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TROUBLE WITH INDIANA'S INSTITUTIONS
STATE OF MISERY
Today, Muscatatuck only has 300 residents. But those residents continue to suffer incredible abuse and neglect at the hands of the people who are responsible for their care. In fact, over the past three years, investigators have substantiated 183 cases of physical, sexual and verbal abuse at the facility, 75 of which occurred in 1999. They cite a large number of injuries and other incidents as "unresolved and unwitnessed".
Advocates for people with disabilities are concerned about the abuses, and are taking action to improve conditions and get more people moved out. Dozens are expected to move out into the community this year.
Parents of those who live in the institution also worry about these reports, but apparently for different reasons. As we have seen repeatedly all over the country, the parents seem less concerned about the impact of the abuse on their adult children than they do about the impact the attention will have on the fate of the institution.
"The parents are worried that the problems will be used as an excuse to close the center," said Frances Egner, president of the Muscatatuck Parents Association.
Because the institution is the largest employer in this rural area, local residents and state employees, many of which are second and third generation employees of the institution, are concerned about the future of their jobs.
Continued downsizing is planned, but the Governor has promised to keep the facility open for the time being, even in light of these continued problems.
STAFF MEMBER ARRESTED FOR ASSAULTING
Robert H. Dobbins, 19, faces charges of battery on a mentally disabled person, Class D felony, battery resulting in bodily injury, Class A misdemeanor, and battery, Class B misdemeanor. His employer, Liberty Health Care, which had contracted with the institution to provide direct care staff, fired Dobbins after an internal investigation.
Neither police nor company officials would provide details of the alleged attack at the institution which houses almost 300 people with disabilities. Dobbins posted $1,550 bond and was released Friday afternoon. An initial hearing is scheduled three weeks from yesterday.
Muscatatuck has been the focus of abuse investigations in the not-too-distant past. Earlier this year, investigators confirmed 183 cases of abuse by Muscatatuck staff members during the previous three years -- 75 of those in 1999. During that same period, 47 state employees were fired for abuse. Another 72 state workers were reprimanded, but some were allowed to remain on the job even after abusing residents. Some were continued to work on the same unit where the abuse had taken place.
"WRITING ON THE WALL" FOR DEVELOPMENTAL
AGREEMENT MOVES HUNDREDS INTO COMMUNITY, BUT
KEEPS INSTITUTIONS OPEN FOR NOW
The state currently houses a total of about 600 people with developmental disabilities in Fort Wayne and Muscatatuck developmental centers. The good news is that the settlement, which is expected to be approved by a federal judge this week, calls for the state to continue to move those people into neighborhoods around the state, and increase oversight of community-based services.
Other parts of the plan are aimed at improving conditions for people living in the aging institutions, but may effectively strengthen the position of those who want Indiana to have some sort of institutional model. Specifically, the plan calls for increased oversight from state officials; thorough investigations of abuse and neglect complaints; punishment of employees involved in abuse cases; decreased use of certain medications that are used to control behavior; and use of physical restraints on people "only after other techniques have failed".
Parents of some institution residents, worried that group homes and other community-based services are not safe, are hoping there will always be an institution in Indiana.Some officials are hinting at the idea of building one or two smaller institutions to house about 150 people who are not expected to move into the community.
There have been a number of problems related to abuse and uninvestigated deaths at both community-based and institution programs over the past few years. Some initiatives are in the works to increase funding for training and staff pay increases in community programs.
The state's institutions have been the focus of abuse investigations over the past few years. New Castle State Developmental Center was closed in 1998 after a hidden-camera investigation by a local television station documented incidents of abuse at the facility. Earlier this year, investigators confirmed 183 cases of abuse by Muscatatuck staff members during the previous three years -- 75 of those in 1999. During that same period, 47 state employees were fired for abuse. Another 72 state workers were reprimanded, but some were allowed to remain on the job even after abusing residents. Some continued to work on the same unit where the abuse had taken place.
LAWMAKERS WANT TROUBLED FACILITY
In announcing the Senate's two-year budget proposal last week, Finance Committee Chairman Larry Borst said the state cannot afford to keep funding Muscatatuck Developmental Center, along with another institution at Fort Wayne, while continuing to build community supports.
