Running head: OVERLOOKED 1

Overlooked: The Shortcomings of Homes for Disabled Children

Brooke P. Gasser

First Colonial High School

Legal Studies Academy

OVERLOOKED 2

Abstract

This paper outlines the shortcomings of homes for disabled children. It examines how the lack of

training can lead to abuse, and how the high cost makes homes for disabled children potentially

dangerous and inaccessible to those who need it most. The author studies three different homes,

ranging from privately to publicly funded and the problems that occur in them. The legislation

put forth to protect these individuals is analyzed and reviewed. The author correlates the lack of

case law to the continuation of maltreatment. Based on the information provided, the author

presents a number of solutions that can help sustain better care and a more fulfilling life for the

disabled citizen.
OVERLOOKED 3

Overlooked: The Shortcomings of Homes for Disabled Children

Homes for developmentally disabled children are meant to be safe havens for our

society’s most vulnerable citizens. But often these homes fall short of providing the necessary

services and education. The main aspects that contribute to this lack of appropriate care are the

cost of these facilities and the maltreatment of these disabled children. According to the

Individuals With Disabilities Education Act (IDEA), a federal law, “child with a disability” is an

adolescent who requires special education or other services because of an impairment, ranging

from “mental retardation, hearing impairments (including deafness), speech or language

impairments, visual impairments (including blindness), serious emotional disturbance, . . .

orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific

learning disabilities” ("20 U.S. Code § 1401 - Definitions," n.d.). The Federal Child Abuse

Prevention and Treatment Act (CAPTA) defines child abuse or neglect as an “act on the part of a

parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or

exploitation, or an act or failure to act which presents an imminent risk of serious harm” ("42

U.S. Code § 5106a - Grants to States for Child Abuse or Neglect Prevention and Treatment

Programs," n.d.). Relative poverty is determined by the relation to others in the same society.

Therefore, people are considered to be poor or in poverty if their economic status falls below the

“prevailing standards of living” ("Poverty," n.d.). The lack of training, which can lead to abuse,

and the high cost make homes for disabled children potentially dangerous and inaccessible to

those who need it most.

Child Maltreatment

Child Protective Services estimates that 1 in 4 children are subject to maltreatment

("Violence Prevention," 2017). Nearly 4% of all children in the United States have a disability,
OVERLOOKED 4

which equates to roughly 29,520,000 children with disabilities. Therefore, according to Child

Protective Services’ estimates, roughly 7,380,000 disabled children experience physical abuse,

sexual abuse, neglect, or emotional maltreatment at least one in their lifetime. Even with

numbers along the lines of these, states are not required to disclose the status of children who are

abused (Child Welfare Information Gateway, 2012), meaning that officials are unable determine

exactly how many disabled children are mistreated each year. Since officials cannot obtain a

solid number, it is very difficult to secure reform.

A disabled child is more at risk for maltreatment if the guardian “views the child as

‘different’... lacks the skills to respond to the child’s needs… is unaware their child with

disabilities is at greater risk of maltreatment… exerts unnecessary control or use physical

punishment” (Child Welfare Information Gateway, 2012).

Children are also more at risk to be abused by an institution at which they reside, if it

“allows for extreme power and control inequities between caregivers and children…

dehumanization and detachment from the children… clustering vulnerable children with others

who might harm them… isolating children… lack of procedures for reporting abuse or

monitoring investigations of abuse” (Child Welfare Information Gateway, 2012).

Cost of Care

“The cost of ongoing treatment or care for a child with disabilities may put a financial

strain on the family or affect parental job stability” (Child Welfare Information Gateway, 2012).

