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Group home's unorthodox sex policy disquiets mother

Kevin Rouse stood before the judge wearing a patchy beard and a rumpled orange jumpsuit. He was accused of following a young boy into a church bathroom, stuffing paper towels into the boy's mouth and masturbating.

It wasn't the first time Kevin, then in his 30s, had been in trouble. As far back as high school, he had yanked down the pants of a boy, pulled another into a room, and fondled a 7-year-old at a movie theater.

But with an IQ of 60, Kevin couldn't understand the charges against him so he couldn't stand trial.

The judge told Kevin he would stay in jail unless his attorney found him a secure group home.

Rose Rouse looked at her youngest son on that pivotal day in 2003 and saw a little boy in a man's body. She had tried to monitor him by herself for years, but he was more than an aging widow could handle. She knew Kevin, who had a childlike obsession with the Buffalo Bills, wouldn't last in prison.

Someone suggested the Human Development Center. Rose had never heard of this place 138 miles from her house in Palm Bay. It was a government-funded, state-licensed facility for developmentally disabled men. And it had a reputation for working with sex abusers. The judge approved, and the next day Kevin was in a van headed to HDC's isolated campus on Stark Road in Seffner.

The nonprofit's goal was to rehabilitate the men and guide them toward independence. Kevin would learn money management and health skills. He would get all this in a secure home where the public would be safe from him.

Over the next seven years, however, Rose would come to wonder if it was Kevin who needed protection from the program.

Rose learned that her son's shoulder was broken after a struggle with a staff member in a dispute over ice cream. She learned that another client forced himself sexually on Kevin and that the staff urged Kevin to have sex with other men on campus as part of his treatment. When she protested on religious grounds, Rose was made to feel that she was the problem. When she asked to have Kevin placed in another program, the state refused even though other men with similar issues were transferred.

Kevin Rouse's story reveals the difficulties of dealing with a population of men with adult sexual urges and often childlike thinking. The staff of the Human Development Center enacted a bold and unorthodox policy permitting sex between residents, but experts who deal with the developmentally disabled question whether the policy did more harm than good, creating a sexually charged atmosphere that may have encouraged sexual assaults.

Compounding the problem, the state agency that oversees HDC did not object to the policy until a whistle-blower complained to a state legislator. An investigation documented multiple instances of improper sexual activity between residents.

HDC officials say that banning sex is not the answer. It would deny basic rights and simply sweep the issue under the rug, a response they say is all too common when dealing with sex abusers.

But two years later, the state still has not written an official policy concerning sex in group homes. The whistle-blower was fired, and the mentally disabled man at the center of the controversy is stuck in a facility that he — like other men there — is desperate to leave.

• • •

A feeling of hopelessness overwhelmed Rose Rouse the first time she stepped onto the dirt driveway of her son's new home. She saw older men milling around outside three squat concrete block buildings. Thick woods fenced in the rear of the property.

Rose, a plain-spoken woman who had spent her earlier years behind the counters of a Kentucky Fried Chicken and a drugstore, didn't like going inside. The couches were worn through and the fridge was Frankensteined together with bolts. The men ate at a graffiti-carved picnic table. The home smelled of urine and the air conditioner worked sporadically, Rose said.

"They would have fans on to keep cool," Rose said, "and when it was cold, they would have the oven doors open to keep warm."

Rose didn't know that HDC received approximately $100,000 in Medicaid funding per person annually for most residents. The more services the men needed, the more money HDC received. And 80 percent of the residents were designated "intensive," like Kevin.

Kevin wanted to move out almost as soon as he moved in. He wasn't alone.

Some men stuck forks in their own necks, sliced their wrists, screamed incoherently at 911 dispatchers, threw televisions, swallowed glass, or spread feces on themselves.

One man told a Hillsborough sheriff's deputy in June 2009 that he wanted to kill himself because "there are sexual offenders living there as well and he was abused as a child."

Between 15 and 30 of the 50 residents at the Human Development Center have been accused of sex crimes. Rose knew Kevin wasn't the only one there, but she was appalled by what Kevin told her happened inside the bedrooms where some men lined their shelves with pornographic DVDs.

The men called it "quiet time."

