State Politics

Investigation finds ‘organizational trauma’ at state-run treatment center in Nampa

The Southwest Idaho Treatment Center (SWITC) in Nampa provides residential care to people with developmental disabilities and mental illnesses. It is run by the Idaho Department of Health and Welfare.
The Southwest Idaho Treatment Center (SWITC) in Nampa provides residential care to people with developmental disabilities and mental illnesses. It is run by the Idaho Department of Health and Welfare. Idaho Statesman file

A report from the Idaho Legislature’s watchdog office calls for the Department of Health and Welfare to make changes at a state-run center where patients were abused and neglected.

The Southwest Idaho Treatment Center, or SWITC, has been battered by downsizing, chronic understaffing and employee injuries, among other issues. It now has symptoms of “organizational trauma, triggered by a haphazard downsizing process and a series of recent traumatic events,” according to the report.

The report, issued Thursday by the Office of Performance Evaluations, was ordered last year by the Joint Legislative Oversight Committee.

It followed a long string of problems at SWITC in the past two years. There was a patient’s death while staff left him unobserved for hours. An internal investigation found several employees participating in or allowing patient abuse and neglect. The facility failed to pass inspections, putting the state at risk of losing its Medicare and Medicaid status worth $8 million a year in federal funds. And the state faced lawsuits and tort claims by former employees who claimed whistleblower retaliation, and the families of patients who died or were injured.

Internal emails and documents obtained by the Statesman showed administrators were aware of pervasive problems with staff morale, actions and attitudes toward residents.

The state’s disability rights group did an investigation last year, finding 49 instances of abuse and neglect.

The Office of Performance Evaluations found the root cause of SWITC’s deterioration began years ago, with downsizing as the state sought to move patients into community-based treatment.

“SWITC has radically downsized over the past several decades. Downsizing is necessarily difficult, but struggles were exacerbated by neglect from the department and the loss of institutional knowledge,” the OPE’s report said.

That pushed the organization into a downward spiral. “As you lose staff, it gets harder to keep existing staff,” an OPE analyst told the committee.

In addition, SWITC was losing huge chunks of staff time to injuries.

“For the first half of 2018, one in 10 staff days was spent out on injury; on one shift that number was one in five,” the OPE said.

Office of Performance Evaluations Director Rakesh Mohan wrote that SWITC’s operating model is “no longer tenable.” He recommended that the Idaho Department of Health and Welfare “create a long-term vision for how Idaho is going to serve these individuals in crisis,” and create a formal system to plan to strengthen SWITC leadership and management practices.

The Idaho Department of Health and Welfare has begun to make changes aimed at stabilizing the center, officials told the oversight committee. Among the changes are higher pay, formal employee training and a career ladder to give employees advancement opportunities.

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