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Archive for May, 2012

Saving the Glavin Center comes down to one man

May 21, 2012 2 comments

In many of the photographs that Rosemary Dumont has of her son Stephen, a red vertical wound can be seen at the top of his forehead, almost seeming to divide his forehead in two.

That wound is the result of Stephen’s habit of banging his head on any hard object near him, such as the corner of a table.  Before he was admitted to the Glavin Regional Center in Shrewsbury five years ago, he would open up the wound on practically a daily basis.

Community-based residences and hospitals tried to solve the problem with drugs, which didn’t work.  It got to the point where no community-based group home would keep or accept him as a resident.  At one point, the only place his parents, Rosemary and Will Dumont, were able to find for him was the controversial Judge Rotenberg Center.  There, Stephen was given electric shocks when he banged his head.  But that didn’t stop the behavior. 

The story was finally different at the Glavin Center where the staff have been able to reduce Stephen’s head-banging episodes to once or twice a year through constant supervision and supportive behavioral treatments.  Now, he’s able to go home to stay with his parents on weekends without the threat of a flare-up of his aggressive behavior.  Those home visits weren’t possible while he was in the community system.

The Dumonts know this “miracle” of treatment for their son will disappear when Glavin is closed, as the Patrick administration is moving quickly to do.   Not only is there no community-based setting that is likely to accept, much less successfully treat, Stephen, any change at all in his living arrangement is likely to trigger a descent into his old cycle of self injury. 

For Stephen, who has an intellectual disability in addition to having cerebral palsy and deafness, the act of leaving a long-term home such as Glavin and its staff and fellow residents results in a conviction that those people have all died.  “He loves all these people (at Glavin) to death,” Rosemary says.  “He can’t handle the change.”

For that reason, the Dumonts are desperate to keep Glavin open.  And they know that for now, the fate of the center rests with one man — State Senator Stephen Brewer of Barre.

Under the Legislature’s current budget process, it is totally up to Brewer whether to approve a state budget amendment that would require an independent cost analysis before the Department of Developmental Services can move more people out of Glavin and subsequently close the center.  Brewer, who is chairman of the powerful Senate Ways and Means Committee, has the authority to decide whether to place all proposed budget amendments in either a reject pile or a pile of amendments headed for a single up-or-down vote on the Senate floor this week.

So far, Brewer hasn’t given the Dumonts much reason for hope that he will accept the study amendment for the floor vote.  When the Dumonts and a small group of other Glavin family members met with Brewer earlier this month to urge him to allow the study amendment to reach the floor, Brewer told them that he “didn’t have the energy” to fight for the Glavin Center, Will Dumont said.  Dumont said Brewer referred to it as a “losing battle.”  The Dumonts, who live in North Brookfield, happen to be constituents of Brewer’s.

The administration is closing Glavin and three other developmental centers, contending they have become too costly to continue to operate.  The Dumonts and other supporters of the centers disagree with the administration’s cost analysis.  COFAR,  a family-supported nonprofit organization that I work for, maintains that the administration’s cost analyses for all of the centers have been flawed and that an independent study is needed.

COFAR moreover believes it would be cost effective to the state to expand the missions of Glavin and the other developmental centers by enabling them to provide medical and other hard-to-get services to community-based DDS clients.  Glavin, for intance, has long provided medical, dental, speech, psychology, guardianship and other services to intellectually disabled persons throughout central Massachusetts. 

It’s the hope of the Glavin families that an independent cost study will establish once and for all that the savings in closing the facility are illusory.  That, they hope, would convince the Legislature to block the administration’s plans to close Glavin.

But the administration strongly opposes an independent study, as does the Arc of Massachusetts and the Association of Developmental Disabilities Providers, which are vocal opponents of the developmental centers.  And Brewer has shown little inclination to oppose those organizations or the administration, as evidenced by his statement to the Dumonts about lacking the energy to fight for the facility. 

Yet, if the battle has been a losing one, that has at least partly been because of Brewer himself.  Last year, Brewer scuttled a similar independent study amendment, which had been filed by Senator Michael Moore of Worcester. Moore has once again filed the study amendment.  It would require that the cost study be done by a non-governmental entity selected by the state Inspector General.

Will and Rosemary Dumont are hoping this time they can scrounge up enough local support for Glavin that they can put some counter-pressure on Brewer.  Will Dumont has enlisted all his friends in his hunting club near his hometown of North Brookfield to call and email Brewer’s office.  Last week, Will, Rosemary and some other Glavin family members visited legislators’ offices in the State House.  Meanwhile, Rosemary has been signing up friends on Facebook to support the cost study, and said last week that her effort had “gone viral.”  Other Glavin families are making calls and sending emails as well and urging their friends to do so.

