The state has terminated its contract with a Biddeford-based service provider that failed to improve its services to adults with developmental disabilities and brain injuries following the death of a client this summer.

Health and Human Services Commissioner Jeanne Lambrew announced Monday that the state is severing ties with Residential and Community Support Services for failing to protect the health and safety of adults in its care.

“The health and safety of Maine people is our chief concern,” Lambrew said in a statement. “This company’s unacceptable failure to ensure the well-being of its residents has led us to take immediate steps to safeguard residents’ health and welfare and transition them to alternative homes. We will do all we can to help ease the disruption and distress caused to residents and their families as we hold the company accountable.”

Maine Health and Human Services Commissioner Jeanne Lambrew said the state is cutting ties with Biddeford-based Residential and Community Support Services. Joe Phelan/Kennebec Journal

Advocates for developmentally disabled adults praised the state’s rare and decisive action.

Residential and Community Support Services, or RCSS, has been a MaineCare provider since 2013. As of Friday, the agency served 70 clients, operating 38 one- and two-bedroom residences for adults with developmental disabilities in southern Maine and provided independent living assistance to others in their own homes.

According to DHHS, staff at one of RCSS’s properties failed to provide a resident with critical medication and failed to summon emergency services. The resident died in late August. DHHS did not release a name or any other details, citing privacy laws.

Following the death, the department suspended all new admissions to RCSS on Aug. 30, began a program audit and asked RCSS to submit a plan of corrections. While that was happening, referrals of concerns about other residents of RCSS properties came into adult protective services and were investigated.

DHHS, in its statement, said that although RCSS made some improvements, it still failed to administer medication, to demonstrate an effective quality management and monitoring system, and to implement effective safeguards

Because RCSS did not make sufficient progress, DHHS took the extraordinary step of terminating the MaineCare contract. MaineCare is the state’s version of Medicaid and provides a host of services to more than 5,700 adults with intellectual and developmental disabilities, autism spectrum disorder and severe brain injuries.

As of Monday, the state said it already had transitioned four residents to alternative housing, a fifth move was in progress, and work was underway to safely relocate the remaining 65 individuals, hopefully within 30 days.

In the meantime, the department will continue to pay for services provided by RCSS while residents are moved to new homes and will assist with finding those placements. RCSS will continue to staff its homes and DHHS will continue to monitor those homes with regular site visits.

The death of the individual in August is now under investigation by local law enforcement, but DHHS spokeswoman Jackie Farwell said she could not identify the agency involved or the community where the death occurred.

RCSS’s chief executive officer, Christine Tiernan, said in an email that her agency received notice of the contract terminations on Monday.

“We have always provided high-quality care to our residents and will continue to do so,” she said. “We will be responding to the notice promptly and in an appropriate fashion. Due to the ongoing investigation we cannot provide interviews at this time with the media. We are cooperating with the investigation and are focused on giving the best support & care to our residents.”

In a statement, the Maine Association for Community Service Providers, a member organization, said it was “deeply distressed and saddened by the reported death of an individual receiving residential services in the community.”

RCSS was not a member of the association, but its members are working with DHHS to help families find new homes.

“We support the department in terminating its contract with any provider who fails to appropriately care for and support its residents,” the statement read. “Sadly, concern for the health and safety of Maine people with intellectual and developmental disabilities is not a new issue.”

Two years ago, under the administration of Gov. Paul LePage and former DHHS Commissioner Mary Mayhew, the U.S. Office of Inspector General issued a scathing audit report that found the state failed to protect adults with developmental disabilities, including some who died under unexplained circumstances.

Over 30 months from January 2013 to June 2015, DHHS failed to properly investigate 133 deaths and also didn’t report 34 percent of the critical incidents involving developmentally challenged MaineCare patients.

By law, community-based providers are supposed to immediately enter a written report of any critical incidents such as abuse, serious injuries, medication errors, suicidal acts and death into a database maintained by the Maine Department of Health and Human Services.

At the time, DHHS officials said the report was accurate but didn’t reflect current practices. Since then, the department has implemented reforms and, now, is under new leadership.

Lambrew, in her statement, said the department is working on additional changes, including a requirement that one- and two-bed homes, like the one where the recent death occurred, be licensed through the state.

Kim Moody, executive director of Disability Rights Maine, the state’s protection and advocacy agency for people with disabilities, including developmental disabilities and mental illness, hailed the decision.

“We’re pleased that the state is taking its oversight responsibility so seriously,” she said. “We’ve not seen any action like this for at least the last eight years.”

Moody said she could only recall one other instance in the last 30 years when the state terminated a MaineCare contract to a service provider.

In recent years, the state’s network of community service providers has faced significant workforce challenges and, in some cases, extraordinary turnover of workers.

Moody said she doesn’t know if those problems plagued RCSS, but she said that phenomenon is a national issue.

The Maine Association of Community Service Providers said there is more the state can do, including creating a Mortality Review Panel, increasing reimbursement rates for services and strengthening adult protective and crisis services.

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