Texas can, should do better for state living center residents

Liz Belile visits her sister Shanna in the Austin State Supported Living Center in West Austin Monday October 30, 2017. Belile’s sister suffers from a seizure disorder and needs permanent care, but having her in Austin has provided her with the opportunity to look in on her regularly and tend to her other needs. (RALPH BARRERA / AMERICAN-STATESMAN)

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.

We can’t let gun violence become the new norm

Texas weeps today.

In a small house of worship in a bucolic small town – one of those where everyone knows everyone else’s business, and that’s just fine – a gunman with a military-style rifle methodically opened fire Sunday morning. When he was done, 26 people lay lifeless inside a Baptist church. The dead ranged from 18 months to 77 years of age and included as many as 14 children and a pregnant woman, investigators said.

Rebecca Thompson of Santa Fe, Texas, prays at a memorial near the First Baptist Church in Sutherland Springs on Monday. JAY JANNER / AMERICAN-STATESMAN

 

Lest we become numb to this kind of carnage, let that sink in for a moment. The victims had come to the sanctuary to pray and to worship. The gunman had come intent on slaughtering them.

The crime scene left even hardened law enforcement officers reeling. Wilson County Sheriff Joe Tackitt said officers found blood everywhere.

“Wherever you walked in the church, there was death,” Tackitt said.

Another horrific mass shooting in a string of massacres in America, this one hit closer to home, in Sutherland Springs southeast of San Antonio. The deadliest in Texas history, it came just 35 days after another massacre with a different dubious distinction — the deadliest mass shooting in American history. That one in Las Vegas left 58 people dead and hundreds wounded.

Law enforcement officials said Monday the gunman may have been motivated by “a domestic situation” and that his mother-in-law attended the church. In the coming days, investigators will seek to unravel answers to that and many other questions, like how the shooter was able to get a gun.

“By all the facts that we seem to know, he was not supposed to have access to a gun,” Gov. Greg Abbott told CNN. “So how did this happen?”

Texans, like all Americans, grieve for the victims and their families, and extend their condolences. All of us are trying to come to terms with such unspeakable horror. How could it happen in our own backyard?

“In God’s backyard,” a reader said on the New York Times’ website.

The website features a clock that is counting the number of hours, minutes and seconds since Sunday’s shooting. The Times’ editorial board is calling for Congress to act on gun control.

But it is “mental health,” not guns, that is behind the Texas mass shooting, President Trump said Sunday in Tokyo, calling the shooter “deranged.”

“I think mental health is the problem here. This isn’t a guns situation,” Trump said.

In proclaiming that a massacre carried out with an assault weapon capable of unleashing lethal damage in seconds, is not about guns, Trump seemed to wish to silence any talk about gun control. His words had an element of misdirection, too – the gunman may have had mental issues, but that does not alter the fact that he used a military-style weapon to kill innocent people.

The president’s reaction is something we’ve become used to seeing after each new mass shooting. Gun advocates, including many of our elected officials, are quick to admonish that it’s not the time to talk about gun control.

But when then?

Offering sympathies and prayers to the victims of these massacres, however well-intentioned, is not nearly enough. Not anymore. Not when deadly mass shootings occur with frightening regularity.

A church should always be a safe space, but the tragedy is that these massacres do indeed happen in our own backyards. This was not the first in a house of worship. They occur in movie theaters, at outdoor music concerts and at elementary schools.

Since a mass shooting at an Orlando nightclub in 2016 left 49 dead and many wounded, at least 639 people have been killed and more than 2,600 have been injured in mass shootings, according to the New York Times.

Regardless where you may stand on gun control, it is long past time to have a national conversation about how to prevent more massacres. And it is time for our elected officials to have the courage to lead.

The dead in Sutherland included mothers, fathers, brothers and sisters. They included wide-eyed young children who will never again kiss their parents goodnight. Among the lasting images described by investigators is of the bodies of parents covering their children’s bodies; they had tried vainly to shield them from harm.

Texas is heartbroken today, but we can turn our anguish into action if we demand our elected leaders address gun violence. If we do nothing, we risk more senseless and heinous slaughter.