Archive

Posts Tagged ‘sheltered workshops’

Questions remain as key disabilities committee kills work opportunities bill

July 13, 2018 4 comments

The Legislature’s family and disabilities rights committee has rejected H. 4541, a bill intended to ensure that developmentally disabled individuals get work opportunities in their state-funded day programs.

A staff member of the Children, Families, and Persons with Disabilities Committee said the committee understands many people cannot find those work opportunities and is therefore discussing other possible ways of providing for them. But details regarding the policies being considered by the Children and Families Committee are sketchy, and the committee hasn’t yet responded to written questions about those ideas.

Barbara Govoni, the mother of a developmentally disabled man, had pushed for months for passage of H. 4541, which would have established optional work activities in DDS-funded day programs for up to four hours a day.

Many people in community-based day programs funded by the Department of Developmental Services have not been able to find such work since all sheltered workshops were closed in Massachusetts in 2016.

H. 4541 had been referred to the Children and Families Committee in May, and the committee effectively killed the measure last month by sending it to a study. With formal business in the current two-year legislative session ending on July 31, any similar legislation will have to be re-filed next January and go through the legislative process all over again.

It isn’t clear what the committee’s objections were to H. 4541. We’ve noted that some committee members appeared to have some misconceptions about the bill, including the idea that it would bring sheltered workshops back to the state.

In fact, the bill would have simply provided work activities for individuals who continued to desire those activities in their day programs, and who either could not or did not want to work in “integrated” or mainstream work settings. As we have reported, many of these people miss the work they used to do in their sheltered workshops, and are unable to relate to most day program activities that replaced that work.

At the same time, it appears that some DDS-funded day programs are, in fact, continuing to offer work activities to some residents. It’s not clear how many such programs currently exist.

A legislative aide to Representative Kay Khan, House chair of the Children and Families Committee, said earlier this week that the committee had been in touch with the Department of Developmental Services about the work opportunity issue, and that one proposal discussed was to hire an ombudsman in the Department who would help individuals and families locate existing day programs that offer work opportunities.

Funding remains a question

Another proposal under consideration by the Children and Families Committee and DDS is to establish new work opportunities programs at additional day programs without making such work opportunities a legislative requirement of DDS.

No details are yet available, however, on the scope of the Children and Families Committee’s or DDS’s proposals. Also unknown is how funding would be appropriated for an expansion of existing work opportunities programs, and what the amount of that funding might be.

The Legislature, unfortunately, has previously shown a reluctance to fund job training and other programs as part of the effort to replace sheltered workshop programs with “integrated” or mainstream work opportunities for DDS clients.

The administration of then Governor Deval Patrick and the Legislature had set up a DDS line item in Fiscal 2015 to fund job training and other programs to help transfer clients from sheltered workshops into mainstream employment. That line item was initially funded with $1 million and was raised to $3 million the following year.

For Fiscal 2017, current Governor Charlie Baker, with the support of the DDS corporate providers, had proposed boosting the job development line item to $7.6 million; but the Legislature wouldn’t agree to the higher funding.

As of Fiscal 2018, the job development line item was eliminated and all funding for those efforts was transferred to the overall DDS Community Based Day and Work line item. It would seem the case needs to be made that additional funding is now needed for the day and work line item to fill the gap in work opportunity programs.

The solution needs to be comprehensive

Robin Frechette, an aide to Representative Brian Ashe, who filed H. 4541 on Govoni’s behalf, said she believes the Children and Families Committee co-chairs and other committee members “understand there is a gap in services to a particular group of individuals who are not able to work out in the community, and it needs to be addressed.”

But Frechette expressed a concern that simply having an ombudsman direct individuals whose day programs don’t offer work opportunities to different day programs that do offer those opportunities could be disruptive to those individuals.  She also said she was concerned that there may be few such programs available in the western part of the state where Barbara Govoni and her son live.

Earlier this week, we sent email queries to both the Children and Families Committee co-chairs and DDS to try to find out more about the proposals under consideration.

We have asked for records from DDS on the number of work opportunity programs that currently exist in DDS-funded, community-based day programs, and the number of work opportunity programs that DDS plans to establish.

We are also asking for the number of DDS clients who have been placed in “integrated employment” or mainstream workforce jobs and the number of DDS clients in community-based day programs since Fiscal 2014.

And we have asked DDS for its assessment as to whether there is a problem in providing suitable work opportunities for people in the DDS system who desire it, and whether some DDS clients are unable to function in mainstream work sites.

In addition, we’ve asked the co-chairs of the Children and Families Committee what the committee’s specific objections to H. 4541 were.

Despite the rejection of H. 4541, the opportunity remains for state legislators and policy makers to address the critical work opportunity problem facing developmentally disabled people across the state in an effective way.  We hope those legislators and policy makers will make a serious commitment to finding a workable solution; but we know from experience that deeds will be more important than words in that regard.

Advertisements

Families tell legislators that work opportunity bill for the developmentally disabled is about choice

A few days ago (on June 12), Barbara Govoni and Patty Garrity took their case to Beacon Hill for passage of H. 4541, a bill that would ensure that developmentally disabled individuals get work opportunities in their community-based day programs.

Also testifying at the June 12 public hearing of the Legislature’s Children, Families, and Persons with Disabilities Committee in support of the bill was Robin Frechette, a legislative aide to Representative Brian Ashe, who had filed the bill on Govoni’s behalf.

