07-05-2006, 08:39 AM
BROKEN HOMES
Dangerous clients plague care homes
By Michele R. Marcucci, STAFF WRITER
It took Nerissa Manalo almost a day to contact police after staff at one of the adult care homes she owns, GS Homes in Fremont, told her one of her clients may have sexually abused another in June 2003, Community Care Licensing records show.
The alleged perpetrator is a registered sex offender, something Manalo told licensing investigators she did not know until after she took him in. Even after she found out he was a convicted child molester, Manalo acknowledged, she failed to account for it in planning care for him, records show.The police detective who investigated the case said he believed the alleged victim was sexually abused, but that the department lacked the evidence it needed to make a case.
Still, licensing investigators substantiated a complaint saying that Manalo failed to ensure the safety of the alleged victim and failed to make a report to police in a timely manner.
A summary of a conference licensing officials held with Manalo afterward states a lack of supervision in the home led to the alleged abuse.
The former client accused in the case denies any abuse happened, both in licensing documents and in interviews. He is not being named in this article because he was not charged with a crime.
Manalo says that if anything did occur, it was consensual.
The incident helps illustrate a sea change in the types of developmentally disabled people the state is seeing, and the lack of resources many say these new groups of disabled people have.
Once, the community system was populated with people who had Down syndrome or a milder form of mental retardation. But now, state hospitals are closing and sending some of the system's more difficult clients into community care. This, coupled with a dramatic rise in the number of people with autism, means community care homes are being filled increasingly with people who have dangerous behaviors and, in some cases, criminal histories.
The current community system was not set up to deal with people who have behavioral challenges or a rap sheet. And there is no money to create the kinds of services those clients would need.
Caregivers who handle clients with violent propensities or a criminal background get no more training than those who work with people who have few behavioral challenges, state officials said.
Autistic clients — who are among the most challenging people to help — now make up about 15 percent of the clients that the system serves. About half the people now coming into the system are autistic, says Jim Burton, Regional Center of the East Bay's executive director. Ten to 15 years ago, they were probably 1 percent to 3 percent of the people the system served, he says.
"In my five years on the regional center board, autism rose 400 percent, just in our area," says Bob Perotti, onetime board president at the Regional Center of the East Bay and a current board member at The Independent Way in Oakland, which provides job training and other services for developmentally disabled people. "They put them in programs, they don't fit. The cost of autism programs is high. And there's no money to start new programs. It's a big problem. Where are they going to go?"
For now, care providers say people with autism and severe behavior issues are being placed into programs not tailored to their needs.
When it comes to autism in particular, the state is being "aggressive in identifying the tsunami that's coming and trying to get out in front of it," says Dale Sorbello, who briefly headed the state Department of Developmental Services.
The state is studying the problem and it has an autism initiative that, under the governor's proposed budget, would be expanded to train professionals to screen for autism, hand out information on how to work with autistic people and help families find information and services.
The state has a locked program at Porterville Developmental Center in Tulare County for people who are determined to be a danger to themselves or others, to which people can be referred either by the courts or a regional center. But the program, which can serve 288 adults and 25 adolescents, has a waiting list, state officials say.
Regional Center of the East Bay has set up crisis homes for people who have behavioral problems that need short-term attention, Burton says. But, even though they are paid more to provide care, they are not subject to any greater requirements than other homes, he says.
The crisis homes may not be any better equipped to deal with the problems as illustrated in a case found in licensing and police records.
Staff at Dayani No. 4 in Brentwood struggled with a violent client before locking him out of the home, and police told licensing workers they felt the client did not belong in the home, licensing records from July 2003 show.
Licensing officials cited the home, saying it did not have a male staffer on duty as required and that staff did not have the training they should have to handle potentially violent clients. The home's staff also had not reported the incident as required, licensing workers found.
The home's owner, Anoosh "Andy" Dayani, could not be reached for comment.
In the GS Homes case, the client accused of abuse was moved to another group home in Union City. He recently left that home, the home's owner says. The man claims he was abused there; the home's owner denies that charge, and says the client assaulted a caregiver and another client. The home's public licensing file did not contain a record of an abuse complaint.
Nerissa Manalo says the alleged abuse victim was capable of defending herself from an assault. She says licensing workers don't know the clients well enough to determine whether such an incident happened or not.
"Nobody knows (the clients) but the care providers themselves. I think we are just blamed for everything," Manalo says, referring further questions to her attorney.
