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Parents continually frustrated by DDS and group-home provider in advocating for adequate care for their son
Ryan Tilly, who has Down Syndrome, had been living in his provider-operated group home in Haverhill for only four months in March of 2016 when he was allegedly assaulted by a staff member of the residence.
It was only the beginning of what would turn out to be a nightmare for Ryan, who turns 24 this month, and for his parents, Deborah and Brian.
The Tillys maintain that in addition to the assault, Ryan was subjected to neglect in the group home, which is operated by the NEEDS Center, a Department of Developmental Services provider. He was also harassed by another resident of the group home so severely in 2016 that he has continued to isolate himself in his room there and was afraid for a period of time to take showers in the residence.
Ryan Tilly
Yet, rather than working with the family to address those problems, both NEEDS and DDS initially turned against the parents, according to the Tillys and to documents in the case. The Tillys were accused of being “volatile and unpredictable,” and of fabricating a charge that the staff was failing to clean clothing that Ryan had soiled.
Ryan’s father, Brian, was banned for months from visiting Ryan in the NEEDS residence, while Deborah had to make appointments in order be able to see him.
A DDS investigation of the Tillys’ charge regarding Ryan’s clothing determined that there wasn’t sufficient evidence to charge the group home with neglect in the matter; but the report did not refute the parents’ allegations. In September 2016, DDS recommended that NEEDS and DDS meet regularly with the Tillys to “foster cooperation,” and that DDS explore possible new residential options for Ryan.
Deborah Tilly
But neither NEEDS nor DDS appear to have fostered that communication, at least initially. The restrictions against the Tillys on visiting Ryan in the group home continued through at least October of 2016, according to emails from the provider.
In response to an email query from COFAR last week, Jim Sperry, NEEDS President and CEO, declined to comment on the overall case.
While the Tillys ultimately filed three abuse complaints against NEEDS involving their treatment of Ryan, DDS consistently maintained that there was a lack of evidence to support the complaints. Yet it appears that DDS failed to interview key witnesses in at least two of those cases.
In the assault case, the DDS report disclosed that the investigator never interviewed a witness who had also originally reported the incident. In the neglect case, DDS also found a lack of evidence to support the charge, yet never interviewed Deborah herself.
We have seen that dynamic many times in which parents and other family members have raised issues or made allegations about care; but rather than thoroughly investigating those allegations, DDS has turned against the family members and branded them as volatile or overly emotional. In those cases, family members are made by DDS and its providers to feel as though they are to blame for the providers’ own failures in care.
For the Tillys, things began to improve only after they hired a lawyer to press their case to improve their son’s care and to overturn the restrictions on visiting Ryan. Their attorney, Thomas J. Frain, is COFAR’s Board president.
Nevertheless, the situation remains unpredictable, Deborah said, and the improvements could be reversed at any time. The Tillys have requested another residential placement for Ryan, including a possible state-operated residence, but DDS has so far not found one for him.
“We had to fight for Ryan’s rights to have us visit him at his residence without the restrictions the NEEDS and DDS placed on us, especially on his father,” Deborah said in an email to us. “We also had to get counsel to insure that the abuse, and neglect Ryan was subject to ended.”
Deborah’s email added that, “We as his parents know our son and can read his behaviors and actions very well….(Yet) the district DDS office continued to side with the providers, leaving parents and guardians fighting to keep their loved ones safe and cared for with dignity.”
Abuse neglect issues: 3 major cases
The following are details about the three complaints filed by the Tillys, based on interviews and documents provided by Deborah. A NEEDS meeting minutes document from that period of time referred to a staff shortage in Ryan’s group home and to “a good deal of turnover” there.
Alleged assault by staff member
Deborah said Ryan had been living at the NEEDS residence for four months when Sperry, the NEEDS president and CEO, called her on March 31, 2016, to inform her that a report had been filed by an anonymous person to the Disabled Persons Protection Commission (DPPC) about an alleged assault on Ryan by a staff member.
The alleged assault had actually occurred on March 17, two weeks earlier, while Ryan was being directed to a van to take staff and residents to a weekly community-based dinner. Ryan, who did not enjoy going on these outings, hit a female staff in the face when she got close to him. He was already agitated because of a previous dental appointment and because the staff member would not let him enter the home after the dental visit, but instead directed him to the van.
