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Who's accountable?

By Spencer Hunt and Debra Jasper
The Cincinnati Enquirer

Taxpayers spend $1.8 billion in Ohio each year on a state mental retardation system that routinely fails to prevent deaths, act on problems or enforce minimum standards of care. Who's in charge:

Ohio Department of Mental Retardation: It has ultimate responsibility. It inspects public institutions and nursing and group homes, and it's supposed to monitor all 88 county boards of mental retardation. However, the department has been so lax that it only began last year to analyze county reports of abuse, neglect and accidents. The department also just started accrediting counties, but last year visited only about two homes of mentally retarded people in each county.

Director Ken Ritchey reports directly to Gov. Bob Taft, who appointed him in 1999. Mr. Ritchey acknowledges widespread problems: "We need a stronger approach."

The Ohio Department of Health: It annually inspects 400 institutions and nursing homes for the mentally retarded. It has the power to cut off funding to troubled homes, but rarely does. It wants authority to fine facilities instead. Says agency director, Dr. Nick Baird: "We're given pretty restricted tools with which to work."

County Mental Retardation Boards: Each of 88 counties monitors group homes and contracts for services for people in their own homes. However, there are no timetables for checking on people, and oversight is spotty or at times non-existent. Counties also investigate unusual incidents and deaths, but their reports to the state often lack essential details. Counties are empowered to take people from homes if they're being abused or neglected, but it's unknown if they do because they work in secret.

Hamilton County has one of the best boards in the state. It's the only one to hire an outside agency to visit mentally retarded people to make sure county workers do their jobs.

"It's very easy to get tunnel vision. Outside people can say, 'This is a serious situation,' " county superintendent Cheryl Phipps says.

Mortality Review Committee: This year-old panel of state agency officials and advocates reviews every death in the mental retardation system. But the committee works in secret, and details from counties are often so sketchy that assessments are hard to make.

"I've seen instances where we don't have a good idea of why a person died," says committee member Dr. Andrew Eddy, medical director for the Mental Retardation Department. "If the coroner isn't called, there is nothing we can do about it."

County coroners: They aren't required to investigate anything except the death of any child under 2 years of age. Whether autopsies are performed varies from coroner to coroner, county to county. In Fulton County, Dr. Eddy pleaded for an autopsy to learn why a 13-year-old, mentally retarded girl died unexpectedly in June 2000. County coroner Benjamim H. Reed refused: "As far as I can remember, there wasn't anything suspicious."

Police: The Ohio State Highway Patrol investigates deaths and crimes at state institutions. Local police investigate crimes in private and county-run homes. Arrests and convictions are difficult, however, because homes do minimal investigations and victims often can't speak for themselves.

"Even if you know for certain something happened, if you have a story from a victim who isn't credible, it doesn't work," Columbus Police Detective Monique Shafer says.

Ohio Legislature: Neither the Senate nor the House has a committee overseeing the mental retardation system. Mental retardation issues are addressed in any of four or five committees, depending on topic.

Inside the Report
Failing the fragile
Ohio is supposed to care for 63,000 people with mental retardation but the system is failing.

Twelve who died
Our investigation found a dozen questionable deaths and there could be more.

Unequal system
The kind of care mentally retarded people get depends largely on where they live.

Who is accountable?
The agencies and departments charged with enforcing minimum standards of care.

Slow reform
The agencies and departments charged with enforcing minimum standards of care.

Take control
How to make sure a person with mental retardation is well cared for and safe.

Photographer's album
A visual journey into the lives of Ohio's mentally retarded.

Ohio's Secret Shame

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