Some people are simply born to do what they do. The lucky ones know early on. Whether it’s a matter of talent, circumstance or destiny, they see their path clearly and walk tall toward their future.
Others struggle, a sense of direction or purpose conspicuously missing. Or something more. Challenges of infinite shapes and sizes can swallow the fortunes of the best of us and spit out lives of inimitable difficulty.
What is so often misunderstood is how much that second set needs the first; and how rare it is for these groups to come together in meaningful and constructive ways. Diane E. Gould seems to have had a pretty good idea about that for a while now. The Worcester native is president and CEO of Framingham-based Advocates, a large nonprofit social service agency.
Under Gould’s guidance the last two years — she’s been with Advocates for 30 years, and was chief operating officer several years before her appointment as CEO in 2013 — the agency has sharpened its focus on the future of care for people dealing with autism spectrum disorders; broadened the scope of its community justice work; and expanded its brain injury rehabilitation program, including a new Worcester location.
Describe Advocates’ connections to Worcester and how you came to locate your new residential brain injury support program on the west side of the city.
When I think of our programs in Worcester, I think of the greater Worcester area. So, we have had residential supports for people with developmental disabilities in West Boylston for a number of years. We have, of course, the Worcester Initiative for Supported Reentry [an anti-recidivism program]; we do the mental health service at the Worcester County House of Correction as well. So, the brain injury program is the newest program in Worcester, but certainly not the first.
We serve a number of people with brain injuries in MetroWest and Greater Boston, in the northeast part of the state. We started serving people with brain injuries maybe six or seven years ago, in partnership with a number of families who had family members who were survivors of brain injury. And our work, really, these days is helping people leave nursing homes.
There are a number of people who have been supported in nursing homes but [who] have not had a great life there and have not really needed that level of support, so our work is helping them transition into the community and become full members of the community.
We purchased our home some months ago, went through our community acceptance process, which we do with notifications of city officials and neighbors, had a community meeting with the neighbors, and then did a fair amount of renovation on the property. … People moved in maybe about 6 or 8 weeks ago, and they’re doing great. We’re very, very excited to be here.
What goes into locating and building a program like this?
We do this in a couple of different ways. Sometimes we will build a new home, buy a piece of property and build a home with specifications that are, you know, to meet the needs of the individuals who’ll be living there. And sometimes we’ll purchase a property and then make whatever renovations are necessary. And so it really depends on the needs of the people who are going to be moving into the community.
So, Advocates is positioned to be more of a “responsive” social service agency?
I think that’s exactly right. We really consider ourselves very person-centered and family-focused, and so our work is really trying to meet the needs of the people.
The organization was founded back in 1975 and based in Framingham, and our main office is still there in Framingham, so a lot of our programs are in the MetroWest area. I think in part, coming into the Worcester area, had something to do with personal ties to Worcester, because I was born and raised in Worcester myself … and so there was some natural affinity based on that.
[After college] I came back for about a year to Worcester and lived in Main South. I was a live-in counselor in a group home, right around the corner from Clark University. It was a wonderful place to live.
Worcester’s also a wonderful community. It’s very diverse, and it has a lot of resources and supports for people. And there are many people who have ties to the Worcester area, who need the kind of supports that we provide. So our focus in providing residential supports in particular is to help people either stay in or return to the communities where they were born or raised, or the communities where they feel most closely tied. And for a lot of people that was Worcester, so it was a natural step for us.
Tell me more about your connections to, and growing up in, Worcester.
So, my family also grew up in Worcester. My mother was born and raised in Worcester, my dad came to Worcester when he was about 3 years old from Nova Scotia, and I have a lot of extended family who grew up in Worcester as well. So I grew up in the Burncoat Street area, in the Clark Street area through grammar school and then the other side of Burncoat Street, which was the Greendale area, until I went to college. So I worked in what was Doctors Hospital at the time; it’s now AdCare hospital. I was a receptionist and admissions clerk there, through junior high and high school.
Then I went to UMass in Amherst for four years, got a degree in English. I came back for about a year to Worcester and lived in Main South. I was a live-in counselor in a group home, right around the corner from Clark University. It was a wonderful place to live. That was a group home for people with developmental disabilities and mental health conditions.
There are myriad social service agencies in and around Worcester, many that try to work together. Do you find that network to be as effective as it could be?
That’s a great question. You know, I think largely I would say that the inter-agency collaboration in Worcester is strong. We have good and collaborative and respectful relationships across social service agencies and health care and other human service agencies, so we have relationships with SMOC [South Middlesex Opportunity Council], with the Edward M. Kennedy Health Center, with Community Healthlink — with a variety of organizations that meet basic needs as well as provide treatment.
