lawsuit says that Monaco’s supervisors at the county repeatedly ignored the safety concerns he raised, took disciplinary action against him, encouraged him to retire early and plotted to “take care of him” after he continued to raise concerns.

The county fired two top mental health officials last week amid an internal investigation by the county. Former Mental Health Director David Hidalgo and Joan Rice, the quality manager, had been on paid administrative leave since August.

The county is investigating the handling of Unity Center complaints along with all county mental health services. The Multnomah County district attorney and the sheriff’s office are conducting a separate investigation.

Monaco, who was an investigator, is suing Multnomah County, the Unity Center for Behavioral Health, its former vice president Chris Farentinos and parent company Legacy Health. Farentinos resigned in January.

Monaco accuses the county of retaliation and the Unity Center of aiding and abetting. The complaint says that as a result, he suffered humiliation, emotional distress, loss of benefits, lost wages and damage to his professional reputation. Monaco is suing for at least $1.1 million plus attorney fees.

“Monaco concluded that the only way he could be free to report the dangerous and unlawful conduct at Unity and other facilities was to resign his employment,” the lawsuit said.

Unity Center Spokesman Brian Terrett issued a statement in response to a request for comment: “Legacy Health has not been made aware of this litigation and has not had a chance to review it in detail,” it said. “It is Legacy Health’s practice not to comment on legal matters or litigation, but rather let the process occur in the appropriate venue.” Kate Willson, a Multnomah County spokeswoman, said the county also does not comment on pending litigation.

Reporting Safety Concerns

As a pre-commitment investigator, Monaco evaluated whether mental health patients involuntarily committed at mental health facilities should be kept there and assessed patient safety.

He reported safety concerns as early as November 2016, before the Unity Center opened. He told his supervisor and the Unity Center’s soon-to-be deputy director that he was concerned with the Unity Center’s structure. The center’s opening was delayed in January 2017 after failing inspections. He reported the problems and patient harm to Multnomah County Auditor Steve March and his supervisor that month.

When the center opened at the end of that month, Monaco immediately observed problems with understaffing, inappropriate medication, safety and retaliation against nurses who complained about health and safety risks for patients and staff, his lawsuit said.

The lawsuit says that Monaco’s supervisor at the county, Bill Osborne, ignored his request for greater oversight. The lawsuit said Monaco told the county auditor in February that he feared retaliation.

Alleged Retaliation

Monaco’s lawsuit said that when he reported safety concerns again to Osborne in May 2017, his supervisor told him that “it’s their liability, not ours” and that “Unity is too big to fail.”

Monaco said he relayed his concerns to Farentinos, Unity’s vice president, and was reprimanded by his supervisors after Farentinos complained. They forbade him from contacting Farentinos again.

In June 2017, Monaco learned that he was under investigation for an alleged HIPAA violation. He claimed in the lawsuit that he overheard another manager, Jean Dentinger, tell Osborne that they were going to meet with human resources about Monaco to “take care of him.”

The lawsuit said Monaco continued to report patient safety concerns in early 2018, prompting his manager to ask him when he was going to retire.

“When Monaco raised concerns, he faced significant pushback,” the lawsuit said.

In May 2018, Monaco reported a patient death at the Unity Center to Joan Rice, the quality manager. She said she would wait to hear from Unity, the complaint said.

Monaco alleged he faced “continuing pressure to take an early retirement,” but felt a duty to report the health and safety issues at Unity. He resigned almost two years short of his planned February 2020 retirement.