Deborah said that Ryan should not be seated near anyone within striking distance while riding in a vehicle. “He becomes very anxious and will hit those who are too close,” she said. This particular day, a male staff had seated another individual very close to Ryan. The female staff member whom Ryan had just hit, reminded the male staff that Ryan needed to sit by himself due to anxiety.
The male staff moved the individual, but the staff member himself sat next to Ryan even though there was room for him to sit elsewhere. Ryan struck the male staff and the male staff became angry. According to Deborah, a witness who was in the van said the male staff stood in front of Ryan and then punched Ryan in the face. The witness reported that Ryan had a swollen lip and a black right eye.
Deborah, who talked to the witness, said the witness had intended to report the incident the next day to the group home manager when she overheard the manager tell the male staff that he needed to “cover his tracks” in regards to a report about a prior incident the week before with a different victim. The witness decided not to talk to the manager at that time, and reported it instead to the DPPC, which referred the investigation to DDS.
According to the DDS report of the incident, staff and supervisors at NEEDS stated that they never saw any visible injuries on Ryan. Yet, at the same time, the report stated that a witness said Ryan suffered a black eye and swollen lip, and that the alleged abuser later stated that Ryan “had given himself a black eye.”
The DDS report also described the witness to the alleged assault as having “thought she saw ALAB (the alleged abuser) hit ALV (the alleged victim, Ryan).”
Despite that assertion, the DDS report stated that the reporter of the incident was never contacted because he or she was anonymous.
Deborah, who interviewed the witness herself, said the witness was the same person who reported the incident to the DPPC. If that is the case, it is unclear how the DDS investigator could seemingly identify this witness and report what she thought she saw, yet not contact her for an interview because the reporter was supposedly anonymous.
“The NEEDS administration knew who the reporter was, as I gave them the information,” Deborah said. “DDS also knew who she was because I gave the information to Ryan’s (DDS) service coordinator. So the investigation was one-sided since the only people who were interviewed were the (remaining) staff from NEEDS.”
Although the assault allegedly took place on March 17, 2016, Deborah and her husband were not informed of it until March 31. In an April 10, 2016, email to Sperry, Deborah wrote: “We have entrusted NEEDS and NEEDS staff to take care of our son in our absence. If we are not being informed about injuries, how can we trust those who are with him on a daily basis?”
In an email response the next day, Sperry maintained that he had not been informed of the assault allegation until March 31. He stated that his agency had “interviewed all staff” who had worked during the time in question and none of them had said they observed an assault or that Ryan had a black eye. Yet, Deborah said Sperry had told her in a phone call that Ryan’s day program staff had reported the black eye.
Sperry added that if the abuse complaint was substantiated by DDS, the alleged abuser would be terminated, and that he would be transferred to another group home even if the alleged abuse was not substantiated. The alleged abuser was reportedly terminated by the provider even though the abuse allegation was not substantiated by DDS.
Alleged neglect
Deborah said that on June 13, 2016, she reported neglect charges against the NEEDS staff to the DPPC because of disturbing changes in his behavior when he came home every other weekend for visits.
She said that during the months leading up to that point, she had noticed that Ryan was afraid to use the shower at his home. He was also urinating and defecating in his room, in his clothing, and in his closet. There were several incidences where Deborah was finding soiled clothing at the residential home in his bureau.
Deborah sad she made several unannounced visits to the group home and found many times he had clothing rolled up in his laundry basket full of feces. Each time, she said, she alerted staff about those problems and followed up with emails to the NEEDS CEO, supervisor and house manager as well as the DDS service coordinator.
While plans were put into place to deal with the situation, the plans were not being followed by the staff, Deborah said. Things came to a head one weekend when Ryan came home smelling of body odor and very dirty. He refused to take a shower claiming he was afraid to go in the bathroom. “This is a young man who would take two showers a day and enjoyed being clean,” she said.
Deborah and her husband took him back to the group home on June 12, 2016. “We were very agitated and wanted to get to the bottom of the issue, and Brian at one point used profanity in suggesting that the “place should be closed down.”
Following the contentious meeting with the house manager, Deborah said, “they began accusing me of bringing the dirty feces into the NEEDS residences. Those accusations were outrageous and I had no alternative but to file abuse and neglect charges.”
