120 residents to be moved from St. Louis County rehab center

ST. LOUIS (AP) -- About 120 residents of the Bellefontaine Habilitation Center in St. Louis County will be moved to private, community-based programs after a federal review showed they were at risk of injury or even death, the St. Louis Post-Dispatch reported Friday.

The new plan by the Missouri Department of Mental Health is a change from one announced in March. It will put the care of most Bellefontaine residents in the hands of four private vendors who will bid to operate group homes on the center's campus in north St. Louis County.

They will care for residents there until other off-campus, community-based arrangements are decided, department spokesman Bob Bax said.

Some Bellefontaine employees and parents of residents were upset when they learned of the decision Thursday.

Betty Coll, vice president of the Bellefontaine Habilitation Center Parents Association and president of the Mental Retardation Association of Missouri, said the plan does not ensure the safety of residents. And Joe Lawrence, spokesman for the American Federation of State, County and Municipal Employees, said the private centers would lack proper monitoring.

"No matter how the state dresses this up, it's going to be highly disruptive for these clients who are often in delicate conditions, and it's going to be damaging to the lives of the staff," Lawrence said.

In March, the Department of Mental Health announced plans to keep residents at Bellefontaine, but under a new structure involving a private care provider. Recent "frightening" developments since then have led to changes in the plan, state Mental Health director Keith Schafer said.

In April, the U.S. Department of Justice labeled the center unsafe and ill-equipped to care for its mentally retarded and developmentally disabled residents. Those findings came 10 months after a Post-Dispatch investigation found widespread mistreatment of residents.

On June 27, an annual federal review of the center resulted in a declaration of "immediate jeopardy" on behalf of a resident. Federal surveyors witnessed a resident smashing her fist into her face, Schafer said. The resident's "behavioral support plan" called for employees to prevent her from hurting herself, as well as other steps to reduce the behavior. But appropriate steps were not taken, Schafer said.

That failure resulted in immediate case reviews of each of the center's 52 residents with patterns of self-injurious behavior. Those reviews revealed treatment failures in 54 percent of the cases, Schafer said.

"We expected, based on a tremendous amount of resources that have been poured into Bellefontaine in the last two to four years, for it to be a very positive survey, and it was not," Schafer said. "It was, in fact, a very frightening survey because it identified a series of significant safety problems."

Schafer said many of Bellefontaine's nearly 700 employees will receive notices of layoffs in January, but private vendors will be encouraged to hire them. The new vendors are expected to take over in mid-February.

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Information from: St. Louis Post-Dispatch, http://www.stltoday.com