As we noted earlier this month, time is running out in the current legislative session to pass this critically important bill. And many legislators appear to have misconceptions about the legislation.

Govoni, Garrity, and Frechette all pointed out that H. 4541 is needed to fill a gap in work activities for the developmentally disabled — a gap that opened up after all sheltered workshops were closed in Massachusetts in 2016.

We too submitted testimony, and I spoke on behalf of COFAR to the four legislators present on the panel — Senator Joan Lovely, Senate co-chair of the committee; Representative Kay Khan, House co-chair; and Representatives Carolyn Dykema and Shaunna O’Connell.

Supporters of H. 4541

Supporters of H. 4541 on June 12 following the Children and Families Committee hearing. They are (from left) Patty Garrity, Robin Frechette, Danny Morin, Barb Govoni, and John Govoni.

The bill is Govoni’s vision and was filed after she had spent months advocating for it.

“I would not be here had there been a realistic decision to incorporate a community-based support program (when the sheltered workshops were closed),” Govoni testified. That program, she said, should have included a work activity option at day program facilities across the state.

Frechette testified that not all developmentally disabled persons are able to work successfully in mainstream work environments. Garrity pointed out that her brother, Mark, is one of those DDS clients who is “not able to compete in a competitive market for a job.”

Garrity said that when Mark participated in a sheltered workshop at his same day program location in Braintree prior to the workshop’s closure, “the work would come in and Mark would get a paycheck at the end of the week that provided him with self-esteem.” That is no longer the case, and not only is Mark bored with his current day program activities, he tends to let everyone he meets know he misses the work he used to do.

It is not clear yet whether the Children and Family Committee co-chairs are in support of H. 4541. An aide to Representative Khan said on Friday (June 15) that Khan and Lovely were “having a discussion” on all bills still in the committee as formal business in the current legislative session winds down, and would make a decision this week on which bills to report favorably.

Misconceptions persist about the workshop closures

During the June 12 committee hearing, comments from some legislators implied that they may not fully understand the intent of H. 4541 or the problems that have occurred as a result of the workshop closures.

Senator Lovely said that a developmentally disabled client of a DDS provider in her district worked as an intern for her and went on to work successfully at a CVS pharmacy. Lovely added, though, in addressing Govoni, that, “We do recognize that CVS may not be a good match for you,” meaning Govoni’s son, Danny Morin.

We want the legislators to know that the promises made that people would be able to move easily from the sheltered workshops and into mainstream employment have not materialized.

barb-g-testifies-for-h-45411.jpg

Barbara Govoni testifies during June 12 public hearing on H. 4541

As we reported in 2016, the number of participants in sheltered workshops dropped by 1,166 between August 2014 and August 2015 — a 61 percent reduction — while the workshops were being closed. In that same period, the number of developmentally disabled persons in corporate-run, community-based day programs increased by 1,116, almost the same number as the number of participants who had left the workshops.

Yet, the number of developmentally disabled people in “integrated employment” settings increased from August 2014 to 2015 by only 337, or about 6 percent.  Placing people in integrated or mainstream employment was supposed to be the reason for closing the sheltered workshops!

Studies in other states have found similar outcomes from sheltered workshop closures.

We also want the members of the Children and Families Committee to understand that while H. 4541 is intended to address that unkept promise of access to mainstream employment, the bill isn’t intended to bring the actual workshops back.

DDS providers pushed for the workshop closures

We further want the legislators to know that while the closures of the sheltered workshops in Massachusetts was a policy of the administrations of then Governor Deval Patrick and later of current Governor Charlie Baker, the closures were supported by corporate providers to the Department of Developmental Services as well. The providers stood to gain financially from the closures to the extent that the closures would mean more funding for the provider-run day programs.

We have  pointed out that organizations representing corporate DDS providers in Massachusetts co-authored at least two reports with DDS in the period leading up to and during the closures of the sheltered workshops in the state. The reports both called for the closures of the workshops and for more funding for day programs.

It seemed to us at the time, and still does, to be inappropriate for DDS to have allowed the providers to co-author a document that called for a public policy intended to ensure more funding for those same providers, particularly given that the policy was opposed by individuals and families who were benefiting from the workshops.

Misconceptions about the federal role in closing the workshops

As the then Patrick administration began closing the workshops in Massachusetts, the administration argued that the closures were mandated by the federal government and that Massachusetts had no choice but to comply with the federal order.

But the federal government was actually telling the states at the time that sheltered workshops were permissible for those who wanted to remain in them; the problem, according to the U.S. Department of Justice, was that some states were “over-relying” on the workshops. It also appears that unlike Massachusetts, many, if not most other states did not view the federal government as having issued a clear directive to close their workshops.

In remarks in late 2016, in fact, then DDS Commissioner Elin Howe stated that Massachusetts was only the fourth state in the country to have closed all of its sheltered workshops.

In comments made during the June 12 hearing of the Children and Families Committee, some of the legislators appeared to have the impression that the federal government had required the closure of all sheltered workshops around the country, and that the workshops no longer existed.

However, sheltered workshops are continuing to operate in other states, and there have been successful legislative efforts in some of those states to preserve the workshops as an option for those who desire them.

In Missouri, families mounted a successful effort last year to protect the workshops in that state, and that movement has reportedly spread to other states.  State legislators in New Jersey similarly passed legislation last year to preserve the state’s sheltered workshops.