However, a July 25, 2016, DDS decision letter found insufficient evidence to support the Tillys’ allegations of neglect, and stated that Sperry claimed Ryan was not exhibiting those behaviors at the group home and that he claimed the parents “are very volatile and unpredictable.”
Deborah said she was never contacted by the DDS investigator. But despite the lack of substantiation of the neglect charge, a DDS action plan called for regular meetings between the Tillys and the NEEDS staff “to foster communication” and to “address any areas of concern that may arise.”
Unexplained head injury
Deborah said Ryan’s NEEDS Center day staff supervisor phoned her on September 29, 2016, to let her know that Ryan had a self injurious episode three days before in which he suffered a laceration on his forehead. She said the supervisor said he was concerned that Ryan might need medical attention to the injury because he believed it was infected.
Deborah said the day staff supervisor could not explain why no one from the day program nor the residential program had notified her of the injury at the time it happened.
On November 15, 2016, Deborah filed a complaint with DDS about the injury and the apparent failure of staff to treat it. On July 21, 2017,the investigation was concluded. Again the charges came back as not substantiated. The only recommendation from the investigator was for NEEDS staff to report any injury to the parents/guardians on the date they occur.
Restrictions imposed on visitation. Family hires lawyer.
Deborah said that after she and Brian held the contentious meeting on June 12, 2016, with the NEEDS house manager over the staff’s alleged failure to clean Ryan’s soiled clothing, both NEEDS and DDS imposed severe visitation restrictions on the Tillys.
Brian was banned from the residence entirely and told that if he showed up at the house, the staff would call the police and that he would be arrested for trespassing. Although a DDS official stated that the ban would last 30 days, it actually lasted for months, Deborah said.
Deborah said that during that time, she was told she would need to make appointments to go to the house to visit Ryan.
Emails in October of 2016 from a group home staff member stated that Brian was still banned from the residence as of that time. On October 12, Deborah asked for clarification of the restriction because Brian had constructed a new bed for Ryan to replace one that was broken, and there was apparently no one else able to put the new bed together in the residence. No such clarification was forthcoming.
The visitation restrictions were lifted only after the Tillys hired Frain as their attorney.
Improvements and continuing issues
As a result of the legal intervention in the case, there have been notable improvements in Ryan’s care, Deborah said. Ryan now regularly sees a psychologist and has a clinical team. The team has started a program to address Ryan’s isolation and to control his behavioral issues with medication.
The staff at the residence has changed and are more open with Deborah about the events in Ryan’s day, she said. Ryan’s behaviors have improved dramatically to the point where his behavioral issues have almost disappeared. “We feel we brought to light the many injustices Ryan was subjected to,” Deborah said. “Things have improved but we still have a wary eye on them.”
Things still happen every now and then, she said. She still occasionally finds dirty clothing in Ryan’s room, and the staff still never seem to fully explain it.
Ryan is still afraid of the resident who had been harassing him and is still reluctant to leave his room. He now must be sedated just to go to the doctor or dentist, and he requires two staff to bring him.
Deborah said she continues to be in daily contact with her son and will often visit unannounced.
Case should be considered by Children and Families Committee
This is one of the cases that we hope the Legislature’s Children, Families, and Persons with Disabilities Committee looks into. The committee has scheduled an oversight hearing on the DDS system for January 17 at 1:30 p.m. at the State House in Boston.
A careful review of this case and DDS’s handling of it should provide much valuable information as to how DDS’s policies and procedures might be improved.
Trial in alleged assault of intellectually disabled man is put off again
Today (Tuesday) marked the fifth time Sheila Paquette has traveled from her home in western Massachusetts to Cape Cod to seek justice in the alleged assault of her brother, John Burns, an intellectually disabled resident of a group home in West Springfield.
But Paquette learned today she will have to make yet another trip to the Cape, along with David V., another resident of Burns’ group home, and Dan Aguda, a Department of Developmental Services instructor. The three were scheduled to testify today in Falmouth District Court in the trial of John Saunders, a former resident of Burns’ group home, who is charged with assaulting Burns during an outing on the Cape in June 2010.
As Paquette and the others sat in the courtroom all morning on Tuesday waiting for the proceedings to finally begin, the judge at the last moment postponed the trial until June 4 because a defense witness had failed to appear. Paquette, who is president of the Advocacy Network, a COFAR member organization, was visibly shaken by the sudden decision.
