A Culture of Fear
The state is slow to fix broken system for people with developmental disabilities.
Mr. R says his developmentally disabled child was abused multiple times at several state-run facilities.
While the first incident of abuse took place 16 years ago, Mr. R didn’t want to provide his real name, the name of his son or the facility where he lives because of what he describes as a persistent culture of fear at state facilities.
“The first incident we were aware of, (my son) was repeatedly punched in the head and when he would make a noise the person … would kick him in the shins,” Mr. R remembers.
But the abuser wasn’t fired. Instead, he was transferred to another state facility. According to Mr. R, the same situation played out several more times with the same child at three different state facilities.
While there is no legitimate excuse for abusing “consumers,” the word used for patients at these facilities, Mr. R says he understands the cause of the abuse, including the hiring of people unsuited for the work and chronic understaffing.
“They are definitely short of staff,” says Mr. R. “I see it … all the time. (The direct care workers) say, ‘I don’t mind being mandated (to work overtime) but not as often as we are.’ They get so whacked out that they aren’t doing the job they’re supposed to be doing and their tempers get short.”
But understanding a problem and trusting the system are two different things. Over the years, Mr. R’s trust may have been irreparably harmed, which is why he doesn’t want his name used for this story. Mr. R also says his son’s situation has improved and he doesn’t want to rock the boat.
“The people are excellent now,” he says of direct care aides who now help clean, bathe and change his son. “They treat him like gold, there.”
For years the system for dealing with people with developmental disabilities in New York State was broken.
Children like Jonathan Carey, a 13-year-old who was killed by his caregivers, were casualties of a revolving door of undertrained, overworked direct care aides who were fired and rehired even after multiple allegations of abuse.
After a 2011 New York Times exposé titled “Abused and Used” revealed gaping holes in the system, Gov. Andrew Cuomo tried to tackle the issue by reforming the state agency responsible for the system, the Office for People with Developmental Disabilities.
He promised better training, greater oversight and the creation of a Justice Center for the Protection of People with Special Needs. Later, OPWDD would create a pilot “self-determination project” to allow for greater consumer input and individualized care.
While some activists like Jonathan Carey’s father, Michael, have been critical of these changes, saying they are minor and that the agency is grossly underfunded, there is evidence that the changes are having a variety of effects—not all positive—at the state’s large hub facilities, known as developmental disabilities service organizations, or DDSOs, including the Broome center in Binghamton and Sunmount in Tupper Lake.
Arrests and Staffing
The most obvious change is that OPWDD has begun taking action. Since January, there have been 12 staff arrests at Sunmount, most for abuse of consumers.
According to an email from OPWDD, the arrests are a direct result of changes implemented by Albany.
“Employees accused of abuse are immediately placed on administrative leave and if allegations are substantiated through the investigative process, commensurate disciplinary action is taken,” an agency spokesperson wrote.“Any abuse of people in our care is completely unacceptable.”
In February, the Adirondack Daily Enterprise reported that Cuomo was aware of the arrests at Sunmount, telling the press, “The state is actually reviewing the operation as we speak, and that review is ongoing. As soon as I know the conclusion of the review, you'll know it.”
While the arrests indicate action, they have also had some unintended consequences.
Because of systemic understaffing, and the time it takes to investigate allegations of abuse—up to a year—the decision to place workers on paid administrative leave has exacerbated an already bad situation. It has left Sunmount and other DDSOs understaffed, and remaining employees facing an increase in mandated overtime.
“We’ve been very clear over the years that the likelihood of mistakes being made are increased when people are working on mandated overtime,” says Steve Madarasz, director of communications for the Civil Service Employees Association, one of the unions representing OPWDD employees. “It’s not healthy when people work under those conditions.”
At the same time, Madarasz says, people are innocent until proven guilty, so paid administrative leave is the best policy. “Nobody condones abuse,” he says. “But allegations are not necessarily proof of abuse.”
Thanks to extensive reporting on Sunmount by North Country Public Radio and the Adirondack Daily Enterprise, we know that several of the direct care aides who were arrested for abusing patients are indeed back on the state payroll after Justice Center investigations.
But mandated overtime has become a problem in its own right.
According to the state comptroller, overtime hours at OPWDD rose 11.4 percent from last year and more than 60 percent from 2009 to 2014, which is among the highest of any state agency.
Madarasz argued that Cuomo’s budget office “prefers overtime costs over hiring adequate personnel.”
In an email, the state Budget Division reported that since 2011-12, total OPWDD personnel costs, including salaries, overtime and temporary personnel, have actually decreased by $13 million, from $1.125 billion to $1.112 billion.
“Any discussion on overtime must recognize that overall personnel costs have declined, and that overtime may be used to avoid a larger, more bloated, and more expensive state bureaucracy,” wrote Morris Peters, a Budget Division spokesman. “Overtime is used carefully and only when needed. (It averages less than 5 hours a week at OPWDD).”
Madarasz is skeptical. “They (the Cuomo administration) ought to just own up to having a serious problem with staffing in this agency,” he says. “Trying to put the best face on excessive overtime by lumping in salary costs for three years where there was a virtual wage freeze in an agency that also has significant turnover seems like misdirection. Bottom line: The excessive use of overtime in OPWDD is fiscally and ethically irresponsible.”
One change that has been lauded by both CSEA and the agency is a modest staffing increase.
The 2015-16 budget provides OPWDD with the ability to hire over 300 more staff members to be used to reduce overtime costs and hours at facilities around the state.
Madarasz is optimistic about the additions. “There have been some very productive conversations about this,” he says.
The hiring challenge is especially difficult at facilities like Sunmount, which is in a rural, isolated area of the state. Since the agency was having trouble attracting qualified applicants, it teamed up with CSEA and another union, the Public Employees Federation, to mount a career fair the second week in May.
But like a battleship trying to do a 180-degree turn, change at OPWDD comes very slowly.
In order to ensure open positions are filled with people who have the temperament for the work, the administration strengthened pre-employment screening requirements designed to reduce abuse and neglect for the clients served by OPWDD, including enhanced psychological and physical exams. Like placing people on administrative leave, this extra screening process delays hiring and can temporarily impact overtime costs.
None of this placates Mr. R.
When asked if he’s noticed positive changes at the facility where his son lives, he says, “not really.”
“I do see some things happening that weren’t occurring before,” he adds, “but I don’t know if it’s got enough bite in it.”
Until some significant progress is made, and staffing levels improve at these facilities, Mr. R and other family members will likely continue to look at OPWDD through the same untrusting lens they have for decades.
And Mr. R. won’t be using his real name in interviews.
Susan Arbetter (@sarbetter on Twitter) is the Emmy Award-winning news director for WCNY Syracuse PBS/NPR, and producer/host of “The Capitol Pressroom,” a syndicated radio program.