Daybreak Youth Services in Brush Prairie signed an agreement with the state Department of Health on Nov. 7 that places conditions on its licenses, including restrictions on patient evaluation, treatment and admissions.
Daybreak, which provides youth mental health and substance abuse treatment at 11910 N.E. 154th St., must use a consultant to review and make recommendations about policies and procedures. It’s also required to submit regular reports to the health department and allow unannounced state inspections.
“Daybreak didn’t meet legal standards in areas including quality improvement, safety and security, admission procedures, sufficient staffing, health care services, medication management, resident rights and failure to report critical incidents,” the Department of Health said in a Tuesday release.
It is noteworthy that the agreed order does not suspend or revoke either of Daybreak’s licenses to operate as a residential treatment facility and a behavioral health agency, Daybreak spokeswoman Sarah Spier said in an email. Further, it does not limit the facility’s current operations, Spier said.
“In fact, the agreed order has caused historic referral sources to resume sending potential clients to Daybreak for evaluation. This is likely due to the fact the (order) rejects the salacious allegations made in the (notices to revoke its licenses) and affirms Daybreak’s position that those allegations were not supported by credible facts,” Spier said.
In June 2018, the sheriff’s office began investigating alleged criminal conduct at Daybreak. Deputies investigated allegations of sexual assault, client and staff safety, and what investigators saw as a pattern of inadequate reporting as required by law. Investigators served a series of search warrants at the facility on Sept. 11, 2018.
The investigation was turned over to the Clark County Prosecuting Attorney’s Office for consideration of charges earlier this year. It is unclear if the prosecutor’s office has filed charges related to the sheriff’s office’s investigation against anyone; no one was available for comment Friday.
The state’s Residential Treatment Facilities and Behavioral Health Agencies program notified Daybreak of its intent to revoke the Brush Prairie facility’s licenses in November 2018. Daybreak appealed the revocations, which kept the facility open in the interim. In its appeal, the facility argued the revocations were based on “inaccurate and unsubstantiated” claims.
Following the searches by deputies, Daybreak filed a complaint for injunctive relief against the sheriff’s office seeking to prohibit investigators from reviewing, releasing or using certain records that were seized. Two Clark County Superior Court judges ruled that deputies had substantial reason to seize the records, but in July, Judge Jennifer Snider granted Daybreak’s motion for a protective order that outlines how substance use disorder patient records, protected health information, and health care information should be used and disclosed.
The state lawsuit is pending in the state Court of Appeals, said Clark County Deputy Prosecutor Leslie Lopez. A similar federal lawsuit with dismissed without prejudice, which both sides agreed to. That kind of dismissal means Daybreak could file it again later.
The health department’s agreed order makes no mention of the seizures, lawsuits or alleged criminal activity at the Brush Prairie facility. It details conditions at Daybreak discovered by state investigators that did not comply with residential treatment facility laws and rules. Among the findings, which were discovered before the revocation notices were issued:
• Daybreak did not document or implement changes to prevent things like resident elopement, assaults, resident-to-staff altercations and allegations of physical or sexual abuse.
• It did not have a policy requiring the “reporting of certain serious or undesirable outcomes to the programs” in use at the facility.
• It did not limit admissions to residents for whom it had appropriate nursing staff in the event someone needed to be restrained, nor did it limit admissions of residents experiencing withdrawal symptoms. (Staff interviewed by investigators said they did not give out medications for substance withdrawal management and were unsure about the use of over-the-counter medications. Daybreak denied it ever provided “withdrawal management services.”)
Another deficiency of note in the order says Daybreak used incident reports to document events such as property damage, self-harm, fights and sexual assaults. The investigators reviewed several of these reports, which were marked “yes” regarding the need for follow-up, but the records did not contain documentation that any follow-up ever happened.
Despite the less-than-desirable findings, the Department of Health wrote that since the potential license revocations were issued, Daybreak made significant changes to address concerns about patient safety.
While the order is in place, Daybreak must submit, on the 10th day of every month, an updated staff list, including changes in position descriptions; all critical incident reports for the previous month; and any updates to procedures that have been implemented; among other materials.
Spier said the agreed order incorporates changes Daybreak has made since new leadership, including CEO Thomas Russell, was appointed about seven months ago. Prior to the order, the facility had already retained a consultant to help and recommend changes, she said.
Some of those changes include leveraging local experts across the entire company, updating security features at the Brush Prairie location, creating new staff training and deciding to serve all males in Brush Prairie and all females in Spokane, where its other treatment center is located.
“At our core, Daybreak is here to save young people’s lives by demonstrating love and bringing hope for their future. We do this by creating a safe environment built upon the commitment to transparency and excellence,” said Russell.
If Daybreak undergoes two unannounced full inspections at Brush Prairie, it will be released from the health department’s agreed order.