As things currently stand, the federal government has not ordered sheltered workshops to close and has extended a deadline for removing Medicaid funding for them until 2022.

We hope the state Legislature will recognize that H. 4541 is in line with federal guidelines because it doesn’t prevent anyone who wishes to do so from seeking employment in the mainstream workforce. The bill simply ensures that work opportunities exist for those who don’t choose to participate in mainstream employment.

In the end, H. 4541 is about choice.

 

 

Mother wages uphill battle for work opportunity bill for her developmentally disabled son

June 6, 2018 3 comments

[Update: The Legislature’s Children, Families, and Persons with Disabilities Committee has scheduled a public hearing at the Statehouse on Tuesday, June 12, at 1 p.m. on H. 4541]

Barbara Govoni personally lobbied for months before a bill was finally filed in the state Legislature that would ensure that developmentally disabled individuals who are unable to function in mainstream work environments are provided with employment opportunities within their existing community-based day programs.

Govoni would now love to see H. 4541 move forward in the current legislative session. She believes it would ensure that meaningful activities are provided for her son, Danny Morin, and for many others like him.

But even though the bill has close to two dozen co-sponsors, time does not appear to be on Govoni’s side.

With the current two-year legislative session drawing to an end, a staff aide to Representative Brian Ashe, who filed the bill on Govoni’s behalf, acknowledged that the chances for passage of H. 4541 this year are slim. The bill was referred last month to the Children, Families, and Persons with Disabilities Committee.

Last September, we reported on Govoni’s efforts to reintroduce steady piecework activities in day programs for those who desire it. Danny had enjoyed the work he did in his Agawam-based sheltered workshop before that program and all other remaining workshop programs in the state were eliminated in 2016. After that, Danny was offered only day program activities in the same location, most of which he couldn’t relate to.

In recent months, Danny has been working once a week for about two hours at a time at an assembly and packaging company in Holyoke. It is a pale substitute for the steady work he enjoyed when he participated in the sheltered workshop.

barb-govoni-and-dan-morin2.jpg

Barbara Govoni and her son Danny Morin

“People are suffering with not having enough work,” Govoni said. “This bill would have a monumental impact on the lives of these people if it were to pass.”

In addition to people such as Danny, there are many Department of Developmental Services clients who are either unable to function in mainstream work environments or are unable to work at a rate that those mainstream employers require.

H. 4541 specifies that the work program would be optional for day program participants and would allow them “an opportunity to work in a supportive employment environment which enhances productivity, safety and self-esteem.”

The work would be offered through the DDS-funded day programs for up to four hours a day. All participating individuals would receive a sub-minimum wage permissible under the federal Fair Labor Standards Act.

The Children and Families Committee had 30 days to act on the bill after it was referred there on May 21. But even if the committee were to act favorably on it within that time frame, the bill would probably still have to go through at least two additional committees including the House Ways and Means Committee before reaching the House and Senate floors.  After July 31, formal business in the current two-year legislative session comes to an end.

A staff aide to Representative Kay Khan, House chair of the Children and Families Committee, said the committee will schedule a public hearing on the bill this month. But the aide said there is only “a very low chance” that bill will reach the floor of the House prior to the July 31 deadline.

We strongly support this legislation and hope it doesn’t lose the momentum it has gained so far if, as seems likely, it has to be reintroduced when the new legislative session begins next January.

We understand the Baker administration and previous Patrick administration objected to sheltered workshops as  “segregated” settings because they offered work activities solely to groups of developmentally disabled persons.

What should make H. 4541 acceptable to people with those objections is that the employment program would be voluntary. In that sense, the bill mirrors  language that was inserted in the state budget in Fiscal Years 2015 and 2016 that stated that sheltered workshops would remain open for those who wanted to remain in them. That language, however, did not prevent the Baker administration from closing all remaining sheltered workshops in 2016.

The voluntary nature of the employment program under H. 4541 may be why the bill has garnered co-sponsors from across the state. We hope more legislators begin to realize that the closures of the sheltered workshops has caused problems for many DDS clients, and that this bill is a good first step in addressing those problems.

Even though the bill’s chances are slim in the current session, we encourage people to call the Children and Families Committee to urge them to act quickly on the measure. You can reach the office of Rep. Khan, House chair, at (617) 722-2011, and Senator Joan Lovely, Senate chair, at (617) 722-1410.

Things ‘sliding backwards’ for two men after closure of their sheltered workshops (an update)

September 12, 2017 Leave a comment

Makeshift solutions that were adopted in recent months to help two men cope with the closures last year of their sheltered workshops have not been successful, members of their families say.

“It’s sliding backwards,” Patty Garrity, the sister of Mark Garrity, said in an interview last week. She said a paper shredding experiment that was tried with Mark in March worked only temporarily. Mark soon lost interest in the activity and is bored in his day program, which replaced his sheltered workshop.

In a separate day program, Danny Morin’s temporary work came to an end a few months after it began. In addition, the clients in Danny’s program are now scheduled to be moved into smaller, separate day programs, and Danny’s mother is concerned he could be separated from his long-time girlfriend, another client in his program.  The director of the program said that clients’ preferences would be considered in the relocation decisions.

While sheltered workshops were operating for both Mark Garrity and Danny Morin, piecework was always available and both men were satisfied and fulfilled by it, their family members say.

