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S.H. v. Reed 2011 Annual Report on OH Juvenile Prison Stipulations

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Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 1 of 41 PAGEID #: 8201

2011

Third Annual Report
On Compliance with the S.H. v. Reed
Stipulation for Injunctive Relief
By Will Harrell, J.D., LL.M
& Terry Schuster, J.D.

S.H. v. Reed Monitor
Special Assistant to the Monitor

S.H. v. Reed Third Annual Report
12/30/2011

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S.H. v. Reed 2011 Annual Report
By Will Harrell, J.D., LL.M.
S.H. v. Reed Monitor

and Terry Schuster, J.D.
Special Assistant to the Monitor

Table of Contents
Preface ........................................................................................................................................ 2
Introduction ................................................................................................................................ 3
Part I. 2011 Compliance Snapshot ............................................................................................ 6
Part II. Recommended Priorities for 2012 .............................................................................. 24
Part III. Recommended Site-Specific Priorities for 2012 ........................................................ 34
Part IV. Additional Monitoring Priorities for 2012 ................................................................. 38

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Preface
This is the third Annual Report in the remedial stage of the S.H. v. Reed (previously S.H.
v. Stickrath) litigation, but this is the first Annual Report since I came on as Monitor at the
beginning of this year and since Harvey Reed was appointed Director of the Department shortly
thereafter. In July, Terry Schuster came on as my Special Assistant and we reached out to
experts in the field to help us adapt the work of our monitoring team to be more efficient,
comprehensive, and responsive to the parties. We developed a site visit reporting protocol
that has helped ensure 1) that our reports are timely and comprehensive; 2) that our
compliance findings are tied to the requirements of the Stipulation and do not conflict with one
another; 3) that the Department is not overwhelmed with multiple reports from the same site
visit; 4) that our reports offer guidance to the Department on priorities; and 5) that the
monitoring team has an opportunity to collaboratively troubleshoot site-specific problems with
central office and facility leaders following the visit.
We have taken significant steps to keep our work transparent and to efficiently and
appropriately share information with interested parties. We have uploaded various document
collections to a private Google Docs site for the monitoring team and plaintiffs’ counsel as a
shared filing cabinet. We have met with the Legal Assistance Program, the Correctional
Institution Inspection Committee, the Office of the Ohio Public Defender, and the Legal Rights
Service for people with disabilities, to open lines of communication and collaboratively address
systemic concerns. We also invited DOJ monitor, Dr. Kelly Dedel, to participate in a recent
Special Inquiry, and are pursuing a memorandum of understanding between the S.H. and DOJ
monitoring teams to reduce redundant efforts and restore some level of collaborative
oversight. Judge Marbley supports this collaboration, and has instructed us to develop a plan
to efficiently and cost-effectively monitor overlapping areas of the two Stipulations.
The Department’s leaders have shown integrity and sincere dedication to reform, and I
am confident in their ability to achieve compliance with the Stipulation. Operation Safety First
and the monitoring team’s Special Inquiry caused some strained relationships, and may have

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set us back in terms of building a strong partnership between the monitoring team and the
agency. The Stipulation, however, makes clear that the goal of monitoring in this case is not
simply to find noncompliance, but to partner with and coach the Department to achieve
compliance.1 It is also our responsibility to keep counsel for plaintiffs informed and involved in
decision-making as partners in the monitoring process. We are operating in this spirit, and will
continue to assess our monitoring approach to ensure that we support and empower the
Department’s leaders while holding them accountable.

Introduction
What follows is the Monitor’s 2011 Annual Report on compliance with the S.H. v. Reed
Stipulation for Injunctive Relief. It consists of four parts. Part one provides a comprehensive
chart with compliance levels for each substantive Stipulation paragraph. It also identifies
paragraphs that require no further monitoring by the S.H. monitoring team. More detailed
instructions on how to read the chart in part one can be found at pp. 6-9. Parts two and three
of this report outline what we believe should be the Department’s general and site-specific
priorities for 2012, and part four lists additional priorities for the monitoring team in the
coming year. This Annual Report relies largely on the monitoring team’s last findings at each of
the facilities, so some relevant updates will be captured in upcoming site visits rather than in
this report. We have collected comments and objections from the parties to a preliminary draft
of this report, and have incorporated their feedback where appropriate. We invite the parties
to voice any remaining objections on the record.
As of December 1st, 2011, the Ohio Department of Youth Services housed 606 youth in
secure juvenile correctional facilities at an average per diem cost of $442 per youth. The
average age of youth in custody was 17.7 years old, and average length of stay was 12.6
months. Of the youth admitted to DYS facilities in fiscal year 2011, 93.3 percent were male and
6.7 percent were female; 56 percent were African American, 34.7 percent were Caucasian, and
1

See Stipulation paragraph 247.

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9.3 percent were other races. 43 percent were admitted for person offenses; 30.7 percent
were admitted for property offenses; 10.7 percent were admitted for sexual offenses, and only
3.3 percent were admitted for drug offenses.2
We recognize that the monitoring team is large and the scope of the Stipulation is very
broad, and believe we are professionally obligated to conduct compliance monitoring as
efficiently as possible. To that end, we have streamlined group site visit reporting and
eliminated conflicting compliance determinations by following a new reporting protocol; in this
report we have clarified monitoring assignments among the team and eliminated unnecessary
overlap; and in the coming year we will streamline our process for gathering data and
documents. In this report, we both provide a comprehensive compliance assessment and also
identify concerns that DYS should prioritize, to ensure that our review is thorough without
being overwhelming. We will continue to do this in our future reports.
We will also continue to identify areas of sustained compliance and suspend monitoring
of certain Stipulation paragraphs as appropriate. Conditions of confinement problems are
chronic and must be continually managed. As the Department demonstrates proficiency in
managing these ongoing problem, and adherence to the principles and requirements of the
Stipulation, we will shift our focus to ensuring that DYS has a sufficient quality assurance system
in place to prevent relapse, and hand off more and more monitoring responsibilities to DYS. As
part of this effort, we will work with DYS in the coming year to develop audit tools for S.H.
monitoring that will help clarify exactly what is required for a finding of substantial compliance,
and that will facilitate the transfer of monitoring responsibilities to the Department when the
case comes to an end.
With the closure of Ohio River Valley JCF in September of this year, DYS has four
remaining secure facilities. We have scheduled three large group site visits for the remainder of
the fiscal year, to Indian River JCF in December, to Scioto JCF in January, and to Circleville JCF in
February. A fourth site visit in April will depend on our findings over the next several months
2

DYS Monthly Fact Sheet, December 2011, available at
http://www.dys.ohio.gov/DNN/LinkClick.aspx?fileticket=sAk4xNhrD%2bw%3d&tabid=117&mid=885.

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and the remaining monitoring budget for the fiscal year. Dental care in DYS facilities is nearing
full compliance. Following reports on dental care at Indian River and Cuyahoga Hills in January,
and brief follow-up visits to all four facilities in April we anticipate that dental care monitoring
can be suspended, barring any significant backsliding.
In drafting this annual report, we’ve drawn from expert reports written at various points
throughout the year, and we’ve identified priorities based on their findings. Because many of
these findings are already “old news,” and we anticipate changes at our upcoming site visits, we
will continually update the compliance chart and the list of general and site-specific priorities.

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Part I. 2011 Compliance Snapshot

The following chart captures compliance determinations from site visits by various
members of the monitoring team. These include visits to Circleville in May and August 2011; to
Scioto in December 2010, and March and May 2011; to Indian River in February, March, and
September 2011; and to Cuyahoga Hills in November 2010, and March and April 2011. It also
draws from reports by Vince Nathan on the Release Authority, Shay Bilchik on regionalization of
service delivery and re-entry, and David Roush on training and quality assurance.3 Compliance
determinations that were not discernible in these reports were made or deferred based on
interviews with monitoring team members in November 2011. The compliance determinations
represent levels of compliance observed at the time of those site visits and in reviews of data
and documents from the months leading up to the visits. Thus the facts underlying these
compliance determinations have likely changed. Indeed, we anticipate improvements in many
areas and look forward to our visits in December, January and February.
Where paragraphs are assessed at each site for compliance, we have listed compliance
determinations for each facility. Where paragraphs apply only to central office or are otherwise
non-site-specific, we have listed compliance determinations in the column marked “General.”
Compliance determinations include “NC” (not in compliance), “PC” (in partial compliance), and
“SC” (in substantial compliance). These are color coded red, green, and blue respectively. Until
recently, monitoring team members filed several separate reports following group site visits,
often making conflicting compliance determinations. For example, experts assessing
compliance with paragraph 49 (unit staffing) made conflicting compliance determinations at
Scioto and Cuyahoga Hills. We have reviewed these conflicting assessments, and have made
final and singular compliance determinations in this report. Beginning with the group site visit
to Circleville in August, the monitoring team began following a new reporting protocol, in which
the Monitor files a single report and makes a single compliance determination for each
paragraph at each institution. We will continue to follow this protocol in future site visits.

