Lawmakers want to improve personal care homes after man's death

personal care homes their focus after brain-injured man dies

vhoneycutt@herald-leader.comSeptember 7, 2011 

Republican State Sen. Jimmy Higdon and state Rep. Terry Mills, a Democrat, say they would consider new legislation to improve Kentucky's personal care homes after both personally searched for a state ward with a brain injury who was found dead Saturday — a month after disappearing from such a home.

"It had a profound effect on me. I've never experienced anything like that," Higdon said.

Said Mills: "We had a situation there that broke my heart and the heart of the community."

Both are from Lebanon, the hometown of Larry Lee, 32, who was found dead Saturday after disappearing Aug. 4.

Lee's remains were found near the Licking River, close by Falmouth Nursing Home, where he went missing.

A cause of death hasn't been determined, but foul play is not suspected.

While Lee was missing, both legislators drove to Falmouth in Pendleton County to search and briefly see the home, which the state classified as a personal care home rather than a nursing home.

Personal care homes provide a type of long-term care for people who do not need full-time nursing home care but need some assistance. Residents of personal care homes are often mentally handicapped or mentally ill and have nowhere else to go.

Both lawmakers say they will work together in the 2012 General Assembly to improve conditions in Kentucky's personal care homes. Higdon said it's likely that he will file legislation to address staff-to-resident ratios and other problems.

Higdon said some conditions that he has been made aware of are not "what I envisioned the state was getting for their dollars that we are paying for personal care homes to care for our most vulnerable citizens."

Melissa Knight said her brother suffered a brain injury in an accident when he was about 11 and developed a mental illness some years later. In addition to his brain injuries, he was schizophrenic, bipolar and diabetic.

Staff at Falmouth Nursing Home said they noticed that Lee was missing when they went to give him medicine. His disappearance launched a widespread search.

Falmouth Nursing Home administrator Tracy Winkle declined to comment Tuesday. The Cabinet for Health and Family Services' Office of Inspector General is investigating conditions at the personal care home.

At the request of Falmouth officials, Higdon, who knows Knight and her family, told them that officials thought Lee's body had been found.

Knight said that if personal care homes are going to continue to exist in Kentucky, she hopes that lawmakers find a balance between the residents' right to "freedom and a good quality of life" and "the safety and health concerns" that can come with their illnesses.

Higdon and Mills said they are in the beginning stages of reviewing personal care home issues, including staffing.

Melissa Knight said that when she visited the personal care home after her brother's disappearance, there was one staff member overseeing more than two dozen residents.

State administrative regulations regarding personal care homes are not specific, but they say that staff should be based on the number of patients and the supervision needed to meet the needs of the residents.

One attendant must be awake and on duty on each floor at all times. In addition, administrators are required to appoint someone to handle record-keeping, health services, activities and food.

Mills said he thinks the General Assembly should "take a hard look" at staffing ratios for all long-term care facilities, including nursing homes that provide more skilled care than personal care homes.

Higdon said he also wants to ensure that personal care homes offer activities for residents and that the buildings are in good repair. He said the Falmouth personal care home was clean but aging.

Mills said one option he and Higdon have discussed is to call for a task force to study conditions at personal care homes.

Knight said that residents at personal care homes need freedom, but a log should be kept of their whereabouts and, if appropriate, they needed to be accompanied when they leave the home.

Knight said Tuesday it was a difficult decision for her family to allow Lee to become a ward of the state, and one they did not make for years. Knight said professionals and court officials advised the family that it was the best option in order for him to receive services for brain-injured people. She said her family took an active role in her brother's life while he was a state ward.

Knight said one issue that has emerged from her brother's death is how state officials choose homes for state wards.

Ten state wards live at the Falmouth personal care home, said Emily Moses, a spokeswoman with the Cabinet for Health and Family Services.

Deborah Anderson, commissioner of the state Department for Aging and Independent Living, the agency that oversees state wards, and her staff walked the streets to search for Lee and handed out fliers. Higdon said he and Mills hope to meet with Anderson soon to discuss issues regarding state wards.

In addition to improvements to personal care homes, Higdon said that he is considering legislation that would set uniform procedures for communities to follow when a vulnerable person such as a child or a person who is elderly, mentally disabled or mentally ill is missing.

"We have the same objective," Mills said of his efforts with Higdon, "and that's to make it better for people like Larry."

Reach Valarie Honeycutt Spears at (859) 231-3409 or 1-800-950-6397, Ext. 3409.

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