The $93 million was to be targeted for building three regional centers and other supports in part to help institution residents make the transition into communities across the state. Lawmakers are afraid that a lack of a solid commitment from the governor's administration to close the facility, along with a clear time-line for down-sizing and closure, could create problems for the 260 residents, their families and for the institution's employees.
"We're trying to get the governor to make a choice," state Senator Luke Kenley told the Courier-Journal.
In 1997, the governor ordered Indiana's New Castle State Developmental Center closed after a television station broadcast showed hidden camera footage of employees abusing residents. It took the state about 15 months to close the institution and move its 150 residents into other settings, including apartments and other community-based options. It is reported that many relatives who had initially opposed the moves, are pleased with the new homes and the progress made by the former institution residents.
While the administration has been slow to commit to closing Muscatatuck, problems with the facility itself have helped push lawmakers in the direction of de-institutionalization over the past year. According to the Indianapolis Star, investigators a year ago confirmed 183 cases of abuse by Muscatatuck staff members during the previous three years -- 75 of those in 1999. During that same period, 47 state employees were fired for abuse. Another 72 state workers were reprimanded, but some were allowed to remain on the job even after abusing residents. Some continued to work on the same unit where the abuse had taken place.
Last December, architects who examined the physical structures at Muscatatuck and Fort Wayne Developmental Centers projected that it would cost the state over $124 million during the next 10 years to refurbish and maintain the aging buildings. Soon after the report, state officials asked for just $10 million over the next two years for building renovation and maintenance.
This report from the Louisville Courier-Journal has more details
about the Senate's position and the reaction from parent groups that fear and
oppose Muscatatuck's closure:
MUSCATATUCK TO CLOSE BY END OF 2003
O'Bannon's announcement came in response to the Senate's threat last month to withhold $93 million in funds, targeted for developing three regional centers and other community-based supports, if the governor did not commit to downsizing and closing the troubled facility. Lawmakers said Indiana could not afford to continue funding Muscatatuck along with another institution at Fort Wayne and at the same time build community supports.
Muscatatuck has been the focus of investigations into abuse and civil rights violations over the past several years. Two years ago, the facility lost millions of federal Medicaid dollars because of poor treatment to its residents, leaving state taxpayers to pick up the remaining cost. The governor's plan will also help the state meet requirements outlined in an agreement reached last year with the U.S. Department of Justice, which investigated alleged civil rights violations.
The writing has been on the wall for the aging institution for some time. In 1997, New Castle State Developmental Center was ordered closed and its 150 residents moved into other settings after a television station broadcast hidden camera footage of employees abusing residents. The down-sizing and closure took about 18 months.
Last December, architects examining the physical structures at Muscatatuck and Fort Wayne Developmental Centers projected that it would cost the state over $124 million during the next 10 years to refurbish and maintain the buildings. Soon after the report, state officials asked for just $10 million over the next two years for building renovation and maintenance, a fraction of what had recommended.
The state currently houses a total of about 600 people with developmental disabilities in Fort Wayne and Muscatatuck Developmental Centers. Family members of some residents have insisted that Indiana will always have a need for institutions and have suggested that the state build one or two smaller institutions to house people they do not want moved into the community.
PERSON CENTERED PLANNING WILL GUIDE MOVES TO
"There have been more than 100 moved out into community-based care and they're better for it," said O'Bannon, "and they weren't moved except with consent of the plan, the person-centered plan."
Responding to pressure from the state Senate, the governor had announced on Thursday that the troubled institution would be closed and most of the residents moved to homes in the community. Lawmakers had told O'Bannon that the state could not afford to invest in expanding community-based supports while continuing to fund the expensive, out-dated facility at Muscatatuck and a similar one at Fort Wayne.
Muscatatuck has been the focus of investigations into abuse, neglect and inadequate care over the past few years. The state has had to use its own money to cover federal funds that were lost because of some of those violations. The state also learned recently that the facility's buildings are deteriorating to the point where millions of dollars would be needed to repair and maintain them.
O'Bannon's announcement regarding family involvement may have been designed to head off some of the arguments by family members of institution residents who have been vocal about their opposition to community supports. Some feel there will always be a need for institutions in the state.
The governor told the Associated Press that the closure is among the first steps the state is taking toward smaller, regional centers and community-based supports for people with mental disabilities.
"As technology changes, as medication changes, as new ways to help those with disabilities changes, we must continue to take those changes and make life better for people in those institutions," he said.
