District officials said yesterday that they have shut down a group home that was faulted for poor care in the deaths of two mentally retarded residents as part of an effort to move mentally and physically disabled people out of problem-plagued facilities.
Officials said they are taking other steps in the wake of a court monitor's report, which found that one woman and three men with special health risks have died since November 2004 because they did not receive timely and competent care. The monitor attributed the deaths to serious neglect in the homes and shoddy oversight by the city.
D.C. officials said yesterday that the deaths involved homes operated by companies with long-standing contracts. Three of the people who died, including two from the same residence, stayed in homes run by Community Alternatives of Washington, D.C., officials said. The fourth person lived in a home operated by Multi-Therapeutic Services.
Brenda Donald Walker, the District's deputy mayor for children, youth, families and elders, yesterday detailed a 90-day plan that she said would help 45 group home residents deemed at greatest health risk. She said the goal was to guard against "the very tragic outcomes" cited by the monitor.
Walker, who formerly headed the city's Child and Family Services Agency, assumed oversight last month of the Mental Retardation and Developmental Disabilities Administration. That agency contracts with vendors to operate about 360 group homes for the city's mentally retarded wards.
"We've got to build up credibility to demonstrate that we are very serious about changing the way the agency does business and improving in short order and in visible and tangible ways the services to consumers," Walker said.
The report by court monitor Elizabeth Jones said the city has been warned repeatedly about problems with getting appropriate health care to group home residents. D.C. officials had promised to make reforms in 1999, after a series of articles in The Washington Post disclosed 350 documented cases of abuse and neglect in the city's group homes.
The public version of the monitor's report, filed in U.S. District Court, is a redacted version of one shared with city officials, advocates and a judge. It did not identify the four people who died or the homes where they resided. And it offered only sketchy details about what led to the deaths.
The mental retardation agency has declined to identify those who died, citing confidentiality concerns.
In her report, the court monitor said the city should cancel contracts with providers that fail to deliver sufficient care. At a court hearing Monday in a nearly 30-year-old lawsuit on the quality of the city's care for the mentally retarded, U.S District Judge Ellen Segal Huvelle and an advocacy group for the mentally retarded expressed concerns about whether the District government could meet its timetable for achieving improvements.
But Marsha Thompson, who in April became interim director of the mental retardation agency, said yesterday that the city already had closed eight problem homes run by Community Alternatives, including the home where two people died, and that it expects to close two others within 30 days.
Community Alternatives, formerly known as VocaResCare Inc., operates about 20 city homes. The contractor will still operate about 18 city homes, Thompson said, "but in order to stay with us, they will have to perform at an acceptable level."
Thompson said she was less concerned about Multi-Therapeutic Services as a contractor, saying it has had particularly difficult homes to manage and has been "pretty good" in its operations. The company operates 12 city homes.
The city is seeking new providers and working to move more group home residents into apartments and other less restrictive settings, Thompson said, and is taking the court monitor's report very seriously.
"I've never known the court monitor to be inaccurate," Thompson said. "She has taken the time to look at these operations in-depth and uncover areas that need correction, and that's something that I as an administrator appreciate."
Steve Dale, executive director of Community Alternatives of Washington, said he has worked with the city and the court monitor to reduce the number of homes that the company operates as a way to be "more focused" on client care.
"Our organization has certainly taken reasonable effort to ensure the health and welfare of individuals," he said. "I'm surprised that there was a feeling that there had been neglect on our organization's part."
Officials at Multi-Therapeutic Services did not return a call seeking comment.