A coming crisis for those needing personal care -Raleigh News & Observer

Commentary: S. Barton Cutter

Direct support professionals carry many different job titles but help people with varying needs, ranging from providing basic physical assistance to opening avenues for people with disabilities to engage in community activities.

Whether they are known as personal-care assistants, support services technicians or other designations, their work is integral to the lives of many people with disabilities and often is undervalued except by those directly served.

In my work as a contractor for the N.C. Council on Developmental Disabilities, I see the necessity of well-trained, reliable direct-support professionals on a regular basis. As one with cerebral palsy, I also rely on direct support workers in my own life. Tom, my current support person, assists me with showering, dressing and eating so that I can earn a living, support my family and participate in my community. He is, in many ways, my lifeline to the world.

Despite Tom's critical service, many people view his line of work as menial, leading to a depreciation of this work force's value. This has led to a growing concern in the field of direct support.

An estimated 50 percent of direct support professionals leave their jobs each year. Low pay -- $8.68 an hour on average -- a lack of benefits, high burnout rates and limited training and minimal opportunity for career growth make remaining in the field untenable.

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THE STATISTICS ON THE COMING NEED FOR WORKERS IN THIS FIELD ARE STAGGERING. In the next decade, there is expected to be openings for 40,000 more nursing aides, orderlies and attendants and home-care aides. The demand for such services by individuals with developmental disabilities is projected to increase 37 percent by 2020.

To be prepared, it is vital that a portion of the money allotted to the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse be spent on improving the direct support work force.

When Gov. Mike Easley asked for a budget increase of $86.5 million for mental health in North Carolina, he cited the need for "continued development of appropriate community services to support the full continuum of care necessary to serve our citizens."

Even while trimming the requested increase to $21.3 million, the House and Senate signaled their support for the goal.

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THIS ACKNOWLEDGEMENT OF THE NEED FOR GREATER SUPPORT comes at a critical time for people in the developmental disabilities community, but the boost in resources will be effective only if that money is well-spent.

Though much of the increase will be used to address mental health and substance abuse needs, many hope this will prove to be an important first step in the development of a stable, adequate support work force for people with disabilities.

Tom, who has been working with me for less than a month, is my third support person in two years. While at first glance, this may appear above average, the average drops drastically when one realizes there may be a one- to two-month gap in services while searching for a replacement.

The N.C. Council on Developmental Disabilities is working to find innovative solutions to lead the way in addressing the direct support work force crisis. Last year, the council and other DHHS divisions invited a team from the Center for Medicare and Medicaid Studies to evaluate the current conditions of the frontline work force in North Carolina.

As a person who understands the need for qualified direct support professionals from both personal and professional standpoints, I commend the governor and the General Assembly for recognizing the growing need for a quality workforce of direct support professionals.

(S. Barton Cutter, a contractor for the N.C. Council on Developmental Disabilites, lives in Raleigh. He can be reached at barton.cutter@gmail.com)

All rights reserved. This copyrighted material may not be published, broadcast or redistributed in any manner.
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State pays nurses way to S. Africa-Raleigh (NC) News & Observer

Michael Biesecker

RALEIGH - An employee at a state mental hospital in Goldsboro used $5,000 in public money to pay for a 15-day trip to South Africa.

Gladwyn "Shryl" Uzzell, a nurse at Cherry Hospital, visited medical facilities, an orphanage, botanical gardens, a former prison for political prisoners under apartheid and the houses of Nelson Mandela and Archbishop Desmond Tutu.

She also went on a safari at a wildlife preserve known for its lions, leopards, elephants and rhinos.

Uzzell said the trip, approved by the hospital's top administrators, provided insights that will apply directly to her state job training other nurses to care for the mentally ill back home in Eastern North Carolina -- especially the tour of an AIDS treatment ward in Cape Town.

"In that country, HIV/AIDS pandemic has such an impact on their nursing staff," said Uzzell, 52, who traveled from May 26 through June 9. "I saw nurses who were able to continue doing what nursing is supposed to be about, which is about caring and putting the patient first, continuing to give and to give, without complaint."

Uzzell, a registered nurse who is pursing a bachelor's degree in nursing at East Carolina University, asked supervisors at the state hospital to pay for the trip after receiving an invitation from the International Scholar Laureate Program.

"This is a once-in-a-lifetime opportunity will enable you to join other highly acclaimed college students on a journey of discovery to one of the most exotic destinations in the world," said a letter signed by Donna J. Snyder, the program director. "The legacy of apartheid will come alive for you as you venture to Soweto ... You will enjoy dinner under the African stars, hear tales of the bush as you spend your days with Kruger [National Park] game rangers and have plenty of time to explore on your own the wonders of this fascinating land."

Nowhere does the four-page letter, which features an official-looking seal incorporating an eagle with the globe in its talons, mention that the student is expected to raise thousands of dollars for the honor of participating.

According to the Better Business Bureau, the International Scholar Laureate Program is one of at least six names used by Envision EMI of Vienna, Va. -- a private, for-profit company that markets overseas travel to students and recent graduates.

A call to Envision's headquarters was not returned, but the company's Internet site touts its history of delivering "unique experiences" on five continents.

"To say we are an 'experiential education' company is akin to saying Microsoft is a software company ... true at the core, but doesn't at all capture the true essence," the site says. "At Envision, all of the 'experiential education' experiences we create and lead do far more than share knowledge by simply doing. They all impart wisdom."

More than a dozen complaints have been filed against Envision in the last three years, according to the Web site for the BBB chapter covering the Washington, D.C., area. But the business watchdog group gives Envision a "satisfactory" rating for resolving complaints from dissatisfied customers.

Jack St. Clair, the director of Cherry Hospital, said he and Uzzell's other supervisors approved spending the $5,000 for the trip. The money came from revenue the mental hospital receives through hosting students, primarily from medical schools in the Caribbean.

Uzzell, whose annual salary is $64,528, said she paid about $1,600 of her own money to cover a three-day extension to the trip.

"I suspect the trip gave her a renewed perspective on things," St. Clair said. "You know, we all kind of get caught up in our own world of work. To get out and see other cultures and to see how other people do things, as a way to benchmark and to help remind us what we are all about, what our priorities are all about, probably gave her a renewed focus that might not have been realized as readily as being here every day." Read more!

State takes control of mental health facility's finances - Wilmington Star-News

By Vicky Eckenrode - July 30, 2008

State health officials will take over the finances of Southeastern Center for Mental Health starting Friday in an attempt to get the beleaguered facility's budget under control.

The N.C. Department of Health and Human Services warned Southeastern administrators in March that the move was a possibility after the center began struggling meeting payments for client services with the state funding it had.

"We appreciate the efforts that you and your staff have undertaken to try to resolve the Center's financial difficulties," Department of Health and Human Services Secretary Dempsey Benton wrote in a letter Tuesday to Southeastern's area director Art Costantini. "Unfortunately, we do not believe that to date those efforts have been sufficient to ensure the Center's long-term financial viability and its ability to continue to provide adequate services for consumers.

"We have concluded that it is time for the Department to fulfill its statutory obligations."

The state agency has appointed Joy Futrell, assistant area director of East Carolina Behavioral Health, to serve as the administrator and work with Southeastern to stabilize its finances.

Her appointment does not replace any of Southeastern's current management team, Benton's letter stated.

But she will be take over responsibilities such as accuracy of financial records, contracts with providers, approval of any budget changes proposed by Southeastern and approval of all requests to spend more than $5,000 on anything not directly related to services.

Though the move by the state is unusual, it will not involve the center's actual operations.

"I don't believe that would impact in any way (the center's) normal actions," Phillip Hoffman, head of resource and regulatory management for the state's mental health division, said recently. "This is focused on their financial affairs."

Costantini said one of the main goals will be to work with the state's administrator on a plan to fix Southeastern's budget. He said state officials outlined a three-month goal to pull together and implement the plan so that Southeastern can reassume control of its finances.

"We're happy that someone is coming in, because now it becomes a joint decision-making process," Costantini said. "We needed that in terms of the (state) division's input."

The center's problems this year started when administrators realized they were going to receive less in state funding than they had expected for mental health, developmental disability and substance abuse services.

The center, which acts as a pass-through for state money to private providers, tried to scale back services that could be reimbursed. But the center still started its new fiscal year in July facing a shortfall between what it had to spend and what it projected the needs to be in the community.

According to a memo from Chris Coudriet, assistant county manager for New Hanover County, Southeastern should be spending $690,000 a month in state funds to make its budget. But the center in July, its first month of the new fiscal year, spent $1.4 million, wrote Coudriet, relaying the information from his meeting with center administrators to county commissioners.

Costantini said the shortfall stemmed from several factors, including reimbursements submitted under higher rates before the center clamped down further on services.

But, he said, the numbers are still not balancing out.

"That's the problem. We're spending at twice the rate that our budget called for," Costantini said. "That's why the state said they needed finally to come in."

Vicky Eckenrode: 343-2339

vicky.eckenrode@starnewsonline.com
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Push grows for guns on campus -Longview (TX) News-Journal

By JIMMY ISAAC - July 31, 2008

Weston Cartwright remembers his first week at LeTourneau University in 2006, and how he amazed his dorm mates when he returned unharmed from a walk to a South Longview restaurant.

"They were like, 'Are you serious?' " Cartwright said.

Since then, he's seen and heard why fellow students deemed a trip into the surrounding neighborhood such a serious mistake. The 20-year-old professional flight major said gunshots, some just a block away, can be heard at least three nights a week from his campus residence.

Longview police spokesman Kevin Brownlee doesn't doubt Cartwright's estimate, considering there were reports of shootings in that area as recent as July 20, when fatal gunfire at a gas station one block from the university left one mad dead and another man injured.

