This guide describes the Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI), which uses a prosecution-based multidisciplinary team approach to address abuse committed against persons with disabilities. Developed in Massachusetts, BPI links law enforcement officials, prosecutors, adult protective and human services workers, self-advocates, and others in the team approach. It has revolutionized the way to recognize, report, investigate, and prosecute crimes against victims with disabilities and is founded on a simple principle: we must ensure equal and effective access to the criminal justice system for persons with disabilities.

As part of a pilot project, three states have already replicated BPI. Other states may use this replication guide of recommended practices, modeled on the Massachusetts BPI, to develop, implement, and successfully maintain their own multidisciplinary partnerships.

Prevalence of Abuse
Risk Factors for Abuse
Challenges Victims Face
Reporting Requirements and Systemic Barriers

Development Stage

Investigations Advisory Panel
Implementation Committee

Implementation Stage

Formation of a Steering Committee
Creation of a Memorandum of Understanding
Implementation of Training Curricula
Recognition of Legislative Limitations
Development of a Public Awareness Campaign
Summary

Pilot Replication Sites

Delaware
Ohio
Oregon

Components of a Successful Replication

Level of Interest
Steering Committee
Memorandum of Understanding
Training
Evaluation
Summary

Conclusion
Resources

Adult Protective Services in Massachusetts
Sample BPI MOU
References

About This Guide

Overview

This state-level replication guide is intended for use by law enforcement personnel, prosecutors, adult protective and human services workers, and others who are responsible for the safety and protection of persons with disabilities who are victims of crime.

The authors recognize that the size of an agency, availability of resources, reporting requirements, and level of expertise vary greatly from jurisdiction to jurisdiction. As such, readers of this guide may decide to develop additional trainings, share resources, form partnerships with neighboring jurisdictions, and/or seek additional funding. Many agencies already have programs to assist persons with disabilities who are victims of crime. After reading this guide, these agencies may determine that they need to improve both their training and policies and may use the guide as a justification for strengthening their resources.

Jurisdictional, logistical, or legal conditions may preclude the use of particular procedures contained herein. The authors encourage all readers to develop and continually update their knowledge, skills, and abilities with respect to recognizing, reporting, investigating, and prosecuting crimes committed against persons with disabilities. In addition, all readers should become familiar with the Americans with Disabilities Act of 1990, as amended; section 504 of the Rehabilitation Act of 1973; and other disability rights laws and regulations.

Acknowledgments

The steering committee of the Massachusetts Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI) wishes to acknowledge the many individuals and organizations of BPI for their interest, involvement, and expertise in developing and implementing BPI since 1999. Replication of BPI would not have been possible without the commitment of each of the multidisciplinary team members successfully participating in the initiative across the Commonwealth of Massachusetts, from small rural townships to large metropolitan areas. Their unwavering support and guidance through the development and implementation stages have enhanced the lives of persons with disabilities by ensuring that suspected criminal activity is recognized, reported, investigated, and prosecuted efficiently and effectively. The steering committee wishes to thank OVC for funding this guide, especially Joye Frost, Acting Director, and Jasmine D'Addario-Fobian, Victim Program Specialist, who provided support throughout production of the guide.

Executive Committee, Massachusetts BPI

Elizabeth D. Scheibel, Esq., Cochair
District Attorney (ret.)
Northwestern District

Jonathan W. Blodgett, Esq.
District Attorney
Essex County

Nancy A. Alterio, Cochair
Executive Director
Disabled Persons Protection Commission

Elin M. Howe
Commissioner
Department of Developmental Services

Steering Committee, Massachusetts BPI

Ed Bielecki
State Coordinator
Massachusetts Advocates Standing Strong

Lester Blumberg
General Counsel
Department of Mental Health

Sabrina Cazeau-Class
Director of Investigations
Massachusetts Rehabilitation Commission

Paul Dreyer
Director, Bureau of Health Care Safety and Quality
Department of Public Health

Elizabeth Dunphy Farris, Esq.
Legal Counsel to the District Attorney
Hampden County

Janet Fine
Executive Director
Massachusetts Office for Victim Assistance

Deborah Fogarty
Director of Protective Services
Executive Office of Elder Affairs

Sherman Lohnes
Director of Investigations
Department of Public Health

Anne Monti
Administrative Assistant
Building Partnerships Initiative

Bernard Murphy
Director of Investigations
Department of Developmental Services

Richard Nagle
Detective Lieutenant
State Police Detective Unit
Disabled Persons Protection Commission

Christopher Walsh
Chief, Medical Fraud Division
Office of the Attorney General

Mary Walz-Watson, RN
Sexual Assault Nurse Examiner Program

Geline Williams
Executive Director
Massachusetts District Attorneys Association

Foreword

The year was 1989. A 19-year-old man with an intellectual disability was placed alone on a bus in Louisiana by his mother. The young man, described by professionals as eager to please, compliant, shy, and lacking self-esteem, was leaving a life comprising years of sexual and physical abuse and deprivation. His destination was Massachusetts. Unbeknownst to all, he was en route to a world all too familiar to him—years of torture and torment at the hands of caregivers.

The young man arrived in Raynham, Massachusetts, and joined an older man with an intellectual disability and two self-designated "caregiver" brothers. Over the next 7½ years, the brothers physically and sexually abused both men and stole their social security checks. The legal status of the relationship between the younger victim and his abusers had been questioned, yet never resolved.

