Day 1 - March 20, 2004
The death of a 39-year-old Weymouth man last year called attention to serious problems with medical care for the 8,700 retarded adults living in group homes. The people caring for them are poorly trained and ill-paid for the challenge of meeting their complex health needs.
Graphic shows abuse cases.
Day 2 - March 22, 2004
Rachel Deline, a 50-year-old retarded woman, died after she was given a double dose of a powerful anti-depressant. No one denies that the system failed her, but no one has been held accountable.
Many group home workers know too little English to understand instructions on giving medicines to retarded residents and fail a state certification test over and over.
Day 3 - March 23, 2004
When retarded people suffer mistreatment and abuse inside group homes, too often no one outside takes action or even notices, advocates and family members say.
Group home workers responsible for recognizing signs of illness in retarded adults and for giving them medicine are paid about the same as cashiers at fast-food restaurants.
A tale of two families with retarded children in group homes.
State hard-pressed to keep up
GARY HIGGINS/The Patriot Ledger
|“Under no circumstances should the health and safety of the individuals be compromised. That is a profound minimum threshold,” says Gerald Morrissey, the state commissioner of mental retardation.|
Officials with the state Department of Mental Retardation say that considering that care workers provide for the daily needs of more than 8,700 retarded adults every day, abuse is infrequent.
They say they are committed to working with families and provider agencies to ensure that errors are prevented.
The department plans to distribute new paperwork to group homes to help workers keep better track of residents' medical symptoms, checkups and doctors' recommendations.
But the proposed Department of Mental Retardation budget for fiscal 2005, which begins July 1, would cut 20 service coordinators, employees assigned to monitor treatment of group home residents. It would add 1,000 retarded clients to the caseload of the 257 remaining coordinators.
"You can't afford to lose those positions," said Leo Sarkissian, head of Arc of Massachusetts, formerly the Association for Retarded Citizens.
On paper, at least, few states offer the oversight Massachusetts does: an independent commission that is supposed to take investigations out of the hands of the state agencies that care for the disabled.
But the Disabled Persons Protection Commission has a narrow mandate to investigate only cases of serious physical and emotional abuse, and only those involving victims from 18 to 59 years old.
The commission rejected 59 percent of the 5,773 abuse complaints it received in fiscal 2003, most because alleged victims were not hurt badly enough.
Even when investigators find abuse, the commission can only make recommendations. It has no power to punish anyone.
Some advocates for the retarded worry about the cases the commission does accept for investigation but must refer to the Department of Mental Retardation or the Department of Mental Health to do the work.
"The perception of them investigating themselves has always bothered me," Griffin said.
Commission director Nancy Alterio said her office closely supervises the outside investigations to ensure they are thorough. She said a position that was lost in a budget cut last year will further delay investigation reports, but she hopes it can be restored next year.
Too few investigators
Meanwhile, the commission simply doesn't have enough investigators to look into every case, Alterio said. Even some priority cases - such as deaths, repeat allegations and accusations that might involve a crime - must be farmed out, she said.
Despite the budget setbacks, Alterio said protections have improved since the Raynham abuse case in 1997. For example, police and prosecutors now are more likely to view assaults against the mentally disabled as a crime, she said.
In 2003, the commission referred 645 allegations of abuse involving retarded victims, whether in group homes or not, to prosecutors. Of those, 108 resulted in criminal charges, Alterio said.
"The benefits of having a criminal investigation is now people are being charged. If they are convicted, it will come up on a check (of criminal records)," Alterio said.
But investigators face daunting challenges in uncovering abuse when the victim is retarded.
Victims may not be able to communicate, forcing investigators to depend entirely on witnesses or physical evidence, said Jeanmarie Carroll, chief of the sexual assault unit for the Norfolk County District Attorney.
Carroll, who has worked in the field for 15 years, said she sees "a pressure right now to make sure that people with disabilities have equal access to the courts and especially to the criminal process, and make sure that cases go forward with aggressive prosecutions if possible."
Still, she said, "It's extremely frustrating to recognize that you have someone with injuries, you're trying to make sure that person is protected, you're trying to develop who's the person responsible for the injuries. And you get to a point in the investigation where you say, 'We're not sure who did this.'"
South Shore Mental Health fired a worker at a group home in Randolph in 2001 for ordering a female resident to grab a male residentís genitals. There was no criminal investigation because it was the retarded woman who committed the assault, and if the worker applies for a job at another group home, the employer would have no way to find any record of the abuse. Budget cuts have prevented the Disabled Persons Protection Commission from making its registry of abusive workers available to employers.
A resident of a group home operated by Vinfen Corp. in Rockland slept with a shard of glass from a window that had broken next to his bed in 2002. The worker who found the glass when he arrived that morning said he had trouble awakening the employee who had been on duty overnight. Because the resident was not hurt, then Disabled Persons Protection Commission did not investigate.
We want to know what you think about this series and the issue of health care for the retarded. Here’s how to tell us.
Write: Your Views, The Patriot Ledger, 400 Crown Colony Drive, Quincy, MA 02169
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In this series we use the term "retarded" to describe people with mental handicaps because it is direct and commonly understood. We do so with respect and an understanding that some prefer such alternatives as mentally challenged or intellectually disabled on the grounds that retarded carries a stigma. Arguments on both sides of the debate are posted here on the web.
|Graphic show how workload is up while salaries are down.|
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