Developmental disability service provision discussed

Members of the Developmental Disabilities Special Investigative Committee and the Health and Human Services Committee heard testimony Oct. 7 regarding developmental disability service provision in Nebraska.

The investigative committee was established by the Legislature in 2009 to address quality of care issues at the Beatrice State Developmental Center (BSDC), including the facility’s decertification by the federal government in the wake of a U.S. Department of Justice report detailing the violation of residents’ civil rights by BSDC workers.

Testimony was given at the Oct. 7 hearing regarding progress on BSDC’s recertification process, recent allegations of abuse by BSDC direct-care staff and updates on transitioning residents to community-based housing.

Jodi Fenner, developmental disabilities director for the state Department of Health and Human Services, said BSDC is making progress toward recertification, with three of the center’s five intermediate care facilities (ICFs) having gained full certification from the federal government.

Fenner explained that federal investigators concluded that BSDC should be broken down into five ICFs that would be independently recertified. Fenner said she was confident that the remaining two ICFs also will pass the certification process.

“I’ve never had a federal surveyor hug me (before),” she said. “They’re very positive.”

Fenner said recent allegations of abuse at the Kennedy Buildings – one of the ICFs yet to be recertified – are “appalling,” but will not jeopardize the certification process.

Sen. Steve Lathrop of Omaha, chairperson of the committee, said approximately a dozen employees from the Kennedy unit are suspected of engaging in, observing or failing to be aware of abuse, which included placing individuals in temporary choke holds until they lost consciousness.

“When I read the report,” he said, “it just made me sick.”

Several senators questioned whether inadequate training, extensive overtime hours or the facility’s culture contributed to the recent alleged abuse.

“There’s a failure somewhere,” Lathrop said. “There was a hot spot in Kennedy and no one saw it.”

Fenner acknowledged that overtime hours increased during the time of the alleged abuse, but said overtime should level off now that the center’s reorganization is complete. She said finding qualified people in Beatrice to do the difficult work of caring for the developmentally disabled is difficult.

“I can’t grow people in Beatrice,” she said, “and I can’t hire people who aren’t qualified.”

Fenner said the abuse was isolated and could have been reported anonymously to Adult Protective Services by anyone who witnessed it.

“I question the character of the people who didn’t report,” she said.

Tammy Westfall, regional vice president of Mosaic, also testified about the progress of transitioning residents from BSDC to community-based housing.

Mosaic operates 11 homes in Nebraska through a contract with DHHS, Westfall said. Thirty-six of the homes’ beds remain available, she said, with a minimum cost to the state of approximately $450 each per day. Westfall said Mosaic is prohibited from accepting anyone but BSDC residents, who are often reluctant to relocate.

“People don’t want to move,” she said. “That is one of the biggest barriers that we have faced.”

Fenner said the state’s contract with Mosaic was initially restricted, but that the company is now free to seek referrals elsewhere. She said there were significant delays in the building of Mosaic’s housing and that many BSDC residents already had been placed elsewhere when the homes were ready for occupancy.

Fenner said the division has sought to help Mosaic recruit individuals to fill the available spaces, but service coordinators have encountered concern about the quality of services in some homes. In addition, she said, only one of the ICF homes has been certified.

“We can’t put people where their needs can’t be met,” Fenner said.