For several years, the brothers managed to evade legitimate inquiries by authorities. This was so even though the victims were observed in public with an offensive odor and wearing dirty clothes. According to witness reports, the older victim was attempting to retrieve food from a dumpster. He begged others, saying he was going to starve. Both victims tried to exchange personal items for food. The older victim's face was bruised and scraped and the younger victim's lip was cracked.

Numerous calls were placed to a hotline and to state and local law enforcement personnel about potential abuse, and school, banking, and community service officials observed indications of abuse and fraud. The abuse allegations, however, were never substantiated; this, although the older victim was hit in the face with a motor chain, blinding an eye and, when bruises became visible, was hit in the stomach instead. The older victim was also chained, screaming, to a hot radiator for more than a half hour, scarring his back, and his head was held submerged under water in a bathtub. Later, it was learned that the younger victim was missing. It was 5 months before he was found. He had run away. His flight brought the case to the attention of law enforcement officers who then investigated and, subsequently, executed a search warrant at the house. The brothers were arrested, charged with numerous offenses, and, ultimately, convicted for their crimes.

The year was 1997. The immediate threats to the victims were over. Although their house of horrors was behind them, the review of how the system had failed them had only just begun. No one knew, then, that this case would become the impetus for significant systemic change in Massachusetts.

Reasons To Act

Crimes committed against persons with disabilities are a frequently unrecognized and underreported problem that has reached epidemic proportions in the United States. The reasons for underreporting and inadequate investigations include a lack of awareness that a crime has occurred, lack of effective coordination between law enforcement and adult protective and human services agencies, and reluctance of police, prosecutors, and judges to rely solely on the testimony of a person with a disability.

Identifying and understanding the following issues allow jurisdictions to more effectively and efficiently address crimes of abuse:

Prevalence of Abuse

In 2008, according to the Bureau of Justice Statistics (Harrell and Rand, 2010):

Persons with disabilities were victims of approximately 40,000 rapes, 116,000 robberies, 115,000 aggravated assaults, and 459,000 simple assaults.
Approximately 15 percent of violent crime victims with a disability believed that they became a victim because of their disability.
Persons with disabilities experienced rates of violence at least twice as high as those experienced by people without disabilities.
Women with a disability had a higher victimization rate than men with a disability; men had a higher rate than women among those without a disability.
People with a cognitive functioning disability had a higher risk of violent victimization than people with any other type of disability.

The following facts, gathered from additional published studies and statistics, outline the incidence of crime committed against persons with disabilities:

In 2000, approximately 5 million crimes were committed against people with developmental disabilities in comparison to 1.4 million child abuse cases and 1 million elder abuse cases (Petersilia, n.d.).
More than 25 percent of people with severe mental illness had been victims of a violent crime during a single year, a rate more than 11 times higher than that of the general population, even after controlling for demographic differences (Teplin et al., 2005).
A study of North Carolina women found that women with disabilities were four times more likely to have experienced sexual assault in the past year than women without disabilities (Martin et al., 2006).
Only 3 percent of sexual abuse cases involving people with developmental disabilities will ever be reported (Valenti-Hein and Schwartz, 1995).

Risk Factors for Abuse

Persons with disabilities are particularly vulnerable to abuse and victimization due to their physical, intellectual, and emotional challenges and, in some cases, their dependence on others for basic needs. Success in identifying and intervening in situations that place persons with disabilities at risk requires an understanding of what makes them more vulnerable to becoming victims of crime, abuse, and neglect.

Common risk factors include the following; this list is by no means exhaustive:

Dependence on others for personal care; lack of control (physically, psychologically, intellectually/developmentally) over the nature of the care.
Socialized to accept being touched by anyone, especially someone labeled "staff."
Difficulty in differentiating between appropriate and inappropriate actions and therefore uncertain as to what constitutes abuse.
Difficulty in understanding the concept of strangers.
Difficulty in accepting the fact that someone they know would harm them.
Disadvantaged by level of sex education, if any.
Challenges regarding communication, including the difficulty of telling others about the abuse.
Lack of certified interpreters (e.g., American Sign Language interpreter, Certified Deaf Interpreter, Communication Access Realtime Translation provider).
Reliance on others for decisionmaking in their best interest.
Required, in a living or work situation, to be compliant; compliance is considered normal.
Ignored disclosures of abuse because they are made by a person with a disability (seen as less credible).
Failure to appreciate indicators of physical abuse, such as unexplained bruises being associated with the person's disability (e.g., history of self-injury).
Failure to appreciate secondary indicators of all types of abuse, such as impaired social interactions being associated with the person's disability (e.g., depression).
Failure to understand that persons with disabilities are harmed by abuse.

Challenges Victims Face

Identifying and understanding the unique challenges persons with disabilities face as victims of crime are critical to accurate recognition of, reporting of, and response to abuse.

These challenges may include the following:

Inability to adequately explain abuse due to the disability.
Intense feeling of fear, shame, or guilt.
Dependence on the caregiver/offender.
Beliefs that they will be blamed.
Beliefs that the abuser will retaliate or actual threats of further harm.
Lack of awareness of what constitutes abuse or neglect.
Lack of knowledge of the protocol for reporting abuse.
Fear of being left without a home or family.
Fear of losing custody of children.
Fear of not being believed.
Fear that freedom/independence will be lost if abuse is reported.

Reporting Requirements and Systemic Barriers

There may be a correlation between jurisdictional reporting requirements and the underreporting of abuse committed against persons with disabilities, low arrest rates, and/or ineffective prosecution of offenders.

