(Cross-posted from the COFAR blog)
State Rep. Anne Gobi (right) listens to Joan Douty (center) talk about her daughter’s experience at GlavinThe administration, which also has no time to listen to people like Joan Douty, claims Glavin and the other centers must be closed because they’re too expensive to operate. But COFAR has maintained that the administration’s claimed cost savings in closing the centers appears to be based on an apples-to-oranges comparison of the average community-based resident and the average facility-based resident. Developmental center residents are older, more medically involved and more intellectually disabled on average than community-based residents.
Moreover, as COFAR and other advocates have noted, the centralized services model of the developmental centers is highly cost-efficient when compared to the dispersed clinical, medical, and day services that characterize the community system.
COFAR has called since last year for an independent study of the cost of closing or maintaining the developmental centers because previous budget amendments have resulted in flawed analyses done by the administration itself, concluding, of course, that the facilities should be closed.
But here’s the problem. In the Massachusetts Legislature, a handful of people make all the decisions, and Rep. Dempsey is one of them. There was no floor vote this week on Rep. Gobi’s amendment for the independent study. In a closed-door meeting in his office, Dempsey simply ordered that Gobi’s amendment be scuttled. It was not included in a catch-all budget amendment boosting human services line items that will be voted on this week.
Among those who Rep. Dempsey apparently has been listening to are the human service vendors in Massachusetts, who run most of the community-based group homes in the state and who are seeking more business when the developmental centers are closed. In a letter sent to Dempsey and other legislators a day before Gobi’s amendment was thrown out, the Association of Developmental Disabilities Providers continued to pump out misinformation about the developmental centers.
The ADDP letter called for rejection of Gobi’s amendment and repeated the dubious claim that the developmental centers are “expensive and inefficient to operate.” So why not agree to an independent study which would settle the question as to which system is most efficient? To that, the ADDP letter made the ridiculous assertion that “this issue has been the subject of study for 30 years.”
Among the other pieces of misinformation in the ADDP letter was the claim that the developmental centers aren’t needed because “families overwhelmingly choose community settings for their loved ones.” The ADDP letter didn’t mention that that’s because admissions to the developmental centers have been effectively blocked since the 1980s.
The fact is that families that are being transferred from the developmental centers targeted for closure have overwhelmingly chosen to be placed at other developmental centers or in state-operated group homes. They are avoiding the vendor-run system because they know it is beset with problems of poorly paid and under-trained staff.
The Senate now remains the only real hope for this sorely needed independent cost study. We believe the study should be done by a non-governmental entity selected by either the State Inspector General or State Auditor. Once again, though, the question remains whether Senate leaders will allow such an amendment to be debated in the light of day or whether they will do what the House did and quietly kill it in the proverbial smoke-filled room.
If Anna’s parents had the same resources as the ADDP providers, and the salaries of the executives who operate these businesses, they might have more political clout to reach the likes of Rep. Dempsey. Perhaps Senator Brewer, Chairman of the Senate Ways and Means Committee, who has always been a supporter of the developmentally disabled and their families, will support an independent cost study.
Rep. Dempsey made the correct decision in blocking the Gobi Amendment. DDS is not trying to close all state developmental centers. They plan to leave open Wrentham and possibly Hogan. With very limited dollars and thousands about to lose Family Support and in home supports, how can COFAR continue to justify keeping excess state institutions open? The DDS material referenced by ADDP shows that the delays, objections and endless appeals by COFAR and its supporters have driven the cost of Fernald up to over $917,000 per person. How can this be justified as thousands of others lose service?
So, Fernald should not be used as an example in asking how COFAR can justify asking for a cost study.
As my post notes, Fernald, which is in the final stage of closure (depending on the outcome of administrative appeals). would not be included in the independent study. Whatever figures DDS is giving for the cost of keeping Fernald open have nothing to do with the study we’re asking for. (And as ssurette notes, there may be two sets of DDS figures regarding Fernald.)
The study we’re seeking would apply to the Templeton, Glavin, and Monson centers, which are in the very early stages of closure. There’s no reason to believe such a study would delay those closures of those facilities if the study found the closures to be cost-effective.
Therefore, if indeed you believe that the developmental centers are taking funds away from the community-based system, you should not object to an independent analysis of that claim.
It’s interesting, by the way, that you state that Rep. Dempsey made the correct decision in blocking the Gobi amendment. I thought we lived in a democracy in which amendments and other proposed legislation are subject to vote.
