LINCOLN — Three years ago, investigators looking into the abuse of “Client 42'' at the Beatrice State Developmental Center found his living unit in a “state of total chaos.”
The employees on that shift didn't know each other's names, let alone who was responsible for which residents. To a person, they were inexperienced or working overtime, or they had been pulled from other parts of the campus to care for unfamiliar residents.
Such staffing practices were not uncommon then at the center.
The resulting care problems contributed to the state institution's losing its federal Medicaid funding in September 2009.
Since then, the Beatrice center has whittled away at job vacancies and, with them, its reliance on overtime. Now, state officials said, the center is ending its longtime practice of sharing staff members among living units and programs.
Officials hope the change — and the organizational restructuring that accompanied it — will help the center regain Medicaid funding.
The Beatrice center serves people with mental retardation and other developmental disabilities. Most also have physical disabilities or mental illnesses.
About 165 people now live at the center, down from 329 in December 2007.
Jodi Fenner, state developmental disabilities director, said the Beatrice center was divided into five affiliated units in August.
Each unit corresponds to a building or cluster of cottages on campus, and each has its own set of employees who will not be called on to work in other units.
The residents in each unit share similar needs. A couple of units house people with greater mental health needs. Others house people with medical complications.
The units operate under one administrative umbrella and continue to share professional, vocational and recreational services.
But each unit, Fenner said, will seek its own Medicaid certification, which is required for funding. The previous Medicaid certification covered the entire institution.
Officials filed an application for certification for the first unit, called the State Building, on Wednesday.
Plans call for the other units to follow one by one.
State Sen. Steve Lathrop of Omaha, chairman of a legislative committee overseeing developmental disability services, said he favors the idea. “If they can get recertified in whole or in part, I'm supportive,” he said.
Ending the policy of pulling staffers from other units also looks to be a positive step, Lathrop said.
The goal is to have all of the units certified, and their Medicaid funding restored, before the state's next budget begins on July 1, Fenner said.
Failing to meet that goal would add to the state's budget shortfall, estimated at $751 million for the two-year budget period.
Nebraska had to find $40 million in state tax money during the current budget period to replace the lost federal money.
The institution was decertified because of its repeated failure to meet federal care standards after a 2006 inspection.
Family members of two residents said the changes at the center appear to be making a difference for residents and employees.
“The campus has a different feel to it, a happy feel,” said Joan O'Meara of Lincoln, whose daughter lives at the center.
Fenner said the idea of splitting the center into smaller units came from consultants hired by the state.
H&W Independent Solutions of California, hired to do a mock Medicaid inspection this spring, was one of the consultants.
The strategy allows the state to get some Medicaid funding more quickly and protects the state from losing as much funding if problems crop up in the future, the company said in its report.
Smaller units also make it easier to prepare for inspection and easier to give employees a badly needed “win,” H&W said.
Such an approach helped a Kentucky facility regain its Medicaid certification recently, the company said.
To be certified, a unit must prove that it can meet federal care standards and maintain that level of care. To do so, it must pass two full federal inspections separated by several months.
Beatrice center officials also are working to fulfill the terms of a settlement agreement with the U.S. Department of Justice.
Contact the writer:
402-473-9583, martha.stoddard@owh.com
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