Glad You Live At Home?

Put simply, there is a lot of bad stuff happening within the service system vulnerable people live in here in Oregon.

Senior care center faulted

Investigation, verdict expose wider problems at Avamere and other for-profit elder care facilities in tri-county area

BY LEE VAN DER VOO AND CHRISTIAN GASTON
The Forest Grove News-Times, Jun 25, 2008

An unprecedented verdict against a Lake Oswego senior care facility last month levied more than $900,000 in damages for an incident that left an 86-year-old woman bruised and in handcuffs.

The woman’s son says he hopes the verdict puts for-profit care companies on notice to improve senior care in Oregon. And a Pamplin Media Group analysis shows there is plenty of room for improvement.

The analysis showed that three for-profit senior care groups with a large presence in the Portland area are being cited for problems more often than their nonprofit counterparts.

Two of those senior care groups, Alterra and Marquis, have facilities in Forest Grove.

The analysis also showed that one for-profit group, Avamere Health Services – which owns and runs the Lake Oswego facility where the woman was injured – has been cited far more frequently than the others.

A Multnomah County jury awarded a landmark penalty against The Pearl at Kruse Way, an Avamere Health Services facility, in a civil trial last month. The $904,200 verdict is believed to be the most money an Oregon jury has ever levied against a care facility for endangering an elderly person and compromising his or her dignity.
The woman, Elvera Stephan, died during the trial from unrelated health problems. The sum was awarded to her estate for injuries she suffered in an incident April 13, 2006.
That night, Stephan, who suffered from dementia, was handcuffed and restrained by police after becoming confused and accusing a caregiver of taking her car keys.
While Stephan’s injuries were caused by police putting her in handcuffs and keeping her on the floor, the jury arrived at the verdict after testimony showed that nurses and caregivers at The Pearl did nothing to intervene.

Testimony also showed that while Avamere marketed The Pearl as providing top-of-the-line care for dementia patients, workers there did not provide the care or have the training or medication that could have helped Stephan that day and prevented the call to police.

The nurse who called police did so from another wing of the facility, reporting Stephan was “extremely agitated” and “aggressive” and “threatening” without examining her, even though Stephan’s caregivers repeatedly asked for help.
Stephan ultimately suffered bruising to her forehead and wrists and twisted one of her knees, according to a subsequent state investigation. The Oregon Department of Human Services fined The Pearl $300 for failing to appropriately assist Stephan on its own before calling police.

Stephan’s son, James Stephan, now hopes the verdict involving his mother sparks discussion and puts care providers on notice to improve services.

“Avamere isn’t just going to have a $300 fine from DHS filed in a folder at DHS and just keep operating the way they were,” Stephan said. “What I hope is that it just brings some more awareness to our society.”

Probes uncover violations
But lately, for-profit care providers have been under fire nationwide. A Pamplin Media Group investigation found:
• For-profit nursing homes often provide worse care than their nonprofit counterparts, based on regulatory benchmarks and on citations issued by Oregon state regulators.
• For-profit companies often insulate themselves by creating labyrinthine corporate structures that make it more difficult to sue them.
• And, in Oregon, regulators say that some care providers are so profitable that relatively small government fines do nothing to encourage them to comply with government regulations.

Across the nation, a 2007 analysis by The New York Times showed that investor-owned companies provided substantially worse care for seniors than similar nonprofit ventures.

The findings echoed a 2001 study by researchers for the University of California and Harvard Medical School, which found investor-owned facilities showed deficiencies at a rate 46.5 percent higher than nonprofit facilities and 43 percent higher than public nursing homes in surveys.

The Pamplin Media Group’s look at three corporate care companies with facilities in the tri-county area – Avamere, Alterra and Marquis Care – showed similar results. The three are the for-profit companies with a large presence of multiple care services in the tricounty area.

The analysis looked at state citations for care violations and injuries at 59 facilities owned by the corporate care groups, five stand-alone for-profit firms and another seven nonprofit facilities.

On average, the corporate care groups were cited by state investigators more frequently than nonprofit and publicly owned senior care facilities.

Avamere had the highest per-patient citation rates. At 30 of its facilities, Avamere averaged one citation for every nine beds over two years between 2006 and 2008.
That rate was higher than citation rates for Alterra and Marquis Care, which received one citation for every 15 and 23 beds in their facilities, respectively, during the same period.

Nonprofit and publicly owned senior-care facilities, by contrast, were cited once for every 32 beds in their facilities.

