The next TYC scandal

Remember the Lubbock State School, and the extreme problems there that eventually led to a Justice Department investigation? Sadly, those problems are far more widespread than just one troublesome facility.

Abuse, neglect and humiliation are a stark reality for hundreds of mentally retarded children and adults living in Texas' state schools, employee disciplinary records show.

With disturbing regularity, employees pushed, hit, kicked, knocked down and dragged residents. One of the worst cases occurred in December 2005, when a caretaker at Brenham State School hit or kicked a resident hard enough to cause three cracked ribs and a lacerated liver.

Workers also frequently neglected their frail charges, in some cases allowing them to eat cigarette butts, scald themselves or be sexually abused by other residents.

The Houston Chronicle reviewed hundreds of pages of documents showing how employees were disciplined for abuse and neglect at nine different facilities. The Texas Attorney General ordered the records released under the state public information laws.

The records show instances in which abusive employees were allowed to remain on the job, working with the same vulnerable population.

Excerpting doesn't do this justice - you have to read the whole thing. The Dallas Morning News is also on this story.

I just want to highlight a couple of things here. One:

Officials with the Department of Aging and Disability Services say outside state investigators confirmed nearly 300 cases of abuse and neglect during each of the past two fiscal years. But they maintain that the majority of direct care workers do a good job.

"Most of the people who work in these state schools are there because they truly enjoy serving the population that we serve, and they are dedicated to a good life for the residents who live in our state schools," said Cecilia Fedorov, a spokeswoman for the department. "In any direct care environment, whether it's a hospital, a nursing home, a state school, you're going to have people who just take advantage of more vulnerable people."

I'm sure that's true. The question is, what is the response when it happens? The evidence here suggests that response has been systematically inadequate.

Evidence also suggests that the response from the Governor's office is inadequate:

A spokeswoman for Gov. Rick Perry, meanwhile, decried the abuses but defended the agency's handling of them.

"There's no excuse for the reports but these events have been dealt with swiftly and decisively," said spokeswoman Krista Moody. "The governor believes Commissioner (Addie) Horn has taken proactive action."

Horn told lawmakers earlier this year she is boosting training for employees. The Legislature responded to problems by appropriating an additional $50 million to hire more than 1,600 employees and move some residents into community group homes.

Ms. Horn has been Commissioner since Feb. 1, 2006, so most of what this report details happened before she was in charge. However, as her bio notes, she was deputy commissioner before then, and she was "director of long-term care services for the Texas Health and Human Services Commission from 2000-2004". As a reminder:

The Texas Department of Aging and Disability Services (DADS) was established in September 2004 as a result of House Bill 2292 (78th Texas Legislature), which consolidated:

• mental retardation services and state school programs of the Department of Mental Health and Mental Retardation


• community care, nursing facility, and long-term care regulatory services of the Department of Human Services, and


• aging services and programs of the Department on Aging.

In other words, she's an insider. It's good that she's addressing this now, but what has she done before now? What did she know before now?

And finally, from the Chron story in my original blog post on the Lubbock State School, a reminder of how this all came to be:

Michael Jones, a spokesman for the state agency that oversees the state school, said he could not comment on the report's contents because "it's still a potential legal matter." But he would say the facility has a new management team that has worked hard to improve training and hire more medical professionals.

Many of the problems stemmed from severe staffing shortages and training issues, the report said.

[...]

State Rep. Delwin Jones of Lubbock, who helped get the school built in the 1960s, said he saw some of the report Friday and said state budget cuts put the school in a difficult position.

"A shortage of personnel put them in a tough spot in trying to deliver the quality of care people deserve," he said, adding he would support efforts to upgrade the quality of care.

It's nice that DADS got an additional $50 million this biennium for more employees and whatnot. The question is, did that even restore what was cut in 2003 to these services? Or, like CHIP, did we fill ten feet of dirt into the 20-foot-deep hole we dug back then?

I expect we'll hear more about this. At least, I sure hope we do. As with the TYC, this sort of thing needs a long, thorough airing out to make sure we at least try to fix what was broken. Vince, diarying at dKos, has more.

Posted by Charles Kuffner on July 24, 2007 to The great state of Texas