Confused? So were we. Were the administration's savings projections when it announced the plan to close the four facilities really off by between 75 and 90 percent? And what was Dr. Bigby actually referring to when she said in December that the savings would be $80 to $85 million?
I called both DMR and EOHHS on Monday morning. I was referred by the EOHHS press office to Jean McGuire, assistant secretary for health and human services. I've emailed the questions above to her. No one from DMR has gotten back to me.
The administration's latest savings projection of $40 to $42 million over four years is included in a report titled “DMR Community Services Expansion and Facilities Restructuring Plan.” The report is dated February 25–meaning it was completed more than two months after the administration announced its plan to close the facilities.
It's difficult to interpret this “Facilities Restructuring Plan” because while it contains a chart with projected savings over four years in closing each facility, it doesn't explain the savings in any way. (Actually the chart shows the savings as occuring over five fiscal years. Well, whatever.)
Presumably, these savings projections were derived by comparing the cost of continuing to operate the four facilities with the projected cost of placing their 895 total residents in other locations. But while the report lists annual budgetary costs of the four facilities totaling $164 million, it doesn't list a total cost of placing the facility residents elsewhere. It's sort of the equivalent of getting a $500 bill from your muffler shop, with no breakdown of the labor or materials costs, and being told to trust them, you're saving money.
And that's not the only projection that is disturbing or lacking foundation in the DMR report.
Consider these projections in the report: Of the 162 residents remaining at the Fernald Developmental Center (which is slated to be closed next year), 83 will be transferred to one of the two facilities that will remain (either the Wrentham Developmental Center or the Hogan Regional Center). Of the 314 residents in the three other facilities slated to close, only one resident (that's right–one) will be transferred to Wrentham or Hogan. The rest will be transferred to community-based residences.
This from an administration that promised in December that everyone who wanted to would be able to transfer to another facility. Here's the quote from Dr. McGuire in December:
A crucial part of the proposal (to close the four facilities) is the assurance that families and guardians who wish for their loved ones to remain in an institutional setting will continue to have that choice.
Apparently not. There are apparently only between 84 and 96 beds in total that will be available at Wrentham. Eighty-three Fernald residents are apparently already going there. Hogan appears likely to be next on the closure list. That's why the latest DMR projection is that only one person from the three other facilities now slated for closure will be going to another facility. So much for the assurance back in December that everyone would continue to have the choice of facility care.
But that's not really a surprise considering this administration's general record of credibility on this issue. Up until December, everyone was being told that there were no plans to close any facility other than Fernald.
In sum, the administration has produced a facility closure plan that:
1. Was dated two months after the closures were announced;
2. Is internally inconsistent (it says the projections are over four years in one place and five years in another);
3. Has no supporting analysis or explanation for the savings projections;
4. Has residential placement projections that are at odds with previous assurances about the availability of facility beds; and
5. Projects the cost savings in closing the facilities that appear to be much as 90 percent lower than what the administration had projected just two months previously.
Yet, somehow, we're supposed to trust that this administation knows what it is doing in altering the lives of hundreds, if not thousands, of the most profoundly retarded residents of the commonwealth.
Isn’t it amazing how the states projected savings numbers just continue to go down. It is just further proof of what we have known all along. There are no savings associated with their plan. I use the word plan loosely. I also believe that the value of what they are really after, the land the Fernald occupies and the windfall from the sale, has continued to drop with the current decline in real estate values. I think it time for the state to re-examine their policy and inject a little common sense into the equation.
<
p>This “plan” is ridiculous. The Governor is arbritrarily displacing 476 people with a promise of facility care for all. My math computes to 393 people with no place to call home that meets their needs. The result–everyone suffers under this plan.
<
p>While Wrentham is currently providing good services to its current residents I have to wonder if they can maintain that level of service to a significantly larger population. If a guardian ops for the Hogan facility, they will more than likely put their family member through an additional trauma of an additional move in a few years.
<
p>What about the 393 other people that will be forced into an already overloaded community-based setting, regardless of needs, because there is no facility care available. Individuals already living in the community will also suffer the consequences of the “Plan”. Staff will be overworked trying to provide care for individuals they are not equipped to deal with thus diminishing services to all.
<
p>What about the individuals who are and have been waiting for services. They will just be bumped further down the list. Under this “Plan” I guess they will just have to wait.
<
p>Good grief!!!
