Friday, February 5, 2010

Washington state's plan to close residential school for developmentally disabled people draws concerns

From Yakima Herald-Republic. In the picture, Julianne Moore who works at Yakima Valley School watches as Kari Burrell of the Governor's police office speaks during a Senate hearing regarding the future of residential habitation centers (RHCs) that includes Yakima Valley School in Selah.


Promising that a proposal to close the Yakima Valley School by 2014 "isn't written in stone," a Democratic leader in the state Senate said Feb. 3 the developmentally disabled will have a choice of living arrangements as the state modernizes its system to care for the vulnerable population.

"It is my goal to make sure individuals do have choice and we not presuppose their choice," Sen. Karen Keiser, D-Kent, said at the start of her committee's hearing on Senate Bill 6780, which she is sponsoring. The Health and Long-Term Care Committee hearing was broadcast on the Internet by public affairs station TVW.

The measure would close the 102-bed Selah school and four other facilities for the developmentally disabled around the state, moving a total of 992 residents to private or state-operated homes. The Selah school currently has 91 residents.

The packed hearing brought out all sides on the always-contentious issue, which has pitted those who oppose the large residential facilities as outmoded institutions against those who say they are the safest places for their loved ones with serious medical and behavioral disabilities.

Gov. Chris Gregoire's social services policy adviser urged even swifter action than Keiser's bill calls for.

"We already have plans we can use to guide us through this process now, not next year," said Kari Burrell.

Larry Jones, past president of the Arc of Washington state, an advocacy group, said it's time for the state to catch up with the national trend away from facilities that he believes isolate residents from normal community life.

"There is no national professional disagreement anymore that every person with a developmental disability, including those with significant disabilities, can successfully and safely live in a community," said Jones, whose daughter is developmentally disabled.

Stacy Gillett of Shoreline said her sister is now living and working happily in a community-supported environment after living many years at Fircrest.

"She has a cat that she cares for. She makes out her shopping list and picks out what movies she wants to watch on Saturday. That didn't happen at Fircrest," Gillett said.

But parent Bob Ge, whose 46-year-old daughter Angela lives at Rainier School in Buckley in Pierce County, said her seizure disorder has prevented her from living in a group home.

"My daughter acts, thinks and behaves like a 2-year old. I would never put my 2-year-old in a house and say, 'Catch a bus.'"

Ge also said a series of stories by The Seattle Times about abuses of the elderly and disabled at adult group and boarding homes show the state isn't capable of adequately regulating private providers.

"The state cannot manage adult boarding homes. How can we move Angela into a boarding home?" he asked.

But the developmentally disabled wouldn't be moved into the equivalent of an adult group or boarding home, said Ed Holen, executive director of the Developmental Disabilities Council, part of the state Department of Commerce.

"These are not like adult family homes or boarding homes. They are much more focused on having trained staff and up to 24 hours a day of support," Holen said.

Sen. Chris Marr, D-Spokane, whose district includes Lakeland Village in Medical Lake, said he is not convinced that one option is better than the other, and he's worried the Senate bill is heading toward an all-community living direction.

"We need choice," said Marr. "We need an array of options. I think the end game is removing choice and I'm very concerned about this. I wonder if this violates a moral contract we've made with a number of people in the community."

Julianne Moore, one of 276 state employees who work at Yakima Valley School, said supporters of the bill are wrongly characterizing state facilities as isolated from the community.

"Our folks are part of the community," she said.

One of the most confusing points in the discussion is cost. Supporters of the schools insist the state will have to lay out millions of dollars to provide additional resources for community living.

Advocates of closing the schools, which are formally known as residential habilitation centers or RHCs, say the move will save the state money in the long run.

The state Department of Social and Health Services said comparable services provided in the community cost $54,000 -- or 30 percent less -- per year per person than in a state-run residential facility.

But school supporters say the difference is largely due to labor costs, with unionized state employees earning higher wages and better fringe benefits than employees of private providers.

Caregivers at private facilities make about $20,000 a year compared to pay of between $27,000 and more than $45,000 for employees at the state-run schools, depending on their training and experience.

Greg Devereux, executive director of the Washington Federation of State Employees, said the difference in labor costs amounts to a quality-of-care issue, with the more highly paid state employees providing better, more expert care.

Caregiver-to-resident ratios are frequently 1-to-1 and 2-to-1 for high-needs residents. Nurses are on site and available around the clock. At private homes, they are on call.

Devereux said the legislation should mandate what he called a "publicly operated continuum of care," including state-operated homes that state employees could transition to along with residents they care for.

"You will stabilize the workforce by providing health care and pensions," Devereux said.

The legislation calls on the state to develop state-operated living arrangements -- called SOLAs -- but they are not mandated.

Committee member Sen. Rosa Franklin, D-Tacoma, worried that there aren't sufficient private resources in the community to handle all of the 992 residents currently at the state facilities.

"My fear is that the services will not be there," Franklin said.

Scott Livengood advocates for the Community Residential Services Association, which represents private operators that serve 4,000 people with developmental disabilities in community settings, many of them former residents of state facilities.

He said the state facilities could be valuable resources for community providers. "We definitely want to use the wealth of knowledge at the RHCs to bring services out to the community," he said.

The legislation envisions retaining some beds at the existing state facilities for skilled nursing care, respite and crisis care. DSHS would also have to come up with a plan for selling off excess capacity at state facilities.