02-13-2006, 09:35 AM
Back story on AS boy's death at Grafton School Inc pasted below this one:
Nonprofit's Quick Exit Stirs Outrage
Provider of Services for Disabled Students Blames Montgomery's High Costs
By Cameron W. Barr
Washington Post Staff Writer
Monday, February 13, 2006; Page B03
When the Grafton School Inc. announced that it would close its Rockville school and its five group homes for developmentally disabled students this month, Betty Bahadori didn't have a moment to be angry. "We were scrambling to take care of these kids," she said, including her 18-year-old autistic son, Cyrus, who has lived in a Grafton group home since 2000.
County agencies, the school system, Grafton employees and parents have succeeded in finding new placements for all but one or two of the 42 students in Grafton's Rockville program. Chief executive James Gaynor II said he is confident that the remaining students will be taken care of before Grafton shuts its doors Friday.
Betty Bahadori's son Cyrus has lived in a Grafton group home since 2000. She said that learning of the impending closure just two months ago was "just really difficult." (By Lois Raimondo -- The Washington Post)
But Montgomery County Council President George L. Leventhal (D-At Large) criticized Grafton for what he called "cavalier and cruel" treatment of the county, which provided millions of dollars for the facilities when they opened in 1998.
"Grafton dropped the ball," he said last week. "Montgomery County has picked it up and is doing the best we can. But significant damage has been done."
Gaynor said that the organization is closing because it cannot sustain the high cost of doing business in Montgomery and that it has lost $3 million over eight years.
Last year, an annual state inspection of Grafton's Rockville school and group homes found scores of regulatory violations in staff training and care of group home residents. State officials prohibited Grafton from accepting new students -- and thus earning new revenue -- until the facilities were brought into compliance. The inspection "expedited us to really take a hard look at the viability and sustainability of going forward," Gaynor said.
The closure highlights the difficulty nonprofit organizations face in doing business in prosperous jurisdictions. Nonprofit groups say that Montgomery's government and private donors generously fund social services but that the vibrant job market and the high price of housing drive up costs.
"It is certainly not recognized by many government funding sources that it costs more to do business in Montgomery County than it does in other places," said Alan Lovell, chief executive of CHI Centers Inc., a Silver Spring-based nonprofit group that serves people with disabilities.
Gaynor said labor and housing costs in Montgomery have been 10 percent higher than at the organization's Virginia sites in Berryville, Richmond and Winchester.
Montgomery provides CHI and other providers with about $7 million annually to bridge the gap between revenue and costs, said county Health and Human Services Director Carolyn Colvin. Grafton did not apply for help with its operating costs but did receive county support when it arrived there nearly a decade ago.
In 1998, the county provided Grafton and another nonprofit group that it shared space with a $1.5 million interest-free loan, supported the issuance of $1 million in state bonds and gave Grafton $1 million in grants.
Grafton's Rockville educational programs and group homes fit in with two long-standing state and county goals: providing social services that are close to the residents who need them and having private organizations do the work, rather than the government. Grafton's departure underscores a problem with privatization, critics say -- organizations can shut down without much notice.
Bahadori said that she was pleased with Grafton's services but that learning of the impending closure just two months ago was "just really difficult." She praises the organization's care for its students and residents but questions why it couldn't find ways to cover Montgomery's high costs. "I don't accept that as a valid reason for closing, because it was a given, and they could have requested more from the funding agencies."
Grafton is jointly liable for the outstanding balance on the interest-free loan, which is more than $900,000. "We are going to hold them accountable for every dollar and duty that they owe us," Leventhal said.
Gaynor said Grafton will fulfill its obligations to repay the loan. Robert DeBernardis, a senior Health and Human Services official, said the organization had paid all 68 monthly payments on time.
Charles Short, a former county director of Health and Human Services who served when Grafton opened, said the organization deserves credit for upholding its standard of care. "I have to respect a decision like Grafton's to close and leave rather than attempt to operate a program with inadequate funding," he said.
Bahadori has found a place for Cyrus with another Montgomery nonprofit group. "You can't imagine how much better I'm sleeping," she said.
