(Cross-posted from the COFAR blog)
On Tuesday of this week, The Boston Herald’s readership was treated to a bombshell headline and story, purportedly about government waste due to delays in the closure of the Fernald Developmental Center.
The headline was “$16M to care for 14 people”; and the story went on to imply that the 14 remaining residents of Fernald, whose guardians have filed administrative and court appeals of their transfers from the Center, are each costing taxpayers more than $1 million per year.
The only problem is that the headline and story are wrong. I just received a letter from Department of Developmental Services Commissioner Elin Howe, confirming our information that the annual cost of caring for the remaining 14 people at Fernald is projected at $8.9 million. It seems the $16 million is the projected cost of keeping Fernald open throughout the current fiscal year, during which time there have been far more than just 14 people living there.
As of the end of last June (at the start of the current fiscal year), there were some 70 residents left at Fernald, according to our records, and by the end of July, that number was down to about 40. The adminstration has steadily moved people out, and 14 is the number of residents who remain as of this month. So, the $16 million cost clearly reflects a higher number of residents than 14.
Moreover, Commissioner Howe stated in her May 25 letter that:
While the costs associated with operating Fernald have dropped following the census (residential population) reduction, the per-person costs have actually increased as the census declines in the final stage of closure. This has been a typical pattern in previous closures.
In other words, a per-person cost spike is something that occurs in virtually all developmental center closures — it’s not something unique to Fernald because of the appeals filed by the guardians. There are certainly added costs associated with the delay in closing Fernald, but those costs are something the administration should have anticipated as part of the overall cost of closure.
Nevertheless, the inaccurate claim that $16 million is being spent on 14 residents was immediately seized upon this week by the Association of Developmental Disabilities Providers, whose members stand to benefit from new state contracts as Fernald and three other developmental centers are closed. ADDP President Gary Blumenthal decried the alleged $16 million cost as “tremendous” and “excessive,” and implied that the Fernald guardians are responsible for it.
On Wednesday, the Herald’s editorial page picked up on the theme, stating that the alleged $16 million being spent on 14 Fernald residents is taking away from community-based services “and it’s impossible to argue that point.” It’s especially difficult to argue it when the editorial’s point is based on deliberately misleading and inaccurate information.
The Herald editorial, by the way, is very carefully worded not to equate the $16 million directly with the 14 residents, although it puts the two numbers as close together in the same paragraph as possible. And of course the editorial never even bothers to mention our longstanding contention that the costs of operating Fernald and the other developmental centers have been overstated by the administration in comparisons made with the community system.
(I talked at length, by the way, with the Herald reporter about that whole developmental center-versus-community cost issue when she called me the day before her story ran on Tuesday. None of that made it into print, of course.)
I would also note that Howe stated in her letter that the 95 staff left at Fernald is a projected number after a current round of layoffs is completed. Howe provided a number of reasons for that apparently high number of remaining staff, and concluded that “all appropriate staff reductions have been or are being taken and the remaining staff are necessary to meet the remaining residents’ needs.”
We’re not sure, however, that it’s the case that DDS has done everything they could to reduce costs lately at Fernald, particularly if — as Stephen Sheehy, the attorney for the remaining residents has pointed out — DDS has failed to take steps to move the remaining residents into one location on the campus. That is something, according to Sheehy, that the residents would welcome, and which would no doubt save some money.
…as The Girlfriend has been working as a nurse with this same clientèle for about 25 years now, in both private and state settings, and she currently woks at a facility in washington state that is the exact equivalent of fernald.
we have had similar problems with declining census (the number of dd clients in the five “residential habilitation centers” has dropped from about 3300 to about 1100 over the past 30 years, and we’re now trying to address the same issues around what to close or not close.
i can tell you that we’re spending about $12,000 a month for client care in this setting in this state, and i suspect that we have a cost and wage structure that’s not much different than mass; i’d suspect that the $12,000 number is probably good for mass as well.
washington state dshs did a cost comparison study that you’ll want to see, they suggest some cost savings are there to be found – but i’ll tell you, based on entirely anecdotal evidence, that the client outcomes are better in the state setting, and the cost saving that might be found aren’t so great as to justify the damage to the clients (which, again, is entirely my opinion, and not a statement of researched fact).
we are about to close one facility (which specializes in autistic cleints), those 50 clients may be moved by fall to another rhc, and we will see how that goes.
will check out the cost study you’ve mentioned.
