Home : Audience : Agency managers :

The Successes and Struggles of Closing a Facility-Based Employment Service

Research to Practice 20

By:

Originally published: 1/1999

Suggested audiences:

"The reasonable man adapts himself to the world, the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man."
-George Bernard Shaw

Introduction

Over the past 15 years there have been substantial changes in the delivery and funding of day and employment services for individuals with disabilities. Most notably, the introduction of supported employment has led to a dramatic increase in the number of individuals with severe disabilities in integrated community employment. Despite these promising changes, the implementation of supported employment has not resulted in a transfer of resources and services from facilities to integrated employment. Data from state MR/DD agencies suggest that while the number of individuals supported in integrated employment has increased, the number in facility-based programs has remained steady or risen over the 8 years between 1988 and 1996 (Institute for Community Inclusion, 1998).

At the same time, it is clear that some organizations have successfully shifted emphasis from facility-based services to community employment, including closing a facility-based program. There is a need for a better understanding of the organizational and systems factors that influence organizational change in order to develop the capacity for change in the broader service system. This brief will present the preliminary findings from a study of ten community rehabilitation providers, six that successfully closed a facility-based program in the period between 1989 and 1994, and four who are currently involved in a change process. The goal of this research is to support organizations and systems in advancing access to integrated employment for all individuals.

Method

Participating organizations were selected using a combination of a national nomination process and results from a survey of 643 community rehabilitation providers in 20 states (McGaughey, 1994).

Data collection consisted of participant observation, in-depth interviews, and document analysis. Primary data collection took place during a two-day site visit with each program. Site visitors interviewed representatives from each of the stakeholder groups to gain their perspectives on the conversion process. Stakeholder groups included at least staff, consumers, family members, board members, and funders.

Table 1.1: Participating Organizations

This table has four columns and six rows. The categories across are: Organizations that Closed a Facility-Based Program; Region; Location; Size.

Bonney Enterprises - Corvallis, OR - Northwest - Suburban - Small

Community Enterprises - Northampton, MA - Northeast - Urban/Suburban/Rural - Large

Life Skills Foundation - St. Louis, MO - Central - Urban - Large

UCPA of Capitol Area - Austin, TX - South - Urban - Large

Independence Association - Brunswick, ME - Northeast - Suburban/Rural - Small

MetroWest Mental Health - Ashland, MA - Northeast - Suburban - Large

Table 1.2: Participating Organizations, continued

This table has four columns and four rows. The categories across are: Organizations in the Process of Closing a Facility-Based Program; Region; Location; Size.

Emory Valley Center, Oak Ridge, TN - South - Rural - Medium

Valley of the Sun School and Rehabilitation Center, Phoenix AZ - Southwest - Urban - Large

The Ranch, Menomonee Falls, WI - Central - Urban/Suburban/Rural - Medium

Rural Employment Alternatives, Conroy IA - Central - Rural - Small

Findings

1. Organizations were successful in closing a facility using either a gradual approach driven by individual consumers' job preference or a rapid approach based on a specific closure date.

Individually-driven change occurred gradually, one consumer at a time, and was characterized by an emphasis on person-centered planning. This approach was more clearly driven by what would benefit each individual. As a result, the change process was less stressful, and these organizations experienced very little resistance to change from families or other stakeholder groups. Organizations using the individual approach, however, did not always clearly communicate values to staff, consumers, and other constituents, and the change process could have been easily derailed by other forces such as funding or staffing. The approach also took much longer, in some cases.

Organizations that chose an organizationally-driven approach established a firm date for closure of the facility, communicated that decision clearly, and completed the closure much more rapidly. They typically found community employment more rapidly for a significant percentage of the individuals they support. The goals and intent of the organization were very clear to all stakeholders, and in some cases stakeholders had ample opportunity to participate in planning for the change. Organizations also displayed considerable creativity and experimentation as they sought to implement the change. The tradeoff for this speed and clarity of intent was a change process that was described, at times, as both stressful and chaotic.