Kevin described it to Rose. Two men would tell a staff member that they wanted to have sex, answer a few questions, receive a few condoms and disappear into a bedroom.

Rose, a devout Catholic, told Kevin that he was not allowed to participate in "quiet time." He assured her that he hadn't and didn't want to.

But soon Rose felt pressure to let Kevin have sex — not from Kevin, but from the staff. The Human Development Center told Rose's attorney that Kevin would benefit. The lawyer urged Rose to consent. She fired him.

In Kevin's 2005 behavioral plan, the HDC staff wrote that they could not evaluate whether Kevin was learning appropriate sexual behavior because his mother wouldn't let him have sex with other campus men — as if that was the only avenue available for him to have sex and the only way staff could monitor his progress.

"Please note that Kevin's guardian has requested that Kevin does not engage in sexual activity with any of his peers," the plan says, "so measurement of this skill is only measured through the occasions of Kevin engaging in inappropriate sexual behavior."

It was a stalemate. Rose, who had raised four boys and was used to fighting for Kevin, wouldn't budge. HDC wasn't going to change its policy. Rose didn't know what to do other than pray to Jude, the patron saint of hopeless cases.

• • •

In March 2008, a registered nurse named Eileen Taylor had a shocking conversation about a client at HDC.

Taylor, 46, a registered nurse for 25 years, was the medical case manager of the Tampa Bay region for the state Agency for Persons with Disabilities. Her job was to dispatch nurses to disabled clients.

In this case, she was trying to figure out why a man suffered from rectal bleeding. "Well you know what goes on there . . . ," the man's caseworker said.

Taylor heard that there were sexual offenders at the group home and that the men were allowed to have sex with each other. She worried that mentally impaired men who couldn't legally consent were being victimized by peers with greater physical or mental abilities.

Taylor learned that another case worker, Tina Hammond, could show her behavior plans from HDC that endorsed the sexual activity. When Taylor showed up, however, Hammond was reluctant.

"I need this job. I'm a single parent," Hammond, 42, said. She was already clashing with HDC staff.

"Where are these guys' families?" Taylor asked.

"These guys don't have families. They have no voice," Hammond said. "Except for one."

She told Taylor about Rose Rouse. Rose's litany of complaints led Taylor, who had never set foot in an HDC home, to suggest an undercover visit.

Taylor didn't trust her bosses, who she said had ignored her prior complaints of medical neglect at other group homes, and she was gathering evidence to prove her point.

On a Sunday morning in June 2008, Rose met Taylor at a Seffner truck stop. They rode in Rose's brown Toyota Corolla to the Human Development Center. Taylor signed in using her birth name of Mary, worried someone would recognize her if she used Eileen.

Taylor saw what Rose had complained about: dirty floors, stained carpets, worn couches and a dirty dining table. She jotted it all down on a napkin.

"It was just apathetic neglect," Taylor said recently. "They were just sort of crowded there, and one little, slight woman who couldn't have been more than 20 years old was watching TV, sitting on her butt, and the house wasn't up to any standards. It was small, it was cramped. It was not clean. Everyone was just sort of lounging around. It reminded me of babysitting."

Taylor fed the information directly to a deputy in the Office of the Chief Inspector General in the governor's office, who coordinated whistle-blower investigations. Taylor reported dangerously low staffing and she made sure to mention her concerns about "quiet time."

• • •

There are many reasons why men were having sex with each other on the campus of the Human Development Center, say the caseworkers, staff and residents. Some are gay. Some would prefer women, but lack the ability to cultivate relationships off campus. Some are predatory. But they are all adults, with adult sexual urges.

Kim Church is the professional who developed the Human Development Center's policies about sex. She had worked with patients from a notorious New York institution shut down after decades of abuse and neglect. The stories of those patients pushed Church to become a behavior analyst who would teach the developmentally disabled independence.

She arrived at the Human Development Center in 1989 and over the next 16 years rose to clinical director of an operation with an annual budget of $5 million. HDC comprised five group homes, two assisted living homes and apartments throughout Hillsborough County and was a rare Tampa Bay area provider that accepted people accused of sex crimes.