In addition, some jurisdictions may have systemic barriers, including statutory or evidentiary rules, that prevent equal access to the courts for people with physical, psychological, or intellectual/developmental disabilities. Legislative reform can be a difficult process; however, change may be necessary. The mandatory reporting of abuse and knowledge of abuse reporting requirements are key. In addition, having access to the victim and his or her confidential and privileged information when abuse is reported is integral to understanding the systemic barriers that may impede equal access to the justice system by persons with disabilities.

A prosecution-based multidisciplinary team approach, linking the chief law enforcement officer in the jurisdiction to those partners who have a role in protecting persons with disabilities, can help make jurisdictions aware of the problem and prepare them to address factors that may affect victims' access to the criminal justice system.

Development Stage

Before the Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI), relationships between adult protective and human services agencies and law enforcement agencies in Massachusetts had, at best, been strained. In fact, with few exceptions, there was no relationship. The blame did not lie with any particular agency. There was a perception that adult protective and human services and law enforcement had competing interests. Other times, because of the lack of an established system of reporting, cases fell through the cracks. Some in adult protective and human services felt that law enforcement's main objective was to arrest and prosecute without regard for the needs of the victim or defendant. In addition, law enforcement agencies had been reluctant to investigate cases involving persons with disabilities because of the difficulties involved and the time it takes to investigate and successfully prosecute them.

The Raynham, Massachusetts, "house of horrors" case described in the Foreword and several other high-profile cases became the subjects of a Commonwealth investigation that culminated in a scathing legislative report (House Committee on Post Audit and Oversight, 1997). The report, which capped a multiyear review of the Department of Developmental Services (DDS) (then named the Department of Mental Retardation), found deficiencies in communication and serious problems with the department's investigations and its responses to abuse and client deaths. DDS, it was concluded, had lost sight of its mission—to focus on the health and safety of its clients.

This section covers the investigations advisory panel that was convened in response to the report and the implementation committee that was created to develop a multidisciplinary approach that would address the panel's recommendations. This approach later became BPI.

Investigations Advisory Panel

In June 1997, in response to the report, the recently appointed commissioner of DDS convened a multidisciplinary investigations advisory panel with representatives from the judiciary, law enforcement, academia, and families of clients from throughout the Commonwealth. The panel reviewed and evaluated DDS's investigations unit and its practices and procedures, including those regarding notifications to and coordination with local police and prosecutors.

Most of the problems hampering the effectiveness of DDS's investigations unit were found to be systemic in nature and included issues such as—

Confusion over which state agency had jurisdiction for a particular complaint.
Excessive caseloads for DDS investigators and poor relations between DDS and the Disabled Persons Protection Commission, an independent oversight agency with statutory authority to conduct adult protective services investigations.
Lack of a layered system prioritizing the most serious cases and the insufficient, untimely, and, in some cases, lack of referrals to the appropriate law enforcement and criminal justice authorities.
Absence of formal procedures and cooperative agreements with law enforcement agencies for managing and investigating complaints of criminal conduct.

The panel's recommendations focused on the screening and investigation of crimes committed against people with developmental disabilities. The recommendations presumed a strong risk assessment and protective services capacity to move swiftly, compassionately, and effectively to provide emergency protective services to people with developmental disabilities who are in at-risk or established risk situations. Recommended screening protocols included the following:

Identifying the specific information required for a complaint or referral.
Referring suspected felony abuse to law enforcement in a consistent and timely manner.
Creating criminal investigation teams within the DDS investigations unit to collaborate with law enforcement and criminal justice authorities in a manner comparable to investigations involving child sexual abuse.
Requiring DDS investigators to complete basic and advanced criminal investigations training.
Requiring law enforcement to attend basic or inservice training regarding adult protective services investigations and other disability-related issues pertinent to their work.

Implementation Committee

Using the panel's recommendations, the Massachusetts Secretary of Health and Human Services convened an implementation committee to develop and implement a coordinated, consistent approach to the investigation of cases involving persons with disabilities. It quickly became apparent to the committee that although the panel's recommendations pertained to DDS, they should also cover other agencies in the Commonwealth that work with persons with disabilities:

In so doing, the seeds of the statewide collaboration, to be known as BPI, were sown.

The committee implemented a new felony reporting protocol outlining the procedure for handling allegations of abuse of a person with a disability. In addition, the committee developed cross-discipline trainings to promote multidisciplinary collaboration and public awareness. BPI was created to coordinate these and other activities to address abuse committed against persons with disabilities. Through collaboration, BPI provides victims with disabilities the protection and services they need to pursue safe and healthy lives and enables communities to hold offenders accountable for their criminal behavior.

Implementation Stage

In developing the Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI), Massachusetts recognized that a multidisciplinary approach to protecting persons with disabilities would enhance their safety and well-being and provide the groundwork for effective prevention strategies.

Formation of a Steering Committee

The initial phase of BPI implementation included the formation of a steering committee. Recognizing the need to be inclusive, BPI leaders invited representatives from law enforcement, prosecution, all of the human service agencies that work with persons with disabilities, and adult protective services to form the steering committee. As work progressed and further needs were identified, additional steering committee members were added, including self-advocates and representatives from statewide victim services and additional state agencies. (Self-advocates are persons with disabilities who work to advance the personal and environmental conditions affecting themselves and other persons with disabilities.)

BPI was implemented through written agreements and protocols, statutory changes, curriculum development, and mandatory trainings with identified partners in law enforcement, adult protective and human services, and others. Massachusetts district attorneys' offices were designated as lead agencies for this prosecution-based model.

