In June 2013, federal investigators filed a complaint in U.S. District Court accusing Providence and Rhode Island of segregating individuals with intellectual and developmental disabilities, also known as IDD.
At the time, students with IDD were required to perform assembly-like tasks in a segregated wing of Mount Pleasant High School, which operated as a pipeline for students to leave and work at a segregated day program in North Providence. Many stayed and worked there for 15-30 years.
The state-funded day program, located in a deteriorating former elementary school, paid its workers low wages to package medical supplies, wrap television remote controls and hand-sort jewelry. One man made as little as 14 cents per hour and there was little to no guidance on how workers might gain other employment.
“One person who [worked there] for approximately 30 years said that he asked the provider nearly every year … to work at a hardware store, yet he [was never] assessed or received service and supports necessary for him to work in an integrated setting, let alone a hardware store,” according to the complaint.
Fast-forward to 2017 and the state still grapples with many of the issues it was accused of four years ago. Segregated work still exists and unemployment remains high, at about 75 percent among adults with IDD. Social-service providers are largely understaffed and underfunded. New federal guidelines call for more costly services, leaving state officials to wrestle with a budget that’s still recovering from cuts realized during the Great Recession.
“What’s happened over the years is that the programs and services that were targeted to assist individuals with IDD have lost funding,” said Stephen Brunero, executive director of the Rhode Island Parent Information Network in Cranston.
But the state has also realized measurable gains, especially in the past year, suggesting movement in a positive direction. Rhode Island in 2014 entered into a consent decree with the U.S. Department of Justice, requiring it to better connect individuals with IDD to integrated-employment opportunities. The employment rate has since grown to nearly 25 percent compared with 19 percent in 2012.
“In many places [the state] is hitting the mark, and other places it’s not hitting the mark,” said John J. “Jack” McConnell Jr., the U.S. District Court judge in Rhode Island responsible for ensuring the state complies with the consent decree.
‘More work needs to be done to break down some of the stereotypes that exist.’
Victoria E. Ferrara, Rhode Island College coordinator of access to integrated employment
Advocates say Rhode Island employers could play a pivotal role in propelling integrated employment, and some businesses are actively engaged. But there are still entrenched barriers to employment that have proven difficult to overcome.
“More work needs to be done to break down some of the stereotypes that exist,” said Victoria E. Ferrara, coordinator of access to integrated employment at the Paul V. Sherlock Center on Disabilities at Rhode Island College.
“The thought is that the individual is going to be a burden in the workplace, they won’t be as productive, or they might sue if it doesn’t work out. But there’s a lot of research to debunk those myths,” she added.
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BUSY KITCHEN: Gerald “Jerry” D’Agostino is a cook at Dr. Day Care, in Pawtucket, where he prepares more than 100 meals per day for the kids. D’Agostino says he enjoys his job because it keeps him busy and occupied. / PBN PHOTO/MICHAEL SALERNO[/caption]
THE WORKERS
When Gerald “Jerry” D’Agostino first left high school, he wasn’t interested in work.
“I was sitting at home all day playing video games because I thought that’s what I wanted,” he said. “Eventually, it got boring, so I wanted to get out a little more.”
The 28-year-old Providence resident, who receives disability services, eventually got a bus pass and started visiting the Providence Place mall, which is where he realized a clear desire to work.
“When I was browsing around the mall, it made me want to work, because there was stuff I wanted to buy, and food I wanted to eat,” he said.
D’Agostino connected with the state for some job training and worked at Goodwill Industries of Rhode Island. After about a year, he connected with The Fogarty Center, a Barrington-based service provider for individuals with IDD. The nonprofit helped him land a job in Pawtucket at Dr. Day Care, formerly Pawtucket Day, where he’s worked as a cook for four years.
“I like how it keeps me busy and occupied so now I’m not stuck in the house every day,” he said.
D’Agostino now advocates through the Fogarty Center for integrated employment opportunities for other individuals with IDD. He said his job has given him greater social and financial independence.
His story exemplifies what the federal government wants to see more of in Rhode Island. The consent decree calls for more “person-centered” planning and integrated employment, which means helping individuals with IDD seek meaningful employment in the private sector.