3

These reports have been shared with the parties and are available from the Monitor upon request.

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The second column in the chart identifies the member or members of the monitoring
team who are currently assigned to monitor each paragraph for compliance. Where we found
it reasonable to eliminate overlap among the monitoring team members, we did so. However,
where compliance would be more fully and properly assessed with input from more than one
team member, more than one has been assigned. For example, paragraph 47 on classification
and housing requires the DYS security classification system to assure placement in a housing
unit based on both risks and programming needs. Monitoring team member Steve Martin has
expertise useful in assessing classification based on risks and team member Orlando Martinez
has expertise useful in assessing classification based on programming needs. The Monitor will
make a single compliance determination based on input and recommendations from both team
members.4
In some paragraphs with multiple experts assigned, we have identified a “lead expert,”
who will consult with the other experts assigned and report for them all. For example, Barb
Peterson has been designated as the lead expert on paragraphs 127 and 128, which relate to
medication administration. Where necessary, she will consult with Daphne Glindmeyer
regarding administration of psychotropic medications, and will report to the Monitor on this
subject for both of them.
Although the monitoring assignments are current, the compliance determinations in the
chart are from findings in various reports throughout the year. Thus, there are paragraphs in
which the expert currently assigned is not the one to have made the compliance findings. For
example, paragraphs relating to mental healthcare were previously assessed for compliance by
Dr. Wills, but are currently assigned to Dr. Glindmeyer and/or Dr. Weisman. While their names
appear next to those compliance findings on the chart, they have yet to assess them.
Compliance monitoring not only involves fact finding; it also involves interpreting the
Stipulation for Injunctive Relief. Thus, when reporting on compliance, it is important to clarify
how the monitoring team interprets the Stipulation. Rows in the chart that are highlighted in
4

Where appropriate, these experts will also seek input from mental health subject matter experts Daphne
Glindmeyer and Andrea Weisman.

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gray are paragraphs that we believe do not require compliance determinations from the
Monitor. They include introductory and concluding paragraphs, non-substantive paragraphs,
and paragraphs that state “general principles” or “guiding principles.” We define a general or
guiding principle paragraph to be one that states a broad requirement that is re-stated in more
specific, measurable terms in other Stipulation paragraphs. The guiding principle paragraphs
are used to interpret the more specific and related substantive terms, but do not require their
own compliance determination. Under this interpretation, 212 of the 274 paragraphs require
compliance determinations from the Monitor.
The meaning of Stipulation paragraph 28, which requires “a strong system of
accountability [to be] put in place,” is not entirely clear. Specifically, it is unclear if this
paragraph refers to establishing a strong system of internal quality assurance or to a strong
system of external oversight that would last beyond the S.H. case. In this report, we have
highlighted it in gray, but we will discuss the proper interpretation of this paragraph with the
parties and revisit this determination at a later date.
Where we have deferred a compliance assessment on a Stipulation paragraph, it is
because the monitoring team has not yet evaluated compliance with that paragraph, further
investigation is required, or the issue is being negotiated between the parties. Our aim is to
address these paragraphs in the coming year and not to defer compliance determinations in the
future.
Rows in the chart that are highlighted in blue are paragraphs that are in sustained
substantial compliance. For those paragraphs, we intend to shift the focus of our monitoring to
the Department’s internal quality assurance and self-assessments. In some instances we have
highlighted the paragraph in some but not all facilities. For example, we believe monitoring of
paragraph 226 on school Intervention Assistance Teams should continue at Circleville, but need
not continue at the other facilities; thus, all facilities except Circleville are highlighted in blue at
paragraph 226.5 There are several paragraphs that monitoring team members believe DYS has
5

To be clear, the Intervention Assistance Teams should continue to meet at each facility even though external
monitoring would be suspended.

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substantially complied with, but which still require some additional monitoring. These
paragraphs are labeled “SC,” but are not highlighted in blue. In total, we have highlighted 53
paragraphs (25%)6 in blue, including 34 paragraphs (16%) that are highlighted at all four DYS
facilities, and an additional 19 paragraphs (9%) that are highlighted at at least one facility.
Note that nearly all of the dental care paragraphs at Circleville are in sustainable
substantial compliance and are highlighted in blue. We anticipate that dental care in all DYS
facilities will be found in full compliance by the end of the fiscal year.

Stipulation Paragraph
1. Stipulation resolves claims
2. Claims; class defined
3. Parties agree to fact finding
report
4. No waiver of sovereign
immunity
5. Parties agree to Stipulation
6. Def.’s best efforts to obtain
funding
7. Purpose of Stipulation
8. Definitions
9. Provisions applying to Paint
Creek
10. Safe environment / LRE
11. DYS mission statement
12. Decisions must meet letter
and spirit of Stipulation

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

N/A

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

Guiding
principle

--

--

--

--

--

N/A

--

--

--

--

--

N/A

--

--

--

--

--

6

This percentage is based on the 212 paragraphs identified that require compliance determinations from the
Monitor (i.e., 53 out of 212 equals 25 percent).

S.H. v. Reed Third Annual Report

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Stipulation Paragraph
13. Continuum of care /
regionalized service delivery
14. Task force / development of
regional facilities
15. LRE / limiting population in
secure confinement
16. Cost-effectiveness
17. Disproportionate minority
confinement
18. Effective and consistent
assessments
19. Youth-focused care
20. Quality treatment
interventions
21. Family engagement
22. Qualified workforce properly
deployed
23. Education system provides
opportunities / complies with
law
24. Responsive grievance system
25. Access to advocates and
attorneys
26. Strong re-entry programs
27. Fair and informed release
process
28. Accountability and
monitoring
29. Top priorities: force,
isolation, mental health,
education
30. P&P review and revision for
priorities in paragraph 29
31. Speedy implementation of
new P&P

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

Bilchik

SC

--

--

--

--

Bilchik

SC

--

--

--

--

Bilchik

SC

--

--

--

--

Guiding
principle

--

--

--

--

--

Bilchik

SC

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

Guiding
principle

--

--

--

--

--

Guiding
principle

--

--

--

--

--

Nathan

SC

--

--

--

--

Bilchik

PC

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

SC

--

--

--

--

PC

--

--

--

--

Guiding
principle
Guiding
principle
Guiding
principle
Guiding
principle
Guiding
principle

Guiding
principle
Guiding
principle
N/A
Martin, Peterson,
Crow, Roush,
Martinez
Martin, Peterson,
Crow, Roush,
Martinez

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Stipulation Paragraph
32. Plan for reforming release
standards and procedures
33. DYS list of changes made
within 30 days of Stipulation
34. DYS description of agency
and program history
35. Review and revision of P&P
in other areas as needed
36. P&P review within 9 months
/ implementation
37. Staff training on P&P
38. Annual in-service
39. Medical and mental health
P&P, general and site-specific
40. Site-specific P&P consistent
with system-wide P&P
41. Annual review of P&P
42. Subsequent paragraphs
contain P&P specifics
43. Admissions and intake
44. Assessments and screenings
45. Content of orientation
46. Revision of Introductory
Handbook
47. Security classification
appropriate to risks and needs
48. Role of unit staff in service
delivery / family engagement
49. Sufficient unit staffing; social
worker caseloads
50. Adequate, low-cost phones
51. Unit staff to have access to
necessary records

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

Nathan

[deferred]

--

--

--

--

N/A

SC

--

--

--

--

N/A

SC

--

--

--

--

General
principle

--

--

--

--

--

N/A

SC

--

--

--

--

Roush

--

PC

PC

PC

PC

Roush

--

PC

[deferred]

[deferred]

[deferred]

--

PC

PC

PC

PC

--

[deferred]

[deferred]

[deferred]

[deferred]

Harrell,
Schuster

[deferred]

--

--

--

--

N/A

--

--

--

--

--

Martinez

--

[deferred]

[deferred]

[deferred]

[deferred]

Martinez

--

[deferred]

[deferred]

[deferred]

[deferred]

Martinez

--

[deferred]

[deferred]

[deferred]

[deferred]

Martinez

--

SC

SC

SC

SC

Martin,
Martinez

--

[deferred]

[deferred]

[deferred]

[deferred]

Roush

--

NC

PC

PC

PC

Roush,
Martinez

--

PC

PC

PC

PC

Roush

--

PC

PC

PC

PC

Weisman,
Martinez

--

PC

[deferred]

[deferred]

PC

Weisman, Glindmeyer, Peterson,
Shansky
Weisman, Glindmeyer, Peterson,
Shansky

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Stipulation Paragraph
52. All youth entitled to
rehabilitation
53. All youth entitled to UCP and
resources to implement it
54. All staff have defined role in
rehabilitation
55. Behavior management is
consistent, positive, and fair
56. Structured programming
57. Expanding the use of
volunteers
58. Care and accommodations
for special needs youth
59. Clear program with P&P for
comfort rooms
60. QA for program and
intervention implementation
61. DYS to develop program and
staffing plan
62. Sex offender program / staff
training / QA and P&P
63. Release decisions for sex
offenders
64. Stay should not be extended
because of delay in services
65. Safe living conditions
66. Adequate staffing is critical
to safety
67. JCOs qualified to work with
youth
68. JCO youth engagement
responsibilities / training
69. Staff training topics / lesson
plans / evaluations / feedback
70. Use of force generally
71. Guiding principles for use of
force policies

S.H. v. Reed Third Annual Report

Expert(s)
assigned
General
Principle
Weisman,
Martinez

General

CJCF

SJCF

IRJCF

CHJCF

--

--

--

--

--

--

[deferred]

NC

NC

PC

Roush, Martinez,
Weisman

SC

--

--

--

--

Roush, Martinez,
Weisman.

