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Human services workers are stuck in 1987 – can’t we do better than this?

June 22, 2008 By AmberPaw

Further, when a program works, it may still be shut down because a provider can get twice as much for a new program, as to keep a program that works up and running.  This is just nuts!

While the state doesn’t adjust what it pays for inflation, it does pay more for services in newer contracts than older ones. Brady said he makes do the way other service providers manage – he takes on newer, better paying contracts to subsidize his earlier ones.

A bill in the Statehouse, backed by Rep. Barbara L’Italien and Sen. Susan Tucker, both Andover Democrats, would allow human service providers to bid on contracts based on the actual cost of doing the service. It also would establish a rate-setting commission to review rates annually.

How bad is it:

There are 185,000 human service workers in Massachusetts. A University of Massachusetts Donahue Institute study found that human service workers earn less than if they had taken comparable jobs elsewhere in the health care industry. The median pay is about $9,000 less than if they’d taken a job elsewhere. Those who work for state facilities earn nearly $15,000 less.

Brady, whose agency employs 330 people across the region, said many of his caregivers could earn more working at McDonald’s, and that some are eligible for food stamps.

Here is the URL for this story:  http://www.eagletribune.com/pu…

This is shameful.  I am told there is a “stuck bill” in Senate Ways and Means.  I also understand that the Chair of SWM, Senator Panagiotakos, is on six conference committees with a budget deadline to meet.

That all being said, the reality is that starving human services demeans and places at risk the most vulnerable citizens.

One day, I hope to say, “Together we did better.”  

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Filed Under: User Tagged With: human-services, payment, social-services, stuck-legisltion

Comments

  1. sabutai says

    June 22, 2008 at 11:38 pm

    Deval Patrick bowed to media pressure by appointing a new Commissioner of Social Services, Angelo McClain.  Problem is, he is entirely unwilling to admit how bad things are in DSS.

    <

    p>Here’s an example from a reliable source:  McClain outright refused to believe that social workers had a caseload exceeding the state’s mandate of 17, no matter what his aides told him or what paperwork he saw.  It wasn’t until he conducted an informal poll face-to-face with social workers at a couple field offices that he accepted reality.  Word is, he still won’t admit that there is an ongoing exodus of social workers to the prescription sector in Cambridge.

    • amberpaw says

      June 23, 2008 at 6:54 am

      Why it does not seem directly related:

      <

      p>1.  The Commissioner does not set the rates for human service providers, who are used by DMH, DOR, DSS, and others.

      <

      p>2.  My post is not about state employees, but rather the independent contractors such as those who run group homes & residential treatment centers and
      THEIR employees worker “7/24” for these unconscionable wages.  Think Italian Home/Knight Center, or your local group home for cognitively impaired adults.

      • justice4all says

        June 23, 2008 at 9:05 am

        Amber,

        <

        p>You should be aware that these vendors have gotten into the service provider business by telling the state to dump their unionized state workers, because they could provide residential and medical services better, faster and cheaper than state workers.  This has allowed the state to pursue this outsourcing…and keep wages artificially low.  

        <

        p>Perhaps it’s time for these vendors to finally admit that they only way they can provide services is to actually pay what state workers are willing to work for…which means those services will probably cost the same as the state worker model.  And if you really want to be sick – take a look at the salaries that some of these “non-profits” are paying their executive directors!  

        <

        p>Perhaps it’s also time for the state to finally commit to something resembling oversight.  I recall the Patriot Ledger ran a series on these group homes and what was happening there was truly unconscionable.  

        • amberpaw says

          June 23, 2008 at 12:30 pm

          I remember the destruction of the Community Mental Health system – and the damage that did to both state workers and the clients served {I represented a couple of the workers, and fought back to no avail, as a matter of fact.]

          <

          p>As to the sickening salaries paid by these NGO/nonprofits to their baronial leaders – that is also a major problem in the health care industry.

          <

          p>There is a new aristocracy [word used deliberately as there IS now a hereditary, multigenerational aspect] which is destructive of democracy as well as sound fiscal policy, at least in my opinion.

          <

          p>I would far rather see unionized state workers caring for vulnerable children.

        • lynpb says

          June 23, 2008 at 6:50 pm

          You have this backwards. In the mid 80s large institutions that had housed people with mental retardation began to discharge these clients into the community where they belonged.

