Texas 82nd Legislative Session

Legislative Recommendations for Long Term Care Reform

1. Direct the Health and Human Services Commission to develop a long range plan to re-balance long term care services for Texans with Disabilities. This plan should include the following components:
1. Develop a diversely represented Task Force to guide plan development.
2. Close and consolidate State Supportive Living Centers (SSLC) as the population decreases. The closure process must include the choices of those choosing to remain in these facilities and ensure those who wish to leave have every opportunity to do so.
3. Ensure supports and services for people living in the community are available, exceptional and accountable.
4. People transitioning from SSLC’s to community settings should develop a Person Directed Plan to ensure the successful transition in order to meet individual needs.
5. Money Follow the Person protocols utilized for people with disabilities exiting nursing homes and private ICF-MR facilities should be incorporated to support people exiting SSLCs.
6. Designate all funding saved through consolidation and closure of SSLCs to fund people with disabilities on Waiting Lists for community services and supports.
2. Consolidate Medicaid Waivers into a system that determines services based on needs generated through Person Centered Planning.
3. Expand Consumer Directed Services (CDS) options to all waiver services and ensure information on how to access these services is readily available and accessible.
4. Personal Care Attendants and other Direct Support Professionals must be paid a living wage of plus appropriate benefits.

Contact David Wittie at 512-512-577-8982 or Cindi Paschall at 817-281-6730 for more information

OR

Email: communitynowfreedom@gmail.com

State Abuse

Despite reforms, abuse in state institutions remains high.

Link to Texas Observer story

by DAVE MANN

Published on: Monday, April 19, 2010

Despite reforms by state lawmakers, abuse and neglect of Texans with mental retardation in state-run institutions has increased the past three years, according to an Observer analysis of state data. Reforms enacted in response to a high-profile abuse scandal have left the facilities with fewer residents and more staff, yet confirmed allegations of abuse rose 57 percent between 2007 and 2009. However, the number of abuse cases has dropped slightly so far in 2010, indicating that perhaps the latest reforms are having some effect.

For the past four years, Texas’ 13 sprawling, state-run institutions for the mentally retarded—formerly known as State Schools and which the Legislature recently renamed State Supported Living Centers—have been the source of horrific tales of abuse. Since 2005, investigations by the U.S. Department of Justice and numerous media outlets, including theObserver (see “Systemic Neglect,” May 1, 2008), have documented hundreds of instances in which Texans with mental retardation were beaten, neglected and, in some instances, killed by the staff charged with caring for them. In the most famous incident, workers at the Corpus Christi State School recorded a “fight club” video in which mentally disabled residents were forced to beat each other.

The abuse scandal was rooted in years of under-funding by the Legislature. Low pay and astronomical staff turnover, which ran as high as 70 percent in some facilities, led the institutions to hire low-grade employees—and in a few instances convicted felons—who never should have been caring for vulnerable, and often volatile, residents.

Despite reforms passed in the past two legislative sessions—including a 12-percent funding increase and nearly 3,000 additional caregivers—the number of abuse and neglect cases remains high.

Confirmed cases of abuse in State Supported Living Centers rose 57 percent between 2007 and 2009, according to an Observer analysis of state data, from 458 incidents in 2007 to 719 last year.

In the first six months of fiscal year 2010, which began in September, confirmed cases of abuse and neglect have dipped by 19 percent. State Supported Living Centers are on pace to report 580 cases of abuse in 2010, which while lower than 2007’s peak, is still historically high.

The facilities are now closely monitored by Justice Department inspectors, and some reforms have already had an effect. In the past six months, State Supported Living Centers have added more than 1,000 full-time employees, according to state records. And the facilities have fewer residents, as state officials transfer more disabled Texans into small, community group homes. State Supported Living Centers now employ nearly 13,000 workers to care for about 4,000 residents.

While the slight decrease in abuse cases so far in 2010 is encouraging, the Legislature’s refusal to give State Living Center employees a pay increase may hamper reform.

State Supported Living Center workers are on average the lowest-paid state employees, according to the Texas State Employees Union. Direct care workers earn a starting salary of roughly $8 an hour. Parents and families of residents have often blamed abuse and neglect partly on low pay.

It’s worth noting that confirmed cases of severe physical and sexual abuse have remained fairly constant the past three years, according to state data. But there’s been a sharp increase in confirmed incidents of “neglect,” which don’t involve physical violence by the staff, but usually consist of incompetent oversight of residents: allowing residents to fall from bed or leave the facility or harm themselves and others. In other words, the kinds of incidents you would expect from a staff that’s largely earning fast-food wages.