"I guess we've grown accustomed to it, which might be a more dangerous thing," Cartwright said from his hometown of Sewall's Point, Fla., where's he's spending his summer break. "You just deal with it because you don't have any way to defend yourself."

He is among thousands of U.S. college students who want that changed. In a letter to the Longview News-Journal dated June 16, Cartwright called for colleges such as LeTourneau to allow licensed students and school staff to carry concealed weapons. It's a stance touted by Students for Concealed Carry on Campus, a national group of more than 30,000 college students, faculty and parents who support concealed handgun rights on campuses.

Cartwright, like the national organization, points to recent school shootings such as those at Virginia Tech University in 2007 and Northern Illinois University in May as evidence that allowing concealed weapons on college campuses is necessary.

The Texas Penal Code prohibits people who aren't licensed peace officers from carrying firearms and other weapons on any school or educational institution whether public or private. The law gives colleges the authority to allow firearms on campus, but it's not clear whether that allowance can be given to individuals or the whole student body, said Terrence Turner, LeTourneau University's director of campus security. The Texas Attorney General's office found no court decisions that could provide legal opinions on how that clause is interpreted.

Cartwright wants LeTourneau University to allow students to at least carry concealed weapons in their cars, but the university — like most East Texas colleges — maintains a gun-free zone.

"That's been an ongoing conversation among students and even faculty and staff," said Doug Wilcoxson, the university's vice president of student affairs. "It's just been the legislation that we fall under."

Utah became the first state to allow concealed weapons on state-supported colleges in 2007. At least a dozen states are considering such bills, and state Sen. Jeff Wentworth, R-San Antonio, said he will introduce a similar bill when the Legislature convenes in January.

Sen. Kevin Eltife, R-Tyler, and Rep. Tommy Merritt, R-Longview, agree with the idea and said they will likely support Wentworth's bill.

Texans must be at least 21 to get a concealed handgun license. Having older, more experienced students and faculty members — some who may have served in law enforcement or military duty — with concealed weapons might deter a school shooting in Texas, Wentworth said.

"I just think it brings a measure of safety that does not currently exist on college campuses," Wentworth said in a telephone interview. "At least it would put on notice those wacky people who go on campuses because everyone is unarmed and defenseless."

Texans for Gun Safety, a Houston-based group that seeks to reduce gun violence through education, does not support such legislation unless steps are taken to ensure mentally ill students or faculty are not carrying weapons. Tommie Garza, the group's executive director, said arming such students is the last thing any campus needs.

"It just doesn't seem like a sensible plan," Garza said. "In a workplace or a school, emotions run so high there. (If a gun is off campus) at least you have that distance to cool off, think it over."

Seung-Hui Cho, a 23-year-old undergraduate, killed 33 people at Virginia Tech before committing suicide on April 16, 2007. He had been declared mentally ill by a Virginia special justice in 2005.

In February, former Northern Illinois University student Steven Kazmierczak, 27, opened fire on that campus, killing five students and himself. His ex-girlfriend told CNN that he had stopped taking medication for anxiety, depression and insomnia three weeks earlier.

Turner, whose 33-year law enforcement career included stints with the U.S. Air Force Security Police, the Arizona Highway Patrol and Longview Police Department, does not carry a firearm as director of LeTourneau's security force despite being a state-licensed peace officer. He credits rapid response time from Longview police as a reason for low crime on his campus, but he's not convinced LeTourneau will remain a gun-free environment.

"I think we have to look at the contingencies both ways because the lawmakers are going to follow their constituency," Turner said. "We have to make sure we are prepared no matter the circumstance."

* * *

Crime on local college campuses

Officials at LeTourneau University and Kilgore College say their campuses are safe.

In its most recent crime data from the U.S. Department of Education, LeTourneau University saw an increase in burglaries in 2006 compared with the previous two years.

There were 17 burglaries and three car thefts reported in 2006, compared with 16 burglaries and no car thefts in 2004 and 2005 combined. There were two aggravated assault cases and no other reported violent crimes during that three-year period, the data shows.

Terrence Turner, the university's chief of campus security, said there have been one vehicle burglary, one residential burglary and one burglary of a coin-operated laundry machine reported to security personnel in the past year at LeTourneau.

"What I can say is if you looked at our crime statistics, we are a very safe campus," said Doug Wilcoxson, the university's vice president of student affairs. "How do we keep our students and employees safe (is first and foremost). In the midst of this part of the community, we've been a very safe place."

Kilgore College spokesman Chris Craddock said there have been no incidents involving firearms on its Longview and Kilgore campuses in the past year. The college has never authorized anyone besides campus and local law enforcement to carry any type of weapon on school property, he said.

Since Sept. 1, Kilgore College has had reports of four assaults, 16 residential break-ins and 17 car burglaries, according to campus Police Chief Bill Lewis. There have been five car burglaries since surveillance cameras were installed campus-wide in December.

Lewis said he would oppose letting students carry concealed weapons on campus.

"We're a small college — about 5,000 students," Lewis said, "but could you imagine if just a tenth of our student body — 500 people — were carrying weapons?" Read more!

Judge rules Bixby patriarch mentally unfit to stand trial - Greenwood (SC) Index-Journal

By KENNY MAPLE

Arthur Bixby might never have a day in court regarding his role in a 14-hour standoff that resulted in the deaths of two Abbeville law officers.

In probate court Tuesday, the accused murderer was found to be mentally ill and a danger to himself and others, Eighth Circuit Solicitor Jerry Peace said.

Bixby, who had been incarcerated at Johnson Detention Center in Laurens, has been committed to the Department of Mental Health.

“What that means is that the Bixby case is done for now,” Peace said. “We can’t try him until he becomes competent.”

The solicitor said those chances are slim for the 79-year-old.

Bixby was deemed not competent to stand trial by Judge Wyatt Saunders in Laurens County. As reported in The Index-Journal, Saunders ruled Bixby, who suffers from a form of dementia, was not and would not become competent.

Attention has been on the accused recently, although his family has been involved in a string of legal issues over the years.

On Dec. 8, 2003, Abbeville County Sheriff’s Office Deputy Danny Wilson and Constable Donnie Ouzts were shot to death in front of the Bixby home at 4 Union Church Road in Abbeville.

Those shootings sparked a 14-hour standoff between law enforcement and Arthur and son Steven Bixby. Both men were eventually apprehended. Arthur Bixby also was shot.

His son was found guilty on two counts of murder in February 2007 and sentenced to death by Judge Alexander Macaulay. He is on death row at a Ridgeville correctional facility.

Rita Bixby, Arthur’s wife and Steven’s mother, was found guilty of conspiracy and two charges of accessory before the fact of murder. She was sentenced by Macaulay to two life terms in prison without the possibility of parole.
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Scott Hadley, who swam to fame as teen, now tries to stay afloat as adult - Sacramento Bee

By Blair Anthony Robertson - brobertson@sacbee.com

According to the yellowed press clippings from the summer of 1970, Scott Hadley was on his way to something big – a successful life, standing in the community, or so it seemed.

Back then, nearly four decades ago, the newspapers and TV stations covered his exploits as a swimmer, especially when the lanky and lean 15-year-old swam 19 miles across Clear Lake, the largest freshwater lake in California, in 11 hours and 53 minutes.

Fifteen boats followed Hadley in the water. A representative from the Amateur Athletic Union was there to certify the record. Sports Illustrated put him in its "Faces In the Crowd" section 19 days later.

It was a simple time for Hadley. He got into the water. He stroked and kicked and breathed. The rest took care of itself.

Hadley knew important people in politics and business and was on a first-name basis with Debbie Meyer and Mark Spitz, Olympic swimming superstars. While still a teenager, the 6-foot-1 Hadley was ranked ninth in the world among marathon swimmers. At Encina High School, he was elected student body president only weeks after transferring from Sacramento High.

These days, it's a different story, a different Hadley.

People look right past him. He's 53, has fought off his demons with cocaine, and has been in and out of homelessness. He often sleeps alone along the American River with a few possessions and the cell phone his sister gave him.

"I'm just relaxing under a tree. It's probably 15 degrees cooler under here," he said by phone the other day. "I'm watching the river go by. It's very serene."

Practically everyone in the family has cut him off except sister Dana Hadley, who says she feels bad when she helps him and worse when she doesn't.

"It's just heartbreaking. He burned many, many bridges," she said. "It was a bane to my mom until she died. I cannot tell you the emotions she went through until she finally said, 'You have to stay away.' "

Politically conservative and a devout Catholic, Scott Hadley eschews government handouts and says he chooses to live a pared down life. He doesn't own a car. He stretches his money by eating the $2.99 special at Del Taco: two burritos, a taco and a small drink.

Maybe it was a curse that the high point in his life came 38 years ago, and that he could never seem to top it or, at least, build on it.

"To him, it's his big accomplishment. It picks him up and makes him feel like somebody," said sister Dana, who witnessed the swim. "He got praise from my dad. Afterwards, dad was so happy, he bought (Scott) a car."

He swam Lake Berryessa two years later. In 1973, sponsors flew him to Naples, Italy, where he placed ninth against the 125 best distance swimmers in the world. He used each swim to raise thousands for charities for the mentally ill.

But it didn't take long before people forgot him. In the spring of 1974, he tried to run clear across the country, attracting media attention once more, only to drop out in pain after a few days.

"Sometimes I had like delusions of grandeur," he said. "I wanted to run across the country and meet President Nixon. But I dropped out. I just couldn't do it."

These days, with a spotty employment history that includes a career as a funeral home embalmer and, more recently, a caregiver for the elderly, Hadley is struggling to get on track.

Often, he will think back to that swim in 1970 in Clear Lake, how the whole world seemed to be watching, how it began in the dark at 5:22 a.m. and how, halfway into it, it was too hard, too much, and he wanted to quit.

