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Nov. 1, 2004 - Officials investigate treatment of a woman in a Randolph group home.

April 20, 2004 - A key legislative committee is saying no to $132,000 more for the cash-strapped agency that oversees care of the retarded

April 16, 2004 - $20M more for salaries proposed for caretakers of mentally retarded

March 26, 2004 - State owes a promise of safety - Editorial

March 25, 2004 - A bill to increase into abuse stalls in the legislature

March 25, 2004 - Care for retarded people in Massachusetts has serious shortcomings - Editorial

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.
Read more ...

Case files

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.
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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.
Read more ...

Case files

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.
Read more ...

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.
Read more ...

A tale of two families with retarded children in group homes.
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Case files

Graphic shows workload up, staffing down.


Tom Quinlan and his mother, Mary, at her Hanover home. Their experience with group homes has left a sour taste, but others are satisfied.
JEFF LOUGHLIN/The Patriot Ledger
Tom Quinlan and his mother, Mary, at her Hanover home. Their experience with group homes has left a sour taste, but others are satisfied.


State hard-pressed to keep up
with rise in abuse complaints

Last of a three-part series

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.

"What you find reported is a tiny fraction of what happens. There has to be much more oversight," said Christine Griffin, executive director of the Disability Law Center of Massachusetts, which provides legal help and advocacy to disabled people.

It is not a new worry. Over and over, horrific abuse cases have led to promises of change.

In 1997, investigators found that the Department of Mental Retardation had for years failed to protect two retarded men in Raynham from abuse that included being tortured with pliers and burned on radiators.

State Commissioner of Mental Retardation Gerald Morrissey, who at the time had just been appointed, promised increased vigilance. Seven years later, he says providing quality care for the retarded remains a top priority.

"We're spending a lot of time making sure that under no circumstances should the health and safety of the individuals be compromised," Morrissey said in a recent interview. "That is a profound minimum threshold for our staff with the providers."

But as the state copes with budget cuts, advocates for the retarded say protections are wearing dangerously thin.

Among the concerns:

  • Since 2002, three retarded people in group homes have died because of abuse or neglect. Seven other deaths at group homes are still under investigation and two cases have been deferred because of criminal investigations.
  • Staffing shortages force the Disabled Persons Protection Commission, which was set up to to provide independent abuse investigations, to refer more than 90 percent of those cases to the state agencies it is was created to oversee, including the Department of Mental Retardation.
  • Abusive employees can keep getting new jobs in residential facilities. The commission keeps a registry of workers found to have abused clients, but it no longer has the staff to make background checks for employers. That could change if legislators adopt Gov. Mitt Romney's proposed budget for fiscal 2005, which includes an increase for the commission.
  • The number of abuse complaints rose 56 percent in the past five years and the backlog of overdue investigation reports has soared from 120 to 512 in 21/2 years.
  • Morrissey says the state is addressing problems, particularly those involving medical care.

"We have made a major strategic focus on health care and oversight," Morrissey said. "Do we have issues? We certainly have issues, but I think we have excellent quality management systems in place."

Critics of the state's system of caring for its most vulnerable citizens say workers are underpaid, poorly trained and stretched too thin to handle their jobs.

They say the inability of private agencies that run the homes to retain workers causes continuity of care to suffer, sometimes with tragic consequences.

"The wages are low, the workers get a meager benefits package, if any, and there is extraordinarily high turnover," said Tom Frain, president of the Massachusetts Coalition of Families and Advocates for the Retarded. "And on top of that, there is no oversight. There is no one coming to check on these people."

Low pay an issue

Employees of day programs that work with clients from local group homes say the lapses in care are frequent.

One former staffer at a day program in Brockton who is now employed at a Weymouth program said repeated, uncorrected neglect and abuse at group homes is a major reason people decide to leave.

"I don't know anyone doing this for a long time who leaves because of the money," said the worker, who requested anonymity. "You see all these things going on and nothing gets done. You can't even sleep at night."

Morrissey agrees that salaries are low.

"Money certainly is an issue," he said. "However, there are many, many fine direct-care workers. They do it because they love their work and they love who they work with and salary is not the primary issue."
“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.
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

Fax: 617-786-7393

Call: 781-340-3156

Please include your home address and telephone


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 showing how workloads are up, while salaries are down
Graphic show how workload is up while salaries are down.


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