…but the impression i get is that the staff believes the cost savings to the system were obtained as a result of the early deaths of certain clients, and not as a result of any efforts or initiatives n the part of the new service providers – and it is a fact that a number of clients who lived in that state setting for years were dead 36 months later.
It would certainly be unfortunate, though not surprising, if an agency based savings projections on closing a facility on early deaths of clients. I’d just note that the Connecticut DDS also looked at closing their remaining developmental center and concluded there would not be a savings in doing so.
The issue of cost analyses in eliminating or privatizing governmental services is always very political, and that’s one of the reasons we’ve called for an independent analysis prior to the shutdowns of the Monson, Templeton, and Glavin developmental centers in Massachusetts. Unfortunately, we heard a budget amendmendment for an independent study was rejected yesterday in the Senate.
That story, posted on The Herald’s site, spawned scores of comments, many filled with vitriolic and bigoted comments against the developmentally disabled residents of Fernald and their families. To learn now that the figures in the story were wildly inaccurate and misleading makes it even worse.
The ARC and ADDP, both of whom are service providers, have a huge stake in this. They stand to profit when Fernald and other such facilities close because they take in the bulk of the residents who are moved. Their private contracts with the state make it even more difficult to track where taxpayers’ dollars are going.
I’m glad someone else noticed the completely disgusting and clearly ignorant comments made by the Herald readership. Tough to figure out which was worse, the article or the comments.
What makes it truly despicable, is that ARC Mass, that views itself as the supreme advocate, has the gall to speak against our most severely mentally retarded and medically fragile citizens. As I said in a previous post, the only time you hear from ADDP and its sock puppet ARC Mass is at budget time. The rest of the year they are content to quietly consume at the public trough. They only lift their snouts when some other disabled person, who doesn’t happen to be serviced by them, might take a few nibbles at what they clearly believe belongs to them. Some advocates–they only appear long enough to attack the most severely disabled and blame them for all the woes of the budget. As I also previously posted, to bad they don’t vent their venom at the real reason their budget are being slash–the give away mentality in every other department of state government.
Please be professional and respectful. Referring to organizations with whom you disagree in an insulting manner is rude and inappropriate. The Arc, both in Massachusetts and nationally have a long history of advocating for people with disabilities and embracing best practice and inclusion. The debate over closing excess state institutions (DDS plans to leave 1 or 2 alone) while thousands of others lose community services is a fair discussion to have. Please Dave from Hvad, how many state developmental centers should be maintained as the State, running out of money, is forced to cut thousands from needed social service programs? Please don’t attack people for asking this question. With our state and nation in fiscal distress, this question must be asked. How long should Fernald at $8 million or $16 million of un-budgeted cost be maintained? And how long should the state pay for six state institutions? DDS is spending $147 million or 11% of its budget for 2% of the total number of people in the Commonwealth identified with DD (33,000), while thousands are losing Family Support and others are on waiting lists? If the same quality of service is available in the community at less cost why should that not be considered? Do you believe that the State has an unlimited pocketbook? Please don’t respond by further attacking The Arc or ADDP. Please answer the questions asked here in a respectful manner.
My comment about ADDP and ARC Mass are my own, not Dave from Hvad.
ADDP and ARC Mass have shown no respect for the people of Fernald or their guardians. You attack the guardians for doing nothing more than exercising their legal right to protect the lives of their family members. The procedure for this is controlled by the Department–not the guardians–blame them if it is slow. You imply that they alone will be the cause of thousands of people losing services with bogus numbers and inaccurate information. When the real story is the reason budgets are slashed is because of the give away mentality in every other area of government but I don’t hear you complaining about that.
