Public Health Committee
JOINT FAVORABLE REPORT
Bill No.: SB-450
AN ACT CONCERNING CONNECTICUT VALLEY AND WHITING FORENSIC
Title: HOSPITALS.
Vote Date: 3/30/2022
Vote Action: Joint Favorable Substitute
PH Date: 3/28/2022
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
The Public Health Committee
REASONS FOR BILL:
This bill is based on recommendations made from the Connecticut Valley Hospital (CVH)
Task Force established following the discovery of abuse involving a long-time resident at
Whiting Forensic Hospital (WFH). This bill makes several changes to both WFH and CVH.
Beginning on October 1, 2022, the bill would replace the current WFH's advisory board with a
10-member oversight board charged with overseeing staff work and investigating complaints.
The board would also be required to request and review information from the hospital and the
Department of Mental Health and Addiction Services (DMHAS) and annually report to the
Public Health Committee the results of these investigations and recommendations.
Regarding initial or discharge hearings, the court would be responsible to consider the safety
and well-being of an individual as well as protecting society.
In addition, the bill would require DHMAS, by January 1, 2023, to establish a working group
to specifically evaluate the Psychiatric Security Review Board (PSRB) and to report its
findings to the Public Health and Judiciary committees by January 1,2024.
Currently, the law requires hospitals to apply to the PSRB to approve any temporary leaves.
This bill would permit both WFH and CVH to directly authorize these leaves if it is believed
this action would advance the individual's care.
Also, under certain conditions, the bill allows patients to temporarily leave the hospital either
by themselves or under the care of a guardian, relative or friend.
Finally, the bill requires DHMAS, in collaboration with various stakeholders and the
Department of Corrections (DOC), to develop a plan to construct a new facility for WFH. The
results of this plan must be reported to the Public Health Committee by January 1, 2023.
RESPONSE FROM ADMINISTRATION/AGENCY:
Nancy Navarretta, MA, LPC, NCC, Commissioner, DHMAS
DMHAS and the Legislature were outraged by the abuse uncovered by a long-time resident
at Whiting Forensic Hospital (WFH) that prompted the establishment of the CVH Whiting
Task Force through PA 18-86. It should be noted that as a result, in 2018, WFH became a
separate hospital, licensed by the Department of Public Health and is currently pursuing
accreditation from the Joint Commission on Accreditation of Healthcare Organization
(JCAHO).
DMHAS has already implemented significant changes in hospital operations to ensure the
highest quality patient care and staff safety:
appointed a Chief Executive Officer who reports directly to the DMHAS Commissioner.
installed a 24-hour high-definition monitoring system in patient areas at CVH and
Whiting that is monitored by an outside contractor.
utilized camera footage to enhance staff education and training, policies and practices
in the areas of restraints and seclusion, and reporting timelines for patient abuse,
neglect, or exploitation.
survey and focus groups to address hospital culture.
implemented of a management system to promote a "recovery-orientated" model.
hired additional staff for discharge planning.
The Governors proposed FY 23 adjusted budget includes $2.5 million for 26 additional
community placements and $1.9 million to expand from 3 to15 beds the pilot program for
community competency evaluation and restoration for offenders of misdemeanor-only crimes.
Also, there is $3 million on the March 31st bond agenda for the planning and designing of a
new WFH building.
There are some provisions of SB 450 that should be modified to address practical and
operational issues and DMHAS is available to work with the committee to accommodate the
contracts, regulations, stipulated agreements, case law, human resource practice, and
federal and state statutes.
State of CT Division of Criminal Justice:
The Division of Criminal Justice takes no position on most of this bill but respectfully opposes
Section 6 and Lines 236-243 to establish a task force to evaluate the continued existence of
the Psychiatric Security Review Board (PSRB). The Division believes that the PRSB should
remain in existence.
The PSRB was established following a report from the Law Revision Commission that found
many individuals who had been committed to the state hospital were released without
oversight or assurances that these individuals would continue their treatment. The board's
mandate includes both inpatient and outpatient supervision. Currently, Connecticut' civil
commitment does not include outpatient supervision. There is the need for the board to have
the authority for outpatient supervision. The elimination of the PSRB would remove this
needed supervision. Consistency in supervision is critical. The PSRB receives reports of
each acquitee every six months and sees everyone at least every two years. It should be
Page 2 of 8 SB-450
noted that it is the defendant who makes the choice to plead to an insanity defense. There
are mechanisms in place for an individual to request release from commitment. The system is
balanced.
Finally, the Division opposes Lines 236-243 which would allow a superintendent to approve a
temporary leave of a patient. We believe that authority should be left to the PSRB which often
places modifications on the leave. The Division recommends this bill be voted out of
Committee with the above requests.
Monty Radler, Public Defender, Connecticut Valley Hospital, Office of Chief Public
Defender
The Office of Chief Public Defender strongly supports SB 450 as it would provide acquittees
under the supervision of the PSRB the rights to due process and protection for their safety.