"I told myself, 'Wow, this is harder than I thought.' At the halfway point, I told my dad I wanted to get out of the water," Hadley recalled. "My dad was in the boat and he said, 'We didn't train this hard for you to quit.' "

After high school, he enrolled at American River College, but he didn't know what he wanted to do. He knew there was no money in swimming. His part-time job at a funeral home turned into a 15-year career as an embalmer.

"Then I was introduced to this white stuff called cocaine," Hadley said. "I was losing money. I lost my job. That whole beautiful life I had was gone."

By his early 40s, a disillusioned Hadley landed at a mission in Santa Barbara, the same town where he had run for City Council. He wanted to kill himself.

"For me, it felt like being in a barrel. You try to climb out and then you slip back down," he said. "It was a whole downward spiral. I was angry at God. I said, 'Why have you done this to me?' But I had really done it to myself. I blamed everybody else."

Hadley's life is not a comeback story, at least not yet. In swimming terms, he's struggling to stay afloat.

He can recall that 1970 swim as if it were yesterday, how his mother put together a blend of liver and honey he could eat in the water for energy, how the only thing he wanted after 12 hours in the lake was a plain old hot dog.

After that, things get hazy. The choices he made are hard to explain or even recall.

He has filled out applications for caregiver jobs. He shaves every day in a public restroom. He dresses neatly. And he waits for answers under that shade tree, watching the river go by.

Once in a while, he'll jump in. The strokes and kicks are stiffer now, the breaths more labored, but he's still that swimmer who made history, the one whose story remains alive in those yellowed press clippings.

"I'm never really alone," he said. "I have what I believe to be God with me. I have memories of good people, and memory is a form of companionship."
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Divided board OKs mental health director’s contract - Waynesville (NC) Smoky Mountain News

By Julia Merchant • Staff Writer

In a move that appears to be uncommon in the North Carolina mental health care field, the board of the Smoky Mountain Center for Mental Health last week approved a five-year contract for organization director Tom McDevitt.

Smoky Mountain Center is the local management entity in charge of overseeing mental health care in 15 western counties — more counties than any other such entity in the state.

The contract guarantees McDevitt a $164,892 per year salary, full employee benefits package and car until Sept. 1, 2013, when he plans to retire.

A request for salary information of the directors of the 24 state local management entities gathered responses from 15. Of those, McDevitt was one of only two that has a contract and is one of the three highest paid directors in the state.

The contract did not sit well with everyone, and divided the board in a 16 to 8 vote.

The eight who voted against the contract were from the original seven counties overseen by the Smoky Mountain local management entity. The rest of the board members are from counties to the north and east which have since merged with the organization. Three counties — Caldwell, Alexander and McDowell — only came on board July 1. The new additions now form a majority on the board, replacing that held by the seven original counties.

Some questioned why an emergency meeting was necessary since McDevitt had two years remaining on his contract.

Board members who voted against the contract have recently butted heads with McDevitt over accusations that he has abused his leadership position. They were quick to say, however, that their opposition to the contract wasn’t a personal attack on the organization’s director — rather, they called a contract unnecessary overall.

“It doesn’t matter who was in that position, but a five-year contract just seemed excessive at this time when a lot of things are unsettled in the mental health field,” said Ronnie Beale, a Macon County commissioner. Beale and McDevitt have been at odds since McDevitt threatened to pull Smoky Mountain out of a Macon County Mental Health Task Force. In a letter, McDevitt accused Beale of attacking the organization for perceived shortcomings.

Haywood County Commissioner Mary Ann Enloe was also opposed to the five-year contract.

“I think employment more or less stands for itself,” she said. “I don’t know what the purpose of a contract would be. Usually if you realize that the situation is not a good match, you don’t throw people out on the street.”

Problems between McDevitt and his board reached a fever pitch in June when McDevitt abruptly announced his resignation at a board meeting after an hour-long closed session argument over the contract and a new set of bylaws. He later retracted his announcement.

As a result of that incident, board members strived to make sure Smoky Mountain Center was protected in the contract if McDevitt was to resign his post.

“What if you got mad and quit and just went home? What kind of protection does Smoky have?” asked Swain County Commissioner Glenn Jones.

Under the contract, if McDevitt leaves before the five years is up, he’s entitled to a three-year buyout. But McDevitt can’t receive the buyout if his departure is connected to a failure to give his best effort in Smoky’s interest. Board members initially wanted that statement clarified, but board attorney Jay Coward said that wasn’t necessary. Any board decision to terminate McDevitt would be up for interpretation and would probably be contested in a court of law anyway, regardless of whether there was more clarification in the contract.

McDevitt took issue with the vagueness of the interpretation of what it meant to fail to act in the Smoky Center’s best interest.

“I think it’s so vague and ambiguous that anything I don’t do in the satisfaction of the board gives them reason to terminate my employment,” he said. He said an independent party, like a court of law, should be in charge of evaluating whether he acted in the best interest of the organization.

Ironically, McDevitt came under fire at the last board meeting for the same thing he was protesting. At that time, McDevitt attempted to amend the bylaws by including a phrase allowing for the termination of a board member at any time if they expressed negativity or criticism toward Smoky Mountain Center. The board protested and the phrase was removed.

During the meeting to approve the contract, board members raised questions about some of McDevitt’s practices. Smoky Mountain Center’s nepotism policy was a topic of concern. McDevitt’s daughter is employed by the organization, and some questioned whether she received special treatment.

McDevitt defended her employment, saying her position in medical record disposal was temporary and would be finished within eight weeks. He said the nepotism policy had become somewhat lax because of the difficulty of finding qualified employees, and that far from receiving special treatment, his daughter is the lowest paid employee in the agency.

The fact that the daughter’s position was temporary was news to Enloe.

“Never had it been mentioned to me before that it was a temporary job that would be ending,” she said.

Enloe asked about the involvement of McDevitt’s wife, who is a Realtor, in the sale of property owned by the Smoky Mountain Center.

“When Smoky sells or buys property, what real estate firm or agent handles that?” she asked.

McDevitt responded that the organization doesn’t own any property. Enloe then asked whether McDevitt’s wife was in any way involved in property transactions for the organization.

McDevitt said his wife is a Realtor with Main Street Realty, in Waynesville, though not a broker, and that “she’s been involved in assisting the foundation and purchasing properties.” The Evergreen Foundation is the private arm of the Smoky Mountain Center that owns the organization’s assets. McDevitt said that Enloe’s question was “answered in the affirmative at this point.”

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Homeless man finds comfort in Catonsville - Baltimore County (MD) Catonsville Times

By Marcia Ames - mames@patuxent.com

7/30/08 -Every now and then, as Nora Reiter drives by Salem Evangelical Lutheran Church, she'll lower her car window and ask Mark Hoffmann whether he wants some dinner.

She knows to find the 51-year-old, homeless man sitting on a bench outside the Frederick Road church, reading a newspaper or gazing at the passing traffic.

Often, he accepts her offer of food and always politely.

"I know he likes beef better than fish," said Reiter, who typically drives to the nearest fast-food chain restaurant, buys a hamburger and delivers it to Hoffmann.

"Please don't make it sound like I'm a saint," she said, agreeing to be interviewed for the Times. "All of our parishioners are being charitable toward him."

A pastoral associate and business manager at St. Mark Catholic Church on Melvin Avenue, Reiter first encountered Hoffmann in June after he began taking Holy Communion at St. Mark.

By coincidence, a Greensboro, N.C., resident familiar with Hoffmann's disappearance from that city visited Catonsville earlier this month, attended Sunday Mass at St. Mark and recognized him there.

By mid-July, Reiter had learned through his friends in Greensboro, and his 27-year-old daughter, Stroudsburg, Pa., resident Kimberly Bono, that Hoffmann had been missing since May from his seven-year residence on a park bench in the North Carolina city.

"Those people were good to him and made him feel like he was OK," she said, referring to churchgoers, merchants and residents in Greensboro. "I can't imagine how scary it would be to live out on a bench or in the woods. That would terrify me."

No one other than Hoffmann may know why he left Greensboro and caused so many to worry about his whereabouts and welfare.

Nor do they know how he made his way some 350 miles north to Catonsville.

He declined an interview with the Times, saying, "I don't want to make a statement.

"It is very kind of you to ask," Hoffmann said, holding a folded newspaper close to his face.

Bono was on vacation last week and unavailable to comment.

Having pieced together Hoffmann's history from St. Mark records, Greensboro residents and Bono, Reiter says the Catonsville native rarely speaks to anyone, has repeatedly declined housing or social services assistance and probably has a mild form of schizophrenia, including hallucinations.

His parents, Murray and Viola Hoffmann, joined the St. Mark parish in 1954, and the church recorded his birth in March 1957.

The parents lived on Locust Avenue when they died as members, she in 1994, he the following year, Reiter said.

State tax records show they had lived there since 1963, when Mark, the youngest of four children, was 6 years old and starting school at St. Mark.

He remained at the school through the eighth grade, then graduated from Mount St. Joseph High School. He later graduated from Lehigh University and worked for a while as an accountant at Duke University in Durham, N.C., 53 miles east of Greensboro, according to Reiter.

How and why he found his way to a bench in Greensboro seven years ago remains a mystery, as does his reason for leaving.

A regular presence at the church, he rarely misses Mass on weekday or Sunday mornings, Reiter said.

At the Coffee Junction on Frederick Road, owner Donna Quick noted that he comes into the shop almost daily to buy a cup of coffee, which he drinks while sitting on a chair outside the store.

"He tells you what he wants and says 'thank you,' " she said, adding that he always wears a coat and long pants despite the summer heat.

She offered no complaint about his presence there.

"He brings out the best in people," said Reiter, who knows of only one person, a businessman, who had complained of Hoffmann's presence in Catonsville.

"They are losing out on a great opportunity to be charitable," she said. "Mark is a very gentle soul."
Read more!