When asked if low salaries contributed to the increase in neglect, Cecilia Fedorov—a spokesperson with the Department of Aging and Disability Services, the state that oversees State Living Centers—said, “I don’t believe there’s ever an excuse for abuse, neglect or exploitation.” She added that salaries at state institutions are a “legislative question,” and not up to the agency.

The agency did ask the Legislature for a salary increase last session for State Living Center workers, and lawmakers denied the request.

Without a pay increase for direct care workers, it’s questionable whether the recent decline in abuse numbers will continue and whether Texas’ institutions for the mentally disabled can be adequately reformed.

Download abuse statistics for State Supported Living Centers in 2008 at www.txlo.com/ssabuse08

Download abuse statistics for State Supported Living Centers in 2009 at www.txlo.com/ssabuse09

Download abuse statistics for State Supported Living Centers in 2010 at www.txlo.com/ssabuse10

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

The Buck Stops Where?

by Emily Ramshaw
February 24, 2010

The attack ad could write itself: On Gov. Rick Perry’s watch, Texas weathered a sexual abuse scandal at the Texas Youth Commission, fight clubs at state institutions for the disabled and deaths of kids monitored by Child Protective Services.

But three of the biggest messes of Perry’s 10-year tenure — two of which spurred U.S. Justice Department investigations — have been noticeably absent on the campaign trail. While U.S. Sen. Kay Bailey Hutchison, Perry’s chief Republican primary opponent, has hit the airwaves on toll roads, immigration and education, she has largely steered clear of these high-profile social services debacles.

Perry spokesman Mark Miner says the agency crises haven’t been campaign issues because the governor did such an effective job managing them. “With CPS, the state schools, the TYC, those are issues the governor has provided leadership on,” Miner says. “When there were problems, he took immediate action.”

Critics say that’s untrue: Concerns about abuse, neglect and poor living conditions had been raised for years before the scandals erupted. Political consultants say Hutchison’s decision not to target those issues has more to do with what she thinks resonates with typical primary voters — and what doesn’t. “The fight clubs, the problems at the TYC — those are horrific things,” says Hutchison campaign manager Terry Sullivan. “But what we’re really trying to focus on are the issues that affect everyday Texans: eminent domain, land grabs, cronyism.”

The blame game

Years of poor staffing and overwhelming caseloads at Texas Child Protective Services finally came to a head in 2004, when children the state was supposed to be monitoring were killed by abusive parents.

Three years later, reports surfaced that administrators at a West Texas juvenile justice lock-up were sexually abusing boys in their care, and a sweeping inquiry turned up widespread sexual and physical abuse throughout the state's youth prisons.

And in 2009, investigators learned that employees at a Corpus Christi state institution were forcing disabled residents into a fighting ring, revelations that uncovered more abusive conditions at other facilities.

In each of these cases, watchdogs had been making noise for years — well before Perry was in office. They sent letters to the governor's staff, to lawmakers and to agency commissioners, and showed up to testify at public hearings. When the headline-making scandals broke, Perry took action: making urgent legislative priorities of the crises, allocating emergency dollars or dispatching his top troubleshooter to the agency.

So is it fair to pin the scandals on the chief executive? Some say yes: The buck always stops with the governor. Others say no: Nothing he could have done would have prevented these tragedies. Still others say he shares the blame with agency heads, state lawmakers and the rest of Texas' elected officials. Texas Tribune pollster and University of Texas government professorDaron Shaw says the reality is that these issues only work, politically speaking, when the incumbent can be definitively blamed for them. Shaw says voters tend to hold mayors, city council members, even state representatives accountable — but that at higher levels of government, the blame gets spread around. “Texas is so disaggregated that most people don’t hold Perry responsible for something like CPS,” he says.

Some political consultants say quietly that the truth is that primary voters simply aren’t interested in another agency sob story. They don't relate; only a tiny fraction of voters have kids in TYC lock-ups or relatives in state institutions. Other political operatives say that in order to hit Perry on these agency issues, Hutchison would have to have her own solutions. Solutions cost money, and increased spending doesn’t sit well with tight-belted Republican primary voters.

But Democratic consultant Harold Cook says that across the board, voters care about anything involving children — and anything involving government dysfunction. “In any poll, in any demographic, everybody’s going to care deeply about children,” he says. “I know [these issues] would work with general election voters and would undoubtedly work with some subset of primary voters.”

