The staff at a Booneville center for the developmentally disabled will no longer put residents in a "safe room" to control their behavior and will receive more training on the use of restraints, the Arkansas Department of Human Services announced Monday.
The planned changes at the Booneville Human Development Center follow a report in January by Disability Rights Arkansas that found staff members had excessively used physical and medical restraints.
The advocacy organization, which has federal authority to investigate the treatment of people with disabilities, also issued a report less than two weeks later blaming the choking death of a resident at the center on a treatment plan that called for staff to ignore the resident when she appeared to be having seizures.
In response to the report on the use of restraints, the Human Services Department assigned a seven-member "quality assurance team" -- including staff members from other human development centers and from Easter Seals, a charity that provides services to the disabled -- that conducted its own review last month.
The report released Monday recommends the Booneville center implement a policy to identify residents who are repeatedly restrained and modify their treatment plans to avoid the need for such measures in the future.
It also recommends improving documentation of the use of restraints, providing better training for staff members on the contents of each resident's treatment plan and making those plans easier for the staff to understand.
The team's report also recommends developing a training program for the staff members responsible for authorizing restraints and creating a panel to review the use of restraints at each of the state's human development centers every three months.
At the request of Disability Rights Arkansas, the review team also investigated the use of the "safe room," which, according to the team's report, had been used to hold residents with "maladaptive behavior."
The team found that the center did not adequately document the use of the room and that center policy didn't specify that residents could not be held in the room for more than one hour, as federal regulations specify.
Noting that the state's four other human development centers do not use such rooms, the team said the Booneville center should stop using the room and should use the techniques used by the other centers.
Melissa Stone, director of the Human Services Department's Division of Developmental Disabilities Services, said in a news release that the report's recommendations will be implemented within 45 days.
The division will monitor the Booneville center and make further changes if necessary, she said.
"It's important that we are continuously improving and monitoring all of the centers, and this review is a big step in that direction," Stone said.
The Booneville center has "a very dedicated staff that treats clients like family," she said, but "we also found inconsistent documentation and a need for some changes that I think the staff and the family of clients will embrace."
Disability Rights Arkansas Director Tom Masseau called the planned changes a "positive step forward" and said his organization will be monitoring the department's progress.
"A lot of these are cultural issues," Masseau said. "The staff are great, but they're so ingrained in, 'This is how we do things,' and change is difficult for people."
Disability Rights Arkansas' Jan. 14 report found 25 instances in September in which residents at the Booneville center, which had 122 residents at the time, 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 use of restraints was also cited in a January 2015 report by Disability Rights Arkansas that also noted the poor condition of some of the Booneville center's buildings and recommended its closure.
In response to that report, the state adopted policies to give staff members more "non-physical de-escalation" approaches and ways to set "appropriate limits that help calm behaviors," according to a Human Services Department statement.
All human development center staffs will be trained on the techniques by the end of this month, department spokesman Amy Webb said Monday.
A Jan. 26 report by Disability Rights Arkansas focused on the death of Shateria Diggs, who had been physically restrained more than 40 times, for a total of almost 37 hours, from January 2014 to February 2015.
Her death on Feb. 26, 2015, came after she threw up and choked on cereal in a TV room.
Although Diggs had been taking anti-seizure medication, a psychiatrist in December 2014 reported that the attacks were "likely pseudo seizures" and diagnosed her with "factitious disorder," indicating she was faking the seizures, according to the Disability Rights Arkansas report.
Diggs' treatment plan called on the staff to ignore Diggs' jerks and twitches during the seizurelike episodes but to monitor her using their peripheral vision.
A supervisor who found Diggs on the floor told the advocacy group that she assumed Diggs was faking a seizure and wasn't sure whether she needed medical attention, according to the group's report. The supervisor was quoted as saying she was uncomfortable attempting to distinguish between a medical emergency and fake seizures.
A Section on 03/22/2016