BY KEN LITTLE
The unexpected death last weekend of a resident at one of the state-run community homes in Greene County was significant enough to merit a visit Wednesday by the commissioner of the state Department of Intellectual and Developmental Disabilities (DIDD), along with several of his top staff members.
Commissioner James M. Henry, of Nashville, visited the department's community home at 2105 Susong Road, where 47-year-old Ronnie Derrick was found dead in his room shortly after 6 a.m. Sunday by the two home workers on duty.
Henry and four of his staff members were interviewed Wednesday at The Greeneville Sun about policies the department follows when an unexplained or unexpected death occurs, as the case is categorized by the DIDD.
But all five, including Stephanie Blevins, director of investigations for the DIDD, said that because the investigation into Derrick's death is still under way, there was little they could say at this time about the specific circumstances.
Henry "felt it was important to come here personally" from Nashville to meet with community home employees, DIDD public information officer Missy Marshall said.
Henry said that since becoming DIDD commissioner in March 2011, he has visited the sites where several other clients (residents) died.
The DIDD was established as a stand-alone department by the Tennessee General Assembly in January 2011.
"Once the investigation is completed, we will provide as many answers as we can," the commissioner said Wednesday in a prepared statement.
He also emphasized that point orally during the interview Wednesday afternoon.
In addition to the DIDD investigation, following initial investigatory work by the Greene County Sheriff's Department, the inquiry into into the circumstances of Derrick's death was passed on to the Tennessee Bureau of Investigation (TBI).
The investigation was referred to the TBI since the community home where the death occurred is a state agency, Sheriff's Detective Lt. Jeff Morgan said Wednesday.
Derrick, who had been in state care for many years and was previously a Greene Valley Developmental Center (GVDC) resident, was found dead in his room by the two employees on duty at the time.
The temperature in the room where Derrick died seemed extremely warm, a report by Sheriff's Deputy Gina Holt said.
"Upon entering the room around 6:40 a.m., I immediately felt the heat inside," the report said.
Derrick, who had been diagnosed at age 13 with autism, was found lying on his side on the bed, facing away from the door, the report said.
"There was obvious discoloration on the body," the report said. "I noticed that the skin on the body was torn away from his body at his right shoulder area."
Blood was evident "around the facial area on the bed," the report said.
The house manager arrived at the scene, and the deputy asked him for Derrick's medical information, the report said.
Derrick took medication for high cholesterol but had no other medical history, according to the report.
"The night workers said they did rounds during the night," the report said.
The regular overnight protocol, or procedure, for Derrick was to visually check on him by looking through the window in the door to his room "because he doesn't like people in his room," the report said.
The two women on duty came to work at 11 p.m. Saturday. They said Derrick was already asleep in his room.
One of the workers said she heard Derrick get up to go to the bathroom about 3 or 3:30 a.m. Sunday, the report said.
At 6 a.m., Derrick did not get up for breakfast to eat in a common area, and the home employees "were worried about him because this was unusual," the report said.
One of them "remembered the extreme heat inside the room when she entered," the sheriff's department report said.
When she went to the control panel in the room, it indicated the temperature there was 77 degrees, the report said.
The workers turned on the air conditioning and opened the window in the room.
"While taking pictures of the scene, I noticed that the door to the closet was hot to the touch. Inside the closet, the wooden shelves and the clothing were all hot to the touch," the report said.
The headboard and Derrick's bed were also "very warm to the touch," the report said.
The calf area of Derrick's right leg was also "very warm, almost hot to the touch," the report said.
An autopsy was performed on Monday.
TBI spokeswoman Kristin Helm said Wednesday night in an email response to questions that the state agency is beginning an inquiry.
"We have been made aware of the death and are looking to see if a criminal investigation is warranted," Helm said.
MEETS WITH STAFF
Commissioner Henry said Wednesday afternoon that earlier in the day he went to the community home where the death occurred and met with some of the staff there.
Many of the staff members had known Derrick for years and were grieving his death, Henry said.
"Most of the staff moved from the developmental center to the community homes," he noted.
Blevins, who is based in Nashville, heads up a DIDD staff of 45 departmental investigators.
Of the 45 investigators, four are based in Greeneville, she said, and have responsibility for Northeast Tennessee investigations.
One of the four based in Northeast Tennessee is responsible for matters involving residents and staff of the department's Greene County facilities.
Investigators typically look into allegations of exploitation, suspicious injuries and "unexplained or unexpected death," Blevins said.
Derrick's death falls into the latter category, she said.
Investigators assigned to cases collect evidence, conduct interviews "and draw a conclusion as to what happened."
"We look at all deaths at least from a health services standpoint," Blevins said.
At the same time, a law enforcement agency could also be conducting an investigation, she said.
"When law enforcement is involved, they work their investigation separately," Blevins explained. "The difference is, [their] investigation is to see if there is any criminal activity."
Added Henry: "Things that we are interested in might not be criminal activity."
'CIRCLE OF SUPPORT'
Derrick lived in a community home known as an Intermediate Care Facility (ICF), for intellectually disabled clients.
Blevins said that in instances where a fatality occurs in an ICF and an investigation is conducted, if a staff member is named as somehow directly related to the death, the staff member is placed temporarily on administrative leave.
She did not comment on the specific situation with employees of the community home at 2105 Susong Road. Derrick had lived in the home about one year.
Each individual has an individual treatment plan involving several staff members in a "circle of support," Henry said.
"[In a DIDD investigation] we would take a look at whether the plan is being followed or [whether] there is a policy violation," he said.
2 DIE OF HEART ATTACKS
There have been two other deaths in community homes in Greene County in recent months, Henry said.
One was in September and the other in October. Both residents died of heart attacks, and the deaths are not considered suspicious, he said.
Dr. Thomas Cheetham, of Nashville, director of the DIDD's office of health services, said that his office gets a report on "every single death" of individuals in state homes -- no matter what the circumstances.
His office then looks at the death "from a whole variety of standpoints."
The life expectancy of people with intellectual developmental disabilities has improved, but it is still below the life expectancy of the general population, he said.
People with intellectual disabilities have two to three times the health problems of the general population, Cheetham said.
But Derrick "was probably in pretty good shape," Henry said.
HOMES FOR ICF CLIENTS
All of the recently-built community homes in Greene County are for ICF clients.
There are 13 such facilities in Greene County, and three more are under construction. Four clients live in each ICF community home.
The DIDD has 685 employees in Greene County, including 196 who work in community homes.
Henry, Blevins, Cheetham and Marshall were joined in their trip to Greene County by Knoxville-based John Craven, DIDD regional director and a Greeneville native.