DDS lags independent DPPC in abuse substantiations
Although the state Department of Developmental Services investigates far more abuse allegations of the developmentally disabled in Massachusetts than does the independent Disabled Persons Protection Commission (DPPC), DDS found a lower percentage of the allegations to have merit than did the DPPC between Fiscal Year 2015 and the present, data provided by the DPPC show.
While the DPPC is technically the lead state agency in investigating complaints of abuse and neglect of the disabled in the state, the agency is so poorly funded that it is forced to refer most of the complaints it receives to DDS and other agencies to investigate.
As the chart below shows, the DPPC “substantiated” an average of 22.7% of the abuse allegations that the agency itself investigated from Fiscal Year 2015 through 2019. During that same time period, DDS substantiated an average of only 13.6% of the allegations that the Department itself investigated.
The chart is based on the DPPC data, provided to COFAR under a Public Records Law request.
When allegations of abuse are substantiated, DDS and its corporate providers of care are usually required to take corrective measures, which can include providing training, changing procedures, and barring alleged abusers from further employment in the system. The DPPC has a separate State Police Detective Unit that refers some of the allegations to local district attorneys offices for separate criminal investigation and prosecution.
The DPPC, which was established in 1987 as an independent agency to investigate allegations of abuse and neglect of adults with intellectual and other disabilities, had only four investigators on its staff (not counting the State Police Unit) as of Fiscal Year 2017, according to its latest online annual report. Despite that, the agency received more than 11,000 reports of abuse of the disabled that year, according to the annual report.
According to the DPPC data, the agency itself investigated an average of only 144 abuse complaints per year between Fiscal Years 2015 and 2018, the last year for which complete data were provided. During that same period, the DPPC referred an average of 1,743 complaints per year to DDS to investigate.
But while DDS does have more investigative resources than the DPPC, DDS’s main function is to manage and oversee care to the intellectually and developmentally disabled through a network of both state-operated and corporate provider-operated group homes and other facilities. As such, DDS appears to face a conflict of interest in investigating allegations of abuse and neglect in its own system.
The DPPC data for Fiscal 2019 are only partial so the percentage of substantiated cases between the DPPC and DDS may not vary as widely as of the end of the year as they appear to do now. But there seems to be a pattern going back to Fiscal 2015 that verifies concerns we’ve raised that DDS has an incentive to downplay complaints of abuse and neglect in its own facilities, whether they are state or provider-operated.
The DPPC doesn’t appear to want to talk with us. Neither Nancy Alterio, the executive director of the agency, or anyone else there has agreed to several requests for an interview.
Apparently, very little has changed since 2004 in the relationship between the DPPC and DDS except that prior to at least that year, DPPC officials were willing to state publicly that DDS was compromised in investigating abuse within its own system.
The January 2004 issue of The COFAR Voice noted that the DPPC had issued a position statement charging that DDS (then the Department of Mental Retardation), the Department of Mental Health, and other state agencies were “vulnerable to pressures that could compromise the integrity of their investigative findings (in abuse cases).”
There have been instances, the DPPC statement noted, in which information contained in investigative reports had been altered “to absolve the service-providing agency from liability.”
The DPPC statement added that among the reasons that the DPPC should conduct abuse investigations internally were that it would lend integrity to the investigation process and would provide a “political safety valve” to other agencies, whose own investigations might otherwise be branded as “whitewashes.”
The DPPC statement even compared the investigations of abuse by service-providing agencies to the recent sex abuse scandal within the Catholic Church in which the system had “closed its eyes to its failings and attempted to protect itself by protecting the wrongdoers within it.”
Thomas J. Frain, COFAR’s president, is also quoted in the 2004 article, as saying, “DMR is dependent on these providers for services and is going to be very reluctant to sanction them for either poor service or abuse. We need an independent organization like the DPPC to do this.”
Seeking additional information
Last week, we asked the DPPC for additional data, including:
- The number of investigators employed by DDS and the DPPC to investigate complaints of abuse from Fiscal Year 2004 to the present.
- Any written agreements between the DPPC or DDS or written policies or guidelines that concern the process of determining which abuse complaints are assigned for investigation by the DPPC and which complaints are assigned for investigation by DDS.
We have also asked both the DPPC and DDS for comment on the data showing a higher percentage of substantiation of abuse complaints by the DPPC. So far, we have not heard back from either agency on that question.
And we’ve asked the DPPC whether they stand by the agency’s statement prior to 2004 that the agency should have the resources to conduct all abuse investigations internally. We’ve asked DDS as well whether they agree that the DPPC should conduct all abuse investigations.
We’ll be back here to report on the answers we get from each agency. It’s certainly possible that the DPPC and DDS will provide a reason we haven’t thought of as to why the abuse substantiation rates differ between each agency. (We would note that the overall percentage difference between 2015 and the present appears to be large enough that it is likely not due to chance alone.)
Whatever that reason given, if a reason is given, for the difference in the substantiation percentages might be, we’ll report it. But the perception of a conflict of interest remains in having the DDS investigate its own system. Thirty-one years after the creation of the DPPC, that needs to be changed.
COFAR blog 
DDS has recently considered if “declining a visit (from a trusted former caregiver) constituted mistreatment (an act or omission which exposes an individual to a serious risk of emotional harm by violating a dying individual her right to visitors under DDS
regulations”.
At the time of the visitors request, the individual appeared unresponsive. DDS stated no one knows whether the individual would have been aware of or able to perceive the visitors presence had she been allowed to visit.”
The requesting visitor provided DDS documentation based on hospice guidance, stating holding a hand of even an unconscious person, may be comforting. Also documentation stated, it is impossible to know whether the unconscious individual understands what is being said, but the need for communication remains.
DDS stated they could not say with any certainty that denying the individual the opportunity to have a trusted former caregiver hold her hand hours before her death exposed the dying individual to serious emotional harm.
DDS also states this was not a violation of the individuals right to visitors, as that right belonged to the individual. As she was unconscious she was unable to express her preference for visitors at that time.
DDS states their decision is AFFIRMED and is the final decision in this matter.
Please, how can an organization have so much power as to be able to determine it is acceptable to deny a dying individual her protected right to have a visit from a trusted visitor because she was not able to speak for herself. In addition, this organization states it would not cause the individual serious emotional harm.
One day this action by DDS will be revisited by others who will shake their heads and say “how could they.”
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