I have worked in Human Services for over 20 years. I have been at one agency for 16 years. I am in charge of 13 homes for adults with developmental disabilities. Some of those homes have not had an increase in funding since 1987. These houses have been level funded despite the fact that rents, salaries, food, gas have increased. When I started at one house we had a nurse, physical therapist, speech and language pathologist, psychologist, and a social worker. Over the years each was cut. The party line was that the clients could access those services in the community and that it was more restrictive for them to get them at home, but in fact the services were cut because we couldn’t continue to afford them.
There is a new campaign called The Campaign to Strengthen Human Services that aims to fix the way Human Service programs are funded. The Campaign launched a web site today www.strengthenhumanservices.org. The Campaign wants the legislature to pass Senate Bill 65.
“Senate 65 seeks to establish a fair system to ensure that Massachusetts human service providers receive adequate rates from the Commonwealth for the cost of delivering services to a million residents in need of care because of mental health issues, developmental disabilities and threats against their personal safety.”
www.strengthenhumanservices.org
Representative Tom Stanley wrote a letter to the Speaker of the House supporting Senate Bill 65. He is looking for other State Representatives to sign the letter.
” Dear Mr. Speaker:
We are writing in support of S. 65, An Act Relative to Rates for Human and Social Service Programs.
We have become increasingly concerned about the stability of the health and human services system and feel that the benefits-both tangible and intangible-that these services bring to the Commonwealth are at risk. In its report, Reforming the Commonwealth’s $2 Billion Purchase of Human Services: Meeting the Promise for Clients and Taxpayers, the Massachusetts Taxpayers Foundation noted that the flaws in the state’s human services contracting system “were sapping the performance of the system even when budgets were growing. But budget reductions are exacerbating the problems clients already face in negotiating an increasingly dysfunctional system for providing services.” We believe S. 65 will address this mounting concern and ensure that individuals across the state are able to continue to receive quality services in their communities.
Under the current human services purchasing system, there are no safeguards to ensure rate adequacy, no appeal rights against unfair prices and no ways to prevent unfunded mandates. As a result, human and social services contracts have not kept pace with more than 15 years of inflation. Across the entire spectrum of social and human services, growing financial instability is threatening the quality of care in community-based programs. Financial instability has resulted in deferred maintenance, delayed implementation of innovative care, and workforce recruitment and retention problems. These workforce challenges are compounded by the existing shortages of direct care professionals. Reform of the system is essential to the development of a more consumer-centered system of care with a higher quality of community care.
S. 65 requires the Division of Health Care Finance and Policy (DHCFP) to treat human and social service providers like other health care providers that have class rates set by DHCFP. It sets a standard of rate adequacy and confers on social service providers the same appeal rights as are accorded to other providers whose rates are set by DHCFP. It also adjusts multi-year contracts for annual inflation, and provides a right to obtain a contract amendment if the procuring government agency adds additional units of service or new program requirements to a contract. The fair and adequate pricing mechanism for human and social services providers contained in this bill will permit the development of a more consumer-centered system of care with more stable providers and a higher quality of community care.
We respectfully request your support of S. 65 and urge you to consider action on the bill before the end of the legislative session.
Thank you for your consideration.
Sincerely,
”
Please talk with your representative and ask him or her to sign the letter.
I hope he can move the Speaker on this.
but it’s not clear to me how this bill will fix the problem. The problem is that the governor and Legislature haven’t adequately funded the system.
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p>I’m also skeptical of the Mass. Taxpayers Foundation report, which largely calls for reducing or eliminating regulation of the provider system, which contracts with the Department of Mental Retardation and other human services agencies. There is too little oversight of this system as it is. Medication errors, physical and sexual abuse and neglect are rampant problems in community-based group homes in the state. The commonwealth has few resources to inspect those homes, and yet the MTF is calling for less oversight and regulation.
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p>Could you provide some documentation?
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p>I am not sure these types of blanket statements are useful.
were voiced by U.S. Attorney Michael Sullivan in his report last year to Judge Tauro in the Fernald case. Sullivan based his statements on reports by the Disabled Persons Protection Commission. Also the Wrentham Association documented abuse in the community system in a brief filed in the Fernald case in 2006. An account of the Wrentham brief can be found in the March 2006 issue of the COFAR Voice.
You need to learn more about community programs. There is a lot of oversight by the state. DMR Service Coordinators visit the houses once a month, Survey and Certification (formerly known as QUEST) monitor annually, and then there are the random visits by Citizen Monitoring Teams.
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p>I have been working in the community for one agency for 16 years. There has not been one incidence of physical or sexual abuse or neglect.
Are you sure the agency has not had one incidence of physical abuse or neglect? That would be quite unusual. As for QUEST and consumer satisfaction surveys, I would refer you to the Wrentham Assn. brief (noted in my comment to HeartlandDEM above). As the COFAR Voice article about the U.S. Attorney’s investigation notes, the Wrentham brief found DMR’s oversight of the community system to be inadequate.
Have you ever been to a community program?
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p>It is easier to hide abuse in the institutions. In the community there are more eyes.
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p>Yes I am sure that there has not been one incident of abuse or neglect.
and management strategies for bulk purchase of supplies? How are energy and facility maintenance costs managed?
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p>Maybe, along with special education we need a dialog about consumers/families contributing to sevices for special needs individuals when the financial means exist?
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p>It is pretty clear that all of the current systems (health care, education, social services, infrastructure, law enforcement…) are collapsing and paradigm shift is needed.
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p>Raise consumption taxes and explore user fees based on financial means-test?