BPI team members work collectively to promote BPI's four goals:

Provide protection, treatment, and continuity of care to persons with disabilities.
Increase awareness of crimes being committed against persons with disabilities.
Increase communication and cooperation between law enforcement and agencies providing services to persons with disabilities.
Ensure that crimes committed against persons with disabilities are promptly reported, investigated by trained law enforcement personnel, and prosecuted by experienced assistant district attorneys.

The steering committee sets BPI's annual agenda and legislative efforts, approves its budget, and oversees its training activities. The hallmark of the Massachusetts BPI has been its ability to ensure support from the highest levels while implementing its initiatives "on the ground." Current agencies represented on the steering committee follow:

Creation of a Memorandum of Understanding

The cornerstone of BPI is a formal memorandum of understanding (MOU), specific to each jurisdiction, that describes each agency's role and responsibility in recognizing, reporting, investigating, and prosecuting cases involving victims with disabilities. Just the existence of the MOU is beneficial in that it requires jurisdictions to address issues of abuse before they become problems and prevents agencies from duplicating services and resources. In short, cases are less likely to fall through the cracks.

Unique to BPI, in Massachusetts, a state police detective unit is assigned to the Disabled Persons Protection Commission (an adult protective services agency that receives reports of suspected abuse). The unit comprises experienced law enforcement officers who review each report of abuse to determine the existence, if any, of a crime. Referral, if appropriate, is then made to the district attorney in whose jurisdiction the alleged abuse occurred. A specially designated assistant district attorney then reviews the referral, assigns it for further investigation by local or state police in his or her jurisdiction, and decides whether there is sufficient evidence to support a prosecution. During the review and investigation phase, there is ongoing communication with the adult protective services investigator—a procedure that is uniform throughout the Commonwealth because of the MOU. BPI's steering committee has recognized that team membership is not static and has ensured that when the inevitable occurs—a change in team membership for any one agency or jurisdiction—the process will remain in place.

Implementation of Training Curricula

Understanding that training increases the likelihood that crimes committed against persons with disabilities will be recognized, reported, investigated, and prosecuted successfully, team members have overseen the development and implementation of cross-discipline training criteria for local and state police, adult protective services investigators, prosecutors, victim/witness advocates, medical personnel, persons with disabilities, service providers, and the judiciary—key factors in Massachusetts BPI's success.

BPI offers the following cross-training curricula to team members:

Adult protective services training: A 40-hour basic criminal investigation training and a 40-hour sexual assault training (the same as mandated for law enforcement officers in the Commonwealth), which is conducted by state police.
New recruit training: A full-day training for every municipal police recruit on his or her role, and that of adult protective services, in recognizing, reporting, and investigating crimes against victims with disabilities.
State police long-distance learning: Mandatory online training for state police officers through the Massachusetts State Police online training academy that also is accessible to municipal police officers and adult protective services investigators.
Service provider training: A 1-day train-the-trainer program that incorporates multimedia elements to educate professionals who provide services to persons with disabilities on recognizing, reporting, and responding to violence committed against persons with disabilities. Recognizing the lack of resources available to service provider agencies, BPI offers this training to satisfy mandated service provider training requirements. Attendees receive the Protect, Report, Preserve: Abuse Against Persons with Disabilities video and its accompanying manual, both of which are also distributed to individuals throughout the Commonwealth who provide services to persons with disabilities.
Court personnel guide: BPI, in partnership with Massachusetts Continuing Legal Education, developed and distributed a practical guide for court personnel on the reporting, investigation, and prosecution of crimes committed against persons with disabilities. The guide, which was distributed to all courts in the Commonwealth, educates court personnel on issues unique to cases involving persons with disabilities.
Persons with disabilities training: A training curriculum and video were created to educate persons with disabilities on recognizing, reporting, and responding to abuse. Through funding provided by OVC, BPI partnered with Massachusetts Advocates Standing Strong and persons with disabilities to develop the training materials. The curriculum, entitled Awareness and Action—Educating Persons with Disabilities to Recognize, Report and Respond to Abuse, comprises a PowerPoint presentation, video clips, video story, written curriculum, trainer guide, and participant workbook. The 3-hour interactive training is taught by persons with disabilities and others. In addition, with Byrne JAG funding from the Massachusetts Executive Office of Public Safety and Security, an interactive educational tool was developed to complement the Awareness and Action training curriculum. Incorporating color-coded cards and images, the tool is used by trainers with disabilities to elicit discussion from persons with disabilities on types of abuse and to teach them how to recognize, report, and respond to abuse and neglect. It is intended for audiences of no more than five people.

Recognition of Legislative Limitations

Recognizing the importance of holding offenders accountable, BPI members identified gaps in the state's statutes concerning victims with disabilities. BPI seeks to create new laws; strengthen existing policies, regulations, and statutes; and support legislative changes that will enhance penalties for those who commit crimes against persons with disabilities and that will affect other issues related to the initiative's efforts.

Development of a Public Awareness Campaign

Recognizing that education and outreach are key to reporting, addressing, and, ultimately, reducing crimes committed against persons with disabilities, BPI developed and is implementing a public awareness campaign. The campaign distributes multimedia and other materials such as laminated cards, magnets, keychains, pens, water bottles, and brochures that are tailored to specific disciplines.

Summary

Although there are many organizations and individuals deeply committed to addressing crime committed against persons with disabilities, these organizations, historically, have implemented their respective efforts independently. Collaboration was not easy, despite the dedication of each individual entity. BPI not only promotes collaboration, it makes it easier through its cross-discipline training programs and thereby provides victims with disabilities the protection and services they need to pursue safe and healthy lives and enables communities to hold offenders criminally accountable for their violence.

