Gail Grossman, the DMR offical in charge of QUEST, was first asked by one of the callers on the line how often the group homes were visited and licensed.
She answered the question very selectively. Each home that provides 24-hour supports is visited at least six times a year by DMR service coordinators, Grossman said. They fill out standard forms regarding their visits, answering such questions as whether the home appeared clean and whether there was food in the refrigerator.
That's all fine and good. But service coordinators are not the people who license the provider agencies that run the homes. The service coordinator's job is to advocate on behalf of individual residents–not make sure the homes are being run well for all residents.
The actual licensing people may not visit a specific group residence in a given year. As the Legislature's House Post Audit and Oversight Committee pointed out in 1997, QUEST license staff surveyed less than 20 percent of the 1,798 group home sites in the state in 1994. We have no reason to believe the situation has gotten any better since then.
That less than 20 percent of group homes are surveyed each year is disturbing because poor training, low pay and benefits and high turnover of group home staff have been well documented. In 2006, the U.S. Attorney in Massachusetts released a report that expressed concerns about high levels of abuse, neglect, and medication errors in the community system.
During the conference call with Grossman, someone on the line was trying to explain what the service coordinators actually do when they visit the homes. She said that after a long battle with DMR, she finally received one of the site visit forms filled out by a service coordinator. “It was very simplified,” she said. “It said things like, 'I've gone to the house. It seemed like everyone was having a good time.' End of report.”
Another question to Grossman during the conference call: How many times have QUEST licensors recommended that providers not be licensed? Also, how many licenses have been pulled for noncompliance with regulations?
Grossman responded that she would have to get the data to reply to the first question. She said she did not believe that any provider license has ever been pulled during the 15 years the QUEST system has been in place.
Another caller commented that when residents or families have complained to service coordinators about conditions in group homes, DMR has responded not by inspecting the homes or correcting the problems, but by threatening to evict the residents. [This was certainly the case with Lisa Burke, a resident of a group home in Medford, who was run over by a staff-driven van in May 2006 while she sat outside the facility in her wheelchair.
After Lisa Burke's parents and other family members voiced concerns about the accident and about staffing, supervision, and training issues at the group home, a regional DMR director responded by threatening to close Lisa Burke's home.]
I'm not sure Grossman even responded to the comment about DMR's habit of retaliating against those who raise concerns about conditions in group homes. But she did have a response to a caller who said that when group homes do get inspected, the DMR inspectors routinely notify them beforehand. This allows the group home managers to temporarily improve conditions in the homes just before the inspectors get there. Grossman's response was that notifying the group homes before inspections is “just common courtesy.”
When we get responses like that from the DMR official in charge of overseeing group homes in Massachusetts, no wonder we're nervous about that quality of that oversight.