1. The administration still has no plan that we have seen to accomodate the thousands of people with developmental disabilities in Massachusetts who are waiting for residential placements and care in the community system.
The administration's "Community Services Expansion and Facilities Restructuring Plan," which is the only plan we've seen for the future of the DDS system, projects the development of only enough new beds to accomodate residents of the ICFs slated for closure. As we've said before (but it seems to bear repeating), this administration seems to have put all of its thought and energy into one thing when it comes to people with developmental disabilities — closing state ICFs and ultimately privatizing their services.
2. The community-based group home system is broken. (This follows from Point 1 above.) Even the Arc of Massachusetts and its member human service vendors acknowledge that continuing budget cuts have decimated supports and services in the community system.
In a joint statement, the Arc and the Association of Developmental Disabilities Providers have noted a "pending loss of residential and day services for hundreds of Commonwealth citizens with developmental disabilities" due to the cuts.
Both the Arc and the ADDP have also previously stated that the administration's ICF-closure plan will not work unless adequate funding is provided to the community system. We couldn't agree more. But Commissioner Howe continues to move at full speed to close the facilities, despite the continuing lack of resources available to upgrade the community system.
We think it would be a better use of taxpayers' money to downsize the current ICFs to better match their current populations — rather than close them — while continuing to take advantage of the centralized services and economies of scale that those facilities offer. That would allow current ICF residents to stay in their longtime homes without competing for limited space available in the community system. But then again, that's not Commissioner Howe's job. She was hired to close the ICFs, period.
3. Closing the four ICFs appears likely to result in further expansions of at least one of two remaining ICFs in Massachusetts. That's because the administration has promised in the Facilities Restructuring Plan that residents of the four ICFs slated for closure will have "choices regarding where they live, including opportunities for community or facility placement" (my emphasis).
Almost all of the Fernald residents have chosen to move to the state-run Wrentham Developmental Center or to state-run, community-based group homes, if they are not appealing their transfers altogether. They want no part of the vendor-operated group homes in the community system. (We understand that about 15 Fernald guardians have filed administrative appeals of their transfer notices.)
At the Wrentham Center, two buildings have been renovated to accomodate more than 60 Fernald residents. But what about the roughly 200 residents who remain in the three other ICFs marked for closure over the next three years? No doubt, most of those residents will similarly choose to stay in state-run ICF care when they receive their eviction notices. It appears the administration will have to expand Wrentham further to accept them. Wouldn't that fly in the face of the administration's philosophical opposition to institutional care?
4. The closures of the ICFs are not saving money. Last year, Secretary of Health and Human Services JudyAnn Bigby asserted that the closures of the ICFs would save the state $85 million a year and that $45 million of that savings would be put back into the community system.
However, in his proposed budget for the current fiscal year, Governor Patrick increased community-based funding by only $2.7 million, or less than 1 percent, and cut the line item for ICFs by 7 percent. In the final FY 2011 budget, community-based line items still ended up with less than a 1 percent increase in funding from the previous fiscal year, despite the phase-down and near closure of the Fernald Center.
By the way, we reported here earlier this month that the Mass. Taxpayers Foundation and the Boston Foundation appeared to be relying solely on the administration's cost projections in recommending to the administration last month that all six ICFs remaining in Massachusetts be shut down.
We noted at the time that all that was available on the MTF's and BF's websites was an executive summary of their joint report and recommendations, which was issued on June 30 and picked up by The Globe. As of today, nearly a month after the executive summary was publicly released, the full report is still not yet available on either the MTF or BF websites.
I agree–downsizing is the way to go. Bigby and Howe both recognize the expediency of consolidation–that’s why they’re consolidating offices and services for increased efficiency that results from centralization!
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p>So much for the dignity and self-determination they talk about.
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p>And then there’s the reductions in disability services and personnel while at the same time having plenty of dollars for private vendor compensation in the hundreds of thousands of dollars!
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p>Hmmm…
Over and over, those who neither vote nor donate are left like dying fish gasping in a drying streambed.
When I go to hell, I will see them there. I will at least get a chair to sit in for all eternity, they will be forced to stand.
As a Fernald guardian who is appealing a transfer, I couldn’t pass up the opportunity to give my perspective.