Laundry list of problems

At Avamere, incidents that led to citations included:
• A patient at Avamere Rehabilitation of Clackamas developed gangrene for lack of foot care. The state cited the facility and fined it $500.
• Workers at Avamere Rehabilitation of Beaverton, who had not received fire safety training, according to state officials, left the door to the laundry room open while a fire broke out, filling the hallways with smoke.
• A patient lost 11.6 pounds after living less than a month at Avamere Rehabilitation of King City. Employees didn’t review the patient’s medical history and “failed to recognize” the patient’s loss of bowel and bladder control. The facility was cited and fined $1,000.

Avamere founder Rick Miller said long-term care is a tough business and one that often is unfairly criticized because it provides services to people who already are often very ill.

Miller said he and business partner, Rick Dillon, have tried to build a unique senior-care system that allows the elderly to get care where and when they need it. Avamere, a 13-year-old Wilsonville-based company, provides home health care, independent living, assisted living, dementia care, skilled nursing and hospice.
“We’re focused on building a business that we want to have when we need this level of care,” Miller said. “And one thing we know about seniors is they don’t want to be in nursing homes.”

But Miller acknowledges that innovation and growth have caused fluctuations in quality.

“We’re not where we need to be,” Miller said. “But we’ve got to be a company where, if there’s a problem, we’ve got to be transparent about that.”

Avamere starts self-reporting

Company data in 2005 and 2006 showed Avamere was falling behind state averages in periodic reviews of facility care, prompting the company to begin self-reporting quality issues to state regulators, a policy Miller believes may account for Avamere’s higher citation rates.

By the start of 2007, the company completed an aggressive restructuring aimed at improvement by appointing a new CEO, a quality control specialist and a company strategist.

Avamere also assembled a volunteer board of current and retired business executives and health-care experts to tackle problems.

Surveys better

Since then, Avamere’s numbers show the company has improved. In 2007, the company’s state surveys were better than Oregon averages, according to Avamere’s numbers.
But Mary Gear, the state’s licensing and quality care administrator, said the Department of Human Services would not still be issuing citations at Avamere if investigations involving the company – brought about by Avamere’s self-reporting or by others – did not turn up problems.

In July 2007, the same year Avamere officials hit high marks on state surveys, regulators had enough concern about the company to invoke a rarely used authority to initiate an investigation.

Citations still pile up

Following a probe of Avamere’s personnel files, state investigators cited nine of the company’s 30 facilities for failing to conduct criminal background checks on workers.

Avamere’s Oregon facilities received 251 citations in the two years between April 2006 and April 2008.

The citations were for everything from failing to provide essential care to failing to shield clients from rough treatment, financial exploitation, corporal punishment, mental and emotional abuse and unwanted sexual contact.

In 65 of the incidents, senior citizens in Avamere’s care were actually harmed. The state levied fines totaling $26,840 in 63 cases.

The $26,850 Avamere paid was a small fraction of the $250 million in revenue reported in 2007 in an article in American Executive magazine.

Penalties not sufficient

Gear said state-imposed penalties often aren’t sufficient to curb problems at senior care facilities.

She said officials tried unsuccessfully to get the 2008 Legislature to raise licensing fees and will try again.

“They are significantly lower than the national average and certainly lower than our neighboring states,” Gear said.

“We also proposed raising our penalty fines. … and again, those are significantly lower than most of our surrounding states.”

What Was She Thinking??

The Oregonian has a story written by Michelle Roberts about a Salem nurse who is in deep trouble for allowing a man with a developmental disability to die in her car while she was googling directions to a hospital in her office.

Though this woman had plenty of options for getting the man help, for some unknown reason she took what appears to be the worst one. The whole matter appears very suspicious to me, and I hope they find out why she did what she did. The whole story can be found here... http://www.oregonlive.com/news/oregonian/index.ssf?/base/news/121427791514260.xml&coll=7&thispage=3

Heavy Load

There is a truly great film out that I believe EVERYONE would benefit from seeing. It'a called Heavy Load and it's a documentary.

You ask what makes this movie so special? It's about the lives of a Punk Band from England as they pursue their dream of making music for a living. What makes their band stand out from others are the members themselves. 3 of the 5 musicians have developmental disabilities (in England labeled learning disabled), and the other 2 are guys who either currently or in the past supported them in the community.

I don't want to give out too much information about the film because I'd hate to ruin it for people who choose to see it. I will say there is a fabulous sub plot that involves some serious advocacy, which in itself is inspiring.

If you want to see an honest, moving and educational film, you MUST see Heavy Load.

