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Sunday, August 5, 2012

An Unfortunate Case in Montana

As previous posts have mentioned, institutional placement can go very wrong. The Billings Gazette has Eve Byron's story about a young ASD man who fared so poorly at the Montana Developmental Center that a state hearings officer ordered the state to send him to the Kennedy Krieger Institute at the cost to the state and federal government of $711,000.
He’s become the most expensive state client using a state program for individuals with developmental disabilities that provides community-based services to people.
After he was released from the Baltimore facility in 2009, he moved to a Montana assisted-living facility.
The average cost for a client using the program, known as a Medicaid waiver, is about $39,000 per year, paid for by state and federal funds.
The cost of the young man’s care runs anywhere from $306,000 to $367,000 a year.
He was evaluated in December 2007 by Dr. Diane Edwards, an expert in developmental and behavioral pediatrics, who recommended he be transferred to Kennedy Krieger. She concluded that his behaviors worsened both in frequency and severity while at MDC.
In fact, Edwards and others reported that his treatment at MDC was counter-therapeutic.
Other doctors testified at the hearing that psychiatric care at MDC was substandard. Hearings officer Joseph Sternhagen noted in his report that the boy’s medication management was being done by MDC’s psychiatrist, who saw the boy about once a month on average.
It said the psychiatrist saw the boy only once in a three-month period, despite knowing he was going to be transitioned to a different housing unit, which was traumatic to the boy.
“It was during this time that (the boy) lacerated his forehead so severely that he had to be transported to the hospital emergency room, however stitches could not be applied because of his unstable behavior and not surprisingly, four days later (the boy) reopened the wound at MDC,” Sternhagen wrote.