Texas families push for better oversight in group homes, institutions to prevent sexual assaults

From the Austin American-Statesman:

Austinite Gloria Culpepper says her oldest daughter has been tormented by nightmares because she was sexually assaulted last year by a fellow resident of
a Houston-area home for people with mental disabilities.

No rape exam was done until days after the incident, when the family obtained a kit, Culpepper said. By then, the results were inconclusive.

The state could not fully investigate possible abuse and neglect at the home because
of inconsistencies in Texas law regarding oversight of facilities for people with disabilities.

"We would have done additional investigation," said Department of Aging and Disability Services spokeswoman Cecilia Fedorov, but "we have no authority to do that."

As Texas scrambles to address problems that a federal inquiry identified at large, state-run institutions for people with mental disabilities, the Culpepper case suggests there's much less oversight of the 860 smaller, mostly privately run facilities serving a similar population. These state-licensed residences, known as intermediate care facilities, are home to about 6,500 Texans.

After the Justice Department reported in December that Texas' 13 institutions known as state schools fail to protect residents from harm, Gov. Rick Perry declared the issue a legislative emergency.

Some lawmakers say reforms shouldn't be limited to state schools and should include intermediate care facilities and home-based services.

"We must protect Texans no matter what setting they choose," said state Rep. Patrick Rose, D-Dripping Springs.

Texas law says the state is responsible for conducting abuse and neglect investigations at state schools, at assisted-living facilities and in a home-based program for people with mental disabilities.

But the private groups that run intermediate care facilities conduct their own investigations. The state checks to ensure they're following state and federal regulations, such as a requirement to protect residents during an investigation.

House Bill 1317 by Rose and others and Senate Bill 70 by Sen. Jane Nelson both seek to change that.

"We shouldn't have a facility investigating itself," said Nelson, R-Flower Mound.

The place where Culpepper's daughter lived for nearly 20 years — Willow River Farms — has intermediate care facilities and assisted-living facilities on the same property.

That complicated the state investigation because the state has the authority to investigate abuse and neglect at one but not the other.

Gloria Culpepper, 65, and her two younger daughters, Cory Culpepper, 32, and Kelly Culpepper-Penick, 40, say that should change. They said they are sharing their story because they want to urge the Legislature to make changes that could benefit others.

"Not only do we want to protect our precious sister and daughter, but we also want to protect everyone else out there," Cory Culpepper said.

Willow River Farms officials acknowledge that a sexual encounter took place but said it was consensual, something Culpepper — and her daughter's psychologist — say is impossible because of the daughter's disabilities.

Eva Aguirre, executive director of the Center Serving Persons with Mental Retardation, a Houston nonprofit that runs Willow River Farms, said the Culpepper case "is a far cry" from problems found in state schools.

She said Culpepper's daughter would often hold hands with a male resident and eat lunch with him.

"It appears to us ... that it was a consensual event between these two parties," Aguirre said. "Persons with intellectual disabilities do have the rights to have sexual relationships."

Aguirre also said Culpepper's daughter, who is 42, is a legally competent adult.

The Culpeppers dispute that and say they specifically told the Willow River Farms staff that their daughter and sister was not capable of making those kinds of decisions and should be protected from men.

Jonathan Morris, Culpepper's daughter's psychologist, said that the daughter "is definitely not capable of a consensual encounter like that. To call that consensual would be equivalent to somebody having sex with a 7-year-old and saying it was consensual."

Morris later said that Culpepper's daughter's mind is more like that of a 3-year-old.

Fedorov, the disability services spokeswoman, said that at state schools, there is no overall policy on sexual activity among residents but that it depends on each resident's level of mental abilities.

For Gloria Culpepper, Willow River Farms seemed ideal for her daughter, who loves to paint and had access to a workshop there.

Located 50 miles west of Houston near San Felipe, it features "cottage-style residences situated around a picturesque central courtyard near the banks of the Brazos River," according to its Web site.