I think the communication is good. It requires attention and commitment, but I think that, you know, our organizations pretty much across the board — we have our eyes on what’s going to be best for the individual or the family that’s coming to us. We can always do better, but that’s what we aim for.
One of the challenges, I think, from a consumer perspective is that it can be — you know, the way the service system is set up, our efforts at collaboration notwithstanding, there are times when people have to go to different doors to get a variety of needs met.
But it has to be difficult for the patient/client/family to wade through this sea of services and providers to find what they really need, no?
Part of our growth and development has been to develop this array of services, so that it’s possible to come to Advocates and get a range of supports and resources. We also have — we started as a very small organization; we started as a coffee shop on the grounds of Westboro State Hospital, and then one group home in the Framingham community. This was back in the 70s — so, we have a lot of respect and regard for what you might call niche providers, small providers that are focusing on the needs of a particular population. We really respect that there is a role for them as well as for the large organizations.
One of the challenges, I think, from a consumer perspective is that it can be — you know, the way the service system is set up, our efforts at collaboration notwithstanding, there are times when people have to go to different doors to get a variety of needs met. And the goal of interagency collaboration is to break down those barriers so that it’s a much smoother path for an individual who needs help. That they can go to one place, and whether they’re getting everything they need from one organization, or they’re walking through one door and that organization is so connected with other agencies so that they don’t have to knock on a bunch of different doors.
What prompted you to choose social work for a career and why have you stayed with Advocates for so long?
So, I think in terms of the choice, service was a value in my family. My mother was a nurse and my brother was a program director for the Department of Youth Services and later he worked for the Department of Corrections … and I have other people in my family, there was some mental illness, also developmental disability in my family, and when I went to college I had my own experience with seeking mental health services, which was very, very helpful to me at a time of transition in my life. And so all of that, my work at what was Doctors Hospital — there was a very good social worker there who was also a mentor for me — and all of those things I think, the value of service in my family, the work in the hospital, the mentoring that I had, my own personal experience, all of that kind of pointed me in the direction of social work.
What kept me at Advocates, really, has been the vision and values of the organization. The mission of helping people regardless of their challenges to have a good life in the community, and values that have to do with promoting communities and creating communities in which everybody can participate, everybody has a valued role, everybody can make a contribution. That’s a great vision, and I think we’ve done a good job promoting that agenda, and that has kept me there.
The power of collaboration in building a system that will really meet people’s needs and help people achieve their goals, and that will promote inclusive and welcoming communities, I think, can’t be [overstated].
You were appointed CEO in late 2013 after Bill Taylor died from a relapse of esophageal cancer. He, like you, had been with Advocates since the early days. What do you think he would say about where you are now?
You know, I hope that he would be proud. We’ve worked to honor his legacy and to move the organization forward. So, he left a great organization, strong and stable, principled, and providing very, very good services.
The world around us at the time, and for a couple of years before he died and since he died, is changing a lot. Health care reform, [which] has changed the face of the service system, holds enormous promise for better health, lower costs. There’s criminal justice system reform kind of in the works. There’s a great wave of individuals being diagnosed with autism spectrum disorders. … We are working hard to make sure that Advocates can play a role in this changing service system, because we feel we have a lot to offer. So I think, in short, he left us in great shape. We’ve worked to remember him and honor his legacy, and preserve the values he embedded in the organization. And we’re working hard to move forward, so I think that he’d be proud.
What’s an example of a lesson you’ve learned in your two years as CEO, and how have you applied it to your position?
This is something I feel maybe I knew already coming into the role because of this great mentoring that I had, but the value of collaboration and partnership in the service of people who need help. And when I talk about partnership and collaboration, I’m talking about collaboration with them, [the] individuals coming to us for help with their families; partnership with communities so that we can help communities make room for people who are different from them; partnership with funding agencies; and partnerships with other organizations.
So, the power of collaboration in building a system that will really meet people’s needs and help people achieve their goals, and that will promote inclusive and welcoming communities, I think, can’t be [overstated]. I feel like I knew something about that coming into this role, but there are different opportunities to apply it because this role is it has greater authority, it’s got greater reach, and so my relationships with colleagues are very, very important and really help to achieve those goals.
You’ve mentioned progress in the treatment of autism spectrum disorders as a priority. Where are you now, and what is your outlook in the foreseeable future?
