Both the Waltham Daily News Tribune and The Worcester Telegram have reported that workers at five of the six remaining state facilities for the mentally retarded in Massachusetts, including Fernald, have been offered $5,000 bonuses to take voluntary layoffs. The reason given for this by the Executive Office of Health and Human Services is that the number of residents in the facilities has been dropping while the number of employees has stayed the same.
This is not, as it might first appear, a matter of declining public demand for the services provided by the facilities. The fact is that starting with the Weld administration in the 1990s, new admissions to the facilities have been sharply curtailed. The demand is there; but it is difficult, if not impossible, to get admitted to them.
The Patrick adminstration has continued this policy of letting the state facilities die by attrition and has actively pursued the former Romney administration's policy of trying to shut Fernald and ultimately privatize the care there. The Fernald case is tied up in the appeals court right now, but the administration's decision to reduce staff at Fernald and four other remaining facilities while the appeal is being decided seems to point to a growing possibility that these facilities will all ultimately be closed and replaced by vendor-run group homes.
This administration has yet to issue a comprehensive plan for the future of care of persons with mental retardation in Massachusetts, so we're left to speculate as to what its intentions are. At least some additional evidence of those intentions can be found in the lack of any interest on the part of the administration in compromise over Fernald or exceptions to their “community-is-better” ideology.
At the Seven Hills Pediatric pediatric nursing facility, which is separate from the state facilities, the care has been uniformly praised as exceptional; yet the administration plans to move dozens of DMR-funded clients out of that facility and into community-based group homes. Families have pleaded to let their children remain at Seven Hills, but the administration has said there will be no exceptions to its community-based ideology.
The administration's September 2007 statement announcing its intent to pursue Fernald's closure in federal appeals court stated:
The state's decision (to pursue its appeal) is consistent with a national shift away from institutional care in favor of community living. Decades of research indicate that community settings offer people with mental retardation the best care available.
No, not for all people with mental retardation. The U.S. Supreme Court recognized in Olmstead vs. LC that for the most profoundly retarded individuals, institutional care may be more appropriate than community care. The state facilities house the most profoundly retarded individuals in Massachusetts. But the Patrick administration doesn't appear to recognize the distinction that the U.S. Supreme court has made.
The “national shift away from institutional care” is part of a national shift away from services provided by government. This retreat has been occurring for the past 20 years at all levels of government, all across the nation. From reconstruction in Iraq to the cleanup effort after Katrina, government has increasingly relied on contractors and private service vendors to get the job done. How has that worked out for everyone? Just because something is part of a national trend or shift, does that automatically make it the right way to go?
The late Larry Terry at the University of Texas warned eloquently about the danager of the emergence of the “hollow state,” which he described as involving “a transfer of power and decentralization of services from central governments to subnational governments and by extension to third parties.” That transfer was a result of what he called “liberation management” (less regulation) and “market-driven management” (privatization). As Terry noted:
The ideas embodied in both liberation management and market-driven management, if swallowed whole, may not serve democracy well…There is a great deal at stake, namely the stability of U.S. constitutional democracy.
Unfortunately, it seems that when it comes to persons with mental retardation, the Patrick administration has swallowed market-driven management whole.
So far, the state facilities have shown they better able than are privately run group homes to provide the high level of care that is needed by the most profoundly retarded individuals.
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p>The term “community-based” is a misnomer in many ways. Fernald is highly integrated with the surrounding community. Community residents use many of Fernald’s facilities and Fernald residents make use of much of what the surrounding community has to offer.
Says who?
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p>You can ask the clients I work with if they would rather live at Fernald or in a community residence operated by a vendor. You can ask the parents of my clients who function at the profound level of mental retardation who have lived in community settings for the past 20 years which they would rather have. To a person they all prefer the community.