--

PC

PC

SC

PC

Roush, Martinez,
Weisman

--

PC

PC

PC

PC

Roush

--

SC

PC

PC

SC

Weisman

--

PC

PC

PC

PC

Weisman

--

[deferred]

SC

SC

PC

Roush, Martinez,
Weisman

--

NC

PC

NC

PC

Roush, Martinez,
Weisman

[deferred]

--

--

--

--

Glindmeyer,
Weisman

--

[deferred]

[deferred]

[deferred]

[deferred]

Nathan. (lead),
Glindmeyer,
Weisman.

[deferred]

--

--

--

--

Nathan

[deferred]

--

--

--

--

Roush,
Martinez

--

NC

PC

NC

SC

Roush

--

PC

PC

PC

PC

PC

--

--

--

--

PC

--

--

--

--

Roush

PC

--

--

--

--

Martin

--

SC

PC

PC

PC

Martin

--

SC

PC

PC

PC

Roush,
Martinez
Roush,
Martinez

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Stipulation Paragraph
72. Fair and appropriate gang
intervention strategies
73. Adequate video coverage to
enhance youth/staff monitoring
74. Safety plans and SMPs tied to
treatment / behavior incentives
75. SMPs / isolation: designed to
meet individual youth needs
76. Seclusion guiding principles
77. Restraints P&P / purpose /
safeguards / documentation
78. Staff training on restraints
79. P&P re. investigations of use
of force and sexual misconduct
80. Guiding principles for P&P in
paragraph 79
81. Eliminating the backlog of
investigations
82. Sufficient staffing to conduct
investigations
83. Coordinated abuse
investigations
84. QA for use of force
85. Opportunity to accomplish
the purpose of confinement
86. Mental health care scope /
individualized / evidence-based
87. Mental health P&P /
disseminated to clinical staff
88. Mental health screening,
assessment, and referral
89. Revise protocols for special
needs and mental health units
90. Clearly articulated criteria for
discharge from MH caseload
91. Adequate trained personnel,
space, and time for MH goals

S.H. v. Reed Third Annual Report

Expert(s)
assigned
Roush,
Martinez

General

CJCF

SJCF

IRJCF

CHJCF

--

NC

PC

NC

PC

Roush

--

[deferred]

SC

SC

SC

Roush,
Martinez

--

PC

PC

PC

PC

Roush, Martinez,
Weisman

--

PC

PC

SC

SC

Martin

--

PC

PC

PC

PC

Martin

--

SC

SC

SC

SC

Martin

--

SC

SC

SC

SC

Martin

--

SC

SC

PC

PC

Martin

--

SC

SC

PC

PC

Martin

SC

--

--

--

--

Martin

--

SC

SC

PC

PC

Martin

--

SC

SC

PC

PC

Martin

--

SC

SC

PC

PC

--

--

--

--

--

--

--

--

--

--

--

[deferred]

[deferred]

[deferred]

[deferred]

--

[deferred]

[deferred]

[deferred]

[deferred]

--

[N/A]

SC

SC

[N/A]

--

PC

PC

[deferred]

SC

--

NC

PC

PC

PC

General
Principle
General
Principle
Glindmeyer,
Weisman
Glindmeyer,
Weisman
Glindmeyer,
Weisman
Glindmeyer,
Weisman
Weisman

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Stipulation Paragraph
92. Mental health staff ratios /
analysis
93. Mental health clinical staffing
of treatment units
94. Annual review of MH staffing
and allocation
95. Occupational and general
activity therapy
96. Sufficient clerical support for
MH clinical staff
97. Mental health resources for
youth in general population
98. Structured, focused design
and planning of treatment
99. Family engagement by
mental health staff
100. Mental health clinician to
meet regularly with girls
101. Disciplinary advocate for
youth on MH caseloads
102. Mental health QA and peer
review
103. Mental health staff capacity
and performance
104. Mental health leadership
105. Training for clinical and
other staff
106. Mental health records and
team coordination
107. Guidelines for suicide P&P
108. Changes to physical plant to
prevent self-harm / safety rooms
109. Youth entitled to medical
care
110. Medical services to meet
the needs of adolescents
111. Develop and implement
chronic care clinics

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

Weisman

--

PC

PC

SC

PC

Weisman

--

[N/A]

SC

SC

[N/A]

Weisman

[deferred]

--

--

--

--

Weisman

--

PC

SC

SC

NC

Weisman

--

PC

PC

PC

PC

--

PC

PC

PC

PC

--

PC

NC

NC

NC

Weisman

--

PC

PC

PC

PC

Glindmeyer,
Weisman

--

[N/A]

SC

[N/A]

[N/A]

Weisman

--

[deferred]

[deferred]

SC

SC

--

PC

PC

PC

PC

Glindmeyer,
Weisman
Glindmeyer,
Weisman

Glindmeyer,
Weisman
Glindmeyer,
Weisman
Glindmeyer,
Weisman
Glindmeyer,
Weisman
Glindmeyer,
Weisman

--

PC

PC

PC

PC

[deferred]

--

--

--

--

PC

--

--

--

--

--

NC

PC

NC

NC

Weisman

--

PC

[deferred]

PC

PC

Weisman

--

PC

SC

SC

[N/A]

--

--

--

--

--

--

--

--

--

--

--

PC

PC

PC

PC

General
Principle
General
Principle
Shansky

14

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 16 of 41 PAGEID #: 8216

Stipulation Paragraph
112. Expectations of central
office medical leadership
113. Define relationship between
Medical and Nursing Directors
114. Medical and Nursing
Directors drive P&P
115. Resources for and
monitoring of Medical Director
116. New medical P&P subject to
review
117. Assessments monitored for
quality and accuracy
118. New protocols and revised
policies on documentation
119. QI for initial health
appraisals
120. Screens by LPN / appraisals
by RN with Dr. signature
121. Requirements for initial
health and MH assessments
122. Medical P&P for transfers;
requirements for progress notes
123. Transfer process and
medical care / transfer summary
124. P&P guidelines for injury
assessment and referral
125. Qualitative reviews of
documentation
126. Additional attention to
special needs of females
127. Standards for
administration of medicine
128. P&P to ensure assessment
of impact of medication errors
129. Prescribing, stocking, and
access to “as needed” meds
130. Routine pharmacy
monitoring
131. Monitoring and reporting of
laboratory services

S.H. v. Reed Third Annual Report

Expert(s)
assigned
Peterson,
Shansky

General

CJCF

SJCF

IRJCF

CHJCF

PC

--

--

--

--

Shansky

SC

--

--

--

--

Peterson,
Shansky

PC

--

--

--

--

Shansky

PC

--

--

--

--

PC

--

--

--

--

--

PC

NC

NC

NC

--

PC

PC

PC

PC

Shansky

--

PC

NC

PC

PC

Shansky

--

PC

PC

PC

PC

Shansky (lead),
Glindmeyer,
Weisman

--

SC

SC

SC

SC

Shansky (lead),
Glindmeyer

--

PC

[deferred]

PC

PC

Shansky

--

SC

SC

SC

SC

Shansky

--

PC

PC

PC

PC

Shansky

--

PC

NC

PC

PC

Shansky

--

[N/A]

PC

[N/A]

[N/A]

Peterson (lead),
Glindmeyer

--

NC

PC

PC

SC

Peterson (lead),
Glindmeyer

--

NC

NC

NC

PC

Peterson

--

SC

SC

SC

SC

Peterson

--

SC

PC

NC

PC

Peterson

--

PC

SC

PC

PC

Peterson,
Shansky
Peterson,
Shansky
Peterson,
Shansky

15

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 17 of 41 PAGEID #: 8217

Stipulation Paragraph
132. Infection control
133. Physical plant: medication
storage / sanitation
134. Review and replace medical
equipment
135. Availability / accessibility of
medical records
136. Medical record to be
chronological and complete
137. Problem lists conspicuous in
file / resolved issues identified
138. Review of medical records /
required contents of Dr. notes
139. Monitoring / review of
abnormal vital signs
140. Face-to-face appointment
for acute illness or
hospitalization
141. QA / QI / peer review /
programming to match needs
142. Protocol for preventive care
/ health education
143. Medical staff to inform
youth regarding care
144. Informed consent /
education on medication uses
145. Protocol to ensure family
engagement in medical care
146. Assessment of nutrition
program
147. Health care staffing and
allocation
148. Relief factor for 24/7
nursing positions
149. P&P defined roles of
medical staff / no tolerance for
aggression
150. Assess medical staff pay and
benefits