ARC Mass is supposed to be an advocate for the developmentally disabled and mentally retarded (the R in ARC). If you are an advocate for people with DD/MR you advocate for ALL people with DD/MR not just the ones who can live in the community. I witnessed this “advocate” sit with the state against the mentally retarded people of Fernald in court. Not the actions of an advocate. ARC Mass acknowledges, in an article in the Waltham paper, that there are 5% of people with DD/MR who can not live in the community, but has done nothing to advocate for them. The people of Fernald fall into that 5%–oh well. ARC Mass who calls Fernald archaic, antiquated, hulking, yet at a reuse committee meeting the Waltham chapter requested the use of several of those archaic buildings so they could provide better services. So their too archaic for the people who live there but not archaic if one of their chapters can get them for nothing.
Lets be honest here, there is plenty of room for compromise here without causing calamity throughout the care system. The Governor could have come to the table years ago to work out an economical and humane solution. He could have sold off 3/4 of the Fernald campus years ago when the real estate was at the height of its value and developers had money to do something with it. The state would have had a huge windfall from the sale, the reduced facility would be more economically viable, the thousands in the community could still use the dental clinic and the therapeutic pool and no lives would be put at risk. Almost a no brainer.
Instead, it has pitted the disabled against the disabled.
The elderly people of Fernald have already paid their dues as children decades ago by way of years of abuse and neglect and fought the battle that paved the way for the industry that employs you as a lobbyist. Real advocates would be asking the administration to come to the table to workout a solution. Give these elderly people a small corner of the campus that would be more efficient and economical to operate. Keep Tufts Dental and the Greene Pool open so that the thousands from the COMMUNITY that use it can continue to do so, and leave these people be.
When ARC Mass and the ADDP show a bit of respect for the people of Fernald, respect will gladly be returned.
To Dave from Hvad and ssurette:
I have driven around the Fernand site, and as someone who has extensive real estate development experience, I can claim with some certainty that the value of the land (and maybe some of the buildings) is still ENORMOUS.
The Commonwealth could enter into a land development partnership with private entities and reap complete and perpetual funding for the care of the remaining 14 residents. Repeat — perpetual.
I am simply at a loss to understand why something has not been done to unlock Fernald’s significant market value. It can be done in a fashion where the state maintains ownership of the land. It can be done in a way that meets the needs of the existing residents, and
additional ones, too.
I would be happy to speak with you to explain how the state could do this except I’m certain the state already knows how to do it. It is unwilling, for ideological reasons, to explore the possibilities. If you think you ca get through to them, I’d be happy to share my experience and knowledge.
The under-utilization of an extremely valuable piece of property because of internecine political turf wars is not only criminal in its neglect of the taxpayers’ money, it’s an unconscionable neglect of those remaining Fernald residents.
You can ping me through BMG.
Our longstanding “postage-stamp” proposal to develop the Fernald campus while leaving a portion intact for the current developmental center residents did envision a partnership which would involve private funding.
The administration, which, as you note is ideologically bent on closing the center and kicking everybody out, refused to consider or discuss the proposal. We’ve tried to get through to them, but it’s been, as Barney Frank would describe it, like talking to a dining room table.
Sure, the state’s pocketbook is not “unlimited,” but we could raise $1.8 billion in a progressive manner through the income tax legislation sponsored by Rep. O’Day and Sen. Chang-Diaz.
The notion that needy people in the state have to fight with each other for services that they all deserve because tax increases are believed to be a political impossibility is toxic. I don’t know if ADDP, ARC and other organizations involved in the issues discussed in this thread are supporting legislation to increase revenues, but I hope so.
I definitely agree with your point that disabled people should not be pitted against each other for services they need. If they want to fight for additional funding for all–I’d gladly join them. But I can’t go along with fighting for one group at the expense of another.
Thanks for your comments. I will look into that proposed legislation.
here. Thanks for your interest.
(Just in case the comment nesting here was confusing, it was dcjayhawk whose “unlimited,” comment I was responding to.)
previously to a post of mine and accused me of being “hard core” and “extreme,” and accused COFAR of running a “distorted campaign against the community,” all without any evidence? And now I see you’re admonishing me to talk to you respectfully.
I agree that we should all be respectful on this site, on both sides of this debate. Let’s all stop the name calling.
Dcjayhawk, I also recall that you took the opportunity last month to repeat the ADDP’s assertion, which we now know to be false, that it costs $917,000 per person to operate Fernald. Based on your comment above, it seems that fact doesn’t matter to you. Whether it costs $8 million or $16 million to operate Fernald, it makes no difference, you say. Just close the place. I’m glad you have such an open mind on the issue.
