How people with developmental disabilities are served in Nebraska drew attention from two legislative committees Monday.
Members of the Health and Human Services and the Developmental Disabilities Special Investigative committees heard testimony and concerns about the Beatrice State Developmental Center and on treatment and services for people who have intellectual disabilities along with mental illness or behavioral issues.
It's been nearly five years since the Legislature stepped in to oversee correction of problems at BSDC after the U.S. Department of Justice issued a report on civil rights violations of residents there, followed by suspension of Medicaid funds for the center.
It's taking too long, said Omaha Sen. Steve Lathrop, special committee chairman.
BSDC has made improvements, required by a settlement agreement with the Justice Department, under the leadership of Jodi Fenner, director of Department of Health and Human Services Division of Developmental Disabilities, Lathrop said. But the federal agency apparently isn't confident enough in those improvements to let go of its oversight.
The most recent report by the monitoring team of independent expert Maria Laurence shows progress on a number of issues, but need for improvement in others. The report focused on how BSDC residents are transitioning into community-based care.
"There are some areas that they would still like to see changes made," Fenner acknowledged.
Some of them relate to the quality of care people who left BSDC are receiving in their community placements, she said.
Lathrop asked Fenner about how the employee overtime issue is resolving. That was regarded by the Department of Justice as a central problem at BSDC when it made its initial report in 2008.
Fenner said the center is better off than in 2007, but not where it would like to be, especially with second-shift workers.
"Recruitment is always a challenge," she said. "Our goal would be to have overtime below 10-12 percent consistently, and we're several percentage points above that right now."
Fenner told the committees she believed the department was meeting all expectations in the agreement with the Justice Department. Lathrop disagreed, saying the reason the monitoring team keeps returning is that the state hasn't satisfied terms of the settlement.
Justice Department expectations and some of its recommendations exceed the terms of the agreement, Fenner said.
"I believe if they don't dismiss (the state from the agreement) when they come back this next time, I think that we need to bring that up with a judge," she said.
The committee also heard testimony from several guardians, parents and experts on whether there is a gap in services for people with developmental disabilities who also have mental illness.
Fenner said more than 70 percent of BSDC residents, as well as a large percentage of people in community-based services, have co-occurring mental illness. Serving people with these disabilities can be "quite difficult," she said, and many medical professionals are not equipped to provide such services.
People might not have the right services in their communities, or they might not qualify for services because of legal definitions of developmental disabilities or lack of collaboration between the two systems.
Eric Evans, with Disability Rights Nebraska, said the situation has been going on for decades. It might be the right time to revisit the definition for who is eligible for developmental services.
Evans said the work of the special investigative committee has been remarkable, and he would like it to expand its scope to all operations of HHS, given the department's repeated problems in the past six years with not only developmental disabilities services but child welfare, assisted living facilities, corporate guardianships and behavioral health issues.
"These are just the tip of the iceberg that we're starting to uncover," he said. "And we need your oversight to ensure that the most vulnerable people in Nebraska are protected."