Washingtonpost.com: Invisible Lives (2024)

The cost of this publicly funded system of care -- group homes, day treatment, medical services -- is about $100,000 per person per year. Elroy is one of the system's 1,100 current beneficiaries: retarded people who, for financial, developmental or other reasons, aren't being cared for by relatives and can't live on their own. Each is assigned to one of the city's 150 group homes, most of which are run on a for-profit basis by health care entrepreneurs. Some of the homes offer competent and affectionate care, city records and home visits indicate. But behind the nondescript doors of other group homes lives a reminder of why Victorian reformers erected vast asylums in the first place: to prevent abuse and exploitation of the retarded in a community's darker corners.

Presented with The Post's findings, city officials professed ignorance of many specifics but acknowledged systemic shortcomings such as poor monitoring, miscommunication among agencies and a failure to fine companies that neglect or mistreat the retarded. "The situation didn't get this way overnight," said Department of Human Services Director Jearline F. Williams, who has overseen the agency since 1997. "And it's going to take some time to turn this around. But I assure taxpayers that there will be dramatic and visible improvements."

Elroy has endured the District's caretaking inadequacies since he was a toddler. The Post is withholding his last name for privacy reasons, because he has been sexually victimized. He lives in a group home run by entrepreneur Rollie Washington and his wife, Dorothy. Real estate records note that there are 11 bathrooms in the million-dollar Upper Marlboro "Manor Farm" where the Washingtons make their home. A city report recently noted that the home they provide for Elroy had no toilet paper. It did have vermin and broken furniture and, city records show, a long record of ill-serving its inhabitants. The Washingtons' company wasn't licensed to do business in the District from 1993 until late 1998, records show. Still, the city government paid their company millions of dollars over those six years for the services they provided Elroy and others.

The world of "simple" people is in truth a complicated place: Words elude, stories shift, times and places blur. But a tour of that world fixes one fact pretty firmly: Even people with IQs of 50 know this isn't the way life is meant to be.

The Altruist's Dream

For some of Elroy's friends, the policy revelation arrived too late: They left by way of Forest Haven's basem*nt morgue. But Elroy and a thousand others survived to reap the fruits of a federal lawsuit pressed since 1976 by the parents of several residents. In 1990, a judge began fining the city heavily to force a shutdown, and the Justice Department's Civil Rights Division joined the parents' suit, launching its own investigation of poor medical care at the asylum. Meanwhile, city and federal officials -- recognizing that the retarded can't defend their own civil rights and that many have been abandoned by their best protectors, their families -- erected a labyrinth of organizations and agencies to protect them.

Each retarded person would receive from the city an annual, individualized plan for therapy and services in a group home and in a separate day program. Ex-Forest Haveners would even be guaranteed a regular vacation. Court-appointed monitors and lawyers, trained personal advocates and other designated protectors would ensure that the city delivered this promised care.

But who exactly would take them in -- some drooling and vacant and crib-bound, a few given to eating their own clothes, none unmarked by their institutional experience? In the beginning, altruists stepped forward, as expected: groups like the religious, nonprofit Community of the Ark, which has operated two group homes in the District since the mid-'80s. In those Ark homes today, the walls blaze with the oil-paint issue of Saturday art classes at the Corcoran. A staff member flips flashcards to teach a resident her address. Another resident peels carrots and accepts congratulations on the second anniversary of his Arlington movie theater job. Then all gather for a pre-dinner prayer, at which well-groomed ex-Forest Haveners hold hands (and paws if you include the house cat, Milton) and sing:

Giving me the things I need
The sun and the rain and the apple seed.

This is what deinstitutionalization's dreamers had in mind. But of the thousand-plus ex-Forest Haven residents, the Community of the Ark could take exactly eight.

While there were other well-motivated group home operators, the District's system swiftly came to be dominated by firms with an interest in profit. Today, more than 80 percent of the group homes are run by for-profit providers, some of them attracted by the city's decision -- made under pressure of mounting federal court fines -- to pay rates as high as $500 a day per retarded client, among the most generous pay schedules in the country.

In their effort to expand the network of group homes quickly, city officials entrusted most of the oversight of the new contracts to an obscure unit of the Department of Human Services: the Mental Retardation and Developmental Disabilities Administration. But that office had little monitoring staff to ensure that the claims of would-be providers had some basis in reality. Moreover, many of the caseworkers directly charged with safeguarding group home residents were former members of the Forest Haven staff -- who, after years of spooning prunes or supervising calisthenics, had been haphazardly retrained and were now supposed to keep an accountant's eye on client funds and monitor medical treatment.

"In the early days, you could pretty much count on providers to be sincere about their commitment," recalls Vincent Gray, who headed the Department of Human Services when Forest Haven closed. "Then, as the dollars began to increase and the need for more homes began to increase, you began to see more people coming on the scene as a business venture. That became a serious problem. Those in it for financial gain needed much more sophisticated monitoring. But this was a system based on trust."