It has been proven, through experimental evidence obtained in the UK, that a family with a

disabled child is more likely to be below the poverty line and reduces the chances of getting out

of poverty. This is because the cost of raising a disabled child is through the roof, and it is not

easy to obtain a caregiver. The situation can also be reversed, by saying that those living in
OVERLOOKED 5

poorer conditions and more likely to develop conditions that would classify one as disabled, such

as “premature birth, low birth weight, exposure to a range of toxins and teratogens, poorer

nutrition, poor housing conditions, exposure to less than optimal parenting, poorer educational

opportunities, injury and accidents.” There is also a third way to look at the connection between

disabilities and poverty, the experimenters call them “third factors.” These third factors can be

classified as “unmeasurable influences” in the lives of those families with disabled children. For

example, hereditary diseases or impairments can cause the family to be socially excluded from

society, which would also “increase the risk of poverty and… the risk of disability.” Because

strong link between poverty and disabled children, the importance of an inexpensive home for

these disabled children is even more of a necessary. For most, poverty is a temporary state, but

with the extensive cost of medical care for children with disabilities, this temporary state could

become the norm (Shahtahmasebi, Emerson, Berridge, & Lancaster, 2011).

According to Mr. Laidlaw, an attorney for St. Mary’s Home for Disabled Children, the

Virginia Department of Medical Assistance determines the cost of care, unless the home is

privately owned. Since St. Mary’s has a foundation that supplies additional funds, the home can

provide a higher quality life for its children. “Each year an independent audit is conducted for all

financial transactions at the Home” (Laidlaw, Personal communication, November 20, 2017).

When the audit is complete and all transactions done by the home have been taken into account,

a “cost settlement report is submitted to the Department of Medical Assistance Services.” The

Department of Medical Assistance Services then decides the amount of money the Home should

receive based on the independent report. “The programs for children with developmental

disabilities are publicly funded. As a result all needs can be addressed but that is the extent.
OVERLOOKED 6

Addressing people’s dreams is not considered a good use of tax dollars” (Laidlaw, Personal

communication, November 20, 2017).

The “tax dollars” that Mr. Laidlaw is referring to are used to cover the basic needs of

children. Any extra activities or items that would make life more enjoyable and more fulfilling

for a child are not paid for by the state, but rather by families, or through donations. Even though

these activities are not classified as a necessity by the state, they make the child’s life seem just a

little bit more normal.

Legal Aspect

The lack of case law on maltreatment and negligence of disabled children in homes is

alarming, mostly since there are multiple articles depicting the first hand accounts of abuse. Most

cases involving lawsuits against homes, for reasons such as neglect and abuse, have been settled

outside of court, and therefore, there is little public knowledge concerning these happenings. Mr.

Laidlaw explained that this is mainly because it cost less to settle a case out of court, then to

continue in a legal battle (Laidlaw, Personal communication, November 20, 2017). At a home

located in Florida, called Carlton Palms Educational Center, there have been numerous cases

brought up against this facility on the grounds of negligence, but not one sees thetrial all the way

through. It can be seen, through the court records, that the Carlton Palms’ attorney continues the

process of appeals, until a settlement is all the family can afford, or until the family is too

exhausted to continue. During an interview, Mr. Laidlaw recalled situations where he had first

hand knowledge of a home that was abusing their residents, and the laws that govern them:

My first paid experience was with a group of individuals who had been moved from a

large state facility where abuse was widespread. Following the discovery of the

conditions at the institution, a suit was filed, New York State Association for Retarded
OVERLOOKED 7

Children vs. Rockefeller. The facility, Willowbrook was eventually closed and special

funds were allocated to the individuals who had lived there. More recently the

Commonwealth of Virginia entered into a settlement agreement with the Department of

Justice (DOJ). DOJ first took interest in Virginia for its failure to discharge individuals

who had been determined to be ready to live in the community by the professional staff

of the institution they lived in. Upon further review, it was determined that the

Commonwealth was in violation of the Olmstead Act. As a result the Commonwealth is

in the process of offering services to hundreds of additional individuals and closing 4 of it

5 state institutions. The are several sections of the Virginia Administrative Code that

address abuse and neglect of children, including those with disabilities. 22VAC40-730-20

applies to all children, 12VAC35-115, applies to both adults and children who are

receiving services provided or licensed by the Department of Behavioral Health and

Developmental Services. In addition, because St. Mary’s Home operates under a state

license as well as federal certification, it complies with additional federal regulations

prohibiting abuse. (Laidlaw, Personal communication, November 20, 2017)

In 2008 a bill was introduced to Congress, in which the federal government would be

required to track all abuse complaints and from there, establish and maintain a website of abuse

in residential homes. It has never progressed any further. The Child Protection Improvements

Act of 2017, as of May 22, 2017, had passed through the House, and on October 16, 2017, it

passed through the Senate. At this point in time, the bill is just waiting for presidential approval.

