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Ohio's secret shame
'We haven't done the job'

By Debra Jasper and Spencer Hunt
Photos by Michael E. Keating

The Cincinnati Enquirer

63,000 people: Where they are
Ohio is supposed to watch over and protect 63,000 people with mental retardation. Where they are in the system:

At home with family: Most people live with their own families, but counties watch over them in special schools, adult day care and workshops that provide jobs. The state also helps families provide care for relatives, paying them anywhere from a few hundred to several thousand dollars a year, depending on their needs.

At home by themselves: About 5,000 people live in their own homes or apartments but receive government-funded nursing services, help with house cleaning and other support. Counties contract with private agencies to provide the services.

Group homes: About 3,000 people live in 250 residential group homes, which provide around-the-clock care. Most of these private homes house four to eight people each, although some have as many as 32.

Institutions: About 8,000 people live in 400 state-run institutions and private nursing homes for the mentally retarded.

These offer more intensive nursing services and are inspected annually by the state Department of Mental Retardation and state Department of Health.

- Debra Jasper and Spencer Hunt

Taxpayers spend $1.8 billion each year to protect and care for 63,000 Ohioans with mental retardation. They range from mildly retarded people who can live alone to adults so profoundly impaired they have the minds of 2-year-olds and require 24-hour care.

Most mentally retarded people live with their families or on their own. They go to government-provided childhood programs, adult day care or jobs at special workshops.

About 11,000 live in group homes and institutions that provide around-the-clock care.

To be sure, not all care is suspect. Many Ohioans live in well-maintained homes with supportive staff. They have access to medical specialists, jobs and recreational activities and go to ballgames and dances.

But thousands of people, caught in the mostly secret workings of overlapping state agencies and 88 county mental retardation boards, aren't so lucky.

Counties bear much of the burden for funding and oversight, but many are too poor to provide basic care and too overwhelmed to routinely check on people.

The state Department of Mental Retardation is supposed to make sure counties do their jobs. But the department is only now, after years of inattention, starting to analyze county reports of deaths, abuse and other serious incidents.

And the state Department of Health, which can cite facilities for failing to provide good care, rarely shuts down even those with repeated problems.

"Frankly, to my chagrin, we haven't done the job we could have," says Dr. Nick Baird, the department director. It is in this environment that overall numbers of deaths, abuse, neglect, accidents, hospitalizations and injuries have skyrocketed. State mental retardation officials say figures are up because they're pushing counties to report problems more truthfully.

But they refuse to reveal details behind the numbers, citing a state law that keeps incidents secret to protect mentally retarded people's privacy.

The law protects more than that: It shields from public view the way government officials investigate reports of deaths, abuse and neglect a process beset with problems.

Inquiries are conducted behind closed doors and results aren't made public, even after cases are closed.

Avoidable deaths >

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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