Heavy Load

There is a truly great film out that I believe EVERYONE would benefit by seeing

What's Fair is Fair

I'm signed up to get regular press releases from the state of Oregon legislature. Yesterday I received such a release which was dated June 13th, and called "immediate", which I found to be interesting as yesterday was the 18th.

The jist of this press release is information about legislation that will be brought forth in the 2009 session. It says that Rep. Ron Maurer will carry a bill that would require state employees to pay into their health insurance premiums, with the savings going to assist low income folks with the healthcare they need and lack.

This is an overdue idea that may meet some resistance. I say "good on ya Rep. Maurer".

RON MAURER
OREGON HOUSE OF REPRESENTATIVES
HOUSE DISTRICT 3

FOR IMMEDIATE RELEASE CONTACT: Allison Mac Mullin
June 13, 2008 (541) 474-5456

REP. MAURER ANNOUNCES PLAN TO EXPAND ACCESS TO
HEALTH, DENTAL CARE

Health Access Oregon Calls for ‘Fair Share’ Contribution from State Employees
SALEM-- Rep. Ron Maurer (R-Grants Pass) today announced Health Access Oregon,
his plan to expand health and dental care access to uninsured Oregonians and those
without adequate primary care and preventative services. Health Access Oregon will be
introduced during the 2009 regular session.

“Oregon needs to focus its limited healthcare resources where they are going to do the most good for the most people, and this means widening portals of entry to primary care and preventive services,” Rep. Maurer said. “A major component of health reform is changing our health delivery system. School based health clinics and community health centers are a great place to start.”

Resources to fund Health Access Oregon will come from a new “fair share” requirement
that will be applied to many of the 46,000 public employees who receive health and
dental benefits from the Public Employees Benefits Board (PEBB).

State employees, who have not contributed to the cost of their health and dental
insurance, would be required to contribute from 13 percent to 15 percent of their
insurance premium cost by 2012. “This is about insurance parity. As a state employee, I must face the reality that the taxpayer cannot continue to pay for everything. I must begin to shoulder some of the burden of my insurance premiums,” Rep. Maurer said.

Most public employees across the United States contribute to their health insurance
premiums. Teachers in Oregon pay an average of 12 percent of their health premium,
while federal employees contribute 25 percent to 45 percent of the costs of their health insurance premium.

Only two states, Oregon and North Dakota, do not require their state employees to
contribute to their insurance premiums. But, North Dakota has an annual deductible of up to $1200 while Oregon’s state employees deductible is $0. In 2006, the average state employee across America contributed 19.2 percent to their health insurance premium.
###

Here's Solution Focussed Action

The State of New York has taken some serious steps in their effort to eradicate the domestic violence, sexual exploitation, medical and other types of neglect, and financial exploitation of adults with developmental disabilities. I'm going to withold my own opinions until I've heard from some other folks.

OMRDD Unveils Aggressive Campaign to Reduce Abuse and Neglect

ALBANY, NY (06/18/2008)(readMedia)

The Office of Mental Retardation and Developmental Disabilities (OMRDD) released a multifaceted approach to reducing serious incidents, abuse and neglect in its service system, Commissioner Diana Jones Ritter announced today.

Foremost in this new effort is the creation of the Division of Workforce and Talent Development, which is designed to bring leadership, heightened investment and oversight to the agency, enhancing it’s capacity to develop and sustain the relationship which is critical to success for people who have developmental disabilities. Research shows that the best way to both prevent abuse and promote richer lives is to strengthen and nourish the relationships between individuals with developmental disabilities and those that care for them. To achieve these goals, OMRDD, with more than 90,000 staff in state and voluntary programs, is expanding and refocusing training and supervision.

“OMRDD’s core mission is to help people with developmental disabilities lead richer lives. Obviously, this is severely undermined each time a person with a developmental disability is the victim of abuse or neglect or the focus of a serious, reportable incident,” said Commissioner Ritter. “My leadership team and I have committed to reducing the number of such incidents. We realize the work our committed, hardworking and dedicated staff perform can be highly stressful, so we must work with a broad set of partners to ensure that our direct-care workers are not only well-trained, but also have the proper foundations of support.”

