Rhonda Frederick sees big changes ahead for individuals with developmental disabilities, and their families. (Sharon Cantillon/Buffalo News)
By Scott Scanlon – Refresh Editor
When you get to be as big as People Inc. during the last generation, sometimes you experience growing pains – particularly in a massive public health care system wrenching through changes.
Rhonda Frederick – chief operating officer of the Amherst-based agency, and subject of today’s In the Field feature in WNY Refresh – is proud of what her company has achieved during the 34 years she has worked at the nonprofit, despite some recent bumpiness:
• Three years ago, Orchard Park officials worked to keep a low-income senior apartment complex from being built, including asking for the ZIP codes of tenants who might one day live there. People Inc. instead built the project in Springville, which is happy to have the residents in its midst.
• In October, the agency will open a complex of senior apartments just south of the Southgate Plaza in West Seneca, after town officials and nearby property owners looked to stop the project. People Inc. had to take its case to state court to get the go-ahead for construction.
• Frederick also has been the point person for the agency in Newstead, where residents expressed deep concern earlier this year upon learning that a registered sex offender would be among those housed in a new group home for individuals with developmental disabilities.
“I’m glad we’ve had the opportunity to work with the town officials in Newstead,” Frederick told me this week. “I believe they handled the situation very well, in that they formed a group home committee and one of the council members, Marybeth Whiting, chairs that committee. There’s another council member and interested parties. We’ve been able to meet and discuss things.”
The registered sex offender remains in the group home, Frederick said, and it’s the first time People Inc. has taken someone into a group home with such a registration.
Is this scenario likely to play out in other group homes over time?
“Right now, for us, probably not,” Frederick said. “Our board and administration have decided to study the issue a little bit more, but there are other individuals with developmental disabilities who will need housing in the future. As you see developmental centers closing, people will be returning to their hometowns, so we may see others. I don’t know.
“New York State needs to be a little clearer on what they’re going to allow...,” she added. “Organizations like ours, it’s our business providing services to people with developmental disabilities. First and foremost, that was this gentleman’s issue. We do provide 24/7 care; we have all kinds of security measures and a very good staffing pattern and I do not feel the community is in any way, shape or form in harm’s way.
“My phone is always open. Last week, I met with a neighbor. This morning, I took a call from a neighbor about the grass. We’re very open, we want to do the right thing. As an organization, we feel we have the clinical expertise and resources to provide services to this particular gentleman.”
Here’s what Frederick had to say on the West Seneca senior apartments – one-bedroom flats open to anyone 62 and older with an income of less than about $23,000 a year:
“In West Seneca, there seemed to be a lot of issues. There were issues with the particular parcel. There were issues with who would live there. I think part of it was just NIMBY, not in my backyard, without a specific concern about what it was. I did not anticipate it in West Seneca. If I learned anything, it was perseverance.
“I think it’s a great project. Right now, we have 161 initial inquiries for tenancy there. There are 46 units, and we won’t be done until October, so the interest and the need is very high.”
What would she like people to know about the seniors who are going to be moving into those apartments, and the agency’s senior projects altogether?
“These are affordable housing units. These are your parents, your grandparents, predominantly women – about 90 percent women – who are living on Social Security and maybe a small pension. The average age is in their 70s.
“When people move in, they’re there for a long time. This isn’t transient housing; people don’t come and go. It’s delightful. I can think of no other word to describe it. We don’t have a lot of parties. We don’t have a lot of cars. We have no one going to school so we have no impact on the school system.”
Tenants can have pets, she said, but they must weigh under 25 pounds.
The controversies have garnered much of the media attention when it comes to the agency in recent years. Meanwhile, People Inc. continued to grow behind the scenes.
• The agency in January 2013 affiliated with the developmental disabilities part of DePaul Developmental Services, which continues to operate its much larger mental health services in Rochester and Buffalo. The developmental disability piece chipped off is now known as People Inc. Finger Lakes.
