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FOR IMMEDIATE RELEASE December 5, 2007 CONTACT: Marla Fischer-Lempke, Public Information Attorney 402.474.3183 marla@nas-pa.org Abuse and Neglect of Beatrice State Developmental Center Residents Persists Despite Proposed Plans for Care and Safety LINCOLN-- Nebraska Advocacy Services, Inc., the Center for Disability Rights, Law, and Advocacy, (NAS) released a report today which concludes that serious injuries and failure to meet accepted standards of care continues at the Beatrice State Developmental Center (BSDC). Despite repeated efforts to meet federal regulations, low numbers of trained staff and failure to provide proper care and treatment to residents creates a setting for chaos and violence. Timothy F. Shaw, Chief Executive Officer (CEO) of NAS states, “Nebraska officials, both executive and legislative, must take real action to ensure the protection and safety of our most vulnerable citizens.” The report finds that since November 2001 state officials have failed to meet accepted professional standards of care at BSDC. In October 2006 and April 2007, the United States Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) found that conditions at BSDC put resident health and safety in immediate jeopardy. These findings meant that over $28,000,000 in federal funds could have been withheld from the total BSDC budget of slightly more than $50,000,000. NAS and the State of Nebraska entered into an agreement for access to the BSDC facility, its residents, and staff after CMS’ notification of the immediate jeopardy status in October 2006. The access agreement allowed NAS to conduct its own investigation into the conditions at BSDC. NAS staff has reviewed hundreds of BSDC incident reports. They have visited BSDC twice each month to conduct their own inspections and on-site reviews, question staff, and observe residents. During a nine month period beginning January 1, 2007, BSDC officials conducted 220 internal investigations of abuse and neglect resulting in 86 substantiated cases of abuse or neglect and 209 staff suspensions. Twenty-two residents have experienced bone fractures including a broken finger, broken leg, fractured knee, broken hip and a broken arm. Ten of those bone fractures were suffered by persons who are non-verbal. Shaw notes that “following the last CMS survey in March 2007 there has been a relentless series of incident reports of serious harm.” The incident reports also document the ineffectiveness of the response to the needs of BSDC residents. Since the last CMS survey in March 2007, NAS has monitored 72 incident reports involving physical injury, physical abuse and neglect, verbal abuse, elopement (residents who have gone missing), or other incidents that depart from acceptable standards of care. Shaw notes, “This equates to approximately one incident report for every five BSDC residents.” According to the NAS report, state officials have violated and continue to violate the legal rights of people living at BSDC. The U.S. Supreme Court has held that persons with developmental disabilities residing in state facilities (such as BSDC) have a right to safety and minimally adequate training to provide for their care and safety. Further, federal law creates a standard of care that requires such facilities to provide adequate staffing, protect residents from harm or other abuse, and ensure “active treatment” to reduce the need for chemical and physical restraints. The report shows that people living at BSDC continue to be at risk of harm. They do not receive adequate treatment or gain skills to help them become self-sufficient. The report states that BSDC suffers a chronic staff shortage. Over 100 direct care staff positions go unfilled each week. As a result, residents are not properly supervised nor are they receiving appropriate habilitation or care. “BSDC is staffed by many dedicated individuals who are genuinely concerned for the well-being of the residents in their care,” says Shaw. “However, the evidence is unequivocal that they are underpaid, undertrained, and overworked by state officials.” The report finds that the lack of well-trained staff for people who need significant help to manage their behavior creates an environment where residents are at risk of harm. Further, the current staffing situation at BSDC makes it impossible for staff to follow accepted professional standards of care and that condition creates a downward spiral of greater chaos and violence at BSDC. To address conditions at BSDC, the NAS report offers eleven recommendations. The recommendations call for independent evaluations, staff training, enhanced compensation, reduction of the population, and changing the organizational culture. The report also recommends establishing a Civil Rights Enforcement section within the Nebraska Department of Health and Human Services and creating an Oversight Commission by the Nebraska Legislature. Shaw suggests, “Whatever is done about the conditions at BSDC, any effort to change the failures must be grounded in the principles of respect for human dignity, affirmation of each resident as a valued citizen, assurance of the bodily integrity of every resident, and a commitment to the protection of their legal and human rights.” “It is time for the public to say, ‘Enough! Enough of this relentless cycle of chaos and violence! Enough promises!’”, says Shaw. “It’s time to put an end to the indifference. These repeated deficiencies and failures as well as the harm and injury to the people living at the Beatrice State Developmental Center must stop.” ### Nebraska Advocacy Services, Inc. (NAS), The Center for Disability Rights, Law, and Advocacy, is a private not-for-profit organization established to assist people with disabilities and their families in protecting and advocating for their rights. NAS, the protection and advocacy system in Nebraska, serves people throughout the State. It operates federally funded protection and advocacy (P&A) programs and is part of a nationwide network of congressionally created disability rights organizations.

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