The quality of care for people with developmental disabilities is tied to the positive relationships in that person’s life – especially those with staff who are deeply involved in their daily lives. The vast majority of those who care for the developmentally disabled are good and caring people. However, research has found when an individual is abused by staff, there are several negative effects. In addition to physical or psychological injury to the victim and the penalties to staff whom are responsible, another result which may be even more devastating relates to the destruction of the very essence of that helping relationship. Abuse harms the relationship and thereby harms the hope, both of which are needed in order to thrive. It is with this in mind that OMRDD is accelerating the development and implementation of the following tactical plan:

• Expansion and refocused training and supervision of key, stress-intensive living or program environments. It has been demonstrated that many instances of abuse, neglect or serious reportable incidents are a by-product of situational stress or environmental circumstances that cause some staff to behave in unacceptable ways. To ensure all direct contact staff – especially those working in highly stressful situations – are properly trained and supervised, OMRDD has invested in expanded training for its developmental aides and their supervisors.

• Expansion and refocusing of training for staff of its voluntary provider agencies. This new focus isdesigned to enhance staff skills both in developing the positive, mission-driven skills needed in their work, and also to provide individual and supervisory tools that help them deal with the stress of their day-to-day working environment.

• Engaging in discussions with OMRDD workforce and labor/management groups on ways to reduce stress in the working environment and to better manage the fallout when staff is determined to have acted in an unacceptable manner.

• The creation of the new Division of Workforce and Talent Development. Already this new Division has taken on the following challenges:

Established mandated core training topics for Developmental Assistant supervisors
Refined the Competencies to which Developmental Aides are trained
Created a workgroup to reengineer the Developmental Aide Traineeship
Revised OMRDD’s approach to training staff to intervene during behavioral crises
Received a multi-year grant from the federal government to examine a wide range of direct support workforce issues including training, career paths and improving recruitment and retention of workers; and developing a workforce that serves self-directing individuals.

Established an accessible and cost efficient online training institute.
Assess the impact of current recruitment efforts on staff.
Commissioner Ritter has also created a new Office of Investigations and Internal Affairs to improve its capacity to investigate reports of abuse and neglect, among other incidents.

OMRDD is reaching out to partner with external groups who have expertise in workforce issues, abuse and neglect, and organizational cultures. The University at Albany School of Social Welfare, Center for Intellectual Disabilities and its Dean, Professor Katharine H. Briar-Lawson, have pledged such a partnership.

“This kind of collaboration brings some of the most respected practitioners to the issue, as well as creates a learning partnership for both our staff and the students in this prestigious school of social work,” said Commissioner Ritter. “As I have said many times since becoming Commissioner, OMRDD has a solid history. However, I believe we have been unable to go from ‘good’ to ‘great’ by the insularity of so much of its work. A hallmark of my time as Commissioner will be not just transparency, but broad partnership and collaboration.”

Eventually, these partnerships will grow beyond the initial partnership with the University at Albany, to help establish a corporate culture within the OMRDD funded system where there will be zero tolerance for abuse and neglect. This abuse prevention strategy will be embedded in the agency’s overall quality management strategy, focusing on staff and their interactions with people with disabilities.
This new effort will involve a three- part approach:

1) The Risk Appraisal portion will use well-established national research on institutional abuse to create a Risk Appraisal Profile for each unit. OMRDD will be using CDDDSO as a prototype for this approach. Having developed a profile of the risk factors for each unit, the agency will work in a collaborative manner with employees, unions, management, individuals and self-advocates to develop the second component;

2) A Prescriptive Prevention Strategy for each unit within the facility that is directly reflective of that unit’s risk profile. Actions in this area will include all levels of the organization and may involve such things as staff training, reevaluation of client groupings, staff counseling and support, anticipation of seasonal factors, and raising the awareness of staff to the issues involved in abuse prevention.

The intent in the Prescriptive Package is not to focus on any individual, staff or system-related problem, but rather to approach the problems jointly in an effort to reduce or eliminate, to the greatest extent possible, the factors which make it more likely that abuse will occur.

3) An Abuse Awareness Campaign will be a system-wide public education and marketing campaign, which OMRDD will again pilot in the Capital District. Aimed at staff of all levels, the theme of this portion of the project will be the preservation and enhancement of dignity and respect for individuals in our care. To the extent that we are able to positively impact upon the nature of the relationship between individuals and staff and promote a heightened awareness on the part of staff to the importance of maintaining people’s dignity and respect, we will decrease the likelihood that staff will abuse individuals or tolerate abusive behavior from their peers.

“Everyone benefits by enhancing the staff to consumer relationship and promoting the highest level of dignity, respect and value between consumers and staff,” said Commissioner Ritter. “The satisfaction of the staff will increase when they feel better about their relationship with those they support, the individuals in our care will thrive upon the increased positive interactions with staff. Furthermore, administration will become increasingly sensitive to the many factors which they must balance to maintain and enhance quality of care.”

