Report: State facility for people with disabilities lacks psychiatrists, trained therapists

Report: State facility for people with disabilities lacks psychiatrists, trained therapists

Posted using ShareThis

By Corrie MacLaggan

AMERICAN-STATESMAN STAFF

Published: 8:54 p.m. Friday, March 19, 2010

Nine months after Texas and the U.S. Department of Justice entered into a settlement to improve health care and more quickly investigate reports of abuse and neglect at state institutions for people with mental disabilities, the facility in Corpus Christi doesn't have staff psychiatrists, has therapists who are ill-equipped to work with people with complex needs and doesn't have a clear zero-tolerance policy for abuse and neglect.

That's according to a new report on the Corpus Christi State Supported Living Center, the first issued by monitors reviewing the 13 institutions as part of the settlement. On Tuesday, the state House Committee on Human Services is set to examine progress at the facilities.

"The state-supported living centers, specifically Corpus Christi, are overwhelmed in meeting their responsibilities for caring for people with intellectual disabilities," said state Rep. Abel Herrero , D-Robstown , who is vice chairman of the committee and whose district includes the Corpus Christi facility.

The report says that the culture appears to be changing for the better at Corpus Christi, where last year staff members were found to have been organizing fights among residents. Staff members seemed to know to report suspected abuse and neglect immediately, and when asked how, they consistently flipped over their badges to show a sticker with instructions. And residents "appeared happily engaged" in activities, the report said.

But it also said that people who might benefit from alternative communication devices don't have access to them, and that residents are over-prescribed psychotropic drugs.

"We agree that there are many areas of concern, many areas in which we need to make changes and improvements," said Cecilia Fedorov , a spokeswoman for the Department of Aging and Disability Services .

The preliminary report about Corpus Christi — reports on the other institutions are expected by summer — isn't evaluating whether the facility is adhering to the settlement terms. That comes later, and the monitors will review each facility every six months until it has been in compliance for a year — a process Fedorov said could take five years or more.

The settlement is the culmination of a Justice Department investigation that began in 2005 at the Lubbock State School after reports of abuse and neglect and later expanded to the other facilities.

In addition to the changes required by the settlement, the Legislature last year mandated video cameras in common areas (they're in place in Corpus Christi but not yet elsewhere); random drug testing of the 12,500 employees (16 have been fired for testing positive, and seven resigned instead of getting tested); and fingerprint background checks for employees and volunteers (these are taking place, officials said).

"Although there are encouraging signs of progress, we still have a long way to go in making the system the best it can be for this vulnerable population," said state Sen. Jane Nelson, R-Flower Mound, chairwoman of the Health and Human Services Committee and author of reform legislation.

In the report on Corpus Christi, the monitors noted that the limited availability of psychiatry services — there are two part-time consulting psychiatrists but no full-time staffers — "appears to have a negative impact on the delivery of services."

Fedorov said that the department is "aggressively recruiting" to find two staff psychiatrists. "We, like everybody who does deal with behavioral health, are competing for very few licensed and qualified psychiatrists," she said.

On the drug issue, the report gave an example of a resident whose behavior deteriorated after his mother's death. He threw temper tantrums, destroyed property and manipulated staff members.

Instead of a behavior management program, "the psychiatrist is prescribing potentially hazardous and dubiously effective drugs to stop the behaviors," the report said.

Beth Mitchell, managing attorney of Advocacy Inc., which advocates for Texans with disabilities, said the communication aid issue raised in the report shows how far behind the centers are in providing adequate care.

"Communication is often the reason people have behavior problems," she said. "If you can't communicate, you act out."

Mitchell also said she's worried about the lack of a clear zero-tolerance policy. "This is a place where people were being beat up, and you don't have zero tolerance?" she said.

Fedorov said that the department does not tolerate abuse and neglect, but that "we need to take steps to make sure that the policy is even more clear to everybody who comes on campus."

As part of a new legislative requirement, Gov. Rick Perry in February appointed an ombudsman for state supported living centers. George Bithos , a dentist and ordained Greek Orthodox deacon, has been visiting campuses since starting the job.

"I have found very dedicated people and people that are open to being looked at," Bithos said. "I've been impressed with the quality of the people, yet I'm aware that there are problems \u2026 that we'll need to take very seriously."

cmaclaggan@statesman.com; 445-3548