Disability Rights Arkansas, Inc. is submitting this statement as a reply to the Division of Developmental Disabilities Services (DDS) response to our January 2016 report on the excessive use of restraint at the Booneville Human Development Center. Although we appreciate the fact that DDS and the DDS Board have issued a response, we believe that the response minimizes the information in the report and the need for immediate action both to protect the individuals with developmental disabilities residing at Booneville HDC and also to provide them with the effective, evidence-based, active treatment that those residents need and that the State is required to provide.

When DRA issued our first report in January 2015 concerning the Booneville HDC, DDS did not respond with any acknowledgement that there was a problem with the excessive use of restraint at this facility. Instead, the response from the State was as described in our January 2016 report, with DDS disavowing any problem with the use of restraint at the facility and attributing the excessive use to “characteristics” of the residents. Specifically, DDS responded to the high numbers reported in January 2015 by blaming the residents for being ambulatory and aggressive, as well has having dual diagnoses. DDS did not acknowledge any need to review or address the use of restraint at the facility. Nor did DDS mention any review or recommendations provided to them by an independent consultant in 2012, or any plan for additional training.

Prior to issuing the January 2016 report, DRA requested information about new training that may have been provided to Booneville HDC staff. We remain concerned about the information in the DDS response regarding Crisis Prevention Institute Training. First, although DDS has asserted that this training is “new,” it is not new. The training, Nonviolent Crisis Intervention, has been around since the 1970s. This raises the question as to why it took DDS until sometime in 2015 to begin introducing this training to the Booneville HDC facility and its staff. Second, on January 6, 2016, DRA was advised that only 58 staff at Booneville HDC had received Nonviolent Crisis Intervention training. We are at a loss to understand how, only one week later, DDS could assert that more than 100 members of the facility’s staff had been trained. Third, based on information provided to us, training of all staff would not be completed until March 2016, though DDS asserts staff began training in March 2015. Assuming the current assertion that 100 staff have been trained is correct, that leaves 2/3 of the facility’s staff without that training.

Furthermore, we are concerned that the response continues to exhibit a lack of understanding about the serious concerns raised regarding use of restraint at the facility. DDS has made questionable assertions regarding the need for restraint at the facility that raise serious concerns about the ongoing culture and belief in the necessity for the use of restraint.   DDS seeks to claim that the large number of restraints is necessary due to “emergency situations.” Many of the so-called “emergency situations” are directly caused by lack of training, lack of appropriate interventions, and escalation by staff as described in DRA’s report.

DRA is seeking further information to assess DDS’s response and steps that are being taken to address the serious concerns about restraint at Booneville HDC. DRA will continue to monitor and review the restraint practices at Booneville HDC, as well as other public and private facilities throughout the State, and encourages persons with concern about the restraint of any person with a disability to contact Disability Rights Arkansas, Inc. at (501) 296-1775 or the Arkansas Office of Long Term Care at (800) 582-4887.