Mother in Duxbury murders her two kids (Boston, Concord: area, winter)

[chicagoliz]

Originally Posted by lrfox

This is two separate issues as far as I'm concerned. The first is that the state can issue a court order requiring a facility to care for a patient if they feel that a patient might otherwise be refused required medical and/or psychiatric care. It happens all the time with complicated cases like people who have both a major mental illness (like something that may cause them to be violent and/or need to be restrained) and a major medical condition requiring near 24/7 treatment. Many hospitals either outright refuse care, or attempt to bounce them to other facilities. Courts often step in to prevent that from continuing. In this case, most hospitals aren't going to want to care for an internationally notorious patient who: has been charged with murder, has major medical needs, likely requires 24/7 law enforcement observation, and has major psychiatric needs. Without a court order, Spaulding or any other private facility could fairly easily refuse to provide care for her.

As to "why Spaulding?" I'm not sure (is she there already?). I don't know why it has to be them (or if it has to be them). I also don't like that she's taking a bed away from someone else who probably hasn't committed similar crimes.

But my understanding is that she isn't there yet and there isn't any certainty that she will be. I thought that the judge yesterday referenced that as a possibility, but not as a certainty (unless I misunderstood or misheard).

I am not aware that Spaulding has refused to have her or that she has even been slated to be transferred there on a date certain. My understanding was that she is in the hospital now, still receiving acute care, and at some point will likely be transferred to a 24/7 rehabilitation facility SUCH AS Spaulding. But I haven't heard that the transfer was imminent, nor have I heard that there was any objection by Spaulding or any refusal to have her.

If there was such a refusal, then there could be a request to a court to order them to take her. But I haven't heard of any such hearing, nor do I know what the basis would be. The choice is not binary -- it's not Spaulding or Shattuck. I assume there are other rehab facilities, although I am not familiar with them. I would assume that Shattuck is only for prisoners, so no one who wasn't a prisoner would be going there (maybe I'm wrong and it is a public facility that treats lots of people, including prisoners). But if she did not want to go to a rehab facility -- i.e. was going to refuse medical treatment, she should be able to do so. If that were the case, she'd either go some home or to prison.

That's why I'm highly skeptical that an order such as this exists. It seems too early in the process and I don't see any reasoning or justification for it. Nor have I heard that there has been any hearing or any need for her/her family to obtain a court order to force them to accept her.

[bostonguy1960]

Originally Posted by tamajane

My husband could not get into Spaulding, but he never killed anyone so didn't have the power of the courts behind him to make that happen.

Would someone on MassHealth never have a chance at Spaulding?

I assume your husband has a fine health plan, so that is disheartening.

[brightdoglover]

Originally Posted by bostonguy1960

Would someone on MassHealth never have a chance at Spaulding?

I assume your husband has a fine health plan, so that is disheartening.

Pretty sure places have a mandate to take so many people on Medicaid or Medicare. I don't know how it's decided if someone can be in a place like Spaulding.

[Beachcomber4]

Originally Posted by brightdoglover

Pretty sure places have a mandate to take so many people on Medicaid or Medicare. I don't know how it's decided if someone can be in a place like Spaulding.

Often times they just don’t have enough beds available.

[brightdoglover]

Originally Posted by Beachcomber4

Often times they just don’t have enough beds available.

Or have closed beds for lack of staff.

[msRB311]

So many people say how lucky they feel to live near such great hospitals...but so many times you wait months or years to get an appt or a bed. Now this. What a state.

[simplexsimon]

Originally Posted by msRB311

So many people say how lucky they feel to live near such great hospitals...

As someone who has family whose health maintenance is fairly high, I do feel this way.

Serious question: where is it better? I'd like to know so I can add it as a place possibly to live in the future.

[lrfox]

Originally Posted by chicagoliz

But my understanding is that she isn't there yet and there isn't any certainty that she will be. I thought that the judge yesterday referenced that as a possibility, but not as a certainty (unless I misunderstood or misheard).

I am not aware that Spaulding has refused to have her or that she has even been slated to be transferred there on a date certain. My understanding was that she is in the hospital now, still receiving acute care, and at some point will likely be transferred to a 24/7 rehabilitation facility SUCH AS Spaulding. But I haven't heard that the transfer was imminent, nor have I heard that there was any objection by Spaulding or any refusal to have her.

If there was such a refusal, then there could be a request to a court to order them to take her. But I haven't heard of any such hearing, nor do I know what the basis would be. The choice is not binary -- it's not Spaulding or Shattuck. I assume there are other rehab facilities, although I am not familiar with them. I would assume that Shattuck is only for prisoners, so no one who wasn't a prisoner would be going there (maybe I'm wrong and it is a public facility that treats lots of people, including prisoners). But if she did not want to go to a rehab facility -- i.e. was going to refuse medical treatment, she should be able to do so. If that were the case, she'd either go some home or to prison.

That's why I'm highly skeptical that an order such as this exists. It seems too early in the process and I don't see any reasoning or justification for it. Nor have I heard that there has been any hearing or any need for her/her family to obtain a court order to force them to accept her.

I think you're right, the court order that was issued is for something entirely different. This is what I read: "Judge Canavan on Tuesday allowed Lindsay Clancy to remain at her current hospital and, upon discharge, to head to a rehabilitation center. Reddington mentioned Spaulding Rehab as one possibility during court proceedings." So the court order in this case was to allow her to remain in the current hospital and be transferred to a rehab facility (possibly Spaulding) when she's ready vs. being transferred to a state hospital.

The only point I was really trying to make in response to the talk in this thread about court orders requiring Spaulding to treat her, is that it wouldn't be unusual for a judge to issue a court order requiring a hospital or healthcare to provide care for someone who has been denied care or is likely to be denied care. It would be premature in this instance, but apparently that isn't what has happened here (yet). It wouldn't be completely out of left field if it did at some point later on.

And no, the choice isn't binary. There are other rehab facilities, and Shattuck isn't the only state facility equipped to handle forensic psychiatric patients. It's worth pointing out that Shattuck isn't just a mental hospital for prisoners. It offers a broad spectrum of services (inpatient substance use, acute mental health, outpatient clinics, shelter services, ambulatory care, and even some acute medical care and surgical procedures) largely to people who are disadvantaged in some way. Patients have to be referred by another state agency (or, I think, some licensed private providers). So you do have many court referrals (the forensic cases), but you also have many homeless patients, as well as economically and/or socially disadvantaged patients needing care beyond what their limited or nonexistent insurance will provide, etc.

[lrfox]

Originally Posted by simplexsimon

As someone who has family whose health maintenance is fairly high, I do feel this way.

Serious question: where is it better? I'd like to know so I can add it as a place possibly to live in the future.

Yeah, my brother was diagnosed with a life-threatening form of Leukemia when he was 2 which required constant treatment. We consider ourselves lucky to have had some of the best care in the world at Boston Children's and Dana Farber basically in our back yard. People spend a fortune on lodging and travel coming from all corners of the globe to be treated at these hospitals (we met many of them over the years). So to have them nearby is certainly an asset. Hopefully it's one that most people won't have to take advantage of.

[timberline742]

Originally Posted by simplexsimon

As someone who has family whose health maintenance is fairly high, I do feel this way.

Serious question: where is it better? I'd like to know so I can add it as a place possibly to live in the future.

Seriously. Great swaths of this country (and I have friends in some of them (plains states)) do all their non emergency medical appointments over a computer monitor (telehealth) because the nearest doctors to actually see are pretty much a full day driving round trip. We have it pretty great, for the USA.