Home invasion: The Arizona Training Program at Coolidge is the only home some developmentally disabled people have known

In fact, "Individual 14" died in the hospital.

But the stories the family members tell reveal more than the DHS reports.

"Individual 2" in the DHS report — the one who did not get his colonoscopy and was hospitalized for dehydration — is Dorrell. His mother and sister actually refused the procedure for both brothers, feeling it was too invasive for their delicate bodies to handle.

They also say they know the woman who died.

They don't trivialize her death, but they also known she was quite old and was riddled with arthritis.

After careful review of the report, the line between neglect and natural death is blurry. ATPC was cited for failing to provide adequate physician care, but not for abuse or neglect.

The death of "Individual 14" was the only death cited by DHS in reports dating back to 2005, which is remarkable, considering the average age of the Coolidge residents (most are in their late 50s) and their relatively diminished life expectancy. There are no deaths mentioned that resulted from neglect. That is not the case in Arizona's group homes. In 2007, at least two men died as a direct result of incompetent caregivers: One choked to death on a burrito in front of his attendant; the other hit his head on a wall, with the knowledge of his caregiver, and suffered a brain hemorrhage in bed that night.

Hacienda also has been citied for everything from violating fire codes to violating protection of a client's rights. There are examples of clients who were not positioned correctly for their feeding tubes, or who were not getting enough oxygen.

The similarity between ATPC and other facilities is one that hasn't come up in the Legislature. Of course, one facility is private; the other is run by the state, but according to Brian Abery, of the University of Minnesota, an Intermediate Care Facility for the Mentally Retarded is an institution no matter how you slice it. (For the record, Abery is against nursing homes, too.)

From Abery's perspective, if one has to close, the other does, too.

Much of the focus remains on ATPC's past, and the fact that it is "isolated" from society, as Timmons puts it. It sits in the center of the fastest-growing part of the state.

Deb Henretta, whose brother Vinnie has lived at the facility since he was 15 (he was injured in a car accident), wishes the argument could move beyond whether or not Coolidge is an institution and shift toward finding a way to tap what she sees as an underused resource.

"ATPC serves individuals with the greatest needs and complex medical conditions," she says. "ATPC could fill that need for elderly individuals who have special needs."

In 2002, the U.S. Surgeon General reported that people with developmental disabilities are less likely to receive good health care. Doctors just aren't trained to do it.

The report cites a need for places like Coolidge to figure out how to provide adequate care for a growing population of geriatrics with developmental disabilities, as well as find a way to train healthcare professionals.

One facility, the North Virginia Training Center in Fairfax, is mentioned in the report.

At a cost of $350,000 a year, it provides critical training on how to care for an aging DD population. There are other centers like it in Massachusetts, Kentucky, New Jersey, Washington State, Florida, and Missouri.

In many ways, the Coolidge center already functions like a nursing home and retirement center. There's even a chapter of the Red Hat Society (a social group for women over 50 in which members wear red hats and purple outfits to their gatherings) on campus. The Red Hats of ATPC dress up in full regalia for their meetings, just as any chapter would.

On posters around Margie's piano room (she's a Red Hatter as well) pictures are displayed from a past meeting. The women are shown looking at themselves, in their outfits, in handheld mirrors. They all look happy with what they see. Another set of pictures shows them gussied up and grinning at a Valentine's dance sponsored by the Red Hat ladies.

In the sensory-therapy room, a place that might make an uninitiated observer squeamish, there is an attendant for every person. When a resident moans, his head is stroked gently. When another laughs as she pushes buttons that make animal noises, her caretaker laughs with her.

Across the compound, the retirement center also is busy with activity. In a colorful room, filled with as many employees as residents, one woman plays with blocks on the floor, while another talks to her caretaker (she's concerned about her waistline).

Sixty miles north of this center of activity, advocates, legislators, and family members continue to struggle with how to make the right decision about Coolidge. In the minds of family members, one fact cannot be disputed: Their relatives have survived long past their projected life spans. When these people were born, they were taken home by parents who expected them to die within a year.

And yet, here they are.

For Deb Henretta, that alone is reason enough to keep her brother in Coolidge.