Sheila Paquette (left) in front of Falmouth District Court Tuesday after the trial of the man accused of assaulting her brother, John Burns, was postponed yet again. To Paquette's right are Dan Aguda, a DDS instructor in John Burns' day program; Deborah Reid, the house manager in Burns' group home; David V., a resident of the group home; and Ed Strout, a Board member of the Advocacy Network, a COFAR member organization.
“I can’t believe this is happening again,” Paquette said to Assistant District Attorney Kerry Whalen. “I’ve come down here five times, and every time there’s another delay.”
“It’s been almost two years (since the alleged assault),” Aguda added. “Memories will start to fade in terms of testifying.”
Whalen tried to reassure them and said she believes the trial will go forward on June 4. The judge, she said, will not grant another continuance to the defense witness.
Paquette isn’t convinced of that, but she and the other prosecution witnesses are prepared to travel to Falmouth again in June. “Anyone who assaults the intellectually disabled should know that these cases will be pursued,” she said.
The last time Paquette and the group from western Massachusetts were in court on the Cape was January 9, when Saunders’ trial was first scheduled. But Saunders himself was a no-show that day.
Saunders was reportedly arrested by police a couple of days after the January trial date and was released after posting bond that had been set by the judge at $1,000. The Falmouth District Attorney’s Office stated that it had requested a $5,000 bond for Saunders. He was present in the courtroom on Tuesday.
Paquette personally filed assault charges against Saunders in July 2010 after she became frustrated with the slow pace of state and law enforcement authorities in investigating the case. The Center for Human Development, a nonprofit firm that contracts with the state Department of Developmental Services to operate the group home in which Saunders worked, subsequently fired Saunders.
Saunders allegedly hit Burns in the face while toileting him during a vacation outing on the Cape for residents of the group home. Burns suffered two black eyes and other injuries. In recent months, Burns has been confined to a wheelchair. Paquette says she was told by her brother’s neurologist he has a neck injury typical of serious whiplash.
Saunders has denied assaulting Burns. The Disabled Persons Protection Commission concluded there was reasonable cause to believe Saunders had used excessive force and had physically assaulted Burns.
The DPPC also recommended that Saunders no longer be permitted to work with DDS clients and cited the CHD group home for failing to identify Burns’ injuries before sending him to his day program the morning after the alleged assault.
Update: some progress to report in abuse case
There have been some new developments in a case we reported on here, involving the alleged assault of an intellectually disabled man by a group home staff worker.
A state investigator has recommended that John Saunders, who has been charged with assaulting John Burns during an outing from his West Springfield-based group home last June, no longer be allowed to work with Department of Developmental Services clients. Saunders was fired after the alleged assault from the group home, which is run by the Center for Human Development.
Saunders allegedly hit Burns in the face while toileting him, causing Burns to suffer two black eyes. Saunders is scheduled to appear in Falmouth District Court on Monday, March 28, at 9 a.m. for a pre-trial hearing that has already been continued several times.
Charges against Saunders were personally brought by Sheila Paquette, Burns’ sister and co-guardian, after Paquette became frustrated with the slow pace of the state’s investigation into the case. Paquette has also been frustrated that she has gotten little information about the case so far from state and law enforcement authorities, which have not released an investigative report done by DDS on the matter.
However, in an email late last week to Paquette, Gail Quinn, the deputy general counsel of the Disabled Persons Protection Commission, did provide Paquette with the investigator’s recommendations. In addition to the recommendation against allowing Saunders to work with DDS clients, the investigator’s report cites the group home for failing to “identify” Burns’ injuries before sending him to his day program the morning after the alleged assault, and recommends retraining of staff in that regard.
Quinn also said the DPPC is changing its policy as a result of this case of withholding investigative reports from guardians of victims of alleged abuse pending the outcome of criminal investigations. She stated that the agency will notify district attorneys’ offices of its intention to send out investigative reports to guardians within a specified time frame unless the district attorney objects. Quinn wrote that the DPPC has issued such a notification to the district attorney in Burns’ case.
Quinn added in her email that, “The delay in getting (investigative) Reports out has been very concerning to us. Your case has brought the issue to the fore, and we have been able to deal with it in a manner that we think represents everyone’s interests in the content of the Report.”