Barbara Govoni, Danny Morin’s mother, is trying to interest state lawmakers in her idea to reintroduce steady piecework activities in day programs for those who desire it. Govoni has proposed legislative language that would require the state to provide a “supportive work environment” to disabled persons who “cannot be comfortably be mainstreamed into a vocational community setting.”

In May, we first reported on the impact of the closures of their sheltered workshops on Mark and Danny and their families.

We noted that paid piecework and assembly work that had been given to Mark and Danny to do in their sheltered workshops were taken away last year and replaced by day program activities that they couldn’t relate to. In each case, their provider agency managed to come up with a makeshift solution to the problem that allowed the men to continue doing work similar to what they had done before.

Now it appears that those makeshift solutions haven’t solved the underlying problems created by the workshop closures for the two men and potentially others.

Sheltered workshops may have closed prematurely in Massachusetts 

All sheltered workshop programs were closed in Massachusetts as of last summer as a result of requirements by the federal Centers for Medicare and Medicaid Services (CMS) that developmentally disabled people work in “integrated employment” settings in which a majority of the workers are not disabled.

But while sheltered workshops have been deemed “segregated” settings because they are offered solely to groups of developmentally disabled persons, many clients and their families and guardians have argued that the programs provide fulfilling, skill-building activities and do not preclude community integration. Moreover, it is not clear that the CMS has necessarily required the shutdown of all sheltered workshops.

In Massachusetts, the Baker administration and former Patrick administration claimed they had no choice but to close all of the workshops in the state, or else the federal government would bring a lawsuit against them.  But many other states have apparently not acted in the haste that Massachusetts did in shutting the programs down. Last year, DDS Commissioner Elin Howe, who has since retired, stated that Massachusetts was one of the first states in the country to close all of its workshops.

Paper shredding activity for Mark Garrity didn’t last

At the Road to Responsibility (RTR) day program in Braintree, which Mark Garrity attends, Mark was frustrated for months after his sheltered workshop at the site was closed in September of 2016. Piecework activities that Mark enjoyed doing came to an end and were replaced by nature walks, cooking classes, and a money management class, none of which interested Mark.

After COFAR contacted DDS about Mark’s situation in early March of this year, RTR staff found a paper shredding activity for Mark to do. The activity received verbal approval from the DDS southeast regional director, who determined that it was in compliance with federal regulations.

The paper shredding seemed at first to be a good solution for Mark, and he even got paid for it. But Mark’s sister, Patty Garrity, said that Mark soon sensed a lack of structure and purpose in the activity.  Mark is also sometimes asked to use the copy machine and to take the copied documents to staff offices; but Patty says that activity usually occupies only a few minutes of his day.

“I think he’s bored,” Patty said. “Every day I would pick him up and ask how’s it going with the shredding. It didn’t hold his interest.”

Patty said that despite the fact that funding was earmarked to pay Mark for doing the paper shredding, he recently stopped doing it. “Now he’s unproductive, and it’s not fair to him,” she said.

RTR officials have said that they did recently offer Mark an employment opportunity at a company outside of his day program; but Patty did not approve that offer for Mark, contending that Mark is not a suitable candidate for outside or mainstream employment. She said he is not able to produce at a rate that employers require in paying a minimum wage.

While his sheltered workshop was operating, Mark was paid by the piece, so the rate at which he was able to produce was not an issue. Moreover, jobs at the sheltered workshop would rotate. Mark was constantly busy then, Patty said, but now he is chafing under the lack of structure.

In addition, Mark appears to fall outside of at least one work category that still exists at his day program for clients who have been determined to be unable or too high-risk to function in the community outside the program. While those clients have been given work to do each day folding t-shirts, Mark has not been offered that work because he has not been ruled unsuitable for community interaction.

“They’re (the RTR staff) trying to do the best they can,” Patty said, “but the people are bored.”

Work at Work Opportunity Center site is intermittent

 At the Work Opportunity Center day program in Agawam which Barbara Govoni’s son, Danny, attends, some piecework has been available intermittently from a company that is located in the same building in the center.

The company, Millennium Press, used to supply piecework activities to the Work Opportunity Center when the Center operated as a sheltered workshop. Now the company rents a portion of the Work Opportunity Center’s building.

The work offered by the Millennium Press to clients of the Work Opportunity Center since the closure of the sheltered workshop complies with federal regulations because non-disabled people also work for that company. Danny Morin and other clients of the Center signed an agreement to be paid a sub-minimum wage for doing the work.

However, Barbara said that the Millennium Press work is not steady. Danny and other clients in the Center were kept busy recently for three to four months putting stickers on envelopes and boxes for the company, but they finished ahead of schedule, she said, and the work came to an end.

Pushing for legislation to bring back workshop activities

Govoni has been trying to interest legislators and her congressman in filing legislation at either the federal or state level that would ensure the legality in Massachusetts and potentially other states of a steady supply of piecework activities for persons who desire them. She met last week with state Representative Brian Ashe, a Democratic legislator who represents her hometown of Hampden, to discuss her proposal.

Such legislation would be similar to language that was inserted in the state budget in Fiscal Years 2015 and 2016 that stated that sheltered workshops would remain open for those who wanted to remain in them. Unfortunately, that language did not prevent the Baker administration from closing all remaining sheltered workshops last year.

Govoni’s proposed legislative language would require the state or states (if her language was enacted by Congress) “to provide a supportive work environment, separate from the mainstream community, to enhance productivity, safety and self-esteem.” The language states that the separate work environment is not meant to exclude “other forms of integration or inclusion.”

