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'Dangerous place to live': Why state-run home for vulnerable adults is under fire again

News Tribune - 9/12/2022

Sep. 12—Lawyers are seeking a court order to prevent Rainier School from admitting any new or returning residents, claiming in a recently filed federal lawsuit that the state-run home for people with developmental and intellectual disabilities in eastern Pierce County is "a dangerous place to live."

The lawsuit, filed on behalf of a current and former resident, accuses Rainier School, which is located about 24 driving miles east of Tacoma in Buckley, of failing to give appropriate care to the two plaintiffs. It alleges that both plaintiffs, and others, were put at "significant risk of harm" by being placed at the state facility despite its well-documented history of problems.

Attorney Darrell Cochran, who is part of a team representing the plaintiffs, said that he has been involved in a half-dozen cases against Rainier School dating back to the mid-1990s, but none have gone as far as to pursue court intervention to essentially shut down the facility barring major changes.

"The effort to get Rainier School either closed or significantly revamped has been a long time in the making," Cochran told The News Tribune.

Jilma Meneses, the secretary of the Washington State Department of Social and Health Services — the state's largest agency — and Susan Birch, the director of the Washington State Health Care Authority, are named as defendants in their official capacities.

The Department of Social and Health Services operates Rainier School, while the state's Health Care Authority provides oversight for it and other Medicaid-funded facilities, according to the lawsuit.

Neither agency would comment on the claims, citing practices of not publicly speaking about pending litigation.

"We can say, however, that our priority is to always do what is in the very best interest and safety for our clients," Department of Social and Health Services spokesperson Lisa Pemberton wrote in an email.

Treatment of two residents is scrutinized

The suit, filed in U.S. District Court in the Western District of Washington, centers around two adults with developmental disabilities, referenced in the filing by their initials: A.M., a 45-year-old woman, and G.G, a 20-year-old man.

A.M. has lived in full-time residential care since she was a teenager and suffers from significant behavioral health issues, according to the federal complaint. She was allegedly moved from a state-run home north of Seattle in February into an under-regulated housing area at Rainier School called Naches Cottage that was set up in response to the COVID-19 pandemic.

A.M. has not had access to the same level of care as she did in the residential home from which she arrived, or as she would have at other facilities in Rainier School, because Naches Cottage lacks specific certification or licensing to entitle residents to receive the same standard of care, according to the lawsuit.

As such, she had been unable to schedule needed dental or optometrist appointments for more than five months as of Aug. 1, the complaint read. She also allegedly did not have a behavior support plan until five months after she was admitted into the facility, which goes far beyond the state Developmental Disabilities Administration's deadline of 30 days.

A.M. reported that staff at Naches Cottage called her names and removed personal belongings from her home, according to the lawsuit.

Meanwhile, G.G., who also has significant behavioral health issues and has lived in 24-hour residential care since he was 16 years old, came to Rainier School in 2020 after he aged out of a program in another state and was brought back to Washington.

Facility staff mismanaged their response to G.G.'s tendencies to be verbally and physically abusive, according to the lawsuit, physically restraining him on multiple occasions, including by using mechanical waist-to-wrist restraints and ankle cuffs.

In January, he threatened to kill himself and was taken to a local hospital. Workers there reportedly documented their concerns about the amount of psychotropic medication he had been prescribed while at Rainier School, the complaint read.

When Rainier School terminated his residency, G.G. was left in the hospital with nowhere to go for four months, and he remains institutionalized in a hospital setting without any community-based options to receive care, the lawsuit claims.

In addition to allegedly failing to provide adequate care for residents, Rainier School is significantly understaffed and employs only one licensed psychologist, according to the lawsuit, which also names as a plaintiff, Disability Rights Washington, a nonprofit and state-designated oversight and advocacy group.

Long list of woes

Rainier School opened in 1939 as Western State Custodial School, with its population peaking in 1958 at more than 1,900 residents, according to the Department of Social and Health Services' website. Now it has approximately 120 residents, according to the lawsuit.

The Department of Social and Health Services' website describes the campus as "situated in a peaceful country setting with a unique and prominent view of Mount Rainier." Among the many large buildings spread out across the campus, residences are "home-like" and staffed for teaching daily life activities. The community includes a gym, bowling alley and coffee shop, along with traditional resources for physical and mental health.

It is one of four state-run centers for people with developmental disabilities in Washington but "uniquely dangerous," Cochran said.

Since 2012, no one under 21 years old may be admitted into a center unless there are no other options for services in the community and, even then, admission is limited to those older than 16 years old who are in a crisis or need short-term service, according to state law.

Generally speaking, state law requires that entry into such a facility is preceded by an application, either by the person with the developmental disability, a legal representative or anyone else authorized by the secretary of the Department of Social and Health Services or a designee to apply.

The lawsuit, which was first reported by NBC affiliate KING 5 News, comes as Rainier School's problems have been mounting for some time.

A former supervisor was sentenced to 24.5 years to life in prison in 2018 for rape of one resident and inappropriately touching another. In 2020, the state was ordered to pay $4.25 million to a family whose foster child nearly drowned after falling to the bottom of a lake while strapped in a wheelchair during a group fishing trip orchestrated by Rainier School staff, Pierce County court records show.

A family of a man who went missing from Rainier School, never to be found, settled a lawsuit with the state in October 2021 for $2.25 million. In March, the state was ordered to pay $1.25 million, county court records show, to the family of a woman who died from a pulmonary embolism after bunion surgery.

"State regulators have determined repeatedly over the course of multiple years that Rainier School is failing to meet federal minimum requirements for health and safety," the federal complaint reads. "On multiple occasions regulators have determined that Rainier School's failures have put residents in immediate risk of serious harm."

In 2019, one of three facilities at Rainier School was decertified by the Centers for Medicare and Medicaid Services for failing to comply with minimum federal standards for effective and appropriate treatment, according to the suit. Most of the facility's 84 residents were moved out of Rainier School, while five were moved into two remaining Rainier School facilities.

Then in July, the state's Health Care Authority said it would terminate the certification of one of those two existing facilities effective Sept. 3, because that facility, similarly, has continuously been out of compliance with federal conditions required to participate in the Medicaid program.

The facility in question is home to roughly 60 people, according to the lawsuit. It was not immediately clear whether the decertification would lead to the facility's closure and, if so, where current residents would be transferred. A spokesperson for the Health Care Authority could not track down answers by deadline Friday.

If it closes, that would leave just one operating Rainier School facility and it too has also come under federal scrutiny for Medicaid program non-compliance, according to the lawsuit.

In addition to preventing Rainier School's population from growing, the lawsuit seeks to require that an independent consultant be hired to monitor the facility and investigate ongoing deficiencies; any resident who wishes to move is promptly discharged to an appropriate new setting; and all remaining residents are provided new care plans that will meet their needs.

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