The MTF/BF report also examines data over a far-too-short, three-year period. Given that DPPC data are available for an eight-year period, from 2002 through 2009, it's curious that the MTF/BF only chose to look at the final three years. But we'll get to that later.
The MTF/BF report claims that the DPPC figures show that in fiscal years 2007, 2008, and 2009, both the Department of Developmental Services and Department of Mental Health community residential programs had
a much lower rate of substantiated instances (of abuse and neglect) than did state-operated institutions in all three years (our emphasis).
This finding is used to support the report's recommendation that all remaining state-run DDS developmental centers be closed and their residents be sent to the community system.
To back up this finding about abuse and neglect, the MTF/BF report refers to an appendix, which lists, among other things, the total number of clients served in all three years in both state developmental centers and the community system as well as the total number of abuse and neglect complaints investigated.
Once again, at first blush, the results appear to be dramatic. In 2009, for instance, the DDS table in the appendix appears to show that 72.7 abuse and neglect complaint cases were “sustained” or substantiated per 1,000 residents in the developmental centers, compared with 48.1 cases substantiated in the community system. That is a complaint substantiation rate that appears to be more than 50 percent higher in the developmental centers than the community.
But there are a number of things both suspect and flat-out wrong with this analysis.
First, if you take another look at the table, you notice that there are no figures listed in the table for the actual number of substantiated cases in any of the years. There are only figures listed for the total number of investigated cases in each year. Yet, the MTF/BF took those numbers of total investigated cases, converted each of them into per-thousand-clients numbers, and then inappropriately put them all in the substantiated column.
The MTF/BF appendix table does provide numbers of substantiated allegations of physical, emotional, sexual, and other types of abuse and neglect. Those allegations are part of each individual case. The differences between the developmental centers and the community in those instances are relatively minor. In some cases the numbers of substantiated allegations were lower in the community and in other cases, they were lower in the developmental centers. We'll get to that later as well.
Why is the MTF/BF's conclusion about the data misleading? First, what the numbers cited by the MTF/BF actually show is that the rate of investigations of complaints was nearly 50 percent higher in the developmental centers than the community over the three-year period.
A higher investigation rate in the developmental centers may mean the developmental centers are actually safer than the community system. Many more complaints per thousand clients were investigated in the developmental centers than in the community system over the three-year period. That stands to reason, given the greater level of oversight that exists in the developmental center system than in the community system.
By the way, we asked the DPPC for the same numbers they gave the MTF/BF to see if we were somehow mistaken about this. The DPPC numbers backed up our interpretation that the MTF/BF report had wrongly labeled the investigated cases as substantiated throughout the appendix. Then I emailed and later called Emil DeRiggi, the Deputy Executive Director of the DPPC, who said he had personally given the MTF/BF the DPPC's numbers. “Your interpretation (about the MTF/BF's mistake) is correct,” DeRiggi said to me, after he had examined the MTF/BF appendix.
But even if the numbers of substantiated cases are higher per thousand residents in the developmental centers than in the community system, that doesn't mean the community system is necessarily any safer than the developmental centers. If more cases per thousand residents are investigated in the developmental centers than the community system, more cases per thousand are likely to be substantiated as well.
For that reason, we think it would be more meaningful to look at the ratio of substantiated cases to investigated cases, rather than at the number of substantiated cases per thousand residents in the developmental centers and community system. Given that the DPPC provided us with eight years of data, we looked at the number of investigated and substantiated allegations of physical and sexual abuse in both the developmental centers and the community system between fiscal years 2002 and 2009.
In the case of sexual abuse, we found that of the total number of sexual abuse allegations investigated, an average of 8.75 percent were substantiated by investigators in the developmental centers over the 8-year period versus 13.04 percent substantiated in the community system. This certainly implies that the community system is more dangerous with respect to sexual abuse.
During the last three years, by the way, the average rate of substantiation of sexual abuse allegations actually dropped in the developmental centers to 8.33 percent and rose in the community system to 13.25 percent.
The results were closer for physical abuse investigations: 19.22 percent of physical abuse allegations were substantiated on average in the developmental centers versus 19.17 percent in the community system.
Here's another problem with the MTF/BF analysis. The DDS appendix table also leaves out figures that were provided by the DPPC of the number of abuse and neglect complaints that were actually made in each year. Those figures show that on average, only 45 percent of the complaints in the developmental centers were investigated by the DPPC and 37 percent were investigated in the community system over the last three years.
These figures provide further evidence that the rate of investigations of complaints is higher in the developmental centers than the community system. And they raise a number of questions, such as who investigated the other 55 percent of the complaints in the developmental centers and the other 63 percent of the complaints in the community system.
Certainly, the MTF/BF analysis falls far short of proving the statement made in the report that “community care is safe.” And that analysis also fails to prove that the community system is any safer than the developmental centers.