Report faults Texas treatment of mentally disabled

link here

By JEFF CARLTON Associated Press Writer © 2010 The Associated Press

May 27, 2010, 4:17PM

AUSTIN, Texas — A mentally disabled man with feces on his hands and legs was found shoeless and pantless wandering through a field in 14-degree weather. Officials say overwhelmed staffers at the state institution where he lived were occupied with other assignments.

A report released Thursday examining conditions at the Lubbock State Supported Living Center found more problems with a state-run facility a year after Texas lawmakers agreed to spend $112 million to improve conditions under threat of a Justice Department lawsuit. The federal government had documented widespread mistreatment of the mentally disabled in Texas.

Among the problems cited by independent monitors at the Lubbock facility was a critical shortage of nurses, resulting in significant medication errors. The facility has 50 vacancies in its nursing department, which is budgeted for 105 employees.

The report also says the Lubbock center has a 60 percent annual turnover rate among employees who directly care for the mentally disabled. Low wages make it difficult to find loyal employees, officials acknowledged. Staffers who work directly with mentally disabled residents make about $22,400 a year in Lubbock.

"This is not easy work, and the pay is not extraordinarily high," said Chris Traylor, commissioner of the state agency that oversees Texas' 13 institutions. "In order for staff to be retained in this work, you have to have a heart for what you are doing."

At least 13 workers have been fired since July for the abuse, neglect or exploitation of residents, according to the report. A member of the monitoring team called the abuse hot line to report neglect of a female resident who appeared to need help. When taken to the hospital, she was diagnosed with a urinary tract infection, an infection in her mouth and pneumonia.

The monitoring team criticized the school for having six workers caring for 20 residents, "all of whom were totally dependent on staff for every activity of daily living."

Medical record keeping was another problem. In one case, a Feb. 24 abdominal x-ray of a resident showed a coin in the lower intestine, but it was not in the resident's medical record and went unreported to the medical team until March 17.

Other problems include grouping too many residents with behavioral issues together, creating tired workers by forcing them to work mandatory overtime, high levels of aggressive incidents among residents and significant underreporting of medication errors.

The report was not entirely negative. It praised the Lubbock facility for its staff's knowledge on reporting abuse and neglect and efforts to serve residents in an integrated setting. It also said communication between medical departments was impressive.

The report was based on monitoring done during a one-week period in mid-March.

The monitors were permitted in the facility as part of an agreement with the Justice Department. It resulted from a series of federal investigations that found that at least 53 deaths from September 2007 to September 2008 were from conditions considered preventable, such as pneumonia, bowel obstructions or sepsis, indicating lapses in proper care.

The Lubbock report and others across the state are considered baseline reports. The institutions will be inspected every six months beginning in July to make sure they are in compliance with the Justice Department settlement. Texas has until the end of 2013 to bring their facilities into compliance.

"It does instill us with a sense of urgency," Traylor said. "We are focused on long-term improvements that will last long after the settlement agreement is concluded."

The 13 institutions are home to about 4,300 residents with significant intellectual and developmental disabilities. The facilities employ nearly 13,000 people.

___

Associated Press writer Jim Vertuno contributed to this report.

Slipping Through the Cracks

by Emily Ramshaw

April 21, 2010 | LINK HERE

Cameron Maedgen knows he’s dangerous. The autistic, brain-damaged and often suicidal 19-year-old — turned over to the foster care system as a drug-addicted infant — has violent outbursts and a fascination with guns. He's been jailed three times and admitted to a San Angelo-area psychiatric hospital six times since January.

But his adoptive mother’s tireless effort to find her son structure — a group home or residential setting where he’ll be safe and well-treated — has been foiled by a single factor: his IQ score. The state calls Maedgen too high-functioning for a residential facility or for the in-home program it funds for people with disabilities. Karen Bartholomeo says her son is too low-functioning, and certainly too unstable, to go without them.

Maedgen isn’t the only one in this conundrum. Advocates say a rising number of autistic and mentally ill children are reaching adulthood without the prospect of services because their IQs are simply too high. The state limits admission to its state-supported living centers to disabled people with IQs under 70 — and generally caps community-based care at an IQ of 75. Just because an autistic person’s IQ averages out higher, these advocates say, doesn’t mean he or she can manage without care.

“There’s nothing for us,” Bartholomeo says, her voice tinged with desperation. “Right now, my only hope is that he doesn’t kill himself, that he doesn’t hurt anyone else and that he stays out of the prison system.”