Well Dave, while I don’t agree with you about the DDS Closure plan, I do agree with you that amendments should be subject to debate, discussion and votes. The Massachusetts practice of making decisions in closed caucus is not the best example of transparency. It is surprising to see decisions made in this manner, however based upon the facts, I think the outcome on the Gobi amendment would have been the same. As people rely less and less on state institutions, how can one support keeping 5 or 6 open with dwindling populations and hundreds to thousands losing service or not getting service in the community? Do you not feel any concern about people in the community losing service because the state cannot afford to continue doing things they way they did 50 years ago? Families no longer choose institutions and for the few who do or want to continue having an institution there will be Wrentham and Hogan. Do you propose keeping Fernald or Glavin or others open forever despite the cost?
We are asking for an independent study of cost of keeping the Monson, Templeton, and Glavin Centers open. (Again, Fernald would not be part of this study.) Our preference is for a study by a non-governmental entity selected by either the state Inspector General or State Auditor.
We believe there is credible evidence to suggest that closing the developmental centers will not result in any signficant savings to the commonwealth. Do you oppose an independent study of this issue?
However, it appears the only conclusion you want is one that says that the state should keep open institutional settings. Fiscal issues are one thing, and this issue has been studied, restudied an analyzed over and over again throughout the country and VOR and others, such as COFAR, oppose the concept of closing institutions however the rest of the nation do not agree with your position. It’s not just fiscal; its’ also about the concept of serving people in local communities, close to their homes. Do we need to have 5 or 6 state institutions forever? Will you concede that at some point, we don’t need the expense of 5 institutions serving a declining population. Do you think it is right to spend $917,000 per individual at Fernald for 17 people while thousands go without service? How can you justify this?
However, it appears that the only conclusion you will say is accurate is one that says the state is wrong. Your argument, used by VOR in other states, and COFAR here at home seems to suggest institutions should be there forever. As the population dwindles, as is the case with Fernald to 17, and the cost hovers at $917,000 annually per person, how can you justify this? Thousands of people are losing Family Support Services, Respite and Day & Employment because there isn’t enough money to go around. Does this seem right to you? How long should state institutions stand when they are fewer and fewer people in them? Is there any point at which you would concede we don’t need 5 or 6 state institutions? Is 1, 2, or 3 enough? Hardline only creates hardships for people who have no service and there are thousands without service now. Should we ignore their concerns?
ADDP is an association of providers/non-profits that was formed to lobby for the providers–not necessarily the people they serve. Since they have the most to gain from the closures, why are their motives never questioned? As previously posted here, why are the huge salaries of their executive ignored? Certainly the elderly, severely mentally retarded residents of Fernald (and other residents of other facilities) have nothing to gain. In fact they are willing to settle for less, a lot less, like a reduced facility that is more efficient and cost effective to operate just to keep a small corner of their world. Bureaucrats will not consider it. The guardians of Fernald residents have chosen to take on Goliath by exercising their wards legal right to object to an involuntary transfer that puts their ward’s life in jeopardy. The only thing they are gaining here are huge legal bills, ulcers, and being villified by the likes of dcjayhawk, the ADDP, and other supposed advocates for trying to save someone’s life. Does anyone really think they would do this on some kind of whim?
Just last week, the Deputy Commissioner submitted figures, via affidavit, to the Superior Court that were vastly different than what they report this week. The DDS figures referenced by ADDP are more than double those provided to the court. How did that happen in a week? Based on the quoted figure, you’d think that Fernald resident’s were being carried around on gold thrones. Guess again.
But since were asking about the $$$$ where are they going? There is no mention that more than 2000 disabled individuals use the specialized dental facilities (Tufts) at Fernald. How exactly are those costs accounted for? Many from the community use the therapeutic pool at Fernald–it is the only therapeutic pool in the area. How are those costs accounted for? More importantly, lets hope no one has a dental problem or requires therapeutic aqua therapy. Tens of thousand were spent on one group of houses on Fernald grounds (they are real houses–not institutional buildings) in anticipation of selling it to the residents as state-operated group homes–out of 253 Fernald residents, there were NO takers. I wonder why? That option has been taken off the table, that group of houses will not be group homes, so it isn’t even available to anyone else, (like someone who has been on the waiting list for years) who might want those residences so those renovation dollars and those homes are wasted. The administration has moved more than 100 administrative people off Fernald grounds into leased offices in Waltham even though the buildings at Fernald they occupied are still open and operational in other words being heated, electric bills, maintenance, etc.–in one specific case to house two people–an operator and an administrator. New signs have been put up all over the property. Entry gates, that do not restrict entry, have been installed. I don’t see the miniscule portion of the overall DDS budget that it takes to operate Fernald while the residents exercise their legal rights as a problem when the DDS so easily squanders money. Funny how they can always seem to find the $$$$ to squander as they cut critical funding to the most vulnerable among us.