Jobs, Economy Drive The Fight to Keep
Governor Frank O'Bannon announced in April that the state would be closing institutions and moving the residents into homes in the community. The plan calls for the closure of Muscatatuck State Developmental Center, an institution housing about 270 people with developmental disabilities, by the end of 2003. The moves to the community would be guided by person-centered planning.
The Indianapolis Star reported that on Tuesday a group of about 80 people gathered at the Statehouse to protest the closure of Muscatatuck and Madison State Hospital which houses people with "mental illness and mental handicaps".
The rally was organized by members of the employees union, who fear the closures will mean they will lose their jobs. The two facilities together employ about 500 direct-care staff members, many of whom are second and third generation employees.
The mayors of two towns near the facilities also presented the governor's office with 13,000 signatures from community members who do not want the institutions closed. They say they are concerned about the economic impact the closures would have on their towns. Muscatatuck is the largest employer in its area.
The union members were joined by parents of people living at the institutions, who claimed they are worried that their family members will not be safe in the community.
No mention was made in the Star article about the opinions of the people who live in either facility.
The decision to close Muscatatuck came after years of documented physical, sexual and verbal abuse of residents by staff members, and lost federal Medicaid funding because of poor care and treatment. State officials and the U.S. Department of Justice agreed to the closures at the end of last year.
Advocates Want Money To Go With
Individuals, Not To Buildings
Advocates for community living want to make sure the money saved by closing Muscatatuck follows the individuals themselves, rather than just going to a different kind of facility in the state.
"We shouldn't be moving people just for moving's sake," said John Dickerson, The Arc of Indiana's executive director, whose group is advocating for more individualized services.
"We should develop services focused outward," Dickerson told the
Commissioner Switches Position On
During a public meeting held at Muscatatuck, commission chairman Sen. Marvin Riegsecker said the June 2003 date for the planned closure needs to be changed. Riegsecker told the approximately 35 people attending the meeting that the commission would probably issue a legislative proposal after it concludes its meetings next month.
Riegsecker had helped pass a budget package that included funds for closing Muscatatuck and providing community-based supports for its residents.
Governor Frank O'Bannon announced in April of this year that the troubled institution would close and set the deadline. O'Bannon's announcement came in response to the Senate's threat to withhold millions of dollars targeted for developing three regional centers and other community-based supports, if the governor did not commit to downsizing and closing the troubled facility. Lawmakers at that time said Indiana could not afford to continue funding Muscatatuck -- along with another institution at Fort Wayne -- and at the same time build community supports. The governor's plan also would help the state meet requirements outlined in an agreement reached last year with the U.S. Department of Justice, which investigated alleged civil rights violations at the facility.
Muscatatuck has been the focus of investigations into abuse and civil rights violations over the past several years. Two years ago, the facility lost millions of federal Medicaid dollars because of poor treatment to its residents, leaving state taxpayers to pick up the remaining cost.
At last night's meeting, parents of Muscatatuck residents and local citizens told the commission that closing the facility would cause a hardship for those residents, along with the employees and neighboring community. Members of one parents group said they plan to file a lawsuit in federal court to stop the closures.
Friday's Indianapolis Star ran this story:
Parent Group Files Suit To Stop Closure
The group of 17 parents claim they are "not willing to risk the potential trauma" that their loved ones would experience in moving to the community from the institution, which currently houses 242 people with developmental disabilities.
In April of this year, Governor Frank O'Bannon announced that the institution would close by the end of 2003 and its residents moved to homes in the community. The decision came, in part, because federal investigators had found repeated incidents of abuse, neglect and exploitation of Muscatatuck residents -- incidents which caused the federal government to cut payments to the state. State lawmakers had told O'Bannon that the state could not afford to invest in expanding community-based supports while continuing to fund the expensive, out-dated facility outside Butlerville and a similar one at Fort Wayne.
The state also learned this spring that the facility's buildings are deteriorating to the point where millions of dollars would be needed to repair and maintain them.
An attorney representing the parents group, the Muscatatuck Association of Retarded Citizens, acknowledged that the group faces many obstacles. Ironically, the suit accuses the state of putting Muscatatuck's residents at risk of harm by closing the facility and moving the people to the community.