You also repeatedly ask how many developmental centers I will support. I’ve answered this question of yours at least four times previously. Here, for the fifth time: We support right-sizing all of the developmental centers, and we believe they potentially already operate just as cost-effectively as the community system. It’s the model of care we want to preserve, not the big buildings. Yet, it is you and your fellow providers in the ADDP who continue to falsely accuse COFAR and the Fernald families of wanting big buildings and who oppose an independent study of developmental-center versus community costs.
Tell me, dcjayhaw, how can you accuse us of wanting to take money away from the community when you yourself oppose an independent analysis of that very issue? Please answer that question, and I would ask you to please be respectful.
in your comment. You state:
This shows a misunderstanding of the DDS budget. You are assuming the 33,000 people in the community have needs that are comparable to the roughly 600 to 700 residents in the remaining developmental centers. But the vast majority of those 33,000 people don’t need anywhere near the level of care that is needed by the developmental center residents.
That’s like complaining that a school with 1,000 students is only buying helmets for 25 students on the football team and should be buying them for everybody.
As we understand it, there are roughly 7,000 people in the state who receive residential care in the DDS community system that is in any way comparable to the developmental centers.
But even those people are, on average, far less intellectually and medically disabled than the developmental center residents. Nevertheless, based on a comparison of those two different populations, DDS has calculated there would be a $40 million savings in closing four of the developmental centers.
We think DDS’s comparison is flawed for that very reason. But even DDS isn’t saying that closing all the developmental centers would save some $120 million, which is what you appear to be claiming, based on the assumption that all 33,000 people with DD need the same level of care as the developmental center residents.
One more point here is that the cost to care for developmental center residents follows them where ever they go. They don’t just go away because they live in a house somewhere. Since the majority of the specialized care they require is available to them at the developmental centers, its really hard to make any sense of how high priced transportation costs and staffing costs associated with obtaining these specialized services on a continuing basis in various locations saves any money. With the unpredictable cost of fuel alone, logically it should cost more.
You refer to the state’s ICFs/MR as “excess” and “institutions” and expect that others will just accept your view without question. These institutions are not excess baggage, but are home for some of the most developmentally disabled and mentally retarded persons in our population. For some it may be the only home they have ever known. These residents were placed there apparently due to the prevailing ideology that existed at the time, that is, by the system that you claim supports you now.
Blaming the threat of loss of community services to some individuals on the continuing need to provide for services to those residents of the ICFs/MR is fundamentally flawed. You are saying that it is okay to take services from one group of individuals in order to serve another group, yet you fail to account for the continuing needs, including needed infrastructure, of the current residents. You also have not mentioned that the guesstimated cost of the asbestos cleanup at Fernald is about thirteen million dollars, and that the historic buildings there cannot simply be bulldozed.
If the state is running out of money, it is because the state has mismanaged the funds it has, not because the state is taking care of those who cannot take care of themselves. And then there is the waste and abuse in the current disability system.
The same quality of service is not available in the “community” at less cost to the Fernald residents, or the residents of any other ICF/MR in MA for the simple reason that, by definition, ICF/MR services do not exist in the “community.” The claim of “equal or better” in the “community” is a hoax.
Your claim that the Arc has a long history of advocating for the disabled is distorted and offensive—the Arc has done nothing to advocate for those so disabled as to require ICF/MR care.
What—a waiting list? DDS denies having a waiting list!