Church, 43, believed the developmentally disabled should be educated to make decisions for themselves, in all aspects of their lives, including sex. She subscribed to the 1975 statement from the World Health Organization that sexuality is "a basic need and aspect of being human."

In the mid 1990s, Church came up with a policy that the Human Development Center would not restrict residents' sexual rights but would educate them on how to have safe sex. The center was receiving more men with a history of sexual issues, and Church felt a need for guidelines to protect the men.

State officials never objected to the policy, she said. They had even handed her a box of condoms at a meeting years before.

The nonprofit taught its residents that to have sex their partners needed to be 18 and able to consent. Condoms had to be used. Sex must take place at an appropriate place and time. And, just like the standards in the outside world, "no means no" — at any time.

Church said her staff did not come up with "quiet time"; that was the name the men gave it. There was no "quiet time" room, she said, nor was this time alone meant specifically for sex. It was just "individual time," Church said, for men who had shown they could make responsible decisions and had demonstrated stable behavior.

"It's not our business what's occurring in their room," Church said.

• • •

National experts contacted by the Times expressed disbelief at the permissive policy.

David Mank, director of the University of Indiana Institute on Disability and Community, wondered why a group home would allow men alleged to have committed sex crimes to live with other disabled men.

"I wouldn't want to put anybody in a situation where they felt like they were at risk or you could project that someone could be at risk," he said.

Randy Shively, a psychologist and counselor of developmentally disabled offenders who monitors Ohio group homes, said, "I have seen strange situations throughout Ohio, but never one like this.

"Offenders," he said, "typically look for weak links or those who are more passive, or those who they could prey upon."

Frank Caparulo, a certified sex therapist who treats developmentally disabled sex abusers for the state of Connecticut, says group homes can never be sure the mentally impaired have consented to sex even if they are interviewed rigorously beforehand. Allowing men who could be considered sexual predators to have sex with their roommates doesn't teach them appropriate boundaries, Caparulo said, only that sex comes easily.

Other group homes that deal with people as developmentally disabled as Kevin address the issue of their sexuality in a more passive way than HDC.

The Upper Pinellas Association of Retarded Citizens, one of the Tampa Bay area's largest providers of group homes for people with "intensive" behavior issues, refers a client who wants to have sex to a therapist to make sure he knows what he was asking for.

"It hasn't been an issue," said Brian Siracusa, senior residential director. He acknowledges that unlike HDC his agency doesn't handle people accused of sex crimes.

Kim Church's belief was that preventing these men from expressing their sexuality would create frustration that could manifest in unhealthy ways.

But reports about sexual activity inside the Human Development Center appear to justify the concerns of the national experts.

Over a four-year period beginning in 2005, incidents reported at HDC included consensual sex that turned into rape, violent groping of a staff member and a public fondling case where a deputy thought the men involved could not determine right and wrong.

Did HDC's permissive attitude toward "quiet time" lead to these incidents? It's impossible to say.

But in August 2008, Kevin Rouse was involved in an encounter that led one state investigator to suggest a connection between the policy and the sexual behavior.

• • •

On Aug. 16, 2008, Eileen Taylor got a call from Tina Hammond. A staffer had found Kevin Rouse in a bathroom with his pants down, receiving oral sex from another client.

HDC staff viewed it as consensual, not possible abuse, which would have required them to report it to the Department of Children and Families. They took away personal privileges for both men.

Taylor saw it differently. She knew that both men involved had been caught repeatedly in inappropriate sexual encounters and that DCF had ordered that they be kept apart. The other man had threatened Kevin multiple times, stepping on his hand when Kevin picked up pennies, swinging a lunch sack at him when he was trying to clean a table. To Taylor, this new incident reinforced her claims of lax oversight and neglect.

So Taylor called the abuse hot line.

Investigators from DCF talked to both men and chalked it up to inadequate supervision. But law enforcement wasn't notified, and Taylor could see no progress.

In September 2008 she took her concerns to state Sen. Ronda Storms, R-Brandon, who was the chair of the Committee on Children, Families and Elder Affairs and also represented the area where Kevin lived.

"It's like the provider owns the men," Taylor told Storms' senior legislative aide, Audie Canney. "They're encouraging homosexual relationships for containment."