The PSRB's lengthy commitments seem to be a mechanism to reassure the public that
acquittees will never get out of an institution and this practice goes against the principle of
recovery and criminal justice.
It should be noted that the CVH Whiting Task Force Final Report recommended by a 6-1
majority vote that abolishment of the PSRB should be a consideration, or its mission should
be amended to balance the protection of society with those of a patient' rights.
Jordan Scheff, Commissioner, Department of Developmental Services (DDS)
The Department of Developmental Services (DDS) is concerned with the language in
sections 3, 4, and 5 which will shift the courts primary concerns from the protection of
society to the safety and well-being of acquittees.
The term well-being is vague, has no statutory definition, and the funding and services
necessary to implement this expanded standard of care are unknown. The "unknown" could
result in a liability issue for DDS, our qualified providers, and employees, if we are unable to
provide acquittees with the appropriate services for their well-being. It is also unclear how
large an impact this change would have on the established system of services and provider
network in DDS.
Rep. Mary Mushinsky
Submitted testimony in opposition to sections of the bill that removes protections afforded
victims and family members and reduces public safety.
Section 6 of the bill will eliminate decades of work by the Psychiatric Security Review Board
(PSRB) safeguarding and protecting the public. If acquittee evaluation and risk assessment
for temporary release is transferred to hospital administrator, this would allow acquittees to
be in the community without supervision. Approval of these proposed changes are frightening
to Wallingford residents who still remember the 1989 slaying of an innocent 9-year-old girl by
an unsupervised release from Connecticut Valley Hospital. This individual was subsequently
sent to Whiting Forensic Hospital which holds the most violent persons with mental illness.
Without supervision there is no way to ensure the acquitee is following their treatment plan
and no longer a danger to society. I strongly urges the Committee to keep public safety
upmost in line 154, strike Section 6 regarding the PSRB, and remove or amend lines 236-243
in the bill.
Page 3 of 8 SB-450
NATURE AND SOURCES OF SUPPORT:
James Welsh, Lead Investigator, Disability Rights Connecticut (DRCT)
DRCT investigated the 2017 incident of abuse and issued a comprehensive report of its
findings and recommendations to the CVH Whiting Task Force in November of 2019.
This bill reflects the findings of the task force and those who have been working to improve
operations at Whiting Forensic Hospital (WFH) and safeguarding the civil rights of persons
with disabilities who are committed to the Psychiatric Security Review Board (PSRB) and
other individuals confined to WFH.
These five elements of the bill will be beneficial to people with disabilities: 1) Converting the
Advisory Board to and Oversight Board; 2) Removing PSRB interference with clinical
decisions about patient movement within and outside the hospital; 3) Requiring the initial
examination of an acquittee committed to DMHAS be conducted by an independent provider;
4) Constructing of a new WFH; and 5) Expanding the capacity of the forensic community
mental health provider system to ensure persons with disabilities can timely transition from
WFH to live in a more integrated setting.
DRCT believes SB 450 does not comport with key provisions of the Americans with
Disabilities Act (ADA) and we would like to work with Public Health Committee's Leadership
to make the necessary changes
Kathy Flaherty, Executive Director, Connecticut Legal Rights Project (CLRP)
SB 450 is a good first step but does not represent everything needed to reform the State's
forensic mental health system, nor does it reflect all the recommendations outlined in the
CVH Whiting Task Force Final Report. To better understand the experience of being a patient
in a mental health system, I recommend reading a series of articles on Mad in America
website. The article by Sean Gunderson depicts stories from CLRP clients residing at Whiting
and Dutcher.
The task force voted 6-1 for the abolishment of the Psychiatric Security Review Board
(PSRB) and DRCT is asking the Committee to consider establishing a working group to
determine how to work towards abolition and that more than one person with direct lived
experience be appointed. We support the proposed oversight board and recommend a
mechanism be added for reporting and investigating abuse and neglect at all DMHAS-
operated facilities. Additionally, we asked that the Patients Bill of Rights be amended to
reflect the 21st century communication methods
Nancy Alisberg
Ms. Alsiberg strongly supports this bill and welcomes the efforts of the Committee to
incorporate the recommendations of the CVH Task Force into an enforceable bill. However,
she has questions regarding certain sections of the bill. She objects to the establishment of
another task force to study the existence of the Psychiatric Security Review Board (PSRB)
since the 2018 CVH Whiting Task Force report clearly concluded that the PSRB should be
abolished. I do not believe there should be different standards for temporary leave for
acquittees served by the Department of Developmental Services (DDS) and those who are
placed in Whiting. Therefore, subsection (a) of Section 7 should be deleted.
Page 4 of 8 SB-450
Section 10 addresses the complex issue of the Department of Mental Health and Addiction
Services (DMHAS) and contract with Yale. I believe DMHAS should investigate and report
on the inability of Yale to recruit and retain staff. Section 11 implies an acquittee's initial
examination would be conducted by Yale and I cannot understand the rationale for this
provision since the CVH Whiting Task Force recommended the elimination of the Yale
contract.