Thank you dcjhawk for your post ~ the Fernald debate is a one sided issue for the few people that go back and forth on this site. People need quality lives in their communites and we need to direct the people and funds in that direction. We are all losing with this infighting
With all due respect, Dave from HVAD and his colleagues do a very good job of getting their view heard on BMG. It is distressing that there are few outlets to have a balanced discussion on these important issues. Anyone tied to the community system, or associated with The Arc or ADDP are accused of having “the most to gain” from closing state developmental centers. The fact of the matter is that the DDS closure plan does not promote the private provider system, but increases state operated programs and keeps 2 (Wrentham and Hogan) ICF-DD centers open. Doesn’t seem like a “most to gain” win as suggested by some. What is lost here is the fact that most in the disability community, including people with disabilities, family members and professionals in the field, believe that smaller settings are the most successful and appropriate settings for PWD. As the state and national economies continue to falter, do we not have responsibility to look at how we spend very limited tax dollars; and shouldn’t political progressives who see BMG as a forum for progressives not be able to have this discussion in a respectable manner. I earlier described COFAR as hardcore, and for that I apologize, but I also wish that the quick response team that cares about these issues would also refrain from attacking The Arc as sock puppets of providers; and not attack ADDP as a vehicle seeking to “profit”. The people I know who work in this field got into it because they care about people with disabilities and see PWD as people who can do better in a smaller and more inclusive setting.
I am not part of any “quick response team” just a guardian that is paying attention and cares about ALL people with DD/MR no matter where they live. Community or facility–doesn’t matter as long it is suited to the individuals needs.
It’s not possible to dismiss the fact that an organization that the people of Fernald are supposed to turn to for help, has turned its back on them and is actually fighting against them.
The point that is missed here is that what the professionals, etc. say is that community is good for MOST. They don’t say ALL. So they acknowledge the fact that everyone can’t live in the community but do nothing in the way of advocacy for preserving their quality of life or what is right for them. If you are in line with what the professionals say about smaller situations, it is logical that 6 smaller or rightsized ICF/MRs would be ideal for the few that can’t live in the community and require the more intensive care available in the ICF/MRs. I don’t see how keeping just 2 large facilities that are jammed packed lines up with that philosophy or could be consider advocacy. It is little more than segregation.
Another huge problem, is ignoring the fact that thousands from the community use Fernalds facilities that are not readily available elsewhere. At one time 2500 people a month used the therapeutic pool. So in advocating for closing this facility, you are advocating for further cuts in services to thousands in the community. Although Fernald is continually portrayed as segregated, the fact that thousands use it is hardly segregated–it is part of the community and part of the community care system.
Another missed point is that there are people who will be irreparably harmed if moved from their home of 70 years. I don’t know why that is so hard to understand.
All I’ve seen so far is the people of Fernald being bashed for being unwilling to accept a situation that puts their family member at risk. What would anyone do?
In reality, the closing rather than streamlining, of Fernald serves no one. It certainly doesn’t serve the current residents. It doesn’t serve people in the community when they no longer have ready access to those specialized facilites. No credible cost savings have been demonstrated.
and hope we can all keep this debate on a high plane. I would just like to respond to your statement that we should stop attacking the ADDP “as a vehicle seeking to profit,” and that the people who work in this field got into it because they care about people with disabilities.
We don’t mean to cast any aspersions on any individuals who work in this field, whether they work in the community-based or state system. That’s a separate issue from pointing out what we think is a conflict of interest on the part of the ADDP, whose members are state-funded contractors, and which is on record as calling for the closures of all of the developmental centers.
Pointing out potential conflicts of interest is part of what I consider to be a respectful debate. That said, I’m not in favor of describing the ADDP as a sock puppet, although I don’t think that term is as offensive as “hard core,” which has more unpleasant connotations. Nevertheless, I would hope we call all refrain from using epithets of any sort in this debate.
Hmmmmm. From the Governor’s appointee, vendor advocate-in-chief, Elin Howe? From wolf in sheep’s clothing, the very best buddy a vendor could have, the ARC? Or….how about the ADDP, whose naked self-interest is the thread of in the whole cloth of most communications from them.
This is dirty politics, man. This is just another serving of ugly from people who should know better. I wonder if the Governor will come forward and have these base assertions corrected? Ten bucks says….”no.”
It really is ugly! It is quite distastful to have post these kinds of comments here but I have to call them like I see them. Fernald guardian are portrayed as the “root of all evil” but are supposed to be respectful to those who act completely disrespectful and unprofessional. The commissioners hand is in this. She knows the figures reported were misleading and inaccurate and at the very least needed clarification yet she allowed them to be published anyway but was careful to neither confirm or deny them in the original story.
Really terrible.
Just wondering if Dave from Hvad sent the facts to the Herald, not that they would try to set the records straight.