Home > Uncategorized > DDS group home provider acknowledges multiple clients missed dozens of medical appointments

DDS group home provider acknowledges multiple clients missed dozens of medical appointments

In the wake of a series of allegations identified by COFAR of poor care of a group home resident, the president and CEO of the nonprofit group home provider has acknowledged missed medical appointments for multiple clients, “failures to follow protocols,” and financial misappropriation in two residences.

The provider, the Center for Human Development (CHD), is funded by the state Department of Developmental Services (DDS). DDS relicensed CHD in 2017 after issuing a licensure report that did not appear to address those managerial problems.

In an August 1 statement provided to COFAR, James Goodwin, CHD’s CEO and president, said his organization has verified that eight clients in two of its group homes missed a total of 59 medical and dental appointments since 2015.

Goodwin said the missed appointments included primary care visits, specialty care visits, and eye and dental exams, and were “a result of failures to adhere to policies in two homes…”  He said it was “important to note that clients continued receiving prescription medications during this time, so many appointments were being kept.”

“We can’t comment on the specifics of an individual’s care,” Goodwin’s statement added. “We have identified instances of failures to follow protocols and isolated instances of inappropriate use of financial resources. All funds have been fully reimbursed. We acknowledge the need for improvement in oversight and strengthening of policies, and improvement in communications with family members and guardians, and we have taken substantial steps to make those improvements.”

Foster mother detailed a series of care problems

Goodwin’s statements were in response to a July 15 COFAR blog post, which detailed a series of problems with the care of Timothy Cheeks, a 41-year-old man with Down syndrome who lives in a group home managed by CHD in East Longmeadow.

Since late last year, Tim’s foster mother and guardian, Mary Phaneuf, has raised issues with CHD and DDS regarding Tim’s care at the residence including:

  • A lack of proper medical care for Tim, including no documented visits to a primary care physician or dentist for seven years;
  • No documented visits to a cardiologist for six years despite Tim’s having been born with a congenital heart defect;
  • A failure to treat Tim for two years for back pain and a degenerative back problem, and to fill a prescription for pain medication for him;
  • A failure to ensure that Tim was receiving Social Security benefits for at least two years;
  • The unexplained removal of Tim from his day program run by the Work Opportunity Center (WOC) in Agawam without informing Mary of that fact. (Phaneuf first discovered and raised this issue with CHD in 2017);
  • The diversion of food stamp benefits for Tim and at least one other resident of a CHD group home; and
  • Erroneous information listed in Tim’s 2018 Individual Support Plan (ISP), including an untrue statement that Tim had visited a primary care physician in September of that year. The doctor listed had apparently not seen Tim since 2011.

Despite the seriousness of those issues, an online June 2017 DDS licensure inspection report for CHD on the department’s website did not mention those or similar problems in the agency’s group homes.

Corrective policies cited

Goodwin said that immediately upon discovering the “failures in the program” in early January, CHD began making “extensive reviews of and changes to policies, increasing oversight and documentation of clients’ medical care and adding additional safeguards against individual failures to adhere to protocols.”

The medical needs of all clients in the program who were affected are now being met, Goodwin said. He maintained that the program failures “can be traced overwhelmingly to the actions of a single staff member.” While Goodwin did not identify that staff member, he was reportedly referring to a former manager of two of CHD’s group homes.

Goodwin also stated that there was “no indication that failures such as these took place at any other CHD programs besides the two Meadows Homes programs.”

Goodwin also said CHD has identified “one instance of impropriety with a food stamp benefit check in one of these programs.” He said all misappropriated funds were immediately reimbursed and that there was “no impact on program function or service.”

In addition, Goodwin said, CHD recently identified one instance of a total of $2,100 in “client money being accessed inappropriately and we have reimbursed the funds.”

A June 7 DDS complaint resolution letter cited two clients affected in two separate residences as a result of an alleged food stamp diversion. Mary Phaneuf also contends Tim is owed $2,400 in missed Supplemental Social Security Income (SSI) funds.

