Allegations of Service Gaps, Lack of Job Supports, Challenge RI Compliance With Consent Decree

By Gina Macris 

this article has been updated

Rhode Island has not expanded job development services to people with developmental disabilities as required by a 2014 federal consent decree, according to a key professional at the Sherlock Center on Disabilities at Rhode Island College. 

Claire Rosenbaum, the adult services coordinator at the Sherlock Center, filed a statement in U.S. District Court April 6 that says the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) does not include job development as part of its standard package of services. Instead, the department expects them to shift money from other funding categories to do that.
 
Rosenbaum’s statement helps lay the groundwork for a challenge to a claim by the state that it is in “substantial compliance” with the decree.  Judge John J. McConnell, Jr. is to hear evidence in the case Friday, April 8 at 10 a.m. 
 
Separate statements about delays and inadequacies in services, particularly for young people eligible for transitional supports, were filed earlier this week by the Rhode Island Disability Law Center and by Tammy Russo, the mother of a 23-year-old man who receives BHDDH-funded services. 
 
Rosenbaum’s statement concurred that “one of the greatest problems is the gap in services experienced by many individuals with disabilities as they transition from youth services to adult services.”  
 
“I know individuals who have experienced a gap in disability services, spanning anywhere from a few weeks to a few months to a year or more,” she said.
 
Often, because many providers are refusing new cases, the only option is so-called “self-directed supports”, in which individuals or their families manage specific BHDDH allocations, organizing services and hiring their own direct service workers, Rosenbaum said.
 
Rosenbaum, who is widely respected in the developmental disability community, has an adult daughter who receives BHDDH-funded services, and her job puts her in touch with about 250 adults with disabilities and their families.
 
She said the lack of openings for new clients in the direct service system makes it difficult for individuals to get job development services. 
 
Unlike BHDDH, the Office of Rehabilitation Services of the state Department of Human Services provides funding to direct service agencies for job development services.  However, it pays a flat rate for each job placement, no matter how extensive the needs of the client. Consequently, the developers tend to work with less challenging candidates for employment,  Rosenbaum said.

Direct ORS employment services tend to be limited to job assessments which many clients find to be “excessive and not beneficial to finding employment,” she said.

In another statement filed with the court, Anne M. Mulready, supervising attorney of the Disability Law Center, said Rhode Island law makes youth with disabilities eligible for adult services once they reach 18, but clients say BHDDH does not process their applications until they approach the age of 21.

Mulready currently represents two 19 year-old clients with complex needs whose families each have been waiting about a year for word on eligibility from BHDDH.

“It will take a significant amount of time to plan for and locate appropriate services for these clients,” she said. “Although they are currently in school, BHDDH participation in planning and coordination needs to be occurring now, so that these individuals will not experience gaps in services when they exit high school,” she said in the statement.

In her statement, Russo said she waited two years for BHDDH to find her son, Joey, eligible for services. She searched for five months to find a service provider, because seven of the ten she contacted were not accepting new clients.

Then, BHDDH delayed the start of services until a month after her son’s 21st birthday, which was Jan. 20, 2014, Russo said.  

Because her son’s agency was unable to organize a program of community-based supports for Joey, Russo did it herself, putting together a schedule that included exercise at the YMCA, education at the library with workbooks and supplies she provided, as well as bowling and volunteer experiences she arranged through people who knew Joey at school or in the community.

In effect, Russo served as the architect of the “person-centered planning” now required under terms of the consent decree. She said support staff have told her that their employer used the plan she organized for Joey as a model for helping other clients.

Rosenbaum, meanwhile, said that another “persistent problem” is inaccurate assessments of individuals’ needs and correspondingly inadequate allocations of funding.
 
“I know individuals who have had their (funding) lowered following a reassessment,” she said, despite the fact that the answers were very similar to the original assessment.
 
“Furthermore, I have heard complaints that some interviewers are not recording the respondents’ answers as given and/or are challenging those responses” during the assessment interviews, Rosenbaum said.  

Attorney General Identifies Group Home Resident Whose Death Prompted Investigations

Rhode Island Attorney General Peter F. Kilmartin has named Barbara A. Annis as the 70 year-old woman whose Feb. 15 death has triggered criminal investigations and unannounced inspections of hundreds of group homes for persons with developmental disabilities. 

Kilmartin’s spokeswoman released Annis’ name April 1, but gave no additional information, according to the Providence Journal. 

Annis lived in the now-closed College Park Apartments at 612 Mount Pleasant Avenue, Providence, a state-run facility built to accommodate patients who have chronic medical conditions as well as intellectual or developmental challenges. 

She was admitted to Roger Williams Hospital Feb. 9 for what the College Park staff reported as a bad bruise, but which the hospital found to be a broken thigh bone that had become infected. After she responded to initial treatment, she was transferred to a nursing home, according to an official of the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH).  But her condition soon worsened and she was readmitted to the hospital, where she died. 

There have been a total of six allegations of abuse or mistreatment at College Park since January, 2015, including an incident that occurred after Annis died. The State Police and the Attorney General’s Medicaid Fraud and Patient Abuse Unit have begun criminal investigations, and 5 of 27 state employees who worked at College Park were placed on paid leave. 

In addition, surprise inspections have begun of all licensed group homes in the state, about 278 private and state-run facilities, according to a spokesman for Elizabeth Roberts, Secretary of Rhode Island’s Executive Office of Health and Human Services. Nine of the 278 homes are vacant. 

Residents who remained at College Park – a total of 14 people – all have been moved, according to BHDDH, which ran the home. The Rhode Island Disability Law Center has opened an investigation into the welfare of those people.   

After College Park closed March 25, Roberts said, “I remain outraged by the alleged incidents at the College Park Apartments group home.”