New details emerged in the near death of a severely intellectually disabled child in the state’s custody, including that a worker for the Department of Family and Protective Services appeared to have ignored safety concerns and attempted to intentionally mislead advocates on who was providing his care.
The 15-year-old boy known as M.R.F. or M.M. in documents nearly died last month from what doctors described as slow poisoning, according to a complaint filed last month with the state ombudsman. The incidents occurred around the time the boy was living at two different homes managed by Maofu Home Health Service, which owns Forever Home Living Center in Sugar Land.
Maofu did not respond to TPR's requests for comment.
TPR previously reported that the boy’s court-appointed special advocate (CASA) flagged problems with Forever Home. The CASA said she found drugs were unsecured at the facility and human feces were smeared on the walls. She said she found her client "zoned out and non-communicative."
The warnings did not appear to trouble the boy’s DFPS case worker, though, who did not see the unsupervised medication as a safety issue, according to a court record filed Wednesday.
“I was Court Ordered to move [MM] from this home. CASA and his attorney wanted him moved. No safety issues, a visit was made by CASA and the home was found not to their liking,” she wrote in the state’s IMPACT system. Her report was included in a court filing.
The court filing also included a text exchange that appeared to show the DFPS worker attempting to obfuscate who was caring for the child. When it became clear that the new home was case-managed by the same Maofu staff member as the first, the DFPS worker requested it be changed.
[Caseworker]: “If it’s you, it is going to look like he wasn’t moved. Can you assign another case manager? CASA and the attorney have to believe that other folks are caring for him.”
[Staff 1]:” Sure.”
Within a few weeks, M.R.F. would be hospitalized at one point with a court-ordered “Do Not Resuscitate.” His organs were to be donated. The boy saw an incredible recovery but is still suffering from the effects of the encephalopathy caused by his acute liver failure, according to the court filing.
Details about the boy’s progress were included in a report from court monitors of the state’s long running federal foster litigation. A spokesperson for DFPS declined TPR's request for comment. Within days of the report, the case worker was reassigned from M.R.F., according to a source with knowledge.
The report flagged other troubling problems including that children at the first home appeared to be sleeping in rooms without mattresses. Case workers also questioned the number of staff in each home, fearing it was too low to meet the many needs of mentally disabled residents.
Monitors extensively documented problems with how the facility managed the boy’s medications. The report said staff were refilling multiple prescriptions, double the amount of powerful drugs like Trazodone at the same time. A state review of M.R.F.’s prescriptions raised questions about why he had been prescribed some of the pills, lacking the underlying conditions. Despite M.R.F. being removed from the facility, his prescription continued to be refilled.
“It is unknown why the facility continues to refill them after he has left. It is unknown the name of the HCS home [MM] was at when these were prescribed and who continues to refill them,” wrote a state official in the boy’s records.
Federal court monitors found similar issues with overprescriptions of other youth under Maofu’s care.
Overmedication of youth has been a national problem for foster care systems and a source of contention between the federal court overseeing Texas’ system and the state’s lawyers. The state’s lawyers argued in court last May that Texas’ practices on medication are beyond the scope of the federal litigation. A December contempt hearing highlighted numerous problems with how the state monitors youths’ medications. Court monitors found numerous children prescribed four or more psychotropic drugs without the requisite medical oversight and review.
The U.S. Court of Appeals for the 5th Circuit is currently weighing whether Texas can be held in contempt for failures in its Provider Investigations Unit. That unit investigates group homes like the one M.R.F. was in, administered by Maofu. Provider Investigations is currently evaluating Maofu’s facilities.
It wasn’t clear whether the state has removed other foster children from these facilities.
“At some point, these tragic stories of children suffering have to end. This child almost died,” said Paul Yetter, an attorney representing past and present foster children in the federal litigation. “And, yet again, the cause is obvious: poor care and supervision by the state.”
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