Greater Oversight for Residential Facilities Serving Disabled Residents

Lilo H. Stainton | August 7, 2017 | Health Care
Assembly adopts governor’s tweaks to ‘Komninos’ Law’; Senate likely to follow suit

By early next year, residential facilities for individuals with developmental disabilities will likely face additional state scrutiny and be tasked with keeping family members better informed under a New Jersey law one step from being finalized.

Citizen advocates have worked for nearly five years with a handful of lawmakers from both parties to pass the new protections, dubbed “Stephen Komninos Law” after a 22-year-old man who choked to death in 2007 when his caregiver at a state-contracted facility left him alone with an unsafe snack, against doctor’s orders.

After many revisions, lawmakers passed the bill in late June. But Gov. Chris Christie issued a conditional veto of the proposal a month later, sending it back to the Legislature for modifications that made it less stringent. The Assembly adopted these recommendations last week, leaving it up to the Senate to make the final changes.

Sweeney makes support clear

Senate President Steve Sweeney, who helped pass a similar law to better protect disabled kids in foster care, has made his support for the measure clear. Senate officials are now working to schedule a voting session for the coming weeks, at which point members can take action on this and other matters, including a possible vote to block the governor’s proposal to shift addiction services from one department to another.

“This legislation will help provide the safeguards and protections to prevent the abuse, the mistreatment or the neglect of those with developmental disabilities who are in the care of others,” said Sweeney (D-Gloucester), who co-sponsored the bill with Sen. Jennifer Beck (R-Monmouth.) “That is our shared priority.”

He and Beck also thanked the advocates for what she termed a “hard-won victory.” Beck added, “I believe that our lifesaving legislation is so strong, that it could serve as a national model.

The state helps provide care for roughly 25,000 individuals with developmental disabilities; about 1,500 people now reside at five state-run residential centers, while the rest live in a wide variety of housing programs overseen by the Department of Human Service’s Division of Developmental Disabilities.

Challenging to track individual care

According to lawmakers, there are more than 2,300 community-based homes, day programs and other facilities that contract with DDD — making it challenge for regulators to track individual care. Operators note that limited funding has made it a struggle to retain and invest in staff; front-line workers earn an average of just over $10 an hour and four in 10 stay on a job less than a year.

Komninos’ Law would ratchet up scrutiny in cases of abuse and force caregivers to do more to keep family members in the loop — on good and bad days. When a resident or day-program participant is found with an injury, staff would have two hours to notify family members and two days to report the incident to DDD. (An exception is allowed for “extraordinary circumstances,” in which case the staff has eight hours to inform the family — and present details of what forced the delay.)

The law also requires DDD officials to make at least two unannounced visits to each community-based residential facility that houses developmentally disabled individuals and requires staff to pass a drug test before being hired and once, randomly, during each year of work. It would also call on state developmental centers to host annual meetings for family members and for community residences to offer to connect family members with each other, for mutual support.

“When the Stephen Komninos bill becomes law, it will provide protections that currently do not exist for our most vulnerable citizens, and it will establish a strong foundation for future improvements,” advocates Tom Komninos, Aileen Rivera, Martha Cray, and Gus Egizi said in a statement released by Beck’s office.

However, the version first adopted by the Legislature would have called for more extensive protections. Initially, staff would have been required to notify family members within an hour — no excuses — and the mandate would have applied to both residential and day programs serving developmentally disabled individuals. Christie’s CV made it two hours instead and eliminated the day-program clause.

The original bill called on DDD officials to make up to six surprise visits annually to all community-based programs, residential and daytime. But this element had been a particular point of contention for state regulators — and some program operators — who felt that would divert resources from more important tasks. Christie dialed it back to twice a year and again focused it on residential facilities.

The drug testing and family outreach aspects remained largely the same.

“We have long held that the state has a certain responsibility to protect people with developmental disabilities from abuse, neglect, and exploitation. No one should ever have to endure the horrors that Stephen went through,” Beck said. “The law we have named in his memory will establish a comprehensive set of checks and balances to ensure that every resident at every facility in New Jersey is safe and receiving the proper care.”