Is it any wonder why attempts to get some kind of accounting of how exactly the dollars are being spent is continually blocked? If there was nothing to hide you’d think the study would be conducted just to put an end to the debate.
Indigent defense was also gutted behind closed doors.
It would be interesting to match the providers and CEOs against OCPF records – for Dempsey and other DeLeo appointed W&M members.
We did post about the issue of political contributions by the vendors a few months ago: http://vps28478.inmotionhosting.com/~bluema24/2011/01/paying-to-play-an-update/
For some reason, I can’t retrieve the entire post (after the BMG changeover), but maybe you can.
day services and other programs due to budget cuts. Take a look at the budget for the past few years. The developmental center line item has been repeatedly cut as the Fernald Center, in particular, has been phased down. Has any of that money been shifted into the family support, day habilitation, and other line items? No, the money is being shifted to the state-operated group home line item.
In other words, this money is following the developmental center residents as they are transferred to state-operated residences. That’s why we are still seeing cuts in family support, day habilitation and other community-based services even though the developmental center line item is being cut. The supposed “savings” in closing the developmental centers is not going to those community-based accounts. The administration is selling the public and its community-based clients a bill of goods on that score.
Yes, Dave, the state operated programs have been expanded as Fernald has been downsized. That apparently was the Administration’s effort to gain state employee support for closing state institutions. If that is the case, why do you continue to demonize the private provider community suggesting that they somehow benefit from the closure of Fernald and the other proposed closings.
We’ve been critical of the private provider community because we think they have a conflict of interest in seeking to close the developmental centers. Ultimately, more contracts will come their way as the state-operated homes are privatized. But most people in the community system won’t benefit from that. The money will follow the former developmental center residents to provide them with residential care. We don’t believe that money will go into day program, family support or other community-based line items that benefit all residents.
I have no problem with people who determine that the level of care available in the private provider community is suitable for their ward/family member. For some people the community is a great option. The reality is it is not suitable or appropriate for all and I have a problem with there being no other option. These development center can easily be downsized and streamlined to make them more economical while maintaining the option. And just to emphasize–these centers have decreasing populations because no admissions have been allowed for more than 20 years. Doesn’t anyone find it interesting that only a handful of Fernald residents opted for a community placement? Just a handful out of 253. Don’t you have to ask yourself why?
If hundreds to thousands of developmentally disabled persons are about to lose their “community” services or are not receiving services, what does that say about the administrations’s “community” services expansion plan? I think it sounds like a waiting list! And mismanaged public funds.
Now that Fernald is nearly closed, where are the savings? Better yet, where are the real numbers to back up the claimed savings? Dave from Hvad has been asking for them for months and has not gotten them. I think it’s because the real numbers do not support the administration’s claimed cost savings. That is, the cost saving claim is a sham.
If the ICF/MR population is shrinking, it’s because that level of care is simply not offered to families because the administration does not want persons receiving this level of care–not because families do not choose this level of care. After all, it’s difficult to “choose” something when you do not even know of its existence, or it’s simply not an option.
I agree. Even though Fernald was not referenced in this recent attempt for an independent cost analysis, it would seems to make the most sense to include Fernald. Since it is the only facility going through the process, it makes sense its the only place to get some real numbers.
From what is posted here, community programs are taking a large hit in funding–does it make sense to force the individuals that require the greatest level of care into those programs? Who does that serve? Certainly not those being forced into it and certainly not those who have been waiting who will now have to wait even longer as the displaced people take priority. Trughaboutdmr said it exactly right about the “community” expansion plan–longer waiting lists and more mismanaged funds.
But it occurs to me as I read this, Dave from Hvad said that as Fernald has downsized the supposed savings have been shifted to the state op budget. I’m not sure I understand this because most Fernald residents opted to be relocated to other ICF/MRs not state-op homes so I don’t think I understand how that translates to an increase in that particular budget.
In response to the above statement from truthaboutdmr; to begin with the department is called DDS, nor DMR for a very specific reason. Second, in response to Dave’s assertion that state operated community programs are likely to be privatized is interesting. When was that announced and by whom? And with respect to why Fernald families are choosing another state institution over community settings, could the answer possibly be tied to the historic anti community and distorted campaign that COFAR and the Fernald League has waged against community programs. Sad to see so many families frightened by the hard line of the extreme. My family could have embraced the same thoughts but had the wisdom to investigate on our own.
in which COFAR or the Fernald League have distorted any facts about the community system. We support the community system as appropriate for most persons with intellectual disabilities, but not for all. We have also pointed out that the community-based system is beset with problems such as poorly trained staff and a lack of oversight. Those are facts, not anti-community distortions.
