A 15-year-old boy with severe intellectual challenges was clinging to life last weekend, and questions over the state’s culpability in what so far is a near-fatality have arisen.
The child, in the custody of the State of Texas, was allegedly slowly poisoned while living in Sugar Land homes operated by Maofu Home Health Services, according to a complaint to the state. The company did not respond to TPR's requests for comment.
“Medical professionals and poison control suspect a slow poisoning of M. R. F. over time by his caretakers having over-medicated him,” said Emily Miller, his state-appointed attorney ad litem, in a letter to Health and Human Services Office of the Ombudsman.
Overmedicating children in Texas foster care has been a long-cited problem, and one raised in contempt hearings against the state last year in a federal lawsuit over its child welfare system.
“We’re actively investigating to ensure the provider followed all state and federal health and safety regulations. If it did not, it will be cited for a regulatory violation and required to come into compliance,” said Jennifer Ruffcorn, press officer for the Health and Human Services Commission (HHSC).
HHSC licenses and inspects Home and Community-based services homes, like the one MRF was living in.
The allegation came as the U.S. Court of Appeals for the 5th Circuit weighs whether HHSC can be held in contempt, and fined, for failures in the department charged with investigating these kinds of homes.
In her letter to the ombudsman, Miller outlined troubling incidents over the last month. Initially the child was living at Forever Home Living Center, a Home and Community based Services provider operated by Maofu. According to the letter, his court appointed special advocate found the home had medications sitting out on a counter for more than an hour in “unlabeled bins,” potentially accessible to any child.
“M. R. F. [was] 'zoned out' and non-communicative, urine-soaked mattresses and mattresses strewn in the back yard, and feces on the wall,” Miller wrote.
An emergency hearing was held, accusing the provider of negligent supervision, the letter explained.
He was ordered by the judge removed. The Department of Family and Protective Services (DFPS) then moved the child to another home managed by Maofu Home Health, where he stayed for the next several weeks.
DFPS did not respond to TPR's questions about why it chose another of the Maofu group homes for placement.
Finally, a foster home was found for the child. Miller said in her complaint the day he was picked up, staff reported he had been vomiting that morning. After one night with the new foster family, where he was up vomiting much of the night, M.R.F. was taken to a hospital.
Doctors were so concerned by his kidneys and liver that he was life-flighted to Children’s Memorial Hermann Hospital.
“His symptoms are liver failure, brain swelling, jaundice, and other conditions that I am not knowledgeable enough to recite,” Miller wrote.
Last weekend, fearing the worst, a court ordered “Do Not Resuscitate” was signed, and the boy was taken off of life support. After he showed signs of improvement, the DNR was rescinded.
He is currently breathing on his own, but still in danger with his health described as “very fluid” by sources with knowledge. Even if he survives, what his quality of life will be after the damage is unknown.
This is not the first time one of the homes has been accused of wrongdoing.
Forever Home Living Center was accused of physical abuse twice last year. A former adult resident of Forever Home Living Center said they saw a staff member punch a child in the back of the head with her fist.
Another report said a staff member hit a child with a dustpan, causing a scar. The same staff member hit a child with her hand and a broomstick, according to court filings by federal oversight monitors.
HHSC was unable to determine whether abuse took place due to what monitors called last November “substantial investigative deficiencies.”
“The investigator did not conduct a face-to-face interview with the child nor observe the child’s alleged injury in-person,” read the November monitor's report.
In another report, a staff member allegedly hit a child with an IQ of 57 all over her body with metal kitchenware. The investigator again did not do an in-person interview, opting to do one over the phone with a child who was known to be deaf or hard of hearing. The case was again unconfirmed and was criticized by monitors for serious investigative deficiencies.
Investigations like these were highlighted when a federal Judge found HHSC in contempt earlier this year.
Questions about HHSC’s continued monitoring of HSCs come at a critical juncture for the longstanding federal lawsuit and oversight of the state’s child welfare system. Janis Jack, the federal judge overseeing the case since 2011, scheduled a September hearing in the case.
But she may be ousted from her role because outside lawyers hired by the state argued earlier this month that Jack was too biased to continue in the role. Those arguments stemmed from contempt findings and $100,000 a day fines levied against HHSC’s director over failures revealed in a December hearing.
In that hearing, HHSC’s Provider Investigations unit — tasked with investigating abuse and neglect claims made against state contracted facilities that assist people with developmental disabilities — was found to have let investigations languish for months without resolve. The unit had long case backlogs that went unimproved for years.
The 5th Circuit Court of Appeals will now decide if those fines and findings can continue. The presence of this potentially tangible near fatality in the same arena may complicate the state’s argument.
