No excuse for violations at Oakland County group homes

This article from The Detroit News, "Repeated violations found at Oakland County group homes", January 10, 2011, is all too familiar. Every year or so a local newspaper features a story about group homes that could just as well have been written last year or the year before that or ten years ago. The story goes something like this: Group home residents live in squalid conditions, are subjected to mistreatment by group home employees, and are neglected to the point where they wander off and get into serious trouble with the police and their neighbors. It is also not unusual for an employee to claim, as happened in this case, that he or she was fired for trying to bring problems to the attention of his or her supervisors.

There are many group homes that provide excellent care and have none of the problems cited in this article. When the best choice for a person is to live in a group home, I think the best care for people with severe developmental disabilities is provided in homes that have strong family involvement and oversight, community support from local churches or other community organizations, and whose management welcomes and encourages this support. What families have to worry about are the many group homes that provide adequate care, but not much in the way of a fulfilling life for their residents and homes that provide neither adequate care nor much of a life for their residents and end up endangering the health, safety, and well-being of the people who live there.

Licensed group homes are operated under strict rules to assure safety and the protection of residents' rights. The caseloads of licensing monitors, however, have been increasing, bringing into question whether monitors can adequately do their job. In addition, administrators in the Michigan Department of Community Health have stated that they want to eventually eliminate group homes as an option for people with developmental disabilities. It is difficult to believe that the State will do much to improve the quality of failing group homes when they would prefer that they disappear.

There are things that families can do to improve the living situation of group home residents.

The first line of defense to protect a resident of a group home is to have a good person-centered plan and service plan that describe in detail all the services the person needs and how they will be delivered. Many problems go back to poor planning. Furthermore the plan of services must take into account the preferences and choices of the resident that are so important for the person's happiness and satisfaction with his or her living situation.

Most of the rights of recipients of mental health services fall under these broad categories listed in the Michigan Mental Health Code:

1. A recipient shall receive mental health services suited to his or her condition.
2. Mental health services shall be provided in a safe, sanitary, and humane treatment environment.
3. Mental health services shall be offered in the least restrictive setting that is appropriate and available.
4. A recipient has the right to be treated with dignity and respect.

Any violation of these rights can be reported to the local Recipient Rights Office. In Washtenaw County, Recipient Rights can be reached at (734) 544-3000. Anyone can make a complaint to recipient rights, whether or not you are related to the person involved. As a complainant, you should receive a written response to your complaint, written updates on the progress of the rights investigation, and a written summary of the conclusion of the investigation and the actions that have been taken to correct the situation.

A Rights Complaint form is available here.

Adult Foster Care Licensing provides an extra layer of monitoring and oversight for group homes and deals with the most serious rights violations and safety issues.  These can involve the death of a resident, accidents or illnesses that require hospitalization, displays of serious hostility, self-inflicted harm or harm to others, and destruction of property. Also included in investigations are incidents involving the arrest or conviction of a resident and absence without notice.

If a resident has a guardian, the guardian must be notified in writing within 48 hours of an incident or event that triggers a licensing investigation. A licensing complaint form can be found here. In addition to the complaint form are rules for AFC homes and notice requirements when a complaint has been received.

AFC maintains a Website on licensed group homes. Look for Special Investigation Reports that go beyond routine licensing inspections for information that may indicate serious problems at a group home.

The best and most reliable monitors of group homes are family members and friends who drop in frequently, ask lots of questions, and do not let serious incidents go by without reporting them to the proper authorities.