The one big social issue Hutchison has homed in on is Perry’s support for mandatory HPV vaccines for adolescent girls, but that issue is far more politically charged than the TYC or the state schools. Hutchison was silent on the Cameron Todd Willingham death penalty case, which looked to some like a high-profile fumble for Perry but would have jeopardized Hutchison’s already fragile relationship with Texas voters, who overwhelming favor the death penalty.

The social services failings might have worked for Hutchison's camp if they’d been woven into a compelling narrative, Shaw says, one that painted Perry as incompetent. Instead, he says, Hutchison has settled on the “Perry as corrupt” approach, though he says the campaign is struggling with that message, too. “They’ve found their voice some, with this idea of Perry putting insiders in office, making special deals,” Shaw says. “But it’s a bit of a reach. And there’s a sense of, ‘He’s been governor for nine years, and this is the best stuff you can come up with?’”

Another story about the atrocities at Lubbock SS

Local News
082209 LOCAL NEWS 1 AVALANCHE-JOURNAL
The mother of a man who died at the Lubbock State School this summer said reports show her son, whose death was ruled a homicide Friday, was "body slammed" against a wall and "choked until he turned blue."
State school death a homicide
By Sarah Nightingale and Robin Pyle AVALANCHE-JOURNAL
Saturday, August 22, 2009Story last updated at 8/22/2009 - 1:52 am
The mother of a man who died at the Lubbock State School this summer said reports show her son, whose death was ruled a homicide Friday, was "body slammed" against a wall and "choked until he turned blue."
Lilly Nicholson also said the report indicated an employee restrained her son by "sitting on him."
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Lubbock County Medical Examiner Sridhar Natarajan ruled Michael Ray Nicholson's death a homicide Friday morning, noting his cause of death as physical altercation with asphyxia.
Nicholson, 45, died at the state school on June 6 while in the care of six employees, who have since been fired.
"Since the death occurred during a physical altercation between individuals the manner of death is classified as a homicide," the autopsy report reads.
Charges have not yet been filed in the homicide. Capt. Greg Stevens said police officials presented on Friday morning a manslaughter case to the Lubbock County Criminal District Attorney's Office. Employees of the office will decide if any charges will be filed.
No suspects have been named.
The mother said she hoped authorities would prosecute those involved.
"This was a senseless thing," Nicholson said. "There was nothing else wrong with Michael. He was murdered."
Just before death
Lilly Nicholson said state reports show her son died while staff struggled to undress him.
The family has received numerous reports they requested from the Lubbock State School - now officially named the Lubbock State Supported Living Center - and the state agencies that oversee the school.
An Avalanche-Journal request to view the documents was recently declined by the Lubbock Department of Disability and Aging Services (DADS) and is awaiting a final decision from the Attorney General's office.
Nicholson said her son - who suffered from Obsessive Compulsive Disorder in relation to the clothes he wore - refused to dress on June 6 while "his one set of clothes" was being washed. Because of the condition, he was "allowed to be naked in his room," she said.
"They did dress him, but they killed him in the process," she said.
Michael Nicholson had a history of psychiatric and behavioral problems with episodes of combative behavior, according to the medical examiner's report.
Nicholson described her son Friday as someone who "did not know how to fight and never seriously injured anyone in his entire life."
"He could be obstinate, contrary, and frustrating when he could not communicate his needs and desires," she said.
Nicholson, who kept her son at home for 15 years, said he "had no physical problems (but) required constant care to keep him safe and healthy."
"He was in special ed classes from the time he was 5 years old, but never was able to advance. He was non-verbal," she said, adding, "he was a joy to us. He was truly innocent and loved the beautiful things in life. He loved to dance, sing and watch cowboy movies."
Nicholson said staff at the school "got carried away."
"If they hadn't done what they did, Michael would be alive today," she said.
According to the medical examiner report, Nicholson was partially on a bed and positioned for a period of time during which his head and neck were abnormally stretched. He was on a mattress with an individual lying over a portion of his upper torso.
He then became unresponsive, the report reads.
Natarajan said there were multiple areas of bruising, abrasions and lacerations on Nicholson's body, though none of those injuries were fatal. The medical examiner also found multiple areas of old bruising on the body.
Most concerning to Nicholson was evidence in the state reports that now dismissed school employee Donnell Smith restrained her son by "laying on him six or seven times."
A-J attempts to reach Smith were unsuccessful. His number is not listed in the phone book, and other numbers The A-J obtained for him were disconnected or went unanswered.
Nicholson said neurosurgeon Dr. Patrick Cindrich had told staff Nicholson was "not to be restrained, period," because of the potential it would cause detriment to a healed broken neck he suffered earlier. The man's neck was broken at the school, his mother said.
A 2006 Department of Justice report investigating practices at the school prohibited the use of manual restraints on school residents.
A report from a division of the Texas Department of Family and Protective Services noted Smith didn't believe he had restrained him because he laid on him, rather than restraining his arms, Nicholson said.
The report, Nicholson said, documents Smith stating he "wasn't going to put up with any of Mike's nonsense."
She said Smith was "agitating" Nicholson by "mocking him and making fun of him" and that after realizing her son was not breathing it was "too long before CPR was performed."
Three other staff, she said, were present in the room while Smith restrained Nicholson, causing him to "turn blue and stop breathing."
"No-one came to his aid," she said.
Investigations
Six state school employees - Smith, Jessica Santos, Abrisha Henderson, Amiya Harper, Craig Stevenson and Omar Jordan - were fired from the school after the incident.
The firings were made when a Texas Department of Family and Protective Services investigation confirmed their involvement in the physical abuse and neglect of Nicholson.
"The department has a zero tolerance policy regarding abuse and neglect of the residents in our care," said Laura Albrecht, spokeswoman for the Texas Department of Aging and Disability.
"We believe we took swift actions when we received those confirmations (of abuse and neglect) from adult protective services."
The employees had been with the Lubbock State School from about six months to three years, Albrecht said.
None of them were listed in the Lubbock phone book, and The A-J wasn't able to reach Santos, Henderson or Stevenson through numbers obtained elsewhere.
The Lubbock State School houses approximately 300 people with the diagnosis of mental retardation. The 24-hour residential facility, located at 3401 N. University Ave., sits on a 226-acres site about three miles north of the city.
The school and others in the state have been under scrutiny by legislators and government officials for years.
In 2008, nearly 270 employees were fired or suspended for abusing or neglecting residents in the state schools, records published earlier this year show.
In June, just days before Nicholson's death, Gov. Rick Perry signed legislation aimed at improving security and oversight at the facilities.
To comment on this story:
sarah.nightingale@lubbockonline.com l 766-8796
robin.pyle@lubbockonline.com l 766-8742
shelly.gonzales@lubbockonline.com l 766-8747

