In an effort to eliminate a massive backlog of maltreatment investigations, state regulators charged with protecting Minnesota's most vulnerable populations are suspending investigations of deaths at state-licensed facilities where no abuse is alleged.
The move is part of a broad series of measures designed to expedite maltreatment investigations at more than 8,800 state-licensed programs and facilities, such as child care centers, mental hospitals and homes for the disabled. Currently, the Minnesota Department of Human Services (DHS) violates state law by taking an average of seven months to complete an investigation of abuse or neglect instead of the required 60 days. The state is under legal pressure to reduce its more than two-year backlog of maltreatment investigations. In April, a federal judge ordered DHS to take action to improve the timeliness of maltreatment investigation reports.
"DHS must and can do better to continue to improve our handling of these important cases," DHS Commissioner Lucinda Jesson wrote in a May 15 letter to a federal judge.
But the agency's move to suspend investigations of certain deaths at state-licensed facilities has aroused concern from advocates and the chair of a key legislative committee that sets social service policy.
"Someone's eyes should be on those [death] cases," said Rep. Tina Liebling, DFL-Rochester, chair of the House Health and Human Services Policy Committee. "Many of these people are vulnerable and have no family members, so I'm not comfortable with no one taking an outside look at these cases."
While advocates agree the state could suspend certain death investigations, such as when an elderly person dies of natural causes, there are other deaths that warrant automatic scrutiny. In some cases, family of the deceased may not have enough information to allege maltreatment, which means an investigation might not be conducted under the new policy.
DHS Inspector General Jerry Kerber said the agency will review all deaths to determine the cause and if care was adequate. However, in a break with past policy, the agency will do only full-scale investigations in cases where the agency "has some reason to believe the death resulted from inadequate care." All deaths of children at state-licensed child care facilities will continue to be subject to full-scale investigations, he said.
"We are not ignoring any deaths, but we are cutting back on some of our public reporting," Kerber said. The office of the state Ombudsman for Mental Health and Developmental Disabilities also provides a layer of oversight, reviewing 800 to 1,000 death reports a year.
Timely investigations are considered an important safeguard against abuse and neglect. The longer a maltreatment investigation takes, the more likely it is that an abusive or neglectful caregiver will go unpunished, putting other people at risk of mistreatment. Lengthy delays can also deprive victims, their families and the wrongfully accused of the right to speedy justice.
In March, a court-appointed monitor overseeing the state's efforts to phase out the use of restraints in state-licensed facilities, criticized the timeliness of DHS's maltreatment investigations. The monitor found 14 percent of DHS maltreatment reports are completed within 60 days, as required; and 65 percent take longer than 120 days.
In one case, it took DHS investigators 452 days to determine whether a patient at Minnesota Security Hospital, the state's largest psychiatric hospital, was placed naked in seclusion for two days, before concluding that the findings were "inconclusive." In another case, it took investigators 375 days to determine that staff at the mental hospital neglected a patient who repeatedly rammed his head against a wall, causing his head to swell and turn purple.
"While there may be situations in which it is not possible to compete certain investigations within 60 days, there appears to be no reason for investigations to take hundreds of days," court monitor David Ferleger wrote in a March report.
The backlog of unfinished investigations has jumped, in large part, because of policy and legislative changes since the late 1990s that require DHS to determine who is responsible maltreatment and the steps to correct the abuse.
The suspension of certain investigations is one of several measures DHS has taken since January to reduce its backlog.
The agency is also cutting back on investigations of low-dollar thefts and writing abbreviated reports for non-complex cases.
The agency has reduced its backlog of maltreatment investigations lasting more than 60 days by more than 100 cases since March.
The agency's goal is to eliminate the entire backlog by the end of the year. "The law makes it clear that there's a timeline that's expected to be met," Kerber said, "so we're going to meet it."