Howe's letter stated:
A number of years ago, the agency developed a comprehensive strategic plan, which we have used as our guide to develop and implement supports and services to individuals with mental retardation in the state.
The letter added that the Department had created a number of survey instruments, run town meetings and forums, and created a number of task forces. It provided no additional information about any of this, particularly the strategic plan. How many years ago, for instance, was the plan developed? Moreover, what, if anything, did it say about the future of the state facilities, and how has that been used as a guide to the Department?
To find out more, I filed a Public Records Law request for a copy of the strategic plan (or an executive summary, if the plan was voluminous). Earlier this month, I received summaries of the plan from DMR. It turns out the plan is dated June 2001 (it was produced during the Swift administration), and it is geared toward the period from 2001 to 2004.
Objective 1.6 of the Strategic Plan called for development of a plan to identify the short and long-term roles of DMR's large state-operated facilities.
The facilities working group, which consisted of DMR staff and “external stakeholders,” was split, with “some advocates calling for closure of all facilities and others saying keep all six, but “right size” them.
There was one document provided, dated April 2005, which stated that DMR was in the process of phasing down and closing Fernald. The document stated that a facilities working group had projected that “current facility bed capacity exceeds what will be required to meet the projected future need.” Interestingly, this does not appear to jibe with the working group report in the original strategic plan. That report stated that there was no consensus on the appropriate number of faciities to meet a projected bed capacity range of 671 to 912 beds.
The facilities working group acknowledged that “the settings that may be appropriate for an individual range from institutional settings to home and community-based settings. Moreover, citing the Olmstead Supreme Court ruling, the working group acknowledged that three criteria apply in deciding whether to place persons with mental retardation in community-based settings rather than state facilities:
1. State treatment professionals must determine that such placement is appropriate. (In the A.T. case, you may recall, treatment professionals had opposed her removal from Fernald and placement in the community-based group home.)
2. The individual must not oppose a community placement. (A.T. told several people she did not want to leave Fernald.) Moreover, the working group “assumed DMR would respect the wishes of the current facility residents…(and that) facility residents who oppose a community placement will not be involuntarily moved to a community setting.”
3. The state can reasonably accomodate the placement, taking into account the resources available to the state and the needs of others with disabilities.
There are a number of other interesting findings by the facilities working group, as reported in the working group report:
- Between 1999 and 2001, there were 56 indivdiuals referred by DMR staff to state facilities for short and long-term stays because they had severe medical or behavioral conditions or forensic involvements.
- Factors that had resulted in referrals to the state facilities included the specialized services available there, “multiple unsuccessful community placements,” a security threat caused by some individuals to the community, and cost. Yes, cost. The working group report stated that referrals occurred when it was determined that the individual's “identified needs would require a constellation of services, the cost of which would be as much as, if not more than, the average cost of institutional care in a DMR facility.” [emphasis added]
