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Phillip Paul's escape prompts state hospital crack down

The escape in September of the man charged with killing a Sunnyside-area woman prompted the state of Washington to tighten restrictions on field trips by patients in state psychiatric hospitals.

Phillip Paul was charged with murdering a Sunnyside woman in 1987, but was acquitted on grounds of insanity. He has been in custody at Eastern State Hospital in Spokane ever since.

Paul walked away from a hospital field trip to the Spokane County Fair in September, and hospital officials waited two hours before alerting law enforcement.

Paul was captured in Goldendale following a four-day manhunt.

Paul's escape led to new controls announced last week by the state's Department of Social and Health Services (DSHS) that will add stringent new controls on how patients being treated at forensic wards in state psychiatric hospitals are selected or allowed to participate in future field trips off hospital grounds.

"Public safety should always be our top priority," DSHS Secretary Susan Dreyfus said. "These recommendations will help us ensure that."

The new policy on therapeutic field trips was among the recommendations included in the final report from the Washington State Psychiatric Hospital Safety Review Panel, which Secretary Dreyfus appointed after Paul's escape during the Eastern State Hospital field trip.

The panel's final report on the escape and overall security and safety issues at Eastern State and Western State hospitals were presented last week.

Among the safeguards in the new policy:

- Only forensic patients who have been cleared for conditional release or partial conditional release by the courts can be considered as participants in therapeutic field trips. Patients whose conditional release status has been challenged will not be permitted on field trips.

- Law enforcement agencies will be notified in advance of field trips, along with notification of victims or victim families who have requested notification.

- Forensic therapeutic field trips will be limited to no more than four patients at a time with a predetermined level of supervision and trip planning that includes a review of patients' ward behavior and any escape or behavioral risk posed by individual patients.

- The hospitals will maintain up-to-date photo files of all forensic patients, with descriptions of clothing worn on the day of the therapeutic field trip.

- Any escape from a forensic field trip will be immediately reported to 9-1-1. All staff with knowledge of the escape will bear the responsibility for seeing that this happens.

Overall, the Washington State Psychiatric Hospital Safety Review Panel found that Eastern State Hospital policies and procedures were out of date, not well organized or distributed to staff; that Eastern staff were not documenting risk assessments as required by policy; and that the hospital generally did not pay sufficient attention to safety and security issues.

DSHS will also take the following recommendations from the panel under consideration:

- An immediate review and update of Eastern State Hospital policies and procedures, along with appointment of an executive policy team for both hospitals that would develop uniform policies and best practices.

- Eastern has been ordered to stop mingling the civil and forensic patient populations.

- Eastern needs a personnel performance review for top executives.

The panel stopped short of endorsing legislative action to create a "guilty but mentally ill" verdict, but it did review and endorse creation of a Psychiatric Security Review Board like one that exists in Oregon.

That board acts as a second layer of authority for decisions involving all forensic patients, including patients sent to the hospital after being found "not guilty by reason of insanity."

In addition, security experts at the Department of Corrections are still visiting both Eastern and Western state hospital campuses to review security procedures and recommend improvements.

The panel did not study or recommend staff discipline at Eastern State Hospital, where the chief executive officer has resigned. Dreyfus said the Washington State Patrol has been assigned to review staff roles during the escape.

She said disciplinary decisions will be announced in accordance with state worker contracts, disciplinary procedures and State Patrol findings.

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