If the Child Protection Improvements Act of 2017 is approved, then this bill would be an

amendment to the Child Protection Act of 1993, by requiring a background check and criminal
OVERLOOKED 8

history review, for those who wish to work with children, elderly adults, or individuals with

disabilities ("S.705 - Child Protection Improvements Act of 2017," 2017).

St. Mary’s Home for Disabled Children

St. Mary’s is a home for disabled young adults and children, located on the border of

Norfolk and Virginia Beach near Military Circle. Their mission statement is “We provide

quality, specialized care within a homelike environment for children and adults with severe

disabilities so each person can achieve his or her fullest potential.” With more than 275

employees (St. Mary's Fact Sheet, n.d.), “St. Mary’s offers a wide array of services, e.g. around

the clock nursing care, active treatment, physical, recreational, occupational and speech therapy.

St. Mary’s has the support of its Foundation to augment the public funds” it receives (Laidlaw,

Personal communication, November 20, 2017).

Background

St. Mary’s Home began during World War II in 1944, as an infant home to take care of

abandoned and orphaned children. Then in 1950s, St. Mary’s transformed into a one of a kind

residential home, where children with severe disabilities could be cared for. Beginning in the

1980s St. Mary’s became “a private, nonprofit, nonsectarian organization” that supplies constant

residential care for those under its roof. Since St. Mary’s began caring for children with

disabilities, they have increased the number of children they provide for, from a dozen to 100.

Over the course of its beginning, the age limit at St. Mary’s expanded from 6 to 21 ("St. Mary's

Home | A Good Life.," n.d.) and then in 2013, with the opening of the Albero House, they once

again expanded the age limit to include adults over 21 (St. Mary's Fact Sheet, n.d.). The Albero

House is a separate building on the same campus as the main building. Its purpose is solely to

house 12 adults, who can no longer be cared for in the main building. The Albero House, while
OVERLOOKED 9

still maintaining an exceptional level of care, provides more of a personalized feel, as every

room is decorated to the liking of the adults. St. Mary’s established the Ronald Mcdonald House

to provide families with a “home away from home” and the opportunity to be close to their

children. Any family with a child at St. Mary’s is welcome to stay at this house, with no cost to

them.

Care and Training

In order to appropriately care for these children, St. Mary’s has constructed “11 Time-

Tested Tips” to discipline a disabled child. Some of these tips include: “don’t compare...change

your standards...different doesn’t mean inferior...provide structure…[and] help the child build a

sense of responsibility” (Comfort and Caring, n.d.). St. Mary’s, like most institutions, has a

policy on training for all the staff, and then one for certain departments. A basic training covers

items that all caretakers for disabled children need to know, and then each department has its

own certain training that applies to that department’s children.

Prior to their first assignment, the direct support professionals (dsp) attend 9 full days of

training. Two of the days are for Person Centered Thinking that uses the Learning

Community (VCU) curriculum and is taught by trainers endorsed by the Community.

One day is in Safety Care which is a behavioral support curriculum that is taught by

trainers certified by the national company that developed the curriculum. The remaining

days are spent in training provided primarily by licensed staff who work at St. Mary’s

and includes the following topics: Creating a Good Life, Human Rights/Abuse/Neglect

Reporting, Confidentiality, Introduction to Splints/TLSP’s, Introduction to Wheelchairs,

Dietary, Feeding Instructions, Medical Overview, Infection Control, Physical Therapy,

