New Hampshire’s intellectual and developmental disability care system recorded 25 deaths and 81 founded cases of abuse, neglect, or exploitation in the final six months of 2025, according to state documents obtained through an open records request.
The New Hampshire Bulletin obtained the records Thursday from the state Department of Health and Human Services. Six of the 25 deaths were classified as unanticipated by the state. Listed causes include a brain injury from a fall caused by atrial fibrillation, heart failure, four cancer deaths, three choking-related deaths, and three deaths from infections including pneumonia, influenza, and COVID-19. Five deaths were listed simply as “unknown at time of report.”
The figures arrive as the state faces mounting scrutiny over how it protects some of its most vulnerable residents.
This system is publicly funded and state-overseen, providing care services to New Hampshire’s adult developmental disability population. The state contracts with 10 private regional agencies to coordinate that care. Those agencies, operating with taxpayer dollars, are responsible for adults who often cannot advocate for themselves or report mistreatment without assistance.
The numbers from the second half of 2025 follow an already troubling stretch. In the first half of 2025, 27 people died within the system. Causes from that period included an intracranial hemorrhage, two organ failure deaths, and seven cases where cause of death was unknown at the time of reporting. Across all of 2024, 57 people died in the system. In 2023, the total was 36 deaths.
That upward trend over recent years raises urgent questions about whether the state has adequate safeguards in place to protect people with disabilities receiving care through these contracted agencies.
On the abuse, neglect, and exploitation front, the Bureau of Adult and Aging Services and the Office of Client and Legal Services completed 289 investigations between July and December 2025. Of those, 81 were deemed credible by investigators, a founded rate of roughly 28 percent.
Looking further back, from January 2023 through June 2025, there were 1,405 total investigations, 467 of which were considered credible. That sustained volume of founded cases suggests the problems within this system are not isolated incidents but a persistent pattern.
The Bulletin’s reporting last November exposed rampant and systemic abuse and neglect being carried out, sometimes fatally, by caretakers against people with disabilities within this system. That reporting prompted calls from advocates and legislators for structural reform and greater accountability. In response, a state senator introduced legislation to increase oversight and improve data sharing across the system. The bill cleared the Senate on Thursday and now heads to the House for consideration.
Whether the legislature will act with the urgency these numbers demand is an open question. Disability rights advocates have long argued that the system suffers from inadequate monitoring, insufficient staffing standards, and a lack of transparency that allows mistreatment to continue unreported.
The structure of the system itself creates accountability gaps. Because the state contracts out care to 10 private agencies rather than delivering services directly, oversight requires coordination across multiple organizations with varying practices and cultures. When something goes wrong, responsibility can be difficult to assign clearly.
Families of people receiving care in this system have also raised concerns about their ability to access information. Without consistent data reporting and public disclosure, it is difficult for anyone outside the system to track trends or flag warning signs before harm occurs.
The Bulletin has indicated it will continue monitoring the data periodically to assess how the system performs as reform efforts proceed. That kind of ongoing accountability reporting matters. A one-time investigation can prompt a response. Sustained scrutiny is what forces lasting change.
For now, the numbers tell a stark story. More than 100 people in New Hampshire’s developmental disability care system experienced either death or founded abuse and neglect in just six months. Nearly a third of all abuse investigations conducted during that period were substantiated. Those are not statistical abstractions. They represent people who relied on the state and its contracted partners for protection and did not always receive it.
