New Jersey has picked a nationally recognized leader to monitor the state’s largest provider of group homes and services for disabled individuals, Bellwether Behavioral Health, a facility that became the subject of news reports regarding abuse and neglect of its residents.
The Department of Human Services told NJ Spotlight that Cathy Ficker Terrill had been hired — at Bellwether’s expense — to review the private, for-profit company’s system of care, services, and supports — including staffing and accountability practices. She will stay on the job as long as needed, the DHS said.
Ficker Terrill has served on a presidential advisory committee and oversaw a federal court settlement with Oregon to ensure proper implementation of community services for individuals with disabilities.
In July, the DHS took the unusual step of suspending admissions at Bellwether facilities here — dozens of group homes and day programs that serve nearly 500 people with developmental and intellectual disabilities, including some of the most clinically complex individuals in the state.
The department has also stepped up regular inspections of these sites and assigned a quality-management team of its own to oversee the work done by Bellwether, a Delaware-based company previously known as Advoserv. The state also ordered the organization to immediately address any gaps in care, including staffing shortages and safety lapses.
“It is vital that we meet the needs of individuals with intellectual and developmental disabilities living in the community and ensure their health, safety, and well-being,” DHS Commissioner Carole Johnson said. “Cathy brings a wealth of experience to this work, and she is actively focused on quality, oversight, and operations. The department will accept nothing less than measurable, long-term improvements.”
In addition, the DHS will “assess what needs to be done to ensure a broader range of providers and choices for individuals with developmental disabilities and their families,” a spokesman said.
Some family members and advocates for individuals with more serious needs, or co-occurring mental and medical needs, have pushed the state to maintain its system of public residential facilities, several of which have been closed in recent years in an effort to encourage people to live in the least restrictive environment possible.
A history of injuries
In early August, WNYC News reported on the injuries suffered by Abdulaye Saccoh, a young man from Trenton who was hospitalized after injuries he suffered at Bellwether’s Branchburg home. Local ambulance squads had visited the facility 156 times in two years, the public media outlet found, and injuries were common at the company’s other homes. Two New Jersey residents died last year in Bellwether’s care, WNYC reported.
Days later, NJ.com wrote about state incident data that showed Bellwether had received 71 complaints of abuse and neglect between March 2017 and March 2018 — far more than most residential providers — nearly half of which were substantiated by the state. (Bancroft Neurohealth had the second highest number of complaints, with 20 incidents reported and 10 substantiated.)
A representative of Bellwether did not reply to requests for comment Monday.
Investigating reports of abuse
Within the DHS, the Division of Developmental Disabilities contracts with some 450 community-based organizations — a mix of nonprofit and for-profit entities of various sizes — to provide housing in group homes, supervised apartments, and other sites, as well as education, job training, and other activities. The division, which serves more than 26,000 Garden State residents, also investigates reports of abuse and neglect made against these facilities.
Advocates for individuals with disabilities welcomed the additional oversight provided by the DHS’s decision to bring on Ficker Terrill and encouraged her to dig deep to get at the root of any problems. News accounts of problems have in the past resulted in new reporting and inspection systems — like Stephen Komninos’ Law, signed last year in honor of a disabled man who choked to death at a residential facility in 2007, which calls for unannounced state inspections.
But these responses don’t always result in systemic change, noted Joe Young, executive director of Disability Rights New Jersey. “We need to look for the causal effect,” he said.
Young said the state now has multiple systems of oversight, including the DDD’s own investigative team and the additional inspections required by Komninos’ Law. Providers are required to report any “unusual incident,” variances that can range from missed medication to a violent assault, but he said it is not necessarily clear when the state must step in and take more dramatic action — like suspending admission.
“I’m not sure they have a red-flag system that makes sense,” Young said.
Tom Hester, a spokesman for the DHS, said the department measures risk in several ways that can help it determine when to take further action. “When corrective actions or other interventions are required, the department expects immediate improvement,” he said. “The department will not hesitate to take action to protect the individuals it serves.”
A friend to people with disabilities
When it comes to the next steps at Bellwether, Ficker Terrill’s input will be valuable, the DHS said. She was CEO of the Council on Quality and Leadership, a national consultant to public and private entities providing services for individuals with disabilities, and led the Illinois-based Institute on Public Policy for People with Disabilities, which provided similar guidance to organizations there.
In addition, she was a two-term appointee to the President’s Committee for People with Intellectual Disabilities, which was formed in 1968 to advise the White House and federal Department of Health and Human Services on policies designed to improve life for residents with those challenges.
In 2016, Ficker Terrill was appointed by a federal court to monitor the state of Oregon’s work to comply with a Department of Justice ruling related to their programs for individuals with intellectual and developmental disabilities.