A District government committee created by Mayor Anthony A. Williams to review deaths at city-funded facilities for the mentally retarded has failed to write mandated annual public reports on its findings since it was established more than three years ago.
The mayoral order, issued in February 2001, specified that the interagency committee was to produce an annual report for Williams (D) by each April 30 that would include statistical data on all fatalities, without identifying any individuals, and an analysis of whether any "pattern of factors" caused or contributed to the deaths.
But the Mental Retardation and Developmental Disabilities Administration Fatality Review Committee, created during a public outcry over inadequate care of the city's mentally retarded wards, has never done those reports.
Neil Albert, the District's deputy mayor for children, youth, families and elders, said yesterday that he has ordered a review to find out who was responsible for the failure involving the reports.
"It's outrageous that we have all these bureaucrats handling this issue and no one can seem to get a report done," said Albert, who was appointed in June. "It's just bureaucratic malaise."
From January 2001 through last month, 111 mentally retarded wards of the city died while under government-contracted care in group homes, according to statistics from city officials.
The fatality review committee works with an independent contractor that investigates deaths in the homes. The committee has issued recommendations to the homes generated from individual death reviews, but it has never produced a public report summarizing systemic problems it found.
Kelly Bagby, legal director of University Legal Services, which runs a federally mandated advocacy program for the mentally retarded, said having the fatality review committee issue a report to the mayor ensures that there is "accountability at the highest level" for quality care.
The report "is a very clear requirement," she said. "If the mayor is not seeing a report based on his order, you'd think he'd be concerned about that."
After Bagby's group complained this spring that no report had ever been filed, the chief medical examiner's office began working on a report -- expected to be done Oct. 1 -- that will include findings from 2001 to the present.
Debra Daniels, a spokeswoman for the Human Services Department, which includes the Mental Retardation and Developmental Disabilities Administration, said the "lead entity" responsible for producing the reports is the chief medical examiner's office, which until last fall was headed by Jonathan L. Arden. She said the mental retardation administration gave his office money to hire someone to do the reports.
Arden resigned last fall amid alleged management problems and after being accused of sexual harassment. Marie-Lydie Y. Pierre-Louis, the interim chief medical examiner, said through a spokeswoman that she "is aware the annual report is delayed and we are working to get it out."
The mayor's 2001 order did not designate committee members by name but said the panel should be co-chaired by the chief medical examiner and a social services professional who has experience evaluating developmental disability services. Under an order Williams issued this year, Pierre-Louis and Dale E. Brown, who heads the mental retardation administration, are co-chairmen of the committee.
The District is the defendant in a 28-year-old federal lawsuit that centers on the quality of care for the retarded, many of whom have severe physical disabilities.
In 1999, a series 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 was investigated.
District officials said they have since overhauled the mental retardation administration's services, including investigating deaths in group homes and making recommendations to address deficiencies that might have contributed to the deaths.
But Bagby said the recommendations are sent to group-home providers in a newsletter, rather than as urgent directives, and have not affected the quality of care. In January, a federal judge ordered Williams to assign a deputy mayor to take charge of the city's long-promised improvements.
The Post has requested copies of 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.
Metro researcher Bobbye Pratt contributed to this report.