The Recruit

Places all over Houston want Trevor Falk and pitch the wonders of community life. He is 24 and has Down syndrome, which makes him a hot commodity for private group homes.

Other clients who weren't eating sat in plastic chairs on another side of the building or roamed around a room about the size of an elementary school classroom. A woman named Linda, who couldn't speak but was angry and crying, hit one of the caregivers several times in the chest before banging her head against a concrete wall.

After leaving the facility, Falk and Robinson stood in the parking lot and hugged, both on the verge of tears.

"There's a racket out here. The group homes are what the Department of Justice is not looking at, at all," Robinson says. "What they think goes on and what really goes on are two totally different things."

Trevor Falk, a 24-year-old with Down syndrome, was kicked out of 13 group homes before moving to Richmond State School.
Paul Knight
Trevor Falk, a 24-year-old with Down syndrome, was kicked out of 13 group homes before moving to Richmond State School.
His mother, Linda Falk, feels safe with him there.
Paul Knight
His mother, Linda Falk, feels safe with him there.

Anthonia Uduma, who owns Four J's, declined to speak with the Press.

The Press visited about a dozen other dayhab centers and residential group homes in the area, and most of the facilities were similar, located in strip malls or business parks.

One place, D&D Care Homes, Inc., on the far southwest side of the city, was nice. Almost all of the 45 residents there were high functioning, and the facility had rooms with brand-new computers and exercise equipment. Private tutors are brought in each day to teach residents a variety of subjects, such as arts and crafts, spelling or reading. A trip to Europe for the group is planned for 2012.

The other facilities were mostly filled with tables where residents sit for six to eight hours a day, watching television, coloring with crayons or working on some other menial task.

"There are actually a lot of people in dayhabs that could work in the community and be taxpaying citizens, and [dayhabs] were initially created to train people for work," says Choate. "But what it basically ended up being is a warehouse and babysitting system."

In the for-profit system, providers sometimes compete for clients, and no other population is more sought after than the residents at state schools. About 37,000 Texans are waiting for the Medicaid waivers that pay for the private group homes — some have been waiting as long as nine years — but state school residents who want to leave are guaranteed a spot in the private homes.

Despite this guarantee, moving out doesn't go quickly. Fedorov says each person who wants to leave a state school is counseled on community living, and any potential provider is screened to determine if his facility is a good fit.

"When someone decides they want to move out of the state school, it doesn't just happen overnight," she says. "There is a lengthy review process."

But residents are leaving. Last year, Richmond State School lost about 20 residents to private homes, according to Barrera. That's at least $94,000 of new revenue per month in the private system.

"It's turned into a very lucrative business for these private providers. They figured out they can make a lot of money caring for this population that can't really complain," Miller says. "That's fertile grounds for abuse."

After Governor Perry made a priority of protecting state school residents, Miller was worried that protection translated to closing the schools in favor of private homes.

"There were at least six or seven bills that could've put us out of business," he says.

One of the strongest bills against Richmond was authored by state Senator Rodney Ellis, a Democrat who represents parts of Harris and Fort Bend counties but not the state school, to develop a strategic plan that would, among other things, "transfer funds from institutions to community-based strategies" and "identify the number and location of state schools and state centers that will be closed under the plan."

The Ellis bill eventually died, but much of the same wording transferred to a similar bill filed by state Senator Judith Zaffirini, a Democrat from Laredo. Near the end of the legislative session in May, two items remained in that bill that scared state school supporters. One would allow a state school ­caseworker to override a guardian's decision for a resident, and another would cause funding to move from the state school to private homes.

Reeves and Robinson, along with Ferguson and Miller, traveled to Austin to testify, and the two items were eventually removed from the bill.

About the same time, the state reached an agreement with the Justice Department to vastly improve the care of residents in state schools, focusing on increased training of staff. The dollar amounts haven't been finalized, Fedorov says, but she expects about $24 million to be injected into the state school system each of the next two years.

"We survived, and it's been nothing short of divine intervention," Miller says.

The worst four months for Trevor Falk were during the spring of 2006.

It started when he moved from his mother's house to live with his father. One afternoon while his father was at work, Trevor got in an argument with his stepmother that escalated into a shoving match. She fell down and broke her foot.

The police were called, and Trevor was sent to the Harris County Psychiatric Center, a short-term care facility where patients can stay up to a month. He was discharged after three days, starting his journey through the 13 group homes.

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