Sex Offenders Receive Big Bills from State Mental Health Agency

November 3, 2011

Investigative Reports

Print Friendly, PDF & Email

The NerveIn South Carolina, convicted sex offenders who have finished their prison sentences can be held indefinitely afterward behind bars if designated as a “sexually violent predator.”

And if they eventually are released from a treatment program run by the S.C. Department of Mental Health, they likely will face six-figure bills for their forced stay in the program, an investigation by The Nerve has found.

The Nerve recently obtained copies of DMH bills for seven offenders who are or were in the program. The bills ranged from more than $100,000 to more than $700,000.

Most of the bills listed a daily flat rate of $268. Based on that figure, a one-year stay in the program would cost $97,820.

The length of time spent in the program for the seven offenders ranges from more than a year to more than seven years. Most of the seven were convicted of sex offenses with children, State Law Enforcement Division records show.

An offender who was released from the program and asked that he not be identified told The Nerve last week that the mental health agency threatened to put a lien on his property to cover his bill of more than $200,000.

“When I pass away, they get it all, and there’s nothing I can do about it,” he said.

The man provided The Nerve with a copy of a DMH letter warning him that the agency would put a lien on his property if he didn’t pay his bill within 20 days. The letter noted that nothing had been paid toward the bill.

“The Department of Mental Health has a lien upon all real and personal property of current and former patients to the extent of the total cost of care,” the letter said, adding, “We want to assure you that once the lien is filed, it certainly will not affect any care you receive while in our facilities.”

The man said he received little professional treatment while in the program, which is housed in the S.C. Department of Corrections’ Edisto unit off Broad River Road in north Columbia. The facility formerly housed the prison system’s Death Row inmates.

“I was more incarcerated than when I was incarcerated,” the man said. “I lived in a prison cell with no electricity other than a light. I wore prison uniforms. I ate prison food.”

Contacted this week by The Nerve, Will Matthews, a spokesman at the American Civil Liberties Union’s national office in New York, questioned the Department of Mental Health’s billing practices.

“While the U.S. Supreme Court has deemed civil commitment of sex offenders post-sentence to be constitutional, forcing sex offenders to pay for their involuntary civil commitment raises serious constitutional issues,” he said.

Matthews pointed out that charging prison inmates for their time spent in state correctional systems has been ruled unconstitutional by the nation’s highest court.

Contacted Wednesday by The Nerve, Laura Hudson, executive director of the nonprofit South Carolina Crime Victims’ Council, said she didn’t have “any objection” to DMH billing offenders who are released, noting, “It’s a very costly program.”

“Many of them are not going to get out because we don’t have any definitive literature that says child molesters can be cured,” Hudson added.

In South Carolina, sex offenders who finish their prison sentences can be forced into DMH’s treatment program through civil commitment procedures.

As of 2007, 19 states, including South Carolina, and the federal government had passed laws allowing for civil commitment of sex offenders, according to a report to Congress by the Congressional Research Service.

The process in the Palmetto State involves initial recommendations by a “multi-disciplinary team” appointed by the Department of Corrections and “prosecution review committee” appointed by the S.C. attorney general to designate an inmate as a sexually violent predator.

If a judge later makes a probable-cause finding supporting the recommendation, the offender is entitled to a trial by judge or jury to determine whether he should be committed to the program. A finding for commitment must be determined beyond a reasonable doubt.

If an offender is committed, a judge must conduct an annual hearing to determine whether the offender can be released from the program; if probable cause is found supporting the release, another trial is scheduled for a final determination. The offender also can file a petition for release, and the DMH director also can initiate release proceedings.

The average length of time spent by an offender in the program wasn’t provided by DMH to The Nerveby publication of this story. But according to a 2010 offender list obtained independently by The Nerve, one person had been in the program since 1999, three since 2000 and four since 2001.

Treatment Not ‘Unconditional Charity’

In written responses to The Nerve, Mark Binkley, DMH’s general counsel, said under state law, certain sex offenders can be confined behind bars after finishing their prison sentences if a civil court determines they are “likely to engage in acts of sexual violence if not confined in a secure facility.”

The other purpose of the state’s sexually violent predator program is treatment, Binkley said. Offenders in the program have been found to have a “mental abnormality” that “contributes, at least in part, to their likelihood of re-offending,” he said.

Binkley said state law requires DMH to establish charges for “provided treatment, care and maintenance to its patients.” According to the statute (44-23-1110), the charges are based on the per-capita daily costs of the “services rendered, which may include costs of operation, costs of depreciation, and all other elements of cost, which may be adjusted from time to time as the Department of Mental Health considers advisable.”

“Regardless of the type of admission, voluntary or involuntary, or the specific type of SCDMH inpatient or outpatient facility, program or service, all SCDMH patients remain liable for the cost of such treatment, care and maintenance,” Binkley said.

“The treatment, care and maintenance of a SCDMH patient is not unconditional charity,” he added, citing a 1954 state Supreme Court case.

Three bills obtained by The Nerve for offenders in the sexually violent predator program state, “All unpaid balances are the responsibility of the patient.” The other four bills reviewed by The Nerve refer to the offenders as “clients” instead of “patients”; Binkley in his written replies to The Nerve described them as “residents.”

Citing state law and court cases, Binkley said his agency can seek liens against the offenders’ property or garnishment of state income tax refunds through the S.C. Department of Revenue to pay off unpaid balances. The agency also can seek reimbursement from an offender’s estate, he said.

