D.C. group home operator scrutinized

Washington Post Staff Writer
Wednesday, March 2, 2011; 9:40 PM

When health inspectors showed up at a group home in Northeast Washington in August, they found one problem after another.

A mandatory evacuation drill hadn't been held. Staff members weren't receiving adequate training. And some of the residents' wheelchairs weren't in proper working order.

The D.C. Department on Disability Services was notified, and Careco, the contractor that operated the home, agreed to fix the problems.

More than three months later, a 71-year-old resident died after falling out of his wheelchair. The man, who had been waiting more than two years for a specialized wheelchair, was still waiting Nov. 24 when he fell as he was being loaded into a van.

Not only had the wheelchair been unsuitable for him, but the seat belt had also malfunctioned, and the man was not properly secured when he was being lifted into the van, according to documents and officials.

Last month, the District closed the 57th Street group home.

Careco, which operates five other group homes and several smaller residences in the city, is being investigated by a federal court monitor and is under heightened DDS supervision. The Silver Spring company, which did not respond to e-mail and phone messages this week, is the latest in a string of DDS providers to come under scrutiny in the past 18 months for their quality of care.

The city is responsible for the care of about 2,000 people with profound developmental disabilities. For years, the District has struggled to ensure safe and effective community care for the disabled. Many were once residents of Forest Haven, which was the District's institution for the developmentally disabled until 1991, when it was closed as part of a long-running class action suit that continues today.

Progress has been noted by the court and others, and the District's detailed investigations of Careco and other providers over the past year and a half are seen as a sign of that progress. But the November death, described in documents filed ahead of a court hearing this week, highlights challenges the city faces as it tries to reform DDS and to end the 35-year-old lawsuit, now known as Evans v. Gray.

Even after the man died and the Health Regulation and Licensing Administration deemed two other residents to be in "immediate jeopardy," it was more than two months before the six remaining residents were relocated and the group home closed.

"The problem is it took so long for decisive action to be taken," Elizabeth Jones, the court's appointed monitor, said in a hearing Wednesday in the Evans case.

While acknowledging that the District could have done more before the man's death, DDS Director Laura Nuss said that the agency had responded quickly and appropriately after the death.

Moving the other residents out immediately was not an option, she told U.S. District Judge Ellen Segal Huvelle: "These are very complex individuals with complex . . . health-care needs. They're not individuals who could be picked up and moved quickly."

Sandy Bernstein, a lawyer with University Legal Services, which represents some of the former Forest Haven residents, said that the residents should not have been moved right away but that it still took too long. "I think it reflects the lack of a crisis plan," Bernstein said in an interview.

Underlying that, Bernstein and others involved say, is a shortage of beds in homes run by well-regarded providers.

"They have to look at ways of expanding their system rather than staying with the same homes run by the same provider," Bernstein said.

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