(Cross-posted from The COFAR Blog)
Despite the fact that an unknown number of intellectually disabled people are waiting for residential services in Massachusetts, new data provided by the state appear to show that virtually none of those people are getting into state-operated group homes.
According to the data, provided by the Department of Developmental Services in response to a Public Records Law request, the number of people living in state-operated group homes in Massachusetts increased by a total of 144 between fiscal 2008 and 2015.
Previously, DDS had provided data showing a total of 156 persons had been transferred from state-run developmental centers to state-operated group homes between fiscal 2008 and 2014.
These numbers seem to imply that the entire increase in population in the state-operated homes since 2008 came from the developmental centers. Also, the numbers appear to imply that up to 12 of those transferred residents have either died or been transferred for a second time to some other location since 2008.
We’ve written previously that DDS data appeared to show that the Department was failing to inform people seeking residential care of the option of state-run services. Families and individuals appear to be directed almost exclusively to group homes run by corporate providers to DDS.
In addition to provider-run group homes, DDS maintains a network of group homes that are staffed by departmental employees. State workers have better training on average than do workers in privately run residences, and have lower turnover and higher pay and benefits.
There are an unknown number of people in Massachusetts waiting for residential care and services from DDS. This number is unknown because DDS doesn’t officially acknowledge a waiting list. The Massachusetts Developmental Disabilities Council has cited a 2010 survey indicating that some 600 people were waiting for residential services in the state, and up to 3,000 people were waiting for family support services.
Despite the apparent lack of sufficient housing and services for all of those who need it, DDS appears to be steadily phasing out state-run services and transferring those services to private providers. Yet, the capacity of the provider-based system is clearly inadequate to meet the entire need for services. And as we’ve recently noted, privatization of state services doesn’t automatically result in lower cost or better quality.
Some other highlights of the new DDS numbers:
- There were a total of 266 state-operated homes in Massachusetts as of April 2015, which amounted to a net increase of 40 homes over the total number in 2008. Previous data from DDS indicated that DDS had closed 28 state-operated residences since 2008.
- Virtually all the (97 out of 99) people living in the state-operated homes that were closed were transferred to the new state-operated homes.
Thus, there has been a total of 253 people who have been transferred since 2008 from the developmental centers and the closed state-operated homes, apparently all to the new state-operated homes.
This raises a further question about DDS’s priorities. Given the hundreds waiting for residential care in the state, why did DDS close 28 state-operated group homes in the past eight years?
- DDS has no projections on the number of people who will be living in state-operated homes in the next five to 10 years.
The bottom line is that it appears the state-operated DDS system has been expanded only enough to accommodate people already receiving services.
The situation may violate the federal Medicaid Law, which requires that intellectually disabled individuals and their guardians be informed of the available “feasible alternatives” for care. In addition, the situation appears to violate the federal Rehabilitation Act, which states that no disabled person may be excluded or denied benefits from any program receiving federal funding.
On July 27, I sent an email to DDS, asking for information on the number of people who have been admitted to state-operated group homes who were not transferred there from other state-operated homes or from the developmental centers. I haven’t yet received a response to that question, but I will be very surprised if the answer is more than a handful of people.
As this post attempts to demonstrate, it is virtually impossible for anyone seeking DDS services to be admitted to a state-operated group home. One of the few people who was able to accomplish it in recent years had to file a federal lawsuit to do so.
Both the administration and the Legislature have provided disproportionate increases in funding to the provider-operated residential system in Massachusetts, and have continued to short-change state-operated care. Now that it turns out that the previous fiscal year ended with a $200 million surplus and not the deficit that had been projected, we hope the Legislature will begin to consider restoring some balance to the DDS system, and begin to fund state-run care adequately.
