- He's a national innovator in shaping community-based support for adults living with intellectual and developmental disabilities.

At St.

John's Community Services, his leadership helped move care from institutions into neighborhoods where people belong, including right here in Tennessee.

I'm Sally Stover, and this is A Conversation with George Liacopoulos.

[bright gentle music] We're so happy to welcome into our studios today, George Liacopoulos.

George, thank you for being with us.

You're here because we wanna talk about the extraordinary work you have done over the years with St.

John's Community Services.

Now, first, if you'll tell me a little bit about what it is that St.

John's does.

- Well, first, thank you for having me here.

I appreciate the opportunity to discuss something that's really near and dear to my heart and who I am as a person.

St.

John's Community Services is a nonprofit organization.

We provide services for people with disabilities, primarily people with intellectual and developmental disabilities, but other disabilities as well, and also people experiencing homelessness, food insecurity, and people that are looking to escape bad domestic situations, you know, trying to get away from domestic violence and such.

And we provide those services from New York state down to Tennessee, hitting Virginia, the District of Columbia, and Delaware in between as well.

- Now, I have a feeling the organization was not that large or widespread when you began working with them.

You didn't start your, I'm gonna use the word ministry, but let's say work in helping people in this way with St.

John's, right?

You were doing something else and then you found St.

John's?

- Correct.

Can you indulge me for a little bit- - Sure.

- On the history of the organization 'cause especially when you said the word ministry.

The brochure tour of a 158-year-old organization, it was founded by St.

John's Episcopal Church in Washington, D.C.

back in about 1868.

It was founded as a hospital.

It converted to an orphanage in the 1870s.

It remained as such until the 1950s when with the advent of foster care, there was really no longer a need for an orphanage, so the church commissioned a group of individuals, committees from the Ladies Guild and others to see if there was a need in the District of Columbia that the organization could fulfill.

And they identified a need for school, for children, young people with special needs, special education services.

And at that point in 1957, the organization became independent from the church and remained as such until the 1980s.

It began to expand into other services beyond education, which I'm sure we'll touch on.

I got my start in the field back when I was a high schooler, a junior in high school in Massachusetts.

I had known for the longest time that I wanted to do something to help people, to help lift people up.

I wasn't sure what form that would take.

Gratefully, I had a teacher in high school who picked up on that interest of mine and she helped me get a job at an institution in the suburbs of Boston in Waltham, Massachusetts.

So I was really excited.

I remember the first day of walking onto this campus and the building where I was to work and all these people that came, you know, rushing towards me with joy and lack of personal space, and it was like, "Whoa, what am I getting into?"

You know, I was kind of a naive high schooler.

But, you know, by the end of that first day, I was just so connected with the people that were living there.

And I had such joy in playing cards with them, helping them to shave, helping them with mealtime prep and such.

I knew this is where I needed to be.

But over time, and I was there for about a year, year and a half, I began to understand how bad the conditions were in that institution.

This is again back in the '70s.

And at that time, primarily for people with disabilities that needed long-term care, institutional life was the way it was until federal legislation started to change that in the '70s through the '90s.

The conditions were really decrepit.

I don't know if you ever saw that exposé that Geraldo Rivera did, I think it was back in the '70s of Willowbrook Institution in New York.

That's kind of what got a lot of national attention toward that.

Well, I experienced that firsthand at this institution in Waltham, Massachusetts, how bad the conditions were for people there, the lack of care, the lack of dignity, the lack of any kind of rights.

I got called into the superintendent's office for trying to do more than I was supposed to, kind of stepping out of my lane.

I got called out on the floor by some of my colleagues, other ward attendants.

It was just a real eye opener for me.

And I left there committed to doing anything that I could to get people out of institutions and into, you know, community life.

And that in essence became my calling.

And I wasn't sure where that was gonna go.

You know, I was still a high schooler, I eventually went into college, you know, started to have different experiences, you know, working with people with disabilities, you know, particularly young people with autism, which was really a strong interest of mine.

In educational settings, in hospital settings, again, not sure where that would all go.

It wasn't until I got to St.

John's Community Services at that time, known as St.

John's Child Development Center back in 1980.

I was doing my doctoral work at the University of Virginia and got connected with the then director of St.

John's through a series of relationships that I had in the university sector.

He asked me to come up and help him identify, again, a pivotal point for the organization, identify needs in the DC Metropolitan area.

So I went and we did kind of a needs assessment.