This new strategy will be developed as a prototype within the Capital District Developmental Disabilities Services Office which is located in Niskayuna, N.Y.. A project team has been identified which includes the CD DDSO director and deputy directors and appropriate managers and staff from OMRDD’s Executive Office and Divisions of Workforce and Talent Development and Quality Management.

A local advisory board involving self-advocates, families, the CDDDSO Board of Visitors, and the workforce, among others, will be developed to support this effort.

The risk assessment phase of this project will begin during the summer. Performance measures are being developed to track these measures impact on staff-to-person interactions and relationships as well as incidence levels of reported and substantiated allegations of abuse, neglect and serious reportable incidents.

In NY state they are taking some serious measures to erradicate

OMRDD Unveils Aggressive Campaign to Reduce Abuse and Neglect

ALBANY, NY (06/18/2008)(readMedia)

The Office of Mental Retardation and Developmental Disabilities (OMRDD) released a multifaceted approach to reducing serious incidents, abuse and neglect in its service system, Commissioner Diana Jones Ritter announced today.

Foremost in this new effort is the creation of the Division of Workforce and Talent Development, which is designed to bring leadership, heightened investment and oversight to the agency, enhancing it’s capacity to develop and sustain the relationship which is critical to success for people who have developmental disabilities. Research shows that the best way to both prevent abuse and promote richer lives is to strengthen and nourish the relationships between individuals with developmental disabilities and those that care for them. To achieve these goals, OMRDD, with more than 90,000 staff in state and voluntary programs, is expanding and refocusing training and supervision.

“OMRDD’s core mission is to help people with developmental disabilities lead richer lives. Obviously, this is severely undermined each time a person with a developmental disability is the victim of abuse or neglect or the focus of a serious, reportable incident,” said Commissioner Ritter. “My leadership team and I have committed to reducing the number of such incidents. We realize the work our committed, hardworking and dedicated staff perform can be highly stressful, so we must work with a broad set of partners to ensure that our direct-care workers are not only well-trained, but also have the proper foundations of support.”

The quality of care for people with developmental disabilities is tied to the positive relationships in that person’s life – especially those with staff who are deeply involved in their daily lives. The vast majority of those who care for the developmentally disabled are good and caring people. However, research has found when an individual is abused by staff, there are several negative effects. In addition to physical or psychological injury to the victim and the penalties to staff whom are responsible, another result which may be even more devastating relates to the destruction of the very essence of that helping relationship. Abuse harms the relationship and thereby harms the hope, both of which are needed in order to thrive. It is with this in mind that OMRDD is accelerating the development and implementation of the following tactical plan:

• Expansion and refocused training and supervision of key, stress-intensive living or program environments. It has been demonstrated that many instances of abuse, neglect or serious reportable incidents are a by-product of situational stress or environmental circumstances that cause some staff to behave in unacceptable ways. To ensure all direct contact staff – especially those working in highly stressful situations – are properly trained and supervised, OMRDD has invested in expanded training for its developmental aides and their supervisors.

• Expansion and refocusing of training for staff of its voluntary provider agencies. This new focus isdesigned to enhance staff skills both in developing the positive, mission-driven skills needed in their work, and also to provide individual and supervisory tools that help them deal with the stress of their day-to-day working environment.

• Engaging in discussions with OMRDD workforce and labor/management groups on ways to reduce stress in the working environment and to better manage the fallout when staff is determined to have acted in an unacceptable manner.

• The creation of the new Division of Workforce and Talent Development. Already this new Division has taken on the following challenges:
Established mandated core training topics for Developmental Assistant supervisors
Refined the Competencies to which Developmental Aides are trained
Created a workgroup to reengineer the Developmental Aide Traineeship
Revised OMRDD’s approach to training staff to intervene during behavioral crises
Received a multi-year grant from the federal government to examine a wide range of direct support workforce issues including training, career paths and improving recruitment and retention of workers; and developing a workforce that serves self-directing individuals.

Established an accessible and cost efficient online training institute.
Assess the impact of current recruitment efforts on staff.

Commissioner Ritter has also created a new Office of Investigations and Internal Affairs to improve its capacity to investigate reports of abuse and neglect, among other incidents.

OMRDD is reaching out to partner with external groups who have expertise in workforce issues, abuse and neglect, and organizational cultures. The University at Albany School of Social Welfare, Center for Intellectual Disabilities and its Dean, Professor Katharine H. Briar-Lawson, have pledged such a partnership.