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

Peterson

--

PC

PC

PC

SC

Peterson

--

PC

SC

PC

SC

Peterson

--

PC

SC

PC

SC

Peterson (lead),
Weisman

--

PC

PC

PC

PC

Peterson (lead),
Glindmeyer

--

SC

SC

PC

SC

Peterson

--

SC

PC

PC

PC

Peterson

--

NC

NC

PC

PC

Shansky

--

NC

NC

NC

NC

Shansky

--

PC

SC

SC

SC

Shansky

--

PC

PC

PC

PC

Peterson

--

PC

SC

SC

SC

Peterson

--

SC

SC

SC

SC

Peterson (lead),
Weisman

--

PC

PC

PC

PC

Peterson

--

SC

SC

SC

SC

Peterson

--

SC

SC

SC

SC

Peterson

--

PC

PC

PC

PC

Peterson

--

PC

[deferred]

PC

PC

Peterson

PC

--

--

--

--

Peterson

PC

--

--

--

--

16

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 18 of 41 PAGEID #: 8218

Stipulation Paragraph
151. Health care staff properly
credentialed / relevant expertise
152. Regularly assess staff
competency / peer review
153. Med staffing sufficient for
population needs
154. All youth have a right to
dental care
155. Dental care must meet or
exceed national standards
156. General dental care
standards to be monitored
157. Dental care P&P reviewed
by class counsel and Monitor
158. Access to routine and acute
dental care / supplies
159. Urgent dental care within
24 hours
160. Scheduling of dental
treatment / eliminating delays
161. Annual dental exam,
cleaning, oral health education
162. Update dental P&P in
various areas
163. Dental screening exam /
individual treatment plan
164. Preventive care / sealant
placement / topical fluoride
165. Develop oral hygiene
education program
166. High priority dental caries /
stabilization / follow-up
167. Guidelines for partial
dentures and crowns
168. Oral surgery / dental
radiographs / dental assistant
169. Availability of dental
specialists
170. Monitor dental treatment
of special needs patients

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

Peterson

--

SC

SC

SC

SC

Weisman, Glindmeyer, Peterson,
Shansky,

--

NC

NC

NC

NC

Peterson

--

PC

PC

PC

PC

--

SC

SC

SC

SC

--

PC

PC

PC

PC

--

SC

SC

SC

SC

--

SC

SC

SC

SC

--

PC

SC

SC

SC

--

SC

SC

SC

SC

--

PC

SC

SC

SC

--

SC

SC

SC

SC

SC

--

--

--

--

--

SC

PC

NC

PC

--

SC

SC

SC

SC

--

SC

SC

[deferred]

SC

--

SC

PC

PC

SC

--

SC

SC

NC

SC

--

SC

SC

NC

SC

--

SC

SC

SC

SC

--

SC

SC

SC

SC

Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter

17

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 19 of 41 PAGEID #: 8219

Stipulation Paragraph
171. QA and peer review /
correction of deficiencies
172. Adequate medical
information available to dentist
173. Dental treatment plan for
each youth
174. SOAP format for dental
record progress notes
175. Appropriate dental space,
equipment, and supplies
176. Dental staffing
177. Licensure of dental staff
178. Number and quality of
dental staff
179. Infection control /
biohazard labeling / sterilization
180. DYS acknowledges the
importance of education
181. Communication between
schools and Bureau of Education
182. JCOs in schools / training /
classroom management
183. Role of superintendent and
facility admin
184. Education staff instructional
duties not hampered by security
185. Ensure sufficient education
space
186. Safety features in schools:
cameras, alert systems
187. Appropriate classroom
furniture
188. Repairs / classroom space at
CHJCF / HVAC at ORV
189. All youth receive full school
day (5.5 hours)
190. Options to meet full school
day requirements

S.H. v. Reed Third Annual Report

Expert(s)
assigned
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
Makrides,
Sauter
General
Principle

General

CJCF

SJCF

IRJCF

CHJCF

--

SC

NC

NC

PC

--

SC

SC

SC

SC

--

SC

SC

SC

SC

--

SC

SC

SC

SC

--

SC

SC

SC

NC

--

SC

SC

NC

SC

--

SC

SC

SC

SC

--

SC

PC

PC

PC

--

SC

NC

NC

SC

--

--

--

--

--

Crow

--

PC

SC

PC

PC

Crow

--

PC

PC

PC

SC

Crow

--

SC

SC

SC

SC

Crow

--

SC

SC

SC

SC

Crow

--

PC

SC

PC

PC

Crow

--

SC

PC

SC

PC

Crow

--

SC

SC

PC

PC

Crow

--

[N/A]

[N/A]

[N/A]

PC

Crow

--

PC

NC

PC

SC

Crow

--

SC

PC

SC

SC

18

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 20 of 41 PAGEID #: 8220

Stipulation Paragraph
191. Recruiting and retaining
school staff / diversity recruiting
192. Centralized hiring process /
staff allocation / HQT placement
193. Academic credit for certain
group programs
194. Analyze vacancies / staffing
ratios / staffing plan
195. Budget for substitutes / hire
and train permanent subs
196. Full education services in
specialty units
197. Facilities to inform Bureau
which students in specialty units
198. Special education teacher
on specialty units
199. Revise policies to provide
professional development
200. Pre-service and ongoing
training for teachers
201. Staff training on collateral
consequences of juv. records
202. Educational aides / yearly
contracts for teachers
203. Improve communication
between facility and school staff
204. Violence interfering with
students’ education
205. Identify and help teachers
with classroom management
206. Contract with education
consultant re. classroom mgmt
207. Progressive school discipline
/ positive behavior management
208. Improve accuracy of
education assessments
209. Clerical support for
guidance counselors

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

Crow

--

PC

PC

PC

SC

Crow

--

PC

PC

PC

PC

Crow

--

PC

NC

NC

NC

Crow

--

NC

NC

PC

NC

Crow

--

NC

[deferred]

PC

[deferred]

Crow

--

[N/A]

SC

[deferred]

[N/A]

Crow

--

[N/A]

SC

[deferred]

[N/A]

Crow

--

[N/A]

SC

[deferred]

[N/A]

Crow

--

PC

PC

PC

PC

Crow

--

SC

PC

PC

PC

Crow

--

SC

PC

SC

SC

Crow

--

SC

SC

SC

SC

Crow

--

SC

SC

SC

SC

Crow

--

NC

PC

PC

SC

Crow

--

NC

PC

SC

NC

Crow

SC

--

--

--

--

Crow

--

PC

NC

SC

SC

Crow

[deferred]

--

--

--

--

Crow

--

SC

SC

SC

PC

19

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 21 of 41 PAGEID #: 8221

Stipulation Paragraph
210. Transition specialists / links
to community / reentry followup
211. Explore options for postsecondary education
212. Job training / career tech /
vocational education
213. Waivers and funding for
career tech programs
214. Satellite career tech / local
business and community
215. Career tech certifications
216. AOT classes at reception /
additional programs at ORV
217. All classroom space wired
for CSLS / staff trained
218. Internet for staff / consider
for youth / library technology
219. Speech therapists / literacy
/ Title I reading teachers
220. School for 12- and 13-yearold students
221. Special Education /
compliance with IDEA
222. Bureau oversight of Special
Education
223. Speedy provision of Special
Ed services following intake
224. Special Ed screening /
qualified staff to screen
225. Individualized Education
Plans
226. Intervention Assistance
Teams / “child find” duty
227. Professional development
in various Special Ed areas
228. Guidance counselors
electronic access to full IEPs

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

Crow

--

PC

PC

NC

PC

Crow

--

PC

NC

NC

NC

Crow

--

PC

PC

NC

PC

Crow

SC

--

--

--

--

Crow

--

PC

NC

NC

NC

Crow

--

SC

SC

SC

SC

Crow

--

[N/A]

SC

[N/A]

[N/A]

Crow

--

PC

PC

NC

SC

Crow

--

SC

[deferred]

[deferred]

[deferred]