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

268 punished for abusing disabled in Texas

Link to article

By JEFF CARLTON – 9 minutes ago

DALLAS (AP) — Nearly 270 employees were fired or suspended for abusing or neglecting residents of large, state-run institutions for the mentally disabled in Texas, according to records obtained by The Associated Press.

The revelations Friday come a day after Gov. Rick Perry signed legislation aimed at improving security and oversight at the 13 institutions, known as state schools. They are home to about 4,600 residents and more than 12,000 full-time employees.

Documents obtained by the AP through an open records request show that 11 of the 268 firings or suspensions were considered serious because they involved physical or sexual abuse that caused or may have caused serious physical injury. Employees may also be fired for a violation as mild as neglecting to protect a resident with mobility problems from stumbling into a wall.

"I think what the number of firings and suspensions say is we do not tolerate abuse or neglect in our state schools," said Cecilia Fedorov, a spokeswoman with the Department of Aging and Disability Services, which oversees the schools.

It was not clear Friday whether any of those fired were prosecuted.

The Department of Family and Protective Services, which investigates allegations of abuse, notifies law enforcement officials about any deaths, alleged sexual assaults, serious physical injuries or incidents involving children. But the agency does not track what happens once police or sheriff's deputies get involved, spokesman Patrick Crimmins said.

The Coalition of Texans with Disabilities said Perry's legislation doesn't go far enough to protect state school residents.

"Why is it that residents in state schools are somehow valued less than other citizens?" asked Dennis Borel, the coalition's executive director. "This speaks to me of a widespread, systemic problem, and personally I don't believe this can be fixed."

Defenders of the state schools include the Parent Association for the Retarded of Texas. Susan Payne, the organization's vice president, said her 47-year-old sister, Dianne, has been well served in the 37 years she has lived in state schools.

"The medical care is unbelievable. She is alive because of the schools," Payne said. "These numbers and these reports make the places sound like hellholes, and that is just not what we see."

Perry declared state school reform a legislative emergency during the most recent session. State lawmakers reached a five-year, $112 million settlement with the Justice Department that documented widespread mistreatment of residents and alleged their civil rights were violated. The state will spend $24 million in each of the next two fiscal years to meet the terms of the settlement, which call for each school to have an independent monitor.

Lawmakers also have provided funding for hiring nearly 3,000 additional employees.

The agreement resulted from a series of federal investigations that found that at least 53 deaths from September 2007 to September 2008 were from conditions the Department of Justice considered preventable, such as pneumonia, bowel obstructions or sepsis, indicating lapses in proper care.