As a result of BPI in Massachusetts, adult protective and human services personnel, medical personnel, law enforcement, persons with disabilities, and others receive routine training in how to recognize abuse, report suspicions, and respond effectively to abuse committed against persons with disabilities. In addition, the Department of Developmental Services, Department of Mental Health, and Massachusetts Rehabilitation Commission are all required to report criminal activity to the Disabled Persons Protection Commission and to the appropriate district attorney.

The success of BPI has been quantitatively measured. See exhibits 1–4 for BPI's progress since 1999.

Data points are available for these exhibits.
Exhibit 1. DPPC Hotline and Investigation Activity

Exhibit 2. Criminal Investigations and Complaints, DPPC Database

Exhibit 3. DPPC Cases Referred to District Attorneys

Exhibit 4. Criminal Activity in the DPPC Database, FY 2010

Assault and Battery on a Person With a Disability	427
Larceny on a Person With a Disability	232
Domestic Assault and Battery	164
Rape	143
Indecent Assault and Battery	113
Caretaker's Negligence	105
Assault and Battery With a Weapon	37
Death	29
Narcotics Violations	23

Note: The types of crimes reported to the Disabled Persons Protection Commission (DPPC) in fiscal year (FY) 2010 involved violence against people and property. Since BPI, legislative changes have allowed prosecution of certain types of caregiver negligence committed against persons with disabilities.

Pilot Replication Sites

In 2008, with funding from OVC, three states began replicating the Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI) in their own jurisdictions. All three pilot replication sites met their project objectives, including forming multidisciplinary teams, capturing statistics on crimes committed against persons with disabilities, and holding monthly teleconference meetings. Each site reported enhanced communication and collaboration in addressing abuse and neglect committed against persons with disabilities. Using a multidisciplinary team approach, the sites also were able to increase awareness of crimes committed against persons with disabilities through outreach.

In addition, each site enhanced its efforts to address abuse and neglect committed against persons with disabilities in specific ways.

Although much remains to be done, the BPI replicated models described in this section prove that a multidisciplinary team approach provides better protection and more successful outcomes than the approaches that existed before the program was implemented.

Delaware

In addition to hosting a statewide conference to introduce BPI, Delaware added a mandatory reporting field on its crime report form, thereby reminding officials to identify and record incidents of crimes committed against persons with disabilities. Delaware also produced and published a report on crimes committed against persons with disabilities. The BPI Delaware multidisciplinary team grew to 31 members, including persons with disabilities. BPI Delaware also created a formal memorandum of understanding (MOU) for cases involving victims with disabilities, and it created a toll free number for reporting allegations of abuse committed against persons with disabilities.

For more information, contact—

Maureen Monagle, Project Manager
Delaware Criminal Justice Council
820 North French Street, 10th Floor
Wilmington, DE 19801
302–577–8442

Ohio

In addition to hosting a major training on BPI, Ohio developed public service announcements using spokespersons with disabilities and created its own letterhead and a newsletter highlighting BPI Ohio's efforts. It issued a toll free number for reporting suspected abuse of persons with disabilities and created a 24-hour reporting line, a Web site, identification cards for persons with disabilities, and a booklet for police officers and community partners on communicating with persons with disabilities. In addition, BPI Ohio formalized an MOU with its partners and distributed more than 400 copies of OVC's First Response to Victims of Crime Who Have a Disability (Office for Victims of Crime, 2002).

For more information, contact—

David Voth, Project Director and Executive Director
Crime Victim Services, Lima
330 North Elizabeth Street, 2d Floor
Lima, OH 45801
419–222–8666

Oregon

BPI Oregon passed legislation mandating that every county establish a multidisciplinary team to address violence committed against persons with disabilities. These teams—comprising a district attorney; local, city, and county law enforcement; protective services; and others—are now meeting. In addition, all Portland Police Bureau officers have been trained in issues related to persons with disabilities. Finally, BPI Oregon now monitors the response of the Independent Police Review division to questions of unreasonable force used by police in responding to cases involving persons with disabilities.

For more information, contact—

Bill West, Project Director
3505 Northeast 28 Avenue
Portland, OR 97212

Components of a Successful Replication

Providing a framework for promptly and effectively recognizing, reporting, and responding to abuse committed against persons with disabilities is key to successfully replicating the Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI). Identifying and coordinating the roles of collaborative partners who serve persons with disabilities in a jurisdiction and addressing statutory and regulatory authority for implementation is essential to developing your own collaboration.

Several components are necessary for developing, implementing, and sustaining a successful partnership.

Level of Interest

The first component requires a recognition of, and desire to, address abuse committed against persons with disabilities in a more effective and efficient way.

Successful replication of BPI requires team members to—

Identify which individuals, organizations, and agencies work with or interact with persons with disabilities.
Determine their roles, responsibilities, and jurisdictions.
Identify those already collaborating as well as those working independently, either intentionally or unintentionally.
Target and meet with potential partners to understand their current efforts and similarities and differences, determine their levels of interest, and establish an environment that fosters trust and open communication.

Steering Committee

Once you determine the level of interest, the next step is to bring together a core group to form a steering committee. This concept can be accomplished at the local, regional, or statewide level. While the inclination might be to cast a wide net, it is far more productive at this stage to begin with a smaller, core committee.

Ask questions that can assist you in identifying steering committee members. For example—

Who are the major stakeholders?
Who has statutory or regulatory jurisdiction?
Who can influence change in an agency, court system, or legislative process?
Who is likely to think outside the box?