************************************************************
Back Story on Grafton School Inc:
Group home faulted in autistic boy's death
He choked on his own vomit while being held; CEO disputes the report
BY MICHAEL MARTZ
TIMES-DISPATCH
Feb 2, 2006
On Dec. 23, 2004, a 13-year-old boy choked to death on his own vomit while being held face down on the floor of a Winchester group home by as many as six members of the staff paid to care for him.
The boy, who was autistic and mentally ***, had arrived the day before at the group home operated at 920 Frederick Ave. by Grafton School Inc., one of Virginia's biggest providers of care for youths with behavioral problems and disabilities. He was placed in the Grafton facility, about five hours from his home in Southwest Virginia, because of aggressive behavior that had caused him to be committed to two state institutions earlier that year.
A state investigation of the death has concluded that the group home's staff was uninformed and ill-prepared to handle the boy, who was 6 feet tall, weighed 241 pounds and had limited ability to express himself. The investigation, completed last month, also found that the staff used an inappropriate form of restraint on the boy and did not relent until he began to turn blue.
"There is evidence to support that staff continued to hold [the boy] in a lying-down restraint when he began vomiting," the report states in respect to one of 12 alleged violations of Virginia interdepartmental regulations for group homes. "Vomiting is a sign of distress. Staff ignored vomiting as a sign of distress."
The home's staff also failed to respond quickly enough to the boy's dis- tress with mouth-to-mouth resuscitation, partly because the necessary safety equipment couldn't be found, the report states.
Grafton, a nonprofit organization that has operated in Virginia since 1958, was to deliver a required plan to state officials today to correct the problems identified by the investigation.
However, Grafton Chief Executive Officer James G. Gaynor II took strong exception to the state report. "We're certainly very much in disagreement with many of the findings," he said Tuesday.
Group homes are a hot topic in this year's General Assembly session because of concerns about the care they provide, as well as their relationships with their surrounding communities. Most of the care is publicly funded by state and local governments, or the federal Medicaid program.
The homes are licensed by different agencies responsible for children and adolescents, using a common set of interdepartmental regulations. In Grafton's case, the Virginia Department of Education is the state agency that licensed the home and led the investigation.
However, the education department was assisted by the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services, and its Office of Human Rights.
The Winchester Department of Social Services also participated in the investigation but issued a separate report based on child protective service regulations. The report found that the group home was not guilty of abuse and neglect under those rules in the boy's death.
In addition to violations of interdepartmental regulations for group homes, the state investigation cites Grafton for eight alleged violations of state mental-health standards and eight alleged violations of human-rights standards for people in therapeutic programs. The most serious was the alleged lack of information about the boy's behavior and medical condition when he was admitted to the home.
"The information collected at the point of admission is significantly inadequate, especially medical information," the mental health department states.
Virginia already has issued Grafton a six-month provisional license for the group home at 920 Frederick Ave., according to the education department. The provisional license is a temporary measure to allow the owner to make changes in the way it operates the home and cares for its residents to bring it into compliance with state regulations.
Grafton, based in Winchester, operates 23 group homes across Virginia, including 12 in the Richmond area, and a large residential facility in Berryville. Each home is licensed separately, so the investigation's findings apply only to the home in which the boy died.
The nonprofit organization has been a linchpin for care of people with behavioral problems related to developmental disabilities, especially autism. The Virginia Autism Resource Center, with offices in Midlothian and Winchester, is a division of Grafton.
Mount Rogers Community Services Board, the Marion-based agency that referred the boy to Grafton, would not comment on the case or the report.
However, Executive Director Lisa Moore said Grafton is an important option for communities that cannot find the special care these children need closer to their homes. "Grafton is a resource that we use once we've explored everything else," she said.
Moore added that her agency also tries to find help for children outside of state institutions. "I don't think being in an institution for a long time is a good alternative either," she said.
The boy, whose name was blacked out of a report provided to The Times-Dispatch by the Department of Education under the Freedom of Information Act, had been admitted to the Southwestern Virginia Training Center in Hillsville twice in 2004 to give his family respite from behavior that had become increasingly aggressive at home and school, the report said.
In November 2004, he was admitted to the Southwestern Mental Health Institute in Marion, where he remained until he was admitted to Grafton on Dec. 22, 2004, the day before he died. The state investigation found that the group home had not collected information about his stay at the training center and partial information from the mental hospital.
"This is particularly troublesome," the report states, "when it is understood, that prior to admission to Grafton, the student spent considerable time at these two facilities."
