In a 2008 photograph on his MySpace page, Peter Smith is standing in front of a tree with pink flowers at the San Marcos Treatment Center. Smith was 17 when Alaska Medicaid referred him to the Texas facility, and after checking in, he started counseling and classes to deal with the behavioral problems that had brought him south.
One day in September 2008, Smith was play-fighting with a San Marcos staff member and another resident when he allegedly was twice thrown onto a bed. Smith broke his neck and was paralyzed, his parents claim, as a result of the roughhousing.
Last summer Smith's parents, Jimmy Smith and Chrystal Ketchum, sued San Marcos and Psychiatric Solutions Inc., San Marcos' Nashville-based parent company, in Alaska Superior Court, claiming the company knew about the play-fighting and did nothing to prevent it. The case has since moved to federal court in Anchorage, with the family seeking compensatory damages of at least $100,000 and punitive damages to be decided at trial. No trial date has been set.
Smith's parents declined to comment, but in an interview with David Karl Gross, their attorney, he painted a picture of a company that knew its employees were acting recklessly when their son was staying at the Texas facility in 2008. "We want to get a picture of who was looking after these kids and what training they had," Gross said.
The state of Alaska contracts with San Marcos to treat a small group of children with severe problems. The Smiths' complaint states about 25 percent of the out-of-state treatment facilities approved by Alaska Medicaid are owned by PSI, and that the state has paid San Marcos more than $12 million since 2003. Over the years San Marcos has been a good facility for Alaska and always had good site reviews, said Pamela Miller, the residential psychiatric treatment coordinator at the Alaska Department of Health and Social Services behavioral health division. She said the number of Alaskans sent to San Marcos has dropped from about 30 in 2006 and 2007 to 13 in 2008, and only nine last year.
Still, PSI, which operates 11,000 beds in 32 states, has been criticized in recent years for poor patient care and failing to report deaths and accidents, according to ProPublica.org, an investigative news site. In Smith's case, Gross argues San Marcos officials knew about the play-fighting and other incidents of injuries with residents. During summer 2008, for example, a resident was allegedly injured while roughhousing, and Texas state officials investigated PSI and San Marcos that same year for encouraging residents to fight among themselves, according to the Smiths' court complaint.
Howard Lazar, the Anchorage attorney representing San Marcos and PSI, declined to comment. Andrea Lindsley, a spokeswoman for San Marcos, declined to comment except to say in a statement that, "At San Marcos Treatment Center, we focus on treating critically ill patients with behavioral health needs no matter what city or state they call home."
While the Alaska Department of Health and Social Services has been successful in lowering the number of youths sent to out-of-state treatment centers, the most complex and difficult cases still leave Alaska because there aren't facilities here for them. Miller would not speak specifically about Peter Smith, but said that in general it is better when children can be treated in Alaska instead of being sent out.
Today, Smith lives in Anchorage. He uses Anchor Rides to get to the mall but he's still paralyzed from the neck down and requires 24-hour care, Gross said.
"He's doing OK under the circumstances, but it's a difficult life," he said.
Contact Joshua Saul at jsaul(at)alaskadispatch.com