-If the State wants to save money then they should sell 75% of the land at all the facilities and leave 25% to the residents that want to live in their home. How does this Governor think he is going to save money….closing the facilities is not the answer…It is going to cost millions of dollars to evict the most vulnerable people in the State ….and ssurette is correct, individuals on the waiting list might as well just give up…they will never receive the services they need! Plan…DMR makes up their plan as they go along! There is no real plan that makes any sense.
This is happening in my area too, and will have an impact on our town. Thank God we have Connecticut to turn to for jobs. I wonder if Gov Patrick ever considers how many Massachusetts residents work in Connecticut, especially those of us in Southern Central and Western MA. Which means we pay Connecticut State income tax, which means less tax receipts for Mass. You know, I’m really getting worried about Central/Western MA. Jobs are really hard to find. Businesses are closing everyday here. Does he even know? Does he even care?
As he can hire his friends. I defer from my rantings against you democRATs for a moment. Check the governor’s list of political contributors. I think you may find contributions from owners of these community residences. There’s gold in those thar places.
I now return you to my anti-dem rants. Social Darwinism! Again.
Change bears the burden of proof.
<
p>How many promises of change have we heard over the pass bunch of years, yet, no follow-up. I’m not saying there’s no change but rather there’s no accountability, or accounting for the results of the change.
<
p>Commonwealth Corp. What was it supposed to do, what did it do, then it vanished in a budget cut.
<
p>Transport reform. What’s the goal here, to make the trains run on time, increase capacity, increase ridership, spend less, cut costs. Such fuzzy goals but large rhetoric.
<
p>Pension reform. Make it fairer? Could that be less clear. Cheaper, increase funding. Give me a roadmap for crying out loud.
<
p>This thread is about decentralizing of institutionalized mental health. Was the goal to save money, because if that was the goal, things couldn’t be less clear that it happened or will happen. If the goal was to provide better service to patients, then that appears to be missing from the cost/benefit discussion.
<
p>I don’t know squat about mental healthcare and institutionalized medicine, and from reading the various threads, that’s not the point. The point appears to be “our way will save money”. Frankly, when the State seeks to change a program to “save money” I know that’s an alternative reality. Save money is secondary, but the real reason for the change is vague. Wonder why. Whatever the reason for the change is ought to be topic then i) did the change accomplish any measured improvement and ii) did the change save costs. Absent that, this is just another reorganization boondoggle.
I agree with you Gary!
<
p>I used to coach debate. The affirmative case has the burden of proving the need for change. Another aspect of the affirmative case is demonstrating that the plan will actually effect the change proposed (in this case save money while not harming people in these facilities).
<
p>The governor may have gone to law school, but whatever argumentation skills he learned there have not transferred to his governance. He has yet to present a case clearly to the populace on any issue. His book will be an interesting one to read.
<
p>I don’t doubt the governor’s intentions, but I have serious qualms about his competence.
A thorough and independent analysis of facility/community costs has to be undertaken because once the facilities are closed and the land sold, the buildings razed and the MR professionals scattered- those resources are gone for good. And speaking of the land…watch “who gets what.” In the past, it has always been the politically hard-wired making out on these deals.
<
p>All you business majors out there – how are supply chain cost savings typically realized in governmental organizations? Economies of scale or in fragmented fiefdoms each managing their own purchasing? The latter only works when costs are off-loaded somewhere else, ie food stamps, Medicare, Medicaid, Section 8, fire, EMS, police, etc. At the end of the day – these are all taypayer costs, costs that never wind up on an income statement or balance sheet. That needs to stop; we should be unafraid to learn what the true federal/state/local community costs are.
<
p>Please don’t get me wrong – I am not suggesting that social services be run entirely like a business, but what we have going on in this state is a systemic avoidance of real management principles. This is AWOL management. How else to explain the bologna being peddled as cost analysis?
<
p>How about some oversight? In 2004, the Patriot-Ledger ran a series of stories called ” The Retarded at Risk,” citing deaths, med errors, abuse and neglect. It cited at 56% increase in abuse complaints over a five-year period. It decried the lack of accountability in the DMR, and the underfunding and staffing at the DPPC, the agency that is supposed to investigate. How much do you think has changed since then? This was fully seven years after the Raynham incident, where 2 men with MR were found in horrific conditions and there were promises of “change” by the DMR. Change? I wonder where we’ve heard that one before?
<
p>It has long been advocated that the facilities could be used as HMOs for people with MR, while providing residential and medical care for people with the most significant disabilities, small number who actually need ICF-MR care. The Globe wrote an editorial supporting in as far back as the 1990s. But this commonsense approach has been ignored, primarily because the lobbyists for the vendor groups have been very successful in keeping this off the table.