In the inverse situation, advocates say, are people with disabilities whose IQs are just low enough to keep them in state institutions but who might be better served in the community. But if their IQs test above 75, they not only don't qualify for the state-supported living centers — they don't qualify for most community-based programs either.

IQ tests are designed to measure the mental ability of children and to identify people who have cognitive or developmental disabilities. They're one of several criteria state officials use to determine whether someone qualifies for services, either at home or in a residential setting. Though the tests and what they seek to measure are complex, "as degrees on a thermometer show a person's temperature, IQ tests measure intelligence calculated from questions or tasks found ... to reflect intellectual functioning," said Cecilia Fedorov, a spokeswoman with the Department of Aging and Disability Services.

Though some experts question the veracity of IQ tests, of which there are a half dozen different varieties, they're recognized by national organizations like the American Psychiatric Association and the American Association of Intellectual and Developmental Disabilities — and so are used by state agencies that need some barometer for offering care.

Currently, 15 percent of the 4,300 residents in Texas’ state-supported living centers have “mild” mental retardation classifications, meaning they have IQs between 50 and 70. Fedorov said local mental retardation authorities perform the initial IQ test when a person applies for services. “Once an IQ determination is made, individuals are not required to be re-tested,” she said.

The cut-off gives institutionalized people and their guardians little incentive to get updated IQ assessments, for fear they’ll be left without any services, said Beth Mitchell, an attorney with the nonprofit disability rights group Advocacy Inc. “The real issue is why we have to tie services to a number — and it’s because of a lack of funding,” Mitchell said. “But if this kid ends up bringing a gun to a public place, ends up getting shot by a cop because we couldn’t spend a couple of extra dollars for care, what’s the cost to society?”

Vicki Hill Riedel’s 22-year-old son, Ryan, faces the same barrier. He has Asperger’s, schizoaffective disorder and seizures — but his IQ is normal. Ryan didn’t last long at a psychiatric group home, which had no experience with autistic patients. He’s been taken to a Plano-area psychiatric hospital so many times that the local police called Texas’ Adult Protective Services division. Ryan faced the exact same hurdle at the local mental health/mental retardation authority — his IQ surpassed 80, so he didn’t qualify for care.

At home, Riedel says, Ryan sleeps half the day then plays video games, occasionally agreeing to do minor chores in return for a trip to a restaurant. Rather than enjoying their retirement, Riedel says, she and her husband are essentially forced to run an assisted-living facility in their home. They have no alternative. And when they grow too old to care for Ryan, he won’t either. “My son,” she said, “is on the leading edge of a tremendous number of children with various levels of autism who will be reaching adulthood very soon.”

Bartholomeo, a social worker at San Angelo’s Goodfellow Air Force Base, became Maedgen’s foster parent when he was 3 weeks old and weighed just 5 pounds. Born addicted to cocaine, he required years of extensive rehabilitation to catch up developmentally. Maedgen’s behavioral problems presented early and only worsened. He was diagnosed with depression, ADHD, bipolar disorder and then finally Asperger’s, a form of autism in which language develops normally. He was on six different medications at once.

Maedgen thrived with structure, but Bartholomeo could only find it for him intermittently. She got him admitted to a youth residential treatment center and then a youth home, but both times he was too tough for workers to handle. Back at home, he was bullied in school and started stealing — jewelry from Bartholomeo, then BB guns from the local Academy store.

Bartholomeo turned Maedgen back over to state custody before he turned 18, hoping he’d have better access to services than she could provide. But when there were no foster homes to take him, and she learned he would be sleeping on the floor of state offices, she brought him back home. She visited private facilities she couldn’t afford. She begged and pleaded with disability officials to put him in a state-supported living center or to find him a group home. But averaged together, his performance IQ of 60 and his verbal IQ of 130 put him at a score of 95 — at the low end of “normal,” and well above the state’s cut-off.

In the last year, Maedgen stole a handgun “because it was pretty,” fired it in a local park, then called the police on himself, Bartholomeo says. He sometimes stops taking his medicine, repeatedly cuts himself, then calls authorities to tell them he’s suicidal. And he’s become violent with his mother.

Bartholomeo recently found a state Medicaid program that gives Maedgen 16 hours a week of cleaning, grocery shopping and laundry help — but not the psychiatric or developmental services he needs. “If I could find a way to get his IQ down to borderline, then he would qualify for a group home, for a little bit of structure,” Bartholomeo says. “He’s got a disability.”

