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Hazel: Jail inmate died within 24 hours of admission to state hospital

Hazel: Jail inmate died within 24 hours of admission to state hospital

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A woman incarcerated at Hampton Roads Regional Jail who was transferred to a state hospital last month after a mental health crisis died within 24 hours of admission, according to Virginia’s top health official.

Central State Hospital workers found the woman dead in bed the morning after she arrived for court-ordered care, Dr. William A. Hazel Jr., the state’s secretary of health and human resources, said Thursday in a sit-down interview in his fourth-floor office at the Patrick Henry Building.

Just what happened to the woman — one of at least 90 state mental hospital patients to die over the past four years, according to state officials — remained unclear. She does not appear to have committed suicide, Hazel said.

His comments and follow-up emails from other state officials Thursday marked a shift in the state’s response to questions about the death, which multiple agencies had allowed to go largely unanswered over the past week. Officials still decline to identify the woman, citing federal privacy protections involving health care records.

She had been jailed on a charge of misdemeanor trespassing, but how long she had been in custody was not revealed. She was in crisis, according to information provided by a spokeswoman for the Department of Behavioral Health and Developmental Services.

But jail and hospital officials delayed transporting the woman from the jail in Portsmouth to Central State Hospital in Petersburg overnight, Hazel said.

“I can tell you we have made sure to let everybody know that will not happen again,” Hazel said. “It’s either an emergency or it’s not.”

A mental health evaluator must determine if someone poses a threat to themselves or someone else before obtaining a temporary detention order for civil commitment.

Efforts to secure mental health treatment for the woman began the afternoon of May 24, Maria Reppas of the state behavioral health department said in an email.

An employee of the Portsmouth Community Services Board — one of 40 such entities across the state that form the backbone of Virginia’s public system of mental health care — placed the first call to Central State Hospital at 5 p.m. that Tuesday.

Pre-screening paperwork was completed and submitted within two hours. The hospital asked if the jail could bring the woman the following morning, according to Reppas. Jail officials touched base with the hospital the next day to ensure a bed was still available and then picked up the court order sending the woman to Central State, Reppas said.

Officials said the woman’s hospital intake paperwork was stamped 2:21 p.m. Wednesday, May 25. She was found dead the next morning.

An official at the jail, which has come under fire after the death of a mentally ill man in custody last August, said inmates subject to a temporary detention order are taken to a hospital for treatment as soon as the jail receives the order.

“All inmates are transported on the same day we are notified that a bed is available,” Lt. Col. Eugene Taylor wrote in an email, adding that there are no exceptions.

Hazel said initial efforts to secure the inmate space at nearby Eastern State Hospital near Williamsburg fell through because there were not enough beds available.

As of Thursday, 13 inmates in Virginia were waiting to be transferred to Eastern State for treatment, 10 of whom had been waiting longer than the seven-day benchmark Hazel said state officials are working to target. There was no wait at five of the eight state mental hospitals, according to information provided by the behavioral health department.

Jamycheal Mitchell, who died alone in a feces-smeared cell at Hampton Roads Regional Jail last August, was twice ordered to care at Eastern State after a judge deemed him incompetent to stand trial. He was never added to the hospital’s waiting list because of clerical errors.

The state medical examiner’s office in Norfolk said he died of heart problems and extreme weight loss after losing 46 pounds over 101 days at the jail. He was charged with stealing $5 in snacks from a 7-Eleven convenience store.

No jail employees have been reprimanded or fired, and policies haven’t been changed in the wake of Mitchell’s death, Taylor has said.

“To us, it’s an unbelievable tragedy, but it was not a circumstance where it could have been prevented by the Hampton Roads Regional Jail,” he said in a previous interview.

Despite multiple requests from the Richmond Times-Dispatch, officials earlier this week would not say what the person who died at Central State in late May had been charged with or provide any potentially identifying information such as name, age or sex, citing federal privacy protections.

“Whether you agree with it or not, those are the rules that we are operating under,” Hazel said Thursday morning of the Health Insurance Portability and Accountability Act, which protects patients’ health information. He also said he would release the date of death if he knew it.

On Thursday evening, Reppas sent an email providing some of the information previously denied — the gender of the deceased inmate, what she was charged with, date of admission to Central State and date of death.

HIPAA was drafted in the mid-1990s at a time when the AIDS crisis peaked and celebrities’ HIV statuses were being splashed across tabloids, said Margaret Foster Riley, a University of Virginia law, public policy and health sciences professor.

Riley said striking the right balance between privacy and the public good can be a thorny issue.

“I have serious problems with the law,” she said. “We have a privacy rule for health care, we have a privacy rule for banks and we have a privacy rule for education, but none of them overlap in a way that makes sense.”

Although identifiable health information about a hospital patient is protected under the act, exceptions are carved out for health care oversight.

A spokeswoman for the Office of the State Inspector General has said the agency has not decided whether or not to investigate policies and procedures in the wake of the Central State death.

The medical examiner has conducted an autopsy, but officials are awaiting the results of toxicology work, which will likely take weeks, Hazel said.

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