Failing Darla

Texas Monthly July (link here)


When you live here long enough, you become inured to certain things that might otherwise drive you crazy, like the fact that we rank, among all states, near or at the bottom of too many lists: dead last in health insurance coverage, forty-ninth for children living in poverty, well below average in the incarceration of nonviolent teenagers, and so on. So when the Legislature gets infatuated with a nonpressing issue—this session it was voter ID—instead of trying to improve dire situations that have persisted for decades, the public response isn’t outrage but a collective shrug. It’s our way to embrace the bright side of the Texas myth (independence, individualism) while ignoring the dark side, which leaves the less fortunate to fend for themselves. Some of these evils have been with us for so long that we’ve come to believe they’re intractable, even though other states have proved they aren’t. And when outsiders say we’re backward in our nonapproach to social ills—what else would you expect from Texas?—the historic response is to circle the wagons in collective defensiveness.
Those were the kinds of thoughts running through my mind this spring when I happened to meet Darla Deese, who is fifty and “developmentally disabled” (the polite term for “mentally retarded”), at the precise moment, after decades of abuse and neglect, that the Legislature had budgeted $507 million for care of people like her. “It’s going to create a lot of opportunities for people . . . to stay in their homes or a community setting,” state representative John Zerwas, of Richmond, jubilantly told the Houston Chronicle. If only that were true. Of the 66,000 developmentally disabled Texans who have been waiting up to eight years for services in their communities—some trapped in institutions, some with families stressed to the max—a mere 7,000 will have their needs met. It is a measure of how bad things are (we rank forty-eighth in funding for the developmentally disabled) that some who fought for the increased appropriation and accompanying reforms are grateful for what they got.
In truth, most people do not care about the fate of the mentally retarded. Adults with developmental difficulties are children in grown-ups’ bodies, which means that they are expensive and time-consuming to care for. In Texas, they and their families have two choices: institutions, which, at best, serve as human warehouses, or community services, which are available to only a lucky few. “I believe waiting lists are immoral,” says state senator Judith Zaffirini, of Laredo, who has done more than any other legislator for the developmentally disabled. In general, the strategy of our state government has been to lurch from crisis to crisis—or lawsuit to lawsuit—while maintaining a dysfunctional system that is outdated, underfunded, and incomprehensibly bureaucratized.
The $507 million came about in response to a 2008 civil rights investigation of Texas’s thirteen state schools by the U.S. Department of Justice. The findings read like something out of a fifties horror movie: residents put in straitjackets, overly and improperly medicated with psychotropic drugs, and worse. “More than 800 employees across all 13 facilities have been suspended or fired for abusing facility residents since fiscal year 2004,” the report notes. “Over 200 of the facilities’ employees reportedly were fired in fiscal year 2007 alone for abuse, neglect or exploitation of residents . . .” Injurious falls went unnoticed, claims of rape unprosecuted. “The mortality rate for some of the facilities raises serious concerns regarding the quality of care that facility residents receive. In recent years, one of the facilities averaged two resident deaths per month.” It’s worth noting that the now infamous “fight club” scandal at the Corpus Christi State School, in which employees pitted residents against one another, occurred months after the feds released their report. In other words, at least one school investigated and found wanting was in no hurry to clean up its act.
This fact would come as no surprise to Darla and her sister and lifelong advocate, Esther Hobbs, who is sixty. The women now share a sun-drenched house in the Montrose section of Houston, where Esther runs a public relations business. New people sometimes make Darla nervous; she shook her head and was reluctant to make eye contact when Esther introduced us. Until a few years ago, she slept with one eye open and often threw her hands up in the air, as if warding off an attacker. “We don’t know what she’s been through,” Esther said of Darla’s 31 years in the state’s care.
Darla’s story is typical of many developmentally disabled Texans’. She was born in Beaumont, into a strict Southern Baptist family of modest means. Her father was a car salesman, her mother a homemaker. A beautiful girl with blue eyes and blond ringlets, she was the last of four children. Her mother had had a medical emergency when she was pregnant that resulted in a loss of oxygen to Darla’s brain. But her oldest sister was more than willing to take her on. “Darla was like my baby doll,” Esther told me. “From the time she was born she was my responsibility.” Even so, this was the late fifties and early sixties, when there was much shame and little hope associated with mental retardation. The family’s doctor urged that Darla be institutionalized, and her parents agreed. “I came home one day and she was gone,” Esther told me. “They didn’t talk about things then.” Darla had been sent to the Mexia State School. She was five.
