Secondly, the editorial repeats the administration's undocumented assertion that it costs $239,000 per resident per year to operate Fernald, compared with $102,000 in the community. As we have repeatedly pointed out (until our heads hurt), the Fernald budget covers many costs and services that don't pertain either directly or exclusively to the residents. We have, in fact, submitted a Public Records Law request to Secretary Bigby, seeking her agency's analyses and records supporting those cost claims.
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Thirdly, the editorial states that the administration has “pledged” that the most profoundly disabled would be given the option of placement in one of the state's five other institutions. While the Executive Office of Health and Human Services did state that this option would be made available, it is not clear how long it would last. Those remaining institutions could well be next on the closure list.
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Secretary Bigby was quoted in the State House News Service as saying that the administration did not have a plan to close those other facilities “at this point.” That doesn't mean such a plan could not be drafted tomorrow. Bigby is also quoted as saying she had made a “verbal commitment” to the families of Fernald residents not to move their loved ones more than once. Such “verbal commitments” are not of much comfort these days.
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Finally, the editorial states that neither U.S. District Court Judge Joseph Tauro nor U.S. Attorney Michael Sullivan determined that residents transferred from Fernald between 2003 and 2005 to community-based settings received substandard care. In fact, during that period, 34 residents were transferred to other state facilities and only nine to community-based residences. Sullivan's report did not make any specific comments about any of those nine residents transfered to the community.
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What Sullivan did say was that DMR was “was in compliance for the transferred residents with certifying equal or better services in the community” (my emphasis). That does not mean that Sullivan found the care in the community to be equal or better in reality, only that DMR had certified it as such, as required by Tauro's 1993 order.
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In fact, Sullivan reported a number of sigificant concerns with community-based care, including a potentially higher risk of abuse and neglect in community-based residences, a longer process to obtain medical care, and higher staff turnover.
Please share widely!
when a downtown Boston newspaper and some self-styled “disability advocates” insist on cannibalizing services from the weakest of the weak?
There are some issues with the Herald's “take” on things:
1. I don't buy the analysis. If centralized service delivery via campus living “works” and is cost effective for colleges and senior citizens, then why not people with MR? What had the DMR done (or not done) to make Fernald so cost-prohibitive. Why is the DMR allowed to perpetuate a myth (aided and abetted by the vendor advocates) without an objective review.
2. Follow the money trail. The residents of Fernald are consent decree clients and the money will follow them whereever they go…. but in the absense of oversight, their services get watered down and their money goes to fatten the bottomline. You should also be aware that many of the “ARCS” are multi-million dollar service providers for the state and many vendors are also members of MARC. Check out those salaries for the EDs. And don't forget Vinfen.
3. House Post-Audit, under the direction of Rep. Fagin, issued a great report on the “challenges” in the community – not the least of which was a number of deaths in which the DMR investigated itself and declared itself innocent. One of them was a young man with spastic quadipalegia who was found dead with a diaper in his mouth. He used to live at Dever where his random vocalizations didn't get him killed. Sexual assaults were also listed, unreported injuries etc.. You can probably call HPA and get the report. The report is now several years old, but it hasn't improved an iota in the intervening years. I know of one former resident who was sexually assaulted last year.
4. Why not use the “postage stamp” to house the remaining residents of Fernald, while at the same time, utilizing it as an HMO for people with MR? One of the biggest challenges families face is the lack of specialized medical supports for their loved ones, and closing facilities scatters the very professionals who know this population best. It's not as simple as picking up the yellow pages. On one occasion when my sister was rushed to Mass General – the doctor on call took one look at her (she had severe CP, compounded by significant scoliosis) and said, “where do I start?” Needless to say, I took her back to Fernald.