U.S. official critical of state's living center agreement

Link here to Corrie Maclaggan's Austin American Statesman article

The U.S. Department of Justice's civil rights chief said Friday that an agreement with Texas on fixing state institutions for people with mental disabilities "falls short" on moving people out of the facilities.

"There are just so many people who are being warehoused in these institutions, and I think that's a tragedy," Thomas Perez , assistant attorney general for civil rights , said in an interview in Austin. He was in town to speak at a National Conference of State Legislatures redistricting law seminar.

Last June, the Justice Department and Texas entered into an agreement to improve health care and speed up investigations of abuse and neglect at the 13 facilities now known as state supported living centers. It was the culmination of a federal investigation that began in 2005 at the Lubbock facility after reports of abuse and neglect and later expanded to the other institutions.

Perez, an appointee of President Barack Obama, took office in October — months after the Texas deal was signed. It's not clear whether his objections — which signal a departure from what the Obama administration said at the time the deal was announced — could affect Texas. He said he inherited the agreement and needs "to respect that on a certain level." But now, he said, he'd like to implement far more aggressive agreements with states.

"The paradigm prior to our arrival was: 'Let's just make sure that the facilities are safe,'" he said. "The new paradigm is: 'Question No. 1 — What is your plan for moving eligible people into communities? Step two ... What is your plan for ensuring that the facilities are safe?"

Texas' philosophy, one state official said, "may be a little different."

"In Texas, we support choice," said Stephanie Goodman, a spokeswoman for the Health and Human Services Commission , referring to the options of living in institutions or smaller group homes or enrolling in state programs that help people with disabilities live at home.

Still, the state is committed to ensuring that the population of the institutions continues to decline, said Cecilia Fedorov , a spokeswoman of the Department of Aging and Disability Services. About 4,300 now live in the institutions, down from 5,428 in 2000.

Texas allows people who want to leave state supported living centers to skip over a waiting list for home-based programs, and last year the Legislature expanded the number of spots in home-based programs available to living center residents.

"We need to be doing everything we can to make successful transitions for people who wish to move," Fedorov said.

Perez said that an ideal agreement would have specific numbers of people that the state should move out and timelines of when that should happen.

The Texas agreement requires the state to identify people who want to move out of the institutions, help them make that transition, and make sure their needs are met in their new setting, Fedorov said. But there are no specific numbers on how many people should move out.

Without those specifics, said state Rep. Elliott Naishtat , D-Austin, a member of the House Committee on Human Services, "what we're dealing with is wishful thinking at best."

At the time the agreement was signed, U.S. Attorney General Eric Holder praised it.

"The Justice Department is committed to protecting the fundamental rights of all our citizens," Holder said in a June 2009 press release. "This agreement reflects that principle by protecting the civil rights of some of Texas's most vulnerable residents."

In the 1990s, Texas closed two state institutions as part of a lawsuit settlement. Later, the state considered closing more, but after heated hearings, decided not to.

Susan Payne of College Station, whose sister, Diane Ward , lives at Denton State Supported Living Center, said she finds it "very offensive" that Perez would say people are being "warehoused."

"Family members of people who live at the state supported living centers are very, very aware of the options in the community, and the families have chosen this as the best setting," Payne said.

But Perez said that moving people out of institutions is long overdue.

"It's a heck of a lot easier to have everybody in one setting," he said. "But ease should never trump what is right, and what is constitutional."

cmaclaggan@statesman.com; 445-3548

Disturbing findings in wake of 'fight club'

By TERRI LANGFORD

Copyright 2010 Houston Chronicle (Link)

March 22, 2010, 10:24PM

Criminal fingerprint checks show at least 36 employees continued to work on the state payroll while caring for the mentally disabled — despite being arrested for felonies ranging from indecent exposure, to aggravated assault, child rape and murder.

Of those 36 with arrests, 17 had felony convictions and the remaining 19 still face trial, according to Texas Department of Aging and Disability Services records released to the Houston Chronicle Monday.

The release of the records, first requested six weeks ago, came on the eve of a House committee meeting Tuesday in which lawmakers will discuss for the first time what improvements have been made regarding care at the facilities in the wake of last year's shocking “fight club” incident in Corpus Christi.

While that's less than one percent of the 11,785 DADS employees who were fingerprinted and work at 13 State-Supported Living Centers, formerly known as state schools, the newest reform shows how pre-employment criminal background screens failed to alert the state to employees with criminal records.

