Although some group homes are safe places with caring, competent staff, recent news indicates that these may be the exception rather than the rule.
People with disabilities are regularly abused and neglected in group homes. Incidents are severely underreported, and the guilty parties often face no consequences.
In a 2016 exposé in the Chicago Tribune, Michael J. Berens and Patricia Callahan described Illinois taxpayer-funded group homes as “a system where caregivers often failed to provide basic care while regulators cloaked harm and death with secrecy and silence.”
The Tribune identified 1,311 cases of documented harm, hundreds of which were not reported by the Illinois Department of Human Services. To find these cases, they combed through state investigative files, court records, industry reports, federal audits, and Medicaid data, among other sources. The stories were shocking. Residents were deprived of food. Forced to wear soiled clothing for extended periods of time. Restrained with duct tape. Taunted about their intellectual impairments.
One man was accused of stealing cookies, and beaten to death by his caregiver.
Other cases may not have involved intentional cruelty from staff members, but still resulted in serious harm and even death. The Tribune’s investigation found that many group home caregivers were woefully unprepared to respond to emergencies. Some also had a very poor understanding of their residents’ conditions, or didn’t appreciate the seriousness of those conditions. Several residents with swallowing disorders such as dysphagia choked to death because they were given unsafe foods or weren’t properly supervised while eating.
Berens and Callahan highlight some important factors that contribute to caretaker incompetence. First, there are few regulations specifying the qualifications necessary to become a group home caretaker. Second, many group homes’ employee training programs are virtually nonexistent. Third, there are very high rates of staff turnover, and the constant influx of new, inexperienced employees decreases the quality of care.
Insufficient supervision of potentially dangerous residents
Many people who live in group homes need assistance with medical matters and/or daily tasks, but do not require supervision. However, some have emotional or behavioral disorders that can lead to violent outbursts. Even individuals with occasional outbursts require constant monitoring. Unfortunately, small group homes often lack the security necessary to manage the behavior of residents with violent tendencies. For example, a man named Stanley was brutally beaten by another resident who had been diagnosed with intermittent explosive disorder and was known to have “insurmountable strength.” Stanley has spastic quadriplegic cerebral palsy, and was unable to propel his own wheelchair, let alone defend himself from attack. As Stanley’s mother put it, “You can’t put someone that’s violent in the same house as someone that can’t even get out of his way.”
Fortunately, Stanley survived. However, others were not so lucky – the Tribune’s investigation revealed three cases of homicide committed by residents. The warning signs were there. One resident who fatally beat another had sent two employees and two housemates to the emergency room just months earlier.
Why are the dangers of group homes so shrouded in secrecy?
There are many reasons why the topic of abuse and neglect at group homes is so infrequently brought to light. For one thing, many states have taken a very hands-off approach to monitoring group homes. In the case of Illinois, the state even allowed the law enforcement histories of individual group homes to be kept confidential, citing patient privacy concerns (after the Tribune conducted its investigation, however, officials said they would increase regulations and transparency).
Additionally, many group home residents are not able to easily report mistreatment. This is especially true of people with intellectual disabilities, who may have difficulty recognizing unacceptable/illegal behaviors, reporting abuse, and describing incidents in a way authorities understand. Moreover, their claims may be discounted by people who think they have overactive imaginations.
NPR recently released a series discussing the results of a year-long investigation into sexual abuse of people with intellectual disabilities. They found that those with intellectual disabilities experience sexual assault more than seven times as frequently as people without disabilities. The data included in NPR’s study came from household surveys and did not include group homes, where the rate of assault is likely even higher. Group home residents may tend to have more severe impairments than those who live on their own or with loved ones, making them less likely to successfully report abuse. Moreover, they may not have access to a phone or computer with which to contact law enforcement.
To learn more about what puts people with intellectual disabilities at such a high risk of sexual assault, and what can be done to increase their safety, click here.
Federal report on dangers of group homes
Despite a fair amount of media coverage, abuse and neglect of group home residents has received little attention from the federal government.
However, in 2013, U.S. Senator Chris Murphy (D-Conn) became concerned about dangers of group homes after reading newspaper reports which indicated that mistreatment of residents may be very common. He requested that the Office of Inspector General (OIG) conduct an audit of Connecticut group homes. After finding that there were indeed serious issues, the OIG also reviewed group homes in Massachusetts and Maine. A federal report detailing the results of their investigations was released on January 17th, 2018.
The report indicates that group homes often failed to report serious injuries and illnesses (resulting in emergency room visits) to the state government. Moreover, of the cases that were reported, the relevant state authorities rarely conducted a thorough investigation.
Some corrective measures are also outlined in this report, including the formation of a “SWAT” team to supervise state-level efforts and compliance with national laws.
The federal report based on the OIG’s investigation is a step in the right direction. However, much remains to be done. Further federal investigations are ongoing, but from news organizations, advocacy groups, and individual reports, it is already obvious that this is a nation-wide issue.
Frequent staff turnover is detrimental to the wellbeing of residents, as are the lax hiring practices used by many group homes. One reason why group homes are unable to find qualified employees who will stick around is that the average pay for caretakers is close to minimum wage. Understandably, many leave for easier, higher-paying jobs.
If more government funding were allocated to group homes, they could use it to hire qualified applicants and give promotions to well-performing employees. Moreover, states should develop clear accreditation and/or training processes for group home employees, and mandate more extensive background checks. Law enforcement histories of group homes should be made public, so that individuals and their families can make better informed decisions regarding residency.
Finally, it is the responsibility of the federal government to ensure that state-level governments behave transparently and sufficiently oversee group home activity. Conducting audits is a good start, but much more extensive involvement is needed to ensure that this crisis does not continue to fly under the radar.
Chicago Tribune: Suffering in Secret
NPR: Abused and Betrayed
Disability Scoop: Government Watchdog Warns of Group Home Dangers
Federal Report: Ensuring Beneficiary Health and Safety in Group Homes Through State Implementation of Comprehensive Compliance Oversight