Taylor showed Canney abuse reports of incidents involving Kevin and the other man in the bathroom as well as case notes that described "quiet time" to Canney. She told Storms.

Storms was shocked.

Her office called Jim DeBeaugrine, the head of the Agency for Persons with Disabilities, as well as Department of Children and Families regional director Nick Cox.

DeBeaugrine said he had never heard of "quiet time" until that day even though Taylor had told his agency's inspector general. He ordered HDC to stop the practice. Cox authorized an investigation into the Human Development Center that began Oct. 9, 2008.

Luis Moran, the latest DCF investigator to be assigned the case, interviewed Church. She defended "quiet time" and blamed Rose for interfering with Kevin's treatment. Church told Moran that Kevin was so aggressive that he would be considered a "sex predator" if he were competent.

But Moran didn't think that Kevin was the problem. It was HDC's policy that made him uncomfortable.

He had looked deeper into the bathroom incident between Kevin and the other man, both of whom he wrote lacked the capacity to consent.

Kevin told Moran the other man threatened him physically if he didn't have "quiet time" with him. Kevin told the other man to stop and said he banged on the bathroom wall for help. The other man confirmed Kevin's version of events.

Moran wrote in his report that this man usually threatened Kevin.

"Staff is aware of the threats," he wrote, "and does nothing about it."

The lack of supervision in Kevin's case was troubling, Moran wrote. It also violated Medicaid funding rules because there were not enough staff members watching the men.

DCF regional director Cox visited Church and her staff during the investigation to relay what Moran and other investigators were discovering.

"We expressed a concern about the 'quiet time' practices that they had there. While we understand that consenting adults . . . have certain rights, the idea that they had set aside certain time for persons to be alone and do whatever they pleased was concerning," Cox said. "We were also concerned about a lack of supervision over some very important patients."

Officials for HDC and its overseer, the Agency for Persons with Disabilities, said that "quiet time" was not part of any treatment plan.

Moran took five months to complete his report, concluding that the state needed to review whether the group home should house sex offenders with non-offenders. Later, Moran privately told Eileen Taylor he would have liked to charge HDC with 18 counts of rape, one for every man on the Seffner campus, she said.

It seemed Moran's report would cause sweeping changes.

DeBeaugrine had already promised DCF that his agency would come up with a policy on sexual interaction affecting many of the 35,000 disabled that the Agency for Persons with Disabilities serves.

Rose believed Kevin would be moved to another facility.

Kevin's support coordinator, Tina Hammond, had found another facility near Rose's home, but the Agency for Persons with Disabilities blocked the move because the home wasn't certified to accept intensive cases like Kevin's. Instead, state officials proposed moving Kevin somewhere even farther away from Rose's home.

Rose visited the locked-down facility with her lawyer. She wasn't allowed to see the rooms. Kevin wouldn't be allowed to bring anything except a radio.

"No way do I want Kevin to be in this facility," she told her attorney, who got a judge to block the state's effort to place Kevin there.

Both Rose and Taylor believe the state was retaliating for the investigation. They knew that other men at the Human Development Center — including a man who groped one staffer and threw a brick at another — were moved into other group homes. That man's legal guardian was a top official with the Agency for Persons with Disabilities.

Some, like Kevin, require a judge's consent to be moved. But in Kevin's case, a judge revised Kevin's order in June 2009 to say he just needed an appropriate, supervised but "non-secure" home. The order doesn't specify it has to be HDC.

The state can't comment on Kevin's case or why he can't leave his group home, but Mike Palecki, an attorney for the state, said the Agency for Persons with Disabilities doesn't place sex abusers anywhere without considering the public risk first. There are 43 "intensive" group homes in the state, but not all accept sex offenders. Two group homes have rejected Kevin in the past year, and the state can't make them accept Kevin.

"We're not heartless people, we're caring people," Palecki said. "There aren't that many options."

Storms launched a two-agency investigation, but nothing changed as a result.

There is "no excuse for APD allowing this type of outrageous behavior to occur," Storms said. "It still seems hard for me to believe that there was no provider anywhere in the state of Florida that was willing to take Kevin."

In some ways, Rose felt she and Kevin were no better off than when Storms' office got involved.