Crow

--

PC

PC

SC

SC

Crow

SC

--

--

--

--

Crow

--

PC

PC

PC

PC

Crow

--

PC

PC

PC

PC

Crow

--

SC

SC

SC

SC

Crow

--

PC

SC

SC

SC

Crow

--

PC

PC

PC

PC

Crow

--

PC

SC

SC

SC

Crow

--

PC

PC

PC

PC

Crow

--

SC

SC

SC

SC

20

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 22 of 41 PAGEID #: 8222

Stipulation Paragraph

Expert(s)
assigned

229. Monitoring progress toward
Crow
IEP goals / teacher evaluations
230. Transition plans / comply
Crow
with IDEA “change of placement”
231. School psychologists
Crow
available / FBAs / disability evals
232. Grievance system / youth
Martin
assistance / fairness / trends
233. Review of clinical grievances
Martin
by uninvolved clinician
234. Grievance orientation for
Martin
youth and parents
235. Youth Advocate position
Martin,
reviewed / redefined
Schuster
236. Discipline system / Youth
Martin
Advocate pilot program
237. Consequences and time
Martin (lead),
Nathan, Weisman
added in line with treatment
Martin (lead),
238. Discipline for youth on MH
Glindmeyer,
caseload
Weisman
Roush
239. Documentation / data
(with input from
access P&P / treatment progress
other experts)
240. Documentation of MH
Glindmeyer,
interventions
Weisman
241. Youth records useful to
Weisman (lead),
Peterson
treatment teams
242. Appointment of Monitor
N/A
and subject matter experts
243. Def’s to pay for monitoring
N/A
costs
244. Monitor to consult counsel
N/A
regarding experts
245. Resolving disputes related
N/A
to Monitor’s budget and staff
246. Monitoring team to
N/A
contract directly with DYS
247. Monitor as coach and fact
N/A
finder / monitoring principles

S.H. v. Reed Third Annual Report

General

CJCF

SJCF

IRJCF

CHJCF

--

PC

PC

PC

NC

--

PC

NC

NC

PC

--

SC

PC

PC

PC

--

[deferred]

SC

[deferred]

SC

--

[deferred]

[deferred]

[deferred]

SC

--

[deferred]

[deferred]

[deferred]

SC

--

[deferred]

[deferred]

[deferred]

[deferred]

--

[deferred]

[deferred]

[deferred]

[deferred]

--

[deferred]

[deferred]

[deferred]

[deferred]

--

PC

[deferred]

[deferred]

[deferred]

--

[deferred]

[deferred]

[deferred]

[deferred]

--

PC

PC

PC

PC

--

PC

PC

PC

PC

21

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 23 of 41 PAGEID #: 8223

Stipulation Paragraph
248. Monitoring team doc
review not a waiver of QA
privilege
249. Monitor will not disclose
confidential, privileged info
250. Audit instrument / data
request forms for site visits
251. Annual compliance report /
interim reports
252. Monitor’s longitudinal study
of youth
253. Process for replacing the
Monitor
254. Monitor not subject to
dismissal without good cause
255. Monitor shall also serve as
Monitor over DOJ findings
256. Resolving disputes over
substantial compliance
257. Youth must still exhaust
grievances before legal action
258. No motion or legal action
without dispute resolution
259. No contempt proceedings
without prior motion and order
260. Presumptive 5-year
monitoring of Stipulation
261. Monitoring for 5 years
unless compliance achieved early
262. Def’s may move to
terminate if compliant for 2
years
263. Court to retain jurisdiction /
has power to enforce Stipulation
264. Def’s to pay Plaintiffs’
attorneys fees and costs
265. Parties to work with AG to
expedite youth criminal cases
266. Parties agree that
Stipulation is fair / protects class

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

[deferred]

--

--

--

--

PC

--

--

--

--

N/A
N/A
N/A
N/A
Harrell,
Schuster
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Harrell
N/A

22

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 24 of 41 PAGEID #: 8224

Stipulation Paragraph
267. Stipulation is binding on
Def’s, successors, and Plaintiffs
268. Def’s must meet Stipulation
requirements immediately
269. P’s can move to enforce /
class reps can be replaced
270. Stipulation does not change
PLRA or other laws
271. Laws / union agreements
not to undermine Stipulation
272. Stipulation is the entire
agreement
273. Stipulation construed as a
whole
274. Stipulation paragraphs are
severable

S.H. v. Reed Third Annual Report

Expert(s)
assigned

General

CJCF

SJCF

IRJCF

CHJCF

N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A

23

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 25 of 41 PAGEID #: 8225

Part II. Recommended Priorities for 2012


Finish implementing the Regionalization and Reentry Plans (Paragraphs 13, 15 & 26).
DYS has made significant progress in regionalization of service delivery, reduction in
population, and reentry preparation and support for youth. DYS should complete
implementation of the Regionalization Plan by expanding the use of the Community
Based Treatment Centers (CBTCs) and broadening the reach of the Behavioral Health
Juvenile Justice (BH/JJ) and Targeted RECLAIM programs to an increasing number of
counties across the state. DYS should also fully implement the Reentry Continuum
Action Plan, including implementation of the Family Finder Tool, adoption of the new
Discharge Agreement, and increased use of video connector technology, the Juvenile
Relational Inquiry Tool, and the Pre-Qualified Vendor’s Initiative.7



Improve the functioning of the Release Authority (Paragraph 32). The parties continue
to dispute various matters related to the Release Authority. In his 2010 and 2011
reports, monitoring team member Vince Nathan makes various recommendations that
should be prioritized in the coming year. They include: building the capacity of the
Juvenile Justice Case Management System (JJCMS) to generate useful reports for the
Release Authority;8 ensuring that youth are fully informed of their right to meaningful
appeals of Release Authority decisions;9 distinguishing the public safety release barrier
from the treatment barrier and serious incident barrier, and the permissible uses of
each;10 reinforcing with staff the essential role of the Interdisciplinary Treatment Teams
in recommending a youth’s release or retention;11 and linking Release Authority reviews

7

Shay Bilchik, Report on Stipulation Paragraphs 13-15, and 26 (Nov. 30, 2011), p. 8 (forthcoming).
Vince Nathan, Report on Release Authority (July 2010), pp. 46-47, 50-52.
9
Id., at pp. 17-19.
10
Id., at pp. 32-34; Vince Nathan & Jim Holzhauer, Memo re. Release Authority Dispute Resolution (October 2011),
pp. 2-3.
11
Vince Nathan, Supplemental Report on Release Authority (Aug. 2011), p. 8.
8

S.H. v. Reed Third Annual Report

24

Case: 2:04-cv-01206-ALM-TPK Doc #: 299 Filed: 01/05/12 Page: 26 of 41 PAGEID #: 8226

to Individualized Treatment Plans as a measure of a youth’s progress and achievements
while in custody.12


Plan for the Training Academy transition (Paragraphs 37-38, 60 & 69). State budget
constraints have necessitated closing the DYS Training Academy, which houses the
Department’s Bureau of Professional and Organizational Excellence (POE). POE and
central office should develop a transition plan for relocating programs and services to
the new shared training space to minimize the negative impact on training and quality
assurance.13



Reinforce consistency and accountability through unit management (Paragraph 48).
Recent large-scale violent disruptions at Scioto and Circleville came about, in part,
because of breakdowns in the unit management model. The Monitor’s Special Inquiry
Report outlines strategies that have proven effective at Circleville in regaining control of
the youth population. Scioto leadership should develop an action plan to support and
empower staff and to hold management accountable for regaining control of the youth
population; and DYS central office should evaluate Scioto leadership based on the
success of that plan. Circleville leadership should develop a local quality improvement
tool to ensure that the management model it has established is memorialized in local
policy.14



Expand family engagement efforts (Paragraphs 48 & 99). With assistance from the
Vera Institute for Justice, and generous support from the Public Welfare Foundation,
DYS has expanded efforts to engage the families of youth committed to their care
through reinforcing positive family connections, reentry planning, and day-to-day case
management.15 The Department’s work with the Vera Institute is extremely impressive

12

Vince Nathan Report (July 2010), at p. 8; see also Orlando Martinez & David Roush, Scioto JCF site visit report
(April 2011), pp. 9-10.
13
David Roush, Report on DYS Bureau of Professional and Organizational Excellence (Sept. 2011), p. 7.
14
Monitor’s Special Inquiry Report re. DYS Tactical Operation Safety First (Nov. 2011), pp. 10, 12-13.
15
See Monitor’s Circleville site visit report (Nov. 2011), pp. 31-32.

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and may become a national model for family engagement. We applaud this
partnership, and look forward to full implementation at all DYS facilities in the coming
year.


Expand youth leadership opportunities (Paragraph 55). Stipulation paragraph 55 states
in part that “Behavior will be managed through the recognition that adolescents learn
from one another as well as adults in authority, via observation, imitation and
modeling.” One way to achieve this would be to expand youth empowerment programs
like the Peer-Mentoring Program that was in place at Indian River during our February
site visit, including programs for youth in medium and close custody units who
demonstrate appropriate behaviors and good social skills.16 DYS is developing a policy
to improve the consistency of Student Councils at each facility, which we strongly
support and encourage.17



Expand recreational and job-related activities for youth (Paragraph 56). DYS should
expand recreational and job-related activities for all youth on the weekends and for
graduates during the week. Youth consistently report that they have too much time
with nothing to do, and that gang-related activities fill the void.18 DYS reports efforts to
supplement activities, for example, through the development of an Activities Committee
and the creation of administrator positions responsible for developing and
implementing additional structured activities.19 We look forward to seeing
improvements in this area at all DYS facilities in the coming months.

