Chris Landreth saw the report and could only shake his head.

Over a 2½-year period, the state of Maine failed to adequately monitor and hold accountable community-based providers who care for adults with developmental disabilities, a federal auditor concluded. Lax oversight by the Maine Department of Health and Human Services led to widespread safety concerns and instances of abuse, including numerous unexplained deaths, that went unreported or were never investigated.

Landreth and his wife, Sue, have long had concerns about her son’s care. Ethan Poulin is 24 and is diagnosed with autism spectrum disorder and intermittent explosive disorder. His intellect is roughly that of a 5-year-old and he is prone to hitting, both himself and others, when frustrated. He lives in a small group home in Auburn, his third such home in five years, and like hundreds of adults with disabilities throughout Maine receives care through Medicaid programs administered by the state.

From September through May of last year – an 8-month period – staff at Ethan’s group home in Auburn logged a total of 96 critical incident reports involving him, including six allegations of neglect, four medication errors, two suspected rights violations and two instances where Ethan was put in a dangerous situation. The rest were physical reports – where Ethan hit a staff member or himself.

Of all those reports, only two were ever examined by state officials and that only happened because Ethan’s family pressed the issue by filing grievances.

“The state simply has no quality assurance over any of its providers,” Landreth, Ethan’s stepfather, said from his home in Manchester. “Every time we visit Ethan, we have to police the place.”

Following the public release of the report by the U.S. Department of Health and Human Services’ Office of Inspector General, several families of adults with disabilities who are receiving care have contacted the Maine Sunday Telegram to discuss their experiences. Some, like Landreth, agreed to talk at length. Some said they feel fortunate that they haven’t experienced any problems. Others had concerns but did not want their names published because they feared that care might get worse if they did so.

‘THEY HAVE LOST THEIR WAY’

Advocates and some lawmakers are pressing DHHS for more answers and assurances that problems in the system are being fixed, but the department has sought to downplay the report’s findings. In a lengthy statement in response to the audit, DHHS officials agreed with some of the findings but said the problems were dated and overstated and have largely been remedied.

Shari Cochran Griffin felt the same lack of surprise as Landreth when she saw the recent story. Griffin thought of her own daughter, Brittney Ireland, who suffers from a rare, severe form of epilepsy. She can no longer walk or feed herself or go to the bathroom on her own. Brittney needs near-constant care – care that’s provided to her in Griffin’s home in North Yarmouth, mostly by Griffin herself with help from direct-care workers.

“There is no question in my mind that if she were living in a home, she’d be dead by now,” Griffin said in an interview last week, while Brittney watched Disney Junior cartoons from her wheelchair in the next room.

Griffin has not had to worry about whether her daughter is receiving proper care in a group home setting – the focus of the inspector general’s report. But she has experienced, for more than a decade, how bureaucratic roadblocks and incessant paperwork have threatened her daughter’s safety. Everything she has tried to get help with from the state – a new wheelchair, a safer bed, a ramp for their home – has been a struggle.

“I’m an advocate for my daughter, I always have been,” she said. “Anytime she was in school and they told me she couldn’t do something, I was like, ‘Oh, yes she can.’

“Now, I’m just trying to keep her alive, keep her safe. Why should that be such a fight?”