State schools have room to improve

By Matt Phinney (Contact)Saturday, June 27, 2009

(Link to article)

Supporters of state-supported living centers say a new law providing more oversight to the 13 facilities will go even further to protect the thousands of residents who live in them, while at least one advocacy group says a need continues for sweeping change to the state system.
This month, Gov. Rick Perry signed a bill that includes random drug-testing for employees, harsher penalties for abuse and neglect of residents and more surveillance at the facilities, which previously have been known as state schools. Some of the measures already have been in place in the state-operated facilities, said Cecilia Fedorov, media officer with the Texas Department of Aging and Disability Services.
That agency oversees the state facilities and regulates private immediate-care facilities for people with mental retardation as well as contracts with providers for community-based services, she said.
Among other things, the new legislation allows for enhanced training on how to recognize possible abuse or neglect, and what the reporting requirements are, as well as the ramifications of not reporting or preventing abuse and neglect.
“I think (the law) is just added benefits,” Fedorov said. “We already have a lot of safeguards in place, and this will allow us to screen even further. The top priorities at all times is the health and quality of life for our residents. This allows us to strengthen that.”
In addition to the law, 1,190 new employee positions will be open statewide for the centers.
That number hasn’t been broken up by individual facilities, Fedorov said.
About 4,600 people live in the 13 state facilities, according to The Associated Press, which is more than six times the national average.
The San Angelo State School, in Carlsbad, had 276 clients as of March 31, and had 760 employees as of April.
Perry declared state school reform a legislative emergency during the most recent session after state lawmakers reached a $112 million settlement with the Department of Justice, which documented widespread mistreatment of residents and alleged their civil rights were violated.
The agreement developed from a series of federal investigations that found that at least 53 deaths statewide in the system from September 2007 to September 2008 were from preventable conditions, indicating lapses in proper care.
After that report came out, there was talk of downsizing, consolidating and even closing some state-supported living facilities, said state Rep. Drew Darby, R-San Angelo, a member of the state’s Human Services Committee.
The talk eventually turned from downsizing to providing more resources to help the facilities protect their residents, led in part by families of residents at the facilities, Darby said.
“I think right-thinking people started working to come up with solutions that addressed the concerns of the Department of Justice and those in the community who believe there needs to be more resources,” Darby said, “while being sensitive to the many hundreds of parents and professionals that believe state-support living institutions are the best place for their loved ones.”
However, Jeff Garrison-Tate with the advocacy group Community Now! said there is no need for 13 state facilities and calls for complete reform of the system. The group works to ensure that people with disabilities who reside in state institutions get a chance to live in community settings.
His daughter has been on a waiting list for years, hoping to enter a community service center, which includes group homes and foster care.
Garrison-Tate said many residents at the state facilities do not have guardians and do not want to be in such large settings.
He said there is a waiting list of 88,000 people wanting to live in community service centers.
“I believe that everyone who wants to leave should have the opportunity to do so per federal law,” he said. “And whenever every one of those folks that wants out gets out, we need a long-range strategic plan to determine if we need these facilities in Texas. I believe we would not need that many.”
A report released this month indicated 27 people were fired or suspended at the San Angelo facility during the 2008 fiscal year. One of the 27 firings or suspensions was considered a Class I violation, physical or sexual abuse that may cause serious physical injury. Thirteen were Class II, which are nonserious physical injuries or exploitation, three were for emotional or verbal abuse and 10 were for neglect.
Fedorov said the number of people disciplined show the agency’s strict employee code of conduct is working to protect the residents.
The new law is a good start, Darby said, but the key for the state is to continue to provide the facilities with the resources to protect the residents.
Garrison-Tate disagrees. He said that while there are many good employees at the institutions, “There is a culture of abuse and neglect in these facilities that goes beyond any amount of money that we dump into these places,” he said.
“History shows we put money into this, and it doesn’t work.”
Garrison-Tate said the law includes worthwhile provisions, such as creating an independent ombudsman position and increasing penalties. However, he doubts that adding cameras in common areas will make a significant difference because most abuse takes place in bedrooms or bathrooms, where cameras cannot be installed.
Fedorov called the cameras “another layer of security. The more eyes you have looking at the situation, the less likely you are going to have abuse or neglect,” she said, adding that the cameras won’t be added quickly because the process must go out for bids, and some construction work will be required to install the systems.
Fedorov also said the state has increased by thousands the number of slots available for people who receive community-based services, she said.
Fedorov described the hiring process as “pretty intense,” including a lengthy orientation, security and background checks and training.
The employee turnover is high during the first six months of employment, which is a probationary period, she said.
The turnover rate is lower after the second year of employment, she said.
Many people who last more than two years make a career out of working at the facility, she said.
PROVISIONS OF SENATE BILL 643
Following is a list of provisions in a new law designed to protect residents at the state’s 13 state-supported living centers.
Establishes the Office of Independent Ombudsman and a new assistant commissioner who will oversee all state-supported living center operations.
Enhances abuse and neglect investigations by notifying and including the Health and Human Services’ Office of the Inspector General in criminal investigations.
Creates a hotline number that is linked to the SSLC Ombudsman’s office to report allegations of misconduct.
Requires video surveillance cameras in all common areas to prevent, deter and detect abuse and neglect.
Requires FBI fingerprint background checks and random drug-testing on employees.
Increases penalties for employees who abuse or neglect residents, or fail to report abuse or neglect.
Requires the Department of Aging and Disability Services to contract with an independent patient safety organization to conduct mortality assessments to determine if deaths could have been prevented.
Helps ensure that the facilities are in compliance with the recent U.S. Department of Justice settlement agreement.
Renames the state schools to SSLCs to more accurately depict the residential care services provided to residents.
Designates the Mexia State School as the forensic SSLC to house high-risk, court-committed residents.
Source:Source: Governor’s office