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p>I’m not sure how good she is at her job–seems to me almost anyone could do what she is doing when you have the full political power of the governor clearing the path for you.
Remember this governor fell all over himself to provide budgetary relief for the zoo new england animals but won’t even consider a compromise or reasonable accommodation where the lives of the elderly, severely mentally retarded and physical disabled people of Fernald are concerned. What the heck, just evict a man who is 98 years old and has lived at Fernald since he was 7. Don’t worry, the zoo animals are ok! Who couldn’t get the job done with that kind of backing. The way I see it, the toughest qualification for the job is having no conscience.
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p>She does have some successes. She did side step a true feasibility study that the legislature asked for. The taxpayers will never be hip to the racket that is the vendor provided system of care. She has managed to scare 100+ people out of Fernald, against their guardians best judgement. She has a couple of hundred more guardians scared to death about their family members futures. Somehow convinced people who are desperate for assistance that the community first plan (that has no real future planning) will provide for them. And somewhere along the way the memory of what the system of care was like when the state was completely in control has been erased. I guess she is pretty industrious after all.
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p>So where are we? The first objection is about to be heard before a magistrate. I have sympathy for this poor magistrate who I can only guess is trying to figure out how he got this mess dumped in his lap. The first hearing was to address a couple of hundred page motion to dismiss from the DDS. No ruling has been issued yet but the DDS is pushing for other appeals to proceed—I’m not exactly sure how that works when you haven’t got past the first motion.
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p>People are being moved around like they are chairs. There are reports from the other facilities (good and bad). Staff are weary. Guardian’s are frustrated. Staffing levels are at minimum (in some cases less than minimum). Our family members are caught between a rock and hard place and beginning to feel the effects.
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p>The battle continues–stay tuned for the next installment.
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p>The whole phonie bunch (governor, secretary, commissioner) should be run out of town on a rail.
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In response to the post from the Dave from HVAD on behalf of the Fernald League, I could not agree more. The report from the Mass Tax Payers and Boston Foundation is full of questions that nobody wants to answer. Both organizations are very well respected espically the Boston Foundation in the non-profit arena, however, there are many points in the Executive Summary that are clearly “one-sided”.
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p>As for the DDS budget, as you begin to analyze it you see very few line items getting an increase and most being decreased. With the exception of of one line item. The Administration & Operations line item is recieving at least 1.7 million to 6.8 million increase from FY-10 depending on whether Massachusetts recieves the 600-700 million in FMAP money. If the FMAP money is recieved then the line item will recieve the larger number.
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p>Not sure what others think but this is very disturbing to me. An increase in this line item represents raises for the Central Office management and staff. Please note: there are some Central Office people who deserve a raise, but during these economic times and the fact that other DDS line items have lost funding and there is a waiting list for services it seems to me that any monies should go to the direct care of the individuals and familes who need it.
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p>Dave mentions that the communuity system is “broken”. I agree with him. The level of saftey for an individual with DD in the community which includes ST OP group homes and vendor operated group homes is at least 30% more dangerous than the six Developmental Centers, (that Commissioner Howe and our “short sighted” Governor Patrick are “hell bent” on closing), according to US Attorney Michael Sullivan’s report to Federal Judge Tuaro in either 07 or 08.
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p>Over the last 10 years the budget for the Disabled Persons Protection Commission, DPPC, has been devestated by cuts. This agency is the only avenue for people with DD and their guardians to report abuse and neglect. Reports of abuse and neglect to DDS fall into a giant black hole. I have worked with many families who have reported to DDS Area Directors and have been told by these directors to “drop the claim” or else. The “or else” is loss of services or transfer or shutting down group homes if there are too many compalints. Several years ago my brother was the receipant of retaliation due to a compliaint my parents filed against a staff person.
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p>If the plan to move everyone into the community continues then the Department has to make it a safer place. There has to be a huge increase in the DPPC budget so that they can investigate the 35% of the claims that they are mandated to do not less than 4% whch they are doing now (through no fault of their own). I am sure that many parents, guardians and clients will agree with me once the complaint is sent back to the DDS it is lost or “no fault” is found, but we know the truth!!!
…before the tragedies that ARE coming hit the press and precious vulnerable lives are destroyed and crippled.
