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Disability Rights Florida Files Lawsuit Against Agency for Persons with Disabilities Regarding Carlton Palms

Friday, July 20, 2018


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Tallahassee, FL, July 19, 2018 - Disability Rights Florida, Florida’s federally funded Protection and Advocacy organization, filed a lawsuit in the United States District Court against the Florida Agency for Persons with Disabilities’ (APD) director, Barbara Palmer. Disability Rights alleged that APD’s program for individuals with developmental disabilities who also need intensive behavioral interventions is inadequate to the point of placing people at risk of being institutionalized without long-term modifications to the services that treat and respond to intensive behaviors for all iBudget enrollees. For years, APD has relied on Carlton Palms Education Center, a large isolated facility in Mt. Dora to house people with challenging behaviors. As a result, little has been done to provide effective services and supports in family homes or small group homes. People who need these services too often must rely on inadequately funded and staffed group homes where they risk wrongful psychiatric institutionalization, bodily harm, and unnecessary physical and/or chemical restraint via overmedication of anti-psychotics.

For the past several years, Disability Rights Florida monitored Carlton Palms’ corrective efforts after the death of a young resident in restraints in the summer of 2013. Ultimately, multiple allegations of abuse and neglect resulted in several licensure complaints and Settlement Agreements with APD. The most recent agreement—July 2016—required transitioning residents to smaller, community settings by March 2019.

In November 2016, Disability Rights Florida determined that there was probable cause to believe that incidents of abuse or neglect continued at Carlton Palms. This includes the frequent use of thirty-four homemade restraint chairs—wooden chairs with bolts in the legs and eyelets in the arms used to hold residents down.

On March 1, 2018, another Carlton Palms resident died under circumstances indicating insufficient behavioral programming which is supposed to be monitored by APD. In April, APD issued another complaint that detailed how, on multiple occasions, Carlton Palms didn’t properly supervise clients who escaped into the neighborhood, left facilities dirty with unrepaired holes in walls, failed to keep track of powerful medicines and abused clients.

As a result, Carlton Palm’s management, Delaware-based Bellwether Behavioral Health, informed APD that they plan to close the Carlton Palms Educational Center on May 31, 2018, and, from that time forward, Carlton Palm’s management has been under the control of an APD appointed receiver.

However, notwithstanding the knowledge that Carlton Palms was going to close its doors since 2016, APD has failed to fund and provide sufficient services for persons with intellectual or developmental services currently in the community, and, as such, failed to provide safe placements for those transitioning from Carlton Palms to the community. There are currently not enough group home providers willing and able to meet this population’s needs. Furthermore, if a person with a developmental disability chose to live with their families, the amount of in-home support is substantially less than the level provided in residential settings.

The current system relies too heavily on a family’s ability to manage potentially dangerous behaviors. APD’s structure for residential habilitation services is also restrictive, with little regard for maintenance staffing required. Transitions are taking place that rely on temporarily approving additional non-Waiver services, paid for out of general revenue. These are not reliable or sustainable.

Currently, there are approximately 130 persons who were transferred from Carlton Palms and over 1,000 individuals in Florida with developmental or intellectual disabilities who require high levels of oversight and supervision for their behavioral challenges. Behavior Focused and Intensive Behavior group homes typically treat those with maladaptive behaviors and are operated by different providers throughout the state. There are insufficient numbers of these group homes—In April 2017, there were only 114 APD-licensed group homes which are authorized to render Intensive Behavioral Residential Habilitation services. Within those homes, there were a total of 733 beds with only 30 vacant beds statewide.

When settings are inadequately staffed, or insufficient in-home services are provided, persons with disabilities are subject to institutionalization resulting from police intervention and involuntary psychiatric admissions. Some settings also rely on the use of physical and chemical restraints to manage a resident’s behavior, which can result in irreversible injury, both physical and psychological. Even after these extreme measures, additional services or supports are rarely provided.

The State’s failure to provide community-based services to people with disabilities is in violation of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973. Hundreds of persons with disabilities have been transferred into settings that have been insufficient staffed for their safety and the safety of staff, have been involuntarily committed to psychiatric facilities, have ended up with criminal charges, or had to seek temporary variances from APD rules in order to receive adequate services. These persons include: 

  • AV, an adult with autism residing at Carlton Palms. AV was referred to a group home in Gainesville without AV’s parent being made aware of the referral. The placement was declined because it was too far from their home. Then AV was referred to an institutionalized placement, which would remove him from the Medicaid Waiver.
  • LP, a woman with autism and self-injurious behaviors residing at Carlton Palms. While a resident at Carlton Palms, LP suffered many injuries as a result of lack of adequate supervision. She even became legally blind due to a detached retina that staff did not identify early enough to be repaired, and, because of the failure of supervision, LP is in a constant state of chemical restraint from antipsychotic medications. LP requires a community residential placement that will meet her behavioral and medical needs.
  • ARS, a man with autism who previously resided in inadequately staffed behavior group homes leading to the use of police and unlawful placement at psychiatric facilities. ARS was transferred to Carlton Palms where he was the victim of complaints of abuse and neglect. He was ultimately transitioned to a typical behavior group home with additional, but precarious, general revenue funding to provide adequate supports and services to keep ARS healthy and safe in the community.
  • SS, an adult with a developmental disability who previously resided at Carlton Palms. Upon transitioning to group homes throughout the state, he has been involuntarily committed because of inadequate services. These interruptions in his services and lack of behavioral treatment for his challenging behaviors have caused SS harm including an emergency room visit for an ill-informed expedited removal from psychiatric medications.
  • TW, a man with autism who resided at Carlton Palms until recently. His parent took him home upon learning of the continued abuse and neglect allegations at the facility. TW received injuries while at Carlton Palms and his parents now question the veracity of explanations for those injuries. TW resides in the family home but desires to live in an adequately staffed group home with a meaningful day activity.
  • JB, a man with autism who resided at Carlton Palms until December 2017. Upon transitioning to a group home with inadequate services he had been subject to continuous chemical restraint and instances of physical abuse. JB would like to be transitioned to his family home with adequate supports that will meet his needs for health and safety, provide effective behavioral services, and offer opportunities for community engagement.

“Persons with autism, intellectual or developmental disabilities have the right to have the supports and services necessary to live with or in the same community as their families,” said Matthew W. Dietz, litigation director of Disability Independence Group. “The failure to provide adequate services leads to costly police intervention, institutionalization in psychiatric hospitals, and barbaric uses of chemical and physical restraint. This traumatic process could be avoided if Florida offered proven and effective services in the community, programs to prevent and de-escalate crises, help for people to obtain safe and staffed housing.”

Disability Rights Florida is represented by their Director of Systems Reform, Amanda Heystek, Nancy Wright, of the Law Office of Nancy Wright, and Matthew W. Dietz, Litigation Director of Disability Independence Group, Inc.

Disability Rights Florida was founded in 1977 as the statewide designated protection and advocacy system for individuals with disabilities in the State of Florida. It has been advocating for access to services, education, employment, independence, and the elimination of abuse and neglect for over 35 years.

Disability Independence Group is a 501(c)(3) non-profit organization that promotes recruitment, education, and employment of persons with disabilities thereby improving their lives through competitive employment and financial stability; and through the changing of society’s perception of persons with disabilities.  

Nancy Wright is a sole practitioner who is focused on the special care needs of persons with disabilities and the elderly, with emphasis on helping clients receive services that allow them to remain as independent as possible, in the home or the community.

Tags for this Post

abuse and neglect, agency for persons with disabilities, developmental disabilities, institutions, litigation, restraint and seclusion,

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