Three years into federal monitoring, the Denton State Supported Living Center continues to make progress, but is far from meeting standards articulated in a 2009 settlement agreement.
The center has shown significant progress in achieving about 40 percent of the standards, according to the latest federal report. However, in demonstrating substantial compliance with those standards, the center has slipped since its last monitoring visit.
In 2008, the U.S. Justice Department unearthed abusive conditions at Texas state schools, as the facilities were then called. After news reports of a “fight club” at the state school in Corpus Christi, the problems gained widespread attention, and the federal government sued the state.
In a 2009 settlement agreement, Texas agreed to meet 171 standards of care for nearly 4,000 people with disabilities living in 13 centers, including Denton. Federal monitors have been evaluating each center every six months since. After the sixth and final visit, monitors are expected to prepare a final report for the judge supervising the settlement.
The standards touch not only on preventing abuse, but also on nearly every area of care, from medical and psychological services, to programs that help residents build life skills and move toward a fuller life in the community.
The inspectors cautioned in the executive summary of their report — released last week for a visit in April — that systemic change is needed, and such progress cannot be measured in a simple compliance count.
“More likely,” inspectors wrote, “most substantial compliance ratings will be obtained in the fourth year of the Settlement Agreement.”
Denton slipped the most in moving residents from the facility, which now has 498 residents, into residential settings in the community, according to Allison Lowery, spokeswoman for the Texas Department of Aging and Disability Services.
“We agree with the monitors that the Denton facility needs to address challenges in this area, including better identifying what services and protections a resident needs to successfully make this transition,” Lowery wrote in an e-mail.
Some of the strongest language in the 440-page report related to other physical and nutritional management, an area the report called “pervasively lacking.”
Physical and nutritional management typically includes those tactics needed to be healthy; for example, food preparation and therapy needed for a person who has trouble chewing and swallowing.
The report noted significant improvements in medical, dental, psychiatric and nursing care, despite some turnover. Inspectors also noted that pharmacy services needed only minor enhancements to achieve compliance.
Inspectors commended the staff for practices that decreased the use of crisis intervention restraint, suggesting that “positive behavior support plans” and other new measures were working.
In 2010, Denton averaged about nine crisis restraints each month. That dropped to six per month in 2011, and five per month in 2012. Moreover, no client had been subjected to a chemical restraint since the monitors’ last visit, the report noted.
“While the Denton living center has a lot more work to do to achieve full compliance, it continues to make the kind of systemic and lasting improvements we’re looking for,” Lowery wrote. “Overall, we’re pleased with the Denton facility’s progress. We believe it’s on the right track.”
Considering how little time is left, it’s unclear whether the state’s living centers will be able to come into compliance, according to Joe Tate, a policy analyst with Community Now!
The nonprofit group helps people who want to move out of the centers and into the community.
The group has a meeting this week with Texas Department of Aging and Disability Services Commissioner Chris Traylor, and Tate suspects the topic will come up.
“We always ask,” Tate said. “We suspect they will renegotiate a settlement agreement to give themselves another year or two.”
Because there has been progress, the monitors may endorse the extension, Tate said, but he questions whether federal monitoring will become a long-term prospect, too.
Some critics claim the living centers have become a poor use of the state’s limited resources, according to Cindi Paschall, who is the parent of an adult with a disability and an advocate with Community Now!
Nearly 4,000 people live in the centers, while more than 100,000 Texans like them are on waiting lists that have all but stalled for lack of funding. In its annual report on quality of services, United Cerebral Palsy moved Texas from 49th to 50th — now the worst in the nation for providing programs that people with disabilities need.
“We just want people to be safe, no matter where they live,” Paschall said.
PEGGY HEINKEL-WOLFE can be reached at 940-566-6881. Her e-mail address is firstname.lastname@example.org .
It its 2009 settlement with the U.S. Department of Justice, Texas agreed to meet 171 standards of care for nearly 4,000 people with disabilities living in the state’s 13 living centers, including Denton’s. Below is a summary of the progress the Denton State Supported Living Center has made so far in complying with those 171 standards.