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^m5. *3>p\.3l; j^gp Y 3150bb 0570 flOtD 3 REPORTING ABUSE OF DISABLED PERSONS: AN UPDATE if Disabled Persons Protection Commission KATHLEEN M. VESEY, COMMISSIONER STEPHEN M. SPINETTO, COMMISSIONER MICHAEL BROOKS, EXECUTIVE DIRECTOR J. MARCH 1992 2, ni/ztq TABLE OF CONTENTS INTRODUCTION i THE COMMISSION 1 THE LAW 4 WHO REPORTS? 6 WHY REPORT ABUSE? 8 CASE REVIEWS 9 Program 10 1 Danvers State Hospital 13 Program 2 19 Metropolitan State Hospital 21 HOW MUCH ABUSE UNREPORTED? IS 26 Department of Mental Health 30 Department of Mental Retardation 30 Department of Correction 41 WHY ABUSE NOT REPORTED? IS 44 ACTIONS TO ENCOURAGE REPORTING 47 CONCLUSIONS AND RECOMMENDATIONS 51 Introduction Reporting of abuse of persons with disabilities by those persons who are aware of it is the key element of any system to end such abuse and, ultimately, to prevent and eliminate it. The Legislature recognized this reality by incorporating within M.G.L. c. 19C, the Disabled Persons Protection Commission statute, a provision mandating reporting by certain persons whose profession gives them a greater opportunity to observe and/or learn of abuse of disabled persons. These persons, referred to as "mandated" reporters, are the backbone of the protection system for persons with disabilities. The Disabled Persons Protection Commission (DPPC) is responsible for insuring that reports are filed as required by c. 19C. As part of this duty, the Commission conducted an investigation of failures to report abuse of disabled adults, as required by Massachusetts General Laws (M.G.L.) chapter 19C, §10, by mandated reporters in certain state facilities and vendor programs. The investigation was authorized by the DPPC Commissioners as a Commissioners' Investigation pursuant to CMR M.G.L. c. 19C, §8, and 118 6.01. The report outlines the basic statutory requirements, examines several individual cases where failure to report abuse occurred, and reviews cases reported under 19C and those c. noted in the public logs of the Departments of Mental Health and Mental Retardation. The investigation also reviewed reporting from the Bridgewater State Hospital, under the operation of the Department of Correction. This report discusses aspects of the present reporting system and provides recommendations for insuring that the reporting provisions of c. 19C are followed so that through reporting, abuse can ultimately be prevented. The Commission The Disabled Persons Protection Commission is a state agency whose purpose is to "provide for the investigation and remediation of instances of abuse of disabled persons in the Commonwealth." (M.G.L. c. 19C.) The primary and most essential step for the Commission in accomplishing its mission to protect disabled adults, and, ultimately, to prevent abuse, is to first be notified that abuse has occurred. Absent reporting of abuse to the Disabled Persons Protection Commission, the abuse and resulting injury to a disabled person will likely continue, especially when the abuse occurs in a private setting, one which, due to its private nature, is not supervised by a state agency or vendor. The Commission receives reports of abuse of disabled adults from certain persons who are required by law to report suspected abuse, i.e., mandated reporters, as well as from other individuals who voluntarily A report. disabled person is defined as a person between the ages of 18 and 59, inclusive, and disabled to such a degree that they are either wholly or partially dependent upon others for daily living needs. (Persons under the age of 18 are covered by the child abuse reporting statute, M.G.L. c. 119, and persons age 60 or over are subject to the provisions of the elder abuse reporting statute, M.G.L. c. 19A. Pursuant to M.G.L. c. Ill, abuse allegations in long-term care facilities, such as nursing homes, are the responsibility of the Department of Public Health, regardless of the age or disability of the alleged victim.) This definition of disabled person includes all residents of state hospitals, inpatient mental health centers, state schools for the retarded, state-funded community residential programs for individuals with mental illness or mental retardation, individuals eligible for mental health or mental retardation services living at home and in the care of another, and those persons with physical disabilities in the care of another person whether in state-operated programs, state-funded programs, or living elsewhere in the state. Given the statutory description of a disabled adult and the above listing of some of those covered by the law, it is clear that the persons sought to be protected by c. 19C are individuals who are at a substantially greater risk of abuse, due to their disability and the resulting dependency on a caretaker. In 1991, the Commission 1 received an average 195 reports of abuse each month. By early 1992, the average has increased to 215 reports per month. Monthly reports increased by 30% from 1990 to 1991 after an increase of 22% from 1989 to 1990. As will be discussed at greater length in the body of this report, the primary reason for this increase is not an increase in actual incidents of abuse, but, rather, increased reporting. The Commission attributes much of this increased reporting to its efforts to publicize the requirement to report, as well as to the fact that it conducted more investigations in facilities in the past year, including the investigations conducted for this report. Even in the context of the increased number of reports, the Commission considered it important that it examine the instances where reports were not made. The Commission receives two types of reports, which are referred to An as internal and external. internal case concerns abuse of a disabled adult whose caretaker is a state agency [M.G.L. c. 19C, §4(b)]; an external case concerns a disabled adult whose caretaker is not a state agency [M.G.L. c. 19C, §4(c)]. For the purposes of the DPPC, the statute defines "state agency" to include "any agency of the Commonwealth that provides services or treatment", or "private agencies providing such services or treatment pursuant to a contract or agreement with an agency of the Commonwealth." This report focuses primarily on reporting of internal cases, i.e., matters where abuse is alleged to have occurred in settings operated or funded by the state. This is so for two reasons. First, it was DPPC regarding vendor programs and state agencies that the received specific allegations of failures to report. Second, agencies and programs maintain records which allow a better determination of what is not reported. When the Commission receives a report of abuse, the report is screened, a process which requires several determinations: 1). Does the allegation constitute an emergency, i.e., a need for an immediate response and investigation within 24 hours? Digitized by the Internet Archive 2012 with funding from in Member Boston Library Consortium Libraries http://archive.org/details/reportingabuseof1992mass