There are nearly 4,000 adults who receive services through the Developmental Disabilities Division, an arm of the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals. And the state is actively trying to connect 2,914 of them to community-based, integrated job opportunities, while working with another 707 students to plan for transitioning into adulthood.
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SUNNY DISPOSITION: Chris Forte has worked part time at Home Depot on Charles Street in Providence since June 2016. He enjoys everything about his job retrieving shopping carts from the parking lot and helping customers load heavy purchases into their vehicles. / PBN PHOTO/MICHAEL SALERNO[/caption]
Chris Forte has worked at the Home Depot on Charles Street in Providence since June 2016. Early in September, Forte walked through the store, chatting with co-workers and offering customers help.
He stopped at the sight of a dog passing by.
“Is he friendly?” he asked the dog’s owner, before bending down to pet.
Forte’s responsibilities include retrieving carriages from the parking lot and helping folks load heavy purchases into cars and trucks. He likes to tell stories, and got a laugh out of one that involved a customer who was convinced that putting a heavy water heater atop an easily dented Toyota Camry would be a good idea.
Forte, who works part time, uses his paycheck to pursue hobbies, including wearable technology. He has a Fitbit to count his steps each day, and a Samsung smartwatch to connect to his phone.
What’s his favorite part of working?
“Everything,” he said with a smile on his face. “There’s something new every day.”
The number of individuals with IDD totals less than 0.4 percent of all Rhode Islanders, but the fiscal 2018 $256.7 million budget – 50.6 percent of which comes from federal funds – of the Developmental Disabilities Division makes up 2.8 percent of the entire state budget. That breaks down to about $64,000 per individual served, an amount that was criticized during the Great Recession for being too high, according to service providers.
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EXCITED: Kerri Zanchi, director of the state’s Developmental Disabilities Division, is excited about a new pilot program aimed at boosting the ranks of social-service providers to help individuals with IDD find jobs. / PBN PHOTO/MICHAEL SALERNO[/caption]
The funding, however, is largely passed through to dozens of social-service providers, which are key partners in delivering direct support to Rhode Islanders with IDD.
“The provider agencies are the feet on the ground,” explained Kerri Zanchi, Developmental Disabilities director. “We’re the umbrella.”
The providers argue the efforts are costly because of the elevated level of support needed for each individual, some of whom require full-time support. And the provider community, which employs thousands of Rhode Islanders, is working with the state to come into compliance with the consent decree.
And with new federal requirements, spelled out in both the consent decree and new Medicaid managed-care guidelines known colloquially as the “final rule,” providing services is becoming more labor intensive and subsequently more expensive.
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TRAINING: Thomas P. Kane, left, president and CEO of AccessPoint RI, a nonprofit social-service provider that supports individuals with intellectual and developmental disabilities, assists Christopher Perry of Coventry with his workout. Perry is a star Special Olympics athlete. / PBN PHOTO/MICHAEL SALERNO[/caption]
“There were some people in state government who thought that organizations could absorb a substantial cut, but it just wasn’t true,” said Thomas P. Kane, president and CEO of AccessPoint RI, a Cranston-based, nonprofit service provider for individuals with intellectual and developmental disabilities.
THE PROVIDERS
There are roughly 40 organizations working with the state to provide services to individuals with IDD.
The providers receive funding from state taxpayers that is matched by federal sources. Leading up to 2008, funding for developmental disabilities increased each fiscal year, reflecting a budget that prioritized integrated services.
“Rhode Island was considered to be one of the more-progressive states, and there was a big focus on community integration,” Ferrara said.
But from 2008 to 2012, funding was slashed $38.6 million, or 15.1 percent, according to state figures. The cuts trickled down to providers and – ultimately – individuals with IDD.
“The significant budget cuts impacted the system itself, and a greater focus was given to grouping people [with IDD],” Ferrara added.
The grouping led to segregation, landing the state in hot water with the federal government. And while the number of segregated work facilities has fallen to four, from nine since the beginning of the consent decree, the federal government in coming years could withhold Medicaid funding if the money isn’t spent on community-based integrated employment.