A case in El Sobrante is another example of the difficult behaviors these homes are increasingly facing. In 2003, at Dell's Residential Home, licensing officials found that staff failed to properly supervise Patrick Bates, who was on probation for battering his girlfriend, court records show.
When Bates wanted to leave the home, he only had to sign out on a log the facility used to track his comings and goings. No staff went with him when he left, according to licensing inspectors.
The care home's staff had not planned for how they would manage his behavior issues or the terms of his probation as required, licensing inspectors found.
Bates wasn't performing his court-ordered volunteer work or attending all of his mandated anger management classes, according to a detailed quarterly report written by the care home's administrator, Tracy Mitchell, licensing inspectors. Mitchell did not return several calls seeking comment.
Bates has since left the home and has been in an out of jail, most recently for hitting his 1-year-old daughter over the head with a video game controller when she stood in the way of the television, court records show. For that, he was sentenced to 90 days in jail and three years' probation.
Bates's case manager, Amber Hellwig, defended Bates to the court, saying she didn't see him exhibit dangerous behavior during three meetings with him.
"I have seen him interact with his daughter in those meetings, and there were no signs of misconduct against her during those meetings," she wrote. "In our meetings, Patrick has expressed a desire to take care of his family, and seems to want to be able to support them in the best way possible."
Hellwig no longer works for the regional center. Efforts to locate Bates were unsuccessful.
Officials at Regional Center of the East Bay, which placed both men, say they forward information on clients — including a client's criminal history — to care providers who, after a trial visit, decide whether they can care for a client. They would not comment on the pair's specific cases.
But they admit that they don't always have that information. Before Megan's Law went into effect in 1996 and a statewide database on sex offenders was created — the information went on the Internet in late 2004 but was available in police stations before that — they might not have known about a client's offenses unless the client volunteered the information. The same holds true on criminal history, they say. They don't have access to criminal databases.
They say they don't have placement criteria specific to clients with criminal histories, or facilities set up specifically to handle them.
Despite the number of care home beds that are open — Burton says the Regional Center of the East Bay has hundreds — they admit that it can sometimes be hard to find the right place for a client, criminal history or not.
"We do have vacant beds. The question is, do we have an appropriate vacant bed? That's always a struggle," Burton says.
Care providers admit they sometimes take clients they can't handle, in order to fill an empty bed and pay their bills. State rates are based on having a full home, they say, with most homes containing six beds. And they can barely pay their bills on those, they say.
And some say they have received no response when calling the regional center about a placement that didn't work out. Often when the regional center has made a last-minute "emergency placement," they say, it leaves them without the time to properly review a client's paperwork. Other care providers say they do not call to complain at all, fearful they will not get any more clients.
And they say they sometimes have a hard time getting the help they need to properly care for a client, even though the Lanterman Act, which authorized community services for people with developmental disabilities, requires that a client's needs be met.
In the GS Homes case, Manalo told licensing investigators she had tried to evict the client accused of abuse twice, after she said he stopped taking the injections that he needed to control his sexual urges. (In an interview, he denied he needed the injections, though he did tell licensing investigators he took the shots monthly.) When he started taking them again, she gave up, she said.
Staff ratios for care homes such as GS Homes are supposed to be at least one staffer for every three clients, according to state law, and administrators at group homes are supposed to work there at least 20 hours a week. Manalo, staff and clients said, dropped by only to drop off groceries, pay staff and meet with clients' case workers. Manalo said she was at the home twice a week. She was not at the home when a reporter visited.
When police asked her why she didn't report the alleged attack earlier, Manalo told them she did not know what to do, licensing records show. She admitted not giving required mandated training to her staff that would have explained when they are required to report such an incident.
The man's regional center caseworker, Sheila White, defended him to police, saying, "He had been good for 10 or 12 years," according to the licensing report. Even though she didn't believe he was guilty, she planned to step up his supervision in the home.
"Where else can I put him?" she told police, according to licensing records.
Burton says regional center officials cannot comment on specific clients' cases.
Licensing officials cited Manalo for several deficiencies after the alleged incident, met with her to discuss it and pledged closer oversight of the home. They considered closing the home at that time, but didn't.
In May 2005, they started the legal process to close the home, after they found that unnamed staff there had locked a client in his room by tying a rope across his door to keep him from wandering into other clients' rooms and that the client had wounds the home's staff had no plans to treat.
