Sunday, February 28, 2010

Supreme Court lets nursing home ruling stand: Facilities fair game for civil rights suits - McKnight's Long Term Care News

Supreme Court lets nursing home ruling stand: Facilities fair game for civil rights suits - McKnight's Long Term Care News

A federal appeals court decision in a case involving a skilled nursing facility—a decision once described as “shocking” by the American Health Care Association—has been allowed to stand by the U.S. Supreme Court.

In the case of John J. Kane Regional Centers-Glen Hazel v. Grammer (see McKnight's, 7/7/09), the U.S. Court of Appeals for the Third Circuit ruled that the Federal Nursing Home Reform Amendments (FNHRA) guarantee a nursing home resident's civil rights. As such, a private civil rights lawsuit can be brought against a facility on behalf of a resident in the event of inadequate care and wrongful death. At the time of the decision, an AHCA legal representative decried the ruling, noting that the FNHRA had never been used to allow such a private right of action since their passage in 1987, reports the Bureau of National Affairs.

On Monday, despite a petition from AHCA, the American Association of Homes and Services for the Aging and at least 14 individual states, the nation's highest court denied a review of the Third Circuit ruling. The decision likely will cause both private and state run nursing homes to rethink patient and consumer rights.

The FNHRA were passed in order to provide more oversight of the quality of care and residents rights standards for nursing homes that participate in Medicare and Medicaid

Thursday, February 25, 2010

The Buck Stops Where?

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?’”

Monday, February 1, 2010

Death at Lubbock State School center of Texas statewide controversy


January 27, 3:41 PMDallas Disability ExaminerSteve Carter


Michael Nicholson was killed June 6th, 2009 by his caretakers at the Lubbock State School.
To date, only one arrest has been made. No trial or conviction has been set.

In a heinous act, of abuse of power caretakers at Lubbock State School killed MIchael Nicholson by strangulation. According to a Youtube video (see below) the violent strangulation of Michael occurred because of a dispute over clothes. It seems that Michael did not want to wear the type of clothes issued by the state school, preferring to select his own.

A common theme occurs all to often in homes for the aged and in institutions serving the disabled persons. The theme is about the loss of liberty afforded people simply because they have a disability or are of a certain age. Institutions decide a person cannot make decisons most of us take for granted such as what clothes to wear, when to entertain guests, and whether or not to have a plant in our room.

Certainly most of these do not erupt into the violent abuse that cost Michael Nicholson his life. Yet, the rules are abusive and are made without logic and enforced variably.

Prosecutors and law enforcement personnel do not take crimes against people with disabilities seriously because they "do not make good witnesses". Community Now! is an advocacy organization pushing for better enforcement of acts of abuse against those in institutions.

Sunday, January 31, 2010

James "J.T." Templeton

James 'J.T.' Templeton
KAYE BENEKE
James 'J.T.' Templeton


Longtime advocate for those with disabilities died Monday.

By Christina Rosales

AMERICAN-STATESMAN STAFF

Updated: 12:31 a.m. Friday, Jan. 29, 2010

Published: 9:56 p.m. Thursday, Jan. 28, 2010

James "J.T." Templeton, born with cerebral palsy and housed for 30 years in a Texas mental institution, wished for an ordinary life. But his advocacy for those with disabilities made his life extraordinary, his friends said.

Templeton died Monday . He was 59.

"Working with him helped develop and open my eyes to the civil rights struggle that people with disabilities are fighting," said Spencer Duran , a project specialist with the Accessible Housing Austin advocacy group.

Templeton moved out of the Austin State School in 1986, following a landmark federal lawsuit filed in 1974 against what was then the Texas Department of Mental Health and Mental Retardation. In the 1990s, he was part of a group that sued the City of Austin to make parks and facilities more accessible. He joined protesters who took over former Gov. Ann Richards' office in September 1991 to urge lawmakers to spend money for state schools on community-based initiatives for the disabled instead.

His close friend Stephanie Thomas said Templeton spoke to numerous lawmakers, including a U.S. Senate committee, and became a "voice for those with disabilities."

Templeton had numerous health problems, including respiratory infections. His partner of 14 years and fellow activist, Karen Greebon , died in 2005.