• • •

Eileen Taylor was definitely in a worse position. In the middle of the investigation into "quiet time" she was fired.

The state maintains Taylor wasn't terminated for exposing "quiet time," but could not elaborate. Palecki, attorney for the Agency for Persons with Disabilities, called Taylor a "disgruntled employee who is lashing out at the agency."

The Florida Commission on Human Relations ruled June 16, 2009, that Taylor, a single mother of two, shouldn't have been fired. She was a legitimate whistle- blower, whom the Agency for Persons with Disabilities retaliated against. The commission recommended that the state pay her back for missed salary, clear her personnel record and reinstate her to the same or equivalent position.

Tina Hammond, Kevin's waiver support coordinator, was also fired by her employer, ADEPT Community Services, a state contractor. Hammond sought protection under the state's Whistle Blower Act, but was denied.

"Did Tina do everything right? Absolutely not," her former boss Maryanne Spielman said. "Did she care about the consumer? Absolutely."

Hammond says the state pressured Spielman to fire her.

"We don't take vengeful actions because a waiver support coordinator represented a client against the agency," Palecki said. "That just doesn't happen. We respect them. They're excellent advocates."

• • •

The policy on sexual activity in group homes that the Agency for Persons with Disabilities pledged to tackle has yet to be adopted two years later.

After the state learned of the Times investigation into the Human Development Center, state officials convened a task force to draft a policy on sexual activity in state-run group homes. Guidelines for private, state-licensed group homes are being discussed, too.

A draft of one policy would ensure that sexually aggressive residents don't room with anyone else, but it doesn't prohibit sexual activity in group homes unless the disabled are children. Prohibiting adult sex might violate civil rights, Palecki said.

The Human Development Center's revised policy on sexual behavior states it will not promote sexual activity among residents. Condoms will still be available, but only if competent adults ask for them.

Church still believes "quiet time" has value and wants it reinstated. So do the residents, she said.

In August, she brought four men to an interview with the Times to talk about "quiet time" and her center. The men declined to disclose their names at Church's urging because some are accused of sex crimes and could be harassed.

One man, who said he is gay, said "quiet time" was his time to express his sexual rights. He wants it back. Another man of lower intellect said he remembered "quiet time" and recited the center's old guidelines. But he got confused when he was asked whether he thought someone could be victimized during "quiet time."

Whether someone has the capacity to consent to sex is studied case by case, Church said. It's a careful balancing act protecting the men and allowing them their legal and consensual desire to have sex.

The answer, she said, isn't a blanket ban.

"We can't just decide as a society that a group of individuals can't make decisions," she said. "They're not born with a certificate that says they're not competent and not able to make choices for themselves."

Occasionally, she said, they will make a bad choice.

• • •

Every other Sunday, Rose Rouse gets in her car about 6:45 a.m. for the 2 1/2-hour drive to Stark Road. She spends about three hours in Seffner, bringing Kevin's favorite chicken wings with blue cheese dressing from the Wing House.

Some of the stained carpets, soiled box springs, roaches and torn couch cushions that inspectors saw as late as this summer have slowly been replaced by new floors and furniture. A new air conditioner hums outside Kevin's home. But it's not enough to buoy Rose, who leaves each time emotionally drained. The 74-year-old has suffered several mild heart attacks over the past two years, and she worries no one will keep an eye on Kevin when she dies.

Sometimes, Kevin, now 42, asks her why he can't move closer to home.

"They're looking, Kevin."

"Tell them I'm good."

Justin George can be reached at jgeorge@sptimes.com or (813) 226-3368.

ABOUT THIS STORY

This story is based on two years of reporting, hundreds of pages of internal Human Development Center documents, caseworker notes, Agency for Persons with Disabilities inspection reports, Hillsborough County Sheriff's Office records, Florida Department of Law Enforcement records, court records and Department of Children and Families investigatory reports. More than 40 people were interviewed. Incidents described at the group homes are taken from DCF reports, HDC documents and sheriff's reports, as well as interviews with staff, nurses, support coordinators and residents.

Group home's unorthodox sex policy disquiets mother 12/18/10 [Last modified: Sunday, December 19, 2010 2:14pm]

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