We emailed Ashe’s legislative aide last month with our support of Govoni’s proposed legislation, but have not heard back. Govoni said Ashe told her he would bring her idea to the attention of “the proper legislative committee” in the Massachusetts Legislature.

Clients at the Work Opportunity Center will be split into groups 

Govoni said the clients in her son’s day program will be split into three groups and that each group will be sent to a different day program location based on where they live. She was told at first that the decisions on the new locations would not be based on any existing preferences the clients had expressed such as preferences for maintaining relationships they may have formed in the Agawam center.

DDS regulations state that the Department must provide services that promote “self‑determination and freedom of choice to the individual’s fullest capability.” If clients are being moved to different locations without regard to their personal preferences, it would appear that they are not being allowed to exercise self-determination or freedom of choice in that respect.

Bob MacDonald, executive director of the Work Opportunity Center, said that after discussing the issue with DDS, he has received clarification that the relocations should take client preferences into account. MacDonald said each relocation decision will take into consideration 1) where the individual lives, 2) the “consumer’s preference,” and 3) the recommendation of the individual’s clinical care (ISP) team.

Without discussing specific people, MacDonald said that if two clients are known to have a relationship or a preference for staying together, that would or should be taken into consideration in the relocation decision.

We hope that Representative Ashe and others in the Legislature will make a sincere effort to promote legislation that will ensure the restoration of steady and meaningful work activities for those in DDS day programs that desire them.

Even if someone believes that DDS-centered work activities tend to segregate or exploit those individuals (and we don’t believe that to be the case), we think everyone should respect the wishes of those individuals and their families and guardians who want to engage in those activities. That is what self-direction and freedom of choice are all about.

A look at the struggles of two families to cope with closures of sheltered workshops in Massachusetts

May 1, 2017 5 comments

When Massachusetts closed its remaining sheltered workshops for people with developmental disabilities last summer, deeming the programs “segregated,” the impact of the closures on workshop participants Mark Garrity and Danny Morin was pretty much the same.

The two men continued to go every day to their respective facilities where their sheltered workshops had formerly been operated by providers funded by the Department of Developmental Services. But while the providers continued to manage the same facilities, each provider now began offering their clients traditional, DDS-funded day program activities instead.

Paid piecework and assembly work that had been given to Garrity and Morin to do in their sheltered workshops were taken away and replaced by day program activities that they couldn’t relate to. In each case, their provider agency managed to come up with a makeshift solution to the problem that allowed the men to continue doing work similar to what they had done before.

Patty and Mark Garrity photo

Patty Garrity and her brother, Mark Garrity

But in each case, the solutions were implemented despite a lack of clear, written standards or guidance from the federal and state governments on the type of work and activities that were now permitted for the men. Their family and guardians were confused as well, often having to rely on information passed along from program staff or family of other clients.

Even some providers acknowledge that the system functioned more smoothly for everyone when the providers were operating their programs as sheltered workshops. At that time, participating companies would ship materials to the providers, and everyone at the workshop sites would have work to do — usually simple assembly jobs or packaging or labeling tasks.

Now, those providers must either send their clients to companies that offer to provide “integrated” work for them, or must try to continue to provide some on-site work under unclear rules that sometimes result in work arrangements that are adopted verbally and on a case-by-case basis. Moreover, most of their clients are now offered only day program activities that do not involve productive work and do not pay anything.

For Barbara Govoni, the mother of Danny Morin, and for Patty Garrity, the sister of Mark Garrity, the sheltered workshops were not only easier for them to deal with, they provided meaningful and satisfying activities for their respective loved ones.

“My argument is whether it was federal or state, they should not have taken away the workshops for those who can’t function in the community and disrupted their lives,” Govoni said. “I’m not opposed to finding jobs in the community or expanding day programs. I get it all has to do with money, but I feel that a group of people are being discriminated against based on the fact they had no voice or vote. They have been taken out of their element where they were comfortable.”

GEDSC DIGITAL CAMERA

Barbara Govoni and her son, Danny Morin

Govoni views the policy of providing integrated employment to all developmentally disabled people as a “misguided one-size-fits-all” approach to a complex social need.

State cites federal pressure to close workshops

All sheltered workshop programs were closed in Massachusetts as of last summer as a result of requirements by the federal Centers for Medicare and Medicaid Services (CMS) that developmentally disabled people work in “integrated employment” settings in which a majority of the workers are not disabled, and that they be paid the minimum wage in those settings. Sheltered workshops were deemed “segregated” settings because they were offered solely to groups of developmentally disabled persons, and the clients were often paid only a nominal amount for the work they did.

In Massachusetts, the Baker administration claimed it had no choice but to follow the CMS rules and close all of the workshops in the state, or else the federal government would bring a lawsuit against them.  But many other states have apparently not acted in the haste that Massachusetts did in shutting the programs down. DDS Commissioner Elin Howe stated late last year that Massachusetts was one of the first states in the country to close all of its workshops.

DDS and its major policy advisors, the Arc of Massachusetts and the Association of Developmental Disabilities Providers (ADDP), had actually wanted to close all of the sheltered workshops in Massachusetts as early as June of 2015. But in the wake of strong protests by families of workshop participants, the state Legislature temporarily slowed the closure process by inserting budget language in fiscal years 2014 and 2015, stating that DDS must continue to make sheltered workshops available for those clients who continued to want them.

