Two men with severe mental and physical disabilities died from choking on food months after they were transferred from the North Jersey Developmental Center in Totowa to privately run homes as part of a massive restructuring of care for the disabled, according to union members and family advocates.
The circumstances surrounding the deaths of Richard Fornarotto, 54, and Steven Cortes, 65, are uncannily similar and point to what some advocates for the disabled say are widespread problems in the way the state has undertaken its plans to close the North Jersey Developmental Center and the Woodbridge Developmental Center, a process that the state says will help improve treatment to thousands of people by better integrating them into their communities, but which advocates say has unnecessarily upended hundreds of lives.
The deaths come at a time when families of those in the developmental centers are fighting the closures, saying such a drastic change could have devastating consequences. However, many circumstances surrounding the deaths are unknown, including whether they were the result of unfortunate accidents or whether the shift from one facility to another played a role.
State officials, citing federal medical confidentiality laws, declined to confirm details about the deaths, including Cortes’ and Fornarotto’s names. But Nicole Brossoie, a spokeswoman for the state Department of Human Services, wrote in an email that there was no “causal connection” between deaths of residents and transfers from community centers.
“Individuals with developmental disabilities often have multiple medical conditions that can shorten their lifespan — regardless of where they live,” Brossoie wrote. “The administration firmly believes that all individuals deserve to be cared for in the least restrictive environment available.”
Fornarotto and Cortes were both under the care of state-appointed guardians, meaning they had no living relatives to manage their affairs. They had both lived in state institutions like the North Jersey Developmental Center since they were children but were transferred to private group homes in recent months, part of the first wave of residents to make the move. And they both choked on bits of food — Fornarotto on a cupcake and Cortes on a sandwich — according to sources with knowledge of their cases.
“These deaths sadden me but they do not shock me,” said Geoffrey Dubrowsky, a member of the New Jersey Council on Developmental Disabilities, which advocates for the disabled, and a relative and guardian of three people with disabilities. “When you move somebody from a facility where they have been most of the their lives, surrounded by the people who know what kind of care they need, these results must be expected.”
Fornarotto and Cortes were among the 639 residents scheduled to be moved from the North Jersey and Woodbridge centers when the state announced the controversial decision in August 2012 to close both institutions and move as many of their residents as possible into privately run group homes, which are smaller and more integrated with surrounding communities and can help some of the higher functioning residents live fuller lives.
The move reflects a long-standing shift in national experts’ opinions about the best way to care for the developmentally disabled — people with such conditions as intellectual disabilities, autism and cerebral palsy — and responds to budget constraints, changes in public policy and regional New Jersey politics.
The closures will save the state $27 million for the next fiscal year, money that will be redirected to community housing, where there are long waits for beds, as well as day programs and other services, officials have said. With a $1.6 billion budget, the state Division of Developmental Disabilities provides services to more than 40,000 disabled individuals, of whom 2,340 have lived in the seven developmental centers. An additional 8,000, most living with their families, are on a state waiting list for community services, such as group homes and day programs.
The decision to close the centers was also hastened by a 2013 settlement with a state advocacy group, Disability Rights New Jersey, which argued in a federal lawsuit that the state was not complying with U.S. Supreme Court mandates to allow people with developmental disabilities to live in the least-restrictive and most-appropriate setting. The settlement sets a deadline for mid-2017 for the state to move, “all individuals determined to be eligible for community placement” — about 600 people. The developmental centers are closing far sooner. The Totowa center is scheduled to close on July 1 and the Woodbridge center will close on Jan. 1.
Brossoie said that, per capita, only Arkansas and Mississippi have more people with developmental disabilities living in institutions and that Governor Christie recommended $102 million in, “new and annualized funding for community placements and community services and supports,” in his budget recommendation for fiscal 2015.
But Christie’s plans to bridge a state budget gap over the next 13 months, announced late last month, also include skipping a $13 million one-time payment to those that provide community-based services to the disabled, such as — adult day care centers and group homes.
“Has any of this happened in a developmental center in the past? Yes it has, but not to this degree,” said Jenelle Blackmon, staff representative of the AFL CIO, who represents staff members at the Totowa center. The union stands to lose dozens of jobs when the centers are closed.
Brossoie did not answer questions about the rate of deaths in developmental centers versus the rate of deaths in community settings.
Cortes was born in Newark but had been in developmental centers since he was 8 years old, according to remarks at his funeral in May. Caregivers at the Cerebral Palsy Home in Livingston, where he was transferred in October, said he wasn’t there long enough for them to know him well, but they were moved by his smile and his evident joy in living
He had a medical condition that made it difficult for him to swallow, although he was a very fast eater, according to staff members familiar with both cases who relayed detailed information to Blackmon and a relative of a developmental center resident.
The staff members would not speak to a reporter directly because they feared for their jobs.
Cortes was supposed to be on a diet of only ground-up or pureed food and to always be in direct eyesight of a caregiver, those sources said. But he was alone in an office on May 17 when a staff member heard a thump, the sources said.
No one knew he had choked until the paramedics who were called to respond found the food lodged in his throat, the sources said.
Fornoratto was on a group trip from the Benchmark Group Home in Branchburg to a ShopRite in February when he grabbed a cupcake from a shelf and stuffed it in his mouth. When he started choking, the group home staff members ran to get water and asked store customers to watch him, the sources said. State law requires staff members to immediately perform CPR and call 911, Blackmon said. He died Feb. 19.
Blackmon said the staff at a developmental center would have known that because they are required by federal law to meet higher standards of care than group homes, which are designed for people who can function at a higher level and would benefit from greater integration into the community.
Advocates against the closings said they accepted the rationale behind the decision to move people out of the developmental centers. But they said the process has been carried out too quickly to ensure the safety and well-being of vulnerable residents.
“I believe their safety is being compromised,” said Assemblywoman Valerie Vainieri Huttle, D-Englewood, who said she had received numerous calls from family members who are concerned about reports of the deaths.