Expert's criticisms draw heated response

LINCOLN — Nebraska's developmental disabilities director lashed out Friday at the independent expert overseeing efforts to improve the troubled Beatrice State Developmental Center.

The expert's latest report criticized the state for the number of former center residents living in nursing homes where, he said, the care was “merely custodial in nature at best and all too often an end of life filled with abject loneliness.”

Jodi Fenner of the Department of Health and Human Services said the expert, John McGee of Omaha, was injecting his own agenda into a report required by a court settlement.

“I think that's fairly clear from his report,” she said. “It's inappropriate.”

Fenner also said the report contains inaccuracies and generalizations not supported by fact.

McGee declined to comment on Fenner's accusations. He has worked in the developmental disabilities field in Nebraska and other states for about 30 years.

The chairman of a legislative oversight committee defended McGee, saying the report showed plenty of reasons for continued concern about the state institution.

Other problems highlighted in the report were the increase in deaths this year, the level of restraint use and weaknesses in the planning for residents to move into community settings.

The report, which the state received earlier this month, is the third one looking at how well Nebraska is complying with a settlement agreement reached with the U.S. Justice Department.

The agreement was reached in June 2008 to stave off a federal lawsuit over conditions at the Beatrice center, which serves people with mental retardation and other developmental disabilities.

Fenner pointed to the criticism of care given to former Beatrice residents in nursing homes as evidence that McGee has an agenda.

Of 356 people who lived at the Beatrice center when the settlement agreement took effect, 51 are now living in nursing homes.

Most were moved into nursing homes in 2008, after state officials set a goal of moving more than 100 residents in hopes of improving care for those remaining.

Six more were among 47 “medically fragile” residents ordered out of the center in February after the death of an 18-year-old woman.

The center has about 185 residents currently.

McGee gave bleak descriptions of visits to 14 of the 51 in nursing homes.

“Many of the individuals whom I observed in nursing homes receive little nursing, little habilitation and little care,” he said. “Sitting in hallways and lying in bed seem to be the most common activities.”

He said the agreement called for Nebraska to “avoid placing residents into nursing homes or other institutional settings whenever possible.”

Fenner said the care provided to those former center residents does not violate the settlement agreement.

She said the developmental disabilities division has no authority over nursing homes, and the decision about where to place people is left to parents and guardians.

She noted that the state is working on community alternatives for former residents who are interested in moving out of nursing homes, a move for which McGee praised the state.

State Sen. Steve Lathrop of Omaha, chairman of the Legislature's Developmental Disabilities Special Investigative Committee, said McGee was correct under terms of the agreement to examine the situation of people moved to nursing homes.

“It is not John McGee's agenda when you see him critical of the number of placements and the lack of habilitation in nursing homes,” Lathrop said.

Fenner also took issue with some of the statistics and conclusions in the report. She did not detail the state's concerns and said officials are working on a response.

By the department's accounting, the state is close to meeting its obligations under the settlement agreement.

As an example, Fenner cited a significant reduction in the use of restraints, as the agreement requires.

The report shows the reduction, but it also shows that restraints were used 390 times from April through June of this year. Ten people accounted for three-fourths of the time spent in restraints.

The agreement followed a Justice Department investigation, which concluded that conditions and practices at the Beatrice center violated residents' constitutional and legal rights.

The center has lost its federal Medicaid funding because of continued care problems. The federal Centers for Medicare and Medicaid Services cut off the funding Sept. 23 after the state lost an appeal.

Contact the writer:

402-473-9583, martha.stoddard@owh.com