Medical care for youths held at the Oak Hill Youth Center is irregular and in violation of a consent decree the District has agreed to obey, according to a report by the court-appointed monitors for the District's facility for juvenile delinquents.

The report, which was presented Sept. 2 in D.C. Superior Court, is the latest in a long series of findings documenting inadequate educational and medical services and substandard living conditions at the Laurel facility.

The report poses another challenge for the D.C. Youth Services Administration, which is trying to transform a detention center that repeatedly has been found in violation of the consent decree that settled Jerry M. Vs. District of Columbia, a 1985 class-action lawsuit filed on behalf of Oak Hill's children.

Investigative reports in 1989 found staff members had beaten children at Oak Hill, and in 1991 a 16-year-old there overdosed on cocaine. Although recent problems at the facility have not been so dramatic, children at Oak Hill have long been denied proper medical treatment, according to their advocates.

"We were very concerned about the findings of the monitors' report and believe that the lack of management structure and good administration puts the children at risk," said Robert L. Wilkins, chief of special litigation and programs at the D.C. Public Defender Service and an attorney for the Oak Hill children. "But we are hopeful that with the appointment of an independent consultant, we can solve those problems and improve the quality of medical care at Oak Hill."

Youth Services Administrator Gayle L. Turner, who was appointed in July 1998, said yesterday she will hire an expert in health care and juvenile justice to recommend longer-term improvements in Oak Hill's medical provision. "Everybody is working together to try to ensure that kids get the appropriate medical services as they need them," she said.

The monitors' report found the Office of Medical Affairs for Social Services, a branch of the D.C. Health Department, provides "fragmented" and inconsistent medical care to the approximately 150 youths at Oak Hill.

American Public Health Association guidelines say doctors should be trained in pediatrics or adolescent medicine. The consent decree for Oak Hill requires a full-time medical officer be on call. However, the report found Oak Hill's medical director at the time, Charles E. Potts, did not have such training and was contracted to work only 20 hours a week.

A second doctor hired in February, Maurice M. Pierre, does have some pediatric experience, but "neither physician acting alone or together takes full responsibility for the management and supervision of all medical services at Oak Hill," according to the report.

The report found there is no fully updated medical policy and procedures manual at Oak Hill. Only one medical exam is conducted when a youth is admitted, rather than an initial checkup followed by a comprehensive exam. Exams take place as late as 10:30 or 11 p.m., when "a youth's fatigue may adversely affect the accuracy of information provided," the report said. Although it is part of Oak Hill's strategic plan for medical care, health education is not a regular part of educational offerings at the facility, the report found.

The report said mental health services at Oak Hill, which are provided separately by the D.C. Commission on Mental Health Services, were adequate.

Turner said important changes in Oak Hill's medical care already had been made. Lynette E. Mundey, a Howard University doctor who was acting chief of the Office of Medical Affairs for Social Services from 1995 to 1996, has been named Oak Hill's interim medical director, succeeding Potts. Turner said the administration already has begun advertising for a permanent, full-time medical director.

In addition, medical records for all Oak Hill children have been moved from Youth Services headquarters to Oak Hill itself, Turner said. "The medical records are going in the fence with the medical-care professionals and kids," she said.

Virginia F. Crisman, the court-appointed assistant monitor for Oak Hill, said she was satisfied that officials were taking the report's findings seriously and working to create a long-term plan for consistent medical care at Oak Hill.

"The new administration at [the Youth Services Administration] took immediate steps to act upon issues raised in the report," she said. "I think we're in a major window of opportunity with this administration."