Daybreak Youth Services strives to move forward

May 24-- May 24--BRUSH PRAIRIE -- Daybreak Youth Services' operational licenses for its Brush Prairie facility "have been and remain active," said newly appointed CEO Thomas Russell.

That's the key message Russell wants the community to know as Daybreak rebuilds its image and trust following allegations that came to light in September of sexual assault, problems with client and staff safety, and what investigators saw as a pattern of inadequate reporting as required by law.

Six months since the state Department of Health notified Daybreak of its intent to revoke the facility's licenses, the center remains open, providing substance abuse and mental health treatment while it appeals the revocation process.

On Tuesday morning, the halls of the facility at 11910 N.E. 154th St. were empty of the 13 patients receiving treatment there. The youth generally have counseling and classes during the day.

Despite their absence, a deck of cards was strewn across a coffee table in the girls' lounge area. Unkempt beds could be seen in patients' rooms. Posters with messages of encouragement hung on the walls. Another noticeable fixture were the cameras mounted on the walls and ceilings in nearly every room of the facility.

"I think people view (the facility) as a normal social environment, but it's not. The staff is handling some of the toughest issues that teenagers can face. ... Experiences have made these kids draw inward. We're trying to get them out of that space," Russell said.

The three-member team that guided The Columbian through the mazelike halls of the treatment center -- hidden in a neighborhood on a dead-end road in rural Clark County -- was eager to share the changes made in the past six months. Changes include the implementation of updated care options, sturdier security doors and new gym equipment.

But the future of the facility remains uncertain.

Potential criminal charges

The Clark County Sheriff's Office started investigating alleged criminal conduct at the Brush Prairie facility in June. About a month ago, investigators handed over a cache of documents to the Clark County Prosecuting Attorney's Office for consideration of criminal charges, sheriff's Sgt. Brent Waddell said Monday.

Waddell described the case as a "pretty tangled investigation."

"There are a lot of people. Some have way more culpability than others. It will be up to prosecutors whether or not anyone is charged," he said.

Chief Deputy Prosecutor Scott Jackson said the attorney handling the case requested that investigators follow up on some of the provided information, which is normal when considering charges. Jackson said a decision should be made within a few weeks.

The allegations from the sheriff's office's investigation prompted a separate investigation from the state Department of Health.

On Nov. 19, the state's Residential Treatment Facilities and Behavioral Health Agencies program notified the youth outpatient and inpatient treatment facility of its intent to revoke its licenses.

Daybreak appealed the revocations, which kept the Brush Prairie facility open. In its appeal, the nonprofit agency argued the revocations were based on "inaccurate and unsubstantiated" claims.

Russell said the agency's stance, today, is on improving care and learning from the past.

"What happened before I was here, I don't know," Russell said in a phone interview on May 14. "In terms of ownership and responsibility, we're taking a hard look at ensuring our policies align with (federal confidentiality laws and regulations) so staff clearly understands and complies, which overall speaks to the changes we've been making."

Russell started about seven weeks ago, and he said leadership has been reorganized across the agency. Daybreak has also implemented new policies regarding confidentiality, reporting and new staff trainings.

It is keeping the health department updated on the changes and will continue to work with officials.

"The kids and their families demonstrate great courage when they call for help, and we intend to keep their trust," the agency's leadership said.

Daybreak's lawyer, David H. Smith, takes a more assertive stance in letters to the U.S. Attorney for the Western District of Washington and local authorities.

In a letter to U.S. Attorney Brian T. Moran, Smith claims that the sheriff's office violated federal law with its "wholesale seizure of computers" and "swept up confidential communications and treatment records for hundreds of minor patients -- far beyond what might be essential to investigate concerns related to the five minor patients mentioned in the original search warrants or the 10 in the second batch."

The law, 42 C.F.R. Part 2, prevents the disclosure of identities of patients seeking substance use disorder treatment and facilities' patient records to police except under certain circumstances, such as "extremely serious" crimes. Smith said investigators have not and cannot claim that the allegations fit this criteria.

Community collaboration

The next hearing on the license revocation appeal, which will not be open to the public, is scheduled for June 19, said Julie Graham, public information officer for the Department of Health. Department investigators, lawyers and Daybreak leaders will meet to "see where we are in terms of solutions," Graham said.

A second public hearing in November will determine the status of the licenses and whether "there can be a settlement to ensure public safety," she said.

In the meantime, department officials are monitoring the Brush Prairie facility by means of on-site visits, including spot inspections, Graham said.

The health department is one of many community partners Daybreak works with, Russell said, to ensure a continuum of care for patients so they don't return to the same environment that prompted their need for help. Having state representatives collaborate with Daybreak about policy and transparency is nothing new, the CEO said. Earlier this month, the health department renewed Daybreak's residential treatment facility license, he said.

At one point, since the investigation began in full, the facility was down to as few as six patients. As of Tuesday, that number had about doubled, said Sarah Spier, Daybreak's director of external communications. The number fluctuates; there were as many as 17 patients recently, three shy of its 20-patient limit until more staff is hired.

The facility's capacity is 45 patients, Russell said. A number of referrals to the facility "dried up in the process of rebuilding," he said. Stakeholders have made the need for the facility apparent, he said, expressing that there are hundreds of kids who require services. Daybreak says it serves around 1,000 patients statewide each year.

Staffing was reduced due to fewer patients, and because of the agency's reorganization. Russell said employees' responsibilities were examined and rearranged to line up with new policies aimed at lawful reporting and ensuring patient confidentiality.

Russell and Spier said they did not know if any of the employees working at the Brush Prairie facility and named in investigative documents were let go. When asked about former CEO Annette Klinefelter, they only said she would not be returning.

In the weeks he's been on board, Russell said there has been some reluctance from partners to refer people to the facility. Referrals come from counseling organizations, medical providers and insurers, among other sources. Spier said Daybreak has spent months quickly and quietly rebuilding relationships.

Clark County Juvenile Court staff and Superior Court judges, after learning of the sheriff's office's investigation, in late June ceased recommending the facility's inpatient services to families and guardians, who ultimately make the decision of what services to use. Juvenile Court Administrator Christine Simonsmeier said Monday that the practice has not resumed, but she has met with Daybreak officials about how to make it happen.

"We do value this program. It's very much needed, but we have an obligation to the community" to see the appeal process through to the end, Simonsmeier said.

New beginnings

Daybreak is implementing new training, such as courses on trauma informed care. Part of the training focuses on the diverse backgrounds of patients, whose histories may include homelessness and sexual abuse, Spier said. The training helps staff recognize signs associated with trauma and act to prevent harm to patients, she said.

Nurses are currently being interviewed for around-the-clock evaluation and treatment services that are "desperately needed in Clark County," Spier said. The nurses will be on hand to help clients with suicidal ideations and other crises. The agency is waiting for increased staff numbers to use a vacant section of the building for the psychiatric care.

Daybreak is also bringing a life enrichment program to Southwest Washington, which was implemented at its Spokane facility three years ago.

The program allows patients to partake in community events and physical activities, and connects them to institutions to build financial equity, among other "holistic therapy" options.

Spier said before the life enrichment program began, the completion rate for patients was around 82 percent. The program has increased the rate to between 95 percent and 97 percent.

Why the Brush Prairie and Spokane facilities operated differently is unclear. Russell said they essentially ran independently of one another. Now, the facilities will be sharing staff and working together.

"We have expertise in Spokane we need here," and vice versa, the CEO said.

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