Mental Clinic for Children May Reopen Amid Probes

Two months after it voluntarily closed amid investigations of patient abuse and substandard care, a children’s psychiatric hospital in Van Nuys may reopen, officials say.

The reopening of the privately owned Children’s Community Mental Health Center is under discussion even as the 41-bed facility remains the subject of two investigations. One, by the licensing and certification division of the county Health Services Department, addresses a broad range of alleged deficiencies at the hospital as well as the Jan. 31 death of an 8-year-old patient. The other inquiry, by the public interest law firm Protection and Advocacy Inc., focuses on the boy’s death and how to avoid future tragedies.

The death was under investigation by Los Angeles police until the county coroner’s office concluded last month that the boy died of a heart infection. That conclusion, however, has not halted the investigations by the county agency or Protection and Advocacy. The law firm is primarily government funded and serves, under federal regulations, as an independent investigator and advocate for people with disabilities.

“We investigate allegations of abuse and neglect,� said Leslie Morrison, the firm’s supervising attorney of investigations. At the Van Nuys facility, she said, “we are looking . . . at whether there is a way to prevent deaths like that in the future.�

The hospital’s president, Brent Lamb, said Saturday that he was not aware of the pending investigations and that privacy laws prevent him from discussing the boy’s death. But Lamb defended the quality of care provided by the facility before its closure.

Noting that the hospital has been in operation for 30 years under various owners, Lamb said: “It has done an outstanding job treating very, very difficult patients.�

Prior to the hospital’s closure, the county Department of Mental Health had notified the facility it would not send any new patients there, officials say. The hospital voluntarily suspended its license and sued the county on the grounds that it violated the hospital’s rights to due process and to receive new patients. The suit is pending, though Lamb said the matter has been settled and the hospital’s attorney said he plans to file a motion for dismissal.

Lamb said the hospital’s voluntary closure had nothing to do with the allegations about its operation. Rather, he said, the hospital--purchased two years ago by its employees--closed because it could not financially operate without the medical reimbursements it received from the county.

Lamb said he expects the facility to reopen within 90 days. The hospital’s attorney, in a separate interview, said he hopes the facility will soon reopen under new management and a county-approved set of guidelines.

“It is not a done deal,� attorney William Bairg said, “but we want to reopen.�

Because it voluntarily suspended its license, officials said, the facility could reopen without county permission. But without an agreement with the county, the hospital would not receive referrals of young patients--from foster care, group homes, schools and Juvenile Hall--who had constituted the vast majority of its clientele.

Further, the hospital would need to win a new certification from the U.S. Health Care Financing Administration for any government reimbursements for patient care.

It is not clear how much time that could take.

In an interview, Lamb insisted that the federal agency was ready to recertify the hospital for operation. “We have resolved our differences with the county Department of Mental Health and [the federal agency] is ready to come back in and recertify us as soon as we request it,� Lamb said.

But an official with the federal agency told The Times on Friday that recertifying the hospital might not occur quickly because the agency had been moving toward terminating the hospital’s certification--unless it fixed its problems--when it closed.

“They had some significant deficiencies,� said Stan Marcisz, director of long-term care operations for the agency, who estimated that a new certification for the hospital could take “30 days to never.�

Still, talks are underway to see if the facility can reopen.

“The hospital . . . is looking for new management, and we are willing to give new management a fair shake,� said Principal Deputy County Counsel Richard Mason.

“But they won’t reopen [with county referrals] unless they meet all of our criteria and satisfy us that employees have been appropriately trained,� Mason said.

County documents show that the facility was under investigation when it closed for allegations that included staffers abusing mentally ill children, children sexually assaulting each other, slipshod records and a lack of such essentials as blankets and toilet paper.

While acknowledging that the hospital could have benefited from improved staffing or training, Lamb said that the facility was well-run and that none of the allegations were substantiated.

But some county officials expressed concern about allowing it to reopen with its former administration and staff. They based that concern, they said in interviews, on warnings about the hospital’s poor operation that were issued for months before its license was voluntarily suspended. Confidential county reports show that mental health department investigators, responding to complaints, found evidence of inadequate supervision, sexual assault among patients and excessive force by staff as far back as August 1999.

Nevertheless, the hospital retained its county license to operate until Jan. 31.

That same day, 8-year-old Anthony Rovegno, who, according to county documents, suffered from manic depression and asthma, had a seizure and was taken to a hospital where he died.

Police closed their investigation into the boy’s death after the coroner’s office ruled it was caused by a heart condition.

His death had been of particular interest to authorities because, records and interviews show, there was strong suspicion that it could have resulted from neglect or medical malpractice.

Det. Kelly Martinelli of the LAPD’s child abuse unit said police were called into the case after the boy was taken to Childrens Hospital and doctors there voiced concern at the reported number of medications the boy was taking.

“The doctors were very concerned with all the medications he was on and the dosages. And because he was such a young child, they were concerned he had possibly had a drug overdose,� Martinelli said.

With no medical records suggesting a heart problem and nothing clearly wrong with the boy’s heart during an autopsy, Martinelli said, it was not immediately obvious why he died.

The coroner’s office said the death was first reported as a possible overdose of the antipsychotic drug Haldol. The drug was one of four medications the child was taking for depression, according to an internal county report.

Further tests concluded that he died from a heart infection known as myocarditis. And the suspicions of a drug overdose, Martinelli said, were not substantiated by a toxicology report that found only trace amounts of Tegretol, a medication prescribed for seizures and mood disorders.

Lamb said he was not aware of any LAPD investigation into Rovegno’s death.

In addition to that case, LAPD Lt. Gregory A. Correa said a check of records at the Van Nuys Division found that officers filed 24 crime reports involving hospital patients and staffers during the last eight months of 2000. The cases--all now closed--included allegations of sexual assault, misdemeanor battery, petty theft and vandalism.

Correa said records show that five sexual assaults and four batteries resulted in arrests. But, he said, it was unclear who was arrested and whether any of the cases were ever prosecuted.

Meanwhile, Isabella Rovegno said Friday that she still believes her son’s death was preventable.

“I am not going to say my son didn’t have problems,� she said. “But he was a great kid . . . and I never want that place to reopen.