A written statement issued by the Executive Office of Health and Human Services that day claimed that it costs $239,000 per resident per year to operate Fernald, and that comparable care in the community system currently costs $102,000 per resident. The statement added:
Closing Fernald, which currently has only 180 residents on 196 acres, will enable DMR to consolidate its resources in order to provide the best services available to all 32,000 of its clients throughout the state.
Sounds convincing. But the Fernald League, which has been fighting to keep Fernald open, didn't necessarily agree with those cost claims and asked EOHHS the very next day for all departmental analyses supporting them. EOHHS referred our request to DMR. We now have DMR's analyses, or, we should say, what passes for them.
Let's first look at the EOHHS/DMR claim that it currently costs $102,000 to care for residents in the community. What was the nature of the analysis that enabled DMR to arrive at that figure? What costs were added together, and how many people were those costs divided by to arrive at that number?
Unfortunately, we still don't know. In the close to 100 pages of documents that DMR provided us, we couldn't find any mention of the $102,000 figure, much less any analysis that went into deriving it. The records did contain the results of an analysis done ten years previously by an internal DMR working group, which estimated the cost of community-based care at $134,247–an amount 32 percent higher than the $102,000 figure.
Generally, one would think, the cost of care would go up in the succeeding ten-year period, not down. So we wrote a follow-up letter to DMR, asking if they could direct us to any documents that referred specifically to how they derived the $102,000 amount. DMR wrote back, saying: “There are no documents responsive to your request that 'refer specifically to the claimed cost' of $102,000.” DMR's letter went on to say that they had provided us with data on the number of DMR consumers in the community “and the costs associated therewith.”
It's true DMR provided several different spreadsheets listing various types of community costs. But nothing appeared to add up to $102,000. Was it some kind of test? Had the $102,000 figure been calculated in someone's head at DMR and we were supposed to figure it out for ourselves? Or was it plucked out of thin air?
And what about the claimed cost of $239,000 per resident at Fernald? In that case, DMR did list that number on a spreadsheet. And as we feared would be the case, the spreadsheet showed that the number was calculated by dividing the entire Fernald budget, adjusted only for staff attrition, by the 181 residents within the Intermediate Care Facility portion of Fernald.
The problem is this calculation didn't take into account the 29 residents of the Marquardt Skilled Nursing Facility on the Fernald campus, or the 265 homeless persons living in three additional buildings on campus. A number of costs attributable to those 294 additional residents, such as heating and electricty and some salary costs, are included in the total Fernald budget. The DMR analysis also did not account for numerous budgetary costs that support community-based clients who use Fernald resources.
There is a lot more we could say about our review of the DMR documents and the failure of the agency to do accurate and, in many cases, basic analyses of the costs and benefits of either closing Fernald, continuing it, or maintaining it in a scaled-back form.
For instance, another EOHHS claim that $14 million to $20 million in capital expenditures would be needed at Fernald was apparently based, at least in part, on preliminary data from Parsons/Brinckerhoff—data which had not been reviewed, verified, or accepted, according to DMR documents. We're not sure what those projected costs would involve, but we're certain they have no relationship to our own “postage stamp” proposal for scaling back Fernald.
To us, it's nothing less than shocking that, with the lives and welfare of hundreds in the balance, government would make major policy decisions with such a paucity of information and thoughtfulness.