The definition of institutions in Section 12 of the bill is unclear. Federal law excludes large
institutions over a certain size from this definition to ensure they dont qualify for federal
Medicaid reimbursements. The language in this section suggests the Committee believes
that this exclusion will no longer apply and goes against the task force recommendation to
provide care in the community. Despite these comments, I believe this bill is a reasonable
step to implement the recommendations of the Task Force.
Jordan Fairchild, Coordinator and Community Organizer, Keep the Promise Coalition
(KTP),
The focus of mental health treatment should be on recovery and living conditions at CVH and
Whiting Forensic Hospitals are not conducive to recovery. KTP supports the recommendation
to abolish the PSRB and asks that at least 3 persons with lived experience be appointed to
the proposed working group. The practices of the PSRB have resulted in the effective
incarceration of individuals who have not been convicted of a crime. In addition, serious
attention must be given to the need for significant investments in community-based treatment
options which focus on recovery and well-being of the client to ensure people with psychiatric
disabilities have access to the appropriate treatment.
Thomas Burr, Community and Affiliates Relations Manager, CT NAMI
The provisions in SB 450 are a good start but NAMI would like to recommend the following:
1) change the proposed task force to examine the abolition of Psychiatric Security
Review Board (PSRB) to a working group; and 2) include 3 members with lived experience
as patients or former patients at Whiting.
NAMI will support SB 450 with the suggested changes.
Christopher DeAngelo, Current Patient at WFH:
Mr. DeAngelo supports this entire piece of legislation and in particular the section addressing
the PSRB. In his testimony, Mr. DeAngelo shares his experience with the PSRB and his
belief that is being treated unfairly. This unfair treatment has resulted in his stay at Whiting
being far longer than his original sentence.
Mr. Vincent Ardizzone, Current Resident at (CVH);
In his testimony, Mr. Ardizzone shares his experience concerning his treatment by the PSRB.
which he believes has been unfair. He contends that his request for leave should be honored
based on evidence submitted by Andrew. Meisler, PhD, professor of Psychiatry at Yale and
Marc Hillbrands, PhD, Forensic Psychology.
James Armstrong, Current Patient, WFH:
Mr. Whiting supports this bill.
Page 5 of 8 SB-450
NATURE AND SOURCES OF OPPOSITION:
Lucy Nolan, Director, Policy and Public Relations, Connecticut Alliance to End Sexual
Violence
Adding the "safety and well-being of aquittees as a primary concern" will change the focus
from the protection of society when considering the discharge and conditional release of
acquittees. This language could ignore safety risk and result in harm to victims.
The proposed task force to evaluate the role of the Psychiatric Security Review Board
(PSRB) consists of several members of the judiciary community and others but there is no
representation for victims who should have a voice and the security in knowing that the PRSB
will continue to keep them in mind.
Switching the approval for temporary leave for acquittees from the PSRB to the hospital
superintendent will remove all consideration for victim notification. The overarching factor in
these decisions should not only be about the acquittees therapeutic advancement, but also
the safety of the community and victims who continue to live with lifelong trauma. The PSRB
should be part of decision-making process for acquittees.
Victims of individuals incarcerated in the Department of Corrections following the commission
of a violent crime are afforded the rights to notification and this should not change for a victim
of persons at Whiting Forensic Hospital.
Liza Andrews, Director of Public Policy & Communications,CT Coalition Against
Domestic Violence, (CCADV)
CCADV has concerns with Sections 6 and 7 of SB 450. Several acquittees under the
jurisdiction of the Psychiatric Security Review Board (PSRB) have committed violent acts
against family members or persons they know. It is the position of CCADV that victims of
these heinous crimes should be given physical and emotional safety to help them heal and to
minimize the risk of additional attack by unsupervised acquittees.
It is important that victims be notified and given an opportunity to have their voices heard
when changes are considered to supervision of acquittees. The PSRB ensures the voices of
victims are heard. Yet, the proposed task force in Section 6 of the bill does not include a
victim advocate. We strongly recommend the inclusion of a victim advocate on the task force.
Currently, the PSRB approves temporary leave for patients under the PSRB and Section 7
propose changing this process by giving this authority to the superintendent of Whiting
Forensic Hospital. This change will undermine the public safety provision currently provided
under the PSRB.
Ken Girardin, Director of Policy & Research Yankee Institute
SB 450 does not address one of the most troubling revelations that led to the establishment
of the CVH Whiting Task Force, and that is, Whiting Forensic Hospital had been forced to
rehire employees who had been fired for abusing patients.
In March 2018, Yankee Institute revealed that unelected arbitrators repeatedly overturned
abuse-related termination of employees at Whiting Forensic Hospital under union contract
terms. This was not addressed by the CVH Whiting Task Force and, is not in SB 450.
Page 6 of 8 SB-450
Although arbitration is an effective tool for weighing evidence, it should never be the last word
in personnel decision that allows employees to continue working with vulnerable population.
State agencies sh