BOUDLER — More than a year after a patient’s rape led to a leadership change at a state-run center for the developmentally disabled, administrators say they are in the beginning stages of revising the Montana Developmental Center’s treatment programs. But the troubled center’s problems, plus the cost of running the state’s most expensive facility, have prompted debate on whether it should be scaled down or even closed.
Gene Haire, who took the helm of the Boulder-based center in May 2011, said he is in the first stages of a multi-year revision to its treatment programs, as well as internal “cultural changes” in the organization. He points to new mission and vision statements, new hires and a pay boost for some employees, but he acknowledges there are many challenges to turning the center around.
“Almost every single component and aspect of this organization has needed to be and is in the process of completely rebuilding,” Haire said. “That’s not an overstatement.”
A series of stories by the Independent Record and Lee Newspapers of Montana finds that the center’s rebuilding has already met with obstacles. The relatives of at least one patient complain of ongoing harsh treatment by center staff. The center also was warned in March that it could lose its certification for Medicaid funding — its sixth warning since 2002 — because the center’s governing body did not ensure that staff had adequate information and resources to provide active treatment services to seven patients.
The center is now in compliance with the federal Centers For Medicare and Medicaid, Haire said.
The center has been in Boulder since 1893. The residents are developmentally disabled, which generally means their IQ is 70 or lower, and about 80 percent have at least one mental illness. Typically, people are committed here by judges who deem the clients to be a danger to themselves or others.
The center has been in the spotlight since 2010, when a staffer raped a patient and state criminal justice investigators said that five others also may have been sexually assaulted. Allen Whetstone is serving a five-year prison term after pleading guilty to sexual assault.
This month, a legislative committee will discuss whether to advance a bill to the 2013 Montana Legislature requiring the state to develop a plan to move most or all of the center’s residents to community-based programs. Most state and private health care officials say it would be a mistake to close the center entirely, but some say they could envision reducing the number of patients from the 50 who now live there by half.
The facility has been described as having a chaotic atmosphere at times and has been accused of warehousing clients, rather than rehabilitating them. Part of that is due to the center being unable to attract and retain licensed professionals, said Bernadette Franks-Ongoy, executive director of Disability Rights Montana.
“As a result of the lack of licensed clinical professionals, most of the 63 residents in the facility receive an hour or less of therapy per week and the remainder of their time is spent in custodial care,” Franks-Ongoy wrote last year to the state Department of Public Health and Human Services.
MDC’s annual budget is $15.5 million, with the federal government covering 60 percent of the costs through Medicaid. With 50 residents, that’s about $300,000 per person per year.
Of the center’s 250 employees, 120 are “psychiatric aides,” direct-care workers who spend most time with the residents and average just $13 an hour.
When clients become out of control, they can be sedated and strapped to a restraint chair until they’re calm. The use of restraints and sedatives is particularly troubling to April Palmer, whose 20-year-old daughter Storme is an MDC client.
Palmer said she and her husband have repeatedly denied giving permission for MDC staffers to use the restraints and sedation, only to find out after the fact that they were used on their daughter. They said staff members are rude to Storme, swear in front of her and punish her for minor infractions.
“People can say everything’s all right and they can bury their heads in the sand if they want to, but my daughter is still getting injured, tied up and having her rights restricted,” Palmer said. “Everything is not fine.”
Haile and new Clinical Director Polly Peterson say they are setting out to make MDC a place that provides “an environment for building healthy, effective and fulfilling lives.”
They’ve hired a second abuse prevention specialist, so that a two-person team will look into allegations, addressing a concern that arose during the rape investigation. They have a new part-time psychiatrist, with a medical background, who at 20 hours per week will triple the amount of time that previously was spent to serve clients.
They’ve also increased the pay for some of the lowest paid employees by $2 to $3 per hour, hoping to retain good workers and recruit others to combat perpetual staff shortages.
Haire said he and others have to empower employees, allowing them to try new treatments and express their ideas.
“Already, I’ve felt a change here; I hesitate to speak for people, but the feedback I’m hearing is people are saying it’s very different now. There’s a sense of openness and they can bring forward their concerns if something isn’t working,” he said.
State officials say the Boulder center still is clearly needed, and they have no plans to close it.
“I don’t think it can go away, because it is a need in a continuum of care for these individuals,” said Anna Whiting Sorrell, director of the Department of Public Health and Human Services, which oversees MDC.
However, Sorrell also says the only time people should come to MDC is when they can’t be served in or near their community.
“One of the most important things to me is to make sure our community-based services are as strong as they can be,” she said.