Testimony on Patient Abuse Reporting

Testimony for Multnomah County Commission – August 23, 2018

Beckie and I are here today to speak about the safety of thousands of patients at Unity Center, and in the dozens of other hospitals, clinics, alcohol and drug treatment centers, nursing homes, jails, daycare centers, schools, adult foster homes, residential care facilities, mental health treatment centers which assist and protect vulnerable populations in Multnomah County.

As best as we can understand it, due to a miscommunication between state staff and County staff, few if any patient abuse investigations were completed by County staff in 2018. This miscommunication is unacceptable, and we commend the County’s quick response to investigate the problem.

In general we tend to trust licensed clinicians. They have education, training, experience, supervision, peer standing, and legal responsibilities to guide their work. We rely on their help for our health, and sometimes with our lives.

Counties provide an additional layer of authority and reassurance by receiving complaints of patient abuse by mandatory reporters, thoroughly investigating the complaint, setting out the facts of the complaint and making recommendations for future action. This tedious process provides an impartial and public accounting and resolution. It is the only layer independent of the clinician or the agency which employs them – independent, authoritative, and impartial. The legal ability to investigate and force actions keeps patients – and their community of friends, family members, allies and neighbors – safe and secure, knowing the clinical services are a safe sanctuary of health and healing.

But a message was received by the County to cease investigations. That alone should have set of sirens – not just a red flag – which should have alerted your offices directly. It took a dozens of messages from one alert employee and finally a dozen newspaper articles to get your attention and commendable response.

Further – and we hope you add this to your inquiry – we’ve been told by career staff in the mental health division there has never been a training about mandatory reporting.

Your investigation will have recommendations. Along with the ones you discover, ours would be the following.

    All county agencies and personnel who interact with people vulnerable populations by Oregon statute should identify a specific single person to receive all abuse complaints by mandatory reporters. This reporting process could go through the county’s main 988-4888 and then be filtered to the appropriate people.

    The identified agency receiver of complaints will be a mandatory reporter, and be licenced by the state as social worker, professional counselor, psychologist, or physician.

    All county personnel who work with vulnerable populations be trained within 180 days on abuse reporting procedures and requirements and annual refresher trainings.

    All contracts include requirement that agency staff receive annual training on abuse reporting.

    Reports of confirmed abuse will be forwarded to law enforcement for prosecution.