Citing inadequate care, Maryland's health secretary imposed a ban on new admissions yesterday against a company providing community-based homes for developmentally disabled people and denied its request to expand two residential facilities in the Towson area.
"I will not tolerate substandard care," Health Secretary Nelson J. Sabatini said in announcing the ban on new admissions at the approximately 15 homes operated in Baltimore city and county by Growth Horizons of Maryland Inc.
Mr. Sabatini said that the health department is examining all of Growth Horizons' sites because of "pervasive problems related to the quality of care," and would consider taking action to strip them of operating licenses if those problems are not adequately addressed.
The actions against Growth Horizons -- the first provider of community-based living to be penalized in Mr. Sabatini's eight months as secretary -- grew out of its applications to expand from three to four the number of beds at homes on Beaver Bank Circle and Rowan Court in Towson.
After no formal opposition was expressed at public hearings on the proposed expansion, the department's administrator of community programs examined the most recent inspection reports on Growth Horizons and found "serious deficiencies in [its] overall program," among them:
* A lack of staff training that results in a failure to meet the health and program needs of clients.
* Clients being placed at risk by "medically unsound practices," including failures to administer medication and -- in one case -- the lack of blood-pressure monitoring equipment at a home occupied by a client requiring regular pressure checks.
* Lack of programs and knowledge by direct-care employees on managing behavior problems, which many Growth Horizons clients display.
Department officials said that the company's plan for correction was weak in some areas and failed to address all the problems noted by examiners. According to the health department, Growth Horizons is receiving $2.3 million in the current budget year -- 40 percent of it in federal funds, and the rest from the state -- to provide community-based living quarters for about 52 people and day programs for 40 others.
The department's Developmental Disabilities Administration is spending $160 million of its quarter-billion-dollar budget this year for community-based programs, which have largely replaced state mental institutions as the chief providers of care.
Overall, the programs reach more than 7,700 clients -- 1,003 of them living in community-based homes. Mr. Sabatini said that there is notenough money available to meet all needs, and that other people are on a waiting list for placement in residential facilities.
"People who are disabled have the right to live in the community," said Mr. Sabatini. "They also have a right to an adequate level of care. It is important we make sure that level of care is provided in these facili- ties."
The health secretary, who has been in charge of the department since February, said that he did not favor closing facilities and that he hoped the problems of Growth Horizons would be resolved.
"I think community-based providers do an excellent job in this state," the secretary said.