"He taught me a lot about how people with speech disabilities are not paid attention to," Thomas said. "Anyone can have opinions about how they want to live. They might not write a doctoral thesis about it, but they can make decisions for themselves."

Thomas said Templeton had a fierce activist spirit but a gentle soul. Duran said Templeton was the voice of reason and experience in pushing for affordable housing on Accessible Housing Austin's board of directors.

"People with disabilities are thought of as a barrier to affordability," Duran said. "They have been excluded in the development process."

Thomas said Templeton shared his story of being dependent on and discouraged by workers at the Austin State School who told him he could not make it in the "real world" so lawmakers could see how their decisions affect real people.

"His advocacy for himself and other people and getting out of the state school was an uphill battle," Thomas said. "He looked toward what he wanted to do and kept working for it."

crosales@statesman.com; 445-3766

Monday, January 25, 2010

Hate Crimes Request

January 23, 2010

Tom Perez

United States Department of Justice

Criminal Investigation Division

P.O. Box 66018

Washington D.C. 20035-6018

Dear Mr. Perez,

On behalf of Community Now! a Texas statewide advocacy group with a mission to support people with disabilities to live in their communities please accept this sincere and critical request to investigate numerous former Texas state employees who committed horrific acts of violence against residents of several state institutions for people with intellectual disabilities. Upon investigation and if warranted, we sincerely request that those individuals found guilty of criminal acts be charged by the DOJ with Hate Crimes against people with disabilities. It was recently reported in the Texas Tribune (note enclosed article) that since 2000, 75 former employees were fired because of confirmed Class 1 Abuse. This level of abuse is the most heinous and includes sexual and physical assault, murder and gross neglect. Of those 75 individuals, only two were incarcerated for their crimes.

It appears that in Texas there is no justice for sadists who commit violent crimes against our most vulnerable and at risk citizens. The Department of Aging and Disability Services (DADS), the agency who operates these facilities points to Adult Protective Services, (APS) the agency that investigates abuse and neglect at these facilities. APS points to local law enforcement and local law enforcement points to the County Prosecutors, and the Prosecutors do little to nothing with these cases. And with everyone pointing fingers at everyone else, people in these facilities are abused without accountability thus sending a clear message to other facility staff that you can get away with murder.

Even with state institution reform legislation passed in the previous Texas Legislative Session (SB 643), it appears that the Ombudsman position with increased oversight authority of these facilities has not been appointed by Governor Perry and even with a network of Ombudsman, there is limited authority by the Texas Attorney General to investigate and prosecute state employees with confirmed Class 1 Abuse if the County Prosecutor is not willing to do so.

As you most likely know, Texas entered into a settlement for numerous civil rights violations investigated by the DOJ CRIPPA division. Currently, the conditions of these facilities are being monitored by the DOJ. Hopefully something will come of this monitoring to ensure the safety of those who live in these facilities. Further, the hope is that the DOJ will ensure Olmstead is honored by closely monitoring the right of residents to leave the facility to live in the community upon their request.

Let me be clear, I am not asking for any further investigation from the DOJ regarding CRIPPA. On behalf of Community Now! we strongly request the immediate investigation and charges of Hate Crimes against those perpetrators of these despicable crimes. I was provided your name by the leadership at the Regional Office of Civil Rights. If you are not the right person to make the decision to investigate these crimes, I implore you to forward this letter to the individual charged with leading Hate Crime investigations at the DOJ with all haste. And if this is not within the authority of the DOJ, please provide me with the contact information of the appropriate person and agency to contact.

I look forward to your prompt response and immediate action to our requests. Thank you for your time and consideration.

Sincerely,

David Wittie, President

CC;

Governor Rick Perry

Lt. Governor David Dewhurst

United States Senator Kay Bailey Hutchison

United States Senator John Cornyn

United States Representative Lloyd Doggett

State Senator Steve Ogden

State Senator Jane Nelson

State Representative Patrick Rose

State Representative Abel Herrera


Thursday, January 21, 2010

Hideously Ironic...

So does anyone have any insight as to how the prosecutors do nothing to people who rape and kill those with disabilities, but this man got 100 years?

