Beatrice care center rouses lawmakers

By Martha Stoddard

LINCOLN, Mar. 21, 2008 (McClatchy-Tribune Regional News delivered by Newstex) --
Shocked and angered by conditions at the Beatrice State Developmental Center, lawmakers pledged Thursday to take multiple steps to address the situation, including a possible investigation of the troubled facility for people with mental disabilities.

Speaker of the Legislature Mike Flood proposed that lawmakers form a special investigative committee to look into the quality of care and related staffing issues.

Sen. Kent Rogert of Tekamah proposed putting $1.2 million into a special fund for use in recruiting and retaining employees at the center.

And Sen. Lavon Heidemann of Elk Creek proposed to allow funding from the Beatrice center to follow residents as they move into community-based services.

Flood said he introduced his resolution in response to what he called a "shocking" report by the U.S. Justice Department of its investigation at the Beatrice center.

"This resolution is designed to take ownership of this problem, not simply throw stones," Flood said.

The report, released Monday, told of conditions and practices at the center that violate residents' constitutional and legal rights. The center currently has about 300 residents.

Among the report's findings were numerous unexplained injuries to residents, incidents of abuse and neglect, and overuse of restraints and psychiatric drugs. The report said staff members were overworked and exhausted.

It also said Nebraska has not done enough to ensure that residents can live in the most integrated setting possible, as required by the Americans With Disabilities Act and by the Bush administration's New Freedom Initiative.

Justice Department officials said a lawsuit against Nebraska is possible if an agreement to correct those violations cannot be reached.

The Flood proposal will be considered by the Legislature's Executive Board at a public hearing next Thursday.

The Rogert and Heidemann proposals were offered and approved as amendments to the main state budget bill.

Several lawmakers referred to the Justice Department report during Thursday's debate.

"Quite frankly, I feel sick" after reading the 45-page report, said Sen. Bill Avery of Lincoln.

Avery said he was especially dismayed because State Health and Human Services officials had told him emphatically last summer that they were taking action to correct problems found by another federal agency and that they would be corrected before the agency's next visit.

The problems were not corrected, however, and the Beatrice center now faces the potential loss of $28.6 million in federal funding from the Centers for Medicare and Medicaid Services.

The center also faces a $1.85 million claim filed on behalf of a resident who suffered two broken legs that went untreated for three to five days.

Rogert said his amendment, approved on a 44-0 vote, would address the persistent employee shortage at Beatrice. It would allow the state to pay signing bonuses or use other strategies to fill vacancies.

The center has been operating for months with 25 percent of direct care positions vacant.

Heidemann's amendment would help carry out a five-point action plan announced by HHS on Monday.

The plan calls for moving one of every three Beatrice center residents into community-based programs by the end of the year, bringing the center's census down to 200 people.

The amendment would allow HHS to move funds from the Beatrice center budget into the budget supporting community programs. Another section of the budget provides a $3 million boost to funding for community-based programs.

The amendment also would require HHS to provide quarterly reports about how the money is being used.

Chris Peterson, chief executive officer for HHS, said she believes the Legislature's approaches will be helpful.

"We agree with all three, and we'll start working right away to implement them," she said.

The budget bill advanced to the final round of consideration with the Beatrice amendments and others that would increase funding for services to elderly Nebraskans and for the state's defense against a school aid lawsuit filed by the Omaha Public Schools.

The seven-member committee proposed by Flood to investigate the Beatrice facility would have the power to hold hearings and issue subpoenas. The panel would be required to issue a report by Dec. 31.

The committee would be authorized to study conditions at the Beatrice center, as well as the placement and quality of care statewide for people with mental retardation and other developmental disabilities.

It also would be charged with looking at HHS, which operates the Beatrice center and other 24-hour care institutions.

Report: 'Human decency' betrayed

The nature and frequency of abuse and neglect allegations at the Beatrice State Developmental Center suggest a "cultural undercurrent that betrays human decency at the most fundamental levels," the U.S. Justice Department said in the report issued this week.

The Justice Department completed an on-site inspection in October. Among the department's findings:

--At least 12 residents a day suffered at least minor injuries, or about 367 injuries per month. About 150 more serious injuries occurred between Sept. 1, 2006, and Oct. 12, 2007.

--More than one-fourth of injuries were of unknown cause.

--Many deficiencies at Beatrice were linked to staffing shortages and heavy reliance on overtime. The Beatrice work force was "wrought with exhaustion and discontent."

--Use of restraints was "the highest in frequency and duration" that a psychology consultant had ever seen.

--One resident was restrained 104 times from June 1, 2006, to Aug. 31, 2007. Another was kept in four-point (arms and legs) restraint for 23 hours and 41 minutes straight, with one 10-minute break.

--Many residents at Beatrice were "grossly overmedicated" with drugs used for psychiatric problems, the consultant said, and "doses used are higher than any I have seen in many other facilities across the country."
-- Martha Stoddard

Newstex ID: KRTB-0149-23938965