Paquette, who is president of the Advocacy Network and a COFAR member, termed the DPPC’s new policy “encouraging,” but said she still isn’t convinced the system is fully on the victim’s side in these types of cases. Nevertheless, she said she is appreciative of Quinn’s comments.
Instances of assault and abuse of persons with intellectual disabilities often don’t get prosecuted by law enforcement authorities, and other state agencies tend to function slowly and inefficiently in these cases. Paquette said she was told by an investigator that had she not personally pressed charges in this case, it could have taken as long as two years for the matter to reach criminal court.
I talked about that today with Emil DeRiggi, deputy executive director of the DPPC, who said the agency supports decisions of individual family members or guardians to personally press charges in abuse cases. “We generally support anyone who learns something happened and believes filing charges is the right thing to do,” DeRiggi said. “I would encourage people to do whatever they think is best in these instances.”
DeRiggi said that in the case of Paquette’s brother, the State Police Unit assigned to the DPPC referred the matter to the district attorney’s office on Cape Cod, where the alleged assault took place. While that implies the case would have gone to criminal court without Paquette’s intervention, it does appear that her decision to press charges on her own may have, at the very least, speeded up the wheels of justice in this instance.
One other note: We have recieved the police report in the case from the Falmouth Police Department, where Paquette initally filed the assault charges. The report states that the alleged assault was witnessed by Burns’ roommate, who “reported seeing Mr. Saunders hand covering the mouth of Mr. Burns…and then witnessed Mr. Saunders strike Mr. Burns in the face with an open hand.” Saunders has denied the charge, according to the police report.
Justice elusive in assaults of the intellectually disabled
When Sheila Paquette found out her intellectually disabled brother had apparently been viciously assaulted while on an outing from his group home last June, she had no idea of the long road she would be traveling to seek justice in the case.
What she — and we at COFAR as well — have learned is that there often isn’t a lot of interest among law enforcement authorities in prosecuting cases of abuse of the disabled, or in the mainstream media in reporting on it. Paquette is a COFAR member and president of the Advocacy Network, a COFAR affiliate, which advocates on behalf of persons with intellectual disabilities in Massachusetts.
Paquette’s brother, John Burns, was allegedly assaulted by John Saunders, a group home staff worker, who allegedly poked his fingers in both of Burns’ eyes while he was toileting Burns. The alleged incident occurred in the late morning at a vacation house on Cape Cod that was rented by the Center for Human Development, a state contractor operating Burns’ West Springfield-based group home.
Burns was not examined by a doctor until the following day, when he was taken, at Paquette’s insistence, to Noble Hospital in Westfield. Paquette said she was told by the medical staff there that Burns’ black eyes “were consistent with somebody taking their fingers and shoving them right into his eyes with sufficient force to cause blood to pool.”
In an article in the Advocacy Network’s Fall 2010 newsletter, Paquette wrote that she took the unusual step some three weeks after the alleged assault of personally filing a felony charge against Saunders of Assault and Battery on a Disabled Person. “Until I filed the charge myself, the situation wasn’t taken seriously by the law enforcement authorities,” Paquette contends.
Photo taken of injuries to John Burns' eyes
Paquette isn’t alone in questioning our society’s commitment to ensuring justice or safety for persons with intellectual disabilities. The New York Times reported yesterday that an inquiry by the paper found that New York State’s group home system of care “operates with scant oversight and few consequences for employees who abuse the vulnerable population.”
An investigation by The Cincinnati Enquirer described “a statewide law enforcement system (in Ohio) that routinely fails to investigate and punish those who abuse and neglect mentally retarded citizens.” There’s not much reason to assume the situation is any different in Massachusetts.
Paquette said the alleged assault of her brother was witnessed by his roommate, who said the incident was entirely unprovoked. Later in the day, Burns and his roommate were driven back to West Springfield by another staff member of the group home. Paquette said her brother had to sit in the back seat with Saunders, the alleged perpetrator, the whole way.
Paquette wrote that she was later told informally by an investigator that her brother spent the night in his group home moaning and crying. But it wasn’t until he was sent the following day to his regular day program that someone from the program called Paquette’s other brother, Jim, who shares guardianship with her. The caller said John Burns had two black eyes and was being sent back to his residence.