Once you identify the core group, take steps to formalize the group into a steering committee. A steering committee can, of course, be used for different purposes. Establishing its role in the initiative should be among its earliest actions. Steering committee members should—

Identify leadership positions and define the role and responsibility of the committee.
Distinguish core and ad hoc members.
Formalize the partnership through a written agreement.
Establish the initiative's mission statement and set its goals.
Set a calendar of regular and routine meetings using agendas and recording and sharing meeting minutes with all committee members.

Memorandum of Understanding

One of the most important functions of a successful partnership is the establishment of collaborative efforts that build relationships, trust, and a sense of a common goal. To successfully replicate BPI, develop memorandums of understanding (MOUs) to foster relationship building for those involved in reporting, investigating, or prosecuting crimes committed against persons with disabilities.

MOUs should include—

A statement of purpose, outlining the roles and responsibilities of each signatory agency.
Names of participating agencies, with designated contacts.
Goals of the MOU.
Protocols for reporting, investigating, and prosecuting crimes committed against persons with disabilities.
A review and evaluation, to assess its effectiveness.

Training

In addition to formalizing a protocol through MOUs, you must provide training (including cross training) for professionals who work to protect persons with disabilities and for those whose responsibility it is to respond to allegations of abuse of a person with a disability. Hold trainings on an ongoing basis and update them, if necessary, to address new issues that arise.

Trainings should address, but not be limited to, the following:

Understanding the prevalence of abuse against persons with disabilities.
Understanding the roles and responsibilities of respective team members.
Identifying what is a crime and what to do when an allegation of a crime is made.
Communicating and interacting effectively with persons with disabilities.
Accessing any protective services needed for victims with disabilities.
Recognizing, reporting, and responding to victims with disabilities.
Emphasizing the importance of using people-first language.
Educating the field on the needs of persons with disabilities, such as physical access to buildings and modes of transportation (e.g., bus, car, elevator/escalator) and communication (e.g., written publications, voice and video recordings, computers, spoken language).
Becoming familiar with the Americans with Disabilities Act of 1990, section 504 of the Rehabilitation Act of 1973, and other disability rights laws and regulations.

Evaluation

Finally, a major component of a successful partnership is the ongoing evaluation of that partnership. Make sure to address and resolve issues and concerns raised during evaluations in a timely fashion. The input of all team members is critical. Team members should—

Meet on a regular basis to review roles, responsibilities, and protocols.
Be flexible in thought and action.
Evaluate their successes and failures using both qualitative and quantitative measures.
Address and resolve all conflict.
Be willing to make any changes needed to sustain the partnership.

Summary

No one person or agency possesses all of the skills, knowledge, and resources necessary to respond to the complex problem of abuse of persons with disabilities. Each person or agency brings different perspectives, experiences, and information to the table. Using each partner's existing resources, your replication of the Massachusetts BPI can bring about successful collaboration. By working together, your BPI team can ensure that crimes committed against persons with disabilities are recognized, reported, investigated, and prosecuted in an efficient and timely manner.

Conclusion

The Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI) changed the way Massachusetts responds to crimes committed against persons with disabilities. Because of BPI, persons with disabilities have equal access to the criminal justice system and the same protections as the population at large. The benefits of a multidisciplinary team approach are obvious:

Common goals and objectives among the people and agencies that assist crime victims with disabilities.
Increased outreach to persons with disabilities and to those responding to abuse committed against persons with disabilities.
Immediate and effective communication among those who respond to crime victims with disabilities and to the crime victims themselves, preventing duplication of services, multiple deliveries of the same message by all parties, and so forth.
Reduction in the number of victim interviews.
Coordination between adult protective and human services personnel, service providers, law enforcement officials, and others.
Enhanced integrity, reliability, and effectiveness of investigations and decisionmaking.
Consistent support and followup for persons with disabilities.
Streamlined and increased referrals for criminal investigations.
Increased arrest and prosecution rates.

Among the many lessons learned from BPI is that the following elements enhance the safety and well-being of persons with disabilities:

Awareness.
Cross-training.
Legislative changes.
Policy development.
Collaboration between law enforcement, prosecutors, advocates, adult protective and human services agencies, medical personnel, and self-advocates.

For more information about the Massachusetts BPI, please visit its Web site or contact—

Disabled Persons Protection Commission, Commonwealth of Massachusetts
300 Granite Street, Suite 404
Braintree, MA 02184
617–727–6465

Resources
Adult Protective Services in Massachusetts

The flowchart below depicts adult protective services in the Commonwealth of Massachusetts.

Descriptions of the agencies that make up adult protective services follow:

Executive Office of Health and Human Services (EOHHS). Oversees 17 state agencies, including most of the agencies that make up adult protective services, and is represented in the Governor's Cabinet.

Department of Children and Families (DCF). Works for the safety, permanency, and well-being of children up to age 17 who have been abused and neglected in family settings or by recognized caregivers.
Department of Developmental Services (DDS). Provides support and services to individuals with developmental disabilities and their families.
Department of Mental Health (DMH). Works to improve the quality of life for adults with serious and persistent mental illness and for children with serious mental illness or severe emotional disturbances.
Massachusetts Rehabilitation Commission (MRC). Helps persons with disabilities to live independently and work.
Department of Public Health (DPH). Licenses and certifies health facilities, including hospitals, long-term care facilities, and home health agencies. The department also investigates complaints of patient abuse and neglect in long-term care facilities.
Executive Office of Elder Affairs (EOEA). Provides services to individuals age 60 and older and investigates allegations of abuse and neglect against these individuals who are living in the community, outside of long-term care facilities, hospitals, and home health agencies.

