How much additional evidence do we need that the Department of Developmental Services (DDS) must be radically restructured and reformed? As parents of adult children with intellectual disabilities, we were horrified to read the federal government’s chilling indictment of DDS’s failure to safeguard people in its care: Connecticut Did Not Comply with Federal and State Requirements for Critical Incidents Involving Developmentally Disabled Medicaid Beneficiaries (A-01-14-00002), released May 25.
The Department of Social Services administers Medicaid funding for individuals with developmental disabilities in Connecticut, but DDS is responsible for monitoring and reporting critical incidents — that is, incidents where injuries to those beneficiaries could be the result of abuse or neglect.
According to the federal Department of Health and Human Services Inspector General’s recent audit, the DDS system of reporting and monitoring critical incidents failed, finding that DDS did “not adequately safeguard 137 of 245 developmentally disabled Medicaid beneficiaries.”
The audit provides numerous illustrations of a completely ineffective DDS system. Alarmingly, DDS received 152 reports of potential abuse and neglect deemed “critical” yet referred only one to the Office of Protection and Advocacy for investigation.
DDS’s excuses were summarily dismissed by the auditors. And we should be clear that the injuries covered by the audit where DDS failed to act included broken bones, head injuries, contusions, facial lacerations and fractured teeth.
Imagine being the parent of a son with profound disabilities who cannot verbally communicate and relies upon others for all of his daily living activities. If he could not communicate to you how he had been injured—and the DDS system fails to monitor and report it—how could you be assured of his well-being? How would you sleep at night?
The audit tells us that because of a fundamentally flawed system, DDS has no idea whether people it directly and indirectly employs are abusing or neglecting people in their care. So while it is possible that many of the injuries were the result of unpreventable accidents, it is equally possible that they were the result of abuse and neglect. DDS’s system is simply incapable of telling the difference. If there are employees whose misconduct disqualifies them from ever working with our children, the DDS system cannot identify them.
It is also important to note what the audit is not about. It is not about the competence of any direct care worker, whether employed directly by the state or by a private provider. It is also clear that the cases of suspected abuse and neglect occur in both private and public sectors. Prior authoritative reports have already documented that there is no meaningful statistical difference between the two sectors when it comes to the quality of care. The purpose of the audit was solely to determine the adequacy of the critical incident monitoring and reporting system. And the conclusion was that it completely failed to protect our loved ones.
The report also details that critical incident training is “optional” and the state’s mandatory reporting statutes are virtually disregarded by healthcare facilities and providers.
Group home workers receive significant training mandated by DDS. Critical incident monitoring and response training must become mandatory too because, tragically, abuse and neglect of our disabled citizens is a fact of life. The failure of this most basic system speaks volumes about the value placed on the lives of individuals with disabilities in this state. The safety of our loved ones demands that it be reformed without delay.
Similarly, the report details that of all incidents studied, only one hospital reported a case of suspected abuse. This utter failure of mandatory reporter responsibility is shocking. DDS must address this problem by educating hospital and professional medical associations on the responsibilities of health care professionals and health care facilities under the mandatory reporter laws.
Sadly, this latest DDS failure is not anomalous, but instead part of a pattern that has pained parents and family members for years. Everywhere we turn, we are confronted by inefficiency and mismanagement. We are forced to trust DDS with our family members’ well being, but now learn that the agency is not fulfilling even its most basic responsibilities.
We have lost confidence in the DDS system and call on Gov. Dannel Malloy to take aggressive steps to restructure and reform DDS. The health and well-being of our family members demand it.
Dawn Lazaroff is Chair of The Arc Connecticut. Tom Fiorentino is Co-Chair of the Governor’s Working Group on the DDS Waiting List and a board member of The Arc Connecticut. Shelagh McClure is Chair of the Connecticut Council on Developmental Disabilities.