More details are available from the Indianapolis Star:
Muscatatuck Still On Track For
That plan got a boost this week when Governor Frank O'Bannon vetoed legislation that could have kept the institution open two years longer.
According to the Indianapolis Star, the governor's move may have been based primarily on finances at a time when lawmakers are trying to find ways to keep the state from going broke. Medicaid currently pays $186,114 a year to house a person at Muscatatuck, compared with between $46,355 and $89,243 a year in the community.
Muscatatuck once housed 1,800 people with developmental disabilities, but that number was reduced to 300 two years ago. The residents left at the institution continued to suffer incredible abuse and neglect at the hands of the people responsible for their care. In the three years leading up to 2000, investigators substantiated 183 cases of physical, sexual and verbal abuse at the facility, 75 of which occurred in 1999.
About one hundred people have moved out since March 2000. Between 10 and 15 are scheduled to move out each month until it is closed around June 2003.
The plan has been opposed by a group of 17 parents who vow to keep the facility open. They want to push legislators to override the governor's veto. But that vote could not even take place until the legislature meets eight months from now. By then over a hundred people could be moved out.
"We have a long way to go to convince many of these families we can deal with their concerns," said John Dickerson, executive director of The Arc of Indiana. "I think their message has been heard, and it sounds like the governor is maintaining his commitment to do things right."
Judge Puts Muscatatuck Moves On
Monday, Special Judge William Vance ordered the state to stop transferring any of the 205 residents with mental retardation housed at the facility -- unless their guardians have given written approval. Vance also ruled that about 60 residents who have already been moved have the right to return.
Vance made the ruling following two days of conflicting testimony regarding the planned June 2003 closure of the facility. Parents of current residents and employees of the facility said they feared the residents would suffer trauma from being moved. According to the Indianapolis Star, families of former Muscatatuck residents testified that their children thrived in community settings when "freed from institutional surroundings".
Last year, Muscatatuck was targeted to be closed after a series of abuse and neglect cases and lawmakers learned of the high cost of institutional services compared to community settings. Last month, Governor Frank O'Bannon vetoed legislation that would have kept the institution open two years longer. Vance's order comes in response to that decision.
"We're not just dropping people off," said Cindy Collier, director of planning for the Indiana Family and Social Services Administration. "Nobody leaves Muscatatuck without extensive planning for their future care."
Collier said the state would review the judge's decision and would likely appeal.
Long-time Resident Apparently Beaten To
He died Sunday night after apparently being beaten to death at the institution that houses about 310 people with mental retardation.
Now State Police and the Allen County coroner's office are investigating to determine what happened at the institution on the days leading up to Reed's death.
Officials at Parkview Hospital said Reed died from a torn pancreas, ruptured intestines, a punctured lung, broken ribs and other internal injuries. A surgeon explained to Reed's family that the wounds appeared to have occurred many times over several days and were too severe to be repaired.
"The surgeon said she had never seen this type of trauma in a beating, only in a car accident," said Yvetter Ruetsch, Reed's niece.
"No one seemed to know anything about how it happened," Ruetsch told the Associated Press after visiting the institution.
Coroner E. Jon Brandenberger had determined earlier that Reed, 38, had died June 9 from blunt force trauma. On Friday, Brandenberger declared the death a homicide, according to the Associated Press.
Reed died at Parkview Hospital three days after he had been beaten at Fort Wayne State Developmental Center, the institution where he had lived for the last 16 years. Hospital officials said he died from a torn pancreas, ruptured intestines, a punctured lung, broken ribs, and other internal injuries. A surgeon had told Reed's family that the wounds appeared to have been inflicted many times over several days and were too severe to be repaired.
Indiana State Police are continuing their investigation into Reed's homicide but have made no arrests. They continue to interview residents and staff at the institution to determine what happened the days prior to his death.
Fort Wayne State Developmental Center houses about 310 people that have developmental disabilities. The facility, along with a similar one in Butlerville, have had a number of problems related to the health and safety of its residents over the past few years.
State Report Reveals More Troubles At
The state settled with the Justice Department to keep the facility open. But three years later a new state report reveals that the institution not only violates residents' rights, it also fails to protect their health and safety.
A 106-page report released Tuesday by the Indiana Department of Health documents the results of the institution's annual survey. Facility personnel were cited for locking doors when they should not have, failed to obtain guardians for residents, kept personal possession from residents and failed to report injuries to the administrator.
