Sky Schaudt/KJZZ

Hacienda HealthCare facility in Phoenix.

More than a year ago, a nurse at Hacienda HealthCare in Phoenix made a 911 call that made international news.

An incapacitated woman had given a birth to a baby boy. Her alleged rapist was her caregiver. Since then, lawmakers, disability advocates and heads of state agencies have been trying to figure out how to keep this population safe. 

Most of will never forget that call made to 911: "We were not prepared for that. Baby’s turning blue. We need someone now!"

The story exposed the public to a disturbing truth: People with intellectual or developmental disabilities are seven times more likely to be sexually assaulted. If that person is female, she’s 12 times more likely to be victimized.

So, how do you stop another Hacienda from happening? Nearly a year ago, Gov. Doug Ducey issued an executive order to strengthen protections for people with disabilities. The order directed the state’s Medicaid agency and the departments of health and economic security to create a working group to identify gaps.

In November, the Abuse and Neglect Prevention Task Force published its report with 30 recommendations.    

Jon Meyers is the executive director of the Arc of Arizona, a disability advocacy group. He was a member of the task force.

"It clearly outlines what the people on the task force consider are the priorities that we should be focusing on here in Arizona," he said.

A section from the report released in November 2019. Read the full report.

Like stronger reporting requirements, more training for staff, so they know what abuse looks like and how to report it, a public awareness campaign to educate Arizonans about abuse, better tracking of incidents — and the list goes on.

The recommendations also have state agencies assigned to them, and, in most cases, deadlines. It’s a lot.  

"It is optimistic, I think," said Meyers. "And my concern is that the cost of implementing some of these recommendations, as important as they are, as absolutely necessary as they are, the cost may prevent us as a state from putting into effect some of the most necessary of them," he said.

And that’s the thing — accountability costs money.

→ Hacienda HealthCare Victim's Attorney Files Civil Suit Against State, Doctors

Ann Monahan is the board president of the Arizona Autism Coalition. She was also on the task force with Meyers.

"I was the one raising my hand a lot of times saying, 'OK, well, who is paying for this?'"

Monahan and the others say they initially were asked by the governor’s staff not to get tangled up in cost when crafting the recommendations.

"We had a finite time frame in which to work on these recommendations and provide them to the governor," said Meyers. "Everyone recognized that there were going to be significant costs involved in implementing them."

So, rather than limit themselves, Meyers says the group tried to identify all of the gaps and what it would take to fill them. Still, we’re talking about a system that’s grossly underfunded, according to Meyers and others.

Then there’s Proposition 206. The voter-approved measure that upped the state minimum wage to $12 an hour starting Jan. 1.

"It's hard work what we do. And minimum wage is not something that should be paid to an individual who is taking care of somebody else's life."
— Ann Monahan, Arizona Autism Coalition

Stuart Goodman, is the co-founder of Goodman Schwartz Public Affairs. He represents the Arizona Association of Providers of People with Disabilities.

He says unlike other industries, providers can’t reduce staffing or increase their fees to offset this latest minimum wage increase.

"In fact, the narrative that we often use is, before Prop 206, minimum wage, we got the employee who want to do better than fast food. Now, we have a have a situation where we're attracting the employee who didn't get that fast food employment and we’ve become the employer of last resort."

And that frightens Ann Monahan as she, and other providers, prepare to ask the Arizona Legislature for more money to care for this population. 

"We used to never be a minimum-wage group," said Monahan. "It's hard work what we do. And minimum wage is not something that should be paid to an individual who is taking care of somebody else's life. This is a life we're talking about. This isn't a hamburger, it's not stocking shelves at Target. This is a life."

But the reality is, caring for that life costs money. Here’s Goodman again.

Freedman family

Diedra Freedman with her son, Andy.

"The state is utilizing private sector entities to perform a state function. That's the reality of the structure. And so there is that disconnect between funding for those programs, at the same time forgetting that the ultimate responsibility: this is a state program that happens to have been privatized."

Republican Sen. Kate Brophy McGee was also on the task force. In a statement, she called the recommendations a solid foundation. She said everyone, from the governor on down, is committed to protecting and improving care for people with disabilities. Though funding was not directly mentioned, Brophy-McGee said some of the recommendations will require follow up legislation, while others could be implemented administratively. 

And a spokesperson for Gov. Ducey called the issue a high priority, and said they will continue to review the recommendations and take steps to implement them.  

While it’s not yet clear if the how the recommendations will be funded — through the state or by the providers — disability advocates and families say this issue isn’t just about money. It’s about our values.

Meet Diedra Freedman. She was part of the task, too. Her 18-year-old son, Andy, has several complex medical conditions, plus autism.

"You know, I know it's an old cliche, I know it's political," she said. "But it really does take a village to raise a child, especially a child like our son, Andy. Now that he's an adult, it takes that same village to allow him to have a quality of life."

And that made her work on the governor’s task force especially meaningful.

"I'm going to be 58 in a couple of weeks. Chances are, I'm not going to outlive my son, even with his complex medical problems. He doesn't have siblings. We do not have relatives in Arizona. We have amazing friends who have become family, but somebody is going to have to look out for him."

As for the young woman at the heart of this story, her attorney recently filed a civil suit against the state of Arizona and her two doctors.