Disabled Persons Protection Commission (DPPC). Investigates and remediates instances of abuse against adults with disabilities between ages 18 and 59, filling the gap between DCF and EOEA. DPPC is independent of EOHHS.

DPPC, an independent state agency, works closely with DDS, DMH, and MRC. These agencies, which all provide services to persons with disabilities, each have a protective services division and an investigations unit. They partner with the state's attorney general, 11 district attorneys' offices, local and state police, and others to implement the Building Partnerships for the Protection of Persons with Disabilities Initiative (BPI). DPH and EOEA are not directly implementing BPI but are on the BPI Steering Committee. DCF is not part of the implementation.

Sample BPI MOU

Memorandum of Understanding for the Reporting and Investigation of Felonies
Committed Against a Person With a Disability

STATEMENT OF PURPOSE

The purpose of this memorandum of understanding (MOU) is to provide a framework for the prompt and effective reporting, investigation, and prosecution of crimes committed against persons with disabilities. This document will identify the reporting and investigating responsibilities of people and agencies providing services to persons with disabilities, their associates, and law enforcement. This MOU shall apply to all felonies involving persons with disabilities occurring in the [Name] District.

PARTICIPATING AGENCIES

District Attorney: [Name]
[Name] District
[Address]
[Telephone Number]

Disabled Persons Protection Commission (DPPC)
[Name]
[Title]
[Address]
[Telephone Number]

State Police Detective Unit (SPDU) assigned to DPPC
[Name]
[Title]
[Address]
[Telephone Number]

Department of Developmental Services (DDS)
[Name]
[Title]
[Address]
[Telephone Number]

Department of Mental Health (DMH)
[Name]
[Title]
[Address]
[Telephone Number]

Massachusetts Rehabilitation Commission (MRC)
[Name]
[Title]
[Address]
[Telephone Number]

GOALS

Compliance with the terms of this MOU should achieve the following goals:

Provide protection, treatment, and continuity of care for persons with disabilities who are victims of a crime.
Ensure crimes committed against persons with disabilities are promptly and effectively reported, investigated, and prosecuted.
Enhance communication and cooperation between law enforcement and professionals and agencies providing services to persons with disabilities.
Increase awareness of crimes committed against persons with disabilities.

REPORTING AND INVESTIGATION OF FELONIES COMMITTED AGAINST PERSONS WITH DISABILITIES

For purposes of this MOU, a person with a disability shall mean, "A person between the ages of eighteen to fifty-nine, inclusive, who has a disability, as defined by M.G.L. Chapter 123B, Section 1 and, as a result of such disability, is wholly or partially dependent on others to meet his daily living needs," M.G.L. Chapter 19C, Section 1.
Programs licensed, operated, or contracted for by DDS, DMH, and MRC and their employees, in furtherance of their duty as mandated reporters pursuant to M.G.L. Chapter 19C, Sections 10 and 13 to report conditions of death and abuse of persons with disabilities including but not limited to "an act or omission which results in serious physical or emotional injury to a person with a disability," must report the following to DPPC:

All cases in which a person with a disability has died.
All cases in which a person with a disability has been the victim of a violation of M.G.L. Chapter 265, Sections—

13F Indecent Assault and Battery on a Person with an Intellectual Disability.
13H Indecent Assault and Battery on a Person Fourteen or Older.
13K Assault and Battery upon an Elder or Person with a Disability.
22 Rape.
24 Intent to Commit Rape.

All cases in which a person with a disability has been the victim of a violation of M.G.L. Chapter 272, Section 35 (Unnatural and Lascivious Acts).
All cases in which a person with a disability has been sexually exploited, as defined in M.G.L. Chapter 272, Section 3 (Drugging People for Sexual Intercourse) and Section 7 (Support From or Sharing Earnings of Prostitute).
All cases in which a person with a disability has suffered a serious bodily injury as a result of a pattern of repetitive actions or inactions by a caretaker, as defined in M.G.L. Chapter 19C, Section 5(5)(c).
All cases in which a person with a disability has been financially exploited, as defined in M.G.L. Chapter 266, Section 30 (Larceny).
Discretionary referrals including, but not limited to, any felonies.

Reports of criminal conduct shall be made to the DPPC Hotline [800–426–9009 or 888–822–0350 (TTY)] for screening by the SPDU assigned to DPPC, pursuant to M.G.L. Chapter 19C, Sections 3(i) and 4(c).
Upon receipt of a report of criminal conduct, the DPPC SPDU shall screen the report and, when appropriate, shall immediately report the incident, pursuant to M.G.L. Chapter 19C, Section 5(5) to an assistant district attorney or designee in the Office of the District Attorney for [Name] District:

[Name and Title] may be contacted at [Telephone Number].
[Name and Title] may be contacted at [Telephone Number].

To ensure that both DPPC and the district attorney receive the report, the human services agency (DDS, DMH, MRC), upon receiving the report, shall immediately report the matter to the DPPC Hotline [800–426–9009 or 888–822–0350 (TTY)] and to [Name and Title] or designee in the Office of the District Attorney for the [Name] District:

[Name and Title] may be contacted at [Telephone Number].
[Name and Title] may be contacted at [Telephone Number].

In an emergency, contact [Name and Title of the local state police commander attached to [Name] District Attorney's Office] at [Telephone Number].

Note: In addition, when necessary and appropriate, notification should be made to other law enforcement agencies and emergency personnel.