Examples include the case of John P. Reed, a 38-year-old resident that died on June 9 after being beaten at the facility. Reed, who was supposed to have had one-on-one supervision, died with a torn liver, pancreas, puntured lung, along with broken ribs and other bones. Earlier this month the local coroner ruled Reed's death a homicide.
The survey documented 26 incidents in which other residents hurt Reed or Reed hurt himself in the months prior to his death. It was also found that medical personnel failed to take seriously Reed's complaints of pain in the days just before he died.
Another case examined was that of a resident who was severely scalded while taking a shower on July 6. An investigation revealed that the resident was left unnattended in the shower while receiving second-degree burns over 13 percent of the body.
In yet another case of abuse, a resident was found to have a broken leg after a physical therapist was seen kicking the resident. The same person was found at various times to have many other injuries of "an unknown origin".
The Fort Wayne Journal-Gazette ran this story Wednesday:
Funding For Developmental Center No Longer
In Jeopardy, But Troubles Persist
But new problems have emerged from the institution that houses 299 people with developmental disabilities.
Tuesday's report outlined several incidents in which the facility had failed to prevent neglect of its residents.
On August 13, a resident tried to choke on a purse strap. Department officials said that staff members failed to report the incident because they believed it was self-abuse instead of a suicide attempt.
On August 24, a resident had wandered into the woods near a local camp. Staff members found the resident unconscious with a bathing suit tied around the neck. Emergency personnel revived the resident who has recovered. Department officials ruled that the facility had failed to provide enough staff members to meet the resident's needs.
Indiana State Police have not released their findings regarding the death of John Reed, a 38-year-old resident that died on June 9 after being beaten at the facility. Reed, who was supposed to have had one-on-one supervision, died with a torn liver, pancreas, puntured lung, along with broken ribs and other bones. The local coroner ruled Reed's death a homicide.
The only other state-run institution, Mustatatuck Developmental Center, is scheduled to close by the end of 2003.
The Indianapolis Star has more details in this report filed
Muscatatuck Parents And Employees Say
State Leaves Them In The Dark
But the president of the parent group that has opposed the closure said families were only informed of the meeting a few days earlier, the Associated Press reported last week.
"None of the family members were notified, and I didn't find out about it myself until last Friday afternoon," said Frank Migliano, president of the Muscatatuck Association for Retarded Citizens.
About 50 people attended the Wednesday meeting, including Muscatatuck staff members and local officials. North Vernon Mayor John Hall said closing the facility -- which is the area's largest employer -- could mean a loss of more than $25 million a year to the economy of Jennings County.
Staff members and family members said they are worried the facility's residents would not be safe in the community.
Governor O'Bannon, under pressure from the state Senate, ordered the institution closed after years of documented physical, sexual and verbal abuse of residents by staff members, and lost federal Medicaid funding due of poor care and treatment. State officials and the U.S. Department of Justice agreed to close the facility and move the residents to other state facilities and community-based settings.
Muscatatuck once housed 1,800 people with developmental disabilities. From 1997 to 2000, investigators substantiated 183 cases of physical, sexual and verbal abuse at the facility, 75 of which occurred in 1999.
Fort Wayne Facility Cited Third Time For
A report released Thursday showed that staff members continued to abuse, neglect and mistreat at least 10 of the institution's 300 residents last month, even after the facility had been found out of compliance during separate July and August visits.
The state will make one more surprise visit within the next month to see if things have improved. If there continue to be violations, the facility would lose its Medicaid funding, which makes up about two-thirds of its $50 million budget.
According to local media sources, the most recent report quotes an employee of the institution as saying that a certain amount of abuse could be expected as supported by statistics from other facilities.
"This philosophy . . . supports that abuse to a client by staff of the facility was highly likely to occur or has already occurred and may well occur again," the surveyors wrote. "The facility has failed, through implementation of its policies, to set up a structure which protects clients from mistreatment, neglect and abuse."
Fort Wayne State Developmental Center had corrected many problems between the July visit and the next report made public on October 1, but several instances of abuse or neglect occurred in October and November.
On October 10, a resident who was supposed to have one-to-one supervision was found choking on a bathroom floor. The employee assigned to provide the supervision was fired.
Another staff member was fired on October 23 after punching a resident in the chest. No criminal charges were filed.
