We can do better than the final DDS budget for current fiscal year

(Cross-posted from The COFAR Blog)

As we start the 2014 fiscal year, there was some good news, but mostly bad news for people with intellectual disabilities and their families in the final budget produced by the Legislature last week.

The bad news is that funding for state-operated care fared poorly in the final budget bill as it emerged from a House/Senate Conference Committee on June 30.  As explained below, this has negative implications for corporate-run, community-based care as well.

The good news is that there will at least be a hearing on the so-called ‘Real Lives’ bill, if that flawed piece of legislation ever gets enacted.  The Conference Committee did not approve the Real Lives language, which we have objected to and which had been quietly inserted into the budget bill by its prime sponsor.

The Real Lives bill’s supporters will have to go back to pushing the measure (H. 151) through the normal legislative process.  The proposed legislation, which is still in the Children and Families Committee, still hasn’t been scheduled for a hearing, according to the legislative website.

The budget Conference Committee did accept the Senate’s proposed funding level for the state-operated group home line item, which is slightly better news than had the Committee accepted the House funding level.  As a result, the state-operated group home line item was cut by only $1.5 million from the governor’s budget, rather than $1.96 million, as the House had previously voted.

The Conference Committee’s proposed funding for the state-operated residences is $9.1 million higher than in the just-ended fiscal year, but it apparently still represents a shortfall in the amount needed, according to the Department of Developmental Services.  That is largely because state-operated group homes appear to be the preferred care setting for a large number of residents of developmental centers that have been marked for closure.

The Conference Committee also decided to cut the DDS administrative line item (which funds service coordinators) by $700,000 from the governor’s budget and cut the developmental center line item by close to $400,000 from the governor’s budget.  Both of those cuts are bad news for state-operated care, and they will adversely affect the quality of community-based care.

First, service coordinators are state employees who make sure that DDS clients receiving both state and privately provided care are getting the right services.  For years, their funding has been cut even as their caseloads have grown.  Service coordinators are integral to maintaining the quality of care in the DDS community-based system.  DDS Commissioner Elin Howe has referred to service coordinators as “the heart and soul of our agency.”

Secondly, while many proponents of community-based care may think that the continuing cuts to funding of the developmental centers is good news for the community system, the opposite may in fact be true.  We’ve noted repeatedly that the money “saved” in phasing down and closing the developmental centers has not been diverted into most community-based accounts as the administration had promised.

The result is that as the developmental centers are closed, their residents are being moved into community-based care ahead, in many cases, of people who have been waiting for years for residential placements.  And those former developmental center residents appear to be absorbing whatever additional funding has been put into the community-based system as the developmental centers are phased down.

For example, we understand that the last residents of the Glavin Regional Center in Shrewsbury were moved in recent weeks into state-operated and corporate-operated group homes in the surrounding area.  Those former Glavin residents were clearly placed ahead of other developmentally disabled persons in the Shrewsbury-Worcester area waiting for residential care.

Some community-based line items did fare slightly better in the Legislature’s budget than they had in the governor’s budget plan last January.  The Conference Committee approved a $2.8 million increase over the governor’s budget for adult family supports, a $1 million increase in autism services, and a $500,000 increase in Turning 22.  The Committee accepted the governor’s budget amounts for both community transportation and day programs.  The Senate had cut the governor’s proposals for both of those line items by $500,000.

The Conference Committee, however, cut the community residential line item by $13 million from the governor’s budget proposal.  That still represents a $59 million increase over the just-ended fiscal year.  But it appears the community system would need a far larger increase than that to begin to address the serious shortfall in care and services that the system is plagued with.

In sum, the administration and the Legislature have chosen with this budget to continue the expansion of corporate care of the disabled without adequate funding or oversight.

The state is continuing to close small, strategically located developmental centers, which provide the most intensive and heavily monitored levels of care, and to scatter the residents to inadequately monitored group homes.   At the same time, the decision has been made to continue to cut funding for one of the few sources of monitoring left of the privatized system — the service coordinators.

And that privatized, community-based system itself continues to be underfunded, contravening the administration’s promised “Community First” agenda.  It would seem that a state that prides itself on the care it provides its most vulnerable citizens could and should do better than that.