Goodwin’s statement added that “staffing changes and appropriate disciplinary action (have been taken) for personnel involved.” A CHD vice president later declined to say how many employees have been disciplined.

DDS commissioner has not commented on the matter

DDS Commissioner Jane Ryder has not responded to a July 9 email from COFAR asking for comment on the overall case or “whether it is possible that the DDS licensure process is not sufficiently comprehensive or thorough to identify issues such as the ones cited here.”

COFAR also asked Ryder in that email whether DDS reviews abuse or other complaints or investigative reports as part of its provider licensure process.

CHD CEO’s statement largely focused on missed medical appointments

Goodwin’s August 1 statement largely focused on the allegations of missed medical appointments. That, however, was only one of many concerns that Mary Phaneuf said she brought to the attention of the provider’s managerial staff late last year.

Phaneuf told COFAR that while CHD did begin in January to address the problem of missed appointments, the provider did not inform her of any plan it had to discover or address the underlying cause of the long-term neglect.

Phaneuf contended upper-level managers at CHD failed to keep their promise of routinely updating her on managerial changes or issues that directly affected Tim. That changed only after COFAR’s July 15 blog post was published, she said.

“Promises made by CHD and DDS to keep me informed of their progress to improve systems and further discoveries of other violations never happened. Until the blog, I had been ignored for months,” Phaneuf wrote in an email.

Goodwin’s statement to COFAR listed a number of “corrective actions” instituted by CHD “immediately…upon discovering the missed appointments,” including the following:

  • “Scheduling and fulfilling appointments to account for those that were missed and otherwise supporting the fulfillment of medical needs of all clients who missed appointments.”
  • “Extensive reviews of and changes to policies, increasing oversight and documentation of clients’ medical care, and adding additional safeguards against individual failures to adhere to protocols.”
  • A requirement that “all medical encounters … be catalogued in a database accessible to all members of the care team.” The database was implemented in March, Goodwin stated.
  • “Regular reviews of medical documentation by nursing staff and senior managers…”
  • Implementation of “compliance software to facilitate more effective oversight of medical appointments.”
  • “More rigorous supervision of on-site and program leaders is now mandated and checked for implementation.”
  • “Development (now underway) of a new protocol to support greater family and guardian engagement in medical decision making and medical care, and a system of automatic updating of family members and guardians on medical appointments and their outcomes.” The new protocol is scheduled to take effect on August 12, a CHD vice president stated.

It is certainly a positive development that CHD has responded to, and taken responsibility for, at least some of Phaneuf’s allegations about Tim’s care; and the corrective actions, if adhered to, should begin to address those problems.

To us, Goodwin’s statement falls short, however, in failing to address all of the allegations, and in largely placing the blame for the situation on a single staff member. When medical appointments are missed for multiple clients over a period of years, the problem points to failures in oversight at top levels of the organization.

In fact, it would have been better if Goodwin had personally accepted responsibility for the issues that Phaneuf raised, and made it clear that he intends to re-examine CHD’s entire managerial culture.

In our view, DDS Commissioner Ryder’s failure to respond publicly regarding this case is unacceptable. Unfortunately,  Ryder has established a disturbing pattern of circling the wagons and not publicly commenting when confronted with questions about her department’s responsibility for problems in the system.

We would also hope that Ryder and other top policy makers in the administration and the Legislature will begin to acknowledge that the problems in this case are not unique. Systematic shortcomings in the care of persons with developmental disabilities in Massachusetts are ongoing and are being made worse by the expanding privatization of services.

A comprehensive investigation of the DDS system is needed, and we would love to see the governor, attorney general, DDS, and key state legislators support that idea.

  1. Amanda Burke
    August 6, 2019 at 12:55 pm

    As the parent of a 30 year old man with Down Syndrome, these are scary situations that leave me extremely worried about my son’s future.

  2. Anonymous
    August 6, 2019 at 3:35 pm

    Although I am not defending CHD or Goodwin, there should have been more checks and balances, a lot of the blame does fall on that particular house manager. Knowing and working with that manager for a number of years, that person was able to describe in detail what was done for the gentleman in the homes that person managed with such convincing detail there was no reason to question what was told to the ISP team. I’m sure that management was not given any reason to question what was or was not happening as tracks were covered or stories told were believable.