"Don't tell people you're doing a conversion. Just use personal futures planning. Talk about people's dreams and goals. That will convert it. [Just] listen to what their dreams and goals are...If you really look at their lives and see how isolated they are, how impoverished they are and how they're going to continue to be, unless they have employment."
- agency staff member

2. Catalysts for change were primarily internal to the organization, and in most cases multiple catalysts influenced the start of the change process.

The organizations identified multiple factors that led to the decision to discontinue facility-based services. While the organizations typically identified a change in values as a primary variable, all identified additional variables including the presence of a new leader (executive director or president), an organizational financial crisis or new financial opportunities, and pressure from consumers to relocate services. It is notable that funders and state policy were rarely reported to be significant factors in the decisions of these organizations to change. An interesting contrast was that for those organizations which had already completed the conversion process, the catalysts were largely internal. However, for agencies in the process of converting their services, there were internal as well as external catalysts such as new grant monies and concern about competition from other providers in the area.

"The purpose was about everyone having a choice to make a meaningful contribution, not about closing the facility...I think we changed in spite of the system, not because of the system."
- agency executive director

3. Leadership for the change process came from several different directions.

While all of the organizations had clear leaders, the notion of a single, charismatic, top level leader driving change was not supported. Leadership occurred in a variety of ways in these organizations. Top level leaders were effective both as strong, visible individual leaders, and also in less visible, facilitative roles. Middle managers also played a critical role in the change process for several organizations. In two organizations, while the need for change was defined by the executive director, middle managers championed the direction of the change process and led the move to close the facility.

4. Organizations which were successful in a change process had a strong culture that emphasized qualities like openness to risk taking, continuous evaluation and improvement of services, and clear and unwavering vision.

The original six organizations which successfully closed a facility-based program had a strong and well-defined culture that emphasized clear shared values, innovation, and a willingness to take risks. These supportive cultures were developed and maintained by a variety of concrete methods including aggressive strategies for sharing values with staff, outreach to both local resources and national experts, open communication and involvement of all staff in planning activities, and clear support for innovation.

5. Organizations that are currently engaged in an organizational change process need to be careful to maintain focus on a clear goal and not be distracted by the change process.

The currently converting organizations have placed relatively less emphasis on closing a facility, and are not as clear about employment as the primary goal of the change effort, as were the original six sites. There is a stronger emphasis on broader outcomes such as community integration. In some cases, these organizations have also invested heavily in team development, sometimes without a clear overriding goal or expectations for outcomes. Finally, these change processes have been more likely to be influenced by external factors such as the availability of funding than the first six organizations.

"Every level of staff, direct service up to administration, and support staff, knows the mission of the organization and is very clear about the values...It is very different from many agencies that go wherever the money is."
- funding source

Recommendations

For Organizations

For External Stakeholders

References

Butterworth, J., Gilmore, D.S., Kiernan, W.E. and Schalock, R. (1998). Day and employment services in Developmental Disabilities: State and national trends. Boston: Institute for Community Inclusion (UAP).

McGaughey, M.J., Kiernan, W.E., McNally, L.C., Gilmore, D.S., and Keith, G.R. (1994). Beyond the workshop: National perspectives on integrated employment. Boston: Institute for Community Inclusion (UAP).

Acknowledgments

This brief reflects the contributions of staff at the Institute for Community Inclusion, in particular Pat Connolly, David Hoff, and Marty Gold, as well as representatives from the agencies who participated in this study. For more information on this study, please contact John Butterworth at (617) 287-4300, john.butterworth@umb.edu, or Sheila Fesko at (617) 287-4365, sheila.fesko@umb.edu

For a publications brochure or general information, contact the Institute for Community Inclusion, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125. (617)287-4300 voice; (617)287-4350 TTY; ici@umb.edu

This document is supported, in part by a cooperative agreement, No. 90DN0032, from the Administration on Developmental Disabilities, Administration for Children and Families, U.S. Department of Health and Human Services. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration on Developmental Disabilities policy.

ICI: promoting inclusion for people with disabilities