Nonprofit's Quick Exit Stirs Outrage
Provider of Services for Disabled Students Blames Montgomery's High Costs
By Cameron W. Barr
Washington Post Staff Writer
Monday, February 13, 2006; Page B03
When the Grafton School Inc. announced that it would close its Rockville school and its five group homes for developmentally disabled students this month, Betty Bahadori didn't have a moment to be angry. "We were scrambling to take care of these kids," she said, including her 18-year-old autistic son, Cyrus, who has lived in a Grafton group home since 2000.
County agencies, the school system, Grafton employees and parents have succeeded in finding new placements for all but one or two of the 42 students in Grafton's Rockville program. Chief executive James Gaynor II said he is confident that the remaining students will be taken care of before Grafton shuts its doors Friday.
Betty Bahadori's son Cyrus has lived in a Grafton group home since 2000. She said that learning of the impending closure just two months ago was "just really difficult." (By Lois Raimondo -- The Washington Post)
But Montgomery County Council President George L. Leventhal (D-At Large) criticized Grafton for what he called "cavalier and cruel" treatment of the county, which provided millions of dollars for the facilities when they opened in 1998.
"Grafton dropped the ball," he said last week. "Montgomery County has picked it up and is doing the best we can. But significant damage has been done."
Gaynor said that the organization is closing because it cannot sustain the high cost of doing business in Montgomery and that it has lost $3 million over eight years.
Last year, an annual state inspection of Grafton's Rockville school and group homes found scores of regulatory violations in staff training and care of group home residents. State officials prohibited Grafton from accepting new students -- and thus earning new revenue -- until the facilities were brought into compliance. The inspection "expedited us to really take a hard look at the viability and sustainability of going forward," Gaynor said.
The closure highlights the difficulty nonprofit organizations face in doing business in prosperous jurisdictions. Nonprofit groups say that Montgomery's government and private donors generously fund social services but that the vibrant job market and the high price of housing drive up costs.
"It is certainly not recognized by many government funding sources that it costs more to do business in Montgomery County than it does in other places," said Alan Lovell, chief executive of CHI Centers Inc., a Silver Spring-based nonprofit group that serves people with disabilities.
Gaynor said labor and housing costs in Montgomery have been 10 percent higher than at the organization's Virginia sites in Berryville, Richmond and Winchester.
Montgomery provides CHI and other providers with about $7 million annually to bridge the gap between revenue and costs, said county Health and Human Services Director Carolyn Colvin. Grafton did not apply for help with its operating costs but did receive county support when it arrived there nearly a decade ago.
In 1998, the county provided Grafton and another nonprofit group that it shared space with a $1.5 million interest-free loan, supported the issuance of $1 million in state bonds and gave Grafton $1 million in grants.
Grafton's Rockville educational programs and group homes fit in with two long-standing state and county goals: providing social services that are close to the residents who need them and having private organizations do the work, rather than the government. Grafton's departure underscores a problem with privatization, critics say -- organizations can shut down without much notice.
Bahadori said that she was pleased with Grafton's services but that learning of the impending closure just two months ago was "just really difficult." She praises the organization's care for its students and residents but questions why it couldn't find ways to cover Montgomery's high costs. "I don't accept that as a valid reason for closing, because it was a given, and they could have requested more from the funding agencies."
Grafton is jointly liable for the outstanding balance on the interest-free loan, which is more than $900,000. "We are going to hold them accountable for every dollar and duty that they owe us," Leventhal said.
Gaynor said Grafton will fulfill its obligations to repay the loan. Robert DeBernardis, a senior Health and Human Services official, said the organization had paid all 68 monthly payments on time.
Charles Short, a former county director of Health and Human Services who served when Grafton opened, said the organization deserves credit for upholding its standard of care. "I have to respect a decision like Grafton's to close and leave rather than attempt to operate a program with inadequate funding," he said.
Bahadori has found a place for Cyrus with another Montgomery nonprofit group. "You can't imagine how much better I'm sleeping," she said.
************************************************************
Back Story on Grafton School Inc:
Group home faulted in autistic boy's death
He choked on his own vomit while being held; CEO disputes the report
BY MICHAEL MARTZ
TIMES-DISPATCH
Feb 2, 2006
On Dec. 23, 2004, a 13-year-old boy choked to death on his own vomit while being held face down on the floor of a Winchester group home by as many as six members of the staff paid to care for him.
