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The Spokesman-Review

Department of Health may (revoke) license of Daybreak Youth Services

SNAP loan program aims to help low-income homeowners make critical repairs to older homes

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The Spokesman-Review

Department of Health may (revoke) license of Daybreak Youth Services

By Emma Epperly

THE SPOKESMAN-REVIEW

One of the only residential treatment centers for youth in Eastern Washington, Daybreak Youth Services, could lose its license after the facility failed to cooperate with a Washington State Department of Health investigation, the agency announced Tuesday. The Department of Health issued a notice of intent to suspend Daybreak’s license after the facility refused to cooperate with an ongoing investigation into patient safety concerns.

Daybreak, founded in 1978, offers trauma-focused addiction and mental health treatment for youth ages 12 to 18 statewide, with inpatient and outpatient services. The Spokane inpatient facility, at 628 South Cowley St., can treat up to 36 girls at a time and is a mirror to the Vancouver area clinic that treats young boys. Daybreak also offers outpatient coed clinics and counseling in Spokane Valley.

In March, the department began investigating allegations of misconduct as a result of “patient boundary issues” with a staff member that were reported to the department, according to a news release.

Daybreak failed to provide information requested by the department despite repeated efforts, the Department of Health said. The facility has 28 days to request a hearing on the license suspension before it takes effect. Requesting a hearing would postpone the suspension until an administrative law judge reviews and makes a decision on the case.

Tom Russell, Daybreak’s Chief Executive Officer, said Daybreak fully cooperated with the investigation and that the organization plans to appeal.

“Clients have a right to file a complaint,” Russell said, but patients often perceive interactions through the lens of their trauma.

“That’s their reality and so we have to look at that,” he said of complaints.

If the license is suspended, Daybreak must transfer all patients and cease operations.

Critical shortage of inpatient treatment facilities

There are very few inpatient behavioral health and substance abuse treatment facilities for youths in Eastern Washington making Daybreak a “key provider,” said Linda Thompson, executive director of the Greater Spokane Substance Abuse Council.

“It is a devastating loss,” Thompson said.

The notice to suspend Daybreak’s license was made months after Daybreak staff raised alarm bells about skyrocketing rates of mental health issues and fentanyl use.

“We have kids dying on our waitlist from fentanyl,” Sarah Spier, director of external relations at Daybreak, said Wednesday.

Patients will travel from all over Eastern Washington to be admitted at Daybreak, Thompson said. Losing those treatment beds will strain an already tight system, she said.

“The overall access to treatment right now is very tough,” Thompson said.

Often it can be a difficult road to get people to the point of seeking treatment and long wait times of weeks or months is another barrier, Thompson said.

“Immediately getting people into treatment is critical,” Thompson said. “The addiction is so strong that you’ve got to reach them when they are open to treatment.”

The investigation

Multiple complaints to the Department of Health allege that a skills coach hired in November 2021 acted inappropriately toward teenage girls in the program almost immediately after he was hired.

On Dec. 8, the man came to the facility to “hang with the girls” on his day off, the complaint alleges. Daybreak counseled the staff member after the incident.

Later that month, a patient filed a grievance that the worker used “prison sign language” to say he loved her. In January, another client complained the man engaged with her on social media.

The staff member asked patients for hugs and talked to them about their bodies, one complaint alleges. When a patient rebuffed his attempt to hug her, the staff member became confrontational, the document said.

The worker also was “slut-shaming” patients by commenting on their clothes, the complaint alleges. In response to the grievances filed against him by patients, the worker bullied and retaliated against patients, the complaints allege.

When asked about the employee’s alleged conduct, Russell noted there was no harm to a patient and that patients in the program all have traumatic backgrounds that shape how they experience the world.

In this instance, Russell said a patient wasn’t adhering to the facility’s dress code and misinterpreted attempts to enforce the policy.

The Department of Health isn’t asking questions about the context of the incidents, Russell said.

Daybreak opened an internal investigation into the worker in January. While the investigation showed a pattern of misconduct, the facility concluded he hadn’t violated Daybreak’s code of ethics and continued to employ him and allow him access to the facility’s teenage patients, according to the Department of Health.

