The head of a Biddeford-based service provider whose contract was terminated by the state Monday is blaming the Department of Health and Human Services for the death of a client this summer.
Christine Tiernan, CEO of Residential and Community Support Services, told the Press Herald on Tuesday that the client – Norman Fisher, 62, of Biddeford – had been in the agency’s care for only 72 hours when he died on Aug. 27. She said that state officials placed him in an RCSS home in Portland with no insulin to treat his diabetes and he then refused medical treatment when the staff tried to take him to the hospital.
Tiernan also said Fisher was under state guardianship and the state had a responsibility to keep him safe. She said RCSS is appealing the state’s decision to terminate its MaineCare contract and is considering suing the DHHS.
“We are absolutely being scapegoated,” she said.
DHHS would not respond Tuesday to Tiernan’s specific allegation that Fisher was dropped off without the medication he required, but department spokeswoman Jackie Farwell said in an email: “We disagree with any characterization to the contrary about the circumstances of the death and continue to prioritize the health and safety of additional residents put at risk by RCSS’ deficient care.”
Farwell said the state is confident in its decision to cancel its contract with RCSS because “the company repeatedly failed to ensure the wellbeing of residents and to correct deficiencies, despite being given opportunities to improve.”
On Monday, DHHS Commissioner Jeanne Lambrew announced that the state would sever ties with RCSS, which was serving 70 adults with intellectual disabilities, after the agency failed to make necessary changes following Fisher’s death.
“The health and safety of Maine people is our chief concern,” Lambrew said in a statement. “This company’s unacceptable failure to ensure the well-being of its residents has led us to take immediate steps to safeguard residents’ health and welfare, and transition them to alternative homes. We will do all we can to help ease the disruption and distress caused to residents and their families as we hold the company accountable.”
Although the state did not identify Fisher because of privacy laws, Tiernan confirmed Tuesday that it was his death that prompted the state to investigate RCSS and eventually terminate the contract.
Portland Police Lt. Robert Martin said detectives are investigating the circumstances of Fisher’s death, but he would not provide any details. Mark Belserene, a spokesman for the state medical examiner’s office, said the office performed an autopsy on Fisher, but it was not authorized to release a cause of death.
According to probate court records, the state petitioned for and was granted guardianship of Fisher in early 2015 because of his intellectual disability.
“The petitioner believes that the person alleged in this petition to be incapacitated is impaired to the extent that he lacks sufficient understanding or capacity to make or communicate responsible decisions concerning his person, and that the appointment of a guardian is necessary,” the petition said.
Fisher’s parents are deceased and although he has siblings, none of them wanted to be his guardian, according to probate records, and the state stepped in. Public guardianships are typically seen as a last resort.
When the state was awarded guardianship, Fisher was living in an apartment in Biddeford and receiving support services from several agencies. He grew up in Biddeford and went through ninth grade there. As an adult, he worked in several places, including as a janitor at River Works in Biddeford, at Palace Playland in Old Orchard Beach and in the kitchen at an elementary school in Biddeford.
Fisher was an accomplished artist and took art classes locally. After his death, the Art Certificate Program in Biddeford – a community support program for adults with intellectual disabilities – held a memorial art show in his honor. A collection of his work was displayed, along with other pieces created in his memory.
Heather Wechsler, a team leader at the Art Certificate Program, said Fisher had a very specific style and often drew cats and other animals.
“He was a very interesting person to talk to,” she said. “He could be a little cranky. I think he was stubborn and set in his ways, but always kind-hearted, too.”
According to probate records, Fisher was severely diabetic and sometimes needed help taking his insulin. Before becoming a ward of the state, he had “a history of living in squalor, filth, hoarding and clutter,” a provider wrote. In one apartment that later burned down, there were cat feces throughout the house and spoiled food. Sue Marcellino of Community Partners, a Biddeford service provider, wrote that Fisher had a limited ability to smell and would sometimes eat rotten food.
Fisher received monthly Social Security disability and Supplemental Security Income payments that totaled less than $800. He also had a federal Section 8 housing voucher.
He had been living in an apartment on Main Street in Biddeford for several years, but was evicted sometime in 2018, according to a report filed by his guardian, Patrick Bourque, a DHHS employee. Bourque didn’t indicate what led to the eviction.
But by the next annual report, filed in July 2019, Fisher was still living there. Bourque wrote that he was looking for other options.
It’s not clear yet what caused Fisher to finally leave, but that’s apparently how he came into the care of RCSS. He was moved from Biddeford to a house on Humboldt Street in Portland’s North Deering neighborhood that RCSS rents for clients. He died three days later.
Tiernan said Fisher was brought there in an ambulance and didn’t have any medication with him at the time. When RCSS staff called the hospital, Tiernan said they couldn’t help. Fisher then refused medical attention and RCSS called DHHS staff. Fisher died before he could receive any additional medical intervention.
Wechsler said she and others at the Art Certificate Program learned about Fisher’s death “through the grapevine” and were saddened.
“It certainly seems like he was neglected,” she said.
After Fisher’s death, DHHS suspended all new admissions to RCSS, launched a program audit and asked that the agency submit a plan of correction to ensure the health and safety of its residents. The state also said it received additional Adult Protective Services referrals about other RCSS residents.
In a statement Monday, DHHS said that despite its efforts to work with RCSS to correct deficiencies, RCSS did not make sufficient progress and the decision was made to terminate the contract.
RCSS has been a MaineCare provider since 2013. As of Friday, the agency was serving 70 clients, operating 38 one- and two-bedroom residences for adults with developmental disabilities in southern Maine and providing independent living assistance to others in their own homes.
Tiernan said she founded the company after working in the field since 1994. She said she’s proud of the work she and her staff have done.
Kim Moody, executive director of Disability Rights Maine, the state’s advocacy organization for adults with developmental and intellectual disabilities, said her organization has long heard complaints about RCSS. Moody said for the agency to blame the state is deflection.
As of Monday, the state said it already had transitioned four residents to alternative housing, a fifth move was in progress, and work was underway to safely relocate the remaining 65 individuals, hopefully within 30 days.
In the meantime, the department will continue to pay for services provided by RCSS while residents are moved to new homes and will assist with finding those placements. RCSS will continue to staff its homes and DHHS will continue to monitor those homes with regular site visits.
The state has undergone reforms since a scathing 2017 report from the U.S. Office of Inspector General found widespread deficiencies in how Maine cares for adults with intellectual and developmental disabilities. Now, every report of a death must go into a database that triggers a report to Adult Protective Services. APS then works with local law enforcement as needed to determine whether a crime has been committed.
Additionally, under the administration of Gov. Janet Mills, the state has discontinued the practice of allowing one- and two-bed homes to operate without a state license, which they had for many years. This change is still being implemented.
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