Her decline there was as predictable as her interminable loneliness. She lost the ability to speak in anything but single words and almost always seemed afraid. When Esther came to visit with her parents, Darla leaped into her arms and wept wretchedly whenever it was time for her family to leave. Then, less than a year into Darla’s stay, her parents got a middle-of-the-night call from a state school worker. “I’ll probably lose my job over this,” she told them, “but your daughter doesn’t belong here.”
For the next year Darla lived at home and attended special-education classes at a Beaumont public school. Esther left home at eighteen and not long after discovered that her parents had moved her sister to the new state school, in Richmond, just south of Houston. Darla would spend the next thirty years there. Initially she lived in a dayroom with thirty or so girls, sleeping in a cubicle and sharing hard wooden chairs. “They had nothing to write on, nothing to read,” Esther said. Darla came home every other Sunday, on holidays, and on her birthday, but she was more like a wild animal, Esther remembers, than a human being. Often she had cuts and bruises; when Esther asked staff what had happened, they always said that Darla had fallen down. Who really knew? The turnover among her direct care staff was high; most worked for minimum wage and had little or no training. Around age twelve, with her parents’ assent, Darla had a hysterectomy; there was sexual activity at the school, they were told, and no one wanted her to get pregnant.
In 1991, when Darla was 32, she was moved to another part of the school. At that point, her female caretakers were replaced by men; even more worrisome to Esther was the fact that some prison inmates purported to be mentally retarded had been shipped to state schools in an effort to ease prison overcrowding. On visits Esther sometimes found her sister’s face smeared with makeup or bruised. Darla developed a fear of trees, which led Esther to suspect that she was being raped in the woods on school property. After Darla’s caseworker reported that she had been sexually abused, Esther complained repeatedly to the state school staff and to the Fort Bend County Sheriff’s Department, but to no avail. (This outcome is unsurprising in cases involving the developmentally disabled: Claims by them or on their behalf are routinely seen as lacking credibility, even though the Justice Department’s Office for Victims of Crime estimates that nearly 83 percent of developmentally disabled women will be sexually abused in their lifetime.) About a year later, Esther was called by a caseworker who reported that Darla had a human bite mark on her back. Esther went to the school looking for her, and she found her huddled in a corner, inconsolable and “beaten beyond recognition.” “She was the saddest person in the whole wide world,” Esther told me.
By the mid-nineties, Esther could no longer live with the situation; she persuaded her mother to allow her to become Darla’s guardian. By then, her own health was suffering—her skin itched as if it were on fire—and when her doctor diagnosed stress and asked about the possible causes, Esther told him about Darla. She remembers his response as if it were yesterday: “Everyone in the medical profession knows what they do to those kids. You need to go get your sister right now.” She did. “It was two years before she would let me hug her,” Esther told me.
If this were a movie, Darla’s life would have taken a dramatic turn for the better. That’s not what happened. She joined the proverbial waiting list to take advantage of government funds and services, but it was eight years before she got any. In the meantime, Esther put together a patchwork of private day care programs, some of which kept Darla no safer than she had been at the state school (a large bruise on Darla’s inner thigh was diagnosed as, yes, evidence of repeated sexual assault). For several years, out of desperation, Esther ran her own school, but she had to close when grants dried up.
It doesn’t have to be this way. Zaffirini and other advocates believe that $1 billion is needed to solve some of Texas’s worst problems, like inadequate training and low staff pay at state schools. More important, though, is the way money is allocated: Too much of it goes only to large, outdated, expensive institutions instead of smaller, cheaper-to-operate community-based programs, which many developmentally disabled people and their families prefer. (The Mexia State School, for instance, is the largest employer in town, a problem for any politician who wants to improve care but remain in office.) Overall, says Zaffirini, it will take a change in the popular will to create a system—from home care to institutions, with many alternatives along the way—that can help the developmentally disabled live decently and safely, earning money and contributing to society.
Until then, the waste of human potential, and human life, continues.