Teen with 47 IQ gets 100 years in sex abuse case

Case stems from charges involving the fondling of a 6-year-old neighbor (Link)


updated 6:06 p.m. CT, Wed., June 10, 2009

PARIS, Texas - A teenager who has profound mental disabilities was sentenced to 100 years in prison after pleading guilty to charges in a sex abuse case involving his 6-year-old neighbor.

Aaron Hart, 18, of Paris, was arrested and charged after a neighbor found him fondling her stepson in September. The teen pleaded guilty to five counts, including aggravated sexual assault and indecency by contact, and a jury decided his punishment.

Lamar County Judge Eric Clifford decided to stack the sentences against Hart after jurors settled on two five-year terms and three 30-year terms, The Dallas Morning News reported Wednesday. The judge said neither he nor jurors liked the idea of prison for Hart but they felt there was no other option

"In the state of Texas, there isn't a whole lot you can do with somebody like him," Clifford said.

Diagnosed as mentally disabled
Hart has an IQ of 47 and was diagnosed as mentally disabled as a child. He never learned to read or write and speaks unsteadily.

Despite being a target of bullies, he was courteous, well-behaved and earned money by doing chores for neighbors, supporters said. His parents say he'd never acted out sexually.

"He couldn't understand the seriousness of what he did," said his father, Robert Hart. "I never dreamed they would think about sending him to prison. When they said 100 years — it was terror, pure terror, to me."

Jurors said they sent the judge notes during deliberations in February, asking about alternatives to prison, but didn't get a clear answer. They believed the judge would order concurrent sentences, jurors said.

District Attorney Gary Young said he sympathized with Hart's situation but stands by his decision to prosecute on five counts. Prosecutors commonly pursue several charges for a single incident to see which the jury will support.

Diversion program not an option
Young said a diversion program was not an option since the law doesn't allow that for serious felonies.

"I hope people will remember he committed a violent sexual crime against a little boy," he said.

Hart's appellate attorney, David Pearson, said the court-appointed doctor did the bare minimum to assess competency and ran tests geared for mental illness, not mental retardation.

He said an appeal will be filed.

Abuse of Power: One Family's Fight | The Texas Tribune

Donnell Smith (left) is charged with manslaughter in the suffocation
death of Lubbock State School resident Michael Nicholson (right).


Abuse of Power: One Family's Fight | The Texas Tribune: "Since Michael Nicholson was suffocated and killed by a Lubbock State School worker last June, his brother has played investigator, medical examiner, detective and attorney. He has pleaded for police and prosecutors to take up the case, which they did this fall. But with each day that passes, David Nicholson fears that the man who killed his profoundly disabled brother — and the other employees who stood by and watched it —�will join the ranks of state workers who are never convicted for their acts. “The physically and mentally handicapped are not equally represented under the laws of Texas,” David says. “And nobody seems to want to do anything about it.”

David has reason to worry. Of the 75 employees fired from Texas’ institutions for the disabled for “Class 1” sexual or physical abuse in the last decade, just 13 have been prosecuted, according to a Texas Tribune investigation. And only two ever served jail time."

Paula Mixson, a consultant who spent two decades working for the Texas agency that conducts abuse investigations, says getting local authorities to pursue these cases is a constant battle. “We really struggled to get our cases to their attention, but they were rarely ‘sexy’ enough,” says Mixson, who retired from the Department of Family and Protective Services in 2003. “In the scale of everything else going on, these aren’t seen as major crimes.”

In Lubbock County, District Attorney Matt Powell insists that’s not the case. The Lubbock County District Attorney's Office, which has prosecuted more serious state school abuse cases in the last decade than any other Texas D.A.'s office, is pursuing a manslaughter charge against 38-year-old Donnell Smith, the Lubbock employee who pinned down and asphyxiated Michael on June 6. Powell won't talk specifically about Michael’s case; he's got a policy against discussing cases he's investigating. But he maintains his office is always “aggressive and proactive” about abuse cases — no matter how difficult they are to prosecute. “You see the same challenge in a lot of these cases: a victim who can’t communicate, no witnesses to it,” he says. “You want to focus on the guy who was really the main abuser.”

