Pineland Closing Gift Key, courtesy of New Gloucester Historical Society
Despite all the systems in place to ensure compliance, problems arose. There were criticisms of the Consumer Advisory Board as ineffective, and media and other criticisms of the Behavior Stabilization Unit, which served as crisis intervention for Pineland residents and those who had moved into the community.
New criticisms of inadequate funding, staff shortages, not enough community options, lack of proper oversight of persons moved into the community, and other non-compliance led to another lawsuit, in 1991. It resulted in a new settlement – the Community Consent Decree in 1994.
In the meantime, the state had decided to close Pineland. Protecting rights and living up to the provisions of the consent decrees – the least restrictive, smallest most home-like settings where persons with developmental disabilities could assume maximum control over their lives and where services were in place to support those goals.
From the beginning of the institutional period, the cost of providing care for people with developmental disabilities was both the reason for building larger and larger congregate settings and an excuse for any evidence of neglect or poor treatment that came to light.
Throughout the history of Pineland you can see the frequent requests for more funding. When Pineland was closed a new pool of money was flooded into the community. This followed a series of cuts and the same types of pleas for additional funds that can be seen through the institutional period.
To this day, disagreements over the amount of funding put towards services plague this system. Reimbursement rates and workers’ paychecks, infrastructure and innovative care – the question of “how do we pay for this?” hangs over all the decisions made.
Workforce Crisis
The bulk of the labor that supports people with developmental disabilities has historically been done by “low wage” earners – high school graduates or those with associate degrees working for minimum wage or very close to it. In addition to “low wages”, society at large can view the job as low skilled and akin to “babysitting.” In addition to a lack of workers to fill the shifts and perform the vital tasks, those that are employed in this field often feel undervalued and overworked. Expectations are low – and services suffer as a result. People with developmental disabilities often don’t get the supports they need from the staff hired to serve them – and the behaviors and reactions that may occur with this lack of support can then lead to abuse and neglect, including an overdependence on traumatic interventions like restraint.
Good direct care providers are also promoted to “supervisor” roles without the training and skills needed to support direct care workers (as the skillset of the two jobs are not the same.) Of course, this assumption of the skills is simply untrue. The lack of value placed on those doing this essential work has led to labor shortages again and again.