4 Deaths in D.C. Group Homes Raise Concerns About Neglect

At a status hearing in the case yesterday, U.S. District Judge Ellen Segal Huvelle expressed concern about the deaths and the slow pace of District reforms. The city, she said, "is being judged on two very important things: Are people getting the services, and are people dying?"

Maria Amato, a lawyer with the D.C. attorney general's office, said that the circumstances surrounding the deaths were complicated and that she was not sure "the finger can be pointed" only at the mental retardation agency.

She and Marsha Thompson, who became interim administrator of the agency in April, said the city has taken several steps to improve services and training and to safeguard group home residents. The city, they said, now has an interagency coordinator and is implementing a 90-day plan, which began Nov. 7, to move 38 at-risk residents into better homes.

Addressing the problem of lax case management, Thompson said the agency, part of the Department of Human Services, "has a long history of nonaccountability." She said she plans to increase the number of mandatory visits to 12 a year and is requiring case managers to provide a daily work schedule.

The agency has about 80 case managers with caseloads that range from 15 to 30 clients, depending on the intensity of their needs.

Sandy Bernstein, legal director for University Legal Services, which represents the plaintiffs in the suit against the District, criticized what she called "short-term approaches" to dealing with such serious failings by the city.

"The situation for [plaintiffs] is grim," she told Huvelle at the hearing. The timetable for addressing problems is so slow, "it will take seven years to get through" the entire group of plaintiffs, she said.

"We've had preventable deaths before," Bernstein said in an interview. "But I don't think it's ever been this clear how dangerous it can be when the system does not work."

The suit covers about 700 plaintiffs, all former residents of Forest Haven, a now-defunct institution for the mentally retarded. Another 1,300 plaintiffs are special-needs clients of the agency.

In 1999, a series of articles in The Washington Post disclosed 350 documented cases of abuse and neglect, as well as profiteering, in the city's group homes.

The series found that none of the 116 deaths that had occurred in the homes since 1993 had been investigated.

District officials said they have since overhauled the mental retardation agency's services, including investigating deaths in group homes and recommending changes to address deficiencies that might have contributed to the deaths.

In January, however, Huvelle expressed frustration with the pace of reforms and ordered Williams to assign a deputy mayor to take charge of the District's long-promised improvements. In April, the head of mental retardation services and two top aides were replaced in what officials said was a departmental restructuring aimed at speeding efforts to change.

The Post has requested copies of group-home death investigations conducted in recent years with the identities of the deceased deleted. The Department of Human Services has rejected the request, citing confidentiality concerns.