At the time of his death, Michael, 45, had lived at the Lubbock State School for three decades. He was non-verbal, fragile, and had the mental capacity of an infant, and he was not supposed to be physically restrained under any circumstances. Yet according to the state abuse report, when Michael refused to get dressed on that June day, Smith repeatedly sat and lay atop him to hold him down, mocking him and then choking him with a towel until his face turned blue. When Michael became unresponsive, Smith didn’t immediately call for help; it took 10 minutes for him to start his failed attempt at CPR. When investigators asked Smith how Michael had died, he lied repeatedly, telling them Michael hit his head while jumping on the bed.

Though Smith, 38, was fired for his acts, and a detailed state investigation released shortly after determined he’d committed “Class 1” physical abuse, David said Lubbock police expressed little interest in the case for two months — until he took matters into his own hands. Outraged at what he calls a complete lack of communication between Lubbock police and prosecutors, David delivered the 66-page state investigative report to the medical examiner himself. In August, the medical examiner declared Michael’s death a homicide. But police didn't issue an arrest warrant until October 28, four and a half months after Michael’s death. Smith, who was charged with manslaughter, made bail several days later. Weeks later, when David called the Lubbock District Attorney's Office, he said he learned police had not yet turned over evidence or reports to local prosecutors.

Two phone messages left with the Lubbock police chief were not returned.

David, who has since drawn disability advocates into the fray, says he’s pleased Smith has been charged — but he's still waiting anxiously for a trial date. And he's livid that the five other employees who witnessed Michael’s death, all of whom have been fired for their inaction, haven’t been charged with failing to intervene. In the highly publicized Corpus Christi State School “fight club” ring last year, workers who watched but didn’t participate were still prosecuted for their involvement. None of those disabled residents died or were seriously injured.

Powell, says in some cases, prosecutors have no choice but to let the lesser criminals off the hook so they have someone to testify against the worst offender. Witnesses to a crime could be charged with failing to intervene, for example, or with making false statements. But if they’re charged, they’re more likely to lawyer up and far less likely to speak freely about the perpetrator’s conduct. “If you have a victim who dies or is unable to relay what happened, you have to rely on guys who may be culpable in some way, but can give witness statements against the main actor,” Powell says. “Sometimes you’ve got to make a pact with the devil to get the main actor.”

But Lilly Nicholson, Michael and David’s mother, says that “pact” is unacceptable for her family. “It just makes me so angry and sick in my stomach,” she says. “We want these people to be prosecuted. If this happened to anyone else, it would be prosecuted to the full extent of the law.”

Wednesday, January 20, 2010



Abuse of Power

Link to Texas Tribune

State employees fired for abusing Texas’ most profoundly disabled citizens are rarely prosecuted for their acts — even when they’re heinous.

A Texas Tribune review of a decade’s worth of abuse and neglect firings at state institutions for people with disabilities found that just 16 percent of the most violent or negligent employees were ever charged with crimes. Of those, the overwhelming majority had their charges reduced or dismissed; just three percent served jail time. Among the abusive employees who were never charged? An employee who punched and kicked a mentally disabled man, fracturing his ribs and lacerating his liver. An employee who sexually assaulted an immobile resident while he was giving him a bath. And a worker who used his belt to repeatedly whip a disabled resident across the face and mouth.

Elected officials, who have been under pressure from the U.S. Justice Department to improve conditions at Texas’ 13 state-supported living centers, say the lack of prosecutions is troubling — but that they can't force local district attorneys to do it.

Meanwhile, local authorities say institutional abuse cases are particularly tough to prove. The victims often can’t verbalize what happened to them. The eyewitnesses are unreliable. And just because an act of abuse is a fireable offense doesn’t mean it rises to the level of criminal conduct or even gets reported to prosecutors.

Advocacy groups say the investigation suggests a breakdown between state abuse investigators and local authorities. It also confirms their worst fear: that there’s no equal justice for people with disabilities. Unless an abuse case receives widespread media attention, like last year’s “fight club” at the Corpus Christi State School, it rarely warrants criminal charges. “If you’re the most vulnerable citizen in Texas and you’re beaten mercilessly, your perpetrator is not held accountable,” said Jeff Garrison-Tate, whose non-profit Community Now! advocates for the nearly 4,600 disabled Texans living in state institutions. “This is what perpetuates a culture of abuse in this state.”

