By Gina Macris
Continuing difficulties at the former sheltered workshop that stood for everything wrong with Rhode Island’s developmental disability system have caused new noncompliance problems for the state in U.S. District Court.
The problems revolve around one private agency, Community Work Services (CWS), a program of the New York-based Fedcap Rehabilitation Services. But the state is accountable to the court for the way it manages its service vendors and for ensuring that adults with developmental disabilities receive high quality supports under provisions of 2013 and 2014 agreements with the U.S. Department of Justice (DOJ).
In both settlements, Rhode Island agreed to end segregation of adults with developmental disabilities – a violation of the Americans With Disabilities Act (ADA) – and instead to offer them the choice of supported employment and integrated non-work activities.
Community Work Services (CWS) was hired in 2013 to correct ADA violations at the former sheltered workshop, Training Through Placement (TTP.) But CWS itself has operated under one form or another of state supervision for 17 months and nearly lost its license earlier this year.
According to the latest report of a federal court monitor, the state has missed two deadlines; one, a July 30 date for improving the quality of individual career plans and another, June 30, for verifying the accuracy of data reported by CWS on its clients’ progress.
Despite the state’s efforts to resolve inconsistencies in data, “problems continue to exist with the information provided by CWS,” according to a Sept. 7 report by the monitor, Charles Moseley, to U.S. District Court Judge John J. McConnell.
The state, the monitor, and the DOJ use that data to determine whether CWS is following the requirements of the ADA agreements.
Blueprints For The Future
And so-called “career development plans” are not supposed to be just paperwork, but blueprints that allow officials to see in an instant how the services a client currently receives fit into individualized short-term and long-term goals.
The plans are intended to reflect a key principle embodied in the ADA; that people with disabilities have choices in how they live their lives.
The monitor also said 70 percent of the clients’ career plans were “unacceptable” and had not been improved in the month after the judge’s July 30 deadline, despite the state’s efforts.
For most of the 64 Individuals who are active CWS clients, the daily activities and yearly individual service plans didn’t line up with the long-range career development plans, according to Moseley.
In other cases, the long-range plans were “well done”, but the plans were “not being implemented in a manner which aligns with the participants’ interests,” Moseley said.
Neither the DOJ nor the judge have responded on the record to Moseley’s latest findings, although McConnell has said in the most recent hearing on the so-called “interim settlement agreement” of 2013 that he considers himself personally responsible for defending the rights of about 125 individuals protected by the agreement.
Former State Official Now Heads CWS
Community Work Services, a Boston-based agency, came to Rhode Island in 2013 as a program of Fedcap, hired by Craig Stenning, then director of the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) to get a jump start on turning around the state’s developmental disability system in the wake of the interim settlement agreement of 2013 and the broader consent decree of 2014.
Between 2013 and 2014, Fedcap was awarded a total of about $1.7 million in state contracts. In 2015, Stenning joined Fedcap’s senior management.
As part of the state’s arrangement with Fedcap, CWS took over Training Through Placement (TTP), which had used the Birch Academy at Mount Pleasant High School as a feeder program for its sheltered workshop. There, adults with developmental disabilities performed repetitive tasks at sub-minimum wages, sometimes for decades, even when they expressed a desire to do something else.
At the hearing in May, Moseley, the monitor, told the judge that the number of former TTP clients who have found regular jobs in the community has remained “essentially flat” for the last four years. Most of the former TTP clients still received services from CWS.
At that point, CWS itself had operated under one or another form of state supervision since May, 2016, for both programmatic deficiencies and substandard facilities at the former TTP building in North Providence.
CWS Nearly Lost License
In his most recent report Sept. 7, Moseley disclosed that state officials had notified CWS in early May – about two weeks before the federal court hearing - that they intended to revoke the agency’s license. But state officials changed their minds after a conference with CWS representatives, the monitor said.
Instead of revoking the license, the state Division of Developmental Disabilities (DDD) decided to give CWS one last chance by continuing the agency’s probationary status from July 1 to Sept. 30, with the possibility of only one more extension, until Dec. 31. The current status of the license is not clear.
Moseley said CWS has brought on new staff, including a deputy director, a job developer and a new position with responsibilities for data and reporting.
According to the CWS website, it also has a new executive director, Craig Stenning, Fedcap’s Senior Vice President for the New England Region and the former BHDDH director.
Less than a year after Stenning’s departure from BHDDH – Governor Gina Raimondo failed to reappoint him – the DOJ and the monitor asked the U.S. District Court for assistance in enforcing the companion agreements of 2013 and 2014, citing a lack of progress by the state.
As a result, McConnell took up the combined cases and held the first hearing in January, 2016. Since then, he has held periodic reviews from the bench.
Extensive State Oversight
Moseley’s Sept. 7 report described the extensive state supervision dedicated to CWS. Licensing officials make monthly regulatory reviews of CWS. In addition, there are unannounced monthly visits coordinated with the state’s chief quality improvement officer for developmental disabilities. Supplementary phone calls and emails from state officials to CWS occur at least once a week.
Meanwhile, the state’s chief employment officer for developmental disabilities provides on-site technical assistance to CWS job developers, reviewing day-to-day activities and observing so-called “person-centered” planning meetings that are designed to put the needs and preferences of the clients first.
In earlier reports, Moseley has said the state simply does not have enough personnel to provide a fully functioning quality assurance program across the board to verify that some three dozen service providers are complying with the “person-first” principles and practices of the ADA. He has required DDD to take steps to create one.
DDD has 24 caseworkers and a handful of supervisory personnel and support staff to manage the needs of a total of about 4,350 individuals. (About 3,700 receive day-to-day services,)
After learning that there had been little change at CWS since 2013, McConnell said he was angered on behalf of those who are “years late in terms of getting the services that the state agreed to,” according to a transcript of the hearing on May 23.
Addressing lawyers and state officials before him, he said, “The truth is that we all, you and you and me and then everybody else, have these hundred-odd people’s rights in our hands. “
McConnell continued. “I don’t take that lightly. I will use whatever powers that I have available to me to ensure that those individuals aren’t forgotten. Dr. Moseley always reminds me that we’re talking about individuals here and not alphabet soups and programs and whatnot. And this time it’s got to stick.”
Praise For Providence and Mount Pleasant
McConnell concluded on what he described as an “optimistic note” for officials of the city of Providence, who during the last few years have made substantial changes at Mount Pleasant High School, enabling special education students who otherwise would have been completely isolated to become part of the broader student body and to have school-to- work experiences in the community.
“Keep up the good work,” the judge told school and city officials. “It doesn’t mean you’re at the finish line, but you’ve showed us that it can be done.”
A version of this article also appears in ConvergenceRI