And one of the things that we learned at that time was that the District of Columbia was under a court order to close its institution for people with disabilities called Forest Haven.

I had gotten my start in the institution in the suburbs of Boston.

Our then director, Tom Wilds, he had gotten his start working at an institution in St.

Louis.

We were both committed to doing anything we could to provide a good community life for people with disabilities, to help get people out of institutions.

So it was a natural for us to kind of pick up on that.

We had to convince our board of trustees to allow us to move in that direction 'cause historically, the organization had supported children, young adults.

And they bought into it, they had the commitment, they allowed us to move ahead with developing services, you know, for people with disabilities.

And we started to provide housing support in DC, so people could come from the institution into the community.

We started to develop other kinds of services where people could learn how to navigate the community, job training programs, teaching them how to access the various resources that are available in the community, and basically, start building the community infrastructure in Washington, D.C.

so that people could come out of the institution and have the supports that they needed to thrive in the community.

- Help me sort of visualize.

You have a group of people who have been in an institution where their daily needs are met in an institutional manner.

- Correct.

- What's that transition like?

- At that time in the '80s, they were moving into homes, in single-family homes in the District of Columbia.

We started slowly with one, then two, eventually expanded to six homes.

At that time, they were called intermediate care facilities with a heavy medical emphasis.

That's what was available in the District of Columbia at that time.

But we provided the staffing support, 'round the clock, you know, staff support so that people could learn how to manage a home, you know, how to cook, how to entertain neighbors, you know, how to do some of the basic life skills that we take for granted that they really needed a lot of support around.

And especially to navigate a community for a number of these individuals, they had grown up in an institution, so they only knew the walls of their building or the campus itself.

And coming into the community was a totally new experience for them.

So we had the staff, you know, that would support them to become acclimated, to begin to understand what community life was like, how to be a good neighbor, how to be a good housemate, how to explore the various resources that was available to them now in the community, which they did not have in an institution.

And for people in an institution, always being told what they would do, when they would do it, what they would eat, when they would eat it, now, all of a sudden, we're trying to support them to make their own decisions.

But it's difficult to make decisions when you don't know what your choices are.

So we've always felt that part of our role was to provide opportunities for people so that they could experience the various things that a community has to offer, and they can begin to understand those options and what they like and what they don't like and for us to support them around that so they can build a good quality life.

- Well, that's a huge stepping stone, I would think, for someone who has those disabilities to now be in a home in the neighborhood, neighbors, groceries, all of that kind of stuff.

But St.

John's does other things for these folks.

I understand that there's help to develop job skills and, yeah.

- So you know, certainly building relationships is very important to us, helping people make connections in the community, develop friendships and reconnect with family members at times.

But you mentioned job training.

It's really central to who we are as an organization in terms of the values.

We all get so much out of the work that we do.

The intrinsic values of contributing in some way, of earning money so that you can then purchase things, you know, that gives you a lot of power and autonomy.

So for us, it was always looking at ways by which we could support people to develop job skills 'cause again, for a lot of people coming from institutions, they never had that opportunity.

So providing opportunities for people to volunteer in different nonprofit organizations so they can get acclimated and introduced to work environments, to build, you know, job skills and to help them to be able to secure work and to retain work through the kind of support that we provide so that they can build that kind of value that we all have from the work that we do.

And over time, so this began in the '80s where we began to work with, at that time, the District of Columbia government in closing its institution.

Eventually, St.

John's moved into Virginia in the '90s, again, helping with the downsizing of institutions there.

What brought us to Tennessee in 1999 was the closing of Arlington Developmental Center here in the Memphis area, which was under a court order, eventually, Clover Bottom out of Nashville.

But over time, and gratefully, institutions have closed.

They're nowhere near as prevalent as they were back in, you know, before the '70s.

So now, we also work with a lot of people that are just coming from different aspects of community life, seeking opportunities to be gainfully employed or seeking ways that they can give back to the community through volunteerism or looking at ways by which they can better engage in their communities.

And we provide all that kind of support.

- Well, you've just answered what was gonna be my next question is, how did this organization move from the D.C.

area to end up here in West Tennessee?

And St.

John's Community Services helps folks all over West Tennessee.

As I understand it, you've got offices and folks working in Martin and Jackson, and put you on the spot.

- Yeah.

- Where else are we in West Tennessee?

- So Memphis is where we got our start.

And how that occurred was, as I mentioned, the government was under a court order to close the Arlington Developmental Center.