Roughly 300 state school employees are fired or suspended every year for abusing or neglecting residents in Texas’ state-supported living centers. Since 2000, about 75 employees have been fired for “Class 1 Abuse” — the most serious physical or sexual abuse. An extensive Texas Tribune search of county and state arrest records, indictments and other court filings revealed just 13 of these fired employees were ever charged with crimes for their acts. Of those, two served jail time. Three had their cases dismissed. And seven received lesser charges or deferred adjudication in a plea deal. One case is still pending.

One employee who was fired for inserting a hairbrush in a resident's anus and fondling another resident's breasts was never charged with a crime. Neither was a worker who beat a resident in the face because she wouldn't be quiet. The woman had to be rushed to the emergency room for stitches. In another un-prosecuted case, a staffer slammed a resident face first into a door; the man sustained a head wound that required staples to close.

The Blame Game

Ask state agencies, local police and district attorneys why there are so few prosecutions and the finger pointing begins.

The Department of Aging and Disability Services oversees the state institutions and is responsible for firing abusive employees. But it doesn’t conduct abuse and neglect investigations — the Department of Family and Protective Services (DFPS) does it for them. Officials with DFPS say whenever they get an allegation of serious physical injury, sexual abuse or death, they contact local law enforcement within the hour. If their investigation concludes a crime may have been committed, they’re required to forward their investigative report to local authorities. But DFPS doesn’t track what happens next. And police departments say they don’t always get the reports from the state. In some cases they have opened their own investigations ahead of DFPS.

District attorneys who responded to the Texas Tribune’s interview request say they don’t always get the message — either from the state investigators or from police detectives. There’s a precedent here: During the Texas Youth Commission’s sweeping abuse scandal three years ago, thousands of un-prosecuted abuse complaints were found sitting in file folders in local police departments.

"We really like to prosecute the bad guys, the employees who pick on people in state institutions. There's no problem there," said Rob Kepple, executive director of the Texas District and County Attorneys Association. If the prosecutors aren't pursuing cases, "I would surmise we're either not getting them, or they don't rise to the level of a criminal offense."

Even when prosecutors do get the case files, they’re not always able to proceed. In some cases, they say, the act the employee was fired for doesn’t qualify as criminal conduct. In other cases, authorities don’t have the evidence or witnesses to prosecute. And occasionally, when a guilty verdict isn’t a sure bet, they don’t have the resources to make the effort. “Trying to determine who’s the guilty party, and being able to prove they were the ones who inflicted the injuries — that’s especially difficult when you have a victim who is incapacitated,” said Lubbock County District Attorney Matt Powell, whose office has prosecuted more of these Class 1 offenders than any other Texas D.A.'s office. Added Taylor County District Attorney James Eidson:"By their nature, these are pretty much circumstantial cases, which is what makes them so difficult."

And despite the fact that these abusive acts are committed by state employees, inside state-operated institutions, and against people who are sometimes wards of the state, Texas' own attorney general doesn't have the authority to step in. Following the 2007 TYC sexual abuse scandal, and revelations that a West Texas district attorney had failed to prosecute an abusive youth prison administrator, the attorney general's office asked lawmakers for more authority to step in. Lawmakers responded by allowing state prosecutors to offer assistance to local prosecutors. But the attorney general's office still can't intervene to force a prosecution.

"The Legislature has not given the Office of the Attorney General authority to prosecute these cases," said Jerry Strickland, a spokesman for Texas Attorney General Greg Abbott. "Only district attorneys have that authority."

But advocates for the disabled say all of these explanations shroud the real reason abusive employees aren’t prosecuted: because their victims can’t demand it. Many are non-verbal or intellectually impaired. Most either don’t have families to advocate for them, or have out-of-town relatives poorly positioned to keep the pressure on local authorities. In short, advocates say, prosecutors know if they don’t make the effort, no one will hold them accountable.

“If someone saw me on the street kicking my dog, I would be in jail,” Garrison-Tate said. “But when a person with a significant disability in our state-operated, taxpayer-funded institutions is beaten, nothing happens to them.”

TOMORROW: Relatives of a disabled man choked and killed in a state school share their struggle for justice.