The Arc of the Triangle, an agency paid to provide care to people with disabilities, told clients and their families in a Friday email in late March that it was suspending face-to-face services the next day.

A former agency employee, Karen Carlton, said she was fired after she protested and told other agency employees that clients could sign on with other agencies.

“To pull supports like that, it just doesn’t make any sense,” Carlton said in an interview with The News & Observer.

On the afternoon of Friday, March 20, agency executive director Jennifer Pfaltzgraff sent an email to clients and their families telling them that in-home services would be put on hold starting that weekend.

“Due to the serious development surrounding the outbreak just this week, The Arc of the Triangle has found it necessary to put face-to-face services on hold beginning Sunday, March 22, 2020, until further notice,” the email read.

The email listed services provided under a Medicaid program designed to help people with disabilities live outside institutions, and said the decision applied to private-pay patients as well.

The same day clients and families received the email, some of the agency’s employees received notice that they were being laid off. The employee mail said the agency decided “to temporarily stop offering most services.” The layoffs were effective the day the email went out or the next day, Saturday.

In an interview Tuesday, Pfaltzgraff said the email to participants and families reflected only part of what happened.

The email did not go to all families, she said. Before it was sent, staff members called families to find out if they would continue to need Arc staff or if they could get by without them, she said, and services continued for people who needed them.

“We made a quick decision six weeks ago with no guidance,” she said. “The decision that we made may not have been perfect, but we were doing the best with the tools and the information that we had.”

In the last six weeks, the agency resumed services for some participants, she added.

Cristina Flake of Chapel Hill said she did get a call from the agency a few days before getting the email, but she was not told during that call that the agency was going to suspend services for her son Derek.

Derek Flake, 37, has autism and generalized anxiety disorder, Cristina Flake said. Her son is very positive and friendly, but becomes like “the incredible Hulk” when he has outbursts.

The day after Flake got the call, one of her son’s Arc workers told her that employees were losing their jobs. She received the agency’s email the following day saying services were on hold.

“I never expected that of an agency with the mission they have,” she said. “No ‘How can we work with you?’ No conversation. Nothing. It was just cold turkey.”

Flake is a former president of The Arc of Orange County board of directors. Separate county agencies merged about six years ago to become The Arc of the Triangle, The News & Observer reported. She was surprised her son was cut off so suddenly, because people at the agency know their situation.

“My husband passed away in 2018,” said Flake, 73. “I take care of him (Derek) basically by myself. If not for my daughter and son-in-law I would be in a bind.” She said she knows other families that are under even more pressure.

After several weeks without professional in-home services, she signed on with a different agency and her son has two new direct care staff who are working well.

“It’s one of those things where something good came from something very bad,” she said.

The coronavirus pandemic exacerbated the labor shortage service agencies face. In-home workers provide the kind of care where social distancing is difficult, if not impossible.

Pfaltzgraff said in an mid-April interview that she could not provide staff with hand sanitizer and protective equipment that the state Department of Health and Human Services suggested they use. Workers were running some programs by video and providing some services by telephone, she said.

Agencies that offer government-paid services to people with disabilities in North Carolina have contracts with organizations called Local Management Entities-Health Maintenance Organizations. Alliance Health is the LME-HMO for Wake, Durham, Johnston and Cumberland counties.

Sean Schreiber, Alliance executive vice president, said other agencies began pulling back on in-home services at the same time as The Arc of the Triangle. Alliance asked agencies about their plans because it wanted to help find alternatives for clients.

“We wanted to make sure they were arranging for care for their members,” he said. “Most agencies have continued with a mix of face-to-face services and work with clients by telephone.”

The contracts companies sign with LME-HMOs say agencies must give 60 days’ notice before closing or dropping a client who needs ongoing care. Schreiber said the contract provision does not apply to companies that suspended services in the pandemic, because the situation is temporary.

“This is a different kind of suspension for us,” he said. “It’s not an official violation of the contract.”

Pfaltzgraff did not say how many families were told their services would end temporarily, how many people had arranged to continue getting face-to-face services from the agency, or how many had their services started up again after being temporarily cut off.

“I don’t know the numbers,” she said. “We serve people with lots of different services.”

Carlton said she has worked with a client for 24 years and continues to, though she is doing it on her own time. Carlton works with the person part-time and said she has another full-time job.

Carlton provided to The N&O emails The Arc of the Triangle sent to families and employees, including an email dated March 13 asking workers if they would be able to pick up extra shifts.

She also provided her termination form, which said Carlton was fired because she sent an email through the electronic medical records system that made “false statements about The Arc of the Triangle,” and “committed slander” by posting false information on Facebook.

Carlton said her internal email, which she could not access, told other workers that they and their families could move to new agencies.

Her Facebook post, a comment on a post by The Arc of North Carolina about federal coronavirus bills, said, “Are you aware that while you were working on this, The Arc of the Triangle, Inc. was shutting down services and laying off direct support staff? Shameful!!!”

Carlton said she never slandered anyone.

Pfaltzgraff would not talk about Carlton’s firing, or the mention of slander in Carlton’s termination form.

“I think that’s a loaded question,” she said.

This story was originally published May 4, 2020 at 5:45 AM with the headline "An agency suspended services for disabled clients and fired an employee who protested."