Maggot case gives rare look at neglect probes
Group home patient suffers two infestations of larval flies in his throat
In his bed at a New York state group home for the severely disabled, Steven Wenger lay helpless against a silent invader.
A slimy, wriggling clump was growing around the hole in his throat near his breathing tube. Nurses peered closer and made a discovery almost unheard of in modern American health care: maggots.
For Wenger, unable to walk, speak or breathe without a ventilator since a car accident 26 years ago, it was the first of two infestations of the larval flies in his throat over successive days last summer, resulting in repeated trips to an emergency room and a state investigation that found days of neglect by caretakers. And if The Associated Press had not obtained a confidential report on the case, it’s unlikely anyone in the outside world would have known anything about it.
That’s because in New York and most other states, details of abuse and neglect investigations in stateregulated institutions for the disabled, addicted and mentally ill are almost never made public, even with the names blacked out.
As a result, it’s easier to check the health record of a neighbourhood restaurant than to find out about lapses in care in state institutions and group homes that people may be considering for their loved ones’ around-the-clock care.
“If a complaint is substantiated, there should be a pretty detailed report ... but you cannot get that information,” said Robyn Grant, director of public policy at the National Consumer Voice For Quality Long-Term Care, a Washington-based advocacy group.
While many states provide extensive information about hospitals and nursing homes, Grant said, most are relatively silent when it comes to data on care of the disabled in state-regulated facilities. She noted there are no consistent disclosure rules, and in many states reports are “redacted to a ridiculous point, to a point where the sentences don’t make any sense.”
In New York, which has one of the nation’s largest disabled care systems, abuse and neglect probes are overseen by the state’s Justice Center for the Protection of People With Special Needs.
Spokesman William Reynolds said it cannot release detailed information on its cases — even with identifying material removed — because of state and federal rules involving medical and personnel privacy, and law enforcement investigations.
But advocates for the disabled and some lawmakers say the Justice Center is keeping too much information hidden, either to shield Democratic Gov. Andrew Cuomo’s administration from embarrassing headlines or to protect the flow of billions in Medicaid dollars to a sprawling system responsible for about one million disabled, addicted and mentally ill people.
“What the hell are they hiding?” asked Harvey Weisenberg, a former state lawmaker whose son who is disabled. “They won’t tell the public, or anybody for that matter, what they’re doing.”
It’s a system so tightly closed that State Comptroller Thomas DiNapoli was stonewalled this year when he tried to audit the Justice Center. He obtained just eight per cent of the reports requested on the 82,000 abuse and neglect complaints between 2013 and 2016.
“What’s troubling is this cloud of secrecy that seems to cover their operations,” said DiNapoli, a Democrat. “So you don’t know if they’re doing the job that they’re expected to do.”
High-profile cases involving criminal charges are often announced in news releases. But as for more routine cases, the Justice Center discloses only broad statistics on the thousands of neglect and abuse allegations made each year, and whether they were substantiated. They include everything from inadequate supervision of patients to physical abuse, sexual assault and death.
Last year, for example, it reported substantiating 4,169 cases of abuse or neglect in public and private care regulated by the state.
Getting more details, even by Freedom of Information request, is difficult. It took advocates eight months to get a bare-bones listing of the numbers of deaths and sexual assaults by facility over a two-and-a-half-year period.
Finding out the punishments imposed is even harder.
The Justice Center reported that 251 employees at stateowned facilities lost their jobs in 2016 over abuse or neglect. Yet more than three-quarters of the substantiated cases happened at privately run facilities, and state officials say they don’t track what happens to those employees. New York is no outlier. In Florida, home to one of the most open government records policies, officials routinely cite privacy laws to withhold details about deaths of people in state care. Two 2016 federal inspector general reports faulted Massachusetts and Connecticut for failing to document or properly report all their serious cases of abuse and neglect.
California’s highest court chided health officials in a 2015 case for redacting records on abuse so heavily that they revealed only “scant” information.