(Cross-posted from the Cofar blog)
Opponents of Intermediate-Facility-Level care in Massachusetts have repeatedly denigrated the Fernald Developmental Center during the past two years as part of a campaign to encourage the shutdowns of that facility and three other state-run developmental centers in Massachusetts for people with severe intellectual disabilities.
Our review shows a pattern in the tactics used by the opponents, which have included repeatedly publicizing inflated figures on Fernald’s per-person cost and falsely characterizing the care at Fernald and other developmental centers as outmoded or obsolete. The ironic purpose of the campaign has been to close the centers as fast as possible without conducting any meaningful cost studies.
The organizations most directly involved in the campaign against Fernald include the Association of Developmental Disabilities Providers and the Arc of Massachusetts. Joining them last year was the Governor’s Commission on Mental Retardation, which the Fernald League noted had previously been reconstituted by the Patrick administration to lobby on behalf of the developmental center closures.
The record appears to show that the efforts to spread misinformation about Fernald have been effective in bottling up cost studies, which would have actually pertained to the three other developmental centers marked for closure. The misinformation has also been damaging to the reputations of guardians and families of the Fernald residents.
Fernald and five other developmental centers are the only sources in Massachusetts of ICF-level care, which must meet federal standards for staffing and supervision. The Patrick administration has targeted the Fernald, Monson, Templeton, and Glavin centers for closure, starting with Fernald, by Fiscal Year 2013. Fernald, which was scheduled to be shut last July, has remained open pending the outcomes of administrative and court appeals filed by the guardians of 14 remaining residents.
For at least the past two years, the ADDP and the Arc have focused during state budget debates in the Legislature on the alleged cost of maintaining Fernald. Our review shows that during this year’s budget debate in April and May, leaders of those organizations repeatedly made inaccurate claims about Fernald’s per-person cost of operation that were as much as 70 percent higher than the most recent projection by the Department of Developmental Services.
In public statements, the ADDP and the Arc also inaccurately blamed those alleged per-person costs on appeals filed by guardians of their wards’ transfers from Fernald. The erroneous cost figures were provided to state legislators as the House and Senate were considering budget amendments in April and May that would have required an independent cost study prior to closing the separate Templeton, Monson, and Glavin centers.
On April 25, ADDP President Gary Blumenthal claimed to the State House News Service that the annual cost per person at Fernald had “nearly quadrupled” to $917,000. The News Service said the cost was based on documents from DDS. The News Service account was picked up by The Boston Globe. However, DDS General Counsel Marianne Meacham told COFAR that to her knowledge DDS has never cited a cost as high as $917,000 per person at Fernald, and that she had no knowledge of any documents listing that amount.
(We called the author of the State House News article to ask for a copy of the alleged DDS documents. The reporter said he was unable to locate them.)
In a May 25 letter to COFAR, DDS Commissioner Elin Howe stated that DDS had actually projected an annual cost of care of $635,414 per person at Fernald, based on the 14 remaining residents. Moreover, Howe stated that overall costs at Fernald had dropped during the past year and a half as the residential population has dropped, but that the per-person cost had risen to the $635,000 amount due to the declining population. She termed the cost spike “a typical pattern in previous closures.”
That per-person cost spikes occur when facilities are closed was not recognized by the ADDP or the Arc in their accounts of Fernald’s costs. On April 25, the same day Blumenthal was citing the $917,000 figure to the State House News Service, a letter to legislators, signed by Blumenthal, Leo Sarkissian, president of the Arc of Massachusetts, and about a dozen human service providers, claimed that Fernald was costing “$1.3 million per month for 16 individuals due to administrative appeals.” That would equate to an annual cost of $975,000 per resident. Later that same day, as the ADDP/Arc letter had requested, the House leadership rejected an amendment to the House budget bill for the cost study for Templeton, Monson, and Glavin.
Whether it was the result of a cost spike due to a declining population or not, the $975,000 figure was wrong. In her May 25 letter, Howe indicated that the $1.3 million cost at Fernald was an average monthly cost, based on a $15.6 million projection for the full current fiscal year. At the start of the year, between 50 and 70 residents were still living at Fernald, not 16. Thus, it would be inaccurate to claim that Fernald was costing $1.3 million per month for only 16 individuals, or that the $1.3 million figure could be annualized, “to understand the high cost of delay and obstruction,” as the ADDP/Arc letter claimed.
