COFAR blog

[NOTE:  Last month, we first posted an article here about the importance of the Templeton Developmental Center to three men living there and to their families.  Below, I’ve posted some more information about those men and their experience, which didn’t make it into that first blog and which we weren’t able to include in the just-released March issue of The COFAR Voice.]

Jimmy Holdsworth kept getting thrown out of community-based group homes and sheltered workshops because his behavior was too volatile and his size and strength were too much for the staff to handle.

For Tony Welcome, community-based programs were ineffective in getting him to stop stealing cars.

Bobby Shepherd’s habit of wandering and trying to make friends with strangers frequently got him into trouble, and community-based programs didn’t provide the structure and supervision he needed.

In each of those cases, the Templeton Developmental Center turned out to be the solution to years of pain and struggle, not only for the men, but for their families.   But it’s a solution that will no longer be available to those families or the families of the 103 other remaining residents of Templeton  as of the end of Fiscal Year 2013.

The Templeton Center is one of four state-run Intermediate Care Facilities in Massachusetts that the Patrick administration has targeted for closure.  The others slated to be closed are the Fernald, Glavin, and Monson developmental centers.

Families and guardians of the residents of the facilities have protested the planned closures and, in the case of Fernald, have filed administrative appeals of the transfers of the residents.

But as many guardians see it, it’s not the closures of the buildings that make up the developmental centers that are at issue; the problem lies in the planned elimination of the federally prescribed level of care provided in them.

At Templeton, for instance, the administration plans to continue to operate three existing residences for persons with intellectual disabilities as community-based programs and to build two additional duplex homes on the grounds.   Those residences, however, will no longer be subject to federal ICF regulations governing staffing and care.

The dairy barn at Templeton

Bonnie Valade, Tony Welcome’s mother and guardian, was only able to get her son admitted to Templeton after a long struggle with the then Department of Mental Retardation (now Developmental Services), which had continually contended that Tony was not intellectually disabled.

By the time Tony was 19, he had already been placed in a number of mental health facilities, which had failed to control his impulse to steal cars.  His IQ had continually been measured in the 50s, which is well below the DMR requirement that a person have a maximum IQ of 70 in order to receive services. 

But when Tony was tested by DMR at at the age of 19, his IQ was found to be 75, making him ineligible for DMR care.  Two years later, DMR rejected him again after measuring his IQ at 71, just one point over the cut-off for eligibility.   As a result, Tony was placed in a Department of Mental Health facility with eight emotionally disturbed females, which turned out to be inappropriate for him, and later in a homeless shelter.

 At one point, with eight different car theft charges pending against him, Tony spent six months in the Worcester County Jail, where he was beaten so badly by another inmate that he had to be placed in solitary confinement for his own protection.  Since Tony was accepted at Templeton in 1989 at the age of 24, he has not had any further behavioral incidents, Valade says. 

When Tony was in the community system, he had alcohol problem.  Today, he suffers a low red blood cell count because  anti-psychotic drugs had been improperly administered to him in the community-based system while he was drinking alcoholic beverages.  The licensed nursing staff at Templeton understand this, Valade says; but Valade is concerned that once he is back in the community system, drugs will be administered to Tony by direct-care workers with minimal training. 

As far as Tony Shepherd is concerned, it will no longer be beneficial for his brother, Bobby, to continue living in his residence at the Templeton Center following a change from ICF-level care there to community-based care.  Shepherd, who is Bobby’s guardian, is concerned that under the community-based care model, the intensive clinical and medical supports that have sustained Bobby for more than 50 years will be greatly reduced.

Shepherd said, for instance, that he is grateful for quick action by Templeton’s nursing staff when he was visiting Bobby last fall and noticed while they were having lunch in the cafeteria that he seemed to be feeling unwell.  Shepherd asked if a nurse was available, and one arrived within two minutes, checked Bobby’s color and vital signs and then returned with a wheelchair and took him to the nurse’s station.

There, according to Tony Shepherd, further examination showed that Bobby was experiencing a drop in his oxygen level.  He was administered oxygen and kept overnight at the nurse’s station for observation.  Had he been living in a community-based group home, it is unlikely that a nurse would have been available to respond to the emergency, Shepherd believes.

Shepherd notes that at Templeton, nurses, doctors, and other trained medical personnel are available on a full-time basis to monitor Bobby’s health and administer his medications.  A clinical board meets quarterly to evaluate the effectiveness of his prescriptions.

Bobby Shepherd’s intellectual disability stems from low oxygen levels that he experienced at birth.  He is verbal, Tony says, but can’t read or write.  He has always been nonviolent, but was never easy for his parents to control because of his habit of wandering away from his house.   He has a trusting and friendly nature, and has always tried to make friends with total strangers.  That would sometimes get him into trouble.

At Templeton, Bobby lives with four other men in a two-story, white farmhouse called Waite Lodge.  He’s free to come and go on the Templeton campus, but lately his breathing problems have kept him from venturing out.

Tony Shepherd is worried about Bobby’s future after Templeton closes.  At 73, Tony is seven years older than Bobby.  “What’s going to happen to him and who is going to look after him if he’s still around after I’m gone?” Shepherd asked.  Bobby, he adds, is a “genuine ‘babe in the woods’” who would become “a target of ridicule and abuse [in a less supervised environment] because of his natural but naive belief that everyone is his friend.”

Had the administration not planned to eliminate the ICF model of care at Templeton, Shepherd said he would be a lot less worried about his brother.  “The staff is simply not going to be here once this place is switched over to state-operated group homes,” he said.  “We’ll be lucky if there are any clinical people left here at all.”

For Jimmy Holdworth’s parents, a social life proved impossible because no community-based residence or program could handle their son, and because he couldn’t be left at home with caretakers other than themselves. 

It was only when his parents were in their 60s that Jimmy was finally admitted to Templeton, according to his sister, Judy Holdsworth, who is now his guardian.  “At Templeton, he learned for the first time to control himself.  It was amazing to me,” she said.

Holdsworth said that in addition to intensive behavioral therapies, the clinical staff at Templeton placed Jimmy on medications to control his impulsiveness and aggression.  At first, she said, her parents resisted the idea of placing their son on any medications, but they were persuaded it was the right thing to do when they saw how carefully it was monitored.

“His psychiatrist and nurse always talked with us about it,” Holdsworth said.  “We’ve been very satisfied with the way it has worked.”  She said her brother is active, alert, and healthy, and “everyone at Templeton can tell when something is bothering him.  That’s part of the miracle that occurred with my brother.”