16

Orlando Martinez & David Roush, Indian River site visit report (April 2011), pp. 8-9.
For a report on the effectiveness of Student Council programs in stabilizing juvenile facilities, see Texas Youth
Commission, Lessons in Leadership: The Case for Student Councils at All TYC Facilities (Jan. 2010), available at
http://www.criminaljusticecoalition.org/files/userfiles/Lessons_in_Leadership.pdf.
18
See Orlando Martinez & David Roush, Indian River site visit report (April 2011), pp. 7-9, 12; Monitor’s Circleville
site visit report (Nov. 2011), pp. 15-16.
19
See, e.g., DYS response to Martinez/Roush Indian River site visit report, p. 2; DYS response to Martin Indian River
site visit report, p. 3.
17

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

Improve services for youth with cognitive and developmental disabilities (Paragraph
58). Some youth with cognitive and developmental disabilities who do not meet the
admission criteria for the Life Skills Unit due to aggressive behavior have not received
treatment responsive to their limitations and rehabilitative needs.20 DYS reports that
the New Freedom curriculum has specific programming designed for youth with
cognitive and developmental disabilities, and has stated that with the full
implementation of full-service treatment units, the needs of these youth will be met.21
In the coming year, the monitoring team’s new mental health experts will evaluate the
sufficiency of full-service treatment units to meet the special needs of this population.
We encourage Director Reed to present this concern to the Ohio Interagency Task Force
on Mental Health and Juvenile Justice, established by HB 86, and to explore alternative
placements for, and the roles of other departments in providing services to, youth with
these disabilities.22 See also the discussion below of youth with serious mental illnesses
under Stipulation paragraphs 76, 88, and 98.



Provide quality assurance for behavioral healthcare services (Paragraphs 60 & 102).
The quality assurance process must assess data over time on outcomes, the
effectiveness of policies, and the competence of staff; and design improvements based
on that data to provide more effective and efficient services. At each of the four
remaining DYS facilities, mental health experts found that programs were not monitored
to assess outcomes and need for improvement; and assessments and care provided to
youth were not systematically reviewed to ensure clinical needs were being

20

Monitor’s Circleville site visit report (Nov. 2011), pp. 17-18; Cheryl Wills & Barb Peterson, Cuyahoga Hills site visit
report (April 2011), pp. 30, 34-35, 37-38, 47; Cheryl Wills & Barb Peterson, Scioto site visit report (March 2011), pp.
10-11, 23, 32.
21
DYS response to Wills/Peterson Scioto site visit report, pp. 8-9; Monitor’s Circleville site visit report (Nov. 2011),
p. 18.
22
See Orlando Martinez & David Roush, Scioto site visit report (April 2011), at p. 15 (“DYS should consider working
with their legislative contacts to explore statutory changes that would direct delinquent youth with intellectual
disabilities to specialized community-based placements.”) Monitoring team member Shay Bilchik will also work
with DYS and community providers to help find appropriate placements for youth with serious mental illnesses.

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addressed.23 DYS reports that this is a department-wide work in progress, and has
begun implementing the behavioral health services quality assurance / quality
improvement process as outlined in its policies, including training, coaching, and
mentoring.24 The monitoring team’s new mental health experts will assess these efforts
in their upcoming site visits.


Address safety and staffing problems with unions, the Department of Administrative
Services, and State legislators (Paragraphs 65-66 & 271). In the Special Inquiry Report,
we discussed provisions in collective bargaining agreements and regulations for the
State’s Department of Administrative Services (DAS) that contribute to severe staffing
shortages in DYS facilities. In violation of Stipulation paragraph 271, the State has
renewed collective bargaining agreements that contain provisions detrimental to youth
safety. As we recommended in the Special Inquiry report, we believe Director Reed and
the S.H. Monitor, as a team, should meet with DAS, collective bargaining units, and state
legislators to negotiate solutions to DYS’s chronic staffing problems. The Monitor and
counsel for both parties will also explore judicial solutions to these problems under the
Stipulation.25



Fully implement gang-intervention efforts (Paragraph 72). Youth gangs have been the
source of violence and disruption at several facilities and continue to affect safety for
youth and staff.26 Indeed, Ohio is perhaps the only state in the country in which youth
gangs originating in juvenile facilities have expanded their presence to adult facilities.
DYS has begun rolling out the Phoenix / New Freedom gang intervention curriculum,

23

Monitor’s Circleville site visit report (Nov. 2011), pp. 18-19; Cheryl Wills & Barb Peterson, Cuyahoga Hills site visit
report (April 2011), pp. 9, 13-14, 31, 44; Cheryl Wills & Barb Peterson, Scioto site visit report (March 2011), pp. 12,
26-27, 32-33, 42-43; Cheryl Wills & Barb Peterson, Indian River site visit report (Feb. 2011), pp. 6, 15, 24, 28, 34-35.
24
DYS response to Wills/Peterson Cuyahoga Hills report, pp. 6, 11-12, 13, 22, 24; DYS response to Wills/Peterson
Scioto report, pp. 4-5, 9, 17-18.
25
Monitor’s Special Inquiry Report re. DYS Tactical “Operation Safety First” (Nov. 2011), pp. 9-10; see also Orlando
Martinez & David Roush, Scioto site visit report (April 2011), pp. 4, 6-7.
26
See Monitor’s Circleville site visit report (Nov. 2011), pp. 22-23; Monitor’s Special Inquiry Report (Nov. 2011), p.
8.

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and we look forward to its full implementation in 2012.27 Additionally, DYS may be wellpositioned to negotiate truces between rival youth gangs at one or more facilities. We
will discuss this further in our upcoming Indian River site visit report.


Find alternative placements and funding for youth with serious mental illnesses
(Paragraphs 76, 88 & 98). Monitoring team member Steve Martin found extraordinary
levels of seclusion and punitive sanctions for a small number of youth at Indian River
with mental health designations.28 In the Special Inquiry Report, the Monitor found that
the Sycamore Unit, which housed twelve youth with mental illnesses and cognitive
disabilities, was operating in practice as an intensive seclusion unit rather than an
intensive treatment and programming unit.29 Stipulation 88 requires that DYS strive to
prevent deterioration or exacerbation of mental health symptoms and needless
isolation for behaviors caused by mental health issues. The monitoring team’s new
mental health experts report that DYS facilities are responsible for some of the most
acutely mentally ill youth in the state, who in other jurisdictions would be transferred to
more appropriate psychiatric treatment facilities. The repeated placement of youth
with mental illnesses in seclusion also impacts the decisions of the Release Authority to
retain youth beyond their minimum sentence expiration dates. We recommend
emergency measures in the short term to transfer these youth to psychiatric treatment
facilities and to obtain funds for their care.30 Longer-term solutions are being explored
by the Director and the Interagency Task Force on Mental Health and Juvenile Justice.
The monitoring team and counsel for both parties will also explore judicial solutions to
this problem under the Stipulation. Addressing these concerns will be a priority for the
monitoring team in 2012.

27

The S.H. Monitor in a previous role as Ombudsman for the Texas Youth Commission issued a report on best
practices in gang prevention and intervention, available at
http://www.tyc.state.tx.us/ombudsman/rpt_GangPrevention.pdf. We recommend this report as a resource
during implementation of gang prevention and intervention efforts at DYS.
28
Steve Martin, Indian River site visit report (Sept. 2011), pp. 2-4, 8.
29
Monitor’s Special Inquiry Report re. DYS Tactical Operation Safety First (Nov. 2011), pp. 14-16.
30
Interview with Andrea Weisman (Nov. 2011).

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

Fill clinical staff vacancies (Paragraphs 91-92 & 96). Monitoring team members found
shortages in psychiatric care hours, and significant vacancies for psychologists,
psychiatric nurses, and social workers in DYS facilities. Team members also found a lack
of clerical support for social workers, causing unit social workers to spend much of their
time completing paperwork and other bureaucratic tasks rather than attending to youth
and coordinating services with staff.31 DYS reports recruiting for and filling some clinical
positions, and has argued that the existing clerical support for behavioral health services
is adequate.32 The monitoring team’s new mental health experts will continue to assess
clinical staffing issues in their upcoming site visits.



