Specifically, the DOJ found that the State of Rhode Island violated the Americans with Disabilities Act and the historic Olmstead decision, which require that individuals with disabilities must be served in the most integrated setting appropriate to their needs. Only 12% of the individuals who are served in Rhode Island participate in integrated employment, with the vast majority receiving services in facility-based programs. Additionally, the investigation determined that only 5% of secondary school students with an intellectual or developmental disability transitioned into integrated employment, although many more were able and willing to do so.
The settlement calls for a shift in funding from facility-based employment services to community-based employment and day services. Over a 10 year period, Rhode Island has agreed to place 2,000 individuals in competitive, integrated employment, 1650 of which currently receive facility-based services. Work hours are expected to average 20 per week, with community-based day services rounding out the week to a full 40 hours. Individuals will be allowed to remain in facility-based employment if they choose, but only after receiving a vocational assessment, trial work, information, and benefits' counseling. The decree also requires Rhode Island's Department of Education to adopt a work first policy, emphasizing competitive employment for transitioning students with disabilities.
Rhode Island is the latest in a string of three states that the DOJ has found to be overly reliant on facility-based day and employment services. The DOJ findings focus on the states' failure to implement policies, funding, and practices that permit individuals to meaningfully access integrated, community-based day and employment services. It is important to note that Rhode Island actively participated in negotiating the settlement agreement, so that it fit their unique circumstances.
Whether the settlement represents a bellwether on the future of facility-based services remains to be seen. There is no question that states, including Indiana, will continue to consider these developments in their efforts to respond to aligning day and employment services with the Center for Medicare and Medicaid Services' recent definition of home and community based services. Providers and consumers remain split on whether these activities represent good public policy. What is certain is that INARF will focus its efforts on keeping members informed, providing assistance in responding to these efforts, and as always, advocating for options, access, and choice.