Running the system on trust reflected the philosophy of some advocates for the retarded, too. Desperate for the new system to succeed, they feared that criticism of the group homes could be misconstrued as an endorsem*nt of asylums. Betty Evans, mother of a young woman who died at Forest Haven and one of the lead actors in the federal suit, was one of many who urged restraint in publicizing troubles in the homes. "They may have problems," she recently told The Post, "but they're better than Forest Haven."

Into this fragile and forgiving civic infrastructure came entrepreneurs like Rollie Washington.

The Manor Farm

As Forest Haven was closing, Washington applied for and received generous federal Medicaid funding to set up homes for retarded people with medical needs. But Medicaid officials started disputing the quality of his services and billing practices. So Washington turned to the D.C. Department of Human Services, which decided he was qualified to care for a dozen of Forest Haven's healthier cases, including mildly retarded Elroy.

The Washingtons' group homes claimed to provide special care for some of the many ex-Forest Haveners who had emotional or behavioral troubles. But before long, records show, city health inspectors were expressing dissatisfaction with what they saw of that care: poor physical conditions the Washingtons were slow to correct and required treatments the residents weren't getting. So, in early 1996, city health inspectors urged that Elroy's home and another one Washington and his wife run be closed because of care so inadequate that its residents were judged to be in danger.

Over the following two years, a federal court monitor urgently petitioned city agencies to protect the residents. But it wasn't until late 1998, 2 1/2 years after health inspectors requested the closure, that city enforcement lawyers met with a representative of the Washingtons' company to discuss problems at the homes. The District's lawyers subsequently declared past concerns allayed -- just days before health inspectors, prompted by The Post's inquiries, returned to the homes and found and reported a level of neglect and squalor they termed "life-threatening."

In interviews, Rollie Washington declined to review documents calling his homes "deplorable" and said the city hadn't complained to him about problems in them. While he refused to discuss the specifics of his contracts, he said he provides services that meet or exceed city requirements. "If I wasn't doing what I should be doing," he said, "why would they have done business with me all these years?"

The Department of Human Services acknowledged that "it is conceivable" that it gave the Washingtons contracts while "failing to scrutinize or question the absence of other documentation," such as licenses to do business in the city. But the department did more for the Washingtons than pay their company at least $4 million during the six years it wasn't licensed. Year after year, the department has also decided that the best "therapeutic vocational training" for several of the city's dependents is mucking out the stables and mowing the lawns at the Washingtons' "manor farm," where the couple breeds thoroughbreds to sell or race at a Bowie track. With the department's permission, these retarded farm workers last year earned, for five-hour days, five days a week, $5 or less a day.

City records show that last year, the Washingtons received an additional $180,000 in public money for providing this "day program."

Under the law, mentally retarded workers may be paid less than the minimum wage for work done as part of a treatment or job-training program. But in the early '90s, Human Services officials raised questions about the possible exploitation of the Washingtons' farm workers and the accuracy of claims about the therapies for which they were billing. A 1994 department investigation called for immediate improvements in services and conditions. Agency records indicate that trained monitors never returned to see whether improvements had been made. Instead, the government relied for information about the well-being of the workers primarily on the monthly reports of a therapist paid by the Washingtons. Rollie Washington declined to say how often the therapist was on the farm.

"I believe in reality therapy," said Washington, who notes that he recently confiscated one of his ward's shoes to keep him from running away. "If you do something wrong, you are going to have to be dealt with."

Reality: a bone-chill morning at the Washingtons' estate. At the manor house, up past the paddocks, Rollie Washington is talking with his lawyer. Down another road, Elroy's housemate DeWitt Stith labors beside a deaf-mute man who lives in another group home run by the Washingtons. They are cleaning stables in unsupervised silence. Startled by visitors, the deaf man brandishes his shovel. But gray-haired Stith sprints over, shedding his dung-smeared gloves. Stith, 52, has been laboring at this farm since 1991, despite his thick-tongued objections: "Work too hard." "Mr. Washington play too rough."

City officials say that Stith needs to be isolated at the farm because he behaves inappropriately in social settings and that he is receiving socialization therapy while training for free-market work as a stable hand. But therapists aren't in evidence. And the career ladder is equally hard to perceive: Stith has "apprenticed" at shoveling and other menial tasks five days a week for seven years. In those seven years, city officials have noted frequently in case files their plans to find Stith better day program options. They declined to produce for The Post any documents showing that such options have been pursued. Department of Human Services officials acknowledge that, because of budget and staff cuts, they have not monitored the farm program, or many other day programs for the retarded, for four years.