Fatal police shooting is a real tragedy -Silverton (OR) Stayton Mail

Commentary: CARL SAMPSON -July 30

When I think about the case in which a Silverton police officer shot and killed a man with mental problems, all I can conclude is that there are no winners.

What transpired that evening, after a homeowner called 9-1-1 as a man threw himself against the front door of her house, could only be described as nightmarish.

Having said that, I could have only wished for a different outcome, in which everyone ended the evening safely: the man, the police officer, the homeowner and her family.

As is so often the case, wishful thinking and reality are two divergent outcomes. When people die, we all think that there could have, and should have, been a better outcome.

Yet, in the heat of the moment, with a police officer under attack and a man out of control, I cannot say what I, or any other reasonable person, might have done differently if we were in his shoes.

That was among the findings of a Marion County grand jury last week, which found that Officer Tony Gonzalez’s actions that evening were justified. Yet, that finding gives no one solace. Not the family of Andrew Hanlon, for sure. And not the officer, members of the police department or anyone else involved.

There can only be the hope that similar incidences might be avoided in the future. The question is: How could similar instances be avoided?

It’s no secret what I think about the American health care system. In my opinion, it can best be described in terms of haves and have-nots.

The haves — those with fat wallets or gold-plated health insurance policies — get what they need, when they need it.

The rest of us, well, we’re just out of luck, aren’t we? Without the money to pay for treatment, we’re left to our own devices.

Politicians yap about this Band-Aid or that idea to throw the public a bone, but none of them is really interested in solving the problem, which boils down to a lack of access to health care for most people.

That’s especially true when it comes to mental health care. That people don’t receive the care they need, to me, is plain shameful.

What’s even more shameful is when a problem arises, it becomes a police matter. I do not know the details of the man involved in this most recent tragedy. However, I do know that health care, particularly mental health care, is hard to come by, and that people who are mentally ill or who have problems need ongoing treatment. Without it, tragedies like the one that took place that night in Silverton are not only possible, they’re inevitable.

Carl Sampson is a freelance writer. He can be reached at pcsampson@wvi.com. Read more!

Schizophrenia Yields Some Genetic Secrets - Washington POst

By Amanda Gardner - July 30, 2008

WEDNESDAY, July 30 (HealthDay News) -- Moving closer to the causes and effective treatment of schizophrenia, researchers say they've found specific gene variations linked to the condition.

Specifically, three rare deletions in the human genome appear to raise the risk of developing the devastating brain disease considerably.

"These findings give a great deal of hope -- for individuals with schizophrenia and their families and loved ones and caregivers -- that we're moving towards an understanding of the causes of the disease," said Dr. Pamela Sklar, corresponding author of a paper appearing inNatureand director of genetics at Harvard Medical School, Boston.

Additional findings, all reported at a Tuesday press teleconference, are detailed in two other papers published in the July 30 online editions ofNatureandNature Genetics.

But the current findings are just the tip of the iceberg, the researchers stressed.

"We've only explained a tiny fraction of why people might develop schizophrenia, and much more work needs to be done to connect specific changes to the full spectrum of other types of genetic factors that might influence schizophrenia, as well as ways they might interact with the environment," added Sklar, who is a member of the International Schizophrenia Consortium, which conducted one of the studies.

Schizophrenia, a devastating disorder characterized by hallucinations and delusions, affects some 1 percent of the population, usually appears in late adolescence or early adulthood and, despite some effective treatments, tends to be chronic.

Breakthroughs in understanding this disorder have been few and far between.

"We've been working on schizophrenia for rather more years than we care to think, and successes have not been dramatic," acknowledged Michael O'Donovan, lead author of theNature Geneticsstudy and professor of psychiatric genetics at Cardiff University in the United Kingdom.

"There has been precious little on diseases of the brain, and what seems to be emerging is that a lot of risk of brain diseases, including schizophrenia and autism, seems to be conferred by rare [gene] variants like rare deletions," said Dr. Kari Stefansson, senior author of one of theNaturepapers and CEO of deCODE in Reykjavik, Iceland.

Schizophrenia tends to run in families, hence the focus on genetic determinants of the disease.

The first two papers, inNature, compared the genomes of 3,300 individuals with schizophrenia against those of 3,200 individuals without the illness.

"We looked at a relatively rare type of DNA change where people have a substantial portion of a chromosome either missing or extra. These are called copy number changes," Sklar explained.

In this case, the consortium found three deletions: one on chromosome 1 and two on chromosome 15, which were seen multiple times in people with schizophrenia. Two of the deletions had never been recognized before. "That triples the number of specific DNA areas that may be responsible for schizophrenia," Sklar said. "All of these together were found in about 1 percent of patients." But they conferred a very large risk, multiplying the odds of getting schizophrenia by a factor of more than 10, Stefansson said.

TheNature Geneticspaper identified three "single-nucleotide polymorphisms" (changes) or SNPs that were associated with schizophrenia and appear to be risk factors for the disease. The strongest association was with a variant near the gene ZNF804A, whose function may be to regulate other genes.

According to O'Donovan, other researchers have looked at what are called "whole chapters" in the genome. In contrast, his team honed in on what he described as tiny spelling differences.

The variations identified are much more common than those reported in the previous two papers.

"In addition to rare variants, we were able to convincingly show that common variants are involved in schizophrenia. But we don't know how much of a role they play compared with rare variants," O'Donovan said. "It means that virtually all of us have genes for schizophrenia, but probably those of us who don't have schizophrenia don't have enough of the genes or possibly have not been exposed to [an environmental stimulus]."

"Schizophrenia is the ultimate human disease, affecting the things that characterize us as individuals," Stefansson added. "Perhaps with a little bit of luck, we will gain insight into the pathogenesis of schizophrenia . . . and will discover enough of the variants to put together meaningful diagnostic instruments for this very difficult disease."

More information

There's more on schizophrenia at the U.S. National Institute of Mental Health.

SOURCES: July 29, 2008, teleconference with Pamela Sklar, M.D., Ph.D., director, genetics, Harvard Medical School; Kari Stefansson, M.D., CEO, deCODE, Reykjavik, Iceland; and Michael O'Donovan, Ph.D., professor, psychiatric genetics, Cardiff University, U.K.; July 30, 2008, online editions,NatureandNature Genetics Read more!

Hospital could lose all federal payments -San Diego Union-Tribune

By Cheryl Clark - July 30, 2008

Sharp Grossmont Hospital in La Mesa has the county's busiest emergency department.
The mistakes, documented by state investigators during two inspections in April and May, included staff members restraining a highly medicated, 25-year-old man with schizophrenia in such a way that he was allowed to suffocate. In addition, hospital workers caused the death of an 83-year-old woman who had undergone a hysterectomy by injecting a dangerous anti-narcotic into her bloodstream.

Other problems included nurses who did not know or use proper CPR, an unsanitary operating-room mattress held together by tape and glue, unsafe storage and handling of food and kitchen equipment, and use of critical medications such as heparin that had expired up to a year earlier.

The investigators also said Sharp Grossmont did not have the required specialists to evaluate emergency patients needing urologists or hand, plastic and oral surgeons. Sharp Grossmont has the busiest emergency department in the county, with about 78,000 patient visits a year.

Loss of federal reimbursement would cripple most hospitals, including Sharp Grossmont, which receives 50 percent of its net patient revenue from Medicare and Medicaid, known as Medi-Cal in California. The two programs cover treatment for seniors, the poor and the disabled.

Dan Gross, executive vice president of Sharp HealthCare, said he was confident the hospital is now in compliance.

“I'm a nurse, and my heart is with every patient and every family,” Gross said. “We at Sharp are so unhappy and so keen to determine what we missed, what could we have done differently and what can we do better. We have an expectation that we provide nothing but the highest quality of care.”

In the spirit of acknowledging Sharp Grossmont's faults and efforts to correct them, Gross provided a copy of the 100-page federal report one day earlier than the government's planned release.

Sharp Grossmont's leaders had until yesterday to document how they had fixed or are addressing the deficiencies. On the deadline day, they hand-delivered their “Plan of Correction” to the Center for Medicare and Medicaid Services' regional office in San Francisco.

Regulators will review the hospital's response and schedule another visit by state inspectors, who work on behalf of the federal government. Sharp Grossmont could lose its federal money by Oct. 15 if problems continue, said Steven Chickering, head certification officer at Medicare's office in San Francisco.

Among the 450 hospitals in Chickering's jurisdiction of Hawaii, California, Nevada and Arizona, 10 to 12 a year have as many major lapses, he said. Ninety-nine percent of those facilities resolve their crises and keep their federal payments, Chickering said.

The violations at Sharp Grossmont “indicate a serious breakdown of the hospital's systems that are designed to ensure appropriate patient care,” said Kathleen Billingsley of the state Department of Public Health, which inspected Grossmont's quality of care.

Chickering called the problems “significant” in five of 18 critical categories: oversight by the hospital's governing body, observance of patient rights, monitoring and improving quality of care, nursing services and physical environment.

“These areas really need close attention and significant changes to ensure good outcomes for the patients,” Chickering said.

Gross and Michele Tarbet, Sharp Grossmont's CEO, said they have launched intense educational programs and taken disciplinary action against employees to put the hospital back on track.

They also said hospital officials have dramatically beefed up professional training of nurses and other staff members, launched rigorous reviews of the psychiatric unit and re-evaluated food storage and maintenance of food-preparation equipment.

Sharp operates the hospital under a long-term lease with the public Grossmont Healthcare District, which opened the hospital more than a half-century ago.

Gloria Chadwick, who serves on the district's board, said she and other board members knew nothing about the problems.

“Certainly it would be a public discussion, but there's been nothing like that at all,” Chadwick said. “This is certainly a concern for the community.”