Body Mechanics, Lifting, Positioning, Osteoporosis, Bed Safety, Mechanical Lift

OVERLOOKED 10

Training, Introduction to Recreation Therapy, Electronic Medical Records, and

Emergency Preparedness. In addition,… all staff are required to have CPR and First Aid

training which adds another day to their training. Once the new staff person finishes the

above training they are allowed to work with the individuals at St. Mary’s under the

guidance of a preceptor, usually a senior level DSP, who has a checklist of critical skills

the new person must master before they are allowed to work without the direct

supervision of the preceptor. This process usually takes a couple weeks. There is also

specific training that is specific to each child but that varies by child. After the initial

training period, there are annual retrainings in a variety of topics ranging from the

application of splints to behavior support to emergency preparedness. We are also in the

process of working with consultants to provide training to all new staff in applied

behavior analysis in the new year. (T. Laidlaw, Personal communication, December 19,

2017)

As Mr. Laidlaw indicated, there are 19 different topics that caretakers must be fully

trained on in order to continue onto supervised working. If more homes were similar to St.

Mary’s in the way that they provide training and care for their employees, then maybe there

would not be as many horrible instances of abuse or maltreatment.

Carlton Palms Educational Center

In contrast to St. Mary’s love and warming spirit, Carlton Palms Educational Center is

mainly focused on avoiding accountability through any measures possible. After many accounts

of severe abuse at this Mount Dora home, they have developed a new name to bury their

reputation. In order to avoid the public becoming aware of its long abusive past, AdvoServ, the

company that runs Carlton Palms Educational Center, has changed its name to Bellwether
OVERLOOKED 11

Behavioral Health. In order to even further themselves from the truth, Bellwether Behavioral

Health executives have stated that “over the past year, a completely new leadership team, with a

different management philosophy, initiated a series of transformational changes designed to

fundamentally alter the trajectory of the company” (Vogell, 2017). This statement comes after

three teen deaths at the facility and a multitude of maltreatment allegations over the past few

years. The company is reluctant to share the aspects of the home or the “management

philosophy” that has been changed. The worst part of this home’s long, drawn out struggle with

abuse is that this is not the first time there has been a name change. Due to another set of abuse

allegations in the late 1970s, the home changed its name from Au Clair School for Autistic

Children to AdvoServ (Vogell, 2017). Au Clair School for Autistic Children or AdvoServ or

Bellwether Behavioral Health, or whatever they decide to be called next, has evaded being shut

down for this long, how much more can these children take?

Legal mishaps

In one court case involving the formerly Carlton Palms Educational Center, Barzilay By

and Through, Sara vs. Carlton Palms Educational Center Inc., the Carlton Palms attorney

appealed for a whole year, at which point the attorney had the case dismissed due to the fact that

the plaintiffs failed to respond to a motion. The judge ruled that the claim be dismissed with

prejudice, meaning that the judge ruled a final judgement and the plaintiffs are not allowed to

make another motion on this claim ("BARZILAY BY AND THROUGH, SARA VS.

CARLTON PALMS EDUCATIONAL CENTER INC Court Case Details," n.d.).

Very few cases concerning Carlton Palms have made it to court in the first place, but

when Carlton Palms has come under investigation, they have been known to hire a lobbyist. This

lobbyist somehow convinces the prosecuting attorney that there was no need to go to court.
OVERLOOKED 12

Unfortunately, this formula has been well tested and proven effective through the lack of legal

evidence against Carlton Palms.

The Agency for Persons with Disabilities filed a legal complaint against Carlton Palms

after it was informed of three separate but recent events involving the abuse of residents. The

Agency for Persons with Disabilities attorney came to the conclusion that a “moratorium on

admissions is necessary to protect the public interest and to prevent the continuance of conditions

that threaten the health, safety and welfare of Carlton Palms residents,” meaning that a year

prohibition concerning admissions would successfully protect those who were or could be

subject to abuse. The thought was that if Carlton Palms’ profits were affected, then they would

learn their lesson and the abuse would ease. But, the state dropped the case when AdvoServ hired

an attorney who happened to work directly with the former governor. Since the state dropped the

case, the home was not forced to admit any wrongdoing and was not forced to pay a fine. The

only improvement, the home agreed to install more security cameras, was made in order to ease

the public opinion. After the case was settled, the state of Florida started to refer more children

and young adults to Carlton Palms (Vogell, 2015). To this day, the now Bellwether Behavioral

Health institution is still in operation.

