Early this year, we reported here that the administration was projecting it would cost $1.88 million to renovate the Wrentham buildings to accomodate some 60 former Fernald residents. That $1.88 million is still listed as the cost of the Wrentham project on the state's supplies and services procurement website, known as Comm-PASS. No updates have been posted to the Comm-PASS website regarding the Wrentham project since last January.
Since January, the state signed a $2.49 million construction contract for the Wrentham renovations, paid a design fee of $133,000, and committed an additional $512,000 for change order contingency costs, according to a document provided by the adminstration under the state Public Records Law. Those are among the costs that have contributed to a total project cost of $3.2 million.
The Fernald Center is the first of four developmental centers the administration plans to close by the end of Fiscal Year 2013. The plans called for closing Fernald as of last June 30. However, that closing has apparently been held up by administrative appeals filed by between 15 and 20 guardians of remaining residents. As of last week, about 20 residents were still left at the Center, down from more than 160 as of March 2009.
The Fernald League has fought the developmental center closures as have most of the families and guardians of the residents, arguing that moving those residents out of their long-time homes would not result in equal or better care for them.
The administration has made the cost-savings issue central to its case for closing Fernald and the other developmental centers. However, the administration has issued conflicting savings projections for the closures and has successfully opposed legislative attempts to require a cost-savings analysis of the Fernald clsoure.
In its Facilities Restructuring Plan, which was issued in March 2009, the administration projected that closing the four developmental centers would save a total of $41.9 million over a five-year period, from 2009 to 2013. However, just a couple of months before that, Secretary of Health and Human Services JudyAnn Bigby contended that closing the four centers would save $80 to $85 million per year.
The Fernald League has long disputed the administration's various cost-savings projections, arguing that they are at best based on a comparison of the average cost of care in the community system with developmental center care. The developmental centers serve a population with much more profound mental retardation and medical issues than the average community-based population. In addition, the administration's cost savings do not appear to factor in certain costs associated with the the developmental center closures, such as renovating and constructing new facilities for the former residents.
Certainly, the $3.2 million in renovation costs at the Wrentham Center represents only the first round of those costs at Wrentham if, as is likely, residents of the three remaining developmental centers marked for closure choose to move to Wrentham.
As Kevin Walsh, the lead author of a study of institutional versus community based costs in the Journal Mental Retardation, stated in 2009,
…when certain costs disappear, when individuals are transferred from ICF/MR (developmental center) settings, it is highly likely that these costs will reappear in other state budgets (such as Medicaid). In nearly all instances, this is almost unavoidable. In short, costs don’t just disappear when individuals are moved.