THE STATE Department of Disabilities and Special Needs provides residential and day programs for 13,000 South Carolinians with severe intellectual disability, autism, traumatic brain injury and spinal cord injury.
These would be, by anyone’s definition, our most vulnerable adults.
Yet a report released this summer by the state’s Legislative Audit Council found that a quarter of the caregivers hired by the state agency and the private facilities it contracts with do not undergo criminal background checks; some facilities haven’t conducted any checks.
It also found that allegations of criminal activity aren’t always forwarded to police, and caregivers are unclear about what should be reported. One example cited involved a vulnerable adult who complained of being sexually assaulted by another vulnerable adult: Officials at the facility determined that the sex was consensual, and closed the case without referring it to SLED’s Vulnerable Adults Investigations Unit.
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We’d like to say that there isn’t a lot of abuse going on in these facilities, as some data suggest, but frankly it’s hard to draw that conclusion, given the lack of consistent reporting.
This isn’t the first time the Legislature’s auditing arm has found problems with patient safety at the department. A 2008 audit recommended that the Legislature require all caregivers to undergo an FBI background check and a National Sex Offender Registry check. That was one of three recommendations made for legislative action. It was one of three recommendations for legislative action that the Legislature ignored. As is too often the case when the professionals hired by the Legislature to make recommendations recommend that the Legislature take action.
This latest audit again recommends that the Legislature require background checks for all caregivers. It recommends that the state create a central registry for people who have been found by an investigative entity to have abused, neglected or exploited a vulnerable adult. Twenty states already run such registries, and our state maintains one for child abusers. Such a registry would help not only the disabilities agency but any other public or private entities, or even individuals, who are hiring people to care for vulnerable adults.
The audit also recommends that state law be changed to make it clear that reports of abuse must be forwarded to the police agency that was created for the very purpose of investigating such charges, so there’s no confusion.
Additionally, it recommends that the Legislature require electronic surveillance of common areas in residential and day facilities, noting that this “would not only protect consumers, but also can provide protection for innocent caregivers” accused of abuse, neglect or exploitation. This might be a long shot; for reasons we still can’t fathom, the Legislature killed a bill this past legislative session to allow people to place video cameras in their relatives’ rooms in residential-care facilities so they could monitor how their relatives were being treated. But the audit noted that concerns about privacy could not possibly exist in common areas.
We can debate what level of care the taxpayers are obliged to provide to people with disabilities, or even if it is obliged to provide care, but here’s what we can’t debate: When the government provides care for people — either directly or indirectly — it has an obligation to ensure basic safety.
We hope the common-sense recommendations in this audit will be the impetus our Legislature needs to provide that most basic level of safety for our most vulnerable adults.