A glint of hope. That’s how Austin American-Statesman reporter Andrea Ball described the slow, gradual progress Texas has achieved in eight years to improve the state’s 13 supported living centers for people with developmental disabilities.
It’s an adequate description. As Ball’s recent investigation showed, all 13 centers report improvements in medical care, fewer resident injuries, and fewer cases of abuse and neglect. However, substandard medical care and safety remain a problem in some centers.
Texas’ 3,000 supported living center residents are among the most severely disabled and hardest to place because they require a level of care and security that can only be provided in an institutional setting.
As such, officials need to continue to push for improvements until each institution delivers the care and protection owed to this vulnerable population.
Sadly, Texas had for decades failed to comply with demands for better medical, dental and psychiatric care for state living center residents. On more than one occasion, Texas promised to do better. Each time, state leaders failed to deliver.
Until now, I hope.
The wheel of change began to move after a 2008 Justice Department investigation found a long list of medical care failings at state living centers, including the deaths in a single year of at least 114 residents, 53 of those from preventable conditions. The Justice Department required the state to overhaul the services the centers provide, the way they perform them and the way they measure success.
Since 2009, the state has spent $233 million to hire, train and monitor new employees. Texas has spent another $24 million for Justice Department-required, independent monitoring teams to evaluate all centers on a regular basis, and $12 million for consultants.
As expected, change has come slowly.
According to Ball’s reporting:
- From 2010 to 2016, a 35 percent decrease in confirmed cases of abuse, from 429 to 277.
- Between 2014 and 2017, a 25 percent decrease in reported injuries to residents, from 42,673 to 32,166.
- Of injuries reported, 298 were considered serious, down from 516 in 2014.
- Since 2014, a 32 percent decrease in reported injuries to center employees by aggressive residents, from 1,624 to 1,111.
Any progress made so far helps, but when Medicaid officials threatened to halt the flow of federal money to nine centers a total of 25 times in the last year over concerns of resident safety and substandard medical care, it’s a loud signal that there’s still plenty of work to be done.
State officials are on the right track. A change in how the Justice Department and state measure progress, by focusing more on individual outcomes instead of processes, should put centers on a faster track to meeting the federal expectations, according to officials. Officials must seize this opportunity to move the needle for meaningful change further and faster.
For most residents, their profound disabilities make them dependent on these institutions. It’s important that officials get it right for them. In doing so, maybe, officials help redeem the word of Texas.