Arkansas most likely to institutionalize people with disabilities, advocates say

From Arkansas News Bureau:

LITTLE ROCK — Gov. Mike Beebe has championed Arkansas’ use of large state-run institutions to house people with developmental disabilities, but advocates for the disabled say such institutions are being phased out almost everywhere except Arkansas.

“Arkansas is behind the curve, there’s no question about it,” said Curt Decker, executive director of the National Disability Rights Network in Washington, D.C.

The U.S. Department of Justice filed a lawsuit last year alleging mistreatment of residents at the Conway Human Development Center (pictured), and on March 9 the Justice Department filed a motion for an injunction to halt all admissions of children to the center. The state denies that any residents have been mistreated.

Less than a week after the Justice Department filed its motion, a report was released showing that numerous deficiencies were found in an inspection of a similar Arkansas facility, the Alexander Human Development Center. The deficiencies included improper supervision of patients and unsanitary conditions.

Defending the Conway facility, Beebe told reporters that community-based care should always be the first option, but “there is sometimes no other option” besides institutionalization.

A state-by-state analysis conducted by The Coleman Institute at the University of Colorado shows that Arkansas uses that option more than most states. The 2008 study “State of the States in Development Disabilities,” which relies on 2006 data, includes the following statistics:

—In Arkansas, 16 percent of people with developmental disabilities were in state institutions. Nationwide, only 7 percent were in institutions.

—In Arkansas, 39 percent of the disabled lived in settings of 16 or more people, compared to 19 percent nationwide.

—In Arkansas, 32 percent of state and federal funding for the disabled went to people in institutional settings. Nationwide, only 19 percent was spent on people in institutional settings.

Earlier this year, United Cerebral Palsey ranked Arkansas second to last among the 50 states and the District of Columbia in supporting community-based living for developmentally disabled people who receive Medicaid-funded services.

In addition to the Conway and Alexander centers, the state has human development centers in Arkadelphia, Booneville, Jonesboro and Warren. A new 16-person facility for children is under construction on the grounds of the Southeast Arkansas Human Development Center in Warren.

“Most of the states have actually closed their (institutions), and we have actually kept all of ours open” and are expanding the system, said Dana McClain, senior staff attorney for the Disability Rights Center in Little Rock.

Much of the impetus in other states for closing the institutions has come from the U.S. Supreme Court decision in Olmstead v. L.C., in which the court said the Americans with Disabilities Act requires public agencies to provide services to a disabled person in the most integrated setting appropriate to the person’s needs.

The Obama administration has directed the Justice Department to redouble its enforcement of the decision, leading to lawsuits in several states.

“Studies have shown, and I think most of the evidence shows, that individuals with intellectual disabilities do better when they live in the community and that services can be provided safely and appropriately in community settings,” said McClain, who is the parent of a developmentally disabled child.

Julie Munsell, spokeswoman for the state Department of Human Services, said there is still a need for institutional care in Arkansas.

“That’s what we’re hearing from clinicians, but more importantly that’s what we’re hearing from families,” she said. “That’s one of the reasons why, although we have opened up more home- and community-based waiver services, we are still adamant about giving families and their loved ones a choice in where they want to be served and how they want to be served.”

Between 2003 and 2008, Arkansas increased its waivers for home- and community-based services from 2,500 to 3,888 slots, Munsell said.

The Conway facility houses about 500 people, while the state’s other five facilities house about 500 between them, according to DHS.

Advocates for the disabled say a 500-bed facility is essentially a warehouse for people.

“Who lives in 500-person facilities?” Decker said. “(Non-disabled) people don’t live that way. But we take people with disabilities and tuck them away, and what we have is a history of documentation of horrible things happening to those people.”

But Munsell said the size of the Conway facility allows it to be “a community … where they (residents) receive all their services — dental services, other physical health services, as well as their active program treatment.”

“Even under the assumption that these individuals can be served in the community, the expertise has to be there to serve them, which can be challenging to find in a rural state like Arkansas,” Munsell said.