Current pre-employment screening only checks for convictions in Texas. The fingerprint checks linked employees to convictions and arrests outside of Texas. Of the 17 with convictions, 13 have been terminated or resigned. The other four are still in “process” according to the agency, which released the numbers without comment.

“Of course it still matters. That amount of people has control over a handful of residents who are unable to communicate abuse or neglect or ward off that type of aggression,” said Beth Mitchell, senior managing attorney for Advocacy Inc., a group that has fought for better care of the mentally disabled in Texas. “You don't want someone like that corrupting other staff. That's what we saw in Corpus Christi. It only took one staff to corrupt a group of staff in the fight club.”

Cell phone fight videos

The incident, at what has now been renamed Corpus Christi State-Supported Living Center, was discovered by police a year ago when a lost cell phone had videos of mentally disabled residents fighting. Voices of the residents' state caretakers could be heard encouraging the residents to fight one another. Since then, four former DADS workers have been convicted as a result.

The fingerprint checks and another new reform, random drug testing — which snared 23 DADS employees who tested positive for drug use — are the only significant progress seen in the year since the cell phone video surfaced and since DADS entered into a settlement late last year with the U.S. Department of Justice.

A “baseline” report on the Corpus Christi facility, the first of 13 to be conducted on each center as part of that DOJ agreement, shows little has been done since the fight club scandal put Texas' care of the mentally disabled in the spotlight.

While the March 10 monitoring report of Corpus Christi State-Supported Living Center revealed “a number of good practices in place,” it also noted “a number of the areas in which there is a need for improvement.”

For example, in the past year, the state has yet to establish a “zero tolerance” of abuse at Corpus Christi, there are no full-time psychiatrists on staff in the Corpus facility and no standard diagnostic procedure in place for residents with psychiatric problems.

“It's pretty clear from the report that they're really far behind in meeting the criteria of the DOJ settlement,” Mitchell said.

Also, the DADS staff in Corpus has not come up with better ways to monitor the physical and nutritional needs of their residents and are not able to pinpoint those residents who are at-risk of abuse.

“The Facility is at the very beginning stages of implementing the process of screening individuals to determine if they fall into an at-risk category,” the report stated.

Documentation problems

In many areas, the monitors noted the Corpus Christi facility failed to keep proper documentation on residents. Dental care records were missing, as was proof that staff reviewed some residents' medication and allergies. The current forms being used at the Corpus Christi center failed to document residents' vocational strengths, needs or preferences.

A spokeswoman for state Rep. Patrick Rose, D-Dripping Springs, the chair of the House Committee on Human Services, said Rose would not be making any comments about the report until Tuesday's meeting. Calls to other members, including state Rep. Abel Herrero, the committee's vice chair, were not returned.

terri.langford@chron.com

Report: State facility for people with disabilities lacks psychiatrists, trained therapists

Report: State facility for people with disabilities lacks psychiatrists, trained therapists

Posted using ShareThis

By Corrie MacLaggan

AMERICAN-STATESMAN STAFF

Published: 8:54 p.m. Friday, March 19, 2010

Nine months after Texas and the U.S. Department of Justice entered into a settlement to improve health care and more quickly investigate reports of abuse and neglect at state institutions for people with mental disabilities, the facility in Corpus Christi doesn't have staff psychiatrists, has therapists who are ill-equipped to work with people with complex needs and doesn't have a clear zero-tolerance policy for abuse and neglect.

That's according to a new report on the Corpus Christi State Supported Living Center, the first issued by monitors reviewing the 13 institutions as part of the settlement. On Tuesday, the state House Committee on Human Services is set to examine progress at the facilities.

"The state-supported living centers, specifically Corpus Christi, are overwhelmed in meeting their responsibilities for caring for people with intellectual disabilities," said state Rep. Abel Herrero , D-Robstown , who is vice chairman of the committee and whose district includes the Corpus Christi facility.

The report says that the culture appears to be changing for the better at Corpus Christi, where last year staff members were found to have been organizing fights among residents. Staff members seemed to know to report suspected abuse and neglect immediately, and when asked how, they consistently flipped over their badges to show a sticker with instructions. And residents "appeared happily engaged" in activities, the report said.

But it also said that people who might benefit from alternative communication devices don't have access to them, and that residents are over-prescribed psychotropic drugs.

"We agree that there are many areas of concern, many areas in which we need to make changes and improvements," said Cecilia Fedorov , a spokeswoman for the Department of Aging and Disability Services .

