It comes as deliberate assault by caregivers and sometimes relatives. It comes as acts of frustration, when people exhausted from the relentless difficulties of caring for patients with intellectual disabilities shove and hit the vulnerable.
Government agencies are often judged as much on their response to abuse as on their success at preventing attacks. By this measure, California and New York have repeatedly failed, as news reports over the past year have detailed numerous cases in which state officials overlooked evidence of attacks and suspicious deaths.
Both New York and California are working to overhaul their abuse response systems. However, the states are taking different approaches.
New York lawmakers plan to add a new independent overseer focused solely on the disabled. This model is considered the gold standard, patient advocates argue. First implemented in Massachusetts, a disability protection agency coordinates with state police on investigations of community group homes and developmental centers.
California Gov. Jerry Brown's administration is working to upgrade an existing in-house police force that has long struggled to investigate crimes at the state's institutions for residents with cerebral palsy and other intellectual disabilities. This force, called the Office of Protective Services, is operated by the same state agency that runs the institutions.
Ideally, California developmental centers officials would not be in control of criminal investigations at their facilities, said Greg deGiere, public policy director for The Arc and United Cerebral Palsy in California. But the state is unlikely to spend to construct a new law enforcement agency in the midst of budget shortfalls.
"That's the problem with everything we do now, we try to fix problems with no money," deGiere said. "But there is stuff that can be done."
One measure deGiere and other patient advocates have lobbied for is having the governor's office, rather than the Department of Developmental Services – which runs the facilities – appoint the institutions' police chief. Such a move could make the in-house police force more independent.
California lawmakers have also introduced two bills that would require the institutions to alert outside law enforcement of suspicious deaths and other serious cases, including sex assault allegations.
In a series of stories in February, California Watch reported that detectives and patrol officers at the state's board-and-care institutions routinely fail to conduct basic police work even when patients die under mysterious circumstances. The facilities have documented hundreds of cases of abuse and unexplained injuries, almost none of which have led to arrests.
The state operates five developmental centers that house roughly 1,800 patients with cerebral palsy and other intellectual disabilities in Los Angeles, Orange, Riverside, Sonoma and Tulare counties. California is budgeted to spend $577 million on the patients and facilities this fiscal year, or about $320,000 per patient.
Rather than expand state government's role, the bills would seek to better engage outside groups in tracking and investigating abuse. SB 1051 would require state and local police agencies to document when a disabled person is a victim in their annual crime statistics.
The bill would also require developmental center administrators to report cases involving "death or harm" to Disability Rights California, a patient advocacy organization.
New York Gov. Andrew Cuomo this week announced theproposed agency in that state would be responsible for prosecuting crimes against the disabled, offering an abuse hotline and referring allegations to law enforcement. It would also track caregivers found to have abused patients and block them from working with the disabled or people with special needs.
"I think it raises the bar significantly on the degree to which states address the issue of abuse and neglect across all disabled populations," Nancy Thaler, executive director of the National Association of State Directors of Developmental Disabilities Services, told The New York Times.
The measures in New York come in response to reporting by the Times, which revealed numerous cases of violence and 1,200 unexplained deaths at homes and institutions for the developmentally disabled.
View this story on California Watch
Story courtesy of our media partners at California Watch (A Project of the Center for Investigative Reporting)