Working with vulnerable populations is inherently multifaceted. It requires ensuring that the individuals in your care receive the safe, dignified, and supportive services they deserve, while also building an environment of compliance and integrity. One where policies, procedures, and standards of care are consistently upheld. This isn’t just about meeting the letter of a regulation; it’s about protecting the people you serve, your staff, and your organization alike. Providers, regulators, and advocates all share that same goal. Working proactively with experienced counsel can help your organization build the policies, training, and culture needed to deliver on that commitment, while also reducing risk and safeguarding the people who make the work possible.
There has been an increase in the number and severity of the investigations performed by The New York State Justice Center for the Protection of People with Special Needs. Recently, it published its 2025 Annual Report, highlighting the agency’s initiatives, program updates, and priorities. The report includes a Systemic Review conducted as part of its quality improvement initiative, which examined sexual abuse and professional boundary violations at OPWDD-certified programs. Together, these publications update providers on the agency’s investigative activities, enforcement outcomes, strategic priorities, and areas of concern. The publications also reveal important trends: reporting is up, substantiation rates are rising, criminal enforcement is accelerating, and the Justice Center is increasingly scrutinizing whether providers’ corrective actions are genuinely effective.
Providers under the Justice Center’s jurisdiction—including those licensed, certified, or operated by the Office for People with Developmental Disabilities (OPWDD), Office of Mental Health (OMH), Office of Addiction Services and Supports (OASAS), Office of Children and Family Services (OCFS), Department of Health (DOH), and State Education Department (SED)—should consider steps to take in light of these reports, including auditing internal practices and ensuring comprehensive policies and training. We summarize these reports and key takeaways below.
2025 Annual Report — Key Trends
Report Volume Continues to Rise
The Justice Center’s Annual Report reflects a 3% rise in total reports to its Vulnerable Persons Central Register (VPCR) in 2025: 90,865 total reports, up from 87,894 in 2024. Of those, 14,525 launched an abuse and/or neglect investigation.
More Cases Closed and Substantiated
The Justice Center closed 11,500 abuse and neglect cases in 2025, approximately 1,600 more than in 2024. Of those, 40% were substantiated (4,571 findings compared to 3,866 in 2024).
Substantiated cases are also growing in severity. In 2025, the Justice Center had more Category 1, 2, and 3 findings, and slightly fewer Category 4 findings compared to 2024. The increases across serious categories underscore the importance of proactive compliance.
Category 1 is the most serious, encompassing severe physical abuse, sexual abuse, or other egregious conduct; a Category 1 finding results in permanent placement on the Staff Exclusion List (SEL). Category 2 involves conduct that seriously endangers the health, safety, or welfare of a person receiving services, and two Category 2 substantiations within three years will also result in SEL placement. Category 3 covers less serious incidents of abuse or neglect. Category 4 addresses incidents mitigated by systemic conditions at a program or facility—such as inadequate training, staffing, or supervision—that increased the likelihood of abuse or neglect, or instances where a perpetrator cannot be identified.
Criminal Enforcement Is Increasing
The Justice Center’s Special Prosecutor facilitated 107 arrests in connection with Justice Center cases in 2025, a 28% increase from the prior year. Providers should be aware that the Justice Center coordinates actively with county district attorneys and local law enforcement, and criminal investigations run parallel to the administrative process. This makes it critically important to engage experienced counsel from the start of an investigation.
Corrective Action Plan Audits Remain a Priority
The Report reflects the Justice Center’s prioritization of Corrective Action Plans (CAPs), which stem from abuse and neglect cases, to ensure facilities take steps to prevent future incidents. The Justice Center most often conducts an audit after finding that a systemic issue (rather than individual misconduct) caused the abuse or neglect. A CAP audit is not merely a formality: it is an active oversight mechanism that often includes site visits and can lead to additional findings, mandatory remediation, and referrals to licensing agencies. Notably, the Justice Center shares its CAP audit findings with the relevant state licensing agency, which may result in further action.
In 2025, the Justice Center conducted 300 CAP audits, assessed 1,911 corrective actions, identified 654 additional findings, and provided 959 resources to providers.
Systemic Review — Sexual Abuse And Professional Boundaries at OPWDD Programs
Additionally, in May 2025, the Justice Center published a detailed systemic review examining substantiated allegations of sexual abuse and violations of professional boundaries at OPWDD-certified programs. The review aimed to help prevent such incidents and ensure victims are protected and receive prompt support.
The Review
The Justice Center audited 24 CAPs involving substantiated offenses of sexual abuse and neglect due to staff failing to maintain professional boundaries from 20 different non-state-operated OPWDD agencies. The audits analyzed facility policies, procedures, and documentation.
