A proposed gathering of national corrections experts to review Maine’s policies and procedures following the suicide of a 16-year-old transgender boy at Long Creek Youth Development Center in South Portland has been postponed.
Department of Corrections Commissioner Joseph Fitzpatrick said Tuesday that the meeting, which had been slated to take place sometime this week, was put off after he and others in the group grew concerned that they would not be able to discuss the circumstances of the death of Charles Maisie Knowles until an investigation into what occurred is completed by the Maine Attorney General’s Office. Knowles hanged himself Oct. 29 and died Nov. 1 at Maine Medical Center in Portland after being taken off life support.
Fitzpatrick is under no obligation to perform such an internal review, but said previously that he prefers to invite scrutiny in hopes of improving department policies and practices.
Knowles’ death was the first at Long Creek, the state’s premier youth corrections facility, in at least 20 years. Knowles, a transgender boy, had been going by the name Charlie but was housed in the girls unit at Long Creek.
His mother, Michelle Knowles of North Vassalboro, said after his death that she begged the facility’s privately run medical staff to provide more comprehensive mental health treatment. Knowles had been diagnosed with serious mental health problems since he was about 9 or 10 years old, Michelle Knowles said.
Knowles was being held in detention after being charged with felony arson in August, for allegedly setting a fire in his mother’s house that injured her and nearly destroyed the home.
Immediately following the death, Fitzpatrick said he also ordered some temporary policy changes, but he has so far declined to identify what they are.
Also unknown so far is which outside advocacy groups he will invite to the table, although he said they will be drawn from the worlds of psychiatric care, corrections, disability rights, civil rights, LGBTQ rights and others. No topic will be off the table, he said.
Fitzpatrick also rebutted the central criticism leveled at Long Creek by Michelle Knowles, who insists that multiple staffers there told her that they could not provide more comprehensive mental health counseling because her son was a detainee and had not been committed by a judge long-term.
But Fitzpatrick said that is not true.
“There is no differential between committed and detained in terms of health care or mental health care,” he said. “In terms of access to psychiatry and medication and clinical social workers and psychologists, it’s the same. We start with an assessment across the board, whether you’re committed or detained, and based on that assessment we provide a level of treatment that’s needed.”
Fitzpatrick said about 169 state employees are responsible for the welfare of 69 committed residents and 12 detainees at Long Creek. None of the current residents identifies as transgender, he said.
All medical services – including psychiatric care – are provided by an outside contractor, Correct Care Solutions, an international company based in Tennessee that provides health care in 38 states across a range of correctional, civil and institutional settings. A staff of about 10-12 CCS employees, along with one state-funded clinical social worker, provide all assessment and treatment needs presented by residents, Fitzpatrick said.
The private contract with CCS for medical care spans all state-run correctional facilities, and has been in place for about four years, the commissioner said.
He also dismissed any suggestion that a private for-profit company such as CCS would have an incentive to provide less costly, substandard health services to Maine people who are detained or incarcerated.
“I’ve been with the department 24 years. I’ve seen those providers, I’ve seen those companies. I’ve seen people in the past who are more concerned with cost containment than quality of care,” he said. “Correct Care Solutions is not that at all. We’ve been extremely pleased with the quality of care.”
But Michelle Knowles has said practices at the facility were different.
She said that because her son – who was biologically female but identified as male from age 3 – was being detained pretrial and had not been committed to Long Creek by a judge, he was unable to access a level of care that more permanent residents may receive.
Instead, medical staff planned to focus on the “day-to-day” issues that confronted Knowles, who had an extensive and well-documented history of mental illness.
“They absolutely could not (provide more care) because my child was a detainee, that’s the difference,” Michelle Knowles said Tuesday. “I was told that multiple times. That is very clear for me, there is no question about that. That’s what frustrated me.”
Only after an outside physician who had previously been caring for Knowles intervened did Long Creek staff agree to provide more extensive, comprehensive mental health treatment, Michelle Knowles said. But the decision to move forward with more care was too late, she said. A day after Michelle Knowles learned of that decision, her son was being rushed to a Portland hospital.
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