“This kind of collaboration brings some of the most respected practitioners to the issue, as well as creates a learning partnership for both our staff and the students in this prestigious school of social work,” said Commissioner Ritter. “As I have said many times since becoming Commissioner, OMRDD has a solid history. However, I believe we have been unable to go from ‘good’ to ‘great’ by the insularity of so much of its work. A hallmark of my time as Commissioner will be not just transparency, but broad partnership and collaboration.”

Eventually, these partnerships will grow beyond the initial partnership with the University at Albany, to help establish a corporate culture within the OMRDD funded system where there will be zero tolerance for abuse and neglect. This abuse prevention strategy will be embedded in the agency’s overall quality management strategy, focusing on staff and their interactions with people with disabilities.
This new effort will involve a three- part approach:

1) The Risk Appraisal portion will use well-established national research on institutional abuse to create a Risk Appraisal Profile for each unit. OMRDD will be using CDDDSO as a prototype for this approach. Having developed a profile of the risk factors for each unit, the agency will work in a collaborative manner with employees, unions, management, individuals and self-advocates to develop the second component;

2) A Prescriptive Prevention Strategy for each unit within the facility that is directly reflective of that unit’s risk profile. Actions in this area will include all levels of the organization and may involve such things as staff training, reevaluation of client groupings, staff counseling and support, anticipation of seasonal factors, and raising the awareness of staff to the issues involved in abuse prevention.

The intent in the Prescriptive Package is not to focus on any individual, staff or system-related problem, but rather to approach the problems jointly in an effort to reduce or eliminate, to the greatest extent possible, the factors which make it more likely that abuse will occur.

3) An Abuse Awareness Campaign will be a system-wide public education and marketing campaign, which OMRDD will again pilot in the Capital District. Aimed at staff of all levels, the theme of this portion of the project will be the preservation and enhancement of dignity and respect for individuals in our care. To the extent that we are able to positively impact upon the nature of the relationship between individuals and staff and promote a heightened awareness on the part of staff to the importance of maintaining people’s dignity and respect, we will decrease the likelihood that staff will abuse individuals or tolerate abusive behavior from their peers.

“Everyone benefits by enhancing the staff to consumer relationship and promoting the highest level of dignity, respect and value between consumers and staff,” said Commissioner Ritter. “The satisfaction of the staff will increase when they feel better about their relationship with those they support, the individuals in our care will thrive upon the increased positive interactions with staff. Furthermore, administration will become increasingly sensitive to the many factors which they must balance to maintain and enhance quality of care.”

This new strategy will be developed as a prototype within the Capital District Developmental Disabilities Services Office which is located in Niskayuna, N.Y.. A project team has been identified which includes the CD DDSO director and deputy directors and appropriate managers and staff from OMRDD’s Executive Office and Divisions of Workforce and Talent Development and Quality Management.

A local advisory board involving self-advocates, families, the CDDDSO Board of Visitors, and the workforce, among others, will be developed to support this effort. The risk assessment phase of this project will begin during the summer. Performance measures are being developed to track these measures impact on staff-to-person interactions and relationships as well as incidence levels of reported and substantiated allegations of abuse, neglect and serious reportable incidents.

Some Good Legislation

In Florida they seem to be a step ahead of us here in Oregon, when it comes to laws that are progressive. The two bills signed into law on Friday will improve the lives of people with physical and developmental disabilities.

GOVERNOR CRIST SIGNS BILLS TO ASSIST PERSONS WITH DISABILITIES

6/13/08

GOVERNOR'S PRESS OFFICE
(850) 488-5394

ORLANDO – Governor Charlie Crist signed two bills into law today that benefit people with disabilities. Senate Bill 856 promotes education of disability history and awareness, and House Bill 739 improves access to Guardian Advocates for people with disabilities. The Governor signed the bills surrounded by individuals with disabilities, their families, and advocates at the 10th Annual Family Café Conference in Orlando.

The Family Café focuses on providing information and resources to people with disabilities. Also joining the Governor were the disability history and Guardian Advocate bill sponsors Senators Mike Fasano (R-New Port Richey) and Victor Crist (R-Tampa) and Representatives Curtis Richardson (D-Tallahassee) and Kevin Ambler (R-Tampa). Lt. Governor Jeff Kottkamp and James DeBeaugrine, interim director of the Agency for Persons with Disabilities, also attended the event.

“Teaching disability history and awareness in our schools will help young people learn that people with disabilities are just like anyone else – with the same wants, desires, and abilities to achieve great things,” said Governor Crist. “Additionally, the Guardian Advocate law will help protect the most vulnerable by reducing legal costs to gain a guardian advocate.”