A state official said they have since put together a proposed settlement plan to close the home.
Dangerous clients plague care homes
By Michele R. Marcucci, STAFF WRITER
It took Nerissa Manalo almost a day to contact police after staff at one of the adult care homes she owns, GS Homes in Fremont, told her one of her clients may have sexually abused another in June 2003, Community Care Licensing records show.
The alleged perpetrator is a registered sex offender, something Manalo told licensing investigators she did not know until after she took him in. Even after she found out he was a convicted child molester, Manalo acknowledged, she failed to account for it in planning care for him, records show.The police detective who investigated the case said he believed the alleged victim was sexually abused, but that the department lacked the evidence it needed to make a case.
Still, licensing investigators substantiated a complaint saying that Manalo failed to ensure the safety of the alleged victim and failed to make a report to police in a timely manner.
A summary of a conference licensing officials held with Manalo afterward states a lack of supervision in the home led to the alleged abuse.
The former client accused in the case denies any abuse happened, both in licensing documents and in interviews. He is not being named in this article because he was not charged with a crime.
Manalo says that if anything did occur, it was consensual.
The incident helps illustrate a sea change in the types of developmentally disabled people the state is seeing, and the lack of resources many say these new groups of disabled people have.
Once, the community system was populated with people who had Down syndrome or a milder form of mental retardation. But now, state hospitals are closing and sending some of the system's more difficult clients into community care. This, coupled with a dramatic rise in the number of people with autism, means community care homes are being filled increasingly with people who have dangerous behaviors and, in some cases, criminal histories.
The current community system was not set up to deal with people who have behavioral challenges or a rap sheet. And there is no money to create the kinds of services those clients would need.
Caregivers who handle clients with violent propensities or a criminal background get no more training than those who work with people who have few behavioral challenges, state officials said.
Autistic clients — who are among the most challenging people to help — now make up about 15 percent of the clients that the system serves. About half the people now coming into the system are autistic, says Jim Burton, Regional Center of the East Bay's executive director. Ten to 15 years ago, they were probably 1 percent to 3 percent of the people the system served, he says.
"In my five years on the regional center board, autism rose 400 percent, just in our area," says Bob Perotti, onetime board president at the Regional Center of the East Bay and a current board member at The Independent Way in Oakland, which provides job training and other services for developmentally disabled people. "They put them in programs, they don't fit. The cost of autism programs is high. And there's no money to start new programs. It's a big problem. Where are they going to go?"
For now, care providers say people with autism and severe behavior issues are being placed into programs not tailored to their needs.
When it comes to autism in particular, the state is being "aggressive in identifying the tsunami that's coming and trying to get out in front of it," says Dale Sorbello, who briefly headed the state Department of Developmental Services.
The state is studying the problem and it has an autism initiative that, under the governor's proposed budget, would be expanded to train professionals to screen for autism, hand out information on how to work with autistic people and help families find information and services.
The state has a locked program at Porterville Developmental Center in Tulare County for people who are determined to be a danger to themselves or others, to which people can be referred either by the courts or a regional center. But the program, which can serve 288 adults and 25 adolescents, has a waiting list, state officials say.
Regional Center of the East Bay has set up crisis homes for people who have behavioral problems that need short-term attention, Burton says. But, even though they are paid more to provide care, they are not subject to any greater requirements than other homes, he says.
The crisis homes may not be any better equipped to deal with the problems as illustrated in a case found in licensing and police records.
Staff at Dayani No. 4 in Brentwood struggled with a violent client before locking him out of the home, and police told licensing workers they felt the client did not belong in the home, licensing records from July 2003 show.
Licensing officials cited the home, saying it did not have a male staffer on duty as required and that staff did not have the training they should have to handle potentially violent clients. The home's staff also had not reported the incident as required, licensing workers found.
The home's owner, Anoosh "Andy" Dayani, could not be reached for comment.
In the GS Homes case, the client accused of abuse was moved to another group home in Union City. He recently left that home, the home's owner says. The man claims he was abused there; the home's owner denies that charge, and says the client assaulted a caregiver and another client. The home's public licensing file did not contain a record of an abuse complaint.
Nerissa Manalo says the alleged abuse victim was capable of defending herself from an assault. She says licensing workers don't know the clients well enough to determine whether such an incident happened or not.
"Nobody knows (the clients) but the care providers themselves. I think we are just blamed for everything," Manalo says, referring further questions to her attorney.