In total, 115 corrective actions were assessed. Of those, 81 (70%) were rated “Implemented,” while 34 (30%) were rated “Insufficient,” meaning they were not fully implemented, not taken in a timely manner, or ineffective and missing key components to mitigate recurrence risk. Fifteen of the audits had at least one insufficient finding. Of the insufficient corrective actions, 47% were ineffective because they did not sufficiently address the issue; 26% were not fully implemented at the time of the audit; and 26% were not completed in a timely manner.
Key Issues of Concern Identified
The review found several issues that providers should be aware of, and seek to mitigate in their programs
- Lack of professional boundaries policies. The Justice Center noted that 14 of the 20 agencies did not have a policy specifically addressing professional boundaries between staff and people receiving services. Three agencies had such policies but lacked the documentation that all staff were trained in them.
- Missed warning signs. In 11 of 24 cases, the Justice Center concluded that management missed opportunities to address inappropriate staff actions before the incident was reported. Warning signs included staff spending excessive time alone with individuals in bedrooms, visiting programs on days off, showing favoritism, and performing unnecessary personal care. In two cases, staff reported boundary violations to management, but management did not report them to the Justice Center.
- Delayed incident reporting. In three cases, the incident was not reported to the Justice Center for two to four days after discovery.
- Gaps in emotional support. In four cases, there was no documentation that emotional support and counseling were provided to the person receiving services after discovery.
- Code of Conduct deficiencies. At 14 of the 20 agencies, not all staff were up to date on annual Justice Center Code of Conduct training and acknowledgements.
Justice Center Recommendations to OPWDD
The Justice Center issued formal recommendations to OPWDD, including: developing a standard professional boundaries policy with explicit language applicable regardless of consent status; creating training resources on warning signs for staff and people receiving services; making professional boundary training mandatory upon hire and annually for all staff (including per diem, temporary, and contracted staff); developing resources for prompt detection and reporting of boundary violations involving nonverbal individuals; and reinforcing the importance of providing immediate emotional support to victims and removing subject staff from contact with all people receiving services upon discovery of an allegation.
What These Reports Mean for Providers
The Justice Center is investigating more cases, substantiating more findings at increased severity levels, making more criminal referrals, and auditing providers’ corrective actions with increasing scrutiny. The Systemic Review adds a further layer of concern, demonstrating that the Justice Center has identified sector-wide compliance gaps and expects robust corrective action. Providers should be proactive in addressing these risks, and consider:
- Audit your policies and practices periodically. Do not wait for a Justice Center investigation or CAP audit to identify gaps in supervision, training, professional boundaries, incident reporting, and safety protocols. Regular internal compliance audits, particularly in areas the Justice Center has flagged, such as choking prevention, restraint use, and professional boundaries can help identify and resolve issues before they become reports. Ensure you have a written professional boundaries policy and appropriate training for all staff. If you need help with policies, contact your attorney.
- Keep up with Code of Conduct trainings. Confirm all staff (including per diem, temporary, and contracted staff) have participated in annual Justice Center Code of Conduct training and have signed acknowledgments on file.
- Investigate issues promptly and thoroughly. When you become aware of a potential incident, consult with counsel and conduct a timely, well-documented internal review. The Systemic Review identified instances where management failed to act on warning signs or delayed reporting for days, compounding harm and exposure. Demonstrating that your organization takes allegations seriously and responds with meaningful corrective action can be critical to the outcome.
- Train management to recognize and act on warning signs. The Systemic Review found that nearly half the cases involved missed warning signs that, if addressed earlier, could have prevented reportable incidents. Supervisors and managers should be trained to identify behaviors that indicate potential boundary violations, enabling providers to investigate before a violation occurs.
- Consult with an attorney. Experienced counsel can help your organization with compliance audits, policy review, staff training, and investigations into reports of misconduct. In addition, subjects of Justice Center investigations have the right to legal counsel. Understanding your rights and obligations early can significantly impact the outcome.
Ultimately, effective compliance is not just about avoiding liability; it is about protecting the individuals in your care so that they receive the safe, dignified, and supportive services they deserve. Being proactive and working with counsel experienced in working with Justice Center investigations, as well as developing the policies, training, and culture needed to deliver on that commitment. Our team regularly represents providers and staff in Justice Center investigations, administrative proceedings, CAP audits, and related matters. Whether you have received a report notification, are subject to a systemic review or CAP audit, or are facing potential disciplinary action or criminal referral, early engagement with experienced counsel is essential to a successful resolution.
