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Casey critical of group home oversight

Tuesday, May 09, 2000

By Gary Rotstein and Jan Ackerman, Post-Gazette Staff Writers

Auditor General Bob Casey Jr. faults Pennsylvania welfare officials as too lax, too slow and too ineffective in ensuring the safety of mentally retarded individuals living in group homes funded through the state.

Following up on condemnations of community group homes by parents of severely retarded individuals recently transferred from the Western Center state institution in Cecil, Casey released a 162-page audit yesterday that criticized the state Department of Public Welfare's handling of cases involving death or possible abuse in community residences.

The audit also found numerous instances in which individuals with criminal backgrounds worked with clients in group homes, and it said training of employees generally is insufficient to guarantee quality care of residents.

The review covered operations of eight group homes in Allegheny, Beaver, Fayette, Washington and Westmoreland counties from July 1994 through June 1999, but Casey said the findings raised concerns about the state's monitoring of providers caring for about 9,000 individuals statewide. Six of the eight homes in the performance audit have received Western Center residents as transfers in recent years.

"You will find some very serious deficiencies on the part of the Ridge administration that should be of serious concern to families and taxpayers," Casey said at a news conference last night. Casey, a Democrat, is running for re-election and has been a critic of the administration.

While a Welfare Department spokeswoman said the audit would be useful as "constructive criticism" of group home oversight, Casey said he was distressed by the department's more formal written response which was included in the audit report and challenged many of his staff's findings.

"This is the abomination," he said. "I do not know what is worse -- the findings or their response. ... Gov. Ridge and DPW should stand up with a plan and implement it so they can give the families peace of mind."

Welfare department spokeswoman Susan Aspey said changes in oversight of the group homes have been in the works even without the audit, but it will help focus attention where it is needed.

"The recommendations are useful and will help us do our job better," she said.

"There's no human service that can guarantee every day a problem won't arise. ... The key is for us to respond quickly and make changes when necessary."

Daniel Torisky, a leader of the Western Center Parents Group, which fought the shutdown of the state institution, said lawyers will seek to use Casey's report at hearings that Allegheny County Judge Paul R. Zavarella will hold today for the five mentally retarded residents still living at Western Center. He said the audit substantiates the parents' allegations that the Welfare Department has failed to investigate group home abuse and deaths.

The audit examined those allegations in addition to staffing issues, the quality of services and the physical condition of the homes examined. The auditor general did not identify the homes or individuals involved in cases, but the most serious allegations related to the state's slowness in probing the deaths of three individuals.

In one instance, a man with severe cleft palate who needed his food chopped and accompanied by liquids, died in his sleep April 5, 1995, from choking on dry toast. Local authorities initially investigated the death and found no wrongdoing, according to the audit, but the state's review two years later led it to refer the case to the state attorney general as a potential case of negligence. The attorney general's office has not taken any action against the home.

Another man died from choking in October 1996 in another county, but in his case it was after lunch at a day program he had visited. The audit said an initial investigation by county officials failed to turn up information found by state welfare investigators a year later: The staff of his home failed to inform the man's caregivers at the day program that his food needed to be pureed rather than chopped.

The audit identified a third case in which a woman living in a group home died from pneumonia, despite having no history of respiratory problems, and neither state welfare nor any other agency investigated the death for two years.

The audit said the state's response to these deaths and other alleged abuse was inexcusably slow.

Welfare Department officials said it has been customary practice to let county mental retardation offices and the providers conduct their own investigations to identify any problems they would report to the state. Aspey said a new policy is being developed that acknowledges Casey's criticisms, and will result in the state undertaking more of its own investigations and doing so more quickly.

Casey also said the state system of criminal background checks for employees in group homes does not safeguard residents. A review of records found that six of 48 current employees and 17 of 158 former employees at the eight group homes had been convicted of various felony, misdemeanor and summary offenses. In one instance, a man with 27 convictions was able to work in a home for more than two years before being identified by the audit and dismissed by his employer.

The explanation for many of those employees' status is that the Older Adults Protective Services Act, which restricts hiring of such individuals in group homes, only took effect for employees hired after July 1, 1997 and it only prohibits employment of those convicted of serious crimes rather than for any offense.

But the audit questioned another loophole, in which workers with criminal histories can work on a provisional basis for a month or more while the results of their clearance checks are awaited. The report noted that school employees in Pennsylvania may not begin work until they receive clearance, and the same should hold true for those caring for retarded citizens.

Welfare Department officials took no position on the proposed legislative change, but Shirley Walker, executive director of the Pennsylvania Association of Resources for People With Mental Retardation, said providers already strapped to find enough employees to staff their homes will be more burdened if they can't fill slots temporarily with people awaiting the clearance.

Among other findings, the audit questioned the state's procedures for ensuring that direct care workers have received mandated training on abuse prevention and other matters, and it said more training should be required. Aspey said those suggestions would be reviewed.

Mark J. Murphy, deputy director of the Disabilities Law Project and an attorney in the original suit that led to Western Center's shutdown, said it would be wrong for anyone to view the auditor general's findings as evidence that removing its 352 residents was a mistake. The auditor general's staff used allegations from the parents' group as a guide to help decide which homes to audit.

"If there are problems in any homes, then go in and fix them, but I would caution any mass conclusions from findings in these particular homes," Murphy said. "I could pick out eight homes I know of and take the auditor general to them, and everyone would be very happy."

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