The deficiencies at Sharp Grossmont first came to light in April, a few weeks after Larry Napolis, a 45-year-old heart attack victim, was placed on a ventilator in the hospital's catheterization lab. The ventilator was not turned on, said state investigators and the San Diego County medical examiner.

Napolis died March 21. The fatality was not reported promptly to state and federal officials as required, state investigators said.

As a team of state inspectors looked into the case in April, another preventable death occurred at Sharp Grossmont.

Jeffrey Christopher, 25, of Bonsall was playing cards with his mother on April 11 and became agitated when visiting hours ended at the hospital's psychiatric unit. Christopher had a history of becoming unsettled and then falling to his knees, resulting in wounds to his knees and feet.

The unit's workers took Christopher to his room and had him lie down on his stomach. They secured him to his bed with restraints at the wrists, ankles and waist, keeping his head and neck above the mattress. They also gave him several medications for his schizophrenia, including ativan and thorazine.

Although nurses continuously monitored Christopher, they did from a chair facing his feet instead of following the standard practice of checking a patient's face. One nurse assigned to his room said she saw him “scoot and wiggle himself lower onto the bed until his face was on the mattress,” according to a report by the county's medical examiner, who conducted an autopsy on Christopher.

“He then began violently hitting his face against the mattress and metal frame of the bed,” and held his breath, the medical examiner's report said.

During a staffing rotation, another nurse entered the room and saw that Christopher had turned blue.

The Medicare report said a nurse tried to resuscitate Christopher, but did not follow American Heart Association guidelines because he had not been trained adequately. Christopher died that night.

At least one-quarter of the federal report, which did not mention Christopher by name, is devoted to chronicling the series of errors that resulted in his death.

“The staff did not intervene by repositioning the patient onto his back so that he would be unable to bury his face in the mattress,” it said.

The federal report also faulted Grossmont officials for not reporting this death until six days after it happened. The government requires official notice within a day.

Gross and Tarbet, the Sharp executives, said a licensed vocational nurse who was watching Christopher didn't notice that he had suffocated.

“The (nurse) assumed that since the patient had been sedated, he was resting quietly,” Tarbet said.

Attorney Peter Haven is investigating Christopher's death for his parents, Barbara and James Christopher of Bonsall.

After learning about the federal report's contents, Haven said the inspections “confirm what we already suspect – that restraints were used inappropriately in at least one instance, and it appears there may be more widespread problems at this medical center.”

Cheryl Clark: (619) 542-4573; cheryl.clark@uniontrib.com Read more!

Cop shown clubbing cuffed vet, taking call, then going on the attack again - New York Daily News.

Vet discharged for post-traumatic stress. Title link leads to video link

BY OREN YANIV AND ALISON GENDAR
DAILY NEWS STAFF WRITERS

A city cop caught on tape beating a handcuffed Army vet paused to take a phone call and then went right back to smashing the man with his baton, police sources told the Daily News.

Officer David London, 43, was stripped of his gun and badge Monday and placed on desk duty as the NYPD Internal Affairs Bureau investigated the July 18 incident, sources said.

"He takes a cell phone break, then turns back to tuning up the [suspect]. He did it while the building security camera was rolling," a source said.

London and his partner stopped Walter Harvin, 28, as he tried to enter the DeHostos Apartment on W. 93rd St., where Harvin's mother lives, about 1:15 a.m.

"I told him don't close it because I don't have the keys," said Harvin, a vet who was discharged in 2004 for posttraumatic stress disorder.

"As I walked into the elevator he grabbed my arm. That's when I pushed him," Harvin said. "I was on the floor and he kept beating me with the stick. He sprayed me with Mace. While I was on the floor, he handcuffed me. I don't remember too much about it."

Security video from the building showed London beating Harvin after he was cuffed and on the ground, a source said.

"You are not supposed to beat a man once he is cuffed, but the video shows the [suspect] down on the ground, cuffed. They even stand him up in the corner and beat him with the [baton] some more," said a police source familiar with the security video.

As London and his partner propped the handcuffed war vet up against a wall, London's cell phone rang, sources said.

Video showed London talking on the phone for 90 seconds before he resumed beating Harvin, sources said.

London told colleagues Harvin went berserk when he was asked to show identification or proof he was entitled to be in the building.

Harvin started punching and kicking the cops, screaming, "You can't take me!" court papers say.

"He is a big guy who fought being cuffed, kicking. He was not quiet, lying there like a lamb," one source said.

London took the cell phone call only because it was an emergency, another source said, although he wouldn't elaborate.

Harvin said he didn't remember much of what happened once the beating started. He was charged with assault and resisting arrest and was released pending a hearing.

Harvin said he told the cop he served 3 1/2 years in the 101st Airborne Division, including six months in Iraq.

"[London] said he was in the Navy. It didn't matter to him. He said I was a disgrace," Harvin said.

oyaniv@nydailynews.com Read more!

Police: Killer thought victim was warlock -KOB-TV Albuquerque (NM)

Video link by clicking title.

Andres Eligeo

Bernalillo County deputies say a mentally ill man at a South Valley group home stabbed to death a roommate after a voice in his head told him the victim was a warlock.

The victim, Samuel Whitehorse, 44, was found cut in the abdomen sitting against a bathtub early Wednesday. He died later at a hospital.

Deputies arrested 27-year-old Andres Eligeo Ortega on charges of murder and tampering with evidence. He was held on a $1 million bond.

Ortega told officers a voice in his head named Steve told him to kill because Whitehorse was a warlock. Investigators say the suspect also believed he worked for the FBI and that he was aiding them.

"Based on the interviews, it sounds like he really thought he was being helpful and that it was a good, just decision as opposed to a vendetta against Mr. Whitehorse," said Sheriff's deputy Mark Kmatz.

The home's caretaker told police that Whitehorse told her he was afraid of Ortega and had made arrangements to move. Ortega and Whitehorse had a confrontation the night before in which Whitehorse said he felt threatened.

Ortega has a criminal record which includes domestic abuse and burglary charges stemming from 2002. He was ruled incompetent to stand trial and committed to a state mental hospital in Las Vegas.

(The Associated Press contributed to this report) Read more!

Suicide rates are higher in the desert -Riverside (CA) Press-Enterprise

Mark Muckenfuss - July 29

RIVERSIDE, Calif. -- People who live in the desert are far more likely to kill themselves than those who live in more temperate regions of California's Inland area.

Local officials seemed baffled by the data revealing the trend.

Experts emphasize that numerous factors might influence these numbers, including age, sex, income levels and even illegal drug activity.

While desert dwellers make up 24.7 percent of San Bernardino County's population, figures from the San Bernardino County coroner's office showed that they accounted for 36.9 percent of the suicides from May 2004 through May 2008.

That difference meant that those living in the High Desert areas such as Victorville, Barstow and Yucca Valley were 49.4 percent more likely to take their lives than the general population.

The figure is lower in Riverside County. Based on data from the same four-year period, those living in desert regions east of the Banning Pass were 30.1 percent more likely to commit suicide than those living west of the pass.

Eve Moscicki is associate director for prevention at the National Institute of Mental Health in Washington, D.C. She cautioned against drawing conclusions from the data.

"I would want to control for a lot of different factors such as age, sex, race, ethnicity, socioeconomic status," she said. "You want to control for that and rule out all of those things first."

Neither Moscicki nor any local experts contacted for this story knew of any studies on suicide that had looked at physical environment or geographical location as a risk factor.

"For years there were theories that suicide rates in the Northern Hemisphere were higher than the Southern Hemisphere," she said. "I'm not sure that's the case any more."

She did note that in Europe, suicide rates can vary from country to country. Many social factors, she said, play into those differences. "There's never a single explanation," she said.

Some regional trends have been noted in the United States as well.

"At a very crude level," she added, "we've known for years that suicides tend to be highest in the western states."

How much of a role environment plays in this is unknown. Moscicki pointed out both Nevada and Alaska rank consistently in the top 10 but share few similarities when it comes to climate or terrain. Both, however, have large areas of sparsely populated land, and isolation, she said, can be a risk factor.

And while western states' suicide rates tend to be higher -- particularly states in the Southwest -- California is an exception.

In 2005, the national suicide rate was 10.9 per 100,000 people. California's rate was 9.1, ranking it 42nd in the country.

In 2007, San Bernardino County's population was 2,026,325. With 157 suicides that year, it would have a rate of 7.7 per 100,000. Riverside County's rate for the same year was 9.4.

Augustine Kposowa is a professor of sociology at University of California Riverside who has studied the area's suicide demography. He had not noticed the trend of higher rates in desert areas, but he said the environment could be a factor.

"Extremely hot conditions can cause people to begin to ask questions as to whether life is worth living," Kposowa said. "They look around themselves and see nothing but very hot weather, the vegetation dying they are more likely to answer in the negative."

Kposowa also said age could be a factor and it does appear to have some influence on the numbers in question. For desert dwellers over age 50 in San Bernardino County, the risk of suicide is even greater. They account for 41.2 percent of suicides in that age group, making them 66.8 percent more likely to commit suicide than the general population.

But older people make up a larger percentage of the population in the desert. The most recent age demographic data for San Bernardino County was culled from the 2000 census.

It showed that 26.2 percent of the county's 50 and older population lived in desert areas. Even adjusting for the higher percentage, those over 50 are still 57.3 percent more likely to take their lives if they live in the desert. The risk is the same when looking at those over 70. Read more!

Death at state facility now requires autopsy -Raleigh (NC) News & Observer

Michael Biesecker

RALEIGH - Gov. Mike Easley signed a new law that requires all deaths in state mental hospitals to receive a formal review by a medical examiner.

Easley signed the bill, which was approved by the legislature July 18, late Monday night with several other bills he wanted to clear from his desk before going into the hospital for shoulder surgery, Easley press secretary Renee Hoffman said Tuesday.

The new law was enacted after a series of articles in The News & Observer that detailed 82 questionable patient deaths in state mental hospitals and homes for people with developmental disabilities.

