New agreement to ensure patients' safety at KCHC approved

The Justice Department's Civil Rights Division and the U.S. Attorney's Office for the Eastern District of New York today announced that they have entered into an agreement with New York City to correct conditions of confinement at the Kings County Hospital Center's (KCHC) psychiatric emergency room and psychiatric in-patient units located in Brooklyn, N.Y. The agreement, in the form of a consent judgement, was approved today by U.S. District Judge Kiyo A. Matsumoto.

Under the terms of the consent judgment, New York City will work to ensure that patients at KCHC are safe and receive the care and services necessary to meet their individual needs. The agreement underscores the city's obligation to actively pursue discharge of patients to the most integrated setting appropriate based on their needs and follow-up services, consistent with the requirements of the Americans with Disabilities Act and the Supreme Court's ruling in Olmstead v. L.C. In addition, the city has agreed to undertake a variety of measures, including improving medical and mental health care, and ensuring that patients are free from undue restraint.

A joint investigation of the psychiatric units at KCHC began in December 2007, under provisions of the Civil Rights of Institutionalized Persons Act (CRIPA). The investigation uncovered systemic deficiencies that violated the constitutional and civil rights of patients with psychiatric disabilities. These violations included failure to protect patients from harm, failure to treat the psychiatric disabilities of patients, the use of drugs to sedate rather than treat patients, failure to provide adequate and individualized discharge planning and follow-up services, falsification of patient medical records, and failure to respond promptly to medical emergencies.

These violations and others contributed to the death of at least one patient in June 2008, Esmin Green, who collapsed in the psychiatric emergency room after waiting 23 hours to be seen by a doctor. Green lay on the floor for over an hour while hospital employees, including doctors and security staff, walked in and out of the area, ignoring her condition and making no effort to attend to her. Subsequently, the Justice Department entered into negotiations regarding remedies the city was required to implement to correct unconstitutional conditions at KCHC's psychiatric service.

"Jurisdictions have a responsibility to protect the constitutional rights of individuals in their care and to protect those individuals from harm. We have worked cooperatively with New York City to craft an agreement that will benefit the lives of persons with disabilities at Kings County Hospital Center," said Thomas E. Perez, Assistant Attorney General in charge of the Civil Rights Division. "We commend Mayor Michael Bloomberg, the Hospital Center, and the New York City Health and Hospitals Corporation for their willingness to work aggressively to remedy these problems."

U.S. Attorney Benton J. Campbell of the Eastern District of New York stated, "This consent judgment is designed to improve the quality of psychiatric care provided to some of our district's neediest and most vulnerable residents. We thank the city for its cooperation in achieving this important goal."

The agreement provides for regular site visits by a team of experts to assess compliance with the agreement, and that this review and assessment occur regularly over a period of at least five years, until KCHC substantially complies with the consent judgment's requirements. Settlement documents were filed today in federal court and will be available on the Justice Department Web site http://www.justice.gov.