COFAR blog

More than five years ago, Mary Phaneuf thought the serious neglect her foster son, Timothy Cheeks, had experienced in his group home in East Longmeadow was finally coming to an end.

In 2019, the Department of Developmental Services (DDS) took the rare step of terminating a contract with the Center for Human Development (CHD) to operate two residences, in one of which Tim was living. Among other problems, CHD, a DDS-funded corporate provider, had failed to take Tim to his doctor’s and dentist’s appointments for seven years even though Tim has a congenital heart defect.

COFAR’s blog posts in 2019 (here and here) concerning Mary’s allegations, and subsequent coverage by The Springfield Republican, led to a DDS investigation of CHD. The contract termination came after the investigation by DDS’s Bureau of Program Integrity found “potential systemic issues” of poor care throughout CHD’s residences.

Timothy Cheeks with his foster sisters, (from left) Nicole Phaneuf Sweeney, Lauren Phaneuf West, and Jessica Phaneuf Szczepanek.

DDS subsequently selected a new provider, the MHA (Mental Health Association), to replace CHD, and Tim was moved into an MHA home in 2019. Tim, 46, has an intellectual disability and Down Syndrome.

In September of this year, Mary got back in touch with us to let us know that many of the same issues that had existed under CHD began to reemerge under MHA.

In the early months, Tim’s care did improve significantly in the new residence. The new staff were communicative, attentive, and committed, Mary said. But as the COVID-19 crisis unfolded and management changes occurred, care started to slip, she said.

Nevertheless, Mary said she remains hopeful that the ongoing case will spark the systemic changes that she contends are necessary to permanently correct the problems.

“This is not to assign blame, but to advocate for change,” Mary wrote. “Many of the staff at MHA and DDS care deeply about the people they serve. The problem lies in a system that too often allows serious issues to repeat due to gaps in communication, training, and oversight.”

Since MHA has been in charge, the problems alleged by Mary include the following:

• In spring 2024, Tim’s Social Security benefits were terminated because of unreported income from his estranged biological father — a situation not caused by MHA, but requiring their timely response. However, the provider failed to meet the required federal timelines for an expedited appeal. As a result, Tim was without benefits for more than 18 months, leaving his personal funds depleted. His benefits were finally restored in October of this year.

• During the same period, Tim’s MassHealth insurance lapsed, interrupting access to medical and behavioral health services. The lapse occurred despite reminder emails from both the Behavioral Health Network (BHN), the provider of Tim’s counseling services, and DDS to MHA to renew Tim’s coverage. Coverage was only reinstated after family intervention.

• In September of this year, Mary discovered, for a second time, that Tim’s feet were red, swollen, and painful, with overgrown nails and large callouses that made it difficult for him to wear shoes. Although a podiatrist had recommended to MHA in February that Tim have follow-up visits every three months and receive prescribed twice-daily foot medication, he was not seen for seven months. Also, it appeared his medications were not being administered consistently.

• MHA staff initially falsely told Mary they stopped taking Tim to his podiatrist because the podiatrist had stopped accepting MassHealth. That claim was later refuted directly by the doctor’s office. This neglect violated Tim’s Individual Service Plan (ISP), which had specified podiatry care and weekly nursing visits for him, Mary said.

• In August 2024, over a year prior to her report in September of this year, Mary first reported to MHA and Tim’s DDS service coordinator that Tim’s feet were in bad shape. She showed them a photo of his feet with large callouses, toenails grown so long they curled over the top of his toes and a large fungal growth on the bottom of one foot. Mary said that after her 2024 report, DDS included Tim’s footcare in his ISP, and MHA committed to a weekly nurse visit to check his feet. “One year later it all fell apart,” Mary said.

• In October 2022, MHA staff gave another client’s high blood pressure and anti-psychotic medications to Tim. Although Mary was told Tim was “fine,” she arrived at the hospital to find him heavily sedated and disoriented. The Disabled Persons Protection Commission (DPPC) later substantiated the incident as abuse.

• In both 2024 and 2025, Tim’s behavioral counseling at Behavioral Health Network (BHN) was suspended due to missed appointments and unreturned calls to the group home. At one point, Mary was told Tim’s appointments were missed because his counselor was hospitalized — a statement BHN later confirmed was untrue. These missed sessions deeply affected Tim’s emotional stability and confidence, Mary said.

• In August 2024, Mary learned from Tim’s day program that MHA had failed to pay for or register him for day program activities for over a year, and that his funds for those activities had been depleted. Mary’s family covered the costs to prevent disruptions in his daily routine. MHA did fix that problem. But Mary said that if she hadn’t discovered it, MHA would have never known about it. “For a whole year those activities, so important for Tim’s quality of life, fell by the wayside,” she said.

Service coordinator supports allegations

In an email on September 3, Tim’s DDS service coordinator, suggested to Mary that she contact the DPPC regarding the alleged neglect of Tim’s feet and the lapse in his health insurance.

Having viewed the photos that Mary had sent him, the service coordinator wrote that an investigation by either the DPPC or DDS “will put a fire under the feet of MHA to ensure that they are following the podiatry/Dr’s orders, and making sure he gets the proper podiatry care.  What you have sent in the pictures is unacceptable.” [Note: We are not publishing the photos due to their graphic nature.]

The service coordinator also stated, “Please don’t worry about anyone ‘getting in trouble’ at MHA. They need to do their jobs accordingly and also be truthful about the care of the people in their services.” He also referred to “Tim not having health insurance for 5 months,” saying, “That is simply not okay.”

Requests and promises of investigation of MHA

At our suggestion, Mary emailed the director of the DDS Bureau of Program Integrity on October 3 to let her know of the allegations involving MHA and to request another investigation. The Bureau had conducted the previous investigation of CHD in 2019. Mary also emailed the DDS Central West regional director and DDS Springfield area director, requesting an investigation.

Those officials responded to Mary the same day, saying they intended to look into the concerns she raised.

It is certainly both frustrating and devastating to Mary and her family to learn that even after an investigation that resulted in the termination of the provider that was neglecting Tim, similar problems have continued under the new organization selected as the replacement. It is a shame that such a vulnerable client has had to undergo this level of neglect twice, in two different residential settings.

All of this appears to show that DDS did not follow up to determine whether the problems identified by the 2019 investigation had been corrected. That investigation was, by all accounts, comprehensive. It is unfortunately more evidence that the group home system in Massachusetts is dysfunctional, and DDS does not have a handle on it.

Nevertheless, Mary said she believes that DDS and its providers are capable of providing good care and ensuring high staff morale and low staff turnover. She maintained that, “The ultimate goal is simple: to create a system where every person with a developmental disability receives consistent, compassionate, and competent care — and where families, providers, and the state work together to make that goal a reality.”

Mary noted that Tim loves music, his day program, and spending time with his family. “His laughter and resilience remind me why this work — ensuring quality care and dignity for people with disabilities — matters so deeply.” She said she remains hopeful that, “by working with MHA and DDS, we can make progress toward systemic improvement.”

We certainly hope that is the case.