    • gael79
      August 12, 2019 at 9:55 am

      And not to defend the manager, I will comment that the responsibilities of a house manager are so vast. Trying to get staff to cover shifts is almost impossible at times and this is just a very small part of the responsibilities. I was a house manager. It is real real hard.
      I still think admin should do 1 shift a week to FEEL the needs of the residents and staff.

    • BJ
      November 5, 2019 at 8:14 pm

      DDS area Director, D.R., was previously a VP at CHD. That’s why DDS doesn’t really do anything to CHD.

  3. Ed
    August 10, 2019 at 9:48 am

    Constant oversight is needed from CEO through house manager to direct care staff. And DDS needs to hold providers accountable. It is encouraging to see corrective actions being taken. But it shouldn’t require the persistence and vigilance of dedicated guardians and advocacy organizations like COFAR to make things right for these vulnerable people.

  4. W. Schuppan
    August 10, 2019 at 11:56 am

    Goodwin, this activity is pervasive and you and only you are in charge of the neglect our homes encounter.
    My daughter’s home is a mess and the comings and goings of staff I attribute to neglect.
    When they find a good staff member, they move or fire them
    My daughter nearly died a few years ago do to upper staff saying they were doing all they could, yet she was worse. We drove from out west to Illinois and took her to the hospital in
    Dixon where they kept her.
    I stayed in Illinois and my husband had to go back to his job. I stept in a chair by her bed until they said she had to go downstairs to the psychiatric area. No such nice amenities down there.
    She recovered there, but upper management said it wasn’t their fault. I wanted to slap her.
    Fix all your problems now!!!!!!
    You have already been reported to Medicare and found guilty.
    Be careful, we pop parents and guardians are watching, I pray.

  5. Kathleen MacKechnie
    August 10, 2019 at 2:34 pm

    I hop I live to see ALL group homes do the right thing. These are human beings!!!
    hope

    • gael79
      August 12, 2019 at 9:59 am

      dDS needs oversize. Thank God for cofat.

      • August 12, 2019 at 11:39 am

        Sorry. DDS needs oversight. Thank God for COFAR.

  6. gael79
    August 12, 2019 at 9:42 am

    I am going to go and meet with ryder in the near future. I can not accept these continued dds practices. I have documentation to discuss with Ryder.

  7. August 13, 2019 at 2:05 pm

    Absolutely true and heart-wrenching.
    My own child, Samantha Martin, was born with a rare genetic syndrome resulting in global developmental delays, autism and epilepsy. Samantha was served under Government direction because the Department informed finances for life-saving medical supports could only be provided through out-of-home care. Instead of receiving extraordinary supports, Samantha sustained numerous injuries, was not presented to any medical professionals for 3 years, was denied intervention for seizures and wasn’t visited by an assigned caseworker for periods up to 14 months.
    Samantha suffered sudden cardiac arrest and died at age 13.
    #NoMoreSilence
    #SamanthasLaw

    • August 13, 2019 at 2:31 pm

      Thank you for your comment, Velvet. So sorry to hear about what your daughter went through. This is why we’re fighting to change the system.

      • August 13, 2019 at 2:42 pm

        Thank you, yes, silence is not an option. 🌹

  8. August 13, 2019 at 3:25 pm

    Reblogged this on Samantha’s Law .

  9. Renee
    August 13, 2019 at 9:38 pm

    Nurses are bullied throughout private and public agencies within DDS if they speak up to support individuals.
    DPPC is a joke, management covers up significant abuse.
    Way too many non-medical management making decisions they have no qualifications for.

  10. Anonymous
    August 14, 2019 at 5:06 am

    I have been witness to bullying by dds and witness to non medical staff making serious medical decisions with negative consequences.

  11. Anonymous
    August 14, 2019 at 7:02 pm

    All supervisors are now being told to not talk to anyone about this issue. And not to open any more cans of worms. Chd what are you hiding. Let’s see your paperwork on client #8.

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