          <

          p>The problem is that the way the state funds these programs makes no sense. Senate Bill 65 will change this. Contracts have not been increased since 1987. That makes no sense.

          <

          p>I have personally seen programs operated by state workers and programs operated by private providers (disclosure I work for a private provider). If I had a family member who needed to live in either of these homes I would choose the private provider in a heartbeat.

          <

          p>As I have said before there is a lot of oversight at community programs. Service Coordinators visit once a month, Licsensing comes annually, and any decent provider has a good QI program.

          <

          p>Do you have any links about the salaries of the Executive Directors or are we supposed to just believe you. How do they compare to salaries in other industries?

          • lynpb says

            June 23, 2008 at 7:00 pm

          • justice4all says

            June 24, 2008 at 9:50 am

            and support why I believe that private service providers are the problem, as opposed to state ops.  I decided to “sleep on it” so I would not respond in anger.  The only thing I can agree with you on is that the deinstitutionalization movement allowed high functioning people who had been inappropriately placed in state institutions to leave, and rightly so.  What the deinstitutionalization movement has also done is shoehorn multiply handicapped, fragile people into inappropriate placements, and to create defacto institutions of places like Rosie’s Place, the Pine Street Inn and of course, prisons.  I can certainly provide you with a white paper to support the mortality rates for these very fragile people.

            <

            p>I also stand by my statement that these vendor ops told the state that they could provide the same as or better level of services for much less money.  I’ve seen their RFPs.  If you want me to start posting them, I can.    

            <

            p>And my own disclosure: I am the former guardian of a family member who lived at Fernald.  I am also the “next in line” for a former Fernald client who was raped within seven months of leaving Fernald.  Yeah.  Good times.  

            <

            p>Now, let’s take a crack at the lack of oversight.  The DPPC is horribly underfunded and has been for years.  The annual site visits are just a dog and pony show – the real deal is what actually happens to people with MR on a day-to-day basis.  In 2004, the Patriot Ledger ran a series of articles that explored and deplored the lack of oversight and quality care for people with MR.  Read the series and weep, because it’s the tip of the iceberg. One of the articles actually addresses the serious shortage of investigators.  

            <

            p>http://www.southofboston.net/s…

            <

            p>Before you tell me that “that was four years ago,” please note that in vital testimony submitted last month to the House Ways and Means committee, Nancy Alterio, the executive director of the Disabled Persons Protection Commission, provides some graphic accounts of the types of cases her agency has investigated lately:

            — a residential staff person punches, grabs and pulls a resident in his care as he attempts to rise off his couch

            — a woman is made to sleep on a mattress stained in feces and urine, her hair filled with lice and her body swarmed by flies

            — a residential staff person runs over a resident, seriously injuring her; meanwhile, staff at the residence change the victim’s clothes to cover up the accident

            — a trusted family friend repeatedly rapes a friend’s disabled daughter over a period of more than ten years

            — a colleague of twenty years is discovered sexually assaulting a resident in his care

            <

            p>You should also be aware that the DPPC’s volume of calls and investigations are rising…while the DMR creates it’s own set of statistics…to “finesse” the numbers.  

            <

            p>http://cofar-mass.org/cblog/in…

            <

            p>Further to my point about vendor ops, a recent report by U.S. Attorney General, Michael Sullivan, revealed:

            <

            p>

            Sullivan’s report found higher trends of abuse and neglect, especially sexual abuse, in community homes when compared to state facilities. He also noted that medical services are sometimes harder to obtain in the community, and staff turnover is significantly higher.

            <

            p>http://www.dailynewstribune.co…

            <

            p>And yeah – Sarkissian has tried to debunk Sullivan’s report, but keep this in mind.  70% of Mass Arc’s funding comes from vendors, and it’s not the little old family advocacy group that it used to be.  The “baby” Arcs are mostly multimillion dollar vendors for the state.

            <

            p>Now, regarding those salaries and financial mismanagement?  

            <

            p>http://www.examiner.com/a-1419…

            <

            p>  http://www.qualitycarewatch.or…

            <

            p>http://ledger.southofboston.co…

            <

            p>http://findarticles.com/p/arti…

            <

            p>And if this isn’t enough – the State Auditor’s site provides compelling support.

