1. The seven state centers for the mentally retarded are Altoona (Blair County), Ebensburg (Cambria County), Hamburg (Berks County), Polk (Venango County), Selinsgrove (Snyder County), Western (Washington County), and White Haven (Luzerne County). The mental retardation unit is at Mayview State Hospital (Allegheny County).

2. Olmstead v. L.C., 119 S.Ct. 2176 (1999).

3. These results are based on a survey of families of 236 former Western Center class members who, according to DPW reporting as of July 20, 1998, had been placed in group homes. Survey results total 99 percent because responses were unclear or incomplete in one percent of the surveys.

4. Title 35 of Pennsylvania Statutes Section 10225 501 et seq. (Supp. 1999).

5. The term "direct care workers" refers to both residential services workers and residential services supervisors (also known as house coordinators) unless otherwise indicated.

6. We designated direct care workers as "current employees" if they were employed in the group homes during the period of our audit fieldwork.

7. Black’s Law Dictionary defines a felony as "a crime of a graver or more serious nature than those designated as misdemeanors" and notes that "under many state statutes, [a felony is] any offense punishable by death or imprisonment for a term exceeding one year." Black’s defines a misdemeanor as "offenses lower than felonies and generally those punishable by fine, penalty, forfeiture or imprisonment otherwise than in penitentiary." A summary offense is the least serious; according to Black’s, a summary proceeding is "any proceeding by which a controversy is settled, case disposed of, or trial conducted, in a prompt and simple manner, without the aid of a jury, without presentment or indictment, or in other respects out of the regular course of the common law."

8. Refer to the appendices for a detailed chart of staff criminal convictions by provider agency.

9. This chart reports information gathered regarding individuals who were employed in the group homes during the period of our audit fieldwork, with the exception of one individual who was employed at a different group home operated by the same provider agency.

10. Title 55 of the Pennsylvania Code Section 6400.21 (1999).

11. Current employees who had been employed by the same provider agency for one year as of July 1, 1998, were exempt from OAPSA’s criminal history background check requirement as a condition of continued employment. Current employees who had not been employed by the same provider agency for one year as of July 1, 1998, were not subject to OAPSA’s criminal history background check requirement until July 1, 1999.

12. 29 Pennsylvania Bulletin 6010-6027 (Nov. 27, 1999).

13. Each of the 186 hires for whom application timing was in regulatory compliance was a resident of Pennsylvania.

14. Title 23 Pennsylvania Consolidated Statutes Annotated Section 6344(b) (Supp. 1999).

15. Title 55 Pennsylvania Code Section 6400.21(e) (1999).

16. The turnover statistics do not incorporate data regarding the residential services supervisors.

17. The tenure of the current direct care staff is reported as of the initial date of fieldwork at each home.

18. Labor Force Statistics from the Current Population Survey, Bureau of Labor Statistics, September 1999.

19. The crude separation rate was calculated by dividing the number of residential services workers who terminated a direct care position in the home during the calendar year by the number of residential services worker positions in the home at the time of audit fieldwork.

20. Salary Levels and Their Impact on Quality of Care for Client Contact Workers in Community-Based MH/MR Programs, Legislative Budget and Finance Committee of the Pennsylvania General Assembly, February 1999.

21. Salary Levels and Their Impact on Quality of Care for Child Care Workers in Licensed Child Day Care Programs, Legislative Budget and Finance Committee of the Pennsylvania General Assembly, June 1999.

23. Volume 64 Federal Register pages 13428-30 (March 18, 1999).

25. Refer to the appendices for data regarding the timing and content of course provision to the direct care workers employed in the eight reviewed group homes during the period of our audit fieldwork.

26. Refer to the appendices for a detailed chart of training violations by provider agency.

27. Self-assessments, conducted three to six months prior to the expiration of a provider agency’s annual license, disclosed only one of the 67 training violations.

28. Title 55 Pennsylvania Code Section 6400.3(e) (1999).

29. We requested current figures from DPW, but that information was not provided to us.

30. Title 55 Pennsylvania Code Section 6400.18(d) (1999).

31. Title 55 Pennsylvania Code Section 6400.18(e) (1999).

32. Title 55 Pennsylvania Code Section 6400.16 (1999).

33. Title 55 Pennsylvania Code Section 6400.19(b) (1999).

34. The manuals were intended for distribution to state institutions. We did not attempt to determine, however, if the manuals were actually distributed to those institutions.

35. Generally, DPW follow-up to the final investigation report is performed by telephone.

36. Title 55 Pennsylvania Code Section 6400.18(c) (1999).

37. Title 55 Pennsylvania Code Section 6400.18(d) (1999).

38. Title 55 Pennsylvania Code Section 6400.17 (1999).

39. Title 55 Pennsylvania Code Section 6400.145 (1999).

40. According to group home personnel, post-administration counts are done to ensure that the amount of medication received by a resident can be reconciled with the remaining amount of medication not yet administered.

41. Homes recently inspected by DPW were excluded from the county’s review.

42. DPW personnel in the Western Region told us that they attempt to conduct one full licensing inspection on an unannounced basis each month, or 12 each year.

43. Title 55 Pennsylvania Code Section 6400.62(a) (1999).

44. Title 55 Pennsylvania Code Section 6400.64(a) (1999).

45. Title 55 Pennsylvania Code Section 6400.67(a) (1999).

46. Title 55 Pennsylvania Code Section 6400.15(a) (1999).