Still another employee was fired after pouring soda pop on a resident on October 18.
The report also cited several incidents in which residents were given the wrong medications, money was stolen and the wrong food was given to residents with allergies.
Police are still investigating the June 9 beating death of John Reed, a 16-year resident of the facility.
Steve Cook, director of the state Division of Disability, Aging and Rehabilitative Services, said that conditions at the insitution have improved significantly.
"The center has demonstrated significant steady progress, but this is still very serious," Cook said.
Muscatatuck's Time Has Come, And
No, it's not the Ritz or the Waldorf-Astoria.
It's the former Indiana Farm Colony for Feeble Minded Youth, known today as Muscatatuck State Developmental Center.
Moving the 167 people into the community would shift money so that another 200 people with developmental disabilities could move off the state' waiting list for community-based services.
In April of 2001, Governor Frank O'Bannon announced that the aged facility would close by the end of 2003. But parents of those housed in Muscatatuck have effectively stalled the closure through the courts. The facility would now close in 2005 at the earliest.
State officials and community advocates say that Muscatatuck is "an idea whose time has come -- and gone", according to an article in the Indianapolis Star.
Indiana's situation reflects the international trend toward deinstitutionalization, which began 25 years ago. For example, more than one third of those in Muscatatuck are 50 years of age or older, and none is under 20 years of age. More than 100 people have left -- and there have been no new admissions -- since 2001. And even though several of the 52 buildings on the campus are shut down, the facility still costs tax payers $54 million each year.
The Indianapolis Star ran two stories on the debate over Muscatatuck.
"A home of hope, heartache--Push to close Muscatatuck stirs
compliance, defiance" (Indianapolis Star)
Bill Throws Out Family Input In
Lawmakers concerned about the costs of operating the state-run facility agreed Monday to remove the law that has given guardians the right to block the residents' relocation. The measure is designed to speed up the closure process, which the parents have successfully delayed.
Two years ago, Governor Frank O'Bannon announced that Muscatatuck would close by the end of 2003 and all of its then-279 residents would either move to homes in the community or be transferred to other state-run facilities. State lawmakers had pressured the governor to close Muscatatuck after investigators found nearly 200 incidents of abuse by staff members in a three-year period.
But members of the state employees union, along with parents and guardians of Muscatatuck residents, have lobbied lawmakers to delay closure until at least 2005.
Guardians still have the power to veto some moves because a temporary court injunction prevents the state from moving residents into group homes without their consent.
State officials say they will continue to work with families, but removing the law will help cut costs as the number of residents continues to drop. It currently costs the state $850 a day to house a person at Muscatatuck. The figure is expected to rise to $1,140 per person per day in 2004.
"It just becomes impossible to maintain that large facility and to justify it financially, as well as from the human perspective," said state Representative Rep. Jeff Espich, R-Uniondale.
Reed Murder Investigation Stalled;
The investigation has come to a standstill, in part because potential witnesses -- employees at Fort Wayne Developmental Center -- could lose their jobs if they come forward with information at this point, according to a story in the Fort Wayne Journal Gazette.
Reed was a 38-year-old resident of the institution that housed 310 people with developmental disabilities. Because he had a history of "aggressive behavior" Reed was required to have 24-hour, one-on-one support.
Reed died at Parkview Hospital on June 9 of last year, three days after he was savagely beaten at the institution. Hospital officials said Reed had a torn pancreas, ruptured intestines, a punctured lung, broken ribs, and other internal injuries. A surgeon told Reed's family that the wounds appeared to have been inflicted many times over several days, that they were too severe to be repaired, and that they appeared more like the injuries of an auto accident victim.
Investigators were not able to determine whether Reed was attacked by another resident or a staff member of the facility.
Allen County Prosecutor Karen Richards says she is frustrated that she cannot promise facility employees that they will not be fired for failing to report abuse or neglect earlier. Richards did offer a two week period in February during which witnesses could report to her office and be immune from criminal prosecution. But no witnesses came forward.
Dan Mohnke, the institutions' superintendent, defended the state's policy to not shield witnesses from firing when they have failed to promptly report incidents of abuse, even if they come forward later with crucial testimony.
"It has been the position of the state for years that failure to report information is a pretty serious matter," he said. "One perspective is to just waive the rule to catch a killer but if you waive it once you are opening up a Pandora's box elsewhere."