State agrees to moving of Western State patient

By Bill Mckelway, Media General News Service
Published: September 3, 2008

The state’s commissioner of mental health yesterday agreed to develop a plan to transfer a longtime mental patient who has been held in various forms of seclusion and restraint since 1986 in a state mental hospital.
The decision portends the end of years of administrative hearings in which Western State Hospital patient Cesar Chumil has fought to be relocated nearer his family in Northern Virginia.
Chumil, who turned 58 seven days ago, was first hospitalized for severe mental problems in November 1981. He has been held permanently at Western State in Staunton since Valentine’s Day 1986, for much of that time in restraints. He was moved into a three-room “limited containment unit” in August 1993.
Yesterday, the state’s mental health commissioner, James S. Reinhard, issued a ruling that upholds decisions from human-rights committees at the state and local level.
Those decisions found that Chumil was being held inappropriately in a form of seclusion inside the suite and that he was being denied access to caregivers fluent in Spanish.
Reinhard wrote in a four-page memorandum issued yesterday that the hospital and the state’s Department of Mental Health, Mental Retardation and Substance Abuse Services “have met with the family to discuss how best to implement a treatment plan that will result in a transfer to another location.”
Reinhard said a final plan will be presented to the State Human
Rights Committee on Oct. 24. Variances allowing Chumil’s continued seclusion in the suite will expire in December.
Alex R. Gulotta, a lawyer with the Charlottesville-based Legal Aid Justice Center, said he is encouraged that Reinhard supports earlier findings in the case. But Gulotta said the family is skeptical that the state will relocate Chumil closer to his family, an objective cited nearly a decade ago by outside psychiatrists.
Gulotta yesterday noted opposition by the hospital to earlier findings by the human-rights committees and noted that Reinhard’s decision does not specifically state that the department will transfer Chumil to a facility closer to his relatives in Northern Virginia.
“Our position is that the state should use the same level of creativity to develop a place for Mr. Chumil that is close to his family as it used to isolate him at Western State,” Gulotta said.
Simply moving Chumil to another hospital that is far removed from his family does not address major clinical failings of his current situation, Gulotta said.
Reinhard called the Chumil case “complex and challenging,” an allusion to Chumil’s long history of violent, apparently untreatable behaviors.
In a psychological assessment of Chumil written in February 2000, a physician noted that in the previous six years there had been “hundreds of staff hits leading to hundreds of workmen’s compensation incidents, thousands of hours in 8-point stationary restraints, and tens of thousands of hours in four-point ambulatory restraints.”
Yet, Chumil has been allowed to leave the hospital with his family scores of times without guards and without restraints.
“Our position has been that much of what Western State has done with Mr. Chumil was for the convenience of the hospital and staff,” Gulotta said.
Reinhard yesterday backed human-rights recommendations requiring rigorous, timely documentation of Chumil’s condition, behaviors and treatment. And he also said efforts were under way to recruit caregivers and physicians fluent in Chumil’s native Spanish.
Bill McKelway is a staff writer for the Richmond Times-Dispatch.