The boy, who was autistic and mentally ***, had arrived the day before at the group home operated at 920 Frederick Ave. by Grafton School Inc., one of Virginia's biggest providers of care for youths with behavioral problems and disabilities. He was placed in the Grafton facility, about five hours from his home in Southwest Virginia, because of aggressive behavior that had caused him to be committed to two state institutions earlier that year.
A state investigation of the death has concluded that the group home's staff was uninformed and ill-prepared to handle the boy, who was 6 feet tall, weighed 241 pounds and had limited ability to express himself. The investigation, completed last month, also found that the staff used an inappropriate form of restraint on the boy and did not relent until he began to turn blue.
"There is evidence to support that staff continued to hold [the boy] in a lying-down restraint when he began vomiting," the report states in respect to one of 12 alleged violations of Virginia interdepartmental regulations for group homes. "Vomiting is a sign of distress. Staff ignored vomiting as a sign of distress."
The home's staff also failed to respond quickly enough to the boy's dis- tress with mouth-to-mouth resuscitation, partly because the necessary safety equipment couldn't be found, the report states.
Grafton, a nonprofit organization that has operated in Virginia since 1958, was to deliver a required plan to state officials today to correct the problems identified by the investigation.
However, Grafton Chief Executive Officer James G. Gaynor II took strong exception to the state report. "We're certainly very much in disagreement with many of the findings," he said Tuesday.
Group homes are a hot topic in this year's General Assembly session because of concerns about the care they provide, as well as their relationships with their surrounding communities. Most of the care is publicly funded by state and local governments, or the federal Medicaid program.
The homes are licensed by different agencies responsible for children and adolescents, using a common set of interdepartmental regulations. In Grafton's case, the Virginia Department of Education is the state agency that licensed the home and led the investigation.
However, the education department was assisted by the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services, and its Office of Human Rights.
The Winchester Department of Social Services also participated in the investigation but issued a separate report based on child protective service regulations. The report found that the group home was not guilty of abuse and neglect under those rules in the boy's death.
In addition to violations of interdepartmental regulations for group homes, the state investigation cites Grafton for eight alleged violations of state mental-health standards and eight alleged violations of human-rights standards for people in therapeutic programs. The most serious was the alleged lack of information about the boy's behavior and medical condition when he was admitted to the home.
"The information collected at the point of admission is significantly inadequate, especially medical information," the mental health department states.
Virginia already has issued Grafton a six-month provisional license for the group home at 920 Frederick Ave., according to the education department. The provisional license is a temporary measure to allow the owner to make changes in the way it operates the home and cares for its residents to bring it into compliance with state regulations.
Grafton, based in Winchester, operates 23 group homes across Virginia, including 12 in the Richmond area, and a large residential facility in Berryville. Each home is licensed separately, so the investigation's findings apply only to the home in which the boy died.
The nonprofit organization has been a linchpin for care of people with behavioral problems related to developmental disabilities, especially autism. The Virginia Autism Resource Center, with offices in Midlothian and Winchester, is a division of Grafton.
Mount Rogers Community Services Board, the Marion-based agency that referred the boy to Grafton, would not comment on the case or the report.
However, Executive Director Lisa Moore said Grafton is an important option for communities that cannot find the special care these children need closer to their homes. "Grafton is a resource that we use once we've explored everything else," she said.
Moore added that her agency also tries to find help for children outside of state institutions. "I don't think being in an institution for a long time is a good alternative either," she said.
The boy, whose name was blacked out of a report provided to The Times-Dispatch by the Department of Education under the Freedom of Information Act, had been admitted to the Southwestern Virginia Training Center in Hillsville twice in 2004 to give his family respite from behavior that had become increasingly aggressive at home and school, the report said.
In November 2004, he was admitted to the Southwestern Mental Health Institute in Marion, where he remained until he was admitted to Grafton on Dec. 22, 2004, the day before he died. The state investigation found that the group home had not collected information about his stay at the training center and partial information from the mental hospital.
"This is particularly troublesome," the report states, "when it is understood, that prior to admission to Grafton, the student spent considerable time at these two facilities."