Thursday, August 18, 2011

MIXED USE LIVING ARRANGEMENTS

In the August 14th Boston Sunday Globe there was a story about a shooting at a public housing complex in Brighton. According to the Globe article on Wednesday August 11th Randy Moore a 54 year old  with a history of mental illness shot and killed his neighbor, William Thomas who was 75 years old and in a wheelchair. After a standoff  for several hours, during which Moore shot multiple rounds at the police, Moore surrendered.

Bill McGonagle, head of the Boston Housing Authority, said that Moore was a diagnosed schizophrenic and lived in public housing for years. McGonagle also stated that Mr. Thomas's death underlines the risks of placing residents with serious mental illness alongside elderly residents. McGonagle went on to denounce the laws that put the mentally ill and elderly together in the same developments as poor public policy. According to the Globe article many other housing authorities across the state and country agree with McGonagle.

Massachusetts Department of Housing and Community Development, HUD, said in a statement that it had an "obligation" and "responsibility" to provide appropriate housing for those with disabilities. According to HUD there is a 70-30 ratio in effect for all 34 elderly housing developments run by Boston Housing Authority in order to meet the demand for non-elderly disabled housing in this area.

On April 15, 2011 the Centers for Medicare & Medicaid Services, CMS, proposed a rule which would effect the program: File Code, CMS-2296-P, Medicaid Program: Home and Community-Based Services (HCBS) Waivers, Federal Register, dated April15, 2011.

The proposed rule by CMS is designed to "remove a barrier for States that wish to design a waiver that meets the needs of more than one target population" by enabling States to combine target groups ( "Aged or disabled, or both; Mentally retarded or developmentally disabled, or both; and Mentally ill") into a single waiver.

What all this means is, individuals with different diagnosis can live "under one roof" with little or no regard to the individuals safety. As we read from the Globe article the mentally ill and elderly are not a good fit and now CMS wants to add individuals with developmental and intellectual disabilities to the mix. According to VOR, a National Advocacy Organization for individuals with DD/ID and with whom CCMR, Inc. is affiliated states that, "equal access" to necessary services does not equate to safety". "Tragedy due to placing incompatible people in the same homes has been reported in Florida, Maryland, Ohio, Washington DC, Wisconsin, Massachusetts, and other states".

As advocates for people with ID/DD we are concerned for the safety of everyone involved.  There is a vast difference between people that are intellectually and developmentally disabled and those individuals with mental illness. Our biggest concern for the ID/DD population is their access to services.  Mental health advocates also say that the issue is not housing but service to individuals with psychiatric disorders. In order for these individuals to live independently they need personal care. Lynda Cutrell of the National Alliance on Mental Illness states that "no matter what the housing situation, they need wraparound services to manage the illness".

The problem of mixed use housing is simple. All sides are right and all sides are wrong.  There is not enough money to provide the needed and proper services on the ground and agencies like DDS and DMH are looking for additional ways to cut services.  Federal agencies like CMS attempt to make policy changes based on "the perfect world" and not reality. Housing officials, the people who are actually working within these developments do not think that mixed use is a good policy and their position is based on experience.

Choice is important but safety for all is more important.

Thursday, August 11, 2011

NEED FOR NATIONAL BACKGROUND CHECKS FOR ALL HUMAN SERVICE EMPLOYEES

Addis Gabriel Woldeguiorguis has a multi-page driving record in the State of New York dating back to 1980. Mr. Woldeguiorguis also has a record of possession of drugs in 2005. On August 3, 2011 Mr. Woldeguioruis drove his van filled with 12 adults with special needs into a garbage truck in Newton. According to the Boston Globe, When police arrived at the scene they found a broken crack pipe, a plastic bag containing suspected crack cocaine, and other empty plastic bags in a green carrying bag found in the van.  According to the Globe,  Mr. Woldeguiorguis told police that he had taken two oxycodone pills four hours before the crash.
The one and only question is why was Mr. Woldeguiorguis driving the van on August 3rd, apparently under the influence of drugs, endangering the lives of 12 special needs people on their way to their job?
The answer is simple: Massachusetts law does not require a national background check for "contracted drivers". In other words Mr. Woldeguiorguis employer did the minimum required by law and checked his MA driving and MA Criminal Offender Record only.
According  WCVB TV Channel 5 Michael Burris was convicted in 1999 of having sex with a minor and was facing charges of illegal gun and drug possession. Mr. Burris served a year in prison and then violated his five year probation by leaving California and moving to Massachusetts.
Upon settling in MA he took a job as a van driver driving people with intellectual disabilities to day programs. Mr. Burris also failed to register as a sex-offender  in MA based on his CA conviction. Finally in 2005 the Massachusetts State Police arrested Burris for not registering as a sex-offender in MA.
Once again no national background check!!!
State regulations only requires agencies such as DDS to do CORI checks on new hires and the employees of DDS vendors in MA only. Our most vulnerable population is at risk. Many of the individuals under DDS care cannot speak or defend themselves from predators. A policy for national background checks is not the only answer to safety of our most vulnerable population but it is a step in the right direction.