But at the same time, the Legislature approved funding for the transfer of the participants out of the workshops and into day programs or employment programs. That move ultimately allowed the workshops to close while enabling legislators to claim they had acted to save the programs.

The closures of the sheltered workshops in Massachusetts resulted in the removal from those programs of close to 2,000 participants, but those closures do not appear to have translated into a steady flow of people into integrated employment.

Verbal permission given for on-site work

At the Road to Responsibility day program site in Braintree, which Mark Garrity attends, I met in late March with Patty Garrity and with senior staff of the provider and DDS officials to discuss Mark’s experience in making the transition from his sheltered workshop to the new system.

Like Barbara Govoni, Patty Garrity said the transition from the sheltered workshop has been difficult. Before RTR ceased operating as a sheltered workshop, Mark did a range of activities there, including collating, packaging, and other production work.

For months, after the workshop was closed in September of 2016, Mark was frustrated and angry, Patty said. RTR provided day program activities for him, but, as Patty put it, they “went over his head.” He wasn’t interested in nature walks or painting or cooking. In particular, he didn’t understand the class on money management.

In addition to his intellectual disability, Mark Garrity had suffered a traumatic brain injury in 1995 after having been hit by a car.  He underwent years of rehabilitation from that accident, which had nearly killed him.

In a letter written before Mark’s sheltered workshop program was ended, Mark’s neurologist, Dr. Douglas Katz, a member of the Department of Neurology at Boston Medical Center and a professor at the Boston University School of Medicine, stated that participating in the workshop had been “an important part of his (Mark’s) rehabilitation effort…and…his life before his injury. It is an activity that is highly rewarding for Mark. He looks forward to it on a daily basis.”

Katz added that, “I understand this program is …likely to close because of new rules passed by the CMS. I think this would be a big loss for my patient Mark. I would support efforts to maintain this structured workshop for Mark and others that benefit from this service.”

As of March 2 of this year, when I first talked to Patty, RTR still had no work for Mark to do that was similar to the work he had done prior to RTR’s changeover from a sheltered workshop to a day program site. But as of March 20, RTR officials said they had found paper shredding work for Mark for two out of the four hours a day that he attended the program.

The paper shredding arrangement at RTR was done after DDS southeast regional director Richard O’Meara determined that it would not violate the CMS rules. O’Meara said the permission he gave to RTR to offer paper shredding to Mark was purely verbal. There was nothing placed in writing about it.

Hearsay information on piecework eligibility requirement 

In January 2016, Govoni said, the Agawam-based Work Opportunity Center, her son’s former sheltered workshop provider, temporarily operated day programs in a function room in a local church after having closed its sheltered workshop program. “I walked in there one day (the temporary day program site),” she said, “and it appeared chaotic, with no structured activities.”

All of the Work Opportunity Center’s clients are now back at the agency’s facility. Govoni’s son gets sent out occasionally to integrated work sites and has some piecework to do at the Work Opportunity site as well. But the work is intermittent. She said she has also heard that those who want to do piecework at the Work Opportunity location will have to take a class explaining what piecework involves.

However, once again, Govoni said she has received nothing in writing about the reported class. She heard about it “through the grapevine.”

In the meantime, Govoni’s son receives a schedule of activities every month at the Work Opportunity Center.  “I’m not saying it’s bad,” Govoni said, “but it’s not what he is interested in.” She said many of the activities are educational, such as lectures on geography or cooking demonstrations. Volunteer work is available as well at a local homeless shelter, and residents are taken on walks to the local library and other locations. “Danny doesn’t want to do that,” she said. “He wants to work.”

Both Govoni and Patty Garrity said Danny and Mark respectively didn’t care about making the minimum wage, and would rather work at their day program sites than get sent out to jobs in the community.

Disagreement over client and family satisfaction

If, like Barbara Govoni and Patty Garrity, family members are confused or dissatisfied by the current situation, O’Meara said, they aren’t letting him know about it. O’Meara said that he and DDS Area Director Colleen Mulligan, who was also in attendance at the March 20 meeting at RTR, are generally the first people whom family members and guardians call when there are problems with DDS care.

“I haven’t gotten a lot of complaints (about the closures of the sheltered workshops in his region),” O’Meara said. “Generally, if people are not happy, we know about it.  These issues are addressed through the ISP (Individual Support Plans). I haven’t had many calls.”

Mulligan added that if problems were occurring like the ones Garrity has described, “I’m not hearing about it.”

But Garrity and some other advocates believe there may be few complaints now because the vocal protests that did occur when the workshop closures were first announced largely died down when families and guardians saw that their protests were having little effect.

A debate over integrated employment

At RTR, Chris White, the agency’s chief executive officer, maintained that even if the CMS requirements have been difficult to comply with, the requirements make sense because he believes that “everyone is capable” of working at integrated employment sites.

White’s viewpoint is in line with an August 2010 DDS policy document that states that “it has now been clearly demonstrated that individuals who were previously considered unemployable in integrated community settings can work successfully.”

But Govoni and Garrity maintained that the ideological viewpoint that the workshops segregated their participants and that integrated employment is feasible for everyone does not apply in their cases. “My son couldn’t wait to go to work (at his former sheltered workshop),” Govoni said. “He was not discriminated against. It was not a sweatshop for him, but the opposite. He doesn’t thrive in integrated sites. He would much prefer staying at the workshop where he was more comfortable. He doesn’t care what he gets paid.”