In minutes, Rollie Washington will speed to the stables and order Stith back to his low-paid labor. But for now, Stith believes that the visitors have come to liberate him from the farm -- free him to go, instead, to a sheltered workshop he's heard about. Elroy, he hopes, will work there, too. Together, they'll learn to make furniture. At the idea of this imaginary rescue, a toothless smile breaks over Stith's face.

"Today," he says happily, inaccurately -- "today is my last day on the farm!"

Elroy's Despair

In 1997, D.C. Medicaid officials decided he wasn't sick enough to rate the expensive treatment he had theoretically been getting at a home operated by a nonprofit company. So the Department of Human Services sent the man to the Southeast home, where monitors and inspectors regularly decried a lack of services and therapy.

Before long, in the bathtub, in the basem*nt, in bedrooms across the house, the man regressed to compulsive sexual behavior, according to city records and interviews with residents, staff and Rollie Washington. "He'd even come after people when they went to use the bathroom," Washington says. "The whole house went crazy."

Elroy, besieged by constant demands to participate in what the new housemate called "digging," couldn't even escape during the day. The predator, as city documents call him, worked beside him in a job-training program at a nursing facility. Elroy grew suicidal, telling staff and relatives that he was going to get AIDS and burn in hell. In 1995, while in the group home's care, he had been run over by a car on Minnesota Avenue, breaking an arm and a leg. Now, announcing his desire to die, he flung himself into the middle of the street on purpose.

He put a fist through a windowpane. He smashed his own glasses, without which -- given blindness in one eye and glaucoma in the other -- he was virtually helpless. Worried about his self-destructive behavior, his day program suspended him from its apprentice cleaning crew, a job that the meticulous Elroy had loved. He spent the next six months, while the city looked with little apparent urgency for a new day program, riding around the District in a van that delivered his housemates to their day programs. Then he went home to sitcoms and some strange televised proceedings regarding Bill Clinton and "Monica Melinsky."

The Absent Protectors

The Mental Retardation and Developmental Disabilities Administration is the city agency chiefly responsible for making Elroy's world safe. But records turned over to The Post indicate that there were only two visits to Elroy's home by monitoring staff between 1995 and 1998. City officials privately note that there was a practical reason for casting a blind eye: During the District's mid-decade budget crises, those who served the retarded were often viewed as non-priority creditors. The Washingtons and other companies had to wait months for their promised payments, giving the District little leverage in demanding quality care.

The Department of Health also was supposed to look out for Elroy, investigating complaints and enforcing minimum safety and treatment standards at his and other group homes. But as the men suffered, their putative inspectors were otherwise engaged. Department of Health officials say that in 1997, they detailed most of the inspectors of homes for the healthy mentally retarded to child-care centers, following a Post report about life-threatening conditions in those facilities. For more than a year, Health Department officials acknowledge, many of the 33 group homes for the high-functioning retarded -- as well as the city's 170 group homes for the mentally ill and the elderly -- went virtually unmonitored.

Even when agencies do investigate reports of abuse in group homes, they often don't get very far. Homes often attribute bruises and bloody lips to accidents or self-mutilation. Rapes get described as consensual sex. Those explanations may in some cases be accurate. But when they aren't, the few clients competent enough to describe what happened may choose, as Elroy does, not to make waves. "I don't think on the negative stuff," he says. "Although I might get hit by a car sometimes," he adds with what sounds like hope.

Advocating on behalf of a reluctant or incapable client: This is where certified personal advocates were supposed to come in. District law mandates that a trained volunteer be assigned to every retarded person in the custody of the city: to visit the group homes and day programs regularly, to listen to the retarded and to convey what they see and hear to city and court authorities. But the once-vibrant advocates program has foundered. There are currently 148 certified advocates, which works out to about one for every seven retarded wards. And many of those certified advocates are inactive. (Two-hundred of the District's group home residents aren't promised an advocate at all because they haven't been officially committed to the city's care; they've been "assigned" to the system by relatives or have entered voluntarily.)

"When you have a system with so many structural problems," says John Connelly, a veteran lawyer for the retarded, "it's even more critical to have people with a genuine interest in the retarded coming in, looking with fresh eyes. But I haven't seen an advocate in years."

In addition to individual advocates, the federal court employs a nonprofit group as a "special monitor" to make sure that Elroy and the other surviving Forest Haveners are getting the services promised to them when the institution closed. Since 1995, that monitoring agency -- the District of Columbia Arc Inc. (not to be confused with the Community of the Ark) -- has sent Human Services officials, health inspectors and court representatives numerous urgent missives about the Washingtons' homes, detailing "serious questions of institutional neglect" and "serious concern" for the health and safety of residents. These chronicles of maltreatment do not include the havoc created by the sexual predator, about which the monitoring agency failed to learn.