• They also forged an affiliation with Headway of Western New York, an organization that helps people with brain injuries and continues to work under its original name
• Almost a year ago, it affiliated with Agape Parents’ Fellowship, a small, faith-based developmental disabilities organization in Lackawanna which also kept its name.
* And last month, Rivershore, an organization based in Lewiston and also working with developmental disabilities, became affiliated.
“In the last couple of years, we’ve seen as a large organization with a great infrastructure and resources, we’ve been able to reach out to smaller organizations that were either struggling or their boards looked at the future and felt that they needed to be affiliated with a larger group,” Frederick said.
What do the affiliations mean?
“We share the same board of directors but the groups have maintained their own 501c3 status,” Frederick said. “Their boards have become advisory. As a small organization – like Agape for example – we do payroll and purchasing and hiring and training, all those things the executive director did but couldn’t continue to do.
“We live in a very incredibly regulatory environment, both from the Office of Persons with Developmental Disabilities as well as every other group that governs not-for-profit organizations. It’s getting harder and harder without people who are specialized in human resources, corporate compliance analysts. With something like Rivershore, nursing is an incredibly important part of what we all do. They have two nurses. If one of them is sick or goes on vacation, or decides to retire, you have a problem. Here, we have a large number of nurses, including supervisors. We have a certified home health agency, a licensed home health agency, the Elmwood Health Center, so we have all kinds of things to help.”
It’s a matter of regulation and resources?
“As the state calls for you to become more efficient, you don’t want to cut direct support services to people,” Frederick said. “You’ve got to cut at the top, so to join forces and work together is a good thing.”
Frederick said all of these changes are just the beginning of how the Affordable Care Act will reshape the care of people with developmental disabilities in the years to come.
How has the desire to decentralize settings for people with developmental disabilities changed People Inc. over the years?
“The philosophy has changed and we want to see more folks fully integrated into the community,” Frederick said. “It’s not quite as easy as teaching somebody how to cook and how to clean and saying, ‘Here’s your apartment.’ There’s more to it. A group home becomes your family. There’s always somebody there, somebody to talk to, and what we’re finding with some people is they have wonderful skills and get out into their own apartment and social isolation is a problem.
“We’ve started a roommate connection with other organizations in Western New York to let others know who’s looking into an apartment or looking for a building where others rent and that might be your support system. I think we’ve started to forget as a field about the social isolation.
People Inc. also has life coaching.
“It’s probably a little different than what most people think,” Frederick said. “It’s more like, ‘Now I’ve got to find the bus and I’ve got to find the pharmacy,’ all these things our folks might need a little more help on.
“We have someone who deals with your service plan and somebody who does your employment, somebody comes and helps you cook. This life coach is somebody who comes and helps you put a whole bunch of things together. Not forever, it’s a temporary thing."
Only a small percentage of individuals with developmental disabilities that People Inc. serves are ready for apartment house living. In fact, roughly 1,000 are on the waiting lists to get into group homes.
As they wait, those people can stay at the agency’s respite homes during a crisis, but otherwise – like the vast majority of those in the region who are developmentally disabled – they will continue to live with family members.
“There’s been no new (group home) development over the last couple of years,” Frederick said, “other than people moving into group homes from institutions, so it’s all crisis management. Right now, the system is totally crisis driven.
"There’s many changes. When we move into a managed care model, thing are going to be different.”
“People will be assessed,” she said. “There’s going to be a standardized assessment tool to assess people’s needs and you and your family will be told what you’ll be eligible for.
“For instance, in the past we might have had people who could start in a group home – gain some skills and some confidence – then move into an apartment. The way we believe the system is going to go is you would be assessed and you would be told the only services you would be eligible for are some supports that are available while you are living in your own home, and that you can’t start in a day program; you need to be competitively employed.
“People were more transitioned into services in the current model. It’s not to say there are people who can’t do this, but not the vast majority.
“We’re really turning around the ship here in a short period of time. It could get very uncomfortable. ... Starting now, and over the next 10 or 15 years, we’re going to see some pretty significant changes. We have to be more efficient and more creative.”