Christy Poe was born three months early with her umbilical cord wrapped around her neck. She was a twin. Her sister, Candace, didn't survive.
The lack of oxygen Christy experienced at birth left her severely disabled, both physically and intellectually. She is deaf, legally blind, has cerebral palsy, bipolar disorder, disruptive behavior disorder, impulse control disorder and profound developmental disability.
It was "absolutely" a miracle that Christy survived, according to her mother Gracie Hoffmaster Gallegos.
As Christy grew older, her aggressive behaviors became too much for the family to handle.
"She'd bite herself, she'd bang her head, she'd kick holes in walls. If (food) was too hot…she'd turn the table over," said Hoffmaster Gallegos. "I had reached the breaking point."
At the age of 11, in 1992, Hoffmaster Gallegos made the difficult decision to put Christy in the Frances Haddon Morgan Center in Bremerton – an institution for people with developmental disabilities.
"When you can't stop her from hurting herself and when you can't protect yourself anymore and you can't protect the sanity of the rest of your family, something has to be done," said Hoffmaster Gallegos.
Finally, the family found some peace after years of chasing one crisis after another. Her mother said Christy was well cared for at the Morgan Center. "Staff there; they were her family," she said.
And most importantly, Christy was safe. Her mother worried about the repercussions of moving her daughter back into a community setting.
"The number one fear is getting hurt. She's a young woman," said her mother. "'What protects my daughter?' She has no communication skills whatsoever to indicate that she's been hurt."
It was settled. Christy would live permanently at the Morgan Center, or another one of the state's institutions, often referred to Residential Habilitation Centers, or RHCs.
"No way I would ever move her. No way," said Hoffmaster Gallegos of what she was thinking when Christy was living at the Morgan Center.
Despite the level of security and services the RHCs provide to hundreds of families in Washington state, there is a push across the country to work toward shutting these types of facilities down. The U.S. Department of Justice considers them a form of segregation and has argued in the courts that people with developmental disabilities should be afforded the right, as guaranteed by the Americans with Disabilities Act, to be integrated into and enjoy the benefits of regular communities.
"Institutionalization denies people those basic rights to make decisions for themselves as human beings," said Sam Bagenstos, a former top civil rights attorney with the Department of Justice. "(We need) to ensure that people with disabilities can participate fully in the community."
Advocates of the RHCs wholeheartedly disagree. They say the residents who continue to live at the institutions have such overwhelming disabilities that the large facility setting is the best and only option. They told KING 5 that moving these severely disabled individuals into the community would put them at great risk.
"I do know that there is a segment that really cannot survive out in the community," said Terri Anderson, whose son lives at Fircrest in Shoreline, one of four institutions still operating in Washington
"If they're medically fragile, they're apt to have a cascade of medical issues as a result (of moving out of an RHC)," said Jim Hardman, president of the advocacy group Friends of Fircrest and a professional guardian for several RHC residents. "(Community living) is not really designed for folks with this level of disability…We're talking about the rarest of the rare, or the rarest of the unusual."
But the state's own experts have found that's not true. A 2013 audit, executed under a $498,500 contract under the direction of the Washington State Auditor's Office, found that developmentally disabled individuals being successfully supported in the community had similar needs as people still living in the state institutions. Researchers found the overwhelming majority of Washington's most severely disabled adults -- 90 percent of them -- currently live with family members or in small assisted living homes. Just 10 percent of people living with the most severe forms of disability live in the state's four RHCs. Researchers used "acuity scales" utilized by the Department of Social and Health Services, which operates the RHCs, to determine each person's level of need. Acuity levels are assigned to each DSHS client based on their assistance needs related to behavior, medical needs, and activities of daily living.
"It's a myth that people can't manage whatever their medical conditions are in a community setting," said Mike Hatzenbeler, the CEO of Provail, a nonprofit agency based in Seattle that supports people with extreme medical and intellectual challenges who live in community settings.
