Check out the transcript of a Q&A session with Gov. Dave Heineman about the Beatrice State Developmental Center.
DEENA WINTER / Lincoln Journal Star | Posted: Monday, June 15, 2009 12:00 am
Questions and answers with Gov. Dave Heineman about the Beatrice State Developmental Center, which is on the verge of losing its federal funding because it has repeatedly failed to meet federal standards for care:
How did BSDC get in this situation? To me that's a complex issue. I've had discussions with individuals who've been involved or associated with BSDC over the years, and I've talked to the interim CEO, Claire Mahon, about BSDC and basically what I hear from people is the challenges of dealing with people with developmental disabilities have been evolving since the mid-1970s, particularly what we do at BSDC. I sense there's some agreement that there should have been over the years a greater focus on the direct care staff and active treatment. More recently, it seems like the federal government has intensified its focus and its pressure on institutions like BSDC. I get the sense they'd like to close BSDC but I disagree with them on that. I think we need to learn from our past decisions and previous mistakes, and the focus has to be on the future. Today might not be perfect, but tomorrow needs to be better. And I believe we can do that.
What is your No. 1 goal for BSDC? I think there are several goals, I don't know if I can distill it down to one. One of the key ones is we want BSDC to be recertified. In order to do that, we need to improve staff training, we need to improve the culture, we need to improve the services that we provide to people with developmental disabilities. At the same time … we need to expand and strengthen community-based services and care.
How many times have you been to BSDC? Several times … probably somewhere between three and six times.
What is your impression of the facility? By and large, I think we have a staff who cares about the residents, they care deeply about them. They're like a family to them. Secondly, I think we need to improve our habilitation services and we need to make sure we evolve from custodial care to active treatment care. And I think we're moving in the right direction there.
Do you have any relatives who have a developmental disability? None that I know of.
Would you allow your son or daughter to live there? Yes. Do we need to improve the care? Absolutely.
Were you involved in the the decision not to appeal Dr. Joann Schaefer's order that medically fragile BSDC residents be moved out? I had conversations about it. I was aware of what was going on. Think about what occurred there: The chief medical officer of the state had declared that BSDC was unsafe for the medically fragile. I think we all respect a medical professional like the chief medical officer, so a week later, to appeal the decision when we weren't in compliance wouldn't have been the appropriate thing to do. Now I don't think there's any question that as we make progress, there'll be the opportunity to ask the license suspension to be reinstated. I talked to Claire Mahon about that and I think we both expect that to occur or that application to be made at some time in the future. Now whether that's four months from now or eight months from now, I don't think any of us know. But clearly at some point in the future, there will be an application for license reinstatement … when we feel the care meets the standards.
Why was that decision not appealed? Look what was going on at BSDC at that time: We'd just had a death. We had some previous situations. I think there was a great concern that the medically fragile were unsafe at BSDC. That's why the chief medical officer took the extraordinary step of exercising her authority under state statute to declare BSDC unsafe for the medically fragile. Now if it's unsafe, it doesn't seem to me that we would want to keep the medically fragile at BSDC in that kind of environment. We'd already lost one person, we didn't want to lose another individual.
Was there any discussion about solving the problem any other way, like sending in an army of nurses and training all employees over a month or two? … The state needed to put (medically fragile residents) in an environment where they were safe. … I don't think we could afford to wait another month.
Of course you probably know the suspicions of some guardians and family members that somehow it was a way to get some people out of BSDC that had resisted that move? Absolutely not true. Dr. Schaefer exercised her independent authority. She called me late Friday afternoon, I think it was Jan. 30th, and indicated the situation and what she was planning to do.
Some of the families and guardians were concerned that that move really took a toll on some of those medically fragile people, and of course two did die - we don't know why necessarily. Does that sort of thing ever keep you up at night? Do you ever worry that somehow the move was stressful for them as those guardians feel? Well, I'm concerned for the families. No one wants to lose a loved one. I lost my dad two summers ago. It's a difficult situation when you lose someone who's close to you. But the primary decision made by Dr. Schaefer was the safety of the medically fragile at BSDC. The chief medical officer made the determination that BSDC couldn't perform the emergency services that were needed. So I know it was a stressful situation and a move -we're in a very difficult situation. If we hadn't moved them and others would have died, everybody would have been very upset, and understandably so. Hey, it's still difficult and a trying situation that we did move some and there were two other deaths I believe, but I don't think anybody's tried to say it was because of the move. It may have been, by and large, natural causes.
Regarding the meeting in Beatrice at the Eagles Club, you made some reference to a legal avenue (to move BSDC residents whose guardians do not want them to move into community programs). What legal process were you referring to? I think there's a lot of misunderstanding and confusion on that and I didn't mean to create that - (I meant) that there were going to be legal options for everybody involved. I just wasn't necessarily talking about the state, I was just trying to state a fact, that everybody involved in this has legal options they can pursue. And in fact, six individuals with developmental disabilities have sued the state. So I was talking about their options as much as anything else.
Who is running things now that you have no CEO for the HHS agency, your DD division head is leaving soon, and you have an interim CEO? We've got an interim CEO, Claire Mahon, who I think is doing a very good job. She's reaching out to families, guardians, parents and everybody who's involved in the situation, and they like what she's doing. She's trying to explain what's going on, the improvements that are being made. The director of developmental disabilities will be with us until early July, then we'll make a decision (on) probably who will be an acting director. The CEO of health and human services, we've been actively looking for that position. In the meantime, we're just coordinating the six division heads. They are fully capable of running their divisions and I hope in the near future we'll have a CEO but we've got to find the right person.
Did you ask for John Wyvill's resignation (as director of the Division of Developmental Disabilities)? I've said repeatedly I appreciate Mr. Wyvill's services and I respected his decision to pursue other opportunities. And beyond that, I'm not going to say anything. It's a personnel issue.
State leaders were concerned that the feds (Medicare) were intentionally trying to close down BSDC because they don't like institutions. Do you think that's a legitimate belief? I don't have any doubt about this whatsoever. The federal government would like to close institutions like the Beatrice State Developmental Center.
And that's based on what? That's based on conversations with the top leadership of CMS (the Centers for Medicaid and Medicare Services, the federal agency that provides half of BSDC's funding). They clearly indicated a preference to close an institution like BSDC.
Have you ever considered relocating the institution to a more urban area? Not really.
Do you think the problems at BSDC have been exaggerated? By who?
Anyone. In a way, it doesn't matter. I know we have challenges at the Beatrice State Developmental Center, and I want those to be corrected. Like many, I'm frustrated by the pace of change, but let's remember, BSDC didn't get into this situation overnight and it will take time to improve the situation.
Do you think that this issue has become politicized? Yes.
Care to expand on that? I think it's pretty obvious.
By whom? I think if you talk to senators privately, they will share with you that this situation has become more politicized. Having said that, what I am most concerned about is taking care of people with developmental disabilities. To make sure we provide them the care they deserve, that we treat them with dignity and respect, and that we continue to move forward to recertify BSDC and expand and strengthen community-based care.
Interview by Deena Winter, who can be reached at 473-2642 or dwinter@journalstar.com.