We’ve opened several homes for individuals with autism spectrum disorders, and we also have developed specialized day supports for individuals on the spectrum in a program in Ashland. So, there are many, many people being diagnosed with autism spectrum disorders these days [Editor’s note: 1 in 68 children per a 2014 CDC report]. We also have a family support center with the Autism Alliance of MetroWest that is growing, and so I foresee additional growth in that area.
There are some unique partnerships that we have with families in that area, families who want to be more involved in the care of their family members than perhaps some family members have in the past. Unique relationships in which a family will purchase a home and then we’ll provide the services within that home, as opposed to our purchasing the home. So, we’re really looking at what do these individuals and families need and want, and how can we arrange our services to help them achieve those goals.
I think the stories of the men who are being released, the stories of recovery, the histories of trauma, of poverty, addiction, violence, and the stories of hope and reconciliation and recovery are profoundly moving and inspiring. And all of that really keeps us going.
What are the nuts and bolts of the WISR program [which assists former prisoners upon release in finding proper housing, employment opportunities and training, with the goal of keeping them out of jail for good]?
For the people we’re serving in the WISR project … There are three components to our reentry services. One is WISR, which has been up and running for several years now and is funded by the Health Foundation of Central Massachusetts in partnership with Probation, District and Superior courts, the Sheriff’s Office, and it has great outcomes — very, very promising outcomes. We’re also working in partnership with the Worcester County Sheriff’s Office on something called WISR Men, which is really focused on men who are in the Worcester County House of Correction who are [being released] into Worcester County, and we just made an arrangement with the Health Foundation to begin a planning project for women.
See, reentry services involve helping people find safe and affordable and decent housing, helping them find employment, for those who are parents helping support their reunification with their family, and health care, behavioral health services — really whatever they need. So, the focus there has really been helping people find housing. Like anyone else.
What surprises or challenges have you faced in implementing WISR?
I want to say first that this is a wonderful program. Our work over many years helping people leave institutional settings and move into the community — this was kind of a natural evolution for us, because prisons and jails are institutions as well. So this capacity we have, and the scale and commitment we have to help people transition, is at play in the WISR program as well.
I’ve been really pleased — I don’t know if I would say surprised exactly — but I’ve been really pleased with the outcomes of this program. The recidivism rates for WISR men that are one year post-release are about 8 percent compared to 20 percent of people who have not participated in WISR, and the two-year recidivism rates are around 12 percent [compared with] 33 percent. So, it’s significantly positive outcomes.
I think the savings associated with it is stunning. It costs about $53,000 a year to incarcerate a person, and it costs WISR about $5,800 a year to support people in the community — [Did you say $53,000 vs. $5,800?] — yeah, it’s a stunning difference. And so those outcomes had been — I mean, we had hoped for them, so it’s not exactly surprising, but still they’re stunning outcomes and I’m very, very happy about them. I think the stories of the men who are being released, the stories of recovery, the histories of trauma, of poverty, addiction, violence, and the stories of hope and reconciliation and recovery are profoundly moving and inspiring. And all of that really keeps us going.
And I think the work in the community has gone very, very well. We’ve not experienced significant challenges in the communities in which these men are reentering. They’re reentering into natural settings, into an apartment or a family home. We’re helping them find jobs. Employers have been largely welcoming and open, and the partnerships across all these [programs] have been just great.
Why are community justice programs so critical; and outside the stark difference in cost you posed, how do you convince the skeptic it’s a worthwhile endeavor, money and time well spent?
The cost of incarceration is enormous, and without adequate reentry supports there’s this revolving door, you know, so people are incarcerated, it costs a lot of money, they’re released. If they don’t have the support that they need to stay out, they go right back in. So there’s this high social cost and personal cost and family costs as well. The real value of the reentry services is helping people come out and stay out.
And when we’re able to do that the communities are safer, they’re healthier, they’re more inclusive, and stronger. And there’s cost savings, so the social and personal and family costs are not just costs today. I mean, you can’t really measure some of those in dollars. It’s easy to measure the difference between what it costs us to support a guy in the community and what it costs us to incarcerate someone, but these other costs are a little harder to measure.
You know, having a parent who is in prison or jail, there’s a huge cost to a child … it contributes to real difficulty. It’s traumatic for kids. And so we’re trying to change the face of that, too. So, there are multigenerational kinds of impacts when a person is incarcerated. … What it means for a kid to grow up without a father who’s in jail, [and] really the stigma associated with that.
Our next phase for WISR, for our reentry services, is a planning project for women, because many women who are incarcerated are parents. They’re wanting to come out and reunite with their kids, and they have really, really challenging histories of trauma and domestic violence and addiction.
But there’s tremendous promise here from the perspectives of economic costs, and as I said, good health.