Truce in Mexia school battle

District, state feuded over care of kids with mental disabilities.
By Corrie MacLagganAMERICAN-STATESMAN STAFF Wednesday, June 17, 2009
Texas lawmakers seem to have found a resolution to a fight between a school district and state officials over the education of youths with mental disabilities.
The dispute centered on who was responsible for supervising dozens of residents of a state institution in Mexia who attend classes through the local school district. Mexia is about 40 miles east of Waco.
The superintendent of the Mexia Independent School District says that the students — many of whom live at the institution because they have been accused of crimes but were deemed not competent to stand trial — can be violent and pose a danger to teachers and students.
Superintendent Jason Ceyanes told lawmakers that the institution should provide staff to supervise the students, something the state did until this past school year. State officials countered that he was trying to avoid teaching the students and said that a written agreement between the school district and the state didn't require such supervision.
A provision in a new state law makes it clear that it's the school district's responsibility to supervise the students. And the Legislature provided money — $5,100 per student per year — for the district to hire behavior specialists to work with the alleged offenders.
The provision is part of a law that improves security and oversight of the 13 institutions previously known as state schools that are now called state supported living centers.
The legislation, signed into law by Gov. Rick Perry last week, came in response to an investigation by the U.S. Department of Justice that reported that the facilities failed to provide adequate care.
The provision satisfied the school district enough for it to drop its lawsuit against state officials.
"We're pleased," Ceyanes said. "Not only did this legislation provide us with the clarification we were seeking, but it also included funding to help us ... keep everyone safe."
Ceyanes said that the specialists will work with students to identify behavior issues and create a plan for addressing them.
"This is not just a person sitting in a room telling kids to be quiet if they start talking out of turn," Ceyanes said. "If you see a kid jump up and get upset, there are strategies to de-escalate that behavior before they actually hit someone."
Laura Albrecht, a spokeswoman for the Department of Aging and Disability Services, said that adding behavior specialists "will certainly be a plus for the students."
State Rep. Byron Cook, R-Corsicana, inserted the provision into the bill after sitting down with state and district officials.
"I'm confident this can work," Cook said. "I think there is a new spirit of cooperation."
The Mexia school district educates 88 residents of the Mexia State Supported Living Center, including 69 alleged offenders, Albrecht said. Both groups attend classes taught by Mexia district teachers, some on the living center's campus and others on a district campus.
The number of alleged offenders at the Mexia living center is likely to grow because under the new law, the center will be the home of certain alleged offenders from across the state.
cmaclaggan@statesman.com; 445-3548

Justice Department, state agree to improve conditions at mental facilities

Click here for link to original story

BY DAVE MONTGOMERY

dmontgomery@star-telegram.com

AUSTIN — The state has reached an agreement with the Justice Department to toughen safety standards at Texas’ residential facilities for the mentally disabled, concluding a four-year investigation of abuses and mistreatment.

"The settlement brings much-needed closure to a sad chapter in our state’s history," said state Sen. Jane Nelson, R-Flower Mound, chairwoman of the Senate Health and Human Services Committee.

"Abuse and neglect of our most vulnerable citizens must never be tolerated," she said.

Nelson, who is sponsoring legislation to improve oversight at the facilities, known as state schools, said the agreement includes independent monitors to inspect the state schools regularly; new standards for medical and psychological care; safeguards to detect and deter exploitation; and strengthened guidelines for employees’ treatment of inmates.

The improvements are expected to cost the state $112 million over the next five years. The price tag would include $51.2 million that the Legislature would have to add to the state budget for the 2010-11 biennium.

Focus on state agency

A Justice Department report presented to Gov. Rick Perry in December said residents are often victims of abuse, neglect and inadequate medical treatment. At least 53 residents died within the past year because of lapses in healthcare, the report concluded.

The investigation centered on the Texas Department of Aging and Disability Services, which operates 13 large facilities, including one in Denton that houses nearly 5,000 residents.

On Tuesday, the state House, acting on a resolution by Rep. Lon Burnam, D-Fort Worth, voted to permit the family of a resident at the Denton school to sue the state for injuries received nearly seven years ago. Haseeb Chishty was left paralyzed and unable to eat on his own, the family said.