A case in El Sobrante is another example of the difficult behaviors these homes are increasingly facing. In 2003, at Dell's Residential Home, licensing officials found that staff failed to properly supervise Patrick Bates, who was on probation for battering his girlfriend, court records show.
When Bates wanted to leave the home, he only had to sign out on a log the facility used to track his comings and goings. No staff went with him when he left, according to licensing inspectors.
The care home's staff had not planned for how they would manage his behavior issues or the terms of his probation as required, licensing inspectors found.
Bates wasn't performing his court-ordered volunteer work or attending all of his mandated anger management classes, according to a detailed quarterly report written by the care home's administrator, Tracy Mitchell, licensing inspectors. Mitchell did not return several calls seeking comment.
Bates has since left the home and has been in an out of jail, most recently for hitting his 1-year-old daughter over the head with a video game controller when she stood in the way of the television, court records show. For that, he was sentenced to 90 days in jail and three years' probation.
Bates's case manager, Amber Hellwig, defended Bates to the court, saying she didn't see him exhibit dangerous behavior during three meetings with him.
"I have seen him interact with his daughter in those meetings, and there were no signs of misconduct against her during those meetings," she wrote. "In our meetings, Patrick has expressed a desire to take care of his family, and seems to want to be able to support them in the best way possible."
Hellwig no longer works for the regional center. Efforts to locate Bates were unsuccessful.
Officials at Regional Center of the East Bay, which placed both men, say they forward information on clients — including a client's criminal history — to care providers who, after a trial visit, decide whether they can care for a client. They would not comment on the pair's specific cases.
But they admit that they don't always have that information. Before Megan's Law went into effect in 1996 and a statewide database on sex offenders was created — the information went on the Internet in late 2004 but was available in police stations before that — they might not have known about a client's offenses unless the client volunteered the information. The same holds true on criminal history, they say. They don't have access to criminal databases.
They say they don't have placement criteria specific to clients with criminal histories, or facilities set up specifically to handle them.
Despite the number of care home beds that are open — Burton says the Regional Center of the East Bay has hundreds — they admit that it can sometimes be hard to find the right place for a client, criminal history or not.
"We do have vacant beds. The question is, do we have an appropriate vacant bed? That's always a struggle," Burton says.
Care providers admit they sometimes take clients they can't handle, in order to fill an empty bed and pay their bills. State rates are based on having a full home, they say, with most homes containing six beds. And they can barely pay their bills on those, they say.
And some say they have received no response when calling the regional center about a placement that didn't work out. Often when the regional center has made a last-minute "emergency placement," they say, it leaves them without the time to properly review a client's paperwork. Other care providers say they do not call to complain at all, fearful they will not get any more clients.
And they say they sometimes have a hard time getting the help they need to properly care for a client, even though the Lanterman Act, which authorized community services for people with developmental disabilities, requires that a client's needs be met.
In the GS Homes case, Manalo told licensing investigators she had tried to evict the client accused of abuse twice, after she said he stopped taking the injections that he needed to control his sexual urges. (In an interview, he denied he needed the injections, though he did tell licensing investigators he took the shots monthly.) When he started taking them again, she gave up, she said.
Staff ratios for care homes such as GS Homes are supposed to be at least one staffer for every three clients, according to state law, and administrators at group homes are supposed to work there at least 20 hours a week. Manalo, staff and clients said, dropped by only to drop off groceries, pay staff and meet with clients' case workers. Manalo said she was at the home twice a week. She was not at the home when a reporter visited.
When police asked her why she didn't report the alleged attack earlier, Manalo told them she did not know what to do, licensing records show. She admitted not giving required mandated training to her staff that would have explained when they are required to report such an incident.
The man's regional center caseworker, Sheila White, defended him to police, saying, "He had been good for 10 or 12 years," according to the licensing report. Even though she didn't believe he was guilty, she planned to step up his supervision in the home.
"Where else can I put him?" she told police, according to licensing records.
Burton says regional center officials cannot comment on specific clients' cases.
Licensing officials cited Manalo for several deficiencies after the alleged incident, met with her to discuss it and pledged closer oversight of the home. They considered closing the home at that time, but didn't.
In May 2005, they started the legal process to close the home, after they found that unnamed staff there had locked a client in his room by tying a rope across his door to keep him from wandering into other clients' rooms and that the client had wounds the home's staff had no plans to treat.
A state official said they have since put together a proposed settlement plan to close the home.