The Disability History and Awareness bill designates the first two weeks of October as a time when public schools will provide instruction on disability issues. Each school will cover disability history, famous people with disabilities, and the disability rights movement. The long-term benefits are as follows:

Better treatment for people with disabilities in society.
Increased attention to preventing bullying of students with disabilities.
Increased hiring, retaining, and promoting of people with disabilities as employees once students become adults.

Greater self-esteem and pride among persons with disabilities, resulting in increased entrance into college, the workforce and community involvement.
Greater inclusiveness in society for all individuals with disabilities.

The second bill signed helps protect the rights of people with developmental disabilities by improving access to a Guardian Advocate. Guardian Advocates are designated by a court to make decisions on behalf of an individual with a disability. Some benefits are as follows:

Clarifies what type of decision-making assistance the Guardian Advocate will provide.
Requires an attorney to be appointed at state expense.
Enhances efficiencies in the system, reducing costs and making it easier for more families to become Guardian Advocates.
Requires disclosure of conflict on interests, preventing egregious conflicts and protecting the vulnerable.
Addresses the process of restoration of rights, which was unclear in previous legislation.

Scary Stuff

Here’s another report I found on the Bend Weekly News Source. It deals with the fact that people with serious mental illness die significantly younger than those without.

Report: One-third of mentally ill Oregonians die before 50

Oregonians with serious mental illness are dying years earlier than their neighbors in the general population, and a grassroots health movement is under way to reverse this trend.

The Oregon Department of Human Services Addictions and Mental Health Division (AMH) has teamed with consumers of mental health services and their families, health care professionals and others to implement a statewide wellness initiative aimed at improving mental and physical health and longevity.

Death comes before age 50 for one third of those treated for mental health problems, according to results of a seven-year AMH mortality study. A staggering 89 percent of people treated for both mental illness and substance abuse die before age 50. The average lifespan of someone who is dually diagnosed is 45.1 years, which equates to an average 34.5 years of potential life lost.

The recent study, titled “Measuring Premature Mortality among Oregonians,” compared the death records of persons who received public substance abuse and/or mental health treatment with the general population.

The early death toll among this segment of Oregonians falls in line with similar results from national and state studies. More importantly, it brings into focus what many individuals with mental illness already knew; by taking charge of their health, habits and lifestyle they can add years – and quality – to their lives, said Bob Nikkel, DHS assistant director for addictions and mental health.

“National research and this study make it clear that persons being treated for substance abuse and mental health problems have many risks that may bring on early death,” said Nikkel. “Our most critical imperative is to help individuals with mental illness live better and longer lives.

“Mental health and substance abuse is an important quality of life issue for Oregonians,” he continued. “Dying prematurely not only destroys human potential, but it has an economic impact as well.”

The AMH study showed substance abuse and mental health clients have higher risks of death associated with suicide, homicide and unintended injuries. In addition, they are economically disadvantaged and vulnerable to many diseases that cause death. For example, antipsychotic medications used to treat someone with mental illness are known to elevate the chance of dying from cardiac arrest; others may lead to diabetes.

The mortality study is available on the DHS Web site at: www.oregon.gov/DHS/addiction/publications/msur_pre_mort_6_2008.pdf

Nikkel said a DHS/AMH wellness committee is working to improve the health and longevity of people with mental illness by drawing on scientific research, literature and successful practices by user groups. Here are some of the committee’s guiding principles:

• We must treat and support the whole person;
• Care coordination and wellness screening are essential;
• Access to a range of health care options and basic health care must be afforded to all Oregonians;
• Early intervention and prevention across the lifespan saves lives, makes a difference in years of productive life lost, and improves quality of life;
• Medication management and empowerment equips individuals with the tools and strength to ask questions and work with treatment providers to find healthier and effective ways to support recovery and wellness; and
• Disparities in health care coverage and access to service must be overcome, along with finding culturally appropriate treatment programs.
Committee members are seeking funding for grassroots-level programs that encourage education and lifestyle changes and for peer-to-peer support services.

For more information visit the DHS wellness Web site at: http://www.oregon.gov/DHS/mentalhealth/index.shtml

Minorities Struggling in Oregon

I came across this interesting study in the Portland Observer. It shows that although we’ve made some progress in regard to minority groups, we have a long way to go in Oregon. The entire study can be found at the Oregon Progress Board's web site, benchmarks.oregon.gov.


Study looked at healthcare, other factors

Asian Americans living in Oregon have made good progress in education, health and safety and financial status over the past 15 years, according to a new study from the Oregon Progress Board.

