Health agency director gives some answers about failure to investigate abuse in care facilities
The Head of the Arizona Department of Health Services offered some new insights into why the agency failed to investigate hundreds of high-priority cases of abuse and neglect for years in long-term care facilities during a special meeting at the Arizona House of Representatives Thursday.
“I’m not here to provide excuses, I’m here to provide solutions and show that we are sincere,” Don Herrington, who has served as interim director of the agency for nearly a year, said to a group of stakeholders and lawmakers.
The House Ad Hoc Committee on Abuse and Neglect of Vulnerable Adults was created after the Hacienda Healthcare sexual abuse case, when a woman in a persistant vegitative state was found to have been raped multiple times and impregnated by a male nurse at the facility.
Thursday’s meeting retreaded many of the same points that were discussed in a joint hearing of the House and Senate last month in which visibly frustrated lawmakers grilled Harrington for hours over a report from state auditors that found the department had not been investigating cases properly.
“I find my rage has not diminished one bit,” Rep. Jennifer Longdon, D-Phoenix, said at the start of the meeting about reviewing the materials again.
The auditor general’s report found that ADHS “artificially extended” the timeline of responding to high-priority complaints up to nearly a year.
The initial investigation was completed in September 2019 and none of the five recommendations made by auditors had been implemented by this year’s follow-up report, according to testimony from Deputy Auditor General Melanie Chesney.
Instead, auditors found that those high-priority cases often would be closed with no investigation.
On average, auditors found that the department regularly failed to initiate an investigation within 10 days on high-profile cases, taking anywhere between 11 to 476 working days. The department told auditors that staffing shortages and the pandemic were issues at play for why they weren’t able to start investigations in a timely manner.
Harrington elaborated on the staffing issues in Thursday’s meeting, saying that he and the auditor general “disagreed” on the fact that COVID-19 played a role in impacting how they investigated the cases.
“(Long-term care facilities) were the most vulnerable places on earth for people to get COVID,” Harrington said, adding that, in the early days of the pandemic, there was no vaccine and no personal protective equipment (PPE) for ADHS staff or long-term care workers.
In the early days, whenever ADHS got PPE, the agency would give it to long-term care facilities and hospitals instead of keeping it for its own workers, making it harder for them to go and inspect facilities, Harrington said. It wasn’t until May 2020, two months into the pandemic, that the department began going into facilities again, because of concerns that an asymptomatic ADHS employee could infect a whole facility, Harrington said.
“We were doing much in the way of infective protection control with the facilities at that time,” Harrington said, adding that a vaccine for COVID was not readily available until December 2020.
Additionally, staffing was a major issue as ADHS uses nurses to conduct investigations — but hospitals, already strapped for nurses during the pandemic, were paying much higher rates and the agency was unable to recruit for vacancies.
“We haven’t become competitive,” Harrington admitted to the committee, adding that it took until the past month for ADHS to add new incentives for hires, including raising the base level pay for RNs and PAs.
Harrington was not able to answer questions from Rep. Tim Dunn, R-Yuma, who asked if the department had been doing anything “outside the box,” such as virtual visits, to ensure it was still trying to do inspections during the pandemic.
Lawmakers also wanted to know what would happen with the cases that were not investigated.
“I really can’t address what happened in the past,” Harrington said, adding that they’re trying to investigate what they can but that several members of leadership and those that did those cases are no longer with the department.
“These are people, not reports, and we are not treating them that way,” Longdon said, beginning to break down into tears as Dunn laid a comforting hand on her. “Folks that are inside these facilities are the most vulnerable among our community.”
The committee agreed to continue with the same recommendations the previous committee had agreed upon and the department and auditor general will have a follow up report in 6 months due to the “serious nature” of the report.