Daybreak didn’t report any of the complaints or concerns to the Department of Health.

The Idaho Department of Health and Welfare stopped referring teens to Daybreak over concerns of poor quality of care and management at the facility, the notice of intent to suspend says.

In February, the Department of Health received a complaint from the Washington State Department of Children, Youth and Families about staff violating patients’ boundaries. A similar complaint was filed by the Spokane Police Department in March, according to the notice of intent to suspend. Spokane police received a complaint from the Caldwell Police Department and since Daybreak is out of its jurisdiction, the department forwarded the information to the Department of Health, said Julie Humphreys, a department spokesperson.

The Department of Health opened two investigations into the facility based on the complaints. Daybreak was cooperative during two site visits in March and April, providing staff records and allowing the worker to be interviewed.

Then in May, Daybreak stopped responding to requests from the Department of Health, specifically for copies of the grievances and complaints filed against the staff member.

In June and July, Daybreak argued that the department’s request for records was “overly broad” and refused to provide patient records requested by the department.

Daybreak prevented the department from interviewing patients, the department said. During staff interviews Daybreak Chief Operating Officer Richard Reathaford told staff to only answer questions about policies and procedures and wouldn’t allow staff to respond to what he called, “he said, she said” questions, according to the intent to suspend.

Reathaford continued to interrupt investigators in an attempt to limit the scope of their questions despite the Department of Health having broad authority to investigate licensees, according to the document.

Staff members have the right to have someone with them when being interviewed by the Department of Health, Russell said. He said Reathaford’s interjections were likely meant to clarify questions and scope, not as interference, like the Department of Health described.

Daybreak understood the investigation to be focused on whether staff members were keeping appropriate boundaries with clients, Russell said.

While Daybreak did provide client records at the end of the last facility visit on July 19, the facility only provided records it deemed to be within the scope of the department’s investigation, the department wrote. Russell denied that claim and said Daybreak provided the complete records for patients who made complaints about the employee but questioned whether records of patients who did not make complaints were releasable under federal law.

Daybreak requested multiple meetings with the Department of Health to discuss the investigation and clarify miscommunications, but the Department of Health did not respond to those requests, Russell said.

Due to Reathaford’s alleged interference and the lack of complete records, the department found the facility to be uncooperative and issued the notice of intent to suspend the license on Aug. 1. The employee voluntarily left Daybreak in June,Spier said.

Prior investigations

In 2018, the Department of Health investigated Daybreak’s inpatient facility in Brush Prairie, just outside of Vancouver, after allegations the facility was unsafe due to numerous unreported altercations and sexual assaults.

The Clark County Sheriff’s Office investigated why staff weren’t reporting the assaults and ultimately charged, Michael S. Trotter, Daybreaks’ former vice president for compliance, with three counts of failure to report child abuse or neglect. Court records indicating the outcome of that case were not immediately available Wednesday.

The Department of Health threatened to revoke that facility’s license but an appeal kept the facility open. Daybreak settled with the Department of Health in 2019 and agreed to improve staffing, training, security, and reporting policies.

In the settlement order, the Department of Health said Daybreak’s failure to meet standards “placed its residents at an unacceptable risk of harm.”

The nonprofit said it made significant changes following the investigation, including hiring Russell as CEO.

The Brush Prairie facility’s license was in good standing as of Wednesday.

While Russell said the complaints should be thoroughly investigated, he has no worries about the care being provided at Daybreak in Spokane.

“I know that what Daybreak is doing today is providing excellent care to the kids that are there,” Russell said. Emma Epperly can be reached at (509) 459-5122 or at emmae@spokesman.com.

SNAP loan program aims to help low-income homeowners make critical repairs to older homes

By Amber D. Dodd

COMMUNITY JOURNALISM FUND

To help low-income homeowners pay for needed repairs to their older homes, such as roofs and sewer lines, Spokane Neighborhood Action Partners has created a revolving loan program that looks to provide relief.

