Safety of group homes hard to check

Why wasn't CPS called in on this situation? Why are these "homes" allowed to take children if they are abusing them? Why aren't they more closely monitored (even for the adults) when many of these patients can not defend themselves? Why....? Why..? Why???
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By JULIE MURPHY, Staff writer
August 28, 2011 12:30 AM

GLENWOOD -- Chris Nicoles sits and draws at the kitchen table while Louise Harwin watches television in the family room.

It's a familiar scenario in homes everywhere, except that Nicoles and Harwin live in a group home for adults with disabilities.

"These houses are supposed to look like any other house in the neighborhood," said Ed DeBardeleben, area administrator for the state Agency for Persons with Disabilities. "These (group homes) are their homes."

Outside of making frequent personal visits, there's little parents or guardians can do to ensure the safety and well-being of loved ones who live in such group homes. Most are left to trust that the system and its safeguards are working.

But are they?

Reviews and violations found on a state website for 57 licensed group homes in Volusia and Flagler counties, as well as for other group homes statewide, are often outdated, with the most recent reports in many cases being more than 3 years old. State inspection reports are often vague, providing few, if any, details about a particular home's overall condition or employees' qualifications.

A recent case of criminal abuse of a disabled Palm Coast teen living in a Palatka group home run by O'Carroll Homes illustrates that sometimes problems slip through cracks.

O'Carroll Homes, which runs several facilities in Palatka and one in Hastings, had its Medicaid waiver agreements pulled by the state after four workers and a former employee accused of burning the 17-year-old girl with a clothes iron were arrested and charged in January.

One of the workers was sentenced to four years in prison earlier this month for his role in the abuse case. Four others have September court dates, according to the State Attorney's Office.

NO EASY FIXES

Many group home providers are paid through Medicaid waiver agreements, according to Agency for Persons with Disabilities spokeswoman Melanie Etters. The waivers pay for care and supplies for adults diagnosed with certain disabilities before the age of 18.

While pulling Medicaid waivers doesn't technically close a home, its residents or their families would have to pay for their care privately. Costs vary widely based on behavioral issues, daily living and medical needs, but can run between $35,000 and $150,000 per year, Etters said.

"In general, APD typically closes about two group homes a month statewide," Etters said. "Generally, there are two main reasons why this occurs. First would be some major incident occurs at the group home endangering the health and safety of one or more individuals. Second would be when a home is continually cited for issues during monthly monitoring and has not corrected any of the issues within a reasonable amount of time, and the agency is concerned for the health and safety of the people living in the home."

After her daughter was burned in January, Jeanette Roscoe moved her to another group home in North Florida and thought she had found an ideal site -- just as she had when she took her daughter to the O'Carroll Homes facility in Palatka 11 years ago.

"The first time I did research, (O'Carroll Homes) were long-standing and had all the credentials," Roscoe said. "I looked at the cleanliness, that she'd have her own room and the ratio of staff to patients."

Roscoe also closely inspected the North Florida facility where she decided to move her daughter, who she said has the mind of a 2- or 3-year-old. Again, Roscoe studied employee folders and resumes, scrutinizing who administered medications and where they were kept.

But again, her daughter suffered serious injuries. This time, she jumped through a window at 5:30 a.m. Aug. 10 and wound up needing more than 100 stitches and staples to close her wounds, Roscoe said.

"It was a 5- to 6-foot drop out the window," Roscoe wrote in an email to The News-Journal that included images of her daughter's injuries. "I thought she had one-on-one supervision, but she didn't. At least she didn't then."

LONG WAIT FOR CARE

The group homes overseen by DeBardeleben's office, which covers Volusia and Flagler counties, include small family-run operations as well as homes owned by large businesses such as Duvall Home, LifeShare, Sunrise Community and National Mentor.

Group home workers are expected to undergo criminal background checks through the FBI, Florida Department of Law Enforcement and local agencies. They must also sign an affidavit that they are of good moral character, DeBardeleben said. "Zero tolerance" training is also required and employees are instructed to treat residents with dignity and respect, as well as to look for signs of abuse or neglect and to report it to law enforcement.

But researching group homes is complicated, said Jim King, executive director for The Arc of Volusia, which provides programs to increase independence and quality of life for adults with developmental disabilities.

"It's not an easy situation," King said. "There (is) a waiting list of people not getting any services. Funding has always been limited and it keeps getting cut. These are all independent businesses -- some big, some small."

DeBardeleben said more than 20,000 people are on the waiting list for Medicaid waivers statewide.

Martin Favis, president of the Duvall Home -- among the largest care providers for the developmentally disabled in the country -- said the challenge is to provide a homey setting for its 160 residents who live in 10 group homes and one larger congregate-living facility. Some pay privately while others have Medicaid waivers.

"Not every individual has a vested parent or guardian," Favis said as he walked through the home where Nicoles and Harwin live. "We want to have compatible homes where people have things in common. This is their home and it should feel that way."

Favis admits things weren't picture-perfect at Duvall before his arrival three years ago.

"We've come a long way in three years," he said. "APD (Agency for Persons with Disabilities) wasn't happy with us. There were funding cuts and financial problems. We had to really mend our relationship."

Group homes are monitored monthly, typically by a two-person team from the Agency for Persons with Disabilities. The exception is "respite homes," those that only take people who need temporary care -- for instance, if a family goes on vacation. They are not inspected if they have no residents during a given month.

"Group homes have their own niche," DeBardeleben said. "We want clients to have a choice so they integrate into the community, and different clients have different needs."

FINDING A NICHE

Some homes have nurses on staff. Others are "intensive behavioral residential habitation group homes," which handle patients who may be a danger to themselves or others.

One Duvall Home niche is that it is an adult-only facility.

"I'm hoping to get (my daughter) placed in Duvall," Roscoe said. "She turns 18 on Sept. 9 and hopefully we'll be able to transfer her that day."

Roscoe, her daughter, her daughter's case manager -- officially referred to as a waiver support coordinator -- and other officials from the Agency for Persons with Disabilities, as well as Favis, are working together to help Roscoe's daughter make the transition.

"I'm waiting for this to all settle down," Roscoe said before breaking into tears.

Roscoe believes her daughter should have been reassessed in January after she was burned. A reassessment is usually done once every three years, with exceptions made for crises.

"That was a crisis," Roscoe said. "I think she was in shock immediately afterward, but I can only guess that because of her limited verbal communication. She wets the bed now and has been self-mutilating. It's post-traumatic stress. And I'm tired. I'm trying to protect her. I'm trying to protect her from other people. I'm trying to protect other people."

Source

http://www.news-journalonline.com/news/local/flagler/2011/08/28/safety-of-group-homes-hard-to-check.html