Where to now? 

A prolonged fight over the Montana Developmental Center's future finally ended with the legislature voting to shut down the facility. The real challenge comes next, as dozens of at-risk patients seek new homes.

When Missoula Developmental Services Corporation Chief Executive Officer Fran Sadowski greets a recent visitor to her Marshall Street office one of her first questions is, "Do you know anyone who needs a job?"

The CEO quickly laughs off the query, but she's also the first to admit that the staffing shortage at this Missoula facility is no joke. In July, MDSC counted 39 open direct-care staff positions out of 158 total.

"The worst thing that happens is that turnover," Sadowski says.

Challenges filling shifts prompted MDSC to keep some of its residents in their group homes this day, rather than allowing them to mingle at the Marshall Street Day Activity Center, where it can be tougher to manage behavior.

Just about everything MDSC does is with an eye toward safety. A sign on the wall inside the day activity center, for example, details when it's appropriate to call 911, versus when to contact a staff nurse. Profuse bleeding warrants emergency services, the sign says, rather than a minor cut.

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MDSC is a nonprofit community caregiver for developmentally disabled people, typically considered individuals with IQs under 70. The Medicaid-funded nonprofit houses up to 75 adults in 12 Missoula residences.

MDSC employees are responsible for an array of client needs, including everything from feeding and bathing to caring for those who are sick and dying. Entry-level direct-care providers earn $9.65 an hour.

MDSC residents fall into two broad categories, Sadowski says. Those who are low-functioning and have "self-help needs" mostly require assistance with the basics, such as personal hygiene and eating.

The other group, considered "behaviorally intensive," presents a more complicated management challenge. "We have people who can destroy property," Sadowski says. "They break windows. They have intermittent impulse control."

While Sadowski's current responsibilities and those of her staff are already stretched, they stand to get even tougher in the wake of a legislative decision to close Montana's last institution for developmentally disabled adults. In April, state lawmakers passed Senate Bill 411, authorizing closure of the Montana Developmental Center in Boulder. The legislation calls for moving clients from the Montana Developmental Center into privately operated group homes such as those run by MDSC.

The impending closure marks the end of an era. After more than 100 years, the Montana Developmental Center will no longer serve as a safety net for individuals unable to care for themselves. Nor will it continue to draw allegations of abuse, neglect and mistreatment, as it has for decades.

Preparing for such a major policy shift has not been easy. When the legislature passed SB 411 it empowered the Montana Developmental Center Transition Planning Advisory Council—a committee including lawmakers, state administrators, organized labor and others—to craft a blueprint for closure. Council deliberations involve how to spend millions of dollars, manage the loss of hundreds of jobs and care for some of the state's most vulnerable and volatile residents.

Sadowski is the lone community service provider on the committee and therefore acutely aware of what challenges remain.

"I think the committee has a large task ahead of us," Sadowski says. "It's a huge undertaking."

In the days leading up to the Montana Legislature's April vote on SB 411, organized labor mobilized. MEA-MFT issued news bulletins with headlines like, "Montana Developmental Center under attack." Public sector labor unions asserted that closing the Montana Developmental Center in Boulder, as SB 411 sought to do, wasn't the answer to quelling longstanding concerns about abuse and mistreatment at the embattled facility—instead, more resources were needed.

"Privatization for private profit at the expense of those who need the care and those who deliver it is not the answer," the AFL-CIO tweeted on April 17.

For more than 100 years, MDC has housed individuals with intellectual disabilities. Most clients are admitted to the facility through a civil proceeding, after being deemed a threat to themselves or others. Others are sent there by way of a criminal conviction.

click to enlarge The old Montana State Training School, first built in 1912, preceded the Montana Developmental Center in Boulder. At the height of its use in 1965 the facility housed 1,011 residents.
  • The old Montana State Training School, first built in 1912, preceded the Montana Developmental Center in Boulder. At the height of its use in 1965 the facility housed 1,011 residents.

Sen. Mary Caferro, D-Helena, carried SB 411. When arguing to shutter the facility, she and other closure supporters, including the federally mandated watchdog Disability Rights Montana, pointed to a string of abuse allegations at the facility. They noted, for example, that the Montana Department of Justice documented 11 allegations of physical abuse by staff in 2014. Those claims included a September 2014 incident in which MDC staffer Sheldon Moffett choked a resident and slammed his head into a door jamb, causing a laceration that required five staples to close. Moffett pleaded guilty to felony abuse of a disabled person in April, just as the legislature was deliberating SB 411.

MDC is slated to spend $13.3 million this year to house just more than 50 clients. Caferro argued that funding would be more efficiently and humanely used if directed to privately operated community group homes.

In response to SB 411, more than 200 facility staffers argued the legislation would endanger some of the most vulnerable people in the state. MDC employees drew from the considerable political muscle of their labor unions, including the American Federation of State, County and Municipal Employees, MEA-MFT and the AFL-CIO, which collectively represent more than 40,000 members. The unions claimed on social media, in newspaper opinion pages and at the legislature that privatizing MDC services, as the bill proposed, was akin to privatizing schools.

They warned that the legislation would leave MDC residents with no safety net. They said it would lead to a disaster.

"I think a year from now or 18 months," AFSCME Executive Director Timm Twardoski told the Independent last spring, "we're going to go 'Oh crap, this thing didn't work.'"

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