The preliminary report about Corpus Christi — reports on the other institutions are expected by summer — isn't evaluating whether the facility is adhering to the settlement terms. That comes later, and the monitors will review each facility every six months until it has been in compliance for a year — a process Fedorov said could take five years or more.

The settlement is the culmination of a Justice Department investigation that began in 2005 at the Lubbock State School after reports of abuse and neglect and later expanded to the other facilities.

In addition to the changes required by the settlement, the Legislature last year mandated video cameras in common areas (they're in place in Corpus Christi but not yet elsewhere); random drug testing of the 12,500 employees (16 have been fired for testing positive, and seven resigned instead of getting tested); and fingerprint background checks for employees and volunteers (these are taking place, officials said).

"Although there are encouraging signs of progress, we still have a long way to go in making the system the best it can be for this vulnerable population," said state Sen. Jane Nelson, R-Flower Mound, chairwoman of the Health and Human Services Committee and author of reform legislation.

In the report on Corpus Christi, the monitors noted that the limited availability of psychiatry services — there are two part-time consulting psychiatrists but no full-time staffers — "appears to have a negative impact on the delivery of services."

Fedorov said that the department is "aggressively recruiting" to find two staff psychiatrists. "We, like everybody who does deal with behavioral health, are competing for very few licensed and qualified psychiatrists," she said.

On the drug issue, the report gave an example of a resident whose behavior deteriorated after his mother's death. He threw temper tantrums, destroyed property and manipulated staff members.

Instead of a behavior management program, "the psychiatrist is prescribing potentially hazardous and dubiously effective drugs to stop the behaviors," the report said.

Beth Mitchell, managing attorney of Advocacy Inc., which advocates for Texans with disabilities, said the communication aid issue raised in the report shows how far behind the centers are in providing adequate care.

"Communication is often the reason people have behavior problems," she said. "If you can't communicate, you act out."

Mitchell also said she's worried about the lack of a clear zero-tolerance policy. "This is a place where people were being beat up, and you don't have zero tolerance?" she said.

Fedorov said that the department does not tolerate abuse and neglect, but that "we need to take steps to make sure that the policy is even more clear to everybody who comes on campus."

As part of a new legislative requirement, Gov. Rick Perry in February appointed an ombudsman for state supported living centers. George Bithos , a dentist and ordained Greek Orthodox deacon, has been visiting campuses since starting the job.

"I have found very dedicated people and people that are open to being looked at," Bithos said. "I've been impressed with the quality of the people, yet I'm aware that there are problems \u2026 that we'll need to take very seriously."

cmaclaggan@statesman.com; 445-3548

Death at Lubbock State School center of Texas statewide controversy

January 27, 3:41 PMDallas Disability ExaminerSteve Carter

Michael Nicholson was killed June 6th, 2009 by his caretakers at the Lubbock State School.
To date, only one arrest has been made. No trial or conviction has been set.

In a heinous act, of abuse of power caretakers at Lubbock State School killed MIchael Nicholson by strangulation. According to a Youtube video (see below) the violent strangulation of Michael occurred because of a dispute over clothes. It seems that Michael did not want to wear the type of clothes issued by the state school, preferring to select his own.

A common theme occurs all to often in homes for the aged and in institutions serving the disabled persons. The theme is about the loss of liberty afforded people simply because they have a disability or are of a certain age. Institutions decide a person cannot make decisons most of us take for granted such as what clothes to wear, when to entertain guests, and whether or not to have a plant in our room.

Certainly most of these do not erupt into the violent abuse that cost Michael Nicholson his life. Yet, the rules are abusive and are made without logic and enforced variably.

Prosecutors and law enforcement personnel do not take crimes against people with disabilities seriously because they "do not make good witnesses". Community Now! is an advocacy organization pushing for better enforcement of acts of abuse against those in institutions.

James "J.T." Templeton

KAYE BENEKE

James 'J.T.' Templeton

Longtime advocate for those with disabilities died Monday.

By Christina Rosales

AMERICAN-STATESMAN STAFF

Updated: 12:31 a.m. Friday, Jan. 29, 2010

Published: 9:56 p.m. Thursday, Jan. 28, 2010

James "J.T." Templeton, born with cerebral palsy and housed for 30 years in a Texas mental institution, wished for an ordinary life. But his advocacy for those with disabilities made his life extraordinary, his friends said.

Templeton died Monday . He was 59.

"Working with him helped develop and open my eyes to the civil rights struggle that people with disabilities are fighting," said Spencer Duran , a project specialist with the Accessible Housing Austin advocacy group.

