(Cross-posted from The COFAR Blog)
Governor Patrick and the state House of Representatives have specified funding for the Department of Developmental Services budget for the coming fiscal year that is way out of balance.
Budget legislation proposed by the governor and approved so far by the House would raise the level of funding to DDS corporate residential providers to more than $1 billion. That’s an increase to the providers of more than $140 million, or more than 16 percent, over current-year spending in FY 2015 dollars. At the same time, both the governor’s and the House budgets would either cut or provide much more meager increases for most other DDS line items.
Here’s a proposal to the Senate Ways and Means Committee to restore some balance to DDS funding. As noted below, we are suggesting to the Ways and Means Committee, which is now considering the entire state budget, that at least part of the proposed increase in the Community Residential (corporate provider) line item be redirected to other DDS line items.
We have calculated that if the governor’s proposed increase in the Community Residential line item were reduced by just 2.1 percent – to a 14.7 percent increase – the Legislature could redirect close to $18 million of the governor’s $145 million increase to the state-operated group homes, DDS service coordinators, the Autism Division, Turning 22 program, Respite and Family Supports, and the remaining developmental centers in the state.
COFAR’s proposed changes in DDS line items for FY ‘15
| Suggested decreases from gov’s FY ’15 budget numbers | Percent inc. from FY ’14 | Suggested increases from gov’s FY ’15 budget numbers | Percent inc./dec. from FY ’14 | ||
| Community res. (providers) | ($18,142,085) | 14.7% | State-operated group homes | $6,755,404 | 10.0% |
| Adm. (service coordinators) | $2,714,544 | 5.0% | |||
| Facilities | $6,254,933 | -7.7% | |||
| Autism Div. | $446,207 | 6.0% | |||
| Turning 22 | $460,003 | 5.0% | |||
| Respite Family | $1,136,399 | 5.0% | |||
| Total | $17,767,489 | ||||
The following are the details of our proposal:
Community Residential: FY ’15 budget line item 5920-2000: 14.7 percent increase
Both the governor and the House have proposed a disproportionately large increase in this line item for the coming fiscal year. We would urge the Senate Ways and Means Committee to propose a lower increase.
The governor proposed a $145 million, or 16.8 percent, increase in Community Residential funding in FY ’15 dollars. The proposed increase would bring the line item to $1.009 billion. This would amount to a 63.7 percent increase in funding for the providers since FY ’07.
On April 30, the House approved a slightly lower increase in the line item to $1.006 billion – still a 16.4 percent increase from the current year in FY ’15 dollars.
If the governor’s proposed increase was reduced by just 2.1 percent in this line item, it would save $18.14 million in FY ’15 dollars, which could be directed toward other line items that have been proposed for little or no increase in funding, or else are slated to be drastically cut, such as the facilities line item.
We would note that our proposal would still allow for a 14.7 percent increase in funding for the Community Residential line item, which would bring the line item to $990.7 million in FY ’15 dollars in the coming fiscal year. This reduction in the line item increase to 14.7 percent would allow for the following increases, or reductions in proposed cuts, in the following line items:
State-operated Residential 5920-2010: 10 percent increase
Both the House and the governor have specified a $12.6 million, or 6.5 percent, increase in funding for DDS state-operated group homes, to $206.3 million. We would urge the SW&M Committee to increase funding for this line item by an additional 3.5 percent, which would add $6.7 million to the amount proposed by the governor in this line item.
DDS data show that close to 42 percent of the 372 individuals moved out of developmental centers in the state since 2008 were placed in state-operated group homes. Just 13 percent of those individuals went to provider-run group homes. (We’ll say more about this in an upcoming post.)
Since 2008, 38 new state-operated group homes have been built in the state, but 3 have been closed or converted to provider-operated homes. DDS has projected that it will build an additional 6 state-operated group homes, but will close or convert 5 state-operated facilities to provider residences. Meanwhile, 157 new provider-operated group homes have been built since 2008.
Additional funding is needed for the state-operated group home system to preserve it as a choice for people waiting for residential care in the DDS system.
State facilities 5930-1000: Reduction from a 12.7 percent cut to a 7.7 percent cut
The governor proposed a $15.8 million, or 12.7 percent, cut in the developmental centers line item for FY ’15, to $109.2 million. The House approved even a deeper cut of 13.5 percent. Since FY ’07, the line item will have been cut by close to 47 percent if the governor’s FY ’15 budget is adopted.
The administration is dismantling the developmental centers; however, since 2008, more than 45 percent of the individuals moved out of the centers have been sent to either the remaining Wrentham or Hogan developmental centers. Some funding should be restored to this account to ensure that current conditions in the remaining centers are maintained.
DDS administration 5911-1003: 5 percent increase
The governor proposed just a $551,000 increase in the DDS administrative account in FY ’15 dollars, to $65.9 million, which is less than 1 percent in inflation-adjusted numbers. The House approved even a smaller increase – just 0.43 percent.
The DDS administrative account pays for service coordinators, who are being phased out of their jobs as the administration and Legislature look to award service coordination work to corporate providers. Providing just a 5 percent increase in this line item would add $2.7 million to the amount proposed by the governor.
Autism Division 5920-3010: 6 percent increase
Both the governor and the House specified virtually no increase in the Autism Division line item, which amounts to a cut of 1.8 percent in FY ’15 dollars. Given the growing public awareness of the prevalence of people with autism in the population, it is troubling that neither the administration nor the Legislature appear to have placed a priority on funding this line item.
COFAR would suggest providing for a 6 percent increase in the Autism Division line item for FY ‘15, which would add $446,207 to the governor’s proposed amount.
Respite family supports 5920-3000: 5 percent increase
Both governor and the House specified a 2.9 percent increase in this line item, which would bring it to $54.9 million in FY ’15. The line item has been constantly under-funded and would be 12 percent lower in FY ’15 dollars than it was in FY ’07 if the governor’s budget is approved.
COFAR is suggesting a 5 percent increase in funding for this line item, which would add $1.14 million to the amount proposed by the governor and the House.
Turning 22 5920-5000: 5 percent increase
This line item has also been constantly under-funded for many years. Both the governor and the House specified no increase in funding for the line item for FY ’15, which amounts to a 1.9 percent cut in funding in FY ’15 dollars.
A 5 percent increase in funding for this line item would add $460,000 to the amount specified in the governor’s and the House budgets.
Our proposal emphasizes family choice
We think this proposal to redirect some DDS funding is consistent with our long-standing position that individuals and their families — and not the providers — should have the primary say in the type of care and services they receive. Families have consistently indicated, for instance, that they prefer state care to care provided by corporate providers. Our proposal would redirect millions of dollars to neglected or underfunded state-operated programs and services.
For that reason, we are not supporting the providers’ call for an additional $5.5 million increase in the DDS community day and work account (5920-2025) because the providers want the additional money to be used to transfer intellectually disabled persons from sheltered workshops to day programs that they run. COFAR is supporting the preservation of sheltered workshops in the state for those who choose to remain in them.
Finally, given the lack of adequate oversight of the DDS contracting system, our proposal to redirect DDS funding would at least reduce some of the increase that may well go straight into the pockets of the corporate executives of the provider companies. We hope the Ways and Means Committee will consider our proposal before releasing their version of the budget this week.