Nearly 1,100 employees have been suspended or fired in the last five years for mistreating, neglecting or abusing residents, according to state records. The 2008 figures are the most in any of those five years.

Copyright © 2009 The Associated Press. All rights reserved.

Perry signs bill overhauling state schools

(link)

hmmm. Look at all that money...

AN OVERHAUL FOR STATE SCHOOLS

Gov. Rick Perry approved new protections and more money for state schools residents.

$48 million: Cost of emergency package to generally improve the schools

$418 million: Cost of community living options for residents

$112 million: Cost of improvements required by the Justice Department.

By JANET ELLIOTT and TERRI LANGFORD Copyright 2009 Houston Chronicle Austin Bureau

June 11, 2009, 9:03PM

ov. Rick Perry signed legislation Thursday meant to overhaul Texas’ troubled state schools, where dozens of individuals with mental disabilities have died preventable deaths or been the victims of abuse over the last several years.

“Our current system had some serious shortcomings. They were exposed,” said Perry, who had declared improvements for the state schools an emergency issue for lawmakers this past session.

As families and supporters of the 13-facility system watched, Perry printed his signature with his left hand. His right arm was in a sling because of a broken collarbone suffered in a bicycle fall Tuesday night.

The $48 million bill is the Legislature’s response to a federal investigation that found deadly lapses in health care and widespread abuse and neglect. It also renames the state school system. They will now be called “state-supported living centers” to reflect that the vast majority of residents are adults.

New protections include video surveillance in common areas, an effort to eliminate problems such as the fights between residents at Corpus Christi State School that police say staffers organized.

Employees will face enhanced criminal background checks, random drug testing and receive more on-the-job training. An Office of Independent Ombudsman will protect client rights. The law also creates state investigations of abuse and neglect complaints involving residents living in privately run facilities.

Community living options

Perry previously signed off on a settlement reached with the U.S. Department of Justice in its investigation of abuse and neglect at the facilities. That $112 million pact will add 1,160 new employees, many of whom will be direct care workers, as well as people who will monitor conditions at the facilities.

The settlement and the reform legislation together represent new spending of about $150 million over the next two years. Additionally, the state is spending $418 million in the next two years to create community living options, such as group homes or home-assisted care, for Texans with physical and mental disabilities.

About 8,000 people, including some now living in state schools, are expected to be able to live in less restrictive settings.

“Whether these Texans live in a state facility or in therapeutic community settings, we are obligated by basic human decency to provide them with a safe setting in which to live, learn and grow,” Perry said.

The governor praised conscientious state school employees, who “deal with daily challenges that most of us couldn’t imagine.” But he said that “bad actors” will be prosecuted; the new law increases penalties for employees who harm residents or fail to report abuse or neglect.

Recent problems

In December, the Justice Department announced that 53 of the 114 deaths of state school residents over a one-year period could have been prevented. The department also determined that restraints were used too often — some 10,143 times on 751 residents during the first nine months of 2008 alone.

Also documented: Some 200 staff members were fired in one 12-month period. Also, despite plans to move more residents out of the state schools, only 164 residents were placed in a community-based care facility in a 12-month period.

In March, video images allegedly showed Corpus Christi State School staff members forcing mentally disabled residents into fights for entertainment.

But critics who claim the state school system is outmoded say the settlement is deja vu all over again.

“We’re back,” complained Beth Mitchell, managing attorney for Advocacy Inc., a nonprofit group that works to protect the legal rights of disabled Texans. “It’s all the same stuff.”

Mitchell was referring to a series of pacts that ended a 1974 lawsuit that charged — like the recent Justice Department report did — that conditions within the system were not acceptable.

Monitors were called, better reporting of abuse was requested, she said, and now it seems the state is back where it was in the 1990s, when the suit was settled for the third time.

Critic says law is vague

Mitchell said the new pact is too vague in pinpointing exact timetables and plans for moving residents into the community. Also, the settlement is light on what type of qualifications the monitors should possess.

“There are no benchmarks or standards for what the monitors are supposed to follow to make sure the state schools have adequate treatment,” Mitchell said.

Mitchell also pointed to the fact that it does nothing to remedy the retention problems state schools have with its direct care staff, who guide residents in their daily activities.

In the past two years, 376 state school workers were fired for abuse and neglect, and 70 percent of those workers were entry-level aides, whose starting salary is about $20,000 a year.

Lawmakers did not approve a proposed pay raise for these staffers.

janet.elliott@chron.com

terri.langford@chron.com