But city officials are often slow to address the quality problems the monitor finds. And while the federal court can fine the District for failing to provide decent services, the plaintiffs in the Forest Haven case have pressed the court much harder on the issue of timely payments to providers, some of which are shoestring nonprofits. In the '90s, judges have fined the city stiffly for being late with payments to operators such as Rollie Washington. But they've never assessed a fine for poor treatment of the retarded.

The staff of Elroy's group home didn't inform city authorities of a crisis at the home until about six months after the predator's arrival, city records show. Residential director Tom Roberson says the staff initially considered the sex consensual. Then, he says, "we waited to see if [the predator's behavior] was an aberration." The home finally informed the Department of Human Services in April 1998, but the city took no action to rescue Elroy and his housemates. Nor did it in May, when city records indicate that the predator's behavior had become so uncontrolled that he had to be taken to D.C. General Hospital's Emergency Psychiatric Response Unit -- where he was evaluated and returned home to the room next to Elroy's. For the next two months, the acts that city officials summarized as "threats to harm himself and others, and persistent sexual advances" escalated. They also increasingly targeted Elroy, according to a graphic report the group home submitted to Department of Human Services officials.

But the department did not notify residents' families or court-appointed attorneys of the damage the predator was inflicting. And it waited until Aug. 31 to move him out of the home -- nearly a year after the attacks began, and five months after city officials learned there was a problem. One staff member describes those months like this: "so terrible, so sexualized, I dreaded going into the house."

Roberson concurs, laughing: "I mean, he was incessant. He could go forever. I told people, man, I want a prescription for whatever this guy's taking. This stuff is better than Viagra!"

Victim or Perp?

Stith repeatedly tried to escape from the home and his labor at the Washingtons' stables by standing in the street and faking seizures. Several times, these performances got him into a hospital, where he basked in the care of nurses until the group home staff found him and took him home. Once, he made his way to a police substation on Pennsylvania Avenue SE, where he lay on the ground by the entrance in the hope of getting an officer's attention. He was found, not by officers, but by a group home staff member. Returned, he grew defiant, violent -- once beating his roommate so badly the elderly man had to be hospitalized.

He was treated with the "reality therapy" of the farm, where -- despite his passionate protests during his annual assessment hearing last fall -- the city assigned him for another year.

The predator who hounded Stith now has a new residence: a home on 13th Street NW, where his room is down the way from a retarded man with stomach cancer.

Stith has a new residence, too: the D.C. jail. In January, he escaped the van that was taking him to the farm and traced a familiar arc of sexual abuse: The victim became an alleged perp. He was arrested a day later on a charge of molesting a 12-year-old retarded boy.

'We're All Scattered Now'

Elroy, that bit of a boy in outsize glasses, proudly leading the canteen cleanup crew.

DeWitt Stith, whom the other children chose on May Day to be the flag bearer. Who, asylum colors streaming, grinned and high-stepped his way across the grass.

Those kids are gone.

In the years after the asylum, some of Elroy and DeWitt's friends were helped, loved -- even transformed -- as were a retarded couple named Ricardo and Donna Thornton. After release from Forest Haven, they hooked up with one of the city's savviest advocates, a D.C. government retiree named Shirley Rees who sometimes walks the city's rougher neighborhoods looking for ex-Forest Haven residents who have chosen steam grates over group homes. She had the experience to truth-squad the system; the Thorntons had enough mental capacity to take advantage of opportunities called to their attention. Nowadays, the couple lives a life as beautifully dull as any other working couple's. They finish their jobs at a hospital and a public library and head home to a tidy subsidized apartment and their non-retarded 12-year-old son, Ricky, whose warmth and brightness have stretched their minds further.

The Thorntons have tried over the years to help lower-functioning Forest Haven friends squeeze similar help from the city. Tried to believe official assurances that life for the retarded would get better. But hope is sometimes hard to hold.

"We're all scattered now," Donna says. "More than likely, people are scared."

Donna starts many of her sentences with "more than likely." Retarded people can't always be certain that things are the way they seem. She wonders whether smarter people can make sense of what happened to the retarded after their liberation from Forest Haven.

A Saturday: Jittery Elroy travels across Southeast from his group home to the D.C. jail. A red pass lets you see a retarded man in an orange jumpsuit who sits in a fortified white cage.

Elroy has brought a greeting card for his friend DeWitt Stith. The guys in the house did their best to sign it. Its front, for some reason, is a smiley face.

Elroy and Stith converse disjointedly across a bulletproof divide. DeWitt doesn't mind the jail -- hash browns for breakfast, large-screen TV, no horse manure. Elroy does mind. It has taken his friend. In this mystifying world, he is even more alone.

Stith returns to his cell.

Elroy returns to his. Bible to stare at. Bedsheets to wash.

Tomorrow: Unexamined deaths and unchecked profiteering