Overview
The Glavin Regional center has provided expertise in the areas of psychological, pharmacological and psychiatric supports of individuals with self injurious behaviors, mood
disorders and other mental health issues, along with providing residential supports for more than 50 people, the Center manages four group homes and acts as a regional resource center for many DMR patients throughout the Commonwealth.
Based on FY 08 data
Census at Glavin: 56 (an additional 7 Medicaid reimbursable beds left vacant)
Census at Lake Street community group homes managed by Glavin = 15
Total= 71Total Budget: $10,371,997
Revenues collected: $7,523,182 (includes Medicaid reimbursement, etc.)
Charges for Care: $293,846
Cost to the Commonwealth (budget – revenues collected-charges for care=$2,554,969
Average cost to the Commonwealth per person: $35,985Notes:
a) layoffs/unfilled positions since FY 08 reduce the budget
b) costs do not include community suports, for example, Tufts Dental program, use of building for UMASS Early Intervention, soccer fields, sale of land along Rt 9 in 2004, etc.)
c) Higher direct care staffing required in group homes than Glavin (1.8 vs. 2.7)
d) Last two placements into community cost approximately $200,000 each.
So…if the actual cost to the Commonwealth is $35,985 per person…why is DMR Commissioner Elin Howe insisting that the cost is $183,000 per person?
Additionally, Commissioner Howe isn’t telling the legislature how adept federal and state governments are at attaching liens to the estates of disabled people in facilties. These estates can be comprises of SSI benefits, inheritances, etc. with significant funds in them. That’s another offset to cost.
Another dirty little secret is that the land and buildings are part of DCAM’s budget…so any sales of buildings and land will not be returning to DMR/DDS. They’ve been peddling this fairy tale for years to people on the waiting list and it’s nothing but a myth. And the money attached to each of the residents follow them…how how is it there will be money saved…much less available for the waiting list by closing the facilties and then building new group homes for the service providers???
Please call your senators and ask them to support the language in line item 5930-1000 for the feasability study. It’s time to for the DMR/DDS to be held accountable for the fairy tales they’ve been telling all these years.
Thanks for the numbers and thanks to the former Glavin superintendent for his analysis.
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p>Considering the expertise and level of services provided, sounds like a bargain to me.
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p>Somewhere along the line I learned that 39 of the 56 (70%) people that call Glavin home were formerly in community based homes and the situations were unsuccessful.
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p>I’m not sure how the DMR/DDS is supposed to convince us that forcing them back into the community is “in their best interest”.
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Justice4All posting presents an excellent explanation of the Commonwealth’s cost to care for a developmentally person at Glavin. The former Glavin superintendent tried to present a similar analysis at the joint information hearing of the Joint Committee on Children, Families and Persons with Disabilities and the Joint Committee on Mental Health and Substance Abuse on May 12, 2009, but the superintendent was a victim of the selective enforcement of the three minute rule on testifying.
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p>I was one of the last persons called to present testimony and heard several outrageous comments.
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p>The DMR/DDS Commissioner said the decision to close four and eventually all the developmental centers and was philosophical decision and not a budget decision by the Patrick Administration.
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p>Most community advocates from the provider supported organizations miss the point that a very small percentage of the total number of individuals who receive DMR services are eligible to receive care in a developmental center like Glavin, Monson or Fernald based on today’s Social Security Act Title XIX standards. Their degree of mental retardation and medical complications do not meet the Title XIX requirements. The cost to provide services for a qualified Title XIX individual is higher than a mildly retarded individual. The Commissioner’s constant comparison of the alleged costs to care for an individual in a developmental center with the Department’s average cost for all the individuals served in the community gives the community advocates the false hope that if the developmental centers are closed, the cost to provide the services will go down and there will be surplus money for the services needed by their loved ones.
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p>One 30-something community advocate berated developmental center parents who were protesting the relocation of their children to Wrentham as being too cheap to buy the extra gas needed for the hour plus longer drive required to visit their children when they are segregated to Wrentham, the last developmental center proposed for Massachusetts citizens who need ICF/MR services. He misses the point that the average developmental center resident’s age is 58 so the parents are 80 plus. Economics is not the parents’ main concern; it is limited night vision and limited reflexes needed to drive. I wonder if the 30-something advocate will remember this in 40 years?
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p>Governor Patrick and many other persons miss represent the Supreme Court Olmstead decision and the Americans with Disability Act. I recommend everyone read an unedited version of these documents and understand that all individuals with disabilities deserve to live in the least restrictive environment based on their own abilities. That means that some of us will be allowed to live in a nursing home or assisted living facility some day if our health diminishes. If the Governor is allowed to close all the developmental centers which provide services based on Title XIX for individuals with mental retardation and is successful in closing a pediatric nursing home in Groton whose residents are all mentally retarded, maybe someday the Commonwealth will close all the other nursing homes and assisted living facilities before some of us need them.
