In many posts I've shared that I held a state job for a very short while. That New York state job was with the Commission of Quality of Care for the Mentally Disabled (a.k.a. CQC). It's an over-sight agency whose mission was to ensure "quality of care" for the mentally disabled and the mental hygiene population of New York State. Basically, it investigates abuse and neglect cases with facilities and agencies that are operating under the jurisdiction of the Office of Mental Hygiene (for the psychiatric population) and/or the Office of the Mentally Regarded/Developmentally Disabled (for the mentally retarded population).
It's a government "watchdog" agency. The people who work for this agency are passionate towards their mission of being "the voices who have no voice".
It's effective. Since its birth 25 years ago, the quality of care provided these two populations have. . . overall. . . increased, especially for the "mentally retarded" population. Sadly, there's still a lot of room for improvement for the "mental hygiene" population.
It's a program from which other state "watch dog" agencies modeled their own programs.
I worked at the CQC for about 6 months in 1999. (It was the only time during my 11 years as a nurse that I was not nursing!) They tried to teach me to become an investigator. My job was to investigate child and adult cases of abuse and/or neglect, and help investigate all deaths of anyone within these populations. Needless to say, I do not pocess the "sleuth" type (detective type) of mentality. I realized this. . . plus the fact that I HATE paper work, which this job generated plenty of. . . so I handed my resignation and became a nurse. Again.
However, my short 6 months stay at the CQC was an eye-opening experience. I witnessed an effective government agency which did its darnest to protect the MRDD and MH crowd. Like I said, the people who worked there were on a mission.
You may not know this, but the governor of NY state is Republican. This is neither good or bad. It just is. However, because of this, the original Director of the CQC, who was director for nearly 20 years, was. . . well. . . let's just say there was a heavy hand for him to hand in his resignation. Know that this gentleman was with the CQC since its conception and played a major role in steering the course of this "watch dog" agency. He's will recognized within this "watch dog" type community as being 1) brilliant; 2) an ardent advocate for these populations of people; and 3) a pot-stirrer who played loyalty and politics to NO ONE and NO PARTY . . . except for the MRDD and MH populations. (More than once raised the "ire" of the former Govenor Coumo, a Democrat.)
Because the governor of NY state is Republican, the "yucky-yucks" of the Republican party played a major role in hiring the new director for the CQC. He started around the same time I started. I never met the original director. But, obviously, I met the new director. He was a very friendly man. A catholic priest with a strong professional psychiatric back-ground. But he was a "party man". And the flavor of the CQC did change somewhat with his new brand of leadership.
Now, I do understand that the "flavor" of any agency or facility will change with different leadership. But I'm afraid that the change for the CQC was a huge step away from the the "mission mindedness" of this agency; a step away for the reputation of the ardent "watch dog" reputation that it pocessed.
I dare say that, under its new leadership, the CQC not so slowly began to step in line with the party wishes, and that was to NOT cause a "stir", especially to the business community.
Before I left the CQC, it was investigating a rather huge case (and I won't say which city) which dealt with an apartment complex and its owner. This apartment complex set aside a significant percentage of rooms for the "mental hygiene" crowd as a place of living. Because of this, it kind-of fell within the jurisdiction of the Office of Mental Hygiene. . . and thus within the "watch dog" eyes of the CQC. The operative words are "kind of". This was a grey area that I fully didn't understand. But basically (from what I DID understand), the owner of this apartment complex received some kind of state funding by setting aside a certain percentage of apartments for the MH population but wasn't held to the strict standards that psychiatric facilites and agencies are held to within New York State.
The CQC found deplorable living conditions for the MH residents of this apartment complex. Rodents, cock-roaches, rooms and appliances of ill-repair, residents sleeping in their own filth, and basically really bad living conditions were founded by the assigned investigators of the CQC. There were pictures and pictures of the horrible living conditions! Basically, there was enough evidence to "hang this character".
This "character" (the owner of the deplorable apartment complex) was a heavy financial contributor to the state Republican party which helped re-elect our current governor. Because of this (and everyone knew politics was involved) the founded evidence was. . .
No further action was taken at that time. A decision partly made by the current director of the CQC.
Realize, though, that I left the CQC soon after the decision was made to "temporarily shelve" the founded evidence. I don't know what action was taken since then. This all took place a little over 4 years ago.
But there was a muzzle. Needless to say, this did not bode well with the long-time CQC investigators.
