The story about a comatose woman who was raped and later gave birth to a baby boy continues to unfold.
On Monday, former Maricopa County Attorney Rick Romley announced he would lead an internal review into the case. As upsetting as this story is, sexual abuse is not uncommon among vulnerable populations, including those with disabilities and the elderly.
"One of the patients just had a baby, and we didn’t know she was pregnant."
That’s an excerpt from the 911 call the day a 29-year-old comatose woman gave birth to a baby at Hacienda HealthCare in south Phoenix last month.
As more details come out about the woman — she had been living at Hacienda HealthCare since she was 3 years old and had a trach and a gastrostomy tube — the story continues to shock disability advocates and the community as a whole. It has also exposed the public to something else — something horrifying.
"The issue of sexual assault, sexual abuse is one that has gone grossly under-reported that it’s much more prevalent than we typically like to think about," said Jon Meyers, executive director of the ARC of Arizona, a disability advocacy group.
In fact, he says, "It’s clearly something that we don’t want to believe happens. But it does. It happens frequently."
At school, in day programs, group homes and long term care facilities. And it isn’t always staff — it could be another resident or someone from the outside. And to illustrate the problem, it’s important to look at the data: last year, NPR and the Department of Justice found that people with intellectual or developmental disabilities were seven times more likely to be victims of sexual assault. But why?
"People with disabilities are incorrectly perceived as being unreliable reporters of their own experience," said Arizona Rep. Jennifer Longdon. She is a wheelchair user and a disability-rights advocate.
She said few cases that are reported are successfully prosecuted.
Another issue, according to Longdon and others, about perception.
"We are often seen as being asexual or non-sexual beings. People can’t even imagine the concept that there is a sexual nature to people with disabilities," said Longdon.
And because of that, Longdon says, "there are instances where we may be seen as 'rape-proof,' and nothing could be further from the truth."
Which means providing staff with the training they need to recognize signs of sexual abuse, especially if a person is non-verbal.
While that might seem like a given, Meyers said that type of training is not required in Arizona.
"No. In the state of Arizona right now, provider organizations can contract with the Division of Developmental Disabilities to provide care for individuals with intellectual or developmental disabilities, and nowhere in that contract is it required that they train their staff to recognize any sexual abuse, any kind of sexual assault, any kind of exploitation that might be taking place."
It’s also important to talk to family and the person with the disability about appropriate sexual behavior.
"People with disabilities often do not receive any kind of sexual health education that might give them the language to not only understand and talk about sexual violence when it happens to them, but to recognize what is the difference between healthy sexuality, healthy touch, and unhealthy sexuality and coercion and things that are violating their boundaries," said Tasha Menaker, chief strategy officer at the Arizona Coalition to End Sexual and Domestic Violence. "And because we don’t do that, when people with disabilities are sexually assaulted, they may not recognize, they may not have the frame of reference to realize this is something that’s a violation of me, this person isn’t actually taking care of me, or invested in me in a healthy way, but actually exploiting me."
Menaker said another hurdle is that the state doesn’t allocate any funding to sexual assault-specific services or prevention services. That means less support for victims, including those with disabilities.
Sexual abuse isn’t just limited to people with disabilities. There’s another population that we’re not talking about.
"About 73 percent of elder sexual abuse cases are in a facility or institutional setting," said Lizzie Kazan with the Maricopa County Area Agency on Aging.
Despite the high number of sexual abuse cases in facilities, Kazan said, the reality is that less than 1 percent of any elder sexual abuse is ever reported.
She said many of the victims are afraid that their abuser will retaliate against them.
As more is discovered about the woman at the center of this story and facility where it happened, some community advocates are hoping it’ll be a catalyst for change.
Later this month, the Arizona Developmental Disabilities Planning Council will present a series of recommendations, including training for all people who work with vulnerable adults on how to recognize and report sexual abuse.