State living center shows progress

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Report: Denton site has more work ahead to meet fed requirements

The latest report from federal monitors shows the Denton State Supported Living Center, while having made progress, still has a long way to go to meet the requirements in the settlement of a federal lawsuit.

Meanwhile, a report to the Texas Legislature shows that, since 2007, the state has doubled what it spends each year on its 13 living centers, even as the centers — including Denton’s — continue to downsize.

In 2008, the U.S. Department of Justice found abusive conditions at Texas state schools, as the centers were then called. After news reports of a “fight club” at the Corpus Christi facility emerged, the federal government sued the state under civil rights laws.

In a 2009 settlement agreement, Texas agreed to meet 171 standards of care for people still living at the state’s 13 centers. Federal monitors have been evaluating each center every six months since then.

Officials have said that Denton’s center is among those making the most progress, but the Dec. 28 report, which includes an early October visit, shows the center was in substantial compliance with 42 — not quite 25 percent — of the standards of care.

“The reports show continued progress and increases in the numbers of areas coming into compliance,” said Cecilia Cavuto, spokeswoman for the Texas Department of Aging and Disability Services.

Under the terms of the settlement, the centers were to be in substantial compliance with all of the standards for a full year before the end of the agreement in July 2014.

Haley Watkins, of Disability Rights Texas, underscored that the original agreement included milestones that would see certain standards come into compliance first — for example, that standards related to abuse and neglect would be addressed in the first year of the settlement.

The latest report on Denton showed, for example, that the facility staff was in substantial compliance with a number of provisions, and components of revisions, for abuse, neglect and incident management. The monitors noted the facility had improved on this standard, but late reporting of serious incidents was still a problem.

The advocacy group is concerned that monitoring reports show many of the Texas facilities making progress in one area, only to see it retreat in another.

“The [latest] Denton report is the first one I saw that actually didn’t regress,” Watkins said. “We continue to hammer on the numbers, but these are people’s lives and they continue to be impacted.”

A January briefing by the Legislative Budget Board to the Texas Legislature showed a continued emphasis on downsizing the centers.

Last year, the state health department halted admissions to the Austin State Supported Living Center and has referred 29 of the center’s residents for transition to community placement. So far, three have made the transition in Austin.

The department has a pilot program in Austin that helps with the transition.

At the time of the monitors’ visit in early October, 492 people lived at the Denton center.

The center has hired two transition counselors, one in September and one in October, who have since helped five residents move into the community.

Data on placements prior to that time was not immediately available, Cavuto said.

Texas has a notoriously long waiting list — between seven years to nine years, according to the nonprofit advocacy group Community Now! — for its Medicaid waiver programs. Medicaid waivers help people with disabilities pay for programs and services they need to live and work in the community.

However, residents who are transitioning out of the state supported living centers have a spot waiting for them in the state’s waiver program so they don’t have to wait, Cavuto said.

What the downsizing means for the long-term future of the facilities is not clear. Some of the residents at the Denton center require complicated medical care. Others have a dual diagnosis of developmental disability and mental illness, Cavuto said.

Texas operates more large facilities than any state, other than New York. But New York’s average “large” institution houses 41 residents, compared to Texas, which averages 324 residents at its 13 facilities.

The Texas centers were provided $541 million from the general fund with the 2012-13 appropriation, with $1.3 billion in all allocated to the facilities.

Texas has not closed residential facilities since 1995 and 1996. The Legislature must approve the closure of any of the 13 centers.

Officials with the U.S. Department of Justice still expect Texas to implement the reforms at all state supported living centers, including Denton, according to spokeswoman Dena W. Iverson.

“We will continue to engage the state about necessary steps to achieve those reforms,” Iverson wrote in an e-mail.

PEGGY HEINKEL-WOLFE can be reached at 940-566-6881. Her email address is pheinkel-wolfe@dentonrc.com .


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