“Those [facilities] need to come into compliance,” Zanchi said pointedly.
A person-centered approach, however, requires a larger workforce. Whereas a couple of employers previously could support many individuals in a group setting, integrated employment requires individualized support.
But providers are still reeling from the cuts, struggling to pay competitive wages and to accept new clients.
“A lot of cuts had to be made internally, which either reduced the amount of service that we could provide to the people who come to our organization, or reduced the salary and benefits to staff,” Kane said.
AccessPoint, which employs about 300 part- and full-time employees, was forced to sell off one of its businesses and lay off workers in the wake of 2011 budget cuts. The organization, which closed its group-employment services this year, had to reduce sick time by 50 percent and offer five fewer holidays.
Since the cuts first happened, health insurance costs at AccessPoint alone have grown nearly $1 million to $1.9 million, while funding has remained relatively stagnant.
“We still fight every day to try and make ends meet, but we’ve had a number of staff leave, and we are constantly in a restructuring mode,” Kane said. “This is not exclusive to AccessPoint. Every agency is dealing with the same thing.”
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FUNDING BACK, BUT IS IT ENOUGH? During the Great Recession the state slashed a major portion of the state’s Developmental Disabilities Division’s budget, which is largely passed through to social-service providers who provide direct support to individuals. Since 2012, the state has increasingly replaced the lost funding, but providers question whether it’s enough, as costs have simultaneously grown. / SOURCES:
R.I. Office of Management and Budget, R.I. Department of Administration, PBN research[/caption]
The state has increased the developmental-disabilities budget each year since it reached a low point in 2012, but funding has only just exceeded 2008 levels.
“The pendulum has swung too far away from helping individuals with IDD and it needs to swing back,” Brunero said.
The state has been trying new ways to work toward achieving greater levels of integrated employment, and received more than $6.1 million last fiscal year to implement a pilot program aimed at boosting ranks among provider groups to help individuals with IDD find jobs.
Zanchi, who took over as director in January, said about 22 organizations applied to be part of the program, which is designed to initially help about 500 individuals with IDD find employment. The new program has come with some growing pains, as agencies are reimbursed based on results, which puts a greater financial risk on the providers.
“It’s been tough,” she said. “It’s a very different model of support than what we’ve contracted with providers before.”
But Zanchi is encouraged by initial results, and the number of individuals with IDD who have found integrated-employment opportunities has grown. The state also now has a better grasp on the number of people it’s trying to serve, seemingly an ever-moving target in the years immediately following the consent decree, making it difficult to implement any change.
The progress has not been lost on Judge McConnell,
who met with state and federal officials for an update on July 28 at U.S. District Court in Providence.
“Compared to a year ago, we’re in a very different place,” he said, approvingly.
But a key component to these efforts is the employers. Rhode Island businesses are not mandated by the consent decree to hire individuals with IDD. Nor is there a court order requiring the private sector to help state officials reach compliance.
But without them, individuals with IDD are less likely to get an integrated job, and the state will inevitably fail to comply in the long term.
“This is about building partnerships and collaboration, but we’re not looking for a handout, we’re looking for a hand up,” said Rory Carmody, program-development director at AccessPoint.
THE EMPLOYERS
Many large Rhode Island employers are relatively active in training and hiring individuals with IDD, including Ocean State Job Lot, Tiffany & Co. and Home Depot, to name a few.
CVS Health Corp., the retail giant based in Woonsocket, has made a commitment to hiring individuals with intellectual, developmental and physical disabilities.
“As one of the largest employers in Rhode Island and across the country, CVS Health is committed to breaking down the employment barriers faced by people with disabilities, including limited access to skills training and, too often, unfairly low expectations,” said David Casey, vice president of workforce strategies and chief diversity officer.
CVS has partnered with different organizations, including Goodwill and AccessPoint, to help connect Rhode Islanders with employment opportunities.
Anecdotally, providers say CVS is making a positive impact, but it’s unclear how many people are benefiting locally, as the retailer would not provide local employment statistics.
‘We still fight every day to try and make ends meet. … Every agency is dealing with the same thing.’
