Lian Emmick, with staff member Brandon Sebastino, at the Judge Rotenberg Center in Canton, Mass., in 2016. Emmick is wearing a shock-delivering device around her waist. Sebastino has the triggering device on his belt. (Rick Friedman)

Disability advocates and state lawmakers are questioning why Maryland is sending teenagers with a mix of intellectual disabilities and behavioral disorders to a facility in Massachusetts that has been the subject of complaints over disciplinary practices.

In January, the Maryland Board of Public Works approved a three-year, $2.7 million contract to house five teens in the Judge Rotenberg Center in Canton, Mass., after child welfare officials said they couldn’t find facilities in Maryland willing to accept them. The contract bars the center from using mechanical restraints or an electric shock device meant to deter bad behavior.

The use of aversion shocks, defended by Rotenberg officials as a last-resort tool for the most difficult-to-control students, has drawn scrutiny from state agencies, the U.S. Department of Justice and the U.N. Special Rapporteur on Torture. The U.S. Food and Drug Administration has proposed banning the device.

Disability advocates note that the center can administer shocks to students at any time, so the teens from Maryland could see the punishment even if they don’t experience it, which advocates said they find troubling.

Glenda Crookes, the executive director of the Judge Rotenberg Center, a facility in Massachusetts for children and adults with intellectual disabilities and behavioral disorders. (Rick Friedman)

They also pointed to other troubling parts of Rotenberg’s track record — including assaults by staff and the ouster of a co-founder who was accused of destroying evidence of abuse.

“Given their past of using what I consider, frankly, to be abusive and inhumane policies, I don’t trust them to do a good job of taking care of Maryland children,” said Del. Eric G. Luedtke (D-Montgomery).

Maryland state welfare officials said social workers are checking in on the teens who were sent to the center every month. They said they turned to Rotenberg because it was the only facility willing to take the teenagers, who are prone to violent outbursts.

“We are not talking about little small children, we are talking about full-grown people . . . who based on their size, layered with their behavior challenges and aggressiveness, require a substantial staff-to-youth ratio in order to meet their needs and make sure they are safe and safe with themselves and also with others,” said Rebecca Jones Gaston, executive director of the state Social Services Administration.

Rotenberg charges up to $900 daily to house, treat and educate students, and has a staff-to-student ratio of nearly 4-to-1. Center officials said their critics are distorting a track record of accepting students from 15 states, including Maryland and Virginia, many of whom have been rejected from other facilities and can be aggressive, self-mutilating or mentally ill. One of the Maryland students was sent there in September.

“We have always been facility that takes students that really nobody else will,” said Glenda Crookes, executive director of the Judge Rotenberg Center. “What is out there on the Internet, and what self-proposed advocates say, is not an accurate picture of who and what we are.”

The center includes both school-age children and longtime adult residents. Just less than 20 percent of the 260 residents are authorized for shock therapy, including one school-age resident. Those who are subjected to shocks typically receive one two-second jolt a week, Crookes said.

Nancy Weiss, a disability advocate and longtime critic of Rotenberg who first visited it in the early 1980s, said the problems go beyond shocks. Over the years, she said, the center has become notorious for other disciplinary methods, including depriving residents of food for acting out and limiting how much they can speak.

“It’s not a humane place to be whether or not you are getting electric shock,” said Weiss, director of the National Leadership Consortium on Developmental Disabilities at the University of Delaware. “Their approach is just cruelty and control.”

Crookes said much criticism of Rotenberg’s practices are outdated or inaccurate. She said the center’s disciplinary approach centers on granting and revoking privileges, such as mall visits and time to listen to music, based on behavior. Many of the center’s critics “have never been here and don’t have understanding of how the treatment works,” she said.

Leslie Margolis, managing attorney at Disability Rights Maryland, said more Maryland institutions would be willing to take extremely troubled and severely disabled teens if they were paid on par with what Rotenberg gets, or if the state pressed them on what resources they would need to do the job.

“It’s really problematic to take kids away from their families, away from their communities and stick them in residential placements — often really far away,” said Margolis, who flagged the Rotenberg contract to lawmakers.

Jones Gaston, the state social services official, said Maryland goes to great lengths to try to keep juveniles in-state, including by offering centers additional funding to hire extra supervisory staff. She said her agency is working on efforts to expand its roster of local providers willing to accept the most difficult children.

Luedtke, the state delegate, said the bigger problem is the lack of services available to better serve the most troubled and vulnerable children at home, rather than in institutions. He is weighing whether to ask a legislative committee on children and families to convene a hearing on the matter over the summer.

“These kids are easily forgotten,” Luedtke said. “It’s almost like it’s easy to ignore the needs of these kids and just lock them away.”