New York Attorney General Letitia James announced a landmark settlement with the Westchester County Health Care Corporation (WMC) and HealthAlliance, Inc. This agreement aims to improve mental health care practices at three hospitals in the Hudson Valley, including Westchester Medical Center in Valhalla, MidHudson Regional Hospital in Poughkeepsie, and HealthAlliance Hospital in Kingston. The settlement mandates the restoration of inpatient psychiatric beds and significant reforms in emergency room practices for patients experiencing mental health crises.
The Office of the Attorney General (OAG) initiated an investigation in 2022, prompted by testimonies during Mental Health Hearings that highlighted inadequate care for patients, particularly young children, facing mental health emergencies. The investigation revealed that WMCHealth had discharged vulnerable patients without necessary evaluations and had kept inpatient psychiatric beds closed for extended periods, putting patient safety at risk.
Under the settlement, WMCHealth must reopen psychiatric beds that were shut down during the COVID-19 pandemic. Previously, HealthAlliance Hospital had closed its 40-bed psychiatric unit in March 2020, ostensibly to accommodate COVID-19 patients. However, these beds were never utilized for COVID treatment and remained closed well past the return of pre-COVID regulations in June 2021. This situation forced patients in crisis to seek care at more distant facilities and contributed to overcrowding in local emergency rooms.
The OAG’s findings included alarming lapses in patient care, such as: – Discharging patients with active suicidal thoughts or severe psychiatric conditions without proper stabilization. – Inadequate management of agitated children, leading to unnecessary medication without attempts at de-escalation. – Failing to safeguard vulnerable patients from leaving the hospital prematurely, resulting in tragic outcomes. – Incomplete patient records and non-compliance with WMCHealth’s internal policies.
For instance, one case involved an adolescent who was discharged despite being deemed actively suicidal, and another teenager was quickly restrained and medicated without sufficient monitoring before discharge. A third patient, who required constant supervision, left the hospital unsupervised and tragically died shortly after.
To enforce compliance with the settlement, WMCHealth must develop and implement new policies for emergency room evaluations, focusing on suicide risk and substance use disorders. Staff must gather comprehensive medical histories from families and past providers to inform treatment decisions. WMCHealth is also required to collaborate with community behavioral health agencies to improve care coordination.
Additionally, the settlement mandates individualized discharge plans for patients with complex needs, ensuring they receive necessary follow-up care. New protocols for using restraints and medications, particularly for children, will require thorough documentation and justification for their use.
Attorney General James emphasized the importance of recognizing mental health crises as emergencies. Her office has set out robust oversight measures, including appointing an internal compliance administrator for WMCHealth to ensure adherence to settlement terms and submitting biannual compliance reports for at least two years.
WMCHealth will pay $400,000 in penalties and fees to New York State, and any violations of the agreement could incur additional penalties of $10,000 per incident. Furthermore, the organization will invest in expanding behavioral health services, including hiring peer counselors and enhancing substance use disorder treatment in emergency rooms.
Local leaders expressed gratitude for the settlement, highlighting the need for accessible and compassionate mental health care. The reforms are expected to restore vital patient services, reduce emergency room wait times, and ensure that mental health patients receive appropriate care when in crisis. This settlement serves as a model for other hospitals across New York State, reinforcing the importance of quality mental health care in emergency settings.