Alden Village North

Alden Village North is a home for developmentally disabled children and adults in

Chicago, Illinois. In early 2011, the Illinois Department of Public Health announced, after eight

“Type A” violations (Type A violations are those that can result in harm or death to a person)

within the last 3 years, that it would be taking away Alden Village North’s license. By taking

away their license to practice, that would effectively close the home completely. Interestly

enough, this home had also been running from its past. Before 2008, Alden Village North was
OVERLOOKED 13

known as the Mosaic Living Center, but they changed their name when new management

stepped in. Because of this change in management, the Illinois Department of Public Health was

only concerned with the last three years. One of the Mosaic Living Center’s most famous cases

of maltreatment is the death of nine year old Jeremiah Clark. “He died on May 21, 2008, of

shock, infection and bowel obstruction… while teachers at his school had found fluids leaking

from the hole where his feeding tube… attached, the nursing home didn’t call a doctor for two

days” ("State Moves To Close Nursing Home After Scandals," 2011).

Solutions

Based on the multitude of evidence, the lack of training and the high cost of care make

homes for disabled children potentially dangerous and inaccessible to those who need it most. If

homes were to “increase [the] funding to allow for the hiring of better qualified direct staff,... the

training and supervision offered to the staff,... the education in abuse identification and reporting

for the individuals [at risk]” (Laidlaw, Personal communication, November 20, 2017), then all

disabled children in homes would be put at less of a risk for maltreatment, because they would be

taken care of by highly qualified staff . Finding a qualified and adequate caregiver for a child

with disabilities is extremely difficult, in order to make essential care easier to access, more

training should be provided for these custodians, including: “disability policy, programs, and

services,... prevalence and categories of disabilities,... issues related to specific disabilities and

their effect on children’s various developmental needs,... supportive intervention strategies that

address communication techniques, adaptive therapies, and children’s sexuality and personal

safety skills” (Child Welfare Information Gateway, 2012).

The homes supplying this imperative care need to receive more public funding in order

hire more qualified staff, or to provide more training for the employees. With that said, it can be
OVERLOOKED 14

seen that privately run facilities do not have the best track record with regards to quality of care.

Therefore, if a home, private or publicly funded, wishes to receive increased funding, there

should be a standard of care that they are required to meet. If this concept were to be

implemented, then the government could easily regulate the quality of the homes.

Even though it can be estimated that about 7,380,000 disabled children are subject to

maltreatment at one point in their life, that is still just an estimate, not the real number. In order

to gain accurate numbers and statistics on the amount of disabled children being exposed to

maltreatment by institutions or a guardian, a regulation, such as the 2008 bill that would have

required the federal government to track all abuse complaints and from there, establish and

maintain a website of abuse in residential homes, is essential. This proposed bill would gather

the data that is necessary to create more legislation, so the government can fully protect these

innocent children and adults. Congress has taken a step in the right direction with the passing of

the Child Protection Improvements Act of 2017, but more must be done.

Additional resources are not considered necessary for children with disabilities, when in

fact they most definitely should be regarded as important as the basic needs to survive. A piece

of legislation, be it the Child Protection Improvements Act of 2017 or a new proposed bill,

should deem additional activities and resources as a necessity, because these additional services

and activities give the children a sense of purpose, hope and a reason to wake up in the morning.

Even though these do not fall under the basic needs such as food, water, and shelter, they most

certainly provide the children and young adults with happiness. Therefore, it can be argued that

these items are in fact very much significant because it is more important to live than to survive.
OVERLOOKED 15
OVERLOOKED 16

References

20 U.S. Code § 1401 - Definitions. (n.d.). Retrieved November 6, 2017.

42 U.S. Code § 5106a - Grants to States for child abuse or neglect prevention and

treatment programs. (n.d.). Retrieved November 6, 2017.

Child Welfare Information Gateway. (2012, March). The Risk and Prevention of

Maltreatment of Children With Disabilities. Retrieved October 25, 2017.

