It’s not about civil rights. He’s all over that map. It’s not about the rule of law or court settlements. It’s not about getting people out of large institutions, since the child and adolescent funding is designed to keep them at home as much as possible. Without it they get stuck in locked adult wards, stuck kids in inappropriate hospital settings. It’s not about preferring older people or minorities, since he is split on the elderly people with developmental disability, and takes the most negative position on the children and adolescent mental health situation — where demographic changes in the state mean that the highest proportion of minorities are being shortchanged.
It’s not even about the money, since the Fernald closure is supposed to be “revenue neutral,” and the Rolland Settlement funding is about triple what he vetoed out of the Rosie D. budget.
It’s not about triage, because many of the people with developmental disability are arguably safer where they are, whereas the children and adolescents with untreated mental illness are a serious risk to themselves and others.
It’s not even about choosing among disabilities, since his budgets which shaped the legislative budgets contained other through-the-bone cuts on both developmental disability (day and respite programs for people living at home) and mental health (clubhouses, really everything for adults but housing and Medicaid matches).
My involvement in these issues really limits my politically acceptable vocabulary for mental failings, but knowing that the governor’s advisors are reasonably well-versed in these issues — other than perhaps Secretary Bigby — I have to think that he is really acting like a… clod! If any of the three potential challengers could get a grip on these issues… the disability community is not huge but we are very highly motivated and spread throughout society, and we have a lot of friends.
By way of disclosure, I am a communications consultant to the Fernald League for the Retarded, Inc.
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p>This administration has no coherent approach to the delivery of human services in Massachusetts. They preach “community first,” and then they cut the community residential budget. They laud personal choice and they involuntarily move people out of institutions in which they have chosen to live. They talk about how sensitive and reasonable they are and they refuse even to negotiate over a proposal to scale back the Fernald Center in order to keep it open.
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p>The only thing that is consistent here is the philosophy that the private sector can deliver human services better and more cheaply than the public sector can. If that’s their belief, why are Secretary Bigby and Commissioner Howe in government to begin with?
Better not tell too many people, or your organization will end up on the attack list of the Deval Patrick campaign, the way the zoos have.
I will find the person’s address and post it.
It will be nice to be helpful for once.
I found it.
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p>morethanable@yahoo.com
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p>Actually, if anyone does have a disability question, I could probably help too. I have been through the system.
other priorities. He’s not engaged in doing the right thing in terms of providing services for people with disabilities. I think this is very calculated. He appointed two service providers to run disability agencies. Their war cry is “community first” – and they then proceed to close down state operated services. Elin Howe is from the Columbus Group, which consults with states on provider options..and she’s also working in NJ, as a court monitor on two consent cases. Some might call that double-dipping, but others might just call her “busy.” It’s a nice gig.
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p>So this is what Mr. “No More Business As Usual” has given us. He fires Commissioner Morrissey, a local guy with years of service in DD, and brings in a outside service provider whose job is to consult with state about provider options. No conflict there!
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p>You know what they same – fool me once, shame on you. Fool me twice, shame on me. I won’t be making this mistake again.
Justice4All, you, Moe and others have made some great points. In fact, we have all spent months pointing out the conflicts of interest in this administration’s efforts to destroy the existing federally regulated level of care for the mentally retarded in Massachusetts.
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p>I think we have punched a lot of holes in the arugments that closing the state facilities will save money and that one size fits all. (The Legislature must agree with us to the extent that they approved a cost-benefit analysis requirement in closing the facilities, although they left Fernald out of it.) But what I don’t understand is the continuing indifference to this. As Ssurette pointed out the other day, few people other than those directly affected by the closings tend to comment on these posts. And overall political assessments on BMG and elsewhere of the job the governor is doing never mention this issue.
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p>I’m not talking just about Fernald. I’m talking about privatization and de-institutionalization in general. It never comes up other than when we discuss it. I don’t get it.
…I don’t comment on things I don’t know much about.
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p>My real reason for commenting here though was to seek clarification on “existing federally regulated levels of care”. If there are federal requirements for these things then why is it even an issue? Doesn’t sound like the state has a choice anyway if I’m interpreting this line correctly.
The federal requirements apply only to the state facilities in Massachusetts.