Many of those patients' bodies were buried or cremated without being autopsied or examined by a pathologist.

State law already required that deaths resulting from homicide, suicide, accidents or unknown causes be reported to a medical examiner. The N&O's review of patient deaths in the state's 14 mental institutions since December 2000 showed that some recorded as "natural" and not reported were known by staff to have died of symptoms related to shoddy care.

Under the new law, all mental hospital deaths, regardless of cause, will be reported to a local medical examiner, who then assumes jurisdiction over the body. The pathologist is then required to independently determine the cause of death and submit a report to the Office of the Chief Medical Examiner in Chapel Hill.

Those written reports will be public records. Until now, the state Department of Health and Human Services has refused to identify those who died in its facilities, arguing that making the names public would violate the dead patients' privacy rights.

michael.biesecker@newsobserver.com or (919) 829-4698
Read more!

Staff shortage at new hospital -Raleigh (NC) News & Observer

Lynn Bonner

The new state mental hospital in Butner, open for about a week, already has more male patients than it can handle in its admissions wards.

Central Regional Hospital, the replacement hospital for Dorothea Dix in Raleigh and John Umstead in Butner, has more than enough space for patients but not enough staff to treat everyone eligible for admission.

The staff shortage happened because the merger of Umstead and Dix in the new hospital is incomplete, state administrators said. Patients and staff from Umstead moved into Central Regional, but the Dix staff and patients are still in Raleigh.

"All we've really done is relocate Umstead," said Dr. Michael Lancaster, the hospital's interim director. "There's a whole lot of capacity we're not using yet."

Central Regional was built to hold 432 patients, but room in its admissions unit now is capped at 110 beds.

Hospital staffers have had to look for space for male patients at Dix, at Cherry, the state psychiatric hospital in Goldsboro, or at community hospitals. The hospital is open to female patients.

The need to divert patients from the new hospital is part of the challenge of managing a complicated move, said Vicki Smith, head of the advocacy group Disability Rights North Carolina. The group monitored the transfer of patients from Umstead to Central Regional last week.

"There is this funny period between the merger of all the resources in one location," she said.

The state has not announced when Dix patients and staff will move to Butner.

Jim Osberg, head of state institutions for the Department of Health and Human Services, said he was not surprised by the diversions from Central Regional. Hospital admissions increased dramatically while the hospital was being built, he said, so Central Regional has to work within the same limits as Umstead did.

lynn.bonner@newsobserver.com or (919) 829-4821
Read more!

Merritt seeks votes to remain watchdog -Rocky Mount (NC) Telegram

By Mike Hixenbaugh

After more than three years at the head of the N.C. state auditor's office, Les Merritt is convinced his role as the "taxpayers' watchdog" is one of the more important in North Carolina.

Unfortunately, Merritt said Tuesday during a visit at the Telegram, very few voters realize the significance of his role as state auditor.

"I understand that it's a down-the-ballot race and that not a lot of money is directed toward the office," said Merritt, a Republican who faces general election opposition from a former staff worker, Democrat Beth Wood. "There might be only one statewide office that would have drawn a lower turnout than the labor commissioner race did last month – and that's the state auditor's office."

Merritt contends, though, that an effective auditor's office is key to efficient and transparent government. During the last several months, his office has investigated and reported abuse in the N.C. Department of Transportation and the state mental health care system.

Merritt's staff, among other initiatives, is working now to ensure the state employee health plan – amid rumors that the fund has fallen into debt – is being operated with the proper oversight.

North Carolina is one of only 17 states where the state auditor is selected by the electorate, which gives the office even more power and influence, Merritt said.

"I don't have to worry about being reappointed," he said. "I don't have to worry about who I upset, which gives us the freedom to be a true watchdog of state government."

Although Merritt is one of only a few Republican state officials, he said he wishes the auditor was a nonpartisan position because it would effectively remove the shroud of suspicion from the office.

That's why Merritt agreed to a new public finance agreement that requires he take only small donations, he said. In exchange, Merritt will receive state money to run his campaign.

"We operate this office from a nonpartisan position," Merritt said. "I am very sensitive to the issue and work hard to make decisions from a nonpartisan position. I believe it's important, once elected, that state officials serve everyone, not just the ones who voted for me."

Merritt has visited a few newspapers in recent weeks, hoping, he said, to touch base with reporters and editors as the election draws near.

His opponent, Wood, resigned as the director of the state auditor's training department last year after she told Merritt, her boss, that she wanted to go after his job. Wood, having made public during the primary race her discontent for the way Merritt managed the office. Wood could not be reached for comment Tuesday.

Wood has accused Merritt of using the office to promote his political agenda, and she argues that employment at the office is based upon political favors.

Merritt shook his head at those accusations Tuesday, instead contending that Wood became disgruntled when the office began to scale back the training department to save money. The disagreement caused tension, Merritt said.

"She had some strengths and worked hard," Merritt said. "But when she offered her resignation, I certainly did take it. I'll put it that way."

Regardless of who voters elect, Merritt said, he hopes voters will take a serious look at the race and vote for the candidate who they think will work the hardest to protect their tax dollars. Read more!

Craven sheriff takes reins of state association -New Bern (NC) Sun-Journal

By Francine Sawyer

Craven County Sheriff Jerry Monette took the reins Tuesday as president of the North Carolina Sheriffs' Association.

The oath of association president is similar to the oath of office sheriffs across the state take when they are sworn into office.

Monette said before being sworn in by senior resident Craven County Superior Court Judge Ben Alford that he looked forward to making an agenda with committee members of the association to take to the General Assembly.

"Mental health reform is needed," Monette said. "Transporting mental patients, often half-way across the state to a mental facility takes patrol officers off the road and out of the county."

He said he was fortunate to have funding for transport personnel to take the patients to statewide hospitals.

He said not all counties are that fortunate and he hopes to see the system streamlined.

Monette, a Democrat, has been sheriff for 14 years and has 22 years in law enforcement.

He said he has been a member of the association for 14 years.

"It's going to be a big year and I look forward to serving, There is much to do," he said.

"I am really excited about being selected as president. But I did not get here by myself. Folks who elected me, my family and staff are the major source of help. No one does it by themselves"

The association heard from guest speakers and held training sessions during the three-day event in New Bern.

The meeting ends today at 10 a.m. Read more!

Mental health report delayed -Raleigh (NC) News & Observer

Lynn Bonner

The legislature's new watchdog, its Program Evaluation Division, is finishing up a long-awaited report on how the state Department of Health and Human Services handled recent changes in mental health services.

In early May, legislators were supposed to discuss the report, titled "Compromised controls and lack of focus hampered implementation of enhanced mental health services." But it was dropped from an oversight committee agenda.

Various reasons were given for its disappearance. Sen. Fletcher Hartsell, a Concord Republican and an oversight co-chairman, said then that the committee didn't have time to talk about it. DHHS Secretary Dempsey Benton said in late May that that his staff asked for more time to comment on it.

On Monday, John Turcotte, head of program evaluation, gave a few reasons for the delay: The committee had two other hefty reports to review, the timing was bad, and "there were some things we wanted to add to the report."

In mid-April, the federal government announced it was withholding millions in federal payments to the state because of concerns that it had been paying improper claims.

"We did not want to disrupt the federal project," Turcotte said. "We did not want to do anything harmful to the state of North Carolina relative to that."

Turcotte said the report would be available to the public when the committee discusses it, perhaps next month.

Louise Fisher, a mental health advocate from Raleigh, said she spent hours trying to track down what happened to the report.

Fisher said an oversight committee member -- a legislator she would not name -- told her the committee did not want a critical report made public while the state had millions of dollars on the line.

"They were trying to keep any more money from being taken," Fisher said.

Fisher said she is interested in the report because finding out what's wrong with the system is essential to its improvement.

"How can you fix anything if you don't know where it's broken?" she asked.

The role of the state in the mental health system's failure has been a sore point for some providers, advocates for the mentally ill and regional mental health offices that are semi-independent of the state.

DHHS critics have said for the past two years that the state didn't offer timely training on new mental health services and wrote rules that allowed private companies to make a lot of money while using workers they could hire cheaply.

"I think they were sadly misinformed and just not up to the task," said Mark Sullivan, executive director of the Mental Health Association in Orange County. "It's not like nobody gave them any warnings. ... This was a disaster waiting to happen."

After program evaluation staff prepare a report, the agency involved is asked to review it. Agencies may suggest changes, Turcotte said, but they don't edit the reports.

Turcotte said the mental health report has gone through three draft stages.

"By the time the report gets to the final stages, there's been a lot of discussion back and forth," he said. "It's doubtful they can make a suggestion that will substantially change what the final recommendation will be."

lynn.bonner@newsobserver.com or (919) 829-4821
Read more!

Lilly May Need Stronger U.S. Warning for Zyprexa,Records Show - Bloomberg News

By Margaret Cronin Fisk and Elizabeth Lopatto

July 30 (Bloomberg) -- Eli Lilly & Co.'s current label warning on health risks linked to its antipsychotic Zyprexa may not be strong enough, according to court documents.

Lilly added a warning to its packaging in October 2007 saying that more than half of patients in 13 studies gained an average of 12 pounds after taking the drug for less than a year. It also says Zyprexa is more ``associated'' with higher blood- sugar levels -- a risk factor for diabetes -- than similar medications.

The warning, approved by the U.S. Food and Drug Administration, may need to be adjusted to link Zyprexa more directly to higher blood sugar and diabetes, according to a letter to the Indianapolis-based drugmaker from the agency. The document was produced for a lawsuit by the state of Alaska claiming the company withheld information on risks of Zyprexa, Lilly's top-selling drug with sales of $4.76 billion last year.

