Local News: Texas Violating Patients’ Constitutional Rights

Federal Report Details Neglect, Abuse in State Schools, Amid Calls to Shut Down the Facilities, Including One in Mexia
By Cindy V. Culp (Tribune-Herald Staff Writer)

From the Waco Tribune-Herald

A federal report that details abuse and neglect at Texas’ institutions for the mentally retarded could further fuel a push to shut down the facilities, including one that is the economic backbone of a Central Texas town.

The Mexia State School was one of 12 institutions studied by the U.S. Department of Justice as part of an investigation into civil rights violations. In the report, issued this week, the department contends that the facilities fall short in providing adequate care to residents and in protecting them from harm.

At least 114 residents died at state-run facilities for the mentally disabled during a one-year period that ended in September, the report said, with at least 53 of those deaths being preventable. The report also notes that the state investigated at least 500 allegations of abuse, neglect and other mistreatment at the facilities from July through September.

The findings have prompted opponents of the institutions to renew calls for them to be closed. At least one state lawmaker has pledged to introduce legislation this coming session calling for the consolidation and closure of several of the facilities.

Also, the Legislative Budget Board issued a report last month that recommends that the state agency in charge of the institutions, the Texas Department of Aging and Disability Services, be instructed to develop a long-term plan with specific strategies for downsizing them. The board develops budget and policy recommendations for state agencies.

In addition, two legislative committees have been studying the operations of the institutions, which are referred to as state schools. The groups are expected to issue reports within the next month or two.

Linda Archibald, executive director of the Mexia Area Chamber of Commerce, said it would be devastating for Mexia to lose its state school. It is the county’s largest employer, providing jobs to more than 1,400 people.

“That is a staple of the community,” she said. “We do not want to lose the Mexia State School. We need the Mexia State School.”

Jim Branson, an organizer with the Texas State Employees Union, said there have been rumblings of closing the facilities for years, but this time, there seems to be more momentum. Branson said it seems the closure efforts are reaching a crescendo just as the Legislature is to convene in January.

“(State school supporters) really better take it seriously,” Branson said. “This is one of the more intense efforts I’ve seen.”

The federal report marks the third time in three years that the Justice Department has investigated Texas’ 13 state schools. Similar findings of mistreatment at the Lubbock State School came out in 2006.

Mexia incidents cited

This week’s report examined the other 12 facilities. Mexia was not singled out as being better or worse than the others. For the most part, the federal report did not disclose where instances of mistreatment occurred.

However, one example clearly refers to an incident at the Mexia campus. It involved a 15-year-old boy who died last January after being strapped to a restraint board.

The report also references another incident that happened at Mexia last July. A resident who was restrained suffered two black eyes, an abrasion on his back, a large bruise on the center of his chest and other injuries, the report said.

Other examples of mistreatment within the system cited in the report include:

* A 17-year-old female resident being raped by a male staff member. Another employee witnessed his colleague in a compromising position with the girl but did not report it for two days.

* One resident on three occasions swallowed latex gloves but the mental disorder causing the behavior was not listed on his charts. The same was true for residents who swallowed other items, including Swiss Army knives.

While some of the examples are of deliberate abuse, many shortcomings are the result of a broken system, the report says.

“Much of the facilities’ difficulties stem from high staff attrition rates and from staff vacancies, especially for direct care staff and clinicians,” wrote Grace Chung Becker, an acting assistant U.S. attorney general. “Until the facilities can successfully retain, train and supervise their staff, they will face enormous difficulties in addressing the identified discrepancies.”

That’s the point Branson and other state school advocates have been making for years, he said. The state puts employees into a no-win situation by subjecting them to poor working conditions. For example, employees are routinely asked to care for too many residents at once or forced to work double shifts. Then, when that environment results in residents getting injured due to inadequate supervision or exhaustion, employees are blamed, he said.

Similarly, the report’s contention that the firing of 800 employees for abuse or neglect over the past four years is corroboration of widespread problems is misleading, Branson said. A large number of those firings were for incidents many people would hardly consider abuse, Branson said. Under the state’s zero-tolerance policy, employees are fired if a resident so much as stubs a toe while a worker is around, he said.

“The standard they are holding people to is somewhat ridiculous,” he said.

The federal government is threatening legal action if the state does not resolve the problems. Corrective steps outlined in the report include better tracking of potential abuse, improved training for workers and more careful use of restraints.

Laura Albrecht, a spokeswoman for the Texas Department of Aging and Disability Services, said her agency is reviewing the letter and will do everything in its power to comply.

No simple solution

Some advocates for the disabled say there is no way to fix the institutions, however. They want the approximately 5,000 people who reside at state schools to be cared for in the community instead, in places like group homes. Money for such care could come from the savings realized by closing the schools, they say.

But opponents of closure say the issue is not that simple. Some point to what has happened with the mental health system.

The number of beds at state-funded psychiatric hospitals has been slashed dramatically in recent decades, with the idea that people should be cared for outside of institutions. That has freed up some money for community care but not enough, critics say. The result is that many people with mental illness don’t get the help they need.

The Legislative Budget Board report acknowledges that gap. Institutional care for the mentally retarded is more expensive than community care, in part because people in institutions tend to have more profound impairments. If the shift advocates are asking for happens, the cost of community care would likely increase substantially, it says.

Furthermore, some people can’t realistically be cared for outside of an institutional setting, said Daniel Burkeen, county judge for Limestone County, where Mexia is located. Some people’s limitations mean they need the type of services offered by the Mexia State School, he said.

“(Community care) is not going to work for everyone,” he said.

Because of that, Burkeen said he doesn’t believe the Legislature will end up closing the Mexia facility. But if things begin to look that way during the upcoming legislative session, local officials will do whatever is needed to make their voices heard, he said.

The Associated Press and Austin American-Statesman contributed to this story.

Published on Thursday, November 4, 2008