In a letter to Nelson on Wednesday, Deputy Texas Attorney General David S. Morales confirmed that the Justice Department had agreed to a "statewide settlement" stemming from its investigation.

Justice Department and state officials also agreed to file documents in U.S. District Court in Travis County to make the agreement legally binding.

The agreement resulted from discussions between the Justice Department, Perry’s office, the Texas attorney general and Aging and Disability Services officials, according to the letter.

'Emergency’ status

Nelson said she will file a resolution today approving the points of the settlement. Her Senate committee and the House Human Services Committee will meet jointly Friday to review the agreement.

Perry gave Nelson’s Senate Bill 643 "emergency" status at the outset of the legislative session to expedite passage. It was the first bill to pass the Senate; the House approved it Tuesday.

A key element of the bill would create a govern-appointed ombudsman to audit the facilities biannually and be a confidential intermediary for parents, clients and guardians.

The bill would also create a hot line for reporting abuse, neglect and misconduct; mandate surveillance cameras in common areas; and require drug tests, fingerprinting and background checks on employees. Investigations uncovered employees who had criminal records.

The settlement brings much-needed closure to a sad chapter in our state’s history."

State Sen. Jane Nelson
R-Flower Mound

DAVE MONTGOMERY, 512-476-4294

Agreement reached to improve state schools for mentally disabled

07:46 PM CDT on Wednesday, May 20, 2009

By EMILY RAMSHAW / The Dallas Morning News

AUSTIN — The state has reached an agreement with the U.S. Justice Department to improve conditions inside Texas’ state schools for the mentally disabled. Under the agreement, Texas must spend $112 million more over five years to improve standards of care, increase monitoring and oversight, and enhance staffing ratios at the facilities.

Lawmakers will reveal the details in a Friday morning hearing with the commissioner of the agency that oversees the schools and the state’s lead negotiator in the deal. Both the House and Senate must pass resolutions concurring with the deal before their session ends June 1.

The agreement calls for spending nearly $45 million in the next two years. If the money is spent and conditions improve, the oversight would be lifted in five years.

“Whether or not the Department of Justice told us this, we needed to be doing these things,” said Sen. Jane Nelson, R-Flower Mound. “We are hoping and expecting these facilities will very quickly get up to standard.”

Nelson leads the Senate committee overseeing the state Health and Human services Commission. Her panel will hold a joint hearing with its House counterpart, led by Rep. Patrick Rose, D-Dripping Springs, Friday to outline the deal.

The agreement follows a federal investigation last year that found widespread civil-rights violations across all 13 state institutions and years of media reports about abuse and neglect inside the facilities.

Throw 'em all into Mexia

What horrors await these people merely accused of crimes?  Isn't Presumption of Innocence a legal right?  

House bill would move all state school residents accused of a crime to Mexia State School

By Cindy V. Culp Tribune-Herald staff writer

Tuesday, May 19, 2009

The Mexia State School and its relationship with the surrounding community soon would undergo decisive change if a bill adopted by the Texas House of Representatives on Monday becomes law.

The legislation would designate the facility — a home for people with mental retardation — as the state’s forensic institution for people with developmental disabilities. That means all state school residents accused of a crime would be sent to Mexia, at least initially, instead of being scattered throughout Texas’ 13 state schools.

That virtually eliminates the chance the Mexia State School ever would close, officials said.

The move also would affect the Mexia Independent School District, the town’s public school system.

The district has been locked in a dispute with the state over the education of students from the institution who have been accused of a crime. The Mexia facility already houses the majority of forensic juveniles in the state school system, with the district serving about 90 such students this year.

Mexia ISD has contended that the state is responsible for providing extra personnel to make sure those students do not endanger other students and staff. The state, however, has said the district is responsible for them during the school day.

The bill would end that tension by giving the district $5,100 per alleged offender student each year. The district would be required to use that money to hire “behavior support specialists” who would attend to the students’ noneducational needs.

That part of the bill was added by Rep. Byron Cook, R-Corsicana, who represents Limestone County. Other key parts of the legislation call for an independent ombudsmen to monitor the 13 state schools, for video cameras to be installed in common areas for security purposes and for staff training to be improved.