Nicole Bishop, SNAP’s marketing and communications specialist, said the program has been running for the past 15 years and is needed now more than ever.

“Keeping somebody in a home that they already own is going to be an improvement and (would use) fewer resources than having them lose the home and finding some place to go if their home is no longer inhabitable,” Bishop said.

Danny Shea has been SNAP’s single-family rehabilitation project manager for eight years. Shea is also a former construction worker and loan manager.

“The average price of a single- family home is ridiculous right now, and if you lose inventory on those start homes and the lower-costing homes, that’s how we’re helping,” Shea said. “We’re not helping $700,000 homes and $500,000. We’re helping the $200,000 to $300,000 homes that are more affordable for low-income people to purchase.”

Sewer pipe problems are a big concern. As more families sought to buy homes after World War II, builders used Orangeburg pipes to move waste into a city’s sewage system.

“They were all coming back to Spokane to build houses, but there was a lack of raw materials,” Shea said. “So simply, to make it quick, a company in New Jersey decided to make sewer pipes out of craft paper, which is the brown paper, rolled it real tight and had it pinned with a cold tar substance.”

The use of Orangeburg pipes stopped by the 1970s, but many older homes in Spokane still use them. The life expectancy of Orangeburg pipes is up to 50 years.

“Well, it’s well past the 50 years and it doesn’t just break or clog, it just collapses,” Shea said. “That’s devastating to a low-in-come person.”

If the Orangeburg pipes are not cleaned or replaced soon enough, it can lead to health and safety issues, such as backed up sewage, contamination of water and other dangerous complications. Shea estimates the average price of a new sewage line could be as high as $15,000.

“And that’s not putting a sewer,” Shea said. “That’s just fixing the line that’s broken. So where do people find that money?”

With the housing crisis, inflation and worries about a looming recession, Shea and SNAP administrators began to recognize the need to subsidize the payment for the dire replacement procedure.

SNAP also has expanded the loan program to roofing, because of the urgency to fix those problems.

“Many roofs in town start leaking and need to be replaced,” Shea said. “Then there’s that $20,000 bill. It can be an insane story trying to find the money to fix that for low-income people.”

Because the city provides the funds through a grant developed by the Department of Housing and Urban Development, the loan program is a “revolving program.”

When the loan is paid off, the money provided by the city can then be lent to the next person.

Shea also mentioned that this is an environmental equity issue, because many of the homes needing service are located in Spokane’s flatland areas north of the river and south of the Shadle Park area. An environmental crisis could uproot the Orangeburg pipes.

The applications are made in the same format as the mortgage applications to increase accessibility. Homeowners can apply the same information they use on their mortgage applications, and SNAP also helps find businesses to place an appropriate bid on replacement costs.

“Then we do a normal mortgage on it like a normal company would, but then we take that money and disperse it out to the contractors as they do their job,” Shea said.

SNAP has hired journeyman plumbers to assess and fix these situations. Tyler Lane has been with SNAP for the past six years as a single-family home rehabilitation assessor. He also owns an older home in the Cherry Deer Park area, occupying a home built in 1923.

“I’ve had to do extensive sewer work, replaced my own roof on the house and I’ve redone all the flooring and replaced a lot of the plaster walls and windows,” he said. “I understand a lot of the challenges homeowners face with the extensive work on my own home as well.”

Lane said the timing of replacing these can take up to months, especially when environmental reviews need to take place.

“The program itself, from the first initial call until the project is complete, can take up to a few months unfortunately,” Lane said. “Because the program is funded by HUD and the city of Spokane, we have to be approved. We try to expedite it as quickly as possible.”

Indigenous tribes and state archaeologists must assess if the area that SNAP’s workers are digging in is safe enough to penetrate.

“It includes a consultation for the sewer ones and we have to provide an environmental review for everyone,” Lane said. “That type of review, at minimum, takes 30 days.”

If the Orangeburg pipes are not cleaned or replaced soon enough, it can lead to health and safety issues, such as backed up sewage, contamination of water and other dangerous complications.