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p>These requirements are spelled out under Title XIX of the Social Security Act, and they apply to the Fernald Developmental Center and other Intermediate Care Facilities for persons with mental retardation (ICFs/MR). Meeting those requirements for staffing and care qualifies the ICFs/MR to receive federal Medicaid funding.
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p>However, federal law allows for a waiver of the requirements for “community-based” group homes. The waiver allows those community-based facilities to qualify for Medicaid funding without meeting the same stringent requirements that the ICFs/MR must meet.
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p>That’s why the Patrick administration wants to get rid of the ICFs and operate completely under the waiver. That way, all of their community-based facilities will still qualify for Medicaid, but they can get away with less staffing and treatment. Our point is that while this may work for people with mild levels of mental retardation, it won’t work for the populations in the ICFs, whose mental retardation and medical issues are much more profound than the average level in the community system.
The reason you don’t get other people to comment on these threads is because you just say the same thing over and over. You support the facility and you attack community programs.
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p>Some community programs are excellent and have been serving the same population as Fernald serves for years.
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p>And despite what some of you say most of us are not in it for the money.
I’m not against community programs. I think some of them are excellent. But our point has always been that not all of them are excellent and that community programs don’t work for everyone. The community system, moreover, has many problems, such as poor training and high turnover of staff and inadequate oversight. In pointing out those problems, it doesn’t mean I’m attacking the system. I’m simply pointing out undeniable facts about it.
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p>What I was trying to explain in my comment above is that the federal staffing and treatment requirements for state ICFs are higher than those for community-based residences and that’s why the administration wants to get rid of the ICFs.
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p>Let’s be clear about this. We are not against the community system. We think both ICFs and community-based care is needed and that people should be able to choose between the two. It is the community advocates, such as yourself, Lynn, who want to elminate the ICFs from that choice.
One day it was an ICF and the next day it wasn’t. The clients were the same people. When it was an ICF we had the required PT, OT, SLP, nursing, pysch, social workers, etc. as part of our team. They came to the house, they treated the clients in the house. When the house switched from an ICF to a DMR provider house we lost all the consultants. We then had to help the clients get the services in the community. It was not that big a deal.
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p>I serve clients who have left Fernald. They are doing very well.
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p>There is nothing magic about the ICFs or Fernald. All but a handful of people would do well elsewhere. Change is hard.
No big deal. No big deal when group home caregivers and their community doctor don’t recognize the symptoms of a lithium overdose.
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p>http://www.southofboston.net/s…
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p>No big deal when the group home fails to fill a prescription, and your loved one with a serious seizure disorder falls ill and dies.
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p>No big deal when the less-than-well trained staff or those lacking English proficiency make med errors…and people die.
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p>http://www.southofboston.net/s…
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p>No big deal when there’s so little oversight…and the people who are abused find there’s no justice. And their abusers keep getting jobs in the system.
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p>http://www.southofboston.net/s…
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p>And no big deal that the lack of a decent pay creates an incredible turnover rate….and the inconsistent care. Click the link on the left, called “workload up, staffing down” Notice how abuse goes up.
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p>http://www.southofboston.net/s…
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p>No big deal. I have no doubt,Lyn, that you believe what you write because of your experience,but please read all of these articles and then tell us “no big deal.”
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p>
Bad things happen at Fernald too.
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p>Med errors happen in hospitals.
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p>The “less-than-well trained staff or those lacking English proficiency” you complain about work a shift in the community and then go back to do their shift at Fernald. It is the same staff.
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p>The average length of stay for my staff is 6 to 10 years. I have a handful that have worked for 25 years. There are staff at the state schools who I wouldn’t keep for a day that have been in their positions for years. I have a staff who has worked for my agency for 25 years and at Fernald for the same time.
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p>I know some people have had bad experiences in the community but that does not make it all bad.
But for the multiply handicapped, and medically fragile – an ICF-MR is an appropriate level of care that these families chose for their loved ones, because they need that medical model. It’s wrong to substitute judgment for people who know what’s best. I have to believe that you wouldn’t want anyone telling you that they know better than you what’s right and appropriate for your child. And yet, that’s exactly what’s happening.
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p>At the ICFs, we have nurses and doctors overseeing medication…we don’t have med-techs. It’s the medical model.
the doctors and families should be the judge of that – not service providers like the ARC.