The state is moving some of the most violent offenders out of its last facility for the intellectually impaired following complaints that staff members were being beaten by patients who should be in a more secure environment.
The moves began the day after a story in The Advocate last week detailed safety concerns by workers at Pinecrest Supports and Services Center near Pineville, where many developmentally disabled patients in state care were sent after funding cutbacks.
Direct care workers at Pinecrest say five of the most troublesome clients have been moved as of Tuesday. Three were sent to Central Louisiana State Hospital, a full service psychiatric hospital in Pineville, and two were sent to the Feliciana Forensic Facility in Jackson.
“As we have done recently with some, we will transition clients to another setting if it is deemed appropriate by our clinical staff,” Louisiana Department of Health Deputy Secretary Michelle Alletto wrote in an emailed statement. Part of her duties are to oversee the 95-year-old Pinecrest with about 430 clients.
She would not give details but stated: “For several months now, LDH has been assessing its client population at Pinecrest to help ensure that the department is treating clients in the setting most appropriate to their needs. This assessment process also takes into account the individual clients’ health and safety as well as the health and safety of other clients that we serve in the facility.”
The state’s efforts to privatize and economize health care at the state’s remaining facility…
The direct care staff is predominantly middle-aged women who for years had cared for individuals with profound intellectual disabilities – bathing, feeding and otherwise helping them through the day. But to save money, the state began relocating clients to private facilities, which generally took those without behavioral problems. At the same time, the state in 2013 closed all the other state facilities as well as reduced services offered by other agencies.
This left a concentration of people diagnosed with milder forms of intellectual disabilities but with violent backgrounds. As the facility of last resort, Pinecrest must take these individuals and has limited legal options on moving them elsewhere.
For the year prior to Feb. 28, the staff filed 524 worker compensation reports after being punched, kicked, bitten, scratched or otherwise assaulted. Three years ago virtually no incidents of violence on the staff were reported.
Reports of patient-on-patient violence and other files that reflect assaults are confidential under state and federal law. Worker’s comp forms, which record possible claims for employee injuries, are public records.
Moving patients from a facility of last resort is not easy.
Because of the dramatic increase in violence at Pinecrest, Alletto in February ordered evaluations done on the clients involved in most of the incidents. Her legal team began looking at state and federal law for flexibility. And Department of Health officials talked to other state agencies to find alternative placements for some of the Pinecrest clientele.
Though four Pinecrest staffers voiced happiness about the removal of the five clients, the facility still has violence.
Mary Williams, who has worked at Pinecrest for 18 years, was injured Monday in an attack involving a 17-year-old male who has history of violence.
Apparently angered at not being taken to McDonald’s, the client pulled ceiling tiles from the bathroom, then while cussing the staffers, started throwing tiles like Frisbees at the women. Williams, who is blind in her left eye, was hit under her right eye by one of the tiles.
“A lot of people got hurt yesterday,” Williams said Tuesday.
She didn’t seek medical treatment, though has a cut under what’s now a puffy eye, but she did file assault charges against the individual with the Pineville Police Department. She said he is expected to be removed from Pinecrest on Wednesday.
“We’re not dealing with truly disabled people anymore,” Williams said. “We’re getting straight up thugs right off the street.”
But she was heartened by the newfound ability to seek help from the police. For years the practice at Pinecrest was to handle such incidents in-house on the theory because the clients are officially diagnosed with intellectual disabilities there was little that law enforcement could do.
Alletto said the “we’ve always done it that way” practice was wrong. She wants staffers to seek criminal charges if they are attacked.
“The staff at our facilities who have been injured or have had their property damaged by a client are made aware that they may contact local law enforcement at any time in which they believe criminal conduct has taken place,” Alletto wrote.
Additionally, the Department of Health is bringing in security experts to train the staff on methods to deescalate situations before they turn violent and better protect themselves if they do.
For the clients, Pinecrest is teaching anger management and coping skills. The facility also is trying to organize programs that are more focused on particular needs of this new group of patients. And Pinecrest has rolled out a program that incentivizes good behavior by giving clients points that can be redeemed for personal items, like chips, socks, watches, ear buds – even laptop computers. The positive reinforcement idea also teaches the patients delayed gratification.