The Nerve asked Binkley for specifics on the number of times the agency sought liens or garnishment of tax refunds, and how much has been collected from offenders over the years, but did not receive a response by publication of this story.

“Virtually all” of the released offenders are “indigent, with no known property,” Binkley said, adding that “most were also known to be disabled and unlikely to obtain employment.”

“Although the agency does charge the residents the established daily care and maintenance rate, it collects almost nothing from the residents, all of whom were in prison or jail prior to their civil commitment to the program,” he said.

Of the 217 offenders who have been admitted to the program since its inception in 1998, 76 have been released, including three so far this year, according to figures provided by Binkley. As of Oct. 24, 133 individuals were in the program, Binkley said.

Matthews, of the American Civil Liberties Union, questioned whether the agency’s collection policy actually saves tax dollars.

“This is something aimed at saving taxpayer dollars,” Matthews said. “But if they’re spending a bunch of tax dollars to get poor people to pay … is that, in fact, the most taxpayer-friendly way to be dealing with this?”

The projected budget for the sexually violent predator program is $9.9 million for the fiscal year that started July 1, which works out to $71,748 for each offender, based on an estimated average daily population of 138, Binkley said.

That figure does not include the cost of food, utilities and external security for program space, which are provided by the Department of Corrections, Binkley said. Corrections also doesn’t charge DMH for the use of cell space, he said.

In comparison, the average annual cost per inmate in the state prison system last year was $15,963, which includes housing, food, security, medical costs and utilities, DOC spokesman Clark Newsom told The Nerve in a written response this week.

The cost of the sexually violent predator program has steadily risen in recent years, from $3.2 million spent in fiscal year 2006 to about $7.3 million in fiscal year 2010, according to Office of State Budget records.

Treatment Program or Prison?

Don Thurber of Easley, who describes himself as an advocate for offenders in the sexually violent predator program, told The Nerve last week that he can’t understand why the per-capita cost is so much higher in the program compared to the regular prison population – especially, he contended, given that offenders in the program typically receive little treatment by a licensed psychiatrist or psychologist.

“Six or seven years ago, it looked like a treatment program,” he said. “Now, it just looks like a prison.”

Thurber was convicted in 2002 of a sex offense with a 13-year-old boy, according to the State Law Enforcement Division records. When asked by The Nerve, Thurber, 59, acknowledged he is a registered sex offender, though he said his crime was committed 26 years ago, and that he has not re-offended since then.

“I sought my own counseling individually,” said Thurber, who noted he was not committed to the sexually violent predator program after serving his 4.5-year prison sentence. “I spent 10 years as a (Boy) Scout leader and did not assault any other boys.”

Thurber said though some sex offenders “don’t deserve to be on the streets,” others likely wouldn’t need to be in the sexually violent predator program if they received specialized treatment while serving their prison sentences.

“The thing we kind of lose is that we should want to rehabilitate people and get them back in a position where they can be contributing members of society, and we don’t meet that goal,” he said.

Newsom told The Nerve that DOC provides a voluntary, “intensive 12-week therapeutic program” for inmates convicted of sex offenses. The program, which is organized by a licensed social worker with a master’s degree, can accommodate up to 49 inmates in each 12-week cycle, he said.

The man who was released from the sexually violent predator program and asked not to be identified toldThe Nerve that he typically spent no more than five hours per week in counseling while in sexual predator unit –mostly group settings that were not headed by a licensed psychiatrist or psychologist.

Another offender in a signed statement obtained by The Nerve said most of the current or former case managers in the program were child social workers who have a conflict of interest because of their experience working with child victims.

Hudson, of the South Carolina Crime Victims’ Council, countered: “It’s my understanding that they do get treatment and have to get treatment. They might not like what they’re getting treated for.”

Long-standing Issues

Whether those who treat the offenders are properly trained is a matter of debate. In a 2006 memo obtained by The Nerve,  E. Selman Watson, a clinical psychologist and former longtime DMH employee,  informed Dr. Brenda Ratliff, DMH’s then-medical director, that “few, if any” staff members have “any specialized or formal training” in treating sex offenders.

“What some case managers do bring to the job, however, is experience and information they have gleaned from the Internet,” Watson wrote. “Prior to my arrival, impressions I have received are that the unit was run like a penal colony with a professional and ancillary staff that had a correctional mentality.”

Watson continued, “Residents have express (sic) that a climate of fear and retaliation has existed for years with some of the population receiving special treatment and others some hardship if they fall out of favor with some staff members.”

Watson also said in his memo that “SVP (sexually violent predator) units across the country have experienced a similar phenomenon and in response encountered wholesale changes in their staff in order to be more therapeutic in their treatment of residents.”

Watson operates a forensic psychology practice in Columbia. According to his firm’s website, Watson, who earned his doctorate degree from the University of South Carolina, spent 27 years at the Department of Mental Health, serving the last two years as director of the sexual predator unit.

Efforts this week by The Nerve to reach Watson for comment were unsuccessful.

Contacted Wednesday, Ratliff, a psychiatrist, told The Nerve that there is “not a lot of training now” for staff who treat those in the sexually violent predator program.

“It is available, but it is not common,” she said.

Asked whether there is a shortage of psychiatrists and psychologists in the program, Ratliff said she has “no way of knowing,” noting that she now works in a different DMH program and hasn’t “been connected to that in three of four years.”

Binkley, the agency’s attorney, did not respond by publication of this story to allegations that offenders in the program were receiving little professional treatment.

Reach Brundrett at (803) 254-4411 or rick@thenerve.org.