We may know whether their efforts have paid off by tomorrow when the Senate begins debate on the budget.  We hope Senator Brewer has enough compassion for the residents and families of the Glavin Center that he will at least put the amendment for the cost study into the pile for a Senate floor vote.

DPPC faults care plan in group home resident’s death

May 4, 2012 2 comments

A state investigative agency has concluded that a Tyngsborough group home resident died last year as a result of having ingested an  inedible object, and that there was sufficient evidence to conclude that his death was due to a lack of adequate supervision by caregivers.

The 50-year-old man, who had formerly lived at the Fernald Developmental Center, had reportedly ingested a plastic bag

The March 29, 2012 report by the Disabled Persons Protection Commission, which was obtained by COFAR, concluded, however, that there was insufficient evidence to identify when or how the man had obtained the material he ingested, or whether he was in his group home, day program, or being transported between the two when he ingested it.  The report also appeared to place the blame for the lack of supervision on the fact that the man’s plan of care, also known as an Individual Support Plan or ISP,  had no requirement that he be kept in sight by staff at all times.

The 50-year-old man had lived in the group home for about a year after having been transferred there from the Fernald Center.  According to sources, the man had a history of ingesting foreign objects, a condition known as pica.

The July 6 death of the resident is one of two cases of sudden death involving former developmental center residents, both men in their 50s, which COFAR  first reported about last August.  COFAR also reported about the case of another man who died suddenly of a blood clot in his lung in a Tewksbury group home on July 24, four days after having been transferred there from the Templeton Developmental Center.  An investigation of that death is apparently still ongoing. 

Both Fernald and Templeton are among four developmental centers that have been targeted by the Patrick administration for closure. 

The March 29 DPPC report leaves many questions unanswered about the Tyngsborough group home resident’s death, including whether the man’s ISP was changed in a significant way after he left the Fernald Center, and whether his level of supervision in the group home was less than the level he had received while at Fernald.  There is an indication in the report that the man’s ISP was changed in September 2010, apparently after he moved to the group home, to remove “target (presumably inedible) items”  from mention in the plan.  Much of this discussion, however, is redacted in the report.

The report in general is heavily redacted.  Not only is the man’s name redacted, but even a discussion about what his ISP actually stated is at least partially blacked out.  In addition, what is apparently the word “pica” is redacted throughout the report.
 
The report states, for instance, that as a result of this case, the Department of Developmental Services issued new guidelines for what are apparently “Pica Management Plans” for DDS clients.  However, the word before “Management Plans” is blacked out.  According to the report, the new DDS guidelines recommend development of a specific behavior plan for each person who has what is apparently pica, required training of staff, a description of the supervision required, and other measures. 
 
The DPPC report also stated that as a result of this case, there is reason to believe providers of transportation for group home residents might not be aware of the diagnoses of what are apparently conditions such as pica among all their passengers. The report recommended that DDS consult with “Human Services Transportation” to ensure that “all potentially dangerous behaviors or medical conditions of a passenger is (sic) shared with the contracted and/or subcontracted provider of transportation.” 
 
And the report includes a recommendation that appears to require that ISPs of all DDS clients with pica include additional protections.  The report recommended that:
…the appropriate DDS designee review the above noted additional finding of risk pertaining to (blank) and ISP language and determine what, if any, action should be taken to identify within a person’s ISP those specific items known to be ingested by the person, as a means to minimize or eliminate the risk they pose.
The man died of aspiration pneumonia and a bowel obstruction, according to the City of Lowell Clerk’s Office, where the death certificate is on file.   After swallowing the plastic bag, the man was reportedly taken to Lowell General Hospital, where he underwent surgery.  
 
The DPPC report indicated that the man had a medically related episode either in his day program or his group home more than two weeks prior to his surgery and more than a month prior to his death.  A description of the nature of that incident was redacted in the report. 
 
The report noted only that the man was first admitted to a hospital on June 7, five days after first exhibiting signs that he was not was not feeling well on June 2.  He was discharged from the hospital on June 11, four days after his admission.   He reportedly did not feel well for several days after his discharge, however, and on June 19, he was taken again to the hospital emergency room and had surgery later that evening.  He died a little over two weeks later.
 
Sources said the staff at the Fernald Center had been aware of the man’s pica condition and had watched him closely to prevent him from ingesting objects while he was living there.  Whether that level of supervision was greater than the level the man received at the Tyngsborough group home could not be determined from the DPPC report. 
 
In both of the sudden death incidents about which COFAR reported, the men had been transferred to state-operated group homes operated by Northeast Residential Services, a division of the Department of Developmental Services.  DDS has refused to discuss or provide any information about these deaths, citing confidentiality and privacy regulations.

In a third case about which COFAR recently reported, a 51-year-old resident of a Northeast Residential Services home died on February 7, 2012 after having been sent back to his residence twice by Lowell General Hospital.  That man had formerly lived at the Fernald Center as well.