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REPORTING ABUSE
OF DISABLED PERSONS:
AN UPDATE
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Disabled Persons Protection Commission
KATHLEEN M. VESEY, COMMISSIONER
STEPHEN M. SPINETTO, COMMISSIONER
MICHAEL BROOKS, EXECUTIVE DIRECTOR
J.
MARCH
1992
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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?
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