On Oct. 24, a facility staffer alerted Gloria Culpepper to a possible sexual incident that might have taken place days earlier, Culpepper said. (She said the staffer told her a male resident came looking for her daughter, said she was his girlfriend and claimed to have had sex with her.)

The Culpeppers said it took them four more days of communication with law enforcement, hospitals and rape crisis centers — people kept saying they weren't trained to handle adults with disabilities — before they got a rape examination kit.

By then, the results were inconclusive, though Culpepper said she found bruises and teeth marks on her daughter's inner thighs.

"No one could give us any kind of direction," Cory Culpepper said. "We've felt very helpless in the whole situation."

Since the incident, they said, they've noticed the woman regressing. She lost control of her bowels. She seems nervous, distant and scared to be alone, they said.

"It's heartbreaking," said Gloria Culpepper, who moved her daughter
home to Austin after the incident.

State law limited what the Department of Aging and Disability Services could investigate. Its investigators did examine whether the entire facility followed state and federal regulations. They found that the facility did not and cited it for failing to investigate and report the incident.

Aguirre said that Willow River Farms was not aware of anything other than a consensual relationship, so there was nothing to report. "It's not that we sat on this information," she said.

But state investigators were allowed to examine whether only part of the facility — the part where Culpepper's daughter lived — neglected to properly protect residents. They were not allowed to investigate whether another part — where the male resident alleged to have been involved lived — neglected to protect residents.

It's unclear whether the outcome would have been different if the state had been allowed to fully investigate.

Fedorov said that investigators would have been able to ask more questions, for example, of employees working exclusively where the alleged perpetrator lived. Questions like: Were you supposed to be watching him? Was he allowed to leave the building? Did you know he left?

"We took every step that we had the authority to take," Fedorov said.

Culpepper's daughter told agency investigators that she did not know what sex was, according to the disability services department investigation report. When asked what the fellow resident did to her, she "stated 'kissed me' then touched her breasts and pointed to her pelvic area," the report said. "When asked if she was hurt, (she) nodded."

The male resident — who, records state, had a history of inappropriate behavior and verbal and physical aggression — told investigators that he had sex with Culpepper's daughter and that "she wanted to do it," according to state reports.

State investigators initially substantiated the allegation that the facility had neglected to protect residents, but after an administrative review, the finding was changed to "unsubstantiated."

"There was not sufficient evidence to validate either party's story any more than the other's," Fedorov said.

Last year, the state's intermediate care facilities reported 517 abuse- and neglect-related incidents to the Department of Aging and Disability Services, Fedorov said. She could not say how many of those were substantiated by the facilities. (She has the information available for individual cases but not aggregated, she said.)

Anecdotal evidence suggests that the Culpeppers are not alone in objecting to treatment at intermediate care facilities.

In 2007, a Dallas Morning News review of inspection and investigation reports on intermediate care facilities in the Dallas area found unsanitary living conditions, medical mistreatment and abuse by employees.

In one case, a resident of a private Denton County facility "was admitted to the hospital after employees found 30 maggots living in a wound on his head," the Morning News reported.

Though many of the facilities had clean records, others had problems, and just one intermediate care facility's license had been revoked in the previous five years, the story said.

In the Culpepper case, the Waller County sheriff's office conducted a criminal sexual assault investigation, and the district attorney, Elton Mathis, presented the case to a grand jury, which declined to issue an indictment.

"I definitely believe something happened," Mathis said. "It's just a sad situation from every angle."

He said the criminal case was complicated by the fact that the alleged perpetrator also had mental disabilities.

"If he didn't understand what he was doing was right or wrong, you have an issue there, too," Mathis said.

The Culpeppers said they weren't notified when the grand jury made its decision.

"They've had every single door slammed into their face since this happened," said the Culpeppers' attorney, John Ramsey of Houston. "The Culpepper family wants to prevent this from happening to anyone else."