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Ryan Libbey, a former patient at Lakeview. His mother Jennifer Cote gave NHPR permission to publish photos of her son's injuries.This series was the basis for a collaborative investigation by NHPR and Reveal, a new investigative public radio program and podcast produced by The Center for Investigative Reporting, a nonprofit newsroom based in California, and PRX. Click here to read the investigation and listen to the documentary, "A Mountain of Misconduct."0000017a-15d9-d736-a57f-17ff8db50000In September 2014, Lakeview NeuroRehabilitation Center in Effingham, N.H. came under scrutiny for abusing and neglecting some of the people it cares for – children and adults with brain injuries and developmental disabilities.NHPR has been looking into these accusations, and it turns out the state had warning signs about series problems at this facility going back to the early 1990s. In this special series and continuing coverage, reporter Jack Rodolico examines the scope of the problems and the state's role in Lakeview's story.

As Lakeview Closes, A Small Town Grapples With Group Homes

At a recent town meeting in Madison, just south of Conway, a tiny room was packed: five zoning board members sat at a table in front of the police chief, frustrated neighbors and attorneys for a company called Becket Family of Services. The mood was tense. This was the third meeting like this one, and the prior two ended in stalemates.

Board member Kevin O’Neil expressed his bewilderment to Becket.

"I’m sorry but it kind of seems to me that you guys just kind of came in here and said, 'We want this,' O'Neil told Becket's attorneys. "I don’t think anybody here wants to hold you up, has a negative opinion – what you do is good work. Why not just work with us?"

Becket operates group homes and schools throughout northern New England. And when state regulators began pull people out of Lakeview in late 2014, Becket rented two residential homes in Madison, and took in a handful of those Lakeview clients.

After a year of controversy stemming from abuse and neglect, Lakeview Neurorehabilitation Center is closing. For years, the facility in Effingham has been a last resort for New Hampshire and other states looking for temporary care for people disabilities and complex conditions.

Yesterday NHPR reported on how Lakeview came to be an integral part of the state’s network of care. Today, we hone in on one town that’s beginning to feel the impact of Lakeview’s closure.

Welcome to the tree house

Though not required by law, Becket never told neighbors or local officials that people with severe disabilities were moving in. At issue now: the town is asking Becket to apply for a special exception to local zoning rules to operate their two new group homes. The company has refused.

Jamie Fox runs Becket’s New Hampshire operations. The company also has facilities in Vermont, Maine and Massachusetts.

Lakeview, by the way, also owned eight group homes like these. But it sold them last December. They were picked up by The Mentor Network, a massive, publicly-traded corporation that runs facilities in 35 states.

Credit Jack Rodolico
The living room of one of Becket's Madison group homes

And the new Becket homes in Madison? They’re normal houses on rural roads with neighbors through the trees.

"We try to pick out homes that we would live in ourselves," says Fox. "The individuals in this home, we spoke with parents, guardians and the individuals to determine on where they would like to be – all of them in a wooded area. So this is our tree house cabin."

Becket specializes in clients with very challenging behaviors, even aggression. The goal is to surround residents with a clinical team, help them communicate better and allow them to live full lives in a community.

Derek Janvrin likes living here.

"I like to make good food," says Janvrin. "I’m a good waiter. I’m a good waiter and I help cook dinner."

His specialty? Homemade chicken fingers.

"That’s what we having tonight, chicken fingers," he says.

A problem of perception?

This is what the state wants: people living in community-based homes. That idea was almost unimaginable under state policy until about 1980. Before then people were housed in institutions using public money. But a series of lawsuits and policy shifts shuttered those facilities. Today the state has 1,300 group homes integrated into communities. Like Becket’s two Madison houses, these group homes have no signs outside advertising what’s happening inside.

Based on my observations they are taking clients they are equipped to handle. The staff appears to be trained in use-of-force. They have used it. You know it is not a pretty thing to look at, but like with police work unfortunately that is an occupational hazard. - Madison Police Chief James Mullen

"Based on my observations they are taking clients they are equipped to handle," Police Chief James Mullen told the room back at that tense meeting in Madison. "The staff appears to be trained in use of force. They have used it. You know it’s not a pretty thing to look at, but like with police work unfortunately that is an occupational hazard."

Mullen says Becket staff has called 911 a few times, but they’ve mostly handled their own problems. Reassurances like this don’t mean much to some neighbors.

"Being a small family with small children," says Kate Sergeant, "I sort of have a bit of an issue abutting the property where there are people with mental and physical issues – whatever they are."

Jim and Ginger Wright live in Henniker, and their son Derek - housemate to the Derek mentioned above - lives in one of the Madison homes.

"I think they don’t understand," says Jim Wright. "They don’t understand who’s living there and why they’re living there."

"You know even though Derek is aggressive, he’s not going to come over to your house and then..." says Ginger. Her husband finishes her thought: "Right he’s going to stay in that house. He’s not going to go anywhere from that house without staff."

"We do know what state law says"

Still, the Madison zoning board is frustrated that a company could open a business that worries neighbors – and the town has no say in the matter.

These same debates happened across the state more than 30 years ago when group homes first opened in the state.

Towns tried to keep them out by using local zoning. Two cases made it to the New Hampshire Supreme Court: the first of those cases involved a home for people with intellectual disabilities, and the second was a home for people with mental illness. In both cases, the court ruled these group homes were carrying out state business. As a result, towns couldn’t use local zoning to “frustrate” state policy.

I vote no and I will tell you why. It is due to cases like this that the law is refined. And I think that we have the responsibility of somehow bringing it to the attention of the people of New Hampshire, and have it legislated. - Kevin ONeil, Madison zoning board member

Becket’s attorney Nathan Fennessy points to a letter from the Attorney General’s office to Madison. That letter says Becket has a contract with the state to operate in Madison, and the town’s local zoning just doesn’t apply.

"We do know what state law says," Fennessy tells the board, "and state law says we don’t have to go through that process and in fact going through that process would be contrary to state law."

The zoning board goes back and forth, debating. They acknowledge neighboring home values could drop. The also acknowledge you can't pick your neighbors. And they admit they just aren’t convinced they don’t have the authority to tell Becket what to do.

But ultimately they vote 4-1 to stop frustrating Becket.

"I vote no and I’ll tell you why," says Kevin O’Neil, the dissenting vote. "It’s due to cases like this that the law is refined. And I think that we have the responsibility of somehow bringing it to the attention of the people of New Hampshire, and have it legislated."

For now Becket can move forward, which it really had already done. The vote in Madison is a relief to Jim Wright. He’s happy his son is in a place where he’s safe.

"We still miss him," says Wright. "We wish he was home but it’s a hard thing to do every day. And that’s how I feel; just that people would be more understanding."

Since Lakeview began shutting down, companies that operate group homes have expanded into small towns in New Hampshire. If that continues, those communities may want to look to Madison for guidance.

Before joining NHPR in August 2014, Jack was a freelance writer and radio reporter. His work aired on NPR, BBC, Marketplace and 99% Invisible, and he wrote for the Christian Science Monitor and Northern Woodlands.
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