“Countless hours and hard work were spent to pass legislation that significantly improves the system of care for individuals with disabilities living in state schools as well as in the community,” Cook said Monday in a written statement.

The future of state schools has been uncertain for months. Some advocates for people with disabilities have urged lawmakers to close or consolidate the institutions. Those efforts failed this session, but the issue is sure to resurface.

In Mexia, the unfolding drama has had another layer due to the tension between the state school and the school district. The problems started at the beginning of the school year, when the state school stopped sending staff along with alleged offender students who attend class on district property.

That alarmed district personnel, who said many of the students have been accused of serious crimes such as sexual assault and aggravated assault. The charges have not been prosecuted or dropped because a judge ruled the youth’s mental retardation makes them incapable of adequately assisting in their own defense. The same is true for adult state school residents who have been accused of a crime.

As a short-term fix, the district hired a police officer to help watch the forensic students. It also filed a lawsuit against the state, asking that the state school either be required to send staff with students or provide enough classroom space at the institution so all forensic students can attend classes there.

District Superintendent Jason Ceyanes was attending a school board meeting Monday evening and could not be reached for comment about the House bill. However, it appears to address the district’s most pressing concerns. Ceyanes has said in the past that the district would be satisfied if the state gave it extra money to hire extra personnel to supervise alleged offender students.

Laura Albrecht, a spokeswoman for the Texas Department of Aging and Disability Services, which oversees state schools, said she had not seen Cook’s amendment to the bill and could not comment on it.

A version of the legislation already has been passed by the Senate. The bill as amended now will go back to the Senate for consideration.

If Mexia becomes the designated state school for forensic residents, it would continue to house regular residents, but in separate facilities. However, those regular residents could ask to move to another state school campus.

Forensic residents would undergo an evaluation at the Mexia campus to determine whether they are at a “high risk” of causing substantial physical harm to someone else. Alleged offenders determined not to be high-risk could petition to be moved to another state school.

The number of forensic residents living at other state schools was unclear Monday.

Cox News Service contributed to this story.

cculp@wacotrib.com

757-5744

Report: Few state school abuse cases confirmed

Officials say memory problems, communication skills of residents can make it hard to prove reports.

ASSOCIATED PRESS
Monday, May 18, 2009

HOUSTON — Only a fraction of complaints about treatment of residents with mental disabilities in the troubled Texas state school system have been confirmed as abuse, according to a newspaper analysis.

About 4 percent of 2,814 state school abuse cases flagged by Texas Adult Protective Services as possible crimes in fiscal years 2005 through 2008 were eventually proved, the Houston Chronicle reported Sunday.

Officials say few cases are proved because of memory problems and diminished communication skills among residents.

The newspaper based its report on data obtained two months after cell phone images revealed staffers at Corpus Christi State School organizing fights between residents. Six former employees were indicted in connection with the fights.

For two years, conditions within the state schools have been the focus of federal investigators who have criticized the system's deadly lapses in health care and civil rights abuses. The state and the Justice Department recently agreed to boost staffing and improve medical care at 11 state schools and two residential centers for people with mental disabilities.

The law requires workers to investigate every bruise or abnormality found on a resident if abuse or neglect is suspected. But making a criminal case is difficult, authorities say, because victims with mental disabilities are tough to interview.

"We get a ton or referrals that don't end up in the criminal courts because there is not enough to go with, or are unfounded," said Limestone County Sheriff Dennis Wilson, whose office investigates the Mexia State School and its state-leading 857 abuse cases over the past three years.

Only about 12 percent of the Mexia cases were confirmed as abuse by Adult Protective Services workers. Since they are using a legal standard lower than what is required for criminal cases, few of the 105 cases they referred went further.

The state schools in Mexia, San Angelo and Corpus Christi, the three with the largest number of referrals to police, also house the majority of residents with mental disabilities accused of crimes. The Mexia residents are generally younger and more active and thus more likely to get hurt by accident.

The facility with the fewest police cases, the Richmond State School with 21, houses mostly residents with severe mental disabilities. None of the 21 referred to police were confirmed.

Although the makeup of the residents plays a role, Richmond Superintendent Al Barrera credited a staff that has experienced little turnover.

"We have the most tenured staff in the system," he said.