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Last month, employees of Maofu Home Health, a provider of group homes for people with intellectual disabilities with facilities across the state, were arrested for abusing a 29-year-old resident with severe autism less than a year after a 15-year-old boy in a Sugar Land Maofu facility nearly died.
The incident raised new red flags about long held concerns around how these types of facilities are regulated by the state.
“The reason these systemic issues persist is because the State has failed to establish a regulatory system that holds providers accountable,” said Beth Mitchell, supervising attorney for Disability Rights Texas.
Mitchell said investigations into providers are often delayed, allegations are minimized, and enforcement actions are weak.
“Providers have little incentive to improve, and vulnerable individuals continue to pay the price.” she said.
Revelations around how this system is underfunded and oftentimes unaccountable are not new.
The Arc of Texas found the average wage for someone providing care for an intellectually disabled person was $10.60. The rate was raised to $13 in the last legislative session.
Advocates have argued for years that direct service providers who can be tasked with feeding or bathing clients are paid too little, which leads to high vacancy rates. These lead to long wait lists of people hoping to access services.
“If you get the rates raised to improve quality, the rest all falls in line.” said Justin Botter, vice president of long-term care and intellectual and developmental disabilities at the Center for Health Care Services.
Botter noted the costs for incarceration and institutionalization are far higher than fixing community based care rates.
Problems with how the Texas Health and Human Services Commission (HHSC) regulates Home and Community-based Services group homes have been well documented by state district courts, where dozens of families have sued providers the past 20 years.
The issues have also been spotlighted in federal court, where a Judge overseeing Texas’ foster care system levied $100,000 a day fines against Cecile Young, HHSC commissioner, over how abuse and neglect investigations made in these facilities are handled. The fines were later nullified and are currently on appeal to the U.S. Supreme Court.
“Our top priority is protecting the health, safety and well-being of people served by the facilities and providers we regulate,” said Thomas Vazquez, assistant press officer for HHSC.
Investigations into these facilities are conducted by Provider Investigations, a unit that has had chronic backlogs, causing months to elapse before an allegation is investigated.
"To address investigation timeliness, the Texas Legislature, during this most recent session, provided HHSC with funding for 21 temporary positions over the next biennium and 34 ongoing positions specifically to address pending investigations. HHSC is already ramping-up its recruitment effort by posting positions statewide," said Vazquez.
Federal court records show the investigations make critical errors as well, often leaving vulnerable people in homes where they have been abused and neglected.
At the now defunct C3 Christian Academy, a child was allegedly abused and neglected 12 times, at one point being dropped off at a hospital with a broken jaw. The director of the facility admitted in court that she didn’t always report abuse allegations. The facility was finally closed in 2023.
“These failures are not isolated,” Mitchell said, highlighting issues with another provider, Sevita/D&S group homes.
HHSC in a statement said it had imposed more than $400,000 in administrative penalties and took more than three-dozen enforcement actions against 34 providers.
HHSC has confirmed to TPR that it is currently investigating Maofu for multiple allegations of abuse and neglect in San Antonio. It completed an investigation into the company’s Georgetown area facilities, and Maofu voluntarily closed its Houston-area locations after TPR’s coverage of the near death of a foster child.
Maofu did not respond to TPR's request for comment for this story. It operates 37 group homes in Texas, with 98 pending investigations for abuse, neglect and exploitation. Multiple investigations can be launched from a single incident into multiple staff members.
Officials with the Department of Family and Protective Services (DFPS) confirmed to TPR that they no longer place children in Maofu homes.
HHSC does allow the company to continue to work with intellectually disabled adults.
“It doesn't make me feel good,” said Jeff Duncan, whose adult stepson lives at another San Antonio-Area Maofu home.
He and his wife were told by a Maofu representative that their son is in good hands and that the abuse incident that the Bexar County Sheriff’s Office made arrests in was isolated, and that it only occurred because they asked the family to move their 29-year-old man to a state school.
But Duncan was not impressed with the home his stepson is staying in, saying it was dirty, there were patched holes in the walls, and that staff seemed unaware of the boy’s intense needs. Duncan said several of the boy’s medications were missing when they brought him home for a visit, and the man was constipated for six days.
He and his wife have gone to Austin to advocate at the legislature to increase funding for the facilities and the regulators. He didn’t see much progress, and felt legislators were uninterested in addressing the problems.
“It's just about money,” he said. “I mean, they'll tell you what you want to hear. And in the end, nothing gets done.”