Thomas P. Kane, AccessPoint RI president and CEO
The retailer is among a minority of private-sector employers to actively work with individuals with IDD. And part of that is because there are some historic concerns about the productivity of individuals with IDD.
“Whereas 60 years ago, when people with disabilities were told they didn’t have to be living in institutions anymore, many members of the community were hesitant. Some of the same doubt is being placed on whether they can be contributing members of the workforce,” said Kiernan “Kie” O’Donnell, co-president of Rhode Island Association of People Supporting EmploymentFirst, or APSE.
CVS, however, is proving that many of those concerns are unfounded.
“We know that skilled, productive workers with disabilities can be brought successfully into the workforce, where they can make powerful contributions to our economy and our society,” Casey said.
Ted Beahm, district human resources manager for Home Depot, met and hired Forte through AccessPoint. He said there’s about 25-30 individuals with IDD working at the nine facilities within his district that covers Rhode Island and South Attleboro.
Beahm said the company has had good success in the hiring process because of the support he’s received through such organizations as AccessPoint.
“Where we turned that corner was when we developed these great relationships with the providers,” he said. “There’s a shared responsibility between the provider and the company that makes sure that we’re acting in the best interest of our associates. And we are a values-based company, so we take these issues very seriously.”
Beahm also recognizes that there’s a stigma that individuals with IDD might not produce at the same level as someone without IDD. But he says the characterization doesn’t hold water at Home Depot.
“It’s critical that everybody does their job and does it well. From a management perspective, it’s about removing obstacles, which flows right into what the associates are doing: Taking care of customers,” he said. “Our customers are looking at us as [a] problem-solver, and I find that is within the capabilities of everyone in the store that we hire.”
He hopes other employers recognize that potential in this section of the workforce.
“I think more employers in the right situation can take advantage of this because, let’s face it, the hiring landscape right now is challenging and more difficult than it’s ever been,” he said. “If the goal is to run your business well, this is another avenue to help that goal.”
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POWERFUL SUPPORT: Thomas P. Kane, left, is president and CEO of AccessPoint RI, a social-service provider that supports individuals with IDD. Christopher Perry of Coventry has won 112 gold, 89 silver and 112 bronze medals in power lifting at the Special Olympics. / PBN PHOTO/MICHAEL SALERNO[/caption]
O’Donnell said some employers are unaware of the federal subsidies and tax benefits, which he called “sweeteners,” that come along with employing individuals with IDD.
There are also state programs, such as On The Job Training through the R.I. Office of Rehabilitation Services, through which employers can receive about 50 percent of an individual’s pay for the first few months, which minimizes the upfront risk of taking on a new employer and helps assuage any preconceived concerns held by the employer.
APSE, which is a national organization that advocates for the inclusion of people with disabilities in the workplace and community, actively engages with both lawmakers and employers to promote opportunities and dissuade stereotypes.
O’Donnell said engaging smaller employers, too, is something that’s a focus right now.
“Because our strategies are based on relationship building, we see that almost 90 percent of our state is made up of small businesses that employ about 50 percent of the workforce,” he said. “With those small businesses, it’s a lot easier to reach the decisionmakers and to start those conversations.”
The state to date has been relatively disconnected from communicating directly with private-sector employers on this issue, relying heavily on providers to make those connections, according to state officials and service providers. But Zanchi said her department is going to take a more active role in creating partnerships through the R.I. Department of Labor and Training.
Zanchi recently spent an afternoon at Blount Fine Foods in Warren, where APSE was hosting a “take your legislature to work” day to show how the food-service provider had made a commitment to hiring people with disabilities.
“Those are certainly the opportunities where we want to promote employers partnering with us,” she said, adding that it’s part of the progress she sees happening throughout the state. “Change is hard, but I think Rhode Island is moving in the right direction.”
For D’Agostino, employment is ultimately important, and while he sees more opportunity out there, he said there’s still a lot to be done.
“Rhode Island is a small state, but a small state can do big things,” he said. “People with disabilities are important and need quality of life, too.”
Eli Sherman is a PBN staff writer. Email him at Sherman@PBN.com, or follow him on Twitter @Eli_Sherman.
