COLUMBUS — A new federal audit of Ohio's problem-plagued mental retardation system criticized the state for operating a fragmented system where people's services depend largely on where they live.

        The report offers some praise for reforms, but concludes the system remains flawed and services continue to vary from county to county.

        “Every consumer is entitled to the same services no matter what his or her county of residence,” the report stated.

        To compile the report, federal officials interviewed eight people and reviewed 20 cases out of 3,400 people who get Medicaid services in their own homes or group homes. The system provides services to about 63,000 people.

        The report said Ohio now meets federal guidelines for health and safety, but major weaknesses remain. Among the problems:

        • The state is failing to give people across the state the same access to well-trained caseworkers, proper medical care and information about their rights to choose their own caregivers.

        • The state has no formal policy in place to ensure “vulnerable consumers earning money in the programs were not taken advantage of.”

        • Case managers fail to document changes in people's needs, including changes in medications or their reactions to them.

        • One mentally retarded man who has trouble walking must “climb the stairs on his hands and knees to get into (his upstairs) home.”

        Despite the problems, the report found that overall people appeared satisfied with their services and homes appeared “clean, comfortable and safe.”

        Ken Ritchey, director of the Ohio Department of Mental Retardation, noted that while the audit may not be meaningful statistically, it is a big improvement over a 1999 report that blasted the state for failing to protect people from beatings, medical neglect, theft and other abuse.

        At the time, regulators said more than 1,000 reports of abuse or neglect languished on a state bureaucrat's desk, never getting investigated.

        They also found:

        • Mentally retarded people were routinely placed in locked rooms and left to urinate on the floor.

        • Untrained workers were put in charge of medicating and caring for extremely fragile people.

        • Mentally retarded people are abusing other mentally retarded people with few, if any, consequences.

        In the latest audit, federal officials said the Department of Mental Retardation has done “a commendable job” developing a new computer system to track abuse and neglect. However, it noted the system is still not fully automated.

        The federal report comes a month after The Cincinnati Enquirer published a special report that showed the state's mental retardation system routinely fails to prevent deaths, abuse and neglect. The newspaper identified 12 people who died under questionable circumstances over the past three years and found 80 to 120 people die avoidable deaths each year.

        The Enquirer also found stunning disparities in the way Ohio funds its mental retardation system, with some counties spending as little as $2,800 a year per person while others spend more than $40,000 on each person.

        Sonya Maywhorter, former director of the Ohio League for the Mentally Retarded, an advocacy group, said federal officials whitewashed those serious problems in this latest audit.

        “They are putting a lot of smoke and mirrors out there but the problems continue to exist,” she said. “The real systemic problems are still in place but (federal officials) aren't willing to do anything about it.”

        Federal officials declined to comment on the audit.

        The federal government in 1999 said some people were in immediate danger and threatened to revoke millions in Medicaid funding by 2000 if the state didn't fix problems. Ohio is now in its seventh extension.

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