Comfort and Caring [PDF]. (n.d.). Norfolk: St. Mary's Home.

Crosse, S. B. (1991, November 30). A Report on the Maltreatment of Children with

Disabilities. Retrieved October 25, 2017, from https://eric.ed.gov/?id=ED365089

Fisher, M. H., Dykens, E. M., & Hodapp, R. M. (2008). Child Abuse Among Children

with Disabilities: What We Know and What We Need to Know. Retrieved December 18,

2017.

Laidlaw. (2017, November 20). The Shortcomings of Homes for Disabled Children [E-

mail interview].

Laidlaw, T. (2017, December 19). The Shortcomings of Homes for Disabled Children [E-

mail interview].

Millercmarbin@MiamiHerald.com, C. M. (2014, September 13). Bound to bed: A girl's

agonizing death. Retrieved October 25, 2017, from

http://www.miamiherald.com/news/politics-government/article2102470.html

Millercmarbin@MiamiHerald.com, C. M. (2016, June 23). After latest abuse case,

Florida moves to close home for disabled. Retrieved October 25, 2017, from

http://www.miamiherald.com/news/article85592982.html

Niece v. Elmview Group Home (January 16, 1997).

OVERLOOKED 17

Palmer, J., Baladerian, N. J., & Coleman, T. F. (n.d.). Disability and Abuse Newsfeed

[PDF].

Poverty. (n.d.). Retrieved November 6, 2017, from http://www.unesco.org/new/en/social-

and-human-sciences/themes/international-migration/glossary/poverty/

Roe, S. (2014, January 31). Questions persist at Chicago facility housing disabled

children.

S.705 - Child Protection Improvements Act of 2017. (2017, October 19). Retrieved

November 28, 2017, from https://www.congress.gov/bill/115th-congress/senate-bill/705

Shahtahmasebi, S., Emerson, E., Berridge, D., & Lancaster, G. (2011, October). Child

Disability and the Dynamics of Family Poverty, Hardship and Financial Strain: Evidence

from the UK. Journal of Social Policy, 40, 653-673.

http://dx.doi.org/10.1017/S0047279410000905

St. Mary's Fact Sheet [PDF]. (n.d.). Norfolk: St. Mary's Home.

St. Mary's Home | A good life. (n.d.). Retrieved December 8, 2017, from

http://saintmaryshome.org/

State Moves To Close Nursing Home After Scandals. (2011, March 04). Retrieved

December 20, 2017.

STATEMENT REGARDING ALDEN VILLAGE NORTH. (2011, March 04). Retrieved

December 20, 2017.

U.S. Senate, Senate - Judiciary. (2017, March 23). Congress.gov [S. Bill from 115th

Cong.]. Retrieved October 25, 2017, from https://www.congress.gov/bill/115th-

congress/senate-bill/705

Violence Prevention. (2017, April 17). Retrieved November 21, 2017.

OVERLOOKED 18

Vogell, H. (2015, December 10). Unrestrained. Retrieved October 25, 2017, from

https://www.propublica.org/article/advoserv-profit-and-abuse-at-homes-for-the-

profoundly-disabled

Vogell, H. (2017, March 28). Bellwether Behavioral Health Is Controversial Group

Home Operator AdvoServ - With a New Name. Retrieved December 12, 2017, from

https://www.propublica.org/article/bellwether-behavioral-health-is-controversial-group-

home-operator-advoserv

Vogell, P. H. (2015, December 10). Profit and Abuse at Homes for the Profoundly

Disabled. Retrieved October 25, 2017, from

https://newrepublic.com/article/125477/profit-abuse-homes-profoundly-disabled

Waldman, H. V. (2014, December 23). New York City Sends $30 Million a Year to

School With History of Giving Kids Electric Shocks. Retrieved October 25, 2017, from

https://www.propublica.org/article/nyc-sends-30-million-a-year-to-school-with-history-

of-giving-kids-shocks

Ward, L. (2006, March 10). Supporting disabled children and their families. Retrieved

October 25, 2017, from http://onlinelibrary.wiley.com/doi/10.1111/j.1099-

0860.1999.tb00134.x/full