Implement the OYAS/ITP and Integrated Electronic Record (Paragraphs 106 & 241).
Monitoring team members have reported that youth have multiple un-integrated care
plans with essential information located in various separate records. Thus, behavioral
healthcare staff must access multiple databases to obtain a complete picture of a
youth’s status, making rehabilitation for youth residents difficult and inefficient.33 DYS
reports that the Ohio Youth Assessment Summary / Integrated Treatment Plan
(OYAS/ITP) and Integrated Electronic Record will resolve these concerns. The OYAS/ITP
is being piloted at Indian River and developed further by the University of Cincinnati
with feedback from DYS.34 We will assess the pilot project in our upcoming Indian River
site visit report, and look forward to its broader implementation in 2012.



Provide peer review and quality assurance for medical care (Paragraphs 115, 125, 138,
141 & 152). DYS facilities have begun to quantitatively monitor implementation of

31

See, e.g., Cheryl Wills & Barb Peterson, Cuyahoga Hills site visit report (April 2011), pp. 4-7, 25, 39-40; Monitor’s
Circleville site visit report (Nov. 2011), pp. 28-30.
32
See, e.g., DYS response to Wills/Peterson Cuyahoga Hills report, pp. 15, 18-20; Monitor’s Circleville site visit
report (Nov. 2011), pp. 28-30.
33
Cheryl Wills & Barb Peterson, Cuyahoga Hills site visit report (April 2011), pp. 9-10, 14, 28, 41, 46-47; Cheryl Wills
& Barb Peterson, Scioto site visit report (March 2011), pp. 12-13, 18, 20, 24, 41, 45; Cheryl Wills & Barb Peterson,
Indian River site visit report (Feb. 2011), pp. 7, 17-18, 36-37; see also Orlando Martinez & David Roush, Cuyahoga
Hills site visit report (June 2011), pp. 8-9; Orlando Martinez & David Roush, Scioto site visit report (April 2011), pp.
9, 25.
34
DYS response to Wills/Peterson Cuyahoga Hills report, pp. 9, 21, 25; DYS response to Wills/Peterson Scioto
report, pp. 3, 8, 15, 19.

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medical care policies. Monitoring team members found, however, that qualitative
monitoring of professional performance and the use of data to improve policies and
performance was not occurring. Quality assurance and quality improvement (QA/QI) for
medical care should include on-site review of processes (intake, sick call, chronic care,
medication management, injury assessment, etc.); review of the professional
performance of nurses in each area; review of physician performance by the DYS
Medical Director; and data studies performed by central office to identify opportunities
for improvement.35 Monitoring team members Ron Shansky and Barb Peterson have
offered their assistance in developing necessary QA/QI tools.


Ensure that medical assessments of youth injuries are properly conducted in clinical
settings (Paragraph 124). In the Special Inquiry Report, we found two youth subjected
to OC spray who were not assessed by medical staff, and inadequate assessments and
decontamination of other youth subjected to OC spray.36 Monitoring team members in
various site visit reports also found several examples of youth who were not seen faceto-face in a clinical setting following uses of force, but who were instead assessed
through the window of a seclusion room door.37 Improvements to the youth injury
assessment process should be a priority for the Department in 2012, and should be
monitored for quality and consistency.



Hire additional permanent substitutes for BUSD schools (Paragraphs 194-195). Each
DYS facility has experienced chronic vacancies and extended leave among school staff,
as well as long periods of time between hiring new staff and those employees beginning
work. As a result, students at various times have gone for prolonged periods without

35

Ron Shansky & Barb Peterson, Cuyahoga Hills site visit report (March 2011); pp. 1-2, 4-5, 7-8; Ron Shansky &
Barb Peterson, Scioto site visit report (Dec. 2010), pp. 2, 4-7; Ron Shansky & Barb Peterson, Indian River site visit
report (March 2011), pp. 1, 4, 6, 8.
36
Monitor’s Special Inquiry Report re. DYS Tactical Operation Safety First (Nov. 2011), pp. 6-7.
37
Ron Shansky & Barb Peterson, Cuyahoga Hills site visit report (March 2011), p. 4; Ron Shansky & Barb Peterson,
Scioto site visit report (Dec. 2010), pp. 3-4, 7; Ron Shansky & Barb Peterson, Indian River site visit report (March
2011), p. 3.

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math and English, speech therapy, career tech, and science classes.38 The BUSD staffing
plan provides only one permanent substitute per facility, and relies too heavily on
itinerant substitutes who are difficult to recruit and limited by the Principal’s budget.
Because this plan has not remedied the deficiencies caused by foreseeable vacancies
and extended leave, and because filling vacancies generally takes two or more school
quarters, we believe DYS should budget for additional permanent substitutes. 39 This is
reasonably required by Stipulation paragraph 195.40


Fully implement career tech and vocational programs (Paragraphs 211-212 & 214). In
various site visits, monitoring team member Ava Crow found schools providing
insufficient vocational programming.41 This was the subject of a special report prepared
at the behest of Judge Marbley. The school district has since obtained additional
funding through grants and developed a suitable plan for career tech that provides
college credit, certifications, and jobs in the facilities. We look forward to assessing
these programs in the coming year.



Reduce the scope of primary rule violations that require intervention hearings, and
expand the use of alternative disciplinary consequences (Paragraph 237). Disciplinary
Hearing Officers and Youth Advocates have been bombarded with Intervention
Hearings. One Youth Advocate, for example, reported participating in an average of 150
hearings per month; and not having the time to meet with youth before the hearing,
interview witnesses, or review incident videos.42 Unit Managers who have acted as
Hearing Officers have been prevented from properly supervising staff and programming
on the units.43 Sanctions imposed at Intervention Hearings also impact the Release

38

Monitor’s Circleville site visit report (Nov. 2011), pp. 57-58; Ava Crow & Anne Flynn, Cuyahoga Hills site visit
report (June 2011), pp. 4-8, 17-18, 21-24; Ava Crow & Anne Flynn, Scioto site visit report (May 2011), pp. 6-7, 12,
22-23, 25; Ava Crow & Anne Flynn, Indian River site visit report (May 2011), pp. 4-6, 18-19.
39
See Monitor’s Circleville site visit report (Nov. 2011), p. 58.
40
Stipulation paragraph 195 states: “DYS shall increase the budget for substitute teachers and provide for more
substitutes at the larger schools. DYS shall also hire and train permanent substitutes….”
41
See Monitor’s Circleville site visit report (Nov. 2011), at pp. 64-65.
42
Interview with Denise Conrad, Youth Advocate at Circleville JCF (Sept. 2011).
43
Id.

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Authority’s decisions to retain youth beyond their minimum sentence expiration
dates.44 Staff from the Department’s Bureau of Professional and Organizational
Excellence have stepped in temporarily to serve as hearing officers and eliminate the
backlog of hearings, and DYS is attempting to revise rules and sanctions to reduce the
scope of behaviors considered primary rule violations. The Department intends to
create a review process that determines if behavior warrants a hearing as opposed to an
immediate consequence, and to improve staff training on de-escalating problem
behaviors.45 We look forward to seeing these remedial measures rolled out in the
coming year.

44
45

Email conversation with Vince Nathan (Dec. 12, 2011).
Email conversation with Steve Martin and Christy Hauck (Sept. 13-14, 2011).

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Part III. Recommended Site-Specific Priorities for 2012
Scioto Juvenile Correctional Facility


Properly house female residents according to risk levels (Paragraph 47). Monitoring
team member Steve Martin advised against the DYS plan to co-mingle minimum,
medium, and close custody female residents on the same housing unit. He
recommended revisiting that plan or, at a minimum, developing management protocols
to minimize the risks of harm associated with co-mingling these populations.46 DYS
reports developing a management protocol and thoroughly reviewing it with staff
working on that female housing unit.47 We will re-assess this housing concern at our
upcoming Scioto site visit in January. DYS contracted with Catholic Charities for 8 beds
at Parmadale Insitute for female residents with significant mental health needs. This
arrangement is a pilot and may be expanded at some point in the future.



Monitor initial medical assessments for quality and timeliness (Paragraphs 117 & 119).
At their last visit to Scioto, monitoring team members Ron Shansky and Barb Peterson
found that intake health assessments were not reviewed for quality and timeliness.48
DYS reports piloting a form at Scioto that provides a comprehensive review of initial
medical assessments.49 We look forward to seeing this and other improvements at our
next Scioto site visit in January.



Increase school attendance and provide a full school day (Paragraph 189). At our last
group site visit to Scioto, monitoring team member Ava Crow found unacceptable
school attendance rates; significant numbers of youth confined to the units and
receiving less than an hour of school each day; education being treated as a reward for

46

Steve Martin, Scioto site visit report (June 2011), pp. 7-10.
DYS response to Martin Scioto report, pp. 4-5.
48
Ron Shansky & Barb Peterson, Scioto site visit report (Dec. 2010), pp. 2-3.
49
DYS response to Shansky/Peterson Scioto report, p. 1.
47

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good behavior; and misuse of the school district’s discretion to excuse absences. 50
Monitoring team members Cheryl Wills and Barb Peterson found that several youth
with poor school attendance had mental health concerns that warranted further
intervention; and that in many cases, mental health team members were not aware of
the problems these youth were having in school.51 DYS/BUSD report efforts to increase
school attendance, reduce and improve unit instruction, eliminate the practice of using
SMPs to limit educational services, and re-train on the use of attendance codes.52 We
will re-assess for compliance with paragraph 189 at our upcoming Scioto site visit in
January.


