One of the key functions of the Department of Developmental Services is performed by service coordinators.
Their job is to make sure clients are actually getting the services in the DDS community-based system that are specified in their plans of care and for which the state is paying. They also determine the most appropriate sources of services for clients, based on their knowledge of the clients and available programs in the DDS system.
DDS even relies on these people to help monitor conditions in group homes. During a phone conversation a couple of years ago, the head of the DDS’s group home licensing office stated that service coodinators ensure that every group home in the state is visited at least six times a year and that conditions in them are checked.
DDS Commissioner Elin Howe has called service coordinators “the heart and soul of our agency.” The SEIU state employee union, Local 509, stated that in its collective bargaining agreement with the state, DDS recognizes service coordinators as performing one of the agency’s “most essential functions in the community-based service system.”
Yet, due to repeated budget cuts in recent years, the average caseload for service coordinators has been rising to the point where it is now about one service coordinator to 60 clients. This is more than three times the standard caseload recommended for social workers in this field, according to the SEIU, which organizes service coordinators and other human serivces workers.
At a budget hearing scheduled for Friday (December 9, from 2 to 6 p.m. at the Agganis Arena at Boston University), advocates will plead for more funding for a wide range of community-based line items that have also been cut in recent years. These pleas are coming in the wake of an announcement by Health and Human Services Secretary JudyAnn Bigby late last month that the state budget for the coming fiscal year will probably necessitate further cuts in these programs and that the administration will have to make “difficult decisions.”
But apparently not all of these advocates are rooting for the service coordinators. The Association of Developmental Disabilities Providers has actually suggested that Bigby further cut the DDS administrative line item, which funds the service coordinators. In the last line of a recent email, informing its members of the Friday EOHHS hearing, the ADDP stated:
ADDP will urge any spending reductions to be focused on the state’s own administrative and service system and to protect the more cost effective and inclusive community delivery systems. (My emphasis)
Perhaps the ADDP will respond here to tell us why the service coordinator positions should be cut further and the caseloads should grow even larger. Could it be that the state-funded providers, who in turn fund the ADDP, don’t really want anyone looking over their shoulder and monitoring the services they are delivering or the conditions in their group homes?
In contrast, the SEIU is asking that the administration to restore $5 million to the DDS administrative line item. The SEIU contends that between 2007 and 2010, 82 service coordinator positions were cut, placing Massachusetts in the bottom 10 percent of the country for monitoring and overseeing the provider contracting system and the care it provides. In a statement, the SEIU contended that:
These (service coordinator) jobs more then pay for themselves by promoting skill development and greater independence in the DDS population. Left to their own devices, programs settle for providing ‘custodial’ care which perpetuates a burdensome, wasteful and inefficient expense to state government.
The SEIU last year tried unsuccessfuly to reopen the federal court case that brought about improvements in care in the DDS system since the 1970s, arguing that the cuts in service coordinators at that time were a violation of a key court order that DDS provide sufficient, adequately trained personnel to meet clients’ needs.