Miguel on the front page of the San Antonio Express

http://www.mysanantonio.com/news/education/Boys_story_puts_focus_on_state_school_woes.html


Web Posted: 02/09/2009 12:00 CST

Boy's story puts focus on school woes

By Janet Elliot- Houston Chronicle
AUSTIN — Less than a week after entering the Lufkin State School for those having mental disabilities, 10-year-old Miguel Favela was in an ambulance speeding toward Houston, near death from an overdose of insulin given to him by the medical staff.
Miguel survived. But the boy's harrowing story — like many others — will resonate in the Legislature as lawmakers try to decide what to do about Texas' state schools, including whether to keep them open at all.
An internal investigation by the Department of Aging and Disability Services, which runs the Lufkin school, found neglect on the part of the medical staff that ordered and administered the insulin. A doctor was cited for ordering insulin without reviewing Miguel's admission records or checking with his mother.
And a nurse misunderstood the doctor's oral order and gave Miguel an insulin dose that was more than three times what had been intended.
Rep. Scott Hochberg, D-Houston, whose office has investigated Miguel's case, said he found a disturbing lack of oversight by DADS officials in Austin over the facilities they run in far-flung corners of the state. For example, he said, the doctor was cleared to come back to work after his peers at the state school concluded he had made an honest mistake.
“That's insane,” Hochberg said. “To the extent that the state operates facilities, I think the state absolutely has an obligation to make sure that the care is up to standard.”
A Justice Department investigation in December found deadly lapses in health care and systemic civil rights abuses of the nearly 5,000 residents who live in the state-school system.
Eight hundred state school employees have been suspended or fired for abusing residents in Texas state schools since 2004, and there were 450 confirmed incidents of abuse or neglect in one 12-month period.
Gov. Rick Perry last week declared improving the state schools an emergency; options range from closing one or more of the facilities to improving employee pay and hiring an independent ombudsman for residents and their families.
After a week in the hospital, Miguel recovered. Now 11, he lives at the Brenham State School.
For his mother, Kelly Favela, the ordeal was consuming: Like thousands of other parents faced with having to work and to care for their mentally disabled children, Favela, a divorced mom, made the difficult decision to place her son in one of the 13 large state-run residential facilities that mainly serve adults.
Favela, a 31-year-old Houston resident, had fought, with the help of her state representative, to get Miguel into a residential facility after his violent outbursts became too much, even for a former Marine such as herself, to handle.
“It became so intense at home. No one could understand how bad it was,” she said.
But the place where she hoped her visually impaired and autistic son would get the intensive supervision and behavior therapy he needed almost killed him.
The doctor who ordered the insulin injections mistakenly believed that Miguel had diabetes mellitus, or “sugar” diabetes. But he suffers from diabetes insipidus, an inability to process fluids that is unrelated to the more common type of diabetes that involves a person's inability to process food.
Favela, a hospital social worker, faults the doctor for not attending a treatment meeting when Miguel was admitted. She said she described in detail the health issues and medication needs for her son, who was born with a genetically deficient pituitary.
Miguel also wears a bracelet that gives information about his diabetes insipidus.
DADS declined to comment on the case.
Miguel's case will revive the discussion over whether children should be housed in large facilities. Advocates say state schools are not appropriate settings for children, but a rising number have been placed there because of a lack of community programs for behavior therapy.
Favela says Miguel can go from being happy and playful to screaming and throwing chairs.
“It's a tragedy to see him so good and happy at times and not be able to bring him home,” she said. “I'm in such a torn position.”



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