Govoni said that efforts to place her son in integrated work settings often did not work. In one case, she said, Danny was not able to do the work fast enough to satisfy the employer, and was terminated from the job. The speed of his work did not matter in the sheltered workshop.

Moreover, Govoni and Garrity maintained that even if integrated employment arrangements were feasible for everyone, there are not enough such jobs available to fulfill the demand now that the sheltered workshops are no longer available.

White said there were about 109 clients at RTR who were involved in “integrated group employment” at various job sites. That number was expected to rise this spring to about 120, he said.

At the same time, some 200 clients remained in RTR’s day program. White maintained, however, that those clients were happy with the activities they were doing, and that some were “on a retirement track.”

But it may be an open question whether all or most former workshop clients are really happy in day programs, or whether they simply have no choice but to remain in them.

Even DDS Commissioner Elin Howe appears to acknowledge that the state and its providers have been unable to find mainstream workforce jobs for a significant number of former workshop participants. While Howe made public remarks last year that we believe painted an overly rosy picture of the integrated employment situation, she did acknowledge that “many people transitioned (from sheltered workshops) to Community Based Day Support programs,” although she did not say how many.

Meanwhile, the Legislature has slowed funding for the transition to integrated employment. In order to carry out the administration’s integrated employment policy, the Legislature initially increased funding of the community-based day program line item in the state budget, and created a new line item to fund the transfers from the sheltered workshops.  The idea was to increase both day program and job development staffing and training.

The new sheltered workshop transfer budget line item was initially funded in Fiscal 2015 with $1 million.  That amount was raised to $3 million in Fiscal 2016, and the governor proposed to boost it to $7.6 million in Fiscal 2017.  But the House and the Senate did not go along with the governor’s plan. The Legislature level-funded the line item for Fiscal 2017. The line item was not included in the governor’s budget for Fiscal 2018.

We agree with Garrity and Govoni that the case has not been made that integrated employment is suitable for all people with developmental disabilities, and it is apparent that not enough integrated work opportunities even exist for all of those that could benefit from it.

We think the federal government needs to rethink its flawed ideology regarding sheltered workshops, particularly the questionable claim that they are discriminatory and segregate their participants.  The experience of Mark Garrity and Danny Morin provide further evidence that that claim is untrue.

DDS commissioner paints overly rosy picture of employment for developmentally disabled

January 19, 2017 2 comments

In opening remarks at a conference on employment opportunities for the developmentally disabled late last year, Department of Developmental Services Commissioner Elin Howe gave what appears to be an overly rosy assessment of the likelihood of mainstream jobs for those people.

In her written remarks delivered to the November 30 conference, which was hosted by DDS and the UMass Institute for Community Inclusion, Howe appeared to imply that former participants in sheltered workshops, which the administration has worked to close, have been placed in mainstream jobs at a record rate.

“There are now more people working in individual jobs in the community than ever before,” Howe stated.

But while the numbers Howe cited show an increase in the number of people placed in mainstream jobs since 2013, it appears that most of that increase occurred between 2013 and 2014, before the workshop closures took place. Since 2014, DDS data indicates that the number of people finding mainstream jobs declined rapidly.

Howe noted that all remaining sheltered workshops in the state were closed as of last July 1, and that Massachusetts was only the fourth state in the nation to do that. But the loss of those workshops should not be a cause for concern, Howe contended, because, there were now more than 3,300 individuals working in “group supported employment” in the state – an increase of over 1,300 people since June 2013.

An increase of 1,300 disabled people in group supported employment would work out to a 65 percent increase in the number of people in that category since 2013, which sounds like a major success story.

But of that total increase cited by Howe of 1,300 individuals, 998 — or nearly 77 percent of them — appear to have entered group supported employment between 2013 and 2014, according to data provided by DDS.

The DDS numbers show there was an increase of only 146 people in group supported employment between August 2014 and August 2015.  Between August 2015 and November 2016, when all remaining sheltered workshops were closed, there was an increase of only 156 people in group supported employment.

So, while the number of people in group supported employment appears to have increased by almost 50 percent between 2013 and 2014, the increase in the two-year period from 2014 to 2016 dropped to about 10 percent.

Group supported employment is defined by DDS as “a small group of individuals, (typically 2 to 8), working in the community under the supervision of a provider agency.” In contrast to sheltered workshops, supported employment places an “emphasis…on work in an integrated environment,” which means that developmentally disabled persons work in the same location as non-disabled individuals.

The closures of the sheltered workshops in Massachusetts has resulted in the removal from those programs of close to 2,000 participants since 2013; but those closures did not appear to have translated into a steady flow of people into supported employment. Even Howe appears to acknowledge that a significant percentage of those former workshop participants have not found mainstream workforce jobs.

In her remarks, Howe stated that “many people transitioned (from sheltered workshops) to Community Based Day Support programs,” but didn’t say how many. Day programs are often really just daycare programs that do not offer work-based or skill-building activities to the people in them.

The Massachusetts Developmental Disabilities Council, which is part of the Baker administration, appears to acknowledge the problem of employment in its State Plan for 2016, noting that:

there are fewer people being placed in successful employment due to staff layoffs and the current fiscal environment. In order for more services to be made available, it is important to create partnerships and work with various state agencies in order to address this significant issue that is and will continue to be of concern. (my emphasis)

Last year, however, the Legislature failed to provide funding sought by Governor Baker for the transition from workshops to supported employment.

