COFAR blog

A new per-client analysis by COFAR of abuse data from the state shows that state-run residential facilities for persons with intellectual and developmental disabilities have had below-average substantiated abuse allegation rates and referrals for criminal investigations among providers in Massachusetts.

COFAR first reported in September on our ranking of residential service providers based on raw data from the Disabled Persons Protection Commission (DPPC). That data concerned more than 14,000 allegations of abuse of persons with intellectual and other developmental disabilities.

Since then, we received information from the Department of Developmental Services (DDS) on the number of clients served in both state-run and corporate provider-run group homes and other facilities.

As a result, we have analyzed the DPPC data on a per-client basis. We’ve also combined total abuse data for those providers operating in more than one region of the state.

The per-client data corrects for larger providers, including the regional system of state-operated group homes. The state-operated residences in total serve more clients than any individual corporate DDS provider.

The data show that the total network of state-operated homes, with 1,118 clients, had more abuse allegations in total than other individual providers between Fiscal 2010 and 2019. But on a per-client basis, the state-operated homes dropped down the list of providers, and were well below average in terms of both substantiated allegations and criminal referrals between Fiscal 2010 and 2019.

Also, the Wrentham and Hogan developmental centers were at or near the bottom of the list of total providers in every measure except for number of clients. In Fiscal 2018, both developmental centers still had well above the average number of clients among providers.

Wrentham and Hogan are the state’s only two remaining developmental centers that meet federal standards for Intermediate Care Facility (ICF) services.

The chart below lists our rankings of the top 10 and bottom 10 providers in terms of numbers of substantiated abuse allegations per client and referrals for criminal investigation per client from Fiscal Years 2010 through 2019.  State-run facilities are highlighted to show their relative placements on the list.

(Complete results of our findings can be found in spreadsheets at this link: DPPC abuse data per client FY 10 to FY 19 sorted.)

These findings are in line with our reporting that state-run residential centers and group homes tend to employ staff with higher levels of training and lower rates of turnover than do corporate-run facilities.

Despite that safety record, the Baker administration and administrations prior to it, have reduced funding for state-run facilities in the DDS system, and boosted funding for corporate, provider-run residences.

In addition, DDS routinely fails to offer state-operated homes as an option for people waiting for residential care, and instead directs those people only to openings in the privatized residences.  As a result, those facilities are slowly dying by attrition.

Ranking by number of residential clients

In COFAR’s latest analysis, we re-examined data from DPPC concerning 79 residential providers, 75 for which DDS provided data on the number of clients served. The total providers analyzed included the Wrentham and Hogan Centers.

The total number of clients served in all residential facilities for which DDS provided data was 8,218 in Fiscal 2018.  (Fiscal 2018 was the middle year in the range of years of client data provided by DDS, which was from Fiscal 2016 to 2020.)

As noted, DDS state-operated group homes, combined from all regions of the state, had a total of 1,118 clients in Fiscal 2018, according to DDS records. That is nearly three times the size of the next largest provider, Seven Hills, which had 397 clients.

The total number of clients in provider-run group homes in Fiscal 2018 was 6,692, according to the DDS data. (Data were not analyzed for providers that had relatively few clients.)

At 272 residents and 136 residents respectively, the Wrentham and Hogan Centers had well above the average number of 92.9 residents served by individual corporate providers in Fiscal 2018.

Ranking by number of abuse allegations 

As noted, the entire network of state-operated group homes had the highest number of abuse complaints among providers from Fiscal 2010 through 2019, according to DPPC data.

There were a total of 2,045 complaints involving the state-operated group homes, which was nearly three times higher than for the individual provider with the next largest number of complaints, Vinfen.  But that would normally be expected given the state-operated network is so much larger than any single provider.

The total number of complaints among all residential providers was 14,088 in the period reviewed. The average number of complaints per provider was 178.

Ranking by number of substantiated abuse allegations per client 

When ranked by total allegations of abuse per client substantiated after investigations either by DPPC or DDS, the state-operated group home network fell to 48th on the list, with a per-client substantiation rate of 0.07. That was well below the average rate among providers of 0.13 substantiated abuse allegations per client.

The Hogan and Wrentham Centers were ranked 71 and 72, with rates of 0.01 and 0.00 substantiated abuse allegations per client respectively.

The Judge Rotenberg Center rose to No. 1 on the list, with a rate of 0.55 substantiated allegations per client.

The average rate among providers of substantiated abuse per client was 0.13. (See chart above.)

Ranking by number of allegations per client referred to DA’s

When ranked by the number of allegations referred per client to district attorneys for criminal investigation,  the DDS state-operated group home system fell even further, to a ranking of 50 out of the 75 providers.

The state-operated group home referral rate was 0.12 allegations per client, well below the average among all providers of 0.21 referrals per client.

The Hogan Center was ranked 70th at 0.03 referrals per client, while the Wrentham Center was ranked 75th, at 0.00 referrals.  That was the lowest among providers for which per-client data were available.

The Judge Rotenberg Center stayed at the top of the list, with a rate of 1.5 criminal investigation referrals per client.  That was more than double the provider with the second highest ranking — Becket Family of Services.

Continuing need for transparency

As we’ve said before, we think this type of provider-based data should be made easily available and accessible online by DDS and DPPC. We have continued to urge the Legislature’s Children, Families, and Persons with Disabilities Committee to approve a bill (H.93), which would require DDS to post online information about provider-based abuse data and performance.

We are urging people to call the Children and Families Committee at (617) 722-2011 (for Rep. Kay Khan, House chair) and (617) 722-1673 (for Senator Sonia Chang-Diaz, Senate chair), and ask the committee to vote favorably on the bill.

We also hope that this data will underscore the need for state legislators to recognize the importance of state-run residential care for persons with intellectual and developmental disabilities.

The state-run residential facilities provide an essential backstop of care for persons who are subject to abuse or are simply not able to cope in the corporate-run group home system. Families and guardians should be routinely informed about state-run care as an option, and should certainly not be forced to fight DDS in order to get that option.