Last year, more than half of the 929 abuse, neglect and exploitation complaints and deaths involving vulnerable adults received by state investigators were referred to various state and local agencies.
But no one agency tracks the outcomes of those investigations to see if the system is doing a good job at protecting South Carolina's intellectually disabled adults.
Some advocates and lawmakers think that should change.
"There is no system and there needs to be," said longtime crime victims advocate Laura Hudson.
Sen. Thomas Alexander, a Walhalla Republican who chairs the budget subcommittee that oversees agencies who care for vulnerable adults, told The Greenville News that until lawmakers can review the entire system, he would like agencies that are referred vulnerable cases from the State Law Enforcement Division to report back to them the outcome of their cases.
"I want to do something in the interim and not have to wait on legislation," he said.
The current system involves a bevy of state agencies with their own jurisdictions. State lawmakers have modified the process over the years, establishing a vulnerable adults unit at the State Law Enforcement Division and ordering that all vulnerable adult deaths and complaints of abuse, neglect and exploitation involving staff at Department of Mental Health or the Department of Disabilities and Special Needs' facilities be reviewed by SLED.
That unit then examines all deaths and reviews all the complaints to see if any warrant criminal investigation or should be referred to other agencies for their review.
If the allegations are non-criminal and involve standard of care or quality of life issues, they are sent to the state Long Term Care Ombudsman's office. If they don't fall under the ombudsman's jurisdiction but aren't criminal, they go to the state Department of Social Services Adult Protective Services unit. If they they are criminal and involve financial exploitation, they are to be sent to the Attorney General's Office. If they are criminal but did not take place in a DMH or DDSN facility, such as group homes, they are sent to local law enforcement, which also can ask SLED for assistance with any investigation. Resident-on-resident crimes also are sent to local law enforcement.
SLED by law cannot publicly disclose any of its vulnerable adult investigative records, a provision officials said was aimed at protecting the privacy of vulnerable adult victims.
Of the 929 deaths or complaints in 2015, 161 were of physical abuse, 151 concerned standard of care issues, 29 alleged neglect, 19 alleged sexual abuse, 33 alleged psychological abuse, 26 alleged some form of exploitation, 154 involved some other type of allegation and 352 reported a death, according to a compilation of figures provided to The News by SLED..
Last year, 260 of those cases were referred by SLED to the state Ombudsman's office, 170 were kept by SLED for investigation, 125 were sent to local law enforcement, 52 were referred to DSS and five were referred to the Attorney General's Office, according to SLED records. Another four were sent to the mental health department's patient advocate.
Of the approximately 300 cases referred for criminal investigation in 2015, SLED knows of seven arrests. But Capt. Michael Greene, who leads the vulnerable adults unit at SLED, said local law enforcement agencies are not required to report back to SLED what happens to the cases so he is not certain of the total number of charges.
"I think there needs to be some accountability in some type of a system that would track those cases," Alexander said. "It's unfortunate that it's not been occurring and I think we'll have to evaluate what would be the best process going forward."
Senate Judiciary Chairman Larry Martin of Pickens said it would be "deeply helpful" if the outcome of all of the complaints relayed outside SLED could be known.
Deborah McPherson is a former DDSN commissioner and employee as well as an advocate for vulnerable adults. She said the current system is filled with confusion and lacks proper oversight.
"There clearly needs to be oversight because what we have now isn't working," she said.
For instance, she said, allegations of abuse or neglect that occur with DDSN's day program get reported to DSS, while allegations that come from group homes are referred to local law enforcement.
"There is confusion about what gets reported to the ombudsman's office, what gets reported to DSS, what gets reported to SLED." she said. "There's confusion throughout the state about who do you call."
Officials have tried to funnel all complaints to SLED's vulnerable adult unit so it can decide what agency should review them. But there is no central authority that checks on the outcomes of all the reviews.
McPherson said while some local law enforcement agencies are aggressive about investigating complaints, some are in need of training in how to deal with vulnerable adults.
"One of two things need to happen," she said. "Either SLED needs to look at group homes or else they need to provide funding and training at the local level."
SLED this year has received three reports of arrests involving local law enforcement, said Thom Berry a SLED spokesman, two from Charleston County and one from Batesburg-Leesville, both for abuse of a vulnerable adult. Three cases in 2015 investigated by SLED resulted in two charges of abuse of a vulnerable adult while the third was for exploitation of a vulnerable adult, Berry said.
Of the cases received by SLED last year, 60 were ruled unfounded and 299 were closed with no findings. Beginning in 2008, SLED categorized any complaint at any U.S. Veterans Administration facilities as no finding because they are not within state jurisdiction, according to SLED.
Greene said he could not explain why the number of arrests appear to be low when compared to the number of investigations. But he said vulnerable adult cases can be challenging because of intellect of the victims.
"In many of these cases you may have people who can't speak, their memory is not the best," he said. "We have cases where the patient literally cannot speak where a person has to interpret what he is saying. You may have a patient who makes an allegation and you come talk to them two days later and he says, 'I don't know what you are talking about. I didn't call you.' Some of these people have dementia, they have schizophrenia. They have lots and lots of impairments."
In a case of assault in the regular community, Greene said, the victim might be able to identify his attacker, talk about what happened and who witnessed it. And that sometimes is the case with vulnerable adults. But in other cases, he said, their impairments limit their communication with investigators.
"At the end of the day I can promise you we investigate every one of those cases fully," he said. "If there are circumstances where we can make an arrest we will make an arrest. But if it's not there, we can't make it happen. We don't want one vulnerable adult to be abused in South Carolina or anywhere else. But on the other side of that coin, we don't want to put an innocent person in jail."
The South Carolina Bar is organizing a task force on vulnerable adults to look at how to improve the entire system of services and protections.
Cindy Coker with the Bar said the 16-member task force will be led by former U.S. Ambassador David Wilkins of Greenville and former Gov. Jim Hodges and will meet for the first time later this month.
She said the multi-year project will look at all aspects of the system, including oversight and accountability, which she said now is "fragmented."
"By statute, certain things are done by SLED in certain situations and they can't do it if it's not in others," she said. "Local law enforcement is supposed to handle it but they don't necessarily have the right training. SLED can help them if local law enforcement asks for help but they don't always ask or know they can ask."