Penn State University is a huge institution.  Its total enrollment hovers just below 100,000 students.  It hires almost 9000 instructors.  Thousands of others rely upon PSU for employment or economic livelihood through providing goods and services to the university, students and faculty.  It is widely beloved by students, alumni and community members.  It is, in many ways, a world unto itself.

In the New York Times this morning, I read an article about other types of institutions: those serving individuals with intellectual and developmental disabilities.  It seems that the State of New York officially guarantees “whistleblowers,” that is, staff who report abuse or neglect, with anonymity.  In practice, however, the names of those who reported have been routinely turned over to their employers.  The employees who followed state law and reported abuse where generally disciplined for not first going up “the chain of command” in the institution.  State officials claim that these practices, having been revealed, will now stop and whistleblowers will receive protection.  We shall see.

Many people have wondered why a college president, a revered football coach and many other highly-regarded individuals would allow accusations of child rape to go uninvestigated at PSU.  While I don’t know the answer, I think it has something to do with the nature of institutions.  Like those working at New York’s disability institutions, a person’s responsibility appears to end when he or she reports an incident up the “chain of command.”  By doing so, the institution can regulate itself within its own rules.  Questions of employment relationships, union contract obligations, statistical reporting and organizational reputation can be effectively managed.  Outside interference, be it through mandatory abuse reporting laws, whistleblower protections, media investigation or licensing and regulatory activity, is viewed as something else to be internally managed, not welcomed.

DRO, along with our 56 sister agencies across America, have authority to enter any facility providing care or treatment to individuals with disabilities in order to investigate complaints of abuse or neglect.  Many facilities fight to keep their doors closed to avoid scrutiny.  Like other P&As, DRO has had to go to federal court to gain entry to facilities so we could investigate reports of physical and sexual abuse.  During the past two years, the Social Security Administration has provided funding for P&As to visit facilities and providers who act as representative payees for their clients.  This initiative was prompted by confirmed reports of exploitation and abuse by some payees who operate institutions.

Oregon is poised to build another large, centralized mental institution in Junction City.  Long term care providers have flexed their muscle in the legislature to be “carved out” of health transformation in order to maintain an economically privileged position in the state budget.  There are clearly forces that promote, desire and love institutions.  Discussions about how to overcome the incentives to place institutional interests above those they are supposed to serve are much quieter.  Like at PSU, they can go up the chain of command and never be heard of again.