This situation has so many different angles that should be investigated.
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p>I guess the real question here is how do you get someone to do that? Does it take a tragedy before someone notices?
Two children died. THEN where were hearings and a revision of the foster care statute – not that changing a department’s name from Department of Social Services(DSS) to Department of Children and Families (DCF) “fixed” an agency with almost uncontrolled discretion due to poorly drafted statutes and appellate decisions that stripped judges of the ability to act in the best interests of kids in state care. Also, two deaths are part of what it took to get a new Commissioner.
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p>We can hope for over sight and protection of the vulnerable without the spilling of blood. Unfortunately, all too often when it comes to the poor, the disabled, and the vulnerable it takes horrible tragedy to get over sight and any reform.
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p>People are not chairs or boxes; what ssurette is describing may well be legal – but it is not moral and this kind of callous indifference to the disabled will lead to tragedy unless someone investigates and holds those in power accountable.
I know the regulars on this thread do not want to hear this. Deb, next time we meet, give me 5 minutes to share the other side.
Long time no comments.
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p>I have never denied the fact that many people who move out of “these places” are doing well and are thriving. Good for them…I think that is fantastic and that option should always be available.
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p>But what you do not want to hear, and refuse to hear, is that for some, not all, “these places” provide the best living situation. Why should that option not be available to them.
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p>No one is forced to stay in “these places”. Community living has been an option for quite some time now. What exactly do you think the guardians’ motivations are?
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p>I know one women who has a letter from the DDS stating her son should be in one of “these places” and she can’t get the placement. And its looking like she will never get the placement. So if the DDS, the same people who are hell bent on closing these places, is still recommending these places and acknowledges that for some it is the best suitable living arrangement, why can’t you? What’s the problem?
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“people who have moved out of those places are thriving.”
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p>But you don’t say everyone in the community system is thriving. If you really do believe everyone in the community system is thriving, then you must not be concerned about the impact of the budget cuts on the system.
I’ve often said on this topic I’d like to hear the other side. Any chance you can take the five minutes you refer to and share what you have to say with everyone here, maybe as its own diary?
There are “different models” of human beings.
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p>A particular human being may need residential level of care for a time – to stablilize, post trauma for example – that is why we have the “residential option” called hospitals for short term care and should have residential options for traumatized children, inpatient medication adjustment, transition and assessment (to specify some of the situations where having enough inpatient beds is critical and not having them could be life threatening).
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p>Still other human beings need specialized equipment, 24 hour support, and present “one in 100,000” type human needs.
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p>I consider that to say that no one, ever needs residential type care and EVERYONE must be “in the community” at all times, no matter what, and no matter how stark the budget cuts and staffing reduction in those community placements are (or how high the turnover is!) is so rigid as to be either deliberately ignoring reality, or out of touch with reality.
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p>In a recent case of mine, two children needed out of home, short term residential placements for reasons of assessment and stabilization. Both are now home, but the residential assessments and med adjustments were crucial.
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p>Take the story of Haleigh Poutre, whose adoptive parent sold the idea to the Department of Social Services that Haleigh was “injuring herself” – an assessment placement to determine if those alleged “self injuries” kept occurring, in a competent residential treatment bed might well mean that Haleigh was spared the permanent brain injuries with which she must now live.
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p>Oh – and how long are the waiting lists for the “community” beds run by private providers? How much is charged, on average? How are the uninsured handled? Inquiring minds want to know.
That is the best comparison
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p>Gaebler is to Fernald as residential school placement is to community living.
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p>As to cost, it is the same to individuals at Fernald as to those in community residences. Insurance is not relevant.
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p>As I suggested before I would like five minutes to let you know a little more about a system that you are not as familiar with. The adult human service world is very different than the kid world
How about the Pine Street Inn? This is the de-facto institutions these days, LynPB. And then just this week, a woman with a history of mental illness took a bullet hours after she was released from a hospital, after her last “episode.” Our failure to adequately provide for people’s needs has costs. This goes for both the DDS/DPH systems.
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p>So let me join Christopher and others and ask you to take the five minutes a write a post about a system you claim most of us are not familiar with. As a friend and co-guardian of someone in a community group home, I know I’d be very interested in hearing what you have to say.