Gov. Mike Beebe spoke to reporters at length today about the surprise Justice Department action yesterday to enjoin further admissions of young people to the Conway Human Development Center, which cares for more than 500 people with severe retardation. The following account is from his spokesman, Matt DeCample:
The governor believes the underlying dispute is one of philosophy. In general, the Department of Justice wants to move disabled people from large facilities to homes or community-based services. The governor agrees that home or community care is the ideal option. However, he says there are many cases where it's not possible. Many families believe the institutional setting is the best option. It's a last resort, but a service that needs to be there, Beebe believes.
On allegations of excessive use of restraints and improper medication: The governor believes that there are standards of care and the state works to make sure that everything is done by the book. If it is found that someone is not following proper procedures, whoever is responsible will be fired, he said. (If Justice is correct, and Arkansas has become a holdout on use of restraints, you do have to wonder who defines "proper".)
Bottom line: DOJ wants these mass institutions to become relics of the past. The state of Arkansas doesn't.
The state said it was caught by surprise by the legal action yesterday because the Justice Department had only recently asked for a continuance in a scheduled court hearing.
My core problem remains this: Has the state investigated cases cited by Justice on deaths and improper care? What were the findings (specifics, not just a state finding of 'no foul')? If rules were broken, were there consequences for employees? Nobody will tell me. That's confidential in the state's view. I will never have any degree of confidence in the state's care of the least among us (not just in Conway but in any branch of the giant Human Services Department) until it will talk in detail about cases where abuse has been alleged and where children have died. This can be done without violating patient privacy. Until officials do, their protestations of good faith inspire little trust.
UPDATE: DHS has also responded. It faults the Justice Department's tactics and findings, defends its care and says the state has increased the number of people receiving community-based care. Again, there is no offer to detail specifics in cases of allegations of improper or negligent treatment.
DHS STATEMENT FROM JULIE MUNSELL
We were very surprised by the tactics of yesterday’s filing by the DOJ as we were scheduled to go to trial later this year to address all the issues raised by the Department of Justice (DOJ). We were following a schedule previously agreed to by the Department of Justice to complete all reports by April 25, 2010. Despite our honoring of that agreement the DOJ now unfairly seeks to deny us the agreed upon opportunity to complete our experts’ reviews. Our experts, who have not been allowed a full opportunity to complete their work as agreed to by the DOJ, have already communicated to us that they are finding many misrepresentations and very flawed conclusions by the DOJ’s consultants. It is disappointing that the DOJ would not honor its agreement as to the schedule and would seek an unfair advantage in this dispute.
The state has worked in good faith for the last seven years to resolve the DOJ’s concerns including bringing the resources of the state’s teaching hospital, UAMS, to ensure the highest quality of care for the state’s most medically fragile children. In addition, The Conway Human Development Center is in substantial compliance with all state and federal standards of care regulated by the Commission on Accreditation of Rehabilitation Facilities (CARF) and the Office of Long Term care. CHDC is in compliance with the extensive federal requirements of ICF/MR regulations. While safety and care remain a top priority, we will continue to encourage that children be placed in the most integrated and least restrictive setting. Despite the preference of many parents and guardians for CHDC, there has been an increase of families around the State who access home and community based waiver services. As affirmed by the United States Court of Appeals for the Eighth Circuit in 2005, the Division of Developmental Disabilities has discharge rules that require an annual review by an interdisciplinary team of medical professionals who determine if an individual can be appropriately served in their community.
All levels of treatment must be accessible so that families can obtain the type of service they need when they need it. The Department will continue to employ a family centered approach that gives families a choice and a voice in the care of those they love.