I have to disagree with you, Lyn. You’re only asking whether your high functioning clients want “Fernald” or “vendor care” and that’s only half the equation. I’ve worked with families for both vendor and state op group homes…and without a doubt, the state op group homes are superior to vendor ops. State ops, because they are union, don’t have the turnover rate that the vendor ops have. Because they don’t have the turnover, they can provide consistent quality care. The state ops also have better access to professional care – physical therapy, occupational therapy, respiratory therapy, psychiatric care, etc. In fact, Fernald provides dental care for all people with MR, regardless of where they live, as well as adaptive technologies, and the gym and pool.
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p>To illustrate the issues with some of the vendor homes…take a look at this series of articles in the Patriot Ledger from 2004. It’s just disturbing. And worse? The DMR provides very little oversight of the vendor ops. There just aren’t enough professional staff to provide it.
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p>http://www.southofboston.net/s…
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p>And in the paper on Sunday – was the abuse of the trust funds of clients. No one is minding the store – not even the lawyers!
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p>http://www.boston.com/news/hea…
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p>And then just last month, in the town of Franklin, an arson fire was set by a resident of a 24 hour supervised group home.
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p>http://www.wickedlocal.com/fra…
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p>And then there’s the sexual abuse.
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p>http://www.heraldnews.com/news…
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p>The young man in this article was moved from group home to group home to get him away from his stalker. These vulnerable folks can’t get a fair shake – even the cops wouldn’t believe him.
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p>The community is not a panacea, Lyn.
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but I’ll put my thirty years of advocating for the disabled at the state and federal level to the test any time, and the guardianship of two very dear loved ones. The data’s on my side, any time you want to see it.
of people with profound developmental disabilities, who are also medically fragile isn’t a progressive value. It’s absolutely stunning that Governor Patrick added more than 1900 jobs to the state budget, while at the same time, trying to evict the residents of Fernald and the other facilities.
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p>http://www.bostonherald.com/ne…
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p>And when the body count goes up (and it will; a study of the deinstitutionalization movement in California proves it) there will be much handwringing and cries of “we didn’t know!” The latest study was published in the Journal of Data Science and can be found here:
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p>http://64.233.169.104/search?q…
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p>A study conducted right after California deinstitutionalized (reviewing mortality rates 1980-1992) found that these fragile people die at a 72% higher rate after they leave their facilities than their community living peers.
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p>Read it and weep, Massachusetts. Together we can….evict people with profound disabilities in Massachusetts.
The U.S. First Circuit Court of Appeals will decide the fate of the mentally retarded residents of the Fernald. Its ruling will literally determine the life and death of many of these people and could potentially impact all mentally retarded people throughout the country. Its decision will set a precedent regarding the way we, as a civilized society, care for our disabled citizens. WHERE IS THE MEDIA??
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p>It appears that the mentally retarded are about to be run over by the progress that has taken 35+ years to achieve.
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p>I guess we have learned nothing from history.
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p>To Lyn-If I could be granted one wish it would be that my brother, a Fernald resident of 40+ years, could live and thrive in a community setting. The reality is it is not possible. You are indeed fortunate that your clients and/or their parents can express their wishes. My brother can’t.
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p>Frankly, I’m surprised that someone who has worked with mentally retarded people for 20 years could make such a comment. You of all people should know that each person is an individual with distinctive abilities and needs. I would also think that you would know there are mentally retarded people that require a unique environment, like Fernald, to have a good quality of life.
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p>We have fought for decades to improve the care, treatment and quality of life of the mentally retarded. It is through these hard fought battles that your clients now have the opportunity to live in the community, work in the community and participate in many community based activities. Thirty years ago those opportunities were nonexistent.
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p>I THINK THATS WHY I FIND IT SO INFURIATING THAT THE PARENTS/GUARDIANS/ CLIENTS THAT ARE NOW ENJOYING THE FRUITS OF THIS DECADES-LONG BATTLE WOULD FORSAKE THOSE THAT PAVED THE WAY FOR WHAT THEY NOW ENJOY.
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