Nevertheless, a month later, on May 24, the Boston Herald ran a story that similarly claimed erroneously that $16 million was being spent to care for a remaining 14 residents at Fernald. That story inaccurately implied that the cost per resident was as high as $1.1 million. Blumenthal was quoted in the Herald story as terming the cost cited by the Herald “excessive” and “the cost of delay” in closing Fernald.
A budget amendment requiring the independent cost analysis prior to closing the Monson, Glavin, and Templeton centers was rejected by the Senate leadership two days after the Herald story ran.
A similar pattern of unsupported or inaccurate information about Fernald was evident during the legislative budget debate a year previously. In May 2010, the ADDP claimed that delaying Fernald’s closure by undertaking a cost study of Fernald and the three other centers marked for closure would cost an additional $13 million a year. There was no backup or explanation for that number.
That same month, the Governor’s Commission on Intellectual Disability cited a $1.3 million cost per month at Fernald in calling for rejection of that same cost study. This number was unsupported as well in the Commission’s letter.
(By the way, the only publication listed on the Governor’s Commission publications page on its website is the administration’s 2009 developmental center closure plan, which the Commission didn’t even write — the document was written by DDS.)
Meanwhile, as the ADDP and the Governor’s Commission were citing those unsupported cost claims for Fernald in 2010, Sarkissian of the Arc of Massachusetts was claiming erroneously that Fernald and the other developmental centers were providing inferior care to community-based facilities. In an op-ed article in The Waltham Tribune, Sarkissian variously termed Fernald and the other developmental centers “decrepit,” “archaic,” “outdated,” “Dickensian,” and “inferior.”
In the op-ed piece, Sarkissian raised issues from the 1960s and earlier about sexual abuse, military experiments, and other issues at Fernald that have not been current for a half century or more.
Last week, I wrote to Blumenthal, asking him to publicly disavow the inflated cost figures for Fernald that he and his organization cited this year. He declined to do so, saying the cost figures had been provided by DDS. The question we still can’t answer is whether DDS itself knowingly publicized inaccurate figures on Fernald’s cost.
Thanks for the opportunity to read the letter sent to our representatives.
I think “the combined leadership of the Mass disability community” has kicked around the disabled people of Fernald enough.
The combined leadership of the disability community should be ashamed of themselves for their “gang” tactics and the use of their combined strength to advocate against another group of disabled people.
The pattery of “the larger the campaign donations” and the presence of lobbyists determining where dollars go is shameful – but only committed citizen activists who pay excruciatingly close attention can change this, even potentially.
Again, the lack of transparency of legislator financial statements, see http://articles.boston.com/2011-06-10/news/29643654_1_mortgages-disclosure-campaign-finance-reports and total immunity to ANY Open Meeting Laws and freedom of information requests has fostered a corrupt culture which is contemptuous of the citizen and lacks integrity all too often.
In response to the posting from Dave from HVAD, on behalf of his client, COFAR: the numbers used by ADDP and The Arc reflect the costs reported by DDS at the time the information was requested. The costs may shift, either higher or lower per individual, as more people leave Fernald. Individual costs and staffing are determined based upon the individual service plan of the individual. At the time of the request in February, DDS responded the costs were $1.3 million with 17 residents, which reflected $917,000 average cost. Dave from HVAD now suggests the numbers have shifted to $635,0000. Those numbers, if accurate are still very high, much higher than the other ICF’s and 5 to 6 times higher than similar services provided in the community. Fernald will eventually close, however the small number of people who are trying to keep Fernald open are using a variety of processes to slow the process and try to reverse a decision that has already been made by the state. ICF services, if desired by families, will be available at Wrentham and Hogan, but not at Fernald. Keeping Fernald open past its closure date is costing the Commonwealth millions of dollars that are not in the current FY 11 or next year’s FY 12 budget. That is the cost of delay. Sadly, all of this is happening co-currently as Family Support Services are being eliminated and other budgets impacting people with disabilities are absorbing millions of dollars in cuts. This loss of services appears to be tied to the costs of delay.
I would still suggest that you fill in some details about yourself in your site profile. Not everyone knows yet that you are Gary Blumenthal, president of the Association of Developmental Disabilities Providers.
Now then, Gary..or..dcjayhawk, stating that the costs at Fernald have “shifted” is muddying the cost issue, which will not help your case. The cost per person at Fernald has never been as high as $917,000.
As Commissioner Howe stated, the per-person cost at Fernald has risen to a maximum of $635,000 even as the overall cost of operating the facility has dropped. The drop in the residential population at Fernald is what is driving the high per-person cost that you so decry. If you didn’t want such a high per-person cost at Fernald, you shouldn’t have advocating closing it.
