Despite reforms by state lawmakers, abuse and neglect of Texans with mental retardation in state-run institutions has increased the past three years, according to an Observer analysis of state data. Reforms enacted in response to a high-profile abuse scandal have left the facilities with fewer residents and more staff, yet confirmed allegations of abuse rose 57 percent between 2007 and 2009. However, the number of abuse cases has dropped slightly so far in 2010, indicating that perhaps the latest reforms are having some effect.
For the past four years, Texas’ 13 sprawling, state-run institutions for the mentally retarded—formerly known as State Schools and which the Legislature recently renamed State Supported Living Centers—have been the source of horrific tales of abuse. Since 2005, investigations by the U.S. Department of Justice and numerous media outlets, including the Observer (see “Systemic Neglect,” May 1, 2008), have documented hundreds of instances in which Texans with mental retardation were beaten, neglected and, in some instances, killed by the staff charged with caring for them. In the most famous incident, workers at the Corpus Christi State School recorded a “fight club” video in which mentally disabled residents were forced to beat each other.
The abuse scandal was rooted in years of under-funding by the Legislature. Low pay and astronomical staff turnover, which ran as high as 70 percent in some facilities, led the institutions to hire low-grade employees—and in a few instances convicted felons—who never should have been caring for vulnerable, and often volatile, residents.
Despite reforms passed in the past two legislative sessions—including a 12-percent funding increase and nearly 3,000 additional caregivers—the number of abuse and neglect cases remains high.
Confirmed cases of abuse in State Supported Living Centers rose 57 percent between 2007 and 2009, according to an Observer analysis of state data, from 458 incidents in 2007 to 719 last year.
In the first six months of fiscal year 2010, which began in September, confirmed cases of abuse and neglect have dipped by 19 percent. State Supported Living Centers are on pace to report 580 cases of abuse in 2010, which while lower than 2007’s peak, is still historically high.
The facilities are now closely monitored by Justice Department inspectors, and some reforms have already had an effect. In the past six months, State Supported Living Centers have added more than 1,000 full-time employees, according to state records. And the facilities have fewer residents, as state officials transfer more disabled Texans into small, community group homes. State Supported Living Centers now employ nearly 13,000 workers to care for about 4,000 residents.
While the slight decrease in abuse cases so far in 2010 is encouraging, the Legislature’s refusal to give State Living Center employees a pay increase may hamper reform.
State Supported Living Center workers are on average the lowest-paid state employees, according to the Texas State Employees Union. Direct care workers earn a starting salary of roughly $8 an hour. Parents and families of residents have often blamed abuse and neglect partly on low pay.
It’s worth noting that confirmed cases of severe physical and sexual abuse have remained fairly constant the past three years, according to state data. But there’s been a sharp increase in confirmed incidents of “neglect,” which don’t involve physical violence by the staff, but usually consist of incompetent oversight of residents: allowing residents to fall from bed or leave the facility or harm themselves and others. In other words, the kinds of incidents you would expect from a staff that’s largely earning fast-food wages.
When asked if low salaries contributed to the increase in neglect, Cecilia Fedorov—a spokesperson with the Department of Aging and Disability Services, the state that oversees State Living Centers—said, “I don’t believe there’s ever an excuse for abuse, neglect or exploitation.” She added that salaries at state institutions are a “legislative question,” and not up to the agency.
The agency did ask the Legislature for a salary increase last session for State Living Center workers, and lawmakers denied the request.
Without a pay increase for direct care workers, it’s questionable whether the recent decline in abuse numbers will continue and whether Texas’ institutions for the mentally disabled can be adequately reformed.