But the news is not as positive for the state's growing population of Hispanics, as well as for the small number of African-Americans and American Indians who live in Oregon.

Each group was evaluated based on a host of indicators, including high school and college completion rates, middle school reading and math scores and high school dropout levels.

The study also considered whether minority groups' access to health and prenatal care had improved since 1992, whether crime and poverty rates had fallen and whether home ownership was on the rise.

Nearly all those targets showed improvement for Asians, save for prenatal care rates, which have leveled off since 2000, and poverty levels, which have been flat since 2000.

By contrast, Hispanics continue to lag behind the rest of Oregon in all key educational measures, and nearly one-third lack health insurance, about double that of the overall state rate. Their bright spot was in crime, where researchers found that the arrest rate among Hispanics had dropped substantially since 1990, to near the overall statewide rate.

The picture was more mixed for African-Americans, who made progress in high school completion and prenatal care, though lag behind many other populations in areas including home ownership and middle school test scores.

College completion rates among adults of color have remained level or declined over the past 15 years. Crime has declined for all racial groups.

Fr American Indians, the overall rating was negative, with poverty rates that are roughly double the statewide levels and declining home ownership levels.

The Oregon Progress Board also reported that the state has become more racially and ethnically diverse over the past 15 years.

The board is a state agency that monitors how closely state goals are reflected in the lives of Oregonians.

"The Race and Ethnicity Report underscores the importance of helping all Oregonians, regardless of ethnic or racial background, achieve the benefits of living and working in Oregon," said Gov. Ted Kulongoski.

"We need to intensify our efforts to enable people of color take advantage of the Oregon Opportunity Grant program, which helps students handle the cost of a college education. We need to expand the Oregon Health Plan to ensure that every child in Oregon receives health care. If we enable minority citizens get a good education and ensure that their children are healthy and ready to learn, we'll empower all minority citizens to achieve financial parity with white citizens," Kulongoski said.

The report appears on the Oregon Progress Board's web site, benchmarks.oregon.gov.

Break's Over

I took a few weeks from blogging to work on some other stuff, but I'm back. I found this story on KATU.com...

By Associated Press
SALEM, Ore. (AP) - A 59-year-old former caregiver has gone on trial, accused of raping a mentally handicapped 70-year-old in her apartment at an assisted-care facility in Sublimity.

John Alvin Taylor is charged with rape and sodomy because the woman is unable to consent legally to sex, although his defense disputes that point.

The woman suffered a brain injury in a car wreck in her early 20s that killed her husband, prosecutor Matt Kemmy said.

In September 2005, a female caregiver preparing to shower the woman found a condom wrapper floating in the apartment's toilet, Kemmy said Tuesday in an opening statement.

The woman told investigators that Taylor had oral, vaginal and anal sex with her, Kemmy said.

The sex confused her, Kemmy said. "She couldn't have babies after the accident. She wasn't sure why he was doing this."

Defense attorney John Halpern said he will challenge the assertion that the woman is incapable of consenting to sex.

"There are some myths surrounding her," Halpern said. "We want to put them to the test."

As testimony began, medication aide Nicole Walczak said Taylor disappeared for a time during their shift the night of Sept. 29, 2005. When he turned up, he told her he had been taking a nap, she said.

He was fired after the shift and arrested in 2007.

Honest Conversation

I've been involved with a group of concerned citizens seeking to come up with strategies to stem the crisis of violence, neglect, abuse, and exploitation of developmentally disabled adults in Oregon. Our group is comprised of folks very close to the situation as well as folks who just want to see something done. I'm grateful to be a part of this work, and genuinely appreciate the work of my colleagues.

It's truly been an eye opening experience. We're actually talking about issues that for far too long have not been talked about nearly as thoroughly as they should. For me it's energizing to discuss in a group some of the very edgy points that my wife and I speak of privately daily.

This class of idividuals have been devalued throughout THE WORLD since the beginning of humanity. Sure, you here about the Shamans in a few cultures where developmentally disabled people hold a high position, but I can assure you that in a vast majority of cultures it's the opposite. In the US and Oregon, that has been the case.

Some of the coolest people I've known in my life have had developental disabilities. That's not to say some of the most uncool people I've known haven't also come from that demographic. I guess that's because people are people no matter what label has been placed on them. And the people who work for them can be equally very cool or uncool. I don't think it wise to say caregivers are all saints any more than they are all evil.

I'm just loving the honest conversation. I believe our group is on it's way to doing something that should have been done long ago. I'm proud to be a part of reforming a system badly in need of reformation. I hope the others are also proud.