Templeton moved out of the Austin State School in 1986, following a landmark federal lawsuit filed in 1974 against what was then the Texas Department of Mental Health and Mental Retardation. In the 1990s, he was part of a group that sued the City of Austin to make parks and facilities more accessible. He joined protesters who took over former Gov. Ann Richards' office in September 1991 to urge lawmakers to spend money for state schools on community-based initiatives for the disabled instead.

His close friend Stephanie Thomas said Templeton spoke to numerous lawmakers, including a U.S. Senate committee, and became a "voice for those with disabilities."

Templeton had numerous health problems, including respiratory infections. His partner of 14 years and fellow activist, Karen Greebon , died in 2005.

"He taught me a lot about how people with speech disabilities are not paid attention to," Thomas said. "Anyone can have opinions about how they want to live. They might not write a doctoral thesis about it, but they can make decisions for themselves."

Thomas said Templeton had a fierce activist spirit but a gentle soul. Duran said Templeton was the voice of reason and experience in pushing for affordable housing on Accessible Housing Austin's board of directors.

"People with disabilities are thought of as a barrier to affordability," Duran said. "They have been excluded in the development process."

Thomas said Templeton shared his story of being dependent on and discouraged by workers at the Austin State School who told him he could not make it in the "real world" so lawmakers could see how their decisions affect real people.

"His advocacy for himself and other people and getting out of the state school was an uphill battle," Thomas said. "He looked toward what he wanted to do and kept working for it."

crosales@statesman.com; 445-3766

Find this article at:

http://www.statesman.com/news/local/james-j-t-templeton-201020.html

Secret film uncovers 'disabled hate crime' in Wales

(link)

Footage of attacks on disabled people and their property was recorded for the programme

Some disabled people in Wales are suffering abuse and threats for no other reason than their disability, an investigation by BBC Wales has found.

Secretly recorded footage for the documentary Why Do You Hate Me? shows a wheelchair user being mocked and threatened in a bar.

In another incident a mother and daughter film an attacker smashing every window on their mobility car.

In Wales in 2009, police recorded 116 such incidents, with 18 convictions.

The programme, to be shown on BBC One Wales on Monday evening, reveals how many such incidents go unrecorded.

I think we haven't collectively picked them up and investigated and prosecuted them in the way we should Kier Starmer QC, director of public prosecutions

The Director of Public Prosecutions, Kier Starmer QC, admitted that the justice system did not always get it right when dealing with so-called disability hate crime.

He said: "I think there are lots and lots of incidents of disability hate crime.

"I think we haven't collectively picked them up and investigated and prosecuted them in the way we should."

A CCTV camera catches a vandal attacking Irene Miles' vehicle

The programme is presented by Simon Green, a wheelchair user from Bridgend, who secretly filmed a couple of his nights out to expose the hostility and abuse he sometimes experiences.

During one evening he was confronted by a group of men who verbally abuse him, swearing at him and calling him a "cripple", and suggesting he could really walk.

Mr Green, who has been a wheelchair user for six years, says during that time he has been physically, as well as verbally, assaulted because he is disabled.

'Nuisance to them'

And though the law has got tough on people who abuse others on the grounds of their race or religion, the attitude towards often low-level but continued abuse of disabled people seems far behind, the programme found.

Mr Green also met Irene Miles, 77, who was born disabled. She and her daughter Lorraine, who is her full-time carer, say they have suffered years of abuse at their Newport home.

Simon Green went under cover to film for the programme

The most recent attack was captured by a CCTV camera and shows a hooded man running around their vehicle, smashing every window before disappearing down the road. The vehicle is a lifeline for the family.

They said they have contacted police 60 times in the last five years, but only this latest incident, which happened last November, has been categorised as a hate crime.

Lorraine said: "I feel as though the police think we're a nuisance to them. I think now they're sitting up and taking note but the help for me and my mum has come far too late."

The family believe their case has similarities with the horrific story of Fiona Pilkington.

She killed herself and her disabled daughter, 18, in Leicestershire in 2007 after years of persistent abuse.

Gwent Police are now reviewing the handling of Lorraine and Irene's case.

Chief Supt Paul Symes says, "I will do my upmost to ensure that this is not a Pilkington case for Gwent Police. I'm aware of what the learning was within Pilkington, part of that involved some criticism around some perception that agencies weren't working together."

Campaigners say disability hate crimes are too often unreported by victims and under recorded by police but that this needs to change.

Why Do You Hate Me? is shown on Monday, 4 January on BBC One Wales at 2030 GMT.