Rather than touting the supposed good news about the closures of the workshops, Howe should have acknowledged ongoing concerns about the apparent difficulty of finding mainstream work for people with developmental disabilities.

House and Senate not following their own funding plan for employment of the developmentally disabled

For the past three years, the state has been carrying out a policy of closing sheltered workshops for people with developmental disabilities and subsequently placing those people in mainstream workforce jobs.

Yet the Legislature, which bought into this policy, is failing to provide the necessary funding for it.

As the Department of Developmental Services and its corporate service providers jointly proclaimed in 2013, the policy has been to move developmentally disabled people out of sheltered workshops and into community-based day programs and ultimately to the mainstream workforce.

Sheltered workshops are settings in which developmentally disabled people work together on simple assembly-line tasks and are usually paid a small wage.  The workshops have gone out of favor because they are viewed as “segregating” their participants from their non-disabled peers in the community.

Since 2013, the majority of the remaining sheltered workshops in Massachusetts have reportedly been closed.  All are scheduled to be closed as of June 30 of this year.

But the problem is that the Legislature, and to some extent the administration itself, aren’t following through on the policy, which calls for beefing up funding for DDS day programs and job development staffing.  Last week, the Senate joined the House in rejecting higher funding levels considered by the policy planners to be needed by both day programs and employment programs for Fiscal Year 2017.

The irony is that the Democratic-run House and Senate have proposed even less funding for these line items for Fiscal ’17 than Republican Governor Baker has.

A likely result of this apparent under-funding is that relatively few people will be placed in mainstream jobs, but rather will be sent to potentially overcrowded day programs with inadequate staffing.

Day and employment accounts were initially increased, but will now be under-funded or cut

In order to accomplish the policy for “integrated employment” of the developmentally disabled, the Legislature initially increased funding of the community-based day program line item in the state budget, and created a new line item to fund the transfers from the sheltered workshops.  The idea was to increase both day program and job development staffing and training.

The new sheltered workshop transfer budget line item (5920-2026) was initially funded in Fiscal ’15 with $1 million.  That amount was raised to $3 million in the current fiscal year, and the governor proposed to boost it to $7.6 million in Fiscal ’17.  But the House and now the Senate are not going with the governor’s plan.

As the House did last month, the Senate last week approved a budget plan for Fiscal ’17 that will eliminate Governor Baker’s proposed $4.6 funding increase for the sheltered workshop transfer line item.  Amendments proposed in both the House and Senate to restore the governor’s increase for the line item were rejected by the House and Senate leadership.  As a result, the account will be level-funded next year, which amounts to a cut when adjusted for inflation.

Yet, even the governor’s proposed $4.6 million increase in this line item was $1 million too low, according to the Massachusetts Association of Developmental Disabilities Providers (ADDP).  The ADDP lobbies on behalf of corporate DDS providers, which operate day and work programs throughout the state.

In addition, the Senate budget approved last week would provide $700,000 less in spending for the community day and work line item (5920-2025) than the amount the House and the governor proposed.  The governor and the House proposed a 4.9 percent increase in that account for Fiscal ’17.

In an email sent to members in early May, the ADDP contended that even the 4.9 percent increase in the day and work line item was $9.8 million less than the what was needed to maintain existing services.  As a result, according to the ADDP,  DDS was already planning to cut 5 percent in funding for contracts with all day and employment providers.

Should the Senate’s budget plan prevail regarding the day and work line item, it would seem the cut in contract funding for day and employment providers would have to be even deeper than 5 percent.

ADDP urged higher funding and staffing for day care and employment programs 

Both the ADDP and the Arc of Massachusetts have become virtual partners with DDS in the operation of the department. The Arc and the ADDP co-authored a report with DDS in 2013 that called for the closures of the sheltered workshops as of June 2015.  While that goal wasn’t met, DDS is continuing to work for those closures as of this June of this year.

In comments submitted to EOHHS Secretary Marylou Sudders late last year, the ADDP maintained that funding for both the community day and work line item and sheltered workshops transfer line items needed to be boosted significantly in order to fulfill the plans to close the workshops and transfer clients to mainstream jobs.  A failure to boost that funding could put the state in violation of requirements issued by the federal Centers for Medicare and Medicaid Services (CMS), according to the ADDP.

The ADDP comments also noted that as of October 2015, the number of individuals receiving community based day services more than doubled from 2,656 individuals as of June 2013, to 5,422. While noting that this increase was directly related to the closures of the sheltered workshops, the ADDP stated that the majority of those persons were not receiving any other DDS-funded employment services.

The ADDP comments also pointed out that DDS day programs require significantly higher levels of staffing than the sheltered workshops did.

As we pointed out in a blog post in January, DDS records show that the number of participants in sheltered workshops dropped by 61 percent between August 2014 and August 2015, and the number of persons in corporate-run community-based day programs increased by 27 percent. Yet, the number of developmentally disabled people in “integrated employment” settings rose during that same period by only about 6 percent.

It appears that the only policy the Legislature and the administration have pursued with a real level of commitment has been closing the sheltered workshops. But that’s only half the plan.  The problem with the Legislature, in particular, is that while it bought into the first half of the plan, it now has seemingly abandoned the critically important second half.

Thousands of people have or will be removed from their sheltered workshops, and the Legislature appears to be leaving an unknown number of them in the lurch.