At that time, it was called the Department of Intellectual and Developmental Disabilities.

Now, it's the Department of Disability and Aging.

The regional office based out of West Tennessee learned through a court monitor up in the District of Columbia, 'cause there's typically a court monitor that is assigned to kind of oversee the closing of institutions and helping move people into the community.

Well, those court monitors talked and the court monitor in D.C.

said, "Hey, you should talk to the folks "from St.

John's Community Services.

"They've got a really good track record and history "and a commitment to supporting people "moving out of institutions and helping build "the community infrastructure necessary to support that movement."

So we got invited to come down, take a look at the area, take a look at the Arlington Developmental Center, see if this was something we were interested in.

Officials from then again, the Department of Intellectual and Developmental Disabilities came up to D.C.

to see firsthand our work.

And they invited us to come down, and again, we had that commitment.

We wanted to do whatever we could to support local governments, families, and others with the whole de-institutionalization effort, and that's what, you know, brought us to western Tennessee.

We eventually moved to Jackson about four or five years later.

It was 2000 that we started to actually provide work, '99 when we first made the connection.

And then we moved up into the Martin and Paris area in 2012.

We were invited by a local organization there called Community Developmental Services.

They were going through some financial hardships and struggles and they invited us to come in and see if there's anything we could do to help in that situation.

The state disability agency was also supportive of that.

We went in, we spent about six months kind of assessing, you know, helping to determine if this was something we could do viably, and decided yes, it is.

It's a way that we could help preserve a longstanding organization, the services for well over 100 people, the jobs for well over 100 people.

And so in 2012, Community Developmental Services became, you know, part of the St.

John's family, and that's what brought us up to the northwest part of Tennessee.

- So when you are working to help people move out of institutions or I know now that you help people who are leaving an abusive home situation or other problems, other reasons.

- Yeah.

- Do you work specifically with employers?

How do you fix somebody up with the right job if there's someone in the Memphis area?

- Correct, so we do work with employers.

We have tremendous connections within the business communities as part of what we do, just kind of reaching out, letting people know about this kind of untapped workforce, you know, people with disabilities are tremendous employees.

But we work with each individual to understand what their interests are in terms of employment, what their work history may be, if they do have, you know, a resume that they're bringing to us.

It's called a discovery process so that we can better understand what they are looking to accomplish through work, the kinds of work environments that they would like to be in, and how they can contribute to a job place.

So we go through that process and then we work with them providing as much or as little support as they need to kind of look out into the community for what is available in terms of employment that could match those interests and the support needs that they have.

We may accompany someone in an interview or just help them prep for an interview and they'll go in.

Eventually, someone will secure a job and then we provide on-the-job support as much as they need until they become proficient enough with their work responsibilities that we can then begin to pull our staff off of the job site and have individuals work independently like we all do.

- So you all have got lots going on now in the West Tennessee area.

Talk to me, if you would please, just looking ahead.

Now, you have retired - Yeah.

- From your main position.

You're still the go-to guy.

[laughs] Tell me what sort of challenges, what are next steps, where is St.

John's going?

- Yeah, I did retire, I retired at the end of March after 44 years as an employee at St.

John's Community Services.

It was a very difficult decision, but years in the making.

I have never looked at it as work or as a job, it's just part of who I am, a very integral part of who I am.

I have such a love for this organization, I couldn't completely walk away.

And what helped me with the transition to retirement a few years ago, I was at dinner with our CEO, Alan Thornton, and one of our longstanding board members, Pat Nichols, and we were talking about that, that we knew that on the horizon, I'd be stepping down at some point soon within a few years.

And it was Pat who suggested, "You know, you don't have to walk away entirely, you can go on the board."

And that's what I did.

- Ah, yeah.

- I retired as an employee and now serve as a volunteer board of trustees member.

I just, I couldn't walk.

- You couldn't walk away completely.

- I could not walk away, no.

The organization's too important to me, it's too much of a part of who I am.

And now, I totally forgot your question.

[laughs] - That's okay, now, what I'm wondering is, are there specific challenges?

You know, the economy is not in a great place.

I think we all know that there are more people suffering food insecurity and housing insecurity, and so I'm just sort of curious what challenges you see and what next steps?

- Yeah.

- Are we looking to additional services or to- - Yeah.

- What's up?

- We certainly... Okay, so we certainly will continue our work with people living with disabilities.