"It's absolutely a myth. We serve people who have as significant or more significant medical needs than many people that live in the institutions," said Hatzenbeler. "If they need to go to the hospital, they go to the hospital. If they need more significant care and they need to go into a skilled nursing facility, we help make that happen."
Rick Serrette is a Provail client with cerebral palsy. He is non-verbal, wheelchair bound and requires tube feeding. He has many additional medical conditions, including a life-threatening choking and seizure disorder. Serrette has lived in a small Provail home with two roommates and around the clock staff since 1997. Before that he lived in various institutions in Washington state for 43 years. To speak, he uses a communications device operated by tapping a switch with his head.
"I think people who believe (that someone with severe disabilities can't live in the community) have never known what it is like to feel locked away. I have had serious medical issues and they were dealt with at my (Provail) home. You can be sick and still live within your home as long as you have the right support," said Serrette. "(The staff) helps me with whatever I need. I get help with things like physical support and medical appointments but also fun things like Mariner's games, movies and shopping."
Provail's Kathy Earl is a supervisor at Serrette's home, and she was a direct caregiver for Serrette when he lived in an institutional setting. Because of his fragile medical state, she and other staff were extremely fearful Serrette would die if he moved into the community.
"He needed quite a bit of support," said Earl. 'What if staff didn't show up? What if there wasn't enough staff to come and help him?'"
Her fears didn't materialize.
"I was very wrong with that. He's done great in the community…In this situation it was great to be wrong. I'm really glad I was wrong," she said.
Vulnerable client dies after leaving RHC
Advocates for the institutions, like state Sen. Pam Roach (R-Sumner), point to disastrous outcomes that have occurred in Washington state when residents have moved from RHCs into a community setting. The Rainier School in Buckley is in Roach's district.
An investigation by DSHS found a 30-year-old Pierce County man who moved from the Frances Haddon Morgan Center died in 2011 due to the careless actions of staff at his new assisted living home. The man had a diagnosis of autism and pica, which causes cravings to eat non-food items such as clay, sand, or toxins. Investigators found that despite staff knowing the client's history of "ingesting toothpaste, mouthwash/aerosol/grooming supplies and attempting to get cleaning supplies in order to consume them", they were inappropriately storing laundry detergent in a milk container. The client was able to access the detergent and drank it on October 3, 2011. He died two weeks later from complications related to ingesting the detergent. Investigators found staff waited 8 hours before calling 911.
Sen. Roach said for the extremely fragile, it is not worth the risk.
"To do what? Put people in an unsafe environment where a person can glug down an entire carton of laundry detergent?" said Roach. "It's actually dangerous for some individuals to leave a state setting….There's a great deal more protection going on in our state institutions than anything going on in the community."
In Christy Poe's case, just as for Rick Serrette, these kind of fears proved off base.
Life change for Christy
Seventeen years after her daughter moved to the Frances Haddon Morgan Center, Christy Poe's mother had a change of heart. She decided to take a risk and move Christy into a community placement, run by the nonprofit Options Unlimited, based in Puyallup. It's been three years since the move and she said none of her fears for Christy have come to fruition.
"Not at all. No, they take very good care of her," she said.
Christy enjoys all sorts of new freedoms and choices she didn't have in the RHC. She has a job alongside a job coach in the warehouse of a Marshall's store. She helps with shopping, goes bowling every week and attends dances. A caregiver is with her at all times. They said Christy's aggressive outbursts are now few and far between.
"I was here when Christy first moved in," said caregiver Trish Johnson. "She was flipping tables, throwing dishes, her aggression was pretty bad. And now you don't see any of that."
According to Christy's mother, her daughter's "is a success story. She is 100 percent happy...She definitely leads a more fulfilling life."
"She has blossomed into a very happy young woman. Part of that is me allowing her to grow up and part of it is the support that she gets. It's all a team effort," said her mother.
The state closed the Frances Haddon Morgan Center in 2011 due to budget cuts. The center was home to approximately 60 residents, most of whom have autism.
Read the complete coverage: Last of the Institutions