State fines Olympia mental health clinic $1,000

Staff writerJuly 12, 2013 

A state agency has fined Olympia’s Behavioral Health Resources $1,000 and has required the mental health clinic to take corrective actions in the wake of an investigation into why BHR did not notify the state it had terminated a counselor for a finding of unprofessional conduct.

The counselor fired by BHR in December, John Alkins, 58, was found dead in his Olympia home April 30. He was strangled. A former patient of Alkins’ at BHR, Lia Tricomo, 27, is charged with first-degree murder in connection with Alkins’ homicide. She is being evaluated at Western State Hospital, and her attorney has indicated she may seek an insanity defense.

Court papers indicate Alkins and Tricomo engaged in sexual activity before Alkins’ homicide. A professional organization for mental health counselors notes that it is generally considered unethical for a counselor to have a romantic or sexual relationship with a patient or former patient.

BHR fired Alkins in December after it found he had “violated BHR policies concerning professional boundaries,” but the firm did not notify the state Department of Health of Alkins’ firing, as required under state law. DOH could have taken an action against Alkins’ credential as a counselor if it had been notified of his firing.

On June 5, a compliance manager for the state Department of Social and Health Services wrote a five-page report to BHR’s CEO, John Masterson, notifying BHR of its fine and the corrective actions BHR needs to take as a result of its investigation. A copy of that letter was provided to The Olympian on Friday.

The letter notes that BHR fired Alkins on December 12, 2012. Under Washington Administrative Code, BHR should have immediately reported Alkins’ termination to the state Department of Health. However, BHR did not do so until May 2, when a reporter from The Olympian called DOH and BHR and asked officials there whether Alkins’ termination was reported.

The DSHS letter notes that “there does not appear to be any causal relationship between any action (BHR) did or did not take” and Alkins’ homicide.

Also according to the letter:

In “2007 or 2008” a client’s mother had complained because “Alkins had inadvertently exposed himself to a child during a session (he had apparently been wearing shorts with no underwear). However, there is no documentation of this event of subsequent disciplinary action.”

The DSHS investigation found that Alkins’ personnel records at BHR included two client complaints, beginning in May 2012. On May 2, one female client complained that Alkins “frequently touched her on the back, arm and leg at the end of a session, and had ‘blown her a kiss’ as she was exiting her vehicle.”

“The agency investigated and determined that the complaint was unsubstantiated but noted that during the general time period, three other female clients had requested transfers to another clinician.”

No disciplinary action was taken against Alkins after the complaint or the transfer requests. However, Alkins was instructed to review BHR’s human resources policy regarding professional behavior and personal boundaries.

In August, another client called the crisis clinic and reported that Alkins had given her a hug. She stated that this made her feel uncomfortable. The complaint was referred to BHR. A BHR employee discussed the matter with the Department of Health, and the complaining client was asked to provide a written statement.

Alkins was placed on administrative leave Sept. 12, 2012, pending the outcome of an investigation. An independent investigator found “it was ‘highly likely’ that John Alkins engaged in frequent touching with clients and frequently discussed his own personal issues with them.”

DSHS also made the following findings in relation to BHR:

• “The agency failed to follow their own policies and procedures related to incident reporting and management. … This is true for the current incident as well as the previous efforts noted in this report.

• BHR failed to follow up on Alkins in May 2012 after he was instructed to review BHR’s policies regarding professional behavior and personal boundaries.

• BHR failed to notify DOH of Alkins’ termination. “It is the opinion of the investigation team that role definition and accountability is unclear in several areas, specifically regarding incident reporting and communication with outside agencies.”

• For nearly three years, BHR’s individual in charge of clinical oversight did not have an active DOH credential. “While clinical oversight may not be a direct service, it is still considered a clinical activity.”

In addition to the $1,000 fine, BHR must provide DSHS with the following documentation:

• A description of actions taken by the agency to ensure that policies and procedures related to incident reporting and management are followed.

• A copy of the agency’s policies and procedures that delineate the process through which DOH will be notified in the case of future occurrence of staff misconduct.

• A description of actions taken to ensure that all staff are provided with clear performance expectations.

• A description of actions taken to ensure that all staff persons hold an active DOH credential.

BHR has already paid the $1,000 fine and has provided DSHS with documentation of its corrective actions, DSHS spokeswoman Kathy Spears said Friday.

“The department will revisit the agency in six months to ensure the corrective actions have been implemented,” Spears said.

BHR spokeswoman Judi Hoefling said Friday that its failure to notify DOH when it fired Alkins was “an administrative glitch.” However, since the oversight and the corrective actions BHR has taken, “we feel pretty confident that something like that will never happen again,” she said.

Jeremy Pawloski: 360-754-5445

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