[NYAPRS Enews] NYT: Unreleased Sundram Report Calls for 24 Disability Abuse Hot Line

[Harvey Rosenthal]

State Faults Care for the Disabled

By Danny Hakim  New York Times March 22, 2012

 

ALBANY - Nearly 300,000 disabled and mentally ill New Yorkers face a
"needless risk of harm" because of conflicting regulations, a lack of
oversight and even disagreements over what constitutes abuse, according
to a draft state report obtained by The New York Times.

In 2010, the number of abuse accusations at large institutions overseen
by the State Office for People With Developmental Disabilities
outnumbered the beds in those facilities - a sign of trouble in
buildings where many of the state's most vulnerable residents are
housed, and where the state has repeatedly had trouble with abusive
employees and unexplained injuries and deaths among residents, according
to the report.

The report was commissioned by Gov. Andrew M. Cuomo
<http://topics.nytimes.com/top/reference/timestopics/people/c/andrew_m_c
uomo/index.html?inline=nyt-per>  in response to a Times investigation
last year into problems of abuse, neglect and fraud in state homes and
institutions for the developmentally disabled. A draft of the report
began circulating in October, but has not yet been released to the
public; people frustrated by the delay separately provided to The Times
an executive summary and a bound copy drafted in December.

Problems were found at all six state agencies that provide residential
service to children and adults with an array of disabilities, mental
illnesses or other issues that qualify them to receive specialized care
by the state.

According to the report, a regulatory maze has complicated and in some
cases constrained the state's response to claims of abuse. At one
agency, the police are summoned if "there is reason to believe that a
crime has been committed," while another agency does so only if a
potential felony has been committed. A third agency turns to law
enforcement only if a local district attorney has "indicated a prior
interest," the report said.

The Cuomo administration has expressed concern about issues identified
in The Times and addressed by the report. Over the past year, the
governor has forced the resignations of the commissioner of the Office
for People With Developmental Disabilities and the top official at the
State Commission on Quality of Care and Advocacy for Persons With
Disabilities, and he has moved to fire 130 employees involved in
accusations of serious episodes of abuse or neglect.

The administration has also taken a number of steps to shore up
oversight and care of the developmentally disabled, putting in place new
rules for drug testing and criminal background checks of staff members
who work with the vulnerable.

"The draft report was the subject of a cabinet and press briefing in
October, and we are currently working on a transformational reform plan
based on the report that will be announced soon," said Richard
Bamberger, the governor's communications director.

But some advocates and lawmakers have been frustrated with what they see
as the slow pace of progress. Michael Carey, an advocate for the
developmentally disabled whose son with autism
<http://health.nytimes.com/health/guides/disease/autism/overview.html?in
line=nyt-classifier>  died
<http://www.nytimes.com/2011/06/06/nyregion/boys-death-highlights-crisis
-in-homes-for-disabled.html?ref=nyregion>  in state care in 2007, said
he was concerned that the governor was waiting to address the issue
until after legislative budget negotiations, which could make it more
difficult to find money for new programs.

"It's gross negligence that that report has not come out, and it's
beyond frustrating," Mr. Carey said, adding, "The reforms to date are
baby steps towards monster problems." And Senator Roy J. McDonald, the
chairman of the State Senate's mental health
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto
pics/mentalhealthanddisorders/index.html?inline=nyt-classifier>
committee, sent a letter this month to the governor urging him to turn
over the report "so that we can begin working towards enacting long
overdue protections and safeguards."

The Times last year identified numerous problems with the state's care
for the developmentally disabled: only 5 percent of abuse accusations
were forwarded to law enforcement, and employees who physically or
sexually abused the disabled were often transferred among group homes
instead of being fired.

Ten percent of deaths of the developmentally disabled in state care were
listed in a state database as having occurring from unknown causes,
suggesting widespread failures in efforts to determine why people die in
state care.

At the same time, executives at some nonprofit organizations hired by
the state to care for the disabled have been earning seven-figure annual
compensation packages and taking a wide range of Medicaid
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto
pics/medicaid/index.html?inline=nyt-classifier> -financed perks for
themselves and their friends and families.

The state report, a 105-page document called "The Measure of a Society:
Protection of Vulnerable Persons in Residential Facilities Against Abuse
and Neglect," critiques the practices at six state agencies that oversee
residential programs for vulnerable populations, at an annual cost of
$17.9 billion. The report's principal author was Clarence Sundram, who
was hired by Mr. Cuomo a year ago as a special adviser on vulnerable
people. Mr. Sundram had been named by Gov. Hugh L. Carey to lead the
Commission on Quality of Care, and he ran the commission for two decades
until he left amid a disagreement with the administration of Gov. George
E. Pataki.

In his report, Mr. Sundram found inconsistent data about accusations of
abuse and neglect at state-run facilities. Some agencies train their
investigators; others do not. Evidentiary standards vary. And
definitions of abuse or neglect vary depending upon which agency has
oversight.

The report found that residential schools run by the Education
Department did not track abuse claims, while the State Health Department
had "no reliable data" for accusations at its homes for mentally ill
adults. At the large institutions overseen by the Office for People With
Developmental Disabilities, the report found 119.68 abuse claims for
every 100 beds.

The homes monitored by the Health Department have been a particular
concern for a decade, since a series of articles in The Times in 2002
called attention to abuse there. Nonetheless, the report found, the
department has few standards for investigating its homes: the agency's
regulations "do not directly address an operator's responsibility to
investigate incidents or allegations of abuse," the report concluded.

The Office of Children and Family Services also has few standards to
determine when and how to investigate abuse accusations at some
facilities. And the Education Department does little to oversee its
programs for the disabled, which include two residential schools - one
for the deaf and one for the blind - with a total of 200 beds, as well
as educational programs at nonprofit residential schools serving 2,500
students.

The department does not require schools to have incident-reporting or
investigation policies, and does not require abuse and neglect
investigations, relying on the Office of Children and Family Services to
conduct child-abuse inquiries.

The Education Department, which reports to the State Board of Regents
and not to the governor, said the Sundram report highlighted "the need
for systemwide reform."

The department "supports change that would enhance protections for
vulnerable children and adults in residential settings across New York
State and in out-of-state facilities," said its spokesman, Tom Dunn.

The report recommended several changes to state laws and regulations in
an effort to prevent and better respond to abuse of the vulnerable. But
it continues to rely to a large extent on self-policing, which could be
a point of criticism among advocates.

"These human services systems did not arrive overnight to the point at
which they find themselves, nor will they get to a dramatically better
level of performance immediately," the report said. "But there is a need
to begin the process of reform with a sense of urgency."

One proposed law would require the establishment of a 24-hour hot line
to report abuse of adults in state care - the state already has a
child-abuse hot line - as well as the creation of a single entity to
review abuse accusations regardless of the agency involved. Another
proposed law would bar people with convictions for violent felonies and
sex crimes from jobs with state agencies, or with state-contracted
nonprofits groups, that provide care for the vulnerable.

Because the current charge often filed against those accused of abuse -
endangering the welfare of an incompetent or physically disabled person
- is a misdemeanor, the report also proposes creating new offenses with
tougher penalties to prosecute such crimes.

During arbitration proceedings against employees accused of abuse, a
representative of the abused vulnerable person should also be present,
the report suggests. And, the report says, the state should follow
through with a promise to establish specific penalties for offenses by
abusive employees, a concept that the Civil Service Employees
Association agreed to during labor negotiations months ago.

 

http://www.nytimes.com/2012/03/22/nyregion/new-york-state-draft-report-f
inds-needless-risk-in-care-for-the-disabled.html?_r=2&hp

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