As for privatizing all state-operated group homes, that is the position of the Association of Developmental Disabilities Providers (http://archive.constantcontact.com/fs084/1101398806423/archive/1103387189763.html).
If you want to talk about demonization and distorted campaigns, you have only to look at the Arc and the ADDP, which demonize the developmental centers and falsely characterize them as “segregated,” and “outmoded.” These were fair characterizations of these facilities in the 1960s and early 1970s, but they don’t apply to the centers today.
COFAR and the Fernald League have always supported a full array of options (both community and facility). It all about what’s appropriate for the individual. You obviously believe that its community or nothing. So who is the extreme. Really hard to fathom that someone who is clearly involved with DDS can’t grasp the concept that some people just can’t live and thrive in the community. To bad your widsom falls short on that.
And where is the alleged distortion with COFAR?
It was a long read, but all i saw was an explanation about why institutions should downsize in Massachusetts. Where is the specific reference you are talking about?
Here’s a quote from the ADDP link referred to above (http://archive.constantcontact.com/fs084/1101398806423/archive/1103387189763.html):
“Under the DDS (developmental-center closure) plan, very few families have moved into the POS private provider system, instead focusing on the State’s expanding state operated and state owned system. ADDP believes the more appropriate expansion should have been the community private provider system which provides in Massachusetts and in other states, a more cost effective, efficient and inclusive opportunity for people with disabilities and their families.”
In other words, ADDP wants an entirely privatized community system. We believe ADDP has a conflict of interest in calling for this because its members are vendors who stand to benefit financially from it. We also believe that ADDP has a good chance of getting its way. It will certainly be easier for the administration to privatize individual group homes than to close the developmental centers.
I’m not sure how you can use the statement that: “ADDP believes the more appropriate expansion should have been the community private provider system” translates into an announcement that the state owned group homes will now be shut down. Kinda stretching a bit Dave? I’m also not sure that any organization has the degree of power you suggest.
Shouldn’t all of our combined efforts be about using limited fiscal resources wisely? We have less money today than we need to operate; how can we justify keeping all Developmental Centers open? How many do we really need? 1, 2, 3, 4, 5, 6? Do you really think the economy will ever return the point of being flush with dollars so that no changes need take place? Be real, not just hardcore.
We have called for downsizing the developmental centers. We also believe they have many cost efficiencies that don’t apply in the community system. But unfortunately, dcjayhawk, you seem to have missed all that in my post and in our comments.
You have also mischaracterized my comments about ADDP. I never said there was an announcement that all state-operated group homes would be closed. I said we believe they will ultimately be privatized and that ADDP is pushing for that outcome.
It’s easy, isn’t it, dcjayhawk, to hide behind an anonymous user name and throw out accusations. Without any evidence, you’ve accused me of being “hardcore” and COFAR of being “extreme” and running a “distorted campaign” against the community system and “demonizing” it. Your charges are false. But obviously, no amount of explanation on my part of our true position stops you from continuing to make those charges.
Perhaps it’s time, dcjayhawk, that you say who you are. Do you work for a provider? Are you just a concerned citizen? You provide no profile information and have written no posts. Are you just on this site to attack COFAR? I’ve fully disclosed who I work for. I think you should do so as well.
Whatever you do, I would request that you stick to the issues in this debate and stop making personal accusations.
I must have touched a raw nerve. Yes, I work for a provider. Does that now make all of my life experiences less than honorable on Blue Mass Group? I also have a family member who was in a state developmental center, then out to the community for two years where his needs could not be met and subsequently failed in that first setting, then back into a developmental center and for the last 16 years, served well in a community setting after we fought to the dickens for a person centered plan built around him and not built around the provider agency. So what does that make me suspect? I’ve seen good community services and I’ve seen not so good, but I do think the system has improved dramatically in the last 20 years with person centered planning and changed to the point where it is appropriate to ask how many developmental centers do we need. 1, 2, 3, 4, 5, 6. DDS is saying 2. Why is that wrong? As for never having posted on BMG; I apologize for not being very computer savvy. I did not understand how to answer or post in the old format. Thank you to whoever improved this format; it is much easier.
which forbid personal attacks. In your comments to this one post, you’ve personally accused me without any evidence of being “hard core,” and referred to COFAR as “hard line,” and “extreme.” You’ve said, again without any evidence, that we are running a “distorted campaign,” and are “demonizing” the community system. These are serious and insulting charges that are intended to marginalize us as a group.
Just like you, our members are doing the best they can to advocate for their family members with intellectual disabilities. That doesn’t make them hard line or extreme. We are a mainstream organization that uses research and reasoned argument to make our case. We respect your opinion, so please respect ours.