            <

            p>http://www.mass.gov/sao/index.htm

            <

            p>Please note the TILL audit of 2002, CGI and TPI of 2003, EMARC of 2004, Human Service Options Inc of 2005, New England Human Services Inc. of 2006.  My favorite is the TILL audit; the ED of TILL was actually on the Governor’s Commission on MR.  And guess who complained about CORI checks for these workers?  The ED of TILL:

            <

            p>http://www.dailynewstranscript…

            <

            p>Need some perspective on those salaries?  Here’s a benchmark survey.

            <

            p>http://www.abbott-langer.com/s…

            <

            p>At the end of the day – I would rather have my loved one in a state operated community home than in a vendor op any day of the week.  Your experiences may be different, Lynn…but the community is no panacea.  

            • lynpb says

              June 24, 2008 at 12:06 pm

              I don’t have the time right now to read all the links but I will soon.

              <

              p>Just remember that bad things happen in the institutions too. remember the rape in the Green building at Fernald a few years ago.

              • justice4all says

                June 24, 2008 at 1:19 pm

                in the institutions, like the July 1996 (12 years ago) rape in the Greene Building at Fernald, but I can tell you, there is far better care in a state operated institution or community group home than in these vendor ops.  For one thing – there are more professionals around – nurses, doctors, psych, PT, OT, etc. – people who can recognize the signs of abuse or neglect and report it.  That’s not happening in vendor ops.  What I’ve witnessed with the vendor ops is the deprofessionalization of services to keep costs down.  Service delivery (medical and professional care) is fragmented at best, and limited.  

                <

                p>And what I find so damned offensive is that the EDs and the rest of the “officers” of these organizations make sure they’re well paid, while a trickle flows down to the direct care workers.  Unions…they’re a good thing.    

                • lynpb says

                  June 24, 2008 at 4:57 pm

                • justice4all says

                  June 24, 2008 at 9:21 pm

                  but I was the one who called House Post-Audit to initiate an investigation when the DMR “investigated itself” after  a former Dever client was found dead, having choked on a diaper.  The DMR claimed he did it himself…despite the fact that he had spastic quadripalegia, which would prevent him from having the muscle control to do such a thing.  This poor guy couldn’t walk or talk, but he was a vocalizer.  This investigation was featured in a damning HPA report.  Most have surmised that the staff in the group home, unused to such an involved individual, had tried to quiet him temporarily and wound up quieting him permanently.  The same report featured the Raynham “House of Horrors.”  You can read about that report here:

                  <

                  p>http://www.buildingpartnership…

                  <

                  p>I’d take a unionized state op group home because the staff are paid reasonably, better trained, and the turnover isn’t as high as it is in the vendor ops.  

  2. lynpb says

    June 23, 2008 at 6:38 pm

    I have been writing about this for months. Please see link below. (I’m not sure if I did that correctly)

    <

    p>http://vps28478.inmotionhosting.com/~bluema24/s…

    <

    p>Senate Bill 65 would make the way DMR funds it’s programs more rational

  3. bean-in-the-burbs says

    June 23, 2008 at 8:14 pm

    The current funding system for human services programs is broken.  The proposed bill would be a big step in the right direction.  

    <

    p>What would you recommend supporters of the bill do?  Is Senator Pangiotakos not a supporter of the bill or just pulled in different directions facing a deadline?  Should we be contacting him or other legislators to urge action?

    • lynpb says

      June 23, 2008 at 8:49 pm

      http://www.strengthenhumanservices.org

    • amberpaw says

      June 23, 2008 at 11:05 pm

      ….the bill IS a step in the right direction.  Especially if it stops turnover.  I don’t have the time right now to chase all the salaries down, and I am talking about the CEO of Blue Cross/Blue Shield, and the like.  Comparing NGO salaries to Hedge Fund manager and Oil Company CEOs doesn’t help – when the workers make 12-14k a year and the CEO makes [in the case of BCBS over 400k I still say something is awry.

      <

      p>And the Community Mental Health system was not institutionalization – it was neighborhood mental health centers – where the staff was on salary, not “fee per service”…something gone the way of the dinosaur.

      • lynpb says

        June 24, 2008 at 11:58 am

        • lynpb says

          June 24, 2008 at 4:57 pm

  4. farnkoff says

    June 24, 2008 at 12:05 pm

    piece from the Boston Globe, because I originally thought it would be about raising pay for child care workers, providers for the mentally ill, or other social service folks. It turned out to be about giving DiMasi and Deval a raise. Get it? “Public servants”-that’s like a euphemism for “politician”.

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