Page 10


FEATURE IP The Hidden Cost of For-Profit Care BY EYAL PRESS AND JENNIFER WASHBURN n April 14, 1998, two days after Easter, Janice Lacy called the Appleridge group home in Houston to see how her sister Trenia had spent the holiday. “They told me she’d had a nice Easter and was asleep,” says Janice, recalling her conversation with a caregiver at the home where Trenia and five other mentally retarded women lived. At about ten the follow ing morning, Janice received a call at work informing her that Trenia had been rushed to the hospital in the middle of the night. Twenty-four hours later, Trenia Wright was dead. Janice was never told the circumstances that led to her sister’s sudden death. But after the body was brought to Dallas to be buried alongside Trenia’s father, the family was curious enough to contact a lawyer. Hospital records and an investigation by the Texas Department of Human Services soon revealed that Trenia’s Easter Sunday was anything but nice. That evening a group of male visitors had come from a nearby home to share an Easter dinner with the ladies at Appleridge. Trenia, who was diagnosed with both cerebral palsy and mental retardation, generally liked male company, but on this night, she grew distraught. Just as the visitors were leaving, she defecated in the hallway and fell to the ground, screaming. At this point, a state investigation found, the direct-care staff poured a mixture of cleaning agents and chemical bleach on the floor Trenia Wright and left Trenia, who had trouble lifting herself on her own, to wallow in it for more than two hours. For the next three days, the staff made no effort to wash Trenia, even as she complained that burns from the chemicals were causing her clothes to stick to her skin. By the time she arrived at the emergency room on Wednesday morning, 40 percent of her body was covered in burns so severe \(and confirmed been napalmed.” Janice Lacy did not know any of these details until it was too late. pany that operated Appleridge, is part of a national for-profit chain with a history of problems. T.H.M.’ s parent corporation, ResCare, contracts with federal and state governments to provide service to a variety of special-needs populations, from the developmentally disabled to troubled youth. Buoyed by a flurry of recent acquisitions, ResCare is now the nation’s largest provider of services to people with developmental disabilities. It operates group homes and other facilities, which are primarily underwritten by Medicaid, in twenty-eight states, and earned more than $485 million in the first nine months of 1999. ResCare is not the only company moving into this particular market. In recent years, numerous large, publicly traded companies including MENTOR, a division of Magellan Health Services, one of the nation’s largest behavioral and mental health corporations have emerged as dominant players in the disabilities sector, a trend that mirrors the for-profit takeover of hospitals and nursing homes. The companies, which have drawn praise from stock market analysts, are capitalizing on a little-noted trend: since 1977, government spending on the disabled has risen from $3.4 billion to more than $22 billion, turning care for the mentally retarded into a major growth industry. Rti esCare, which stands for “Respect + Care,” touts its “innovave, efficient services” as a boon for states looking to control osts while moving individuals out of expensive state facili ties into a variety of community-based programs. The company also insists that Trenia Wright’s death was “an isolated incident” that “has nothing to do with ResCare’ s overall quality of supports.” But a review of thousands of pages of state documents from across the country along with interviews with advocates, case managers and former ResCare employees opens a window onto a broader pattern of neglect: THE TEXAS OBSERVER 9 MAY 26, 2000