The district attorney designee for [Name] District shall immediately, but in no event longer than 24 hours upon receipt of said report of criminal conduct, determine if the report warrants further criminal investigation and which entity shall conduct the investigation of the alleged crime. [Name and Title] or designee shall notify DPPC of the determination(s) within said 24-hour period. The district attorney for [Name] District shall retain supervision of any criminal investigation of the matter until said District Attorney's Office has determined that the matter is not appropriate for further criminal investigation or for criminal prosecution.
In the event that the district attorney determines that the matter is not appropriate for either criminal investigation or prosecution, the district attorney shall relinquish the matter to DPPC to continue its adult protective services (APS) investigation, otherwise referred to as a civil investigation, pursuant to M.G.L. Chapter 19C, Section 4. If such APS/civil investigation reveals additional facts that may make further criminal investigation or prosecution appropriate, these additional facts shall be immediately reported to DPPC and to [Name and Title] or designee for a determination as to what further action is warranted. After completing the reevaluation of the case, the district attorney's designee shall communicate the results of the reevaluation to the assigned investigator and/or DPPC.
When the district attorney assumes jurisdiction of the matter and assigns the case for criminal investigation, the APS/civil investigator shall coordinate his or her investigation with the assigned law enforcement investigator. As long as the district attorney retains jurisdiction of the matter, the district attorney shall supervise the coordination of any criminal and APS/civil investigation.

HUMAN SERVICES CRIMINAL INVESTIGATIONS LIAISONS

Recognizing the importance of cooperation and communication between the human services agencies and the Office of District Attorney [Name], the following individuals have been identified and designated to act as liaisons between the respective agencies and the Office of District Attorney [Name]:

[Name] District Attorney's Office
[Name]
[Title] Assistant District Attorney
[Telephone Number]

[Name]
[Title] Victim Witness Advocate
[Telephone Number]

[Name]
[Title] Interviewer
[Telephone Number]

[Name]
[Title] Coordinator
[Telephone Number]

State Police Representative for the [Name] District
[Name and Title]
[Telephone Number]

Disabled Persons Protection Commission
Primary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[24-Hour Hotline]
[TTY]
[Cell]
[Fax]

Secondary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[24-Hour Hotline]
[TTY]
[Fax]

State Police Detective Unit at DPPC
[Name]
[Title]
[Address]
[Telephone Number]

Department of Developmental Services
Primary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[Cell]
[Fax]

Secondary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[Cell]
[Fax]

Department of Mental Health
Primary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[Cell]
[Fax]

Secondary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[Cell]
[Fax]

Massachusetts Rehabilitation Commission
Primary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[Cell]
[Fax]

Secondary Contact:
[Name]
[Title]
[Address]
[Telephone Number]
[Cell]
[Fax]

REVIEW AND EVALUATION

Designees of the district attorney, DPPC, DDS, DMH, MRC, and the State Police agree to meet semiannually to review this MOU, assess its effectiveness, and modify it as necessary. The parties agree to keep records of the reports made to the Office of the District Attorney [Name] pursuant to this MOU including but not limited to those reports that result in arrest, prosecution, or both.

Key factors to the success of this MOU are continuing communication and coordination with a commitment to a rapid response to inquiries and maintaining an updated and accurate list of contact people.

AUTHORIZED SIGNATURES

OFFICE OF THE [NAME] DISTRICT ATTORNEY

_______________________________________________ Date: ________________
[Name]
[Name] District Attorney

DISABLED PERSONS PROTECTION COMMISSION

_______________________________________________ Date: ________________
[Name]
Executive Director

MASSACHUSETTS STATE POLICE

_______________________________________________ Date: ________________
[Name]
Superintendent

DEPARTMENT OF DEVELOPMENTAL SERVICES

_______________________________________________ Date: ________________
[Name]
Commissioner

DEPARTMENT OF MENTAL HEALTH

_______________________________________________ Date: ________________
[Name]
Commissioner

MASSACHUSETTS REHABILITATION COMMISSION

_______________________________________________ Date: ________________
[Name]
Commissioner

References

Harrell, E., Ph.D., and M. Rand. 2010. Crime Against People with Disabilities, 2008. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

House Committee on Post Audit and Oversight. 1997. "Are You Sure About This Guy?" Report on the Massachusetts Department of Mental Retardation: An Investigation by the House of Representatives Post Audit and Oversight Bureau. Boston, MA: Massachusetts House of Representatives, House Committee on Post Audit and Oversight.

Martin, S., N. Ray, D. Sotres-Alvarez, L.L. Kupper, K.E. Moracco, P.A. Dickens, D. Scandlin, and Z. Gizlice. 2006. "Physical and Sexual Assault of Women with Disabilities." Violence Against Women 12(9):823.

Office for Victims of Crime. 2002. First Response to Victims of Crime Who Have a Disability. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crime.

Petersilia, J. Ph.D. n.d. When Justice Sleeps: Violence and Abuse Against the Developmentally Disabled. PowerPoint presentation. Irvine, CA: University of California, Irvine.

Teplin, L., Ph.D., G.M. McClelland, Ph.D., K.M. Abram, Ph.D., and D.A. Weiner, Ph.D. 2005. "Crime Victimization in Adults With Severe Mental Illness: Comparison With the National Crime Victimization Survey." Archives of General Psychiatry 62(8):914.

Valenti-Hein, D., and L. Schwartz. 1995. The Sexual Abuse Interview for Those with Developmental Disabilities. Santa Barbara, CA: James Stanfield Company.