Yes, there are some additional operating costs associated with the delay in closing Fernald. But it’s completely inaccurate to say that it is costing $1.3 million per month for 17 residents. The $1.3 million is an average monthly figure based on a full fiscal year during which there have been as many as 70 residents at Fernald. You are further failing to take into account the costs of transferring those remaining residents and housing them elsewhere.
It is unfortunte that you and your counterparts in the Arc and the rest of the provider community continue to misrepresent Fernald’s costs and continue to place the blame for those costs on the families and guardians of the remaining residents there. Those families are simply exercising their legal rights to appeal the transfers of their wards. If you want to take those rights away from them so badly, why haven’t you filed legislation to do so?
The numbers citied by ADDP and The Arc reflect the costs at the time the information was requested from DDS. People who support the downsizing from six to two ICFs do so because they believe that six centers are not needed, and that equal to or better care is available in the community. They also believe, as does the overwhelming majority of the disability, consumer and family community, that best practice is to support community alternatives, however for those who do not prefer that choice, DDS is supporting the continued operation of Wrentham and Hogan. I understand your client, COFAR, does not support or agree with that position. I think we both agree that over $1 million per person is excessive; we also believe that the current expenditure that you endorse of $635,000 per person is excessive and not the best use of limited tax dollars. Excessive costs in one area result in cutbacks and loss of service in other areas. The state treasury is not infinite. I respond to your postings because you present one opinion on behalf of your client and not the full picture. If BMG is a site devoted to the free exchange of views between progressive Democrats, then it is important that alternative views to your client, COFAR, be shared.
I continue to be troubled by this debate. Are providers truly debating because they are so convinced that best practices of care are available only in their organizations? I would strongly disagree that their services provide best practices universally. The quality of care in their organizations varies from program to program, sometimes from shift to shift. Best practices include a range of services, they do not preclude institutional care. And to suggest that Hogan and Wrentham are still available reflects a disregard for residents who will be displaced from their homes at other facilities.
I know that legislators are responsive to reports of excessive spending and their recent vote to not fund a cost analysis reflects their knee jerk reaction to the misleading (inaccurate) information provided them. When I met with Sen. Brewer, he quickly quoted the inflated cost per resident at Fernald in defense of his lack of support.
I continue to be struck by the animosity and tenor of the providers’ organizations, and again, wonder about their motivation.
that the ADDP and Arc have jumped on falsely inflated cost estimates to support their position of closing the ICFs/MR.
But why have none of them noted the timing of the figures released? Where is the relation of the decision in 2008 to close developmental centers and cost figures for 2011?
Why has no one asked for 2008 data? This would have been relevant at the time the closure plan was being considered and developed, and when there were more than 200 residents at Fernald. Surely the per-resident cost would have been lower then. Is it that these groups are in such a hurry to close the developmental centers before the truth comes to light that they wish the residents legal rights be trampled in the process?
Each and every person wth DD is a precious human being and should be treated as such. This disability is very complicated. It consists of a variety of diagnosis and requires care that is individal to each person. What may be good for one person may be detrimental to another.
What the ADDP is saying, without saying it is,hundreds with DD should be sacrificed so the money used to keep them open will follow their organization. This really upsets me and I would have to ask the question, “What are we becoming and who are we”? I wish they would use their energy and critism towards the people that we need to be criticizing, OUR GOVERNOR AND LEGISLATORS, and stop spreading false information that will destroy the lives of many people with DD. We are all aware of the troubling budget, but we also are aware of the wasteful and senseless spending.
Hogan and Wrentam will never be able to keep up with the overload of people. I will ask the question again Mr Blumenthal, “what do you suggest we do with all these people”? And by the way, you can never prove that these people would receive “equal or better care” in the community because it is obvious you don’t know anything about them. You have done nothing but critized the family members that are trying to do the best for their loved ones. How can you say you know how it feels to have a loved one suffering from this terrible disability when you cannot have compassion towards their needs.
Trying to get an accurate assessment of the current cost of operations at Fernald appears to be as difficult as counting casualties in the fog of war. The stream of misinformation is remarkable. Figures are being manipulated by The ARC and ADDP to support a mission of ICF closures. Lost in all this is the very real pain and suffering that the parents and guardians are enduring, when all they want to hold onto is what they believe is the best care available for their loved ones. Requesting independent cost studies and filing appeals against unwanted transfers are not reasons for denigration or reputation smearing. Quite the contrary. They are indications of strength and caring.
Its not easy to stand against everyone, including traditional advocates. Thanks for noting the strength and caring of these people.