Maine’s Department of Health and Human Services has a responsibility to keep adults with developmental disabilities safe. There are state laws and regulations that outline what the state agency is supposed to do. There are requirements from the federal government. And the state has made assurances to the federal government that it will live up to its responsibility.
But the state has failed to do its part to keep adults with developmental disabilities safe. That’s the conclusion from a report released Thursday by the U.S. Department of Health and Human Services’ Office of the Inspector General concerning the safeguards Maine has in place to ensure this population’s well-being.
The inspector general’s office delved into what happened with more 2,600 adults with developmental disabilities in Maine during a 2½-year period, from January 2013 through June 2015. In that time, the Office of the Inspector General’s findings showed, Maine’s system for ensuring this population’s safety failed at almost every turn.
The nonprofit service providers who run group homes and other residential settings where adults with developmental disabilities live are required to report “critical incidents” to the state’s Adult Protective Services unit — everything from the use of a restraint on a resident to a medication error to an allegation that a resident has been sexually abused. But the service providers didn’t report every incident, including at least hundreds of serious incidents that resulted in emergency room visits.
After reporting critical incidents, providers are required to perform their own administrative reviews to pinpoint causes and determine how to prevent similar incidents in the future. The providers must submit those reports to DHHS, but DHHS couldn’t explain why it was missing nearly 8,700 of them.
DHHS’ Adult Protective Services Unit is required to investigate reports of critical incidents where abuse, neglect or exploitation is suspected. But data reviewed by the inspector general’s office showed DHHS investigated just 5 percent of the reports it should have.
State law requires that DHHS “immediately” report all instances of suspected abuse, neglect or exploitation to the local district attorney’s office. But the Office of the Inspector General found the state didn’t comply with this requirement either. Of 296 reports involving suspected sexual abuse or sexual exploitation, auditors discovered that DHHS referred just five of those reports to law enforcement for investigation.
During the 2½-year audit period, 133 residents in the care of service providers died — which also should have prompted DHHS review, especially of accidental and unexplained deaths. But DHHS didn’t investigate any of the 133 deaths.
The findings of the inspector general’s office point to a system failing to do its part in keeping adults with developmental disabilities safe. The work that’s supposed to happen to discover and analyze major safety and welfare lapses so they don’t persist simply isn’t happening.
To hear it from DHHS, however, the federal audit’s findings are no cause for alarm.
“It is important to note that the report provides an historical look rather than evaluating practices as they are today. … We are proud that we have successfully made improvements since the audit period,” DHHS said of federal audit in a statement released Thursday.
But somehow, the service providers who are key to making any systemic changes “have not been made aware of those improvements and seek clarity from the Department,” Lydia Paquette, executive director of the Maine Association for Community Service Providers, said in a written statement from the organization.
DHHS attributed lapses the federal audit identified during a 2½-year period from 2013 through much of 2015 to a departmental reorganization that took place in 2012. And, as the Office of the Inspector General noted in its report, DHHS simply couldn’t explain some of its fundamental lapses.
An examination of DHHS’ response to the Office of the Inspector General’s findings reveals a concerningly selective interpretation of the state laws and regulations and dictate the department’s responsibilities.
The reality is that as Gov. Paul LePage and former Health and Human Services Commissioner Mary Mayhew were speaking ad nauseum over the past several years about prioritizing the needs of residents with developmental disabilities over those of other needy populations, they actually were failing the very population they were claiming to help.