It’s like the old-fashioned broken record where a phrase is repeated over and over and over again.

Federal inspectors report serious problems with client care at the Beatrice State Developmental Center, home to more than 300 people with developmental disabilities and cite the institution for what are called “immediate jeopardy” issues, as well as broader systemic problems.

State Health and Human Services leaders promise to do better and make changes.

Groups representing the interest of people with developmental disabilities recommend that the governor establish a “blue ribbon” commission and call for change, primarily moving people out of the state-run institution into community programs.

The most recent visit of federal Centers for Medicare and Medicaid Services inspectors in late February and early March repeats the same themes, except that now, the state faces the loss of $28.6 million in federal funding.

But state agency leaders say the current response, including the decision to move 100 people from Beatrice into community programs by the first of the year — and at least half of those by July 1 — and a plan to close the on-campus hospital this spring is a dramatic change.

This is a “180-degree turn” in what we are doing at Beatrice, said John Wyvill, the new director for the Division  of Developmental Disabilities for state Health and Human Services.

The most recent federal inspection shows that Beatrice is failing in the same areas in which it has failed before, said Deb Weston, director of The ARC of Nebraska.

Two of the three problems cited as “immediate jeopardy” issues during the recent visit are repeats of problems, according to Bruce Mason, litigation director for Nebraska Advocacy Services, whose agency has studied the federal reports and conducted its own investigation.

Problems with staff who do not stop clients from hurting themselves or try to find better ways of getting clients to stop the behavior has been documented by previous investigations, said Mason. The problem “clearly exists and has not been eradicated or even minimized,” he said.

There is also a history of minimizing the seriousness of self-injurious behaviors, he said.

An Advocacy Services investigation also pointed to cases in which clients were injured but there was no indication how the injuries occurred, he said.

“This is one of the most troubling aspects of the CMS findings that coincide with our findings,” Mason said.

“There does not seem to be an ability to eliminate, to report or even to take appropriate intervention activities,” he said.

Federal inspectors have found immediate jeopardy issues during at least four visits since September 2006.

This week, two groups representing people with developmental disabilities — The ARC of Nebraska and ADAPT NE — again urged Gov. Dave Heineman to create a commission that would investigate problems at Beatrice and look at the state’s system of caring for people with developmental disabilities.

These two groups and Nebraska Advocacy Services want a commission much like one established by former Gov. Norbert Tiemann that led to creation of the current community-based system of care.

But the administration has not given any indication there will be such a commission, leaders of those groups say.

“We haven’t heard anything back on the gubernatorial commission, except to say they received our information,” said Mary Agnes, spokeswoman for a grassroots advocacy group called ADAPT NE.

“What is lacking is an overall plan,” said Mason. What’s occurring now is on an “ad hoc basis.”

“To deal with issues that impact Nebraska’s most vulnerable requires the best minds in the state to come together,” he said.

“There appears to be a lack of political will in the governor’s office to give this a concerted effort,” Mason said.

Heineman said he understands the advocacy groups’ concerns and is considering them, but didn’t say whether he would establish a blue ribbon commission. He did say that Health and Human Services has brought in an expert group, Liberty, to help solve issues.  

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.