We begin with an urgent call for reform on behalf of New Jersey's most vulnerable residents.

A new report paints a stark picture of systemic failures within the state that are hurting the thousands of individuals here with intellectual and developmental disabilities.

It details a lack of oversight, enabling continued abuse at state run homes, along with too few supports blocked by walls of bureaucracy to help those residents and their families.

But perhaps the most shocking is the lack of progress by leadership at all state levels to hold agencies accountable when they've aired or to install checks and balances on the millions of taxpayer dollars that flow to these state licensed facilities.

Many of the recommendations made by Paul Aronsohn, the New Jersey Ombudsman for intellectual and developmental Disabilities and their families have been made year after year.

He joins me now to talk about the most severe among them.

Paul, thanks for coming in to talk about this report, because you say it's a call to action for some of the most severe persistent challenges facing the lives of these residents.

What are they?

Can you lay them out for us?

Well, first of all, let me tell you just a little bit about our office by the nature of our office.

The folks that come to us for assistance usually are ones that are have a time sensitive situation.

They're in crisis.

There's a problem.

So we're not you know, those you're not.

Getting the calls when things are sunny and rosy, Right?

We get it right.

So we get folks that are there in moments of need.

And what we do and we've sort of outlined this in our reports, is we get daily calls and conversations about abuse and neglect in concrete living settings for children as well as adults.

We work with families that have severe autism.

That's autism with severe challenging behavior, self-injurious behaviors, aggressive behavior, children again, as well as adults.

We work closely with folks that have medical complexities that are not being met, either supports private duty nursing or whatever medical needs they have are not being met.

And so those are the folks that we're dealing with on a daily basis.

So when you look at that, would you say abuse and neglect is still by and large the biggest issue that's being brought to your attention?

Yeah, I would definitely say that.

And again, I can't quantify it.

I always point this out in our report.

I can't quantify how much, you know, what percentage of the folks are are being, you know, experiencing abuse and neglect.

But I can tell you daily, these are the families, these are the individuals that we're working with most.

I mean, I read some of the anecdotes in this report, and I'll just share a couple because, I mean, quite frankly, they're disturbing.

They're emotional.

And I imagine that's why you decided to include them.

One parent who wrote in that her son was found eating raw frozen meat multiple times.

Another that her son was abused after being shuffled between group homes with to the point of hospitalization and then others where there are unexpected deaths.

And the state's not investigating them.

Why?

It's a good question.

I mean, you would think that, you know, on the one hand, you would think maybe the state would, you know, investigate all deaths that happen in group home settings.

But definitely the unexpected ones.

When you have an individual who's otherwise healthy living, fine, you would expect that there would be, you know, an automatic default that we would be investigating them.

And apparently we're not.

Who is is anyone having oversight over a situation like that?

Well, you know, the department of Human Services, you know, for adults and the Department of Families for Children.

But again, they're the ones that are responsible for conducting these investigations.

But apparently it's just not happening.

You know, all the time when you would think it would be.

So it's being left to the agencies themselves to self investigate.

You know, so when it comes to deaths, I mean, I think there's always a mortality review that's done sort of some a cursory review of sort of the situation.

But it's an investigation into, you know, why this why what happened, what led to this death, particularly, again, if it's unexpected investigations more generally or either done by the agency, the private agency or by the state, more often than not, it's done by a private agency.

So the report also, you know, lays out just different areas.

Of course, that you are looking at that are come up as issues for families.

I mean, housing being one, the lack of supports.

But what stood out to me the most that you looked at was money.

There doesn't seem to be a lack of it coming from the state.

The governor put about $1,000,000,000 more into the budget toward these services.

And yet these agencies are not responsible for making sure that the money is going where it needs to go.

How can that be?

It's an excellent question, and that's something that we find concerning.

Again, we you know, since I took this job over six years ago, I rarely, if ever, say that we need to put more money in the system.

Certainly we could use it like everyone could and certain families could use more, more resources.

But the governor, Governor Murphy and the legislature have been very generous in terms of dedicating a lot of resources, financial resources, to to care for folks with intellectual and developmental disabilities.

But there's seems to be a lack of oversight as to how these agencies are spending the money.

So give us an example.

I mean, I know that agencies are given a certain pot of money and there's a threshold for what they need to pay their direct support providers.

But families and individuals who have a budget through the state, they have a different pot of money and different rules.

Can you just make sense of that for us?

Yeah.

I'll do my best because it gets into the minutia.

I don't want to.

Over, you know, simplify, but.

So on the one hand, you have what they call self-directed families in the adult system.

These are families that get given a nice budget from the from the state and are able to spend it to hire staff as it is needed for for their loved one.

And they can do that.

But there's a certain set of rules and limitations placed on them that are not placed on the agencies.

There's also no public reporting of revenues for these agencies.

Nursing homes have that.

Long term care providers have that.

The state is really allowing minimal training for these workers, for them to be paid low wages and have little supports.

I know you are not in the business of making recommendations, but what is the takeaway?

You know, I look at it this way, Brianna.

You know, everything we do in this space is is hard, right, for for people who are working in government, making policy on this for the direct care workers, for the providers, educators, everybody working mostly.

This is not easy.

Right.

But none of it's rocket science either.

It's real common sense.

You take staffing, for example.

We know that if you paid staff a living wage, provide the right amount of training, hold them to the right standards.

You're not only going to have less turnover in staff, but you're going to have less abuse and neglect.

It's just real simple, very common sense.

We look at folks with autism and severe autism.

We know if we intervene early, early intervention, right.

If we identify it early and if we provide treatments and therapies early on, we know we're going to make for a better life for that individual in that family.

And so a lot of this is, you know, difficult.

But it's common sense.

And I think we can find our way forward.

We just need to.

You know, I quoted my mom at the end of this report, something she she always had these pearls of wisdom and something she always said to us as children, as well as adults, is where there's a will, there's a way.

And I really believe that.

Paul Aronsohn thank you so much.

Thank you.

Support for the medical report is provided by Horizon Blue Cross Blue Shield of New Jersey, an independent licensee of the Blue Cross Blue Shield Association.