That was the first Paquette had heard about the injury to her brother. She said she gathered her camera and a notebook and went to the group home to find her brother indeed with two big black eyes. It was then that she began to experience the first of many frustrations with the state’s system for responding to reports of abuse of the intellectually disabled.
After examining her brother, she asked the house manager to report the injury to the police and the Disabled Persons Protection Commission. But when a police officer arrived at the house, he said he couldn’t investigate the incident because it had occurred in another town, outside his jurisdiction.
The DPPC was called immediately to investigate. But the chronically under-funded agency handed the investigation over to the Department of Developmental Services (which funds the contractor running the group home).
Fortunately, Paquette said, the management of the group home did take the situation seriously. Both the house manager and his supervisor questioned Burns’ roommate on separate occasions about what he saw, and were convinced his description of the event was consistent and credible. Burns’ roommate is intellectually disabled, but is able to communicate. CHD fired Saunders immediately, based on the assault allegation.
Nevertheless, the system has been slow and inefficient in tracking Saunders down. Saunders failed to show up in Falmouth District Court for a pre-trial hearing that had been scheduled in October. He is currently free on bail and is currently scheduled to appear in court on March 28.
In the meantime, Paquette has gotten little information about the case, she says, from the investigating authorities. The DPPC, for instance, will not release the report done on the incident by DDS even to her because the matter is under criminal investigation.
“I’ve gotten nothing in writing from DPPC and nothing from CHD,” Paquette says. “The DPPC says they can’t release anything to me because it’s in criminal court, but it’s in court only because I happened to file the charges.
“What did the DDS find out about this case?” Paquette adds. “What did CHD write up? If everyone in those agencies has seen those reports, why not the victim, or at least why not me, who is the victim’s voice? It’s almost surreal. It’s just like fog. I’m trying to stay calm, but I find myself getting more and more irritated.”
At COFAR, we’ve also been frustrated in trying to get media coverage of this case. Although we notified the media around the state prior to a pre-trial hearing for Saunders that was scheduled for March 3, no one showed up to cover the hearing, and nothing appeared in any media publication about it.
Paquette said her goal isn’t “to put someone in jail for 30 days, it’s to have a jury hear this case, to let people know about this problem (of abuse of the intellectually disabled), and to make sure agencies check on their employees and make sure they can fire them if they are causing these types of problems.”
We all know that the media is facing its own financial issues and is cutting back on its coverage of issues in all facets of society. Yet, in New York and Ohio, newspapers have recognized the importance of the problem of abuse of the disabled.
After we sent follow-up emails to some local newspapers in the Cape Cod (location of the pre-trial hearing) and Springfield areas (location of Burns’ group home), we heard back from the editors of The Cape Cod Times and The Daily Hampshire Gazette. We were told by the Cape Cod paper’s editor that their news editor is “considering” a story about the incident that would run around the time of the next court date. The editor of The Gazette said somewhat apologetically that West Springfield is outside of that paper’s circulation area, but otherwise, “we would have covered this type of story.”
The Springfield Republican initially assigned a reporter to the story, but nothing has appeared in the paper, and neither the reporter nor the executive editor have responded to our follow-up emails about the matter.
Paquette noted, by the way, that 15 years ago, her brother was badly injured by a house manager in a different residence in Westfield. At that time, The Boston Globe sent a reporter all the way out to Westfield to interview her, and Geraldo Rivera sent a television reporter as well. Times have apparently changed.
Among the issues Paquette would like to find out is why the firm running the day program, in particular, didn’t bring her brother to the hospital immediately, but rather just sent him home after observing his black eyes.
She also wants to know whether a State Police unit attached to the DPPC is conducting its own investigation of the case, separate from the Falmouth District Attorney’s Office. It was only after she filed the charge that the DPPC sent a Massachusetts State Trooper to her home to interview her, Paquette says.
Paquette believes her decision to personally file the charge took many people by surprise. “I don’t think it occurred to anyone I would go and file charges myself,” she says. “I believe everyone was waiting around for DPPC and DDS to go do whatever they do.” She said she was told by a DDS investigator that had she left the matter entirely in that agency’s hands, “this more than likely would have taken two years for this to get to the criminal court. I short circuited the process, she says.”
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