We have... It was beginning in 2018 that we began to provide support for people experiencing homelessness and people experiencing food insecurity, which we're doing here in western Tennessee, as well as in New York state, primarily Tompkins County, the Ithaca, New York area.

We will continue to build on that work 'cause the need is becoming even more prevalent.

I have to acknowledge that our CEO, Alan Thornton, he came on board toward the end of 2017.

And our board was very intentional in looking for someone that brought in the skills and the experience in working with people experiencing homelessness.

We had that on our radar since 2011, but didn't have the wherewithal to start to move in that direction.

Alan brought that experience and that knowledge to St.

John's and helped us to establish a foothold in New York state doing that kind of work and then eventually here in Tennessee.

So we'll continue to build on that work.

And here in Tennessee, in particular, we have a food pantry that we operate out of Martin, Tennessee that is providing tremendous outreach for people that have that kind of food insecurity in that community, and we're gonna look to expand that work.

Some of the challenges that lay ahead, particularly with respect to people living with disabilities, you know, the one... What are they called?

The One Beautiful Bill that got passed by the current administration.

There are a lot of changes coming to Medicaid and Medicaid funding, which is primarily the vehicle through which services for people with disabilities are provided.

Some of that's gonna be taking place later this year and certainly, in the start of 2027, there will be a lot of reform to the Medicaid system, a lot of cutbacks in Medicaid funding that will affect eligibility for people that need those kinds of services.

There's also some movement to get back to institutional care under that bill.

There are provisions in there that allow states to move away from community services and open the door to more institutional care, as a way to save money.

They also say it's probably more appropriate for some people to have that institutional care.

So there's some concern among the disability community, family members, individuals that are receiving services now that some people in the future may be forced back into institutional care.

So we really need to have as much attention to that as we can and to exert every effort that we can to assure that people still have, you know, that civil right to life in the community.

- Right, right.

Well, so tell me, so you have... Some of your funding then comes from Medicaid for those individuals.

- Right.

- You know, it's an interesting world these days for those of us in the nonprofit business.

Tell me a little bit about your funding model and if there are ways that people who like what you're doing and like this mission might wanna help.

- Yeah, well, certainly 'cause primarily, our funding source is Medicaid.

It probably comprises about 90%, if not higher.

And Medicaid is an entitlement program for people that meet certain criteria, including financial need.

So there's not a lot of money that comes out of Medicaid funding.

So we really rely on private fundraising, private donations and such to help, you know, supplement to kind of bridge the gap between the Medicaid funding and the actual expenses in providing those services.

It's, you know, since the 1980s, we've talked about, "Well, we need to move away from Medicaid funding," but there really is no other viable source for people with long-term care needs, such as the people with disabilities that we support.

So we are constantly trying to do everything that we can to raise private funds to help supplement, you know, that funding model.

- Good.

- Yeah.

- Yeah, I do want to say that the idea of having to move back to that institutional model sure feels like a backward step to me.

I guess I've watched too many old movies.

- Oh, yeah.

- And read those stories that... Have you got a big... I guess what I'm asking is, have you got a big fight ahead of you trying to keep people in homes and neighborhoods and not go back to building institutions?

- No, we very well may have a fight on our hands.

There are states that are now, one in particular, and I don't wanna call out any individual states.

- It's 1 of 50.

- But, yeah, there is one state in particular that is suing the federal government citing a Department of Justice interpretation of the Olmsted Act which came out, I think it was in 1999, it was a Supreme Court ruling that really averred the civil rights of people with disabilities to have service in the community.

There is now a state that's suing the federal government, citing the department, a recent Department of Justice interpretation of the Olmsted Act that would move away from community services and back into institutional care.

There's another state that is suing to allow them to place children with disabilities in nursing homes.

So you're seeing this kind of movement right now among states, you know, throughout the country.

It's not just these two, there are others that are trying to move care back into the institutions.

Certainly as a way to save money.

I mean, the projections from the Office of Management and Budget for the Big Beautiful Bill is that over the next 10 years, there'll be over $900 billion cut from the Medicaid program, and that's going to impact services in so many ways.

Institutional care is a way to provide, you know, more congregate care.

States claim that it's a way to save, you know, funds when there's fewer dollars to go around.

But it's really not the case.

You know, research over the decades has shown that community-based care is not only more appropriate and dignified for people, but it's also less expensive, less costly than institutional care.

- George, thank you for being here, and thank you for watching.

This has been A Conversation with George Liacopoulos.

[bright gentle music] [acoustic guitar chords]