State officials are once again reviewing the procedures used by staff at a Booneville center for the developmentally disabled after an advocacy group found an excessive use of physical and medical restraints.
While the use of restraints at the Booneville Human Development Center decreased from June 2014 to September 2015, it remained far higher than at the state's three other similarly-sized centers for the disabled, according to a report released Thursday by Disability Rights Arkansas.
In a January 2015 report, the organization recommended closing the Booneville center, citing the poor condition of some of its buildings and the frequency with which residents are restrained.
In response to that report, the Developmental Disabilities Services Division changed the policies at the Booneville Center and another center to ensure all the centers were using the same restraint techniques, according to a Department of Human Services statement.
In the report, released Thursday, Disability Rights Arkansas noted that in September 2015, the Booneville center, which had 122 residents, reported 25 instances in which residents were strapped to a padded board.
By comparison, such "mechanical" restraints were used three times each that month at the Jonesboro Human Development Center, which had 104 residents, and the Warren Human Development Center, which had 92 residents.
The Arkadelphia Human Development Center, which had 117 residents, didn't report any uses of such restraints that month, according to the disability group's report.
During the same month, the Booneville center reported 23 instances in which residents were given "chemical" restraints in the form of sedatives or other drugs.
That compared with two such instances at the Jonesboro center and no instances at the Arkadelphia or Warren centers.
The report found that staff members at the Booneville Center often failed to follow a policy requiring them to use less restrictive measures first. And it found that staff members failed to document the underlying cause of residents' behavior that led to the use of restraints.
In one instance, a resident who had been restrained was released and allowed to have breakfast and take her medications, according to Disability Rights Arkansas, a private, independent agency with federal authority to investigate the treatment of people with disabilities.
Even though the resident had calmed down, a nurse announced that she was still going to administer a chemical restraint in the form of a shot, which caused the resident to throw water, attempt to bite herself and fight with the staff, according to the report.
The center's staff members are "not improving," said Tom Masseau, director of Disability Rights Arkansas.
"There's a serious problem going on in how they're treating residents at the center," he said.
In a written response, the Human Services Department said Melissa Stone, who was named director of the department's Developmental Disabilities Services Division on Thursday, plans to "take an in-depth look at the practices, diagnoses and admissions" at the center.
"She also plans to work with [the Booneville center] to ensure staff is re-trained, if necessary, on appropriately documenting client interactions and emergency interventions," the department said in its response.
According to the response, the center has "a unique population that requires intense treatment and emergency interventions."
"Many of our residents are directly admitted from the Arkansas State Hospital, other HDCs, or jail," the department said in the response. "Often admissions occur because the safety of the resident being admitted or others in the referring environment could not be ensured."
Staff members at the Booneville center have special training in dealing with such residents, the department said in the statement.
Stone read the response at a special meeting Thursday of the state's Board of Developmental Disabilities Services, which supervises the centers' management.
In unanimous votes, the board approved the written response and named Stone the division's permanent director. She had been interim director for about three months after the previous director, Jim Brader, resigned to take a job with a nonprofit organization that provides services to the disabled.
The state's five human development centers provide round-the-clock care to people with developmental disabilities.
Disability Rights Arkansas, a federally funded nonprofit organization, didn't include restraint statistics on the Conway Human Development Center in the latest report because that center has more than 400 residents, including children and medically fragile residents, and wasn't considered comparable to the Booneville center.
In response to its January 2015 report, the state adopted policies to give staff more "non-physical de-escalation" approaches and ways to set "appropriate limits that help calm behaviors," according to the Human Services Department statement.
More than 100 employees have been trained in the techniques, and the remaining employees will complete the training by the end of March, the department said in the statement.
Masseau said the response hasn't gone far enough. He also disputed the department's claim that residents at the Booneville center are more difficult to deal with than those of the other centers.
According to the group's report, 72 percent of residents at the Booneville center have been identified as displaying aggressive, destructive behavior or a tendency to injure themselves, compared with 63.3 percent at the Arkadelphia center, 61.3 percent at the Jonesboro center and 57 percent at the Warren center.
"I'm a little frustrated that we continue to throw these numbers out there, and we just get lip service," Masseau said.
Metro on 01/15/2016