``We anticipate that additional labeling changes will be necessary when we have reviewed the results of the additional analyses that we have requested,'' FDA administrator Tom Laughren wrote to Lilly in an Aug. 28 letter.

The letter states: ``Given that you're completing these analyses and our review of them will take some time, we believe that it is in the best interest of the public health to make interim labeling changes now based on the data that we already have available.''

Zyprexa Sales

Zyprexa generates about a quarter of Lilly's revenue. Prescriptions for the drug didn't significantly decrease after its latest warning, according to data compiled by Bloomberg. A March 2004 warning about the risk of diabetes and high blood sugar spurred a 5 percent drop in sales in 2005.

Lilly hadn't submitted all the requested additional information to the agency by Dec. 11, two months after its latest labeling change, according to the documents. The documents were released yesterday after Bloomberg News filed a motion to unseal them.

``Have all the analyses been submitted to the FDA yet?'' Robin Wojcieszek, Lilly's associate director of regulatory affairs in the U.S., said in testimony that day, according to the documents, which she said also included analyses of studies dating back to 1996. ``No. they have not,'' she answered.

A lawyer for the state of Alaska read her the passage in the FDA letter that mentioned ``interim'' changes. ``There may be additional changes?'' he asked. ``That's correct,'' she said.

Label Change

Lilly doesn't expect more label changes, company spokeswoman Marni Lemons said in an interview July 8. Lemons didn't immediately return messages after business hours yesterday.

``It is safe to assume that since this letter is dated August 2007, and we made a pro-active label change in October 2007 based on all the compiled data we have at the time, we feel very confident that our label is correct and accurate as it currently stands, based on all the information that we have, all of which has been made available to the FDA,'' Lemons said July 8.

Lemons referred to the FDA questions on whether the agency had finished the additional analyses referred to in the August letter. An FDA spokesman, Christopher Kelly, didn't immediately comment.

Another label change probably ``won't have a major impact on sales per se because a lot of this information has become fairly obvious, given the CATIE study and other kinds of data,'' Les Funtleyder, a Miller Tabak & Co. analyst in New York, said yesterday in a phone interview.

Second-Generation Antipsychotics

The CATIE study, by the National Institute of Mental Heath, reviewed the effectiveness of second-generation antipsychotics, including Zyprexa. That study found that Zyprexa's advantages over an older medicine were ``modest and must be weighed against increased side effects.''

Lilly rose 64 cents to $48.26 in New York Stock Exchange composite trading yesterday. The stock has last 9.6 percent this year.

The FDA letter was submitted as evidence in March by the state of Alaska in its Zyprexa lawsuit a few days before Lilly agreed to pay $15 million to settle the case. Lilly also paid $1.2 billion to resolve claims brought by more than 31,000 patients who said they weren't adequately warned that Zyprexa could cause weight gain, diabetes or pancreas inflammation, Lemons said.

Lilly faces Zyprexa suits filed by nine other states that claim the company failed to warn of all risks and engaged in improper marketing. Separate consumer-protection investigations continue in about 30 other states, the company said May 6 in a regulatory filing. The U.S. Attorney's Office in Philadelphia is investigating off-label marketing of the drug.

Risks Downplayed

Patients suing Lilly claim the company downplayed risks for years to boost Zyprexa sales and prevent stronger warnings of possible side effects.

Lilly trained its sales force to downplay risks for Zyprexa and to encourage doctors to prescribe the drug beyond approved uses for schizophrenia and bipolar disorder, according to court documents.

Stronger warnings would have reduced the chance that state Medicaid programs would designate Zyprexa as a first-line drug for its patients, according to an undated document in the Alaska case titled ``Scenario and Contingency Planning Session, US Zyprexa Brand Team.''

Zyprexa would ``lose access and become primarily a 2nd or 3rd line treatment,'' the Lilly document states.

Studies have shown Zyprexa and similar medications known as atypical antipsychotics are associated with weight gain and an increased risk of diabetes. These studies prompted the FDA to require Lilly and other drugmakers to warn doctors of the risks in September 2003 and again in March 2004.

Information Request

The FDA told Lilly in March 2007 that it wanted more information about weight gain and high levels of sugar and fat in the blood connected to Symbyax, a drug combining Zyprexa and Prozac.

``We do not feel that current labeling for either Symbyax or Zyprexa provides sufficient information on these risks,'' the FDA's Laughren wrote, according to Alaska trial documents.

In August, the FDA requested added warnings to Zyprexa's label about hyperglycemia, or high blood sugar, weight gain and hyperlipidemia, or high level of blood fats, the documents show. Lilly should add that Zyprexa was ``associated with a greater potential to induce hyperglycemia than other atypical antipsychotics,'' the FDA said in its Aug. 28 letter.

Lilly took out references to causation for high blood sugar in the language suggested by the FDA, Wojcieszek testified in December. ``We did not include that in our proposal,'' she said.

``To this day, Lilly denies that olanzapine can induce or cause hyperglycemia, correct?'' the lawyer for Alaska asked.

``We don't feel that the -- that we have data to support that particular statement that FDA included,'' she answered.

The case is Alaska v. Eli Lilly and Co., 3AN-06-05630 CI, Alaska Superior Court, Anchorage District.

To contact the reporters on this story: Margaret Cronin Fisk in Southfield, Michigan, at mcfisk@bloomberg.net; Elizabeth Lopatto in New York at elopatto@bloomberg.net.
Last Updated: July 30, 2008 00:01 EDT Read more!

Man unfit to stand trial after Taser shooting -Winona (MN) Daily News

By Nolan Rosenkrans
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A man twice shot with a Taser by authorities has been ruled unfit to stand trial.

Seth Allan Frick, 24, was charged with several counts of assaulting a police officer, including two felonies. Two misdemeanor counts, including a drug paraphernalia charge, were dropped.

He appeared before Judge Jeffery Thompson for a post- competency hearing Tuesday, when a doctor’s report was presented that stated he was not fit to stand trial.

The last time he appeared before Thompson, in April, Frick erupted and was shot with a Taser by a Winona County jailer.

This time, he appeared calm in court while discussing his condition with Thompson.

“You seem a lot better than the last time I saw you,” Johnson said to Frick.

“I got a little oxygen into my system,” Frick said.

Frick questioned the doctor’s ruling, saying he was deemed to be suffering from temporary paranoia, and said he didn’t know if he could explain the doctor’s decision. Johnson cut him off as he continued.

“Let’s just leave it at that,” Johnson.

Johnson accepted the doctor’s report. Based on that and Johnson’s observations of Frick in court, he recommended Frick be referred to the Department of Human Services to commence a mental health hearing for possible commitment. Johnson said that if commitment proceedings are not begun within 30 days, the Winona County Attorney’s office needed to either re-file charges or Frick would be released. Frick has been in Winona County Jail since February.

“Let’s try to do something other than warehousing him in jail,” Johnson said.

Frick was arrested Dec. 30 near a Kwik Trip on West Broadwest Street when he asked officers why they were arresting someone else during a driving under the influence stop.

Police say he refused to leave when asked and got into a fight with five officers. During the scuffle, Frick was shot several times with a Taser.

Contact Nolan Rosenkrans at (507) 458-3519 or nolanrosenkrans@winonadailynews.com. Read more!

Rural Mental Health Clinics in Fernley, Dayton to close - Reno (NV) Gazette-Journal

FERNLEY--Fernley and Dayton patients who are seeking treatment for such mental health disorders such as depression, bipolar disorder, schizophrenia, and other such disorders, must now find help at the Mental Health Clinics in either Silver Springs or Fallon.

The Nevada Division of Mental Health and Developmental Services' Eric Skansgaard, regional director for rural mental health centers, has reported that due to the State of Nevada's massive revenue shortfall ($1.2 billion), the NDMHDS has decided to consolidate all north Lyon County Mental Health Centers to Silver Springs.

Unfortunately, the consolidation is coming at a time when mental health resources, the lack of psychiatrists and other mental health professionals are deficient in the rural communities, Skansgaard added, also indicating that mental health professions in Fernley and Dayton were contacting patients to inform them of the changes, and that those patients can seek treatment from either the Silver Springs, Fallon or Carson City mental health centers.

Further, clients who live in Dayton can receive assistance from either the Silver Springs Mental Health Center or in Carson City.

Skansgaard added, although the two centers will not be operational, all of the employees will be retained.

The regional director did not disclose the number of patients that will be impacted by the change and he also did not want to disclose the number of employees who would be transferred to the new locations.

He indicated he has directed staff to work with the patients to work out a realistic transitional plan.

A Stakeholders meeting was held on Friday at the Silver Springs Mental Health clinic but the outcome of that meeting was not made public.

When word of the "consolidations" circulated throughout the Fernley community, some residents questioned how they would be able to get to either the Fallon or Silver Springs centers because of lack of transportation.

Some also questioned if transportation could not be obtained, how patients would access their prescriptions for medications.

About three years ago, the Nevada Division of Mental Health and Developmental Services considered consolidating its services in Silver Springs when the Silver Springs-Stagecoach Hospital District considered adding onto the mental health wing of the Lahontan Medical Center facility.

However, after the Division of Mental Health and Developmental Services conducted a series of stakeholders meetings in both Fernley and Dayton, it was agreed that a consolidation was not the desire of both communities, and thus those efforts to consolidate were dropped.

However, this consolidation, according to Skansgaard is a "consequence of the state revenue shortfall."

"¢The Rural Mental Health Center in Silver Springs is located in the Lahontan Medical Center's facility at 3595 Highway 50 (east). The phone number is 577-0319.

"¢The Rural Mental Health Center in Fallon is located at 151 North Maine Street, in Fallon. The phone number is 775-423-7141.

"¢In Carson City, the Mental Health facility is located at 1665 Old Hot Springs Road, #150. The phone number is 775-687-4195. Read more!

