Advocates for the disabled are hopeful that legislation passed by the General Assembly will give Maryland regulators more tools to fix dangerous conditions at state-licensed facilities — such as the one where a 10-year-old Baltimore boy died last year.
The two bills — the most recent of several reforms enacted after a Baltimore Sun investigation into group homes — empower regulators to respond more aggressively when they find problems at such facilities. The reforms are designed to improve how regulators monitor the financial stability and health care quality of state contractors hired to care for disabled adults and children.
One bill, introduced by Del. Samuel I. "Sandy" Rosenberg at the request of the Maryland Disability Law Center, authorizes regulators to order immediate remedies to unsafe conditions without waiting to provide notice, and to suspend a license if fixes are not implemented. The second bill, introduced by the health department, allows regulators to impose a new $5,000 civil fine against providers that violate rules.
Rosenberg and a law center official said the bills were prompted by a 2014 Sun investigation that detailed oversight lapses of LifeLine and Second Family, the state's two top operators of group homes for disabled foster children.
Damaud Martin died at LifeLine's Laurel-area group home on July 2, more than a month after regulators had identified major issues at the company. Problems included questionable medical care, a founder imprisoned for arson, unpaid taxes and police reports of abuse and neglect unknown to regulators.
"We would hope that if this horrible circumstance arises again that this legislation would enable [the state health department] to act more promptly and hopefully save a life, which it was unable to do in the story of Damaud Martin that The Sun wrote about," Rosenberg said.
The state medical examiner has said the boy's death was ahomicidecaused by severe head injuries suffered years ago, before he was in LifeLine's care. Health inspectors cited the company for violations of state regulations related to his care but did not find that LifeLine's services caused the death. Officials at LifeLine, which has shut down its group homes for children, could not be reached for comment.
Second Family had its own problems. It fired two employees in 2014 for slapping, kicking and pushing a mute, autistic child. Another employee was fired July 16 and the company was cited for neglect after a disabled child rolled off a bed whose side rail had been left down. The state also cited Second Family for failing to train its nurses to care for the eight LifeLine children who were relocated to its facilities after Martin died; four of the children ended up in emergency rooms.
Second Family officials did not respond to requests for comment, but the company has retained state contracts by complying with regulatory orders to correct problems.
The two legislative measures, passed in the final days of the 2015 General Assembly session that ended Monday, would give the state "new authority to protect people with developmental disabilities," said Nancy Pineles, managing attorney for the Maryland Disability Law Center, the state's federally designated advocate for people with disabilities.
"The new powers, to order protective action in emergencies and to issue fines, are needed when people are at risk of harm from dangerous conditions," Pineles said in a statement. "However, these statutory enhancements will not substitute for close monitoring and active enforcement of rules intended to protect vulnerable people with developmental disabilities."
She said the state has "long lacked the capacity to adequately monitor providers and enforce safety requirements, though a modest increase in staff was appropriated this year after The Baltimore Sun exposed serious problems with the monitoring of LifeLine."
Bernard Simons, deputy health secretary for developmental disabilities, said the department's bill establishes a $5,000 penalty that will help to deter providers from violating state rules or delaying remedies. Another section, which tightens the screening of applications from all providers, will help the state flag problematic providers that are seeking licenses, he said.
Simons said the legislation fulfilled the pledge for improved oversight that former health secretary Dr. Joshua M. Sharfstein and former human resources secretary Ted Dallas made to lawmakers last summer at an Annapolis hearing. That hearing was convened to discuss problems at LifeLine that were detailed by The Sun.
State health officials did not oppose Rosenberg's bill but did not formally support it, either. They said in hearings that they believed they already had authority to suspend licenses. The bill notes, however, that the health department did not suspend any licenses last year.
"If they believe they have the authority, they have not exercised it," Pineles said. "We want people to be protected from harm whenever the state sees that it's necessary. If they find a serious problem by a provider agency, then that problem has to be corrected so that no one else is harmed."
Since The Sun's investigation was published, the health department and the Department of Human Resources, which awards group home contracts, have implemented new financial monitoring to spot fiscal problems before they affect the quality of health care. In January, the state also hired a company to assess staff training at group homes for disabled foster children. There are currently about 40 children in those homes.
The health department in October issued five recommendations to improve oversight of group homes for disabled foster children, including the hiring of an additional person to coordinate oversight of such facilities. Other fixes involved improving communication between the health and human resources departments.