Clearly, the CQC, at least at one point, was a successful government agency whose purpose was to act as a "watch dog" for a certain population of New York state citizens. The CQC has effected positive changes for facilities and agencies that cater to the MRDD and MH crowd. Basic living conditions were improved; residents were no longer sleeping in their own filth (which may not have been the case 25 years ago!). Appropriate care and treatment were assured for physical ailments. The basic standard of living was improved through vocational and recreational programs. Quality of Care programs and policies were developed and implimented for many-a-facility within New York state that catered to these populations of people. The list of accomplishments is lengthy. . . and the basic reputation of the CQC is positive and well respected.
But since the original director (who did not play to any politics) left and current director (who does play to politics) took over the CQC, a muzzeling of the agency has taken place.
Personally, I find this disgusting.
Below is another example of an attempt to "Muzzle the Watchdog". This article is from the Opinion section of the Times Union paper. Please read it.
Government can and does act as an important "watchdog" for its citizens. The LAST thing WE need as citizens of this country is a muzzled watchdog.
Muzzling the Watchdog
First published: Tuesday, July 15, 2003
A House subcommittee has taken the first step to weaken the states' power to regulate the financial services industry. If the bill should ultimately become law, investors will be more vulnerable than ever to Wall Street's excesses.
The proposal, called the Securities Fraud Deterrence and Investor Restitution Act of 2003, is blatantly mislabeled. Deterrence depends on alert policing of the marketplace. Weakening regulatory oversight can only encourage unscrupulous brokerage houses to think they have a better chance of getting away with fraud. "The idea that you would take out your local cop on the beat, your state securities regulators, if someone engages in a conflict of interest, is a giant step backward," Christine Bruenn, Maine's securities administrator, told The New York Times.
The legislation is an obvious reaction to the high-profile investigation conducted last year by New York Attorney General Eliot Spitzer. Acting under a long overlooked state statute, Mr. Spitzer pursued Merrill Lynch and other brokerage houses that sought lucrative investment banking deals by publicly touting stocks that their brokers had privately labeled as losers. As a result of a settlement reached with Mr. Spitzer, brokerage houses must now abide by strict new conflict-of-interest rules that have helped to restore credibility to the markets.
By moving so aggressively, Mr. Spitzer not only jolted Wall Street's giants, but also clearly embarrassed the Securities and Exchange Commission, which had remained on the sidelines until the attorney general's investigation caught steam. The subcommittee's bill would prevent any state regulator from ever following Mr. Spitzer's lead by prohibiting any state from imposing rules on brokerage firms that differ from those established by the SEC. It also would prohibit states from imposing penalties, consent orders or settlements.
Ostensibly, the purpose of the federal law would be to bring uniformity to the national financial services market. But the sponsor of the subcommittee bill, Rep. Richard Baker, R-La., has acknowledged through a spokesman that his legislation was prompted "when a New York state official began to dabble in national regulatory matters ... "
And well that Mr. Spitzer did dabble. As for meddling, there is a long history of state regulators taking the initiative on behalf of investors before the SEC got involved. Far from treading where they didn't belong, they helped to protect investors by acting sooner rather than later. If anything, they need more powers, not less.
Last edit by Ted on Jul 15, '03
Jul 15, '03
Hoping this is not too "nurse & patient" for current events.
The State Department of Health Services (DHS) has RNs dedicated to enforcing regulations and laws.
For Acute care facilities they find a deficiency and the hospital must write a "Plan of Correction". One example is assigning staff to patients or units they are not competent to care for. Another is unsafe staffing. One problem is that they go in weeks or months after being called. Often they must rely on documentation.
Even when the DHS witnesses unsafe illegal conditions there is NO fine or penalty.
Some facilities are cited year after year for the same violation. Often the "Plan" is something like. "We are in the process of revamping our acuity system."
Only when the nurses threaten or actually show the public record of the violation is any true change made.
The best example was the county hospitals RNs and MDs reporting to the DHS that patients lives were in danger because no dialisis RNs were available nights and weekends. They called those who were off duty and sometimes someone came in.
The staff of nurses, nursing management and physicians were so upset when a patient died that they told the family the truth, their loved one died because the hospital would not hire more nurses or pay the existing staff to be on call.
They got the story into the newspaper. Only then were nurses hired.
At another hospital the nurses held a vigil singing hymns and giving copies of the DHS public record to staff, physicians, and the press. Their staffing then improved as the hospital finally did what was promised in writing to the state.
Long term care has less stringent regulations. They go by hours per patient day (HPPD). Night shift gets much less help. That is why we get patients from nursing homes with pressure sores, dehydrated, with UTI, and contractures.
There are stiff fines for neglect or patients rights abuse. Most fines are from complaints by patients or their families. This may belong on a different topic but is VERY distressing. (I could go on as could most of us).