Wounds in jail death graphically described - Akron (OH) Beacon-Journal

By Ed Meyer

Summit County Jail inmate Mark D. McCullaugh Jr. suffered multiple anal injuries during his fatal 2006 struggle with sheriff's deputies from ''an object that has to be rigid and unforgiving,'' a medical examiner's official said Tuesday.

Demonstrating the injuries in a series of graphic autopsy photos — each magnifying the area of the injuries — the forensic pathologist who performed the autopsy on McCullaugh said there were three specific areas of impact into and against the anal sphincter muscle.

''The anal blood vessels are crushed and leaking blood into the tissues,'' Chief Deputy Medical Examiner George C. Sterbenz said as he narrated the photos with a red laser pointer.

His testimony marked the first time that a medical examiner's official explained McCullaugh's anal injuries in detail, and it came after Sterbenz had been on the witness stand for more than five hours over two days in the trial of Deputy Stephen Krendick.

Before court adjourned for the day, defense lawyers for Krendick began their cross-examination of Sterbenz, but did not ask any questions about the alleged anal injuries.

Krendick, 35, is charged with one count of murder for the death of McCullaugh on Aug. 20, 2006, after a violent struggle in the inmate's cell in the jail's mental health unit.

Four other deputies indicted in connection with the case are scheduled to go to trial later this year.

Sterbenz did not identify the rigid object that he said caused the anal injuries, but in questioning by Assistant Cuyahoga County Prosecutor John R. Kosko, Sterbenz did say that ''these were foreign-body, sodomy-type injuries.''

Defense lawyer James M. Kersey objected to the term sodomy, and after a conference at the bench with all of the lawyers, Judge Herman F. Inderlied Jr. ordered the term to be stricken from the court record.

Causes of death

In testimony that backed up previous Summit County autopsy findings, Sterbenz concluded his time on the stand for the state by describing the causes of McCullaugh's death.

Sterbenz said McCullaugh died from asphyxia resulting from the combined effects of chemical, electrical and mechanical restraints.

McCullaugh, who was shackled in a hogtied position, choked to death within ''minutes'' of being sprayed with ''a large amount'' of pepper spray, Sterbenz said.

Using his autopsy photos, Sterbenz also pointed out 10 distinct marks on McCullaugh's back from what he said were Taser stun-gun barbs.

In Monday's opening statements, Kosko said Krendick used an entire 16-ounce can of pepper spray, shooting it into McCullaugh's cell through an open flap in the cell door while McCullaugh was naked and restrained.

Kosko said the 16-ounce can, previously described in court records as the ''Sergeant's can,'' was the type used by deputies on numerous people in riot situations.

Krendick asked Sgt. Brett Hadley for the can after the initial confrontation with McCullaugh, and Hadley turned it over, Kosko said.

Hadley and Deputy Brian Polinger — identified by Kosko as the one who opened the cell door flap in the moments before McCullaugh was hit with the pepper spray — were indicted for reckless homicide.

The other deputies, Dominic Martucci and Mark Mayer, were indicted for felonious assault.

In their first chance to question Sterbenz, Krendick's defense team began with Akron attorney Robert C. Baker spending much of the afternoon on McCullaugh's background of psychological problems and the possible life-threatening effects of a ''drug cocktail'' that he received from a jail nurse.

The purpose of the drug cocktail — separate injections of Geodon and Ativan apparently given to McCullaugh before he was pepper-sprayed — was to calm him down, Sterbenz said.

But when Baker tried to question Sterbenz about whether the drugs and the stress from the jail-cell struggle could have caused sudden cardiac death, Sterbenz answered quickly.

''The real issue here in terms of life-threatening [injuries],'' Sterbenz said, ''is the inhalation'' of fumes from ''large amounts'' of the pepper spray.

Fumes from the pepper spray, he said, caused ''severe airway burns.''

Other factors

Krendick's other lawyer, James M. Kersey of Cleveland, contended in opening statements that a combination of heart disease and a condition known as excited delirium caused McCullaugh's death.

And on that issue, Baker followed up with Sterbenz and appeared to create the first hole in the prosecution's allegations about the cause of death.

Revealing the intricacies of his autopsy, Sterbenz said McCullaugh had a ''significantly enlarged heart'' weighing 570 grams.

Such a condition, combined with high blood pressure and blockages in the three main coronary arteries, which McCullaugh also had, could ''place someone in danger of sudden cardiac death,'' Sterbenz said.

But Sterbenz also pointed out that his autopsy report listed heart disease as a ''contributing factor'' in the death.

The trial, entering its third day, is being conducted before Inderlied without a jury. The prosecution is expected to call jail medical personnel in the next round of witnesses.


Ed Meyer can be reached at 330-996-3784 or emeyer@thebeaconjournal.com. Read more!

Court tackles tough challenge -New Orleans Time-Piscayne

By Katy Reckdahl

Anthony Bridges is bipolar. But the illness wasn't diagnosed until he was charged with marijuana possession.

Schizophrenia and bipolar disorder run in Eloise Jones' family, "generations back," she said. But she didn't get help until she was arrested for possessing drug paraphernalia.

On Monday morning, Judge Arthur Hunter honored Bridges, Jones and nearly 20 others who'd excelled in meeting conditions imposed in his mental-health court, which addresses the root cause of these defendants' criminal behavior: unchecked mental illness.

That's a challenge, given the city's overtaxed mental-health system, Hunter said. High post-Katrina rents also make it difficult to stabilize mentally ill people living in less than desirable conditions, he said.

But even cities with better-equipped mental-health systems have trouble handling people with "co-occurring disorders" -- an addiction on top of mental illness -- who make up the majority of those who end up in Hunter's courtroom.

"It's a nationwide problem," Hunter said. Some mental-health providers won't deal with addicts. And drug-rehab centers often won't take people who also are mentally ill.

More than half of the nation's prison and jail inmates have a mental-health problem, according to U.S. Department of Justice data. Rates for females are higher, with nearly three-quarters of women in local jails and state prisons reporting a history of mental illness.

Hunter's courtroom on Monday reflects those statistics. Mental-health court participants are older than the usual felony defendant. Some are graying. About half are women.

"Almost everyone has someone in their family that suffers from mental illness," said case manager Kiana Wright.

Jones, 49, can rattle off a list of kin who she believes suffer from the same affliction, from a grandmother to cousins to some of her grandbabies, she said.

Hunter said "the vast majority" of defendants in the court have some history of mental-health treatment, albeit inconsistent.

"Part of it is their lack of desire -- they've been actively using drugs," said case manager Janice Bolin. "But when they're ready to seek treatment, it's hard to get in New Orleans."

Local drug-rehab centers often have long waiting lists, especially for women, Bolin said. So she and others in the court are quick to use new resources, like the traveling mental-health teams financed by the state Department of Health and Hospitals and run by Jeffrey Rouse, a psychiatrist with the Orleans Parish coroner's office.

"We're basically providing a clinic without walls," Rouse said, bringing medication, housing assistance and other resources to those who suffer from mental illness but can't or won't go to community psychiatric clinics.

Hunter took over the felony-level court in January after its originator, Judge Calvin Johnson, retired. When it began in 2004, it was one of the earliest such courts in the nation. Now it's one of about 150 nationwide.

At least once a week, defendants take a drug test and visit their case manager. Most must also attend GED classes, observe a curfew, see a counselor and psychiatrist, and get clean if they have an addiction. Defendants are also urged to take their medication, although they can't legally be forced to do so.

The penalty for a positive drug test and other violations is jail time. A group at Monday's ceremonies lined the front row of the courtroom clad in orange jumpsuits. They did not receive a certificate.

But even defendants who perform well in mental-health court aren't guaranteed a reduced or dismissed sentence upon completion. Hunter plans to work with the new district attorney to change that.

Until then, defendants must be content with a framed certificate, a photo op with the judge and their caseworker, and some sense of accomplishment. "After all my years of running, I'm finally standing strong," Jones said. "That feels good."

. . . . . . .

Katy Reckdahl can be reached at kreckdahl@timespicayune.com or 504.826.3396. Read more!

Mother gets 19 years for newborn'sdeath - Denver (CO) Post

Diagnosed as bipolar in her 20s and hospitalized and treated several times for mental-health issues.

By Ann Schrader

GOLDEN — A 30-year-old Lakewood woman was sentenced Tuesday to 19 years in prison for giving birth in a toilet and letting the baby drown.

Cheri Kostur was charged with child abuse resulting in death for the Jan. 21, 2007, death of her daughter, Kerra.

However, a jury deadlocked in June, and a plea agreement reduced the charge to child abuse resulting in serious bodily injury.

"I miss my daughter very much," Kostur told the court, "and if I could do it over, I would help her."

Kostur also was sentenced for unlawful use of methamphetamines.

During the trial, the jury did not hear about Kostur's meth use after the judge ruled the information prejudicial and inadmissable.

The arrest affidavit states Kostur admitted to police that she smoked meth the day before Kerra's birth and marijuana two days before.

Kostur told officers she usually stayed high for a day and a half after smoking meth. She also admitted to smoking marijuana and meth earlier in the pregnancy.

Prosecutor Natalie Judson said Kostur did nothing to rescue the premature infant from the toilet. Instead, Kostur cut the umbilical cord with child-size scissors and then threw the baby into a trash can in a tied plastic bag.

Defense attorneys argued that Kostur did what she could and that she didn't know she was about to give birth.

Her attorney told the court she attempted to hang herself at the age of 9, had no education after ninth grade and was diagnosed as bipolar in her 20s and hospitalized and treated several times for mental-health issues.

Kostur's mother, Laura Porter, testified that she was angry with her daughter about the baby's death, saying she had lost another grandchild. Porter said Kostur replied: "Good, now I can hang out with my friends."

Kostur's three other children are with their fathers.

Ann Schrader: 303-278-3217 or aschrader@denverpost.com
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