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Advocates For Disabled Demand Action After Abuse

By Jennifer Brice

DENVER (CBS4)- The community is demanding action after reports of abuse at the Pueblo Regional Center. Eight employees were fired as a result of the federal investigation that found patients were burned with hair dryers and some had words carved into their skin.

The Colorado Cross Disability Coalition (CCDC) and Parents of Adults with Disabilities Colorado (PAD-CO) organized a news conference Friday at the state Capitol. They say it's in response to Colorado's statewide crisis in disability services for those with intellectual disabilities. The advocates are demanding statewide changes.

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Denver Fox is the founder of Parent of Adults with Disabilities. He says his son had a near-death experience in a host home.

"He was deprived of adequate liquid intake for several weeks at his Arapahoe County host home and he has profound disabilities-- could not speak for himself."

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Fox says his son, Andy, miraculously survived. He says Andy's case was investigated but the abuser not held criminally responsible.

"The abuser was fired but since there is no caregiver registry, he is free to provide caregiving in other settings," said Fox.

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Advocates and parents like Maureen Welch say until administrators and staff become civilly and criminally liable they do not believe abuse will stop. They want legislation to protect the disabled.

"We are not here to vilify the industry," says Welch.

She adds that there are amazing people doing the hard work of caring for people with disabilities, "But we do need more checks and balances. We need to fix this very broken system."

Kathy Hartman says his son was at the Regional Center in Wheat Ridge for two years. She, too, is outraged about his care.

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"Many of the same problems exist at Wheat Ridge as documented at Pueblo Regional Center and it is unacceptable, unsafe and criminal," said Hartman.

CBS4 asked the state agencies involved for a response to the claims outlined by these advocates and families. Below are the full responses, including the corrective action plan and report from U.S. Centers for Medicare and Medicaid Services (CMS). They investigated the abuse claims at Pueblo Regional Center.

Response from Colorado Department of Human Services:

The Colorado Department of Health Care Policy and Financing submitted to the U.S. Centers for Medicare and Medicaid Services (CMS) a corrective action plan intended to address findings they made regarding incidents of abuse and neglect at Pueblo Regional Center (PRC) in 2014 and 2015. One of CMS's findings was that staff turnover at PRC remains too high.

We have made many system-wide changes to improve care at the regional centers during the last year and a half, and we have addressed -- or are in the process of addressing -- many of the concerns expressed by CMS.

Part of the corrective action plan includes efforts that the Department will pursue to improve staff retention and reduce the need for overtime not only at Pueblo Regional Center, but our two other regional centers as well. The staffing plan includes a review of wages we currently pay staff with an eye toward making compensation more competitive, and adding positions at PRC. A focus of our plan will be to reduce the number of double shifts we ask staff to work. We also will continue to improve staff training in a number of areas, including the use of restraints, and one-on-one supervision of clients who require that level of care.

CMS, which oversees federal dollars spent at PRC, has recommended that we do not admit new residents at PRC until staff turnover is reduced. CMS also may disallow Medicaid expenditures at PRC from November of 2014 to November of 2015, a move that could require the state to refund to the federal government the Medicaid dollars spent there during that timeframe. The state is considering appealing both of these recommendations.

In addition, the state plans to hire an independent monitor in the coming weeks to oversee implementation of the plan while improvements, including decreasing staff turnover, are put in place. The independent monitor will assist with continued reforms and support the team in implementation of best practices.  The full details, including the scope and duration of the independent monitor's role, will be discussed with CMS.

We are confident that all of the changes that PRC has made since the uncovering of abuse and neglect will result in a better environment for both our staff and our regional center residents. We have made a lot of progress in regional center operations and we look forward to working with our state and federal partners to continue our improvement efforts.

Response from Colorado Department of Health Care Policy and Financing:

 Residents living at the Pueblo Regional Center (PRC) have intellectual or developmental disabilities and qualify for health coverage under Medicaid which is administered by our department (HCPF). We contract with the Dept. of Human Services (DHS) to oversee staff and daily operations at PRC in accordance with federal rules. We also contract with the Colorado Dept. of Public Health and Environment (CDPHE) to conduct site surveys to ensure services are delivered in accordance with state and federal rules.

A substantial majority of the incidents and issues identified in CMS' report, were self-reported by our Department to CMS more than 18 months prior to their April 2016 site visit to PRC. Since March 2015, our Department, DHS and CDPHE have already implemented multiple procedural and other changes to address the great majority of findings in CMS' report and ensure compliance of federal requirements.

HCPF has increased oversight activities to include monthly on-site PRC visits, an on-site visit to the Community Centered Board (BlueSky Enterprises) that works with PRC and has conducted additional on-site surveys through our contract with CDPHE.

CMS requested a Corrective Action Plan (CAP) which we submitted last month. Some of the provisions CMS requested in the CAP include hiring an independent monitor, effectively separating quality assurance from PRC/CDHS, improvements in reporting of incidents, and a PRC staffing plan to address turnover. There were a small handful of smaller requests in the CAP, but these are the major ones. The process for identifying an independent monitor has begun, but that role has not been hired yet.

I am including a very long document that includes the CMS cover letter to their August report, the report itself, our Corrective Action Plan and our cover letter to the plan that summarizes where we object to some of CMS requests. The CAP sets in motion a period of back & forth discussions between the state and CMS to come to some common ground after they review all that we have already done. It's important to remember this report was generated long after we initially reported the issue to CMS.

HCPF has assigned two additional staff to more closely monitor critical incident reports. We have relocated 1 staffer to CDPHE's office to review all critical incidents that come in from all facilities statewide, and a 2nd staffer to review critical incident reports that come specifically from PRC. We believe these additional reviews can more quickly capture and respond to any critical incidents that arise.

LINK: Pueblo Regional Center Report and Corrective Action Plan 

Jennifer Brice is a reporter with CBS4 focusing on crime and courts. Follow her on Facebook or on Twitter @CBS4Jenn.

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