Improve safety in the school building (Paragraph 204). Because youth from various
housing units mix and interact at school, and large numbers of youth move through the
hallways between classes, the school building has been one of the most disruptive and
violent locations at Scioto. In our Special Inquiry Report, we recommended that facility
and school leadership develop an action plan to ensure safety in the school building.53
We are confident in the abilities of the new principal at Scioto, and we expect to see an
effective plan in action at our upcoming site visit in January.



Improve practices in the school’s ABC room (Paragraph 207). At our last group site visit
to Scioto, monitoring team member Ava Crow found ineffective behavior management
by teachers and Youth Specialists in the school’s ABC room; no permanent Youth
Specialist assigned to the room; and lag times at shift changes in which no Youth
Specialist was present.54 DYS/BUSD committed to developing a plan to improve the
effectiveness of the ABC room,55 and contracted with an expert consultant on classroom

50

Ava Crow & Anne Flynn, Scioto site visit report (May 2011), pp. 2-5, 22.
Cheryl Wills & Barb Peterson, Scioto site visit report (March 2011), p. 15.
52
DYS response to Crow/Flynn Scioto report, pp. 1-2.
53
Monitor’s Special Inquiry Report re. DYS Tactical Operation Safety First (Nov. 2011), pp. 11-13.
54
Ava Crow & Anne Flynn, Scioto site visit report (May 2011), pp. 19-21, 25.
55
DYS response to Crow/Flynn Scioto report, p. 8.
51

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behavior management, and we look forward to seeing improvements at our upcoming
Scioto site visit.

Circleville Juvenile Correctional Facility


Provide youth with face-to-face appointments following episodes of acute illness,
hospitalization, or specialty appointments (Paragraph 140). Stipulation paragraph 140
requires a face-to-face appointment with the physician or nurse to discuss the results of
any youth specialty appointment or hospitalization and the plan of care. At their last
visit to Circleville, monitoring team members Ron Shansky and Barb Peterson found
youth whose care was compromised by lack of communication and failure of clinicians
to follow up with the patient.56 We hope to see this resolved and internally monitored
at our upcoming Circleville site visit in February.



Expedite the process for providing unit instruction to youth outside of their rooms
(Paragraph 189). At our last group site visit to Circleville, monitoring team member Ava
Crow found that education for students secluded on their units was not engaging or
effective. Students were awakened from napping in dark cells and offered school work
through the door; the vast majority of students declined work; and no youth were
permitted out of their rooms to receive unit instruction. We recommended expediting
the process for student safety assessments (to determine which students could safely
receive instruction outside of their rooms), and adapting unit space to stimulate active
engagement with teachers. 57 We look forward to improvements at our upcoming site
visit in February.

56
57

Monitor’s Circleville site visit report (Nov. 2011), p. 44.
Id., at pp. 55-57.

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Cuyahoga Hills Juvenile Correctional Facility


Provide additional training and supervision to use of force investigators (Paragraphs
79-84). At his last site visit to Cuyahoga Hills, monitoring team member Steve Martin
found problematic use of force investigations, and recommended additional training
and oversight for facility management staff assigned as investigators.58 DYS has since
reported training investigators and instituting quality reviews of completed
investigations by the Direct Deputy and Superintendent.59 We look forward to assessing
these efforts in the upcoming year.



Evaluate the leadership and supervision of school administrators (Paragraphs 205 &
222). Following our last group site visit to Cuyahoga Hills, monitoring team member Ava
Crow reported that the assistant principle did not adequately supervise and evaluate
teachers, and that the school district has failed to address these deficits through
evaluation or discipline of that assistant principal.60 This was a repeat finding, and
continues to be a concern of the monitoring team for the coming year.

58

Steve Martin, Cuyahoga Hills site visit report (Dec. 2010), pp. 5-6, 9.
DYS response to Martin Cuyahoga Hills report, p. 2.
60
Ava Crow & Anne Flynn, Cuyahoga Hills site visit report, pp. 16-17, 22.
59

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Part IV. Additional Monitoring Priorities for 2012


Monitor the new de-centralized admission and intake process (Paragraphs 43-44).
Stipulation paragraphs 43 and 44 require a consistent, orderly intake system with
trained personnel administering screenings and assessments. DYS has de-centralized
the admission process by decreasing the amount of time at the Scioto reception center
and assigning certain responsibilities to parent institutions. Monitoring the quality and
consistency of this new admissions process at the reception center and parent
institutions will be a priority in 2012.



Investigate the effects of classification “overrides” (Paragraph 47). Plaintiffs’ counsel
has raised concerns with the DYS classification system. Specifically, counsel is
concerned about the number of youth designated as low and moderate risk by the OYAS
instrument who are classified as close custody (high risk) due to mandatory and
discretionary “overrides” in the DYS classification process. They have argued that
overrides do not sufficiently distinguish between youth and disproportionately affect
youth of color. Monitoring team member Steve Martin is currently gathering
information related to classification overrides, and will report findings and
recommendations in the coming year.



Evaluate sexual behavior treatment under the new full-service treatment unit model
(Paragraph 62). DYS screens and assesses youth with sex offense adjudications, and
places them into one of two programming tracks: low needs or standard needs. Youth
assigned to the low needs program receive 24 group sessions over a period of six to nine
weeks, and youth assigned to the standard needs program receive 60 sessions over a
period of nine to twelve months. Youth are housed in general population units and
receive sex offender programming from licensed clinicians on an outpatient basis.61
Concerns raised in the last year regarding the integration of sex offenders into general

61

DYS response to Wills/Peterson Cuyahoga Hills report, pp. 3-4, 12, 23.

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population housing units have been sufficiently addressed by DYS with research from
the University of Cincinnati.62 Two new mental health experts have joined the S.H.
monitoring team, and they will assess implementation of DYS sex offender programming
in the coming year.


Investigate the extent of health, mental health, and education services provided
through the seclusion room door (Paragraphs 91, 124 & 185). Various members of the
monitoring team have expressed concerns regarding youth being provided with health
care, mental health care, and education through a seclusion room door instead of in
more appropriate clinical or educational settings. Assessing the extent of these
practices, and identifying appropriate alternatives, will be a priority for the monitoring
team in 2012.



Evaluate the effectiveness of the grievance system (Paragraph 232). While grievance
policies and procedures are sufficient, youth at every facility continue to express a lack
of confidence in the effectiveness of the grievance process, particularly with regard to
addressing complaints of staff misconduct. We will assess the grievance process, the
timeliness of responses, and the independence and authority of grievance coordinators,
and make recommendations as appropriate. One area of concern that we have already
begun to address is ensuring that youth are appropriately informed of the results of
investigations once they have been completed. This will be discussed further in the
upcoming Indian River site visit report.



Evaluate the Youth Advocate position (Paragraphs 101 & 235-236). Stipulation
paragraph 235 requires that the youth advocate position be reviewed and redefined. In
the upcoming year, the monitoring team will thoroughly review the degree to which
Youth Advocates have enhanced the disciplinary hearing process, and affected youths’
perceptions of fairness – particularly for youth with mental health disorders – and we

62

See Brian Lovins, “The Use of Specialized Units,” White Paper on self-contained specialized treatment units
(Sept. 2011).

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will recommend, as appropriate, alterations in the Youth Advocate role that would
better serve these ends.


Investigate the application of seclusion time and Intervention Hearing time,
particularly for youth with mental health disorders (Paragraphs 237 & 238).
Monitoring team member Steve Martin found over 4000 days of intervention hearing
time imposed in disciplinary hearings at Indian River in a single month, as well as very
substantial blocks of seclusion time.63 At Scioto, Martin found substantial numbers of
seclusion hours, and identified a small number of youth who accounted for a majority of
those hours.64 Various monitoring team members have expressed the concern that
youth with serious mental health disorders receive a disproportionate number of
seclusion hours and intervention hearing days, exacerbating their mental health issues
and lengthening their stays in DYS custody, at great cost to the State.65 In the upcoming
year, monitoring team members Steve Martin, Vince Nathan, Daphne Glindmeyer, and
Andrea Weisman will collaboratively monitor compliance with Stipulation paragraphs
237 and 238, and attempt to identify clear recommendations for reducing the use of
these severe sanctions, particularly for youth with mental health disorders.

63

Monitoring team conference call (Aug. 26, 2011).
Steve Martin, Scioto site visit report (June 2011), pp. 6-7, 9.
65
Monitoring team conference call (Aug. 26, 2011); Interview with Andrea Weisman (Nov. 2011).
64

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