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p>Several parents brought some very medically challenged children to the hearing and vowed never to place their children in a developmental center. My concerns are what services do they plan to ask for in 40 years, when they cannot be the primary caregiver? Do they understand that the round the clock nursing and other DMR services that they receive today were not available to parents in the 1960 and 70’s?
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p>A developmental center is not a correctional institution where the residents never leave the facility for any reason. A developmental center is similar to a retirement or condominium community where residents come and go as necessary to enjoy all the values of life.
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p>Mav
mav–very well said.
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p>I attended the committee hearing and witnessed the testimony of the mothers with the very medically/developmentally challenged children. I know they brought their children in for shock value–one picture is worth a thousand words. After all they are fighting for their children’s lives–I get that. I understand and empathize with their fears. However, they have focused their efforts on the wrong enemy.
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p>I also witnessed the berating of development center parents, which angered me, who are they to judge, but back to my point.
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p>They DON’T KNOW that the services they receive were not available in the 60’s and 70’s. They aren’t old enough (they looked 30ish to me). They have no clue what that battle was. They have no idea what it is like to have no help and no options. They only know the fear of no help. If they had a clue about the history, they wouldn’t be so judgemental of those that fought the battle for what they now have.
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p>Their only contact with DMR/DDS has been through the various advocacy groups and private-providers. The ones that have the most to gain by facility closures. These are the organizations that have pitted the disabled against each other by instilling this fear and misinformation. And apparently the administration is on board with that.
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p>I also had the same thought about what they will remember in 30 or 40 years when our great system of care has been dismantled and they require more extensive services that no longer exist.
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p>They need to realize we are advocating for ALL-community and development centers–now and in the future and that there is more than enough room for compromise so that all are served.
It is written:
Put me away in an institution against my will and not let me out even though the opportunity arises and I’d have self injury behaviors as well. Oh wait … but these individuals’ lives have no value right? There is so much about the brain we do not know…if one cannot express him/herself it is determined that the person cannot understand. So much ignorance in this world. Who are we to take what belongs to God and stash away where no person without a disability would dare live?
Segregation still exists in the school districts with increase # of substantially separate classrooms. It scares me to think what the future holds for our children who do not speak verbally and are not given the tools to communicate.
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p>This really isn’t about a person’s life … it’s about fear of change, loss of control and paychecks.
Please. This shopworn ideology has far too many miles on it to have much traction here, Mama Di.
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p>The facility families (and a lot of the Boulet families) recognize that centralized service delivery models – you know, like the ones on college campuses, over 55 residences, assisted living and the like…work for their loved ones. Are we segregating older Americans by allowing them to live as they choose in a centralized service delivery setting? Of course not! Is Brooksby Village a segregated residence?
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p>No one is at the facilities against their will; those days are long gone and you know it.
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p>So let’s take a look at your BS, shall we? Who isn’t being given the tools to communicate? The residents at the facilities that have access to speech therapists and adaptive technologies – or their community living peers who may wait months for an appointment?
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p>Fear of change? Damn straight. You want to push medically fragile, profoundly disabled people out of a medical model that works…for a broken community system with very little oversight.
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p>Loss of paychecks? Well, there are some that might find the closure of facilities an anti-state worker, anti-union thing. And it is…this is all about the already wealthy service providers getting the contracts. Care to guess what the CEO of Vinfen makes? More than $500K in 2007, more than twice what the governor makes. I would suggest that its the service providers looking for the big payday, who really pay their workers a pittance and have huge turnovers as a result….and not the union workers of the state.
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p>This indicates just how ignorant you are:
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p>You are aware that there are community group homes at Glavin, right? That there are women’s homeless shelters at Fernald? You know that Fernald hosts Tufts dental, Adapt (adaptive technologies), physical therapy, occupational therapy, respiratory therapy, and psychiatric services? And that the community – including the able-bodied, use the pool, and playing fields?
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p>And you know what really cracks me up? There are private service providers that have the same model – there’s one in Plymouth. Where’s the outrage and concern?
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p>So, what’s your stake in this, Mama Di? Is it your paycheck that you’re worried about?
The state pays for Medicaid and is reimbursed for 50% of the costs, so wouldn’t all of the $7.5M be part of the Medicaid budget and therefore half of it be an actual state expenditure?
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p>That would make the $35K an additional expense for the state above Medicaid expenses. There’s also the question of Medicaid reimbursement towards institutions versus community based services. Would the Medicaid payments for these same people be less in a community versus at the Galvin? If so the savings to the state would be the $35K plus the reduced Medicaid spending.
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The 7.5 M includes what the state has to pay towards Medicaid. And in most situations, community residential services, unless ICF-MR based, or similiar, aren’t Medicaid reimbursable. Not that it’s compelling argument to place ALL people with MR into state facilities; it’s not. The argument is to allow people who need that level of care to keep it, because the state costs aren’t so exhorbitant as Commissioner Howe is making it out to be. Hence – the request for a study. It’s the Mack truck to roller skates cost comparisons that are hurting the analysis.