Critical incidents involving state Department of Disabilities and Special Needs facilities, employees and those with disabilities have increased as well as allegations of abuse, neglect and exploitation, according to the most recent statistical report by the agency provided to The Greenville News.
The figures also show that while only 22 allegations of abuse and neglect in community residential facilities were classified as substantiated during the past three fiscal years, 199 staff members at those facilities involved in the allegations were fired during the same time period for misconduct, policy or procedural violations.
A total of 1,276 allegations of abuse, neglect and exploitation at community residential facilities were made during the past three years, the records show. Another 196 such allegations were reported at the agency’s day services and 379 at DDSN’s regional centers during the same time period.
The data was supplied to the South Carolina Commission on Disabilities and Special Needs for its Thursday meeting. Select facts from the data were included in a packet distributed to the public during the meeting.
A total of 1,659 critical incidents were reported at community residential facilities for the most recent fiscal year, up from 1,385 in 2015, according to the records.
Agency officials cautioned commissioners not to be alarmed by the critical incident numbers because they said some of the incidents might be duplicates and many do not involve wrongdoing on anyone’s part.
DDSN defines critical incidents as “an unusual, unfavorable occurrence that is not consistent with routine operations; has harmful or otherwise negative effects involving people with disabilities, employees, or property; and occurs during the direct provision of DDSN service.”
They can include medical problems, hospitalizations, accidents, injuries or law enforcement involvement.
Statewide, according to DDSN, about 15-20 percent of the agency’s service population will have a critical incident of some type during the year.
About 35-40 percent of such incidents during the past two years were related to major medical issues or hospitalization, officials said.
During the meeting, Commissioner Vicki Thompson of Seneca said the increase in such incidents for the most recent year is 25 percent. The rate per 100 increase, she said, was 15 percent.
“This year there has been a significant increase,” she said. “We have to bring that down.”
Susan Kreh Beck, associate state director for DDSN, told Thompson that it is important to remember that the numbers can be duplicated. One incident, she said, could be reported multiple times under different categories.
“Were there duplicated reports last year?” Thompson asked.
Beck said the system reporting remains the same.
DDSN Director Beverly Buscemi said officials have talked about revising the system because it currently can include the theft of a lawn mower from a shed.
“All critical incidents are not created the same,” she said. “When you say that word, it makes it sound like it’s always something that is a fault of a person. That may not be the case. Maybe somebody has a medical issue and is admitted unexpectedly into the hospital. But nobody did anything incorrect.”
She said she agrees that improvements can be made in how the agency collects and reports data.
“I think that is something as an agency we need to work on in the upcoming months,” she said.
Thompson said while she agrees accuracy of data is important, “I am more concerned with keeping people safe and what are we going to do to lower critical incidents.”
She asked if the agency was conducting any kind of safety training, if officials know where the problems and increases are. She said one consumer was involved in 10 critical incidents and she wondered if the agency was trying to find out how that happened.
“That’s the kind of thing I am interested in,” she said. “I understand about the definition of critical incident. I understand about people getting older. But we need to get a plan.”
The majority of critical incidents, according to the agency, are for medical issues, accidents and injuries.
“Major medical incidents have been steadily increasing but this is largely impacted by our agency’s aging population and increasing medical needs,” the agency said in its material released at the meeting.
For the most recent fiscal year, the agency reported, about 9 percent of all critical incident reports were related to aggression by consumers.
Thompson also noted that while the number of substantiated allegations of abuse and neglect in community residential settings was single digits in recent years, she is concerned that providers are not following up after initial reports to see if an arrest is made.
The agency defines substantiated abuse and neglect as those allegations in which an arrest is made or the allegation is founded by the state Department of Social Services or the state Attorney General’s Office.
The agency does not investigate such allegations itself but relies on law enforcement or DSS. But DDSN does require providers to conduct a review in such cases for policy and procedural issues and employees can be disciplined as a result of that review, which is independent of any criminal probe.
According to the agency’s summary in the agenda packets, the number of statewide allegations of abuse neglect and exploitation per 100 individuals for community residential dropped during the past five years from a high of 11.47 to a low of 8.78 in fiscal year 2014. But it also noted the rate in the fiscal year ending in June was 9.9.
The data shows that the rate increased in 2015 to 9.9 and stayed there for 2016. The number of allegations increased from 437 in 2015 to 456 in 2016.
The number of substantiated allegations went from 11 in 2014 to 7 in 2015 and 4 in 2016. The number of staff fired during that same time period at the facilities went from 65 in 2014 to 74 in 2015 to 60 in 2016, according to the data.
At DDSN’s regional centers, such allegations have dropped from 167 in 2014 to 102 in 2015 to 110 in 2016. There were only two substantiated cases in 2016, though 24 staff were terminated.
The abuse allegations can include physical abuse, neglect, psychological abuse and exploitation.
“DDSN casts a very broad net which I think you would glean from the definitions of all the incidents,” said Lois Park Mole, a DDSN spokeswoman. “Because we want to err on the side of making sure we know everything that is going on. You want to err on the side of the consumer so you have more information or over reporting, if you will.”
The agency serves about 30,000 individuals with mental retardation, traumatic brain injuries, spinal cord injuries and autism.