Healey administration keeping wraps on policy that may involve future closure of the Wrentham Developmental Center
The Healey administration is developing a new policy regarding admissions to the Wrentham Developmental Center, according to a response by the Department of Developmental Services (DDS) to a Public Records request we filed last month.
But the administration is declining to release any details about that policy.
We are concerned that what appears to be the first change in policy regarding the Wrentham Center in recent years could involve or lead to the closure of the critically important Intermediate Care Facility (ICF).
On Tuesday, I sent an email query to DDS Commissioner Jane Ryder about the development of the new policy. I also emailed State Senator Robyn Kennedy and Representative Jay Livingstone, the co-chairs of the Legislature’s Children, Families, and Persons with Disabilities Committee, to ask whether they were aware of the policy change.
To date, I haven’t received a response from Ryder or from Kennedy or Livingstone.
On April 24, we submitted a Public Records request to both DDS and the Executive Office of Health and Human Services (EOHHS) seeking policies regarding admissions to the Wrentham Center and Hogan Regional Center, and admissions to DDS’s state-operated group homes.
We also asked for any projections or plans concerning the future census and closure of Wrentham, Hogan, or the state-operated homes.
In addition, we asked for records containing current data on the census or number of residents at Wrentham and Hogan, and data concerning both the census and number of vacancies in the state-operated group home system.
EOHHS stated that it had no records responsive to our request.
DDS responded last week with updated census numbers (see our discussion of that below). That response included a letter stating that the Department does have a “responsive record relating to admissions” at Wrentham.
But the letter said the Department was withholding that record from public disclosure because it is “a draft memorandum relating to policy development,” and is therefore exempt from disclosure under the state’s Public Records Law. The letter added that “…release of this record could taint the deliberative process if prematurely disclosed.”
The Public Records Law exempts from disclosure “inter-agency or intra-agency memoranda or letters relating to policy positions being developed by the agency…”
COFAR has filed Public Records requests with DDS for the past several years seeking records containing projections and plans concerning the future census and closure of Wrentham and Hogan and the state-operated group homes. In the past, DDS consistently stated that it had no such documents. This is the first time DDS has stated that it does have such a record.
New data show ICF census continuing to drop
Both the Wrentham and Hogan Centers provide a critical backstop for care for those persons with the most severe and profound levels of intellectual and developmental disabilities. And both centers meet strict ICF standards under the federal Medicaid law and regulations for care and staffing.
However, new data received last week from DDS under the Public Records request referred to above continue to show a decline in the census in both facilities. The data confirm that the administration is phasing out both the Wrentham and Hogan Centers.
The census at Wrentham as of April 24, the date of our Public Records request, was 159. That is down from 168 in the preceding fiscal year, and down from 323 in Fiscal 2013 – a 51% drop.
The census at Hogan as of April 24 was 88. That is down from 95 in the preceding fiscal year, and down from 159 in Fiscal 2011 – a 45% drop.
As the chart below containing the updated DDS numbers shows, the census in each facility has been dropping each year since Fiscal Year 2013 in Wrentham’s case, and since Fiscal Year 2011 in Hogan’s case.
Administration already appears to be excluding virtually all new admissions
We have reported on, and heard privately from several families that have been denied placements for their loved ones at Wrentham and Hogan. (See here and here.) The case of Kristen Robinson may be one of the most extreme examples of this.
Kristen, who is profoundly intellectually disabled, legally blind, and quadriplegic, has been confined to Faulkner Hospital in Boston for nearly two months following a choking incident in her family’s home in early April. Yet, DDS has continued to deny her family’s request that she be placed at the Wrentham Center.
In fact, DDS Commissioner Ryder had initially promised Kristen’s sisters on May 10 that Kristen would be at least temporarily placed at Wrentham for evaluation and rehab as of May 14. But the next day, Ryder rescinded that promise and claimed Kristen’s sisters had “misheard” her.
State-operated group home census continuing to drop
New DDS data in response to our Public Records request also continue to show a drop in the census of the DDS state-run group home network.
As of April 24, the census in state-run group homes was 986. That is down from 996 in the preceding fiscal year, and down from 1,206 in Fiscal 2015 – an 18% drop.
DDS also continuing to claim they don’t track vacancies in state-operated group homes
Despite the dropping census in the state-operated homes, the capacity or total number of available beds in those residences rose by 17 from the year before, according to the latest DDS data. “Capacity” is defined by DDS as the number of beds available in the state-operated group homes on a specific date.
According to the latest data from DDS, the capacity for state-operated group homes as of April 24 was 1,148. That is up from a capacity of 1,131 as of June 30, 2023. That is despite the fact that the census in the homes, as noted above, dropped by 10 residents from the preceding year. This implies a growing number of vacancies exists in those residences.
But DDS claimed in response to our April 24 Public Records request that it doesn’t track vacancy rates in state-operated group homes. The Department said it didn’t have any records showing state-operated group home vacancies as of June 30, 2022 or 2023, or as of April 24 of this year.
We have appealed to the state’s Public Records supervisor, arguing that we find it hard to believe that DDS would not know or keep track of vacancies in the group home system that it directly manages. We regularly hear from family members who say they are told by DDS that there are no vacancies in state-operated or provider-operated group homes in specific areas of the state when they request such placements for their loved ones.
We would ask how DDS officials can truthfully say vacancies do not exist in given areas if they don’t know or keep track of that information.
All of this new data reinforces our concern about the future of state-run care for people with intellectual and developmental disabilities in Massachusetts. The statement by DDS that it is developing a new policy regarding admissions to the Wrentham Center fuels that concern.
It’s unfortunate that this administration is not only continuing to pursue an ideology of privatization of human services in Massachusetts, but is unwilling to share information with the public about it.
The same goes for the co-chairs of the key committee that has primary jurisdiction over issues involving people with disabilities – the Children, Families, and Persons with Disabilities Committee.
After having met with us once last fall to discuss our concerns about the direction in which the administration is headed, the co-chairs also seem to have lost interest in communicating with us.
COFAR blog 
Makes me wonder if there were to be a ‘prescriptive‘ order by a Primary Care Physician or by a clinical team (as exists with long-term care admission procedures), DDS would be obligated to comply with an admission to an ICF.
This may be the missing link! Make DDS comply with a medical order(s).
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I would assume that the DDS would just ignore it. You would have to use it in court to see what would happen.
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The other thing we absolutely need to know from the State/DDS is: What are they going to do with intellectually disabled people who require skilled nursing facility care?
This doesn’t begin to address the fact that Intensive Support homes are anything but for individuals with severe autism and intellectual disability. However, right now, Kristen Robinson’s family cannot get her the medical treatment she needs because DDS is blocking access to care.
Is the State’s plan to contract with out-of-state vendors to provide this care, if needed?
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Vinfen operates a nursing home. There might be others as well that might take our loved ones. None of them have the services like Wrentham Developmental Center.
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Creating a new policy for admission to Wrentham?
I think not.
Medicaid clearly makes the policies regarding admissions.
The Medicaid statute states that if a state does include ICFs in its “Medicaid State Plan,” as Massachusetts does, the state must provide that:
There is nothing in the Medicaid statute that exempts states from offering an ICF as an option in response to an application for that form of medical assistance. Persons who are found to be eligible for HCBS waiver care and have been found to meet the eligibility requirements for ICF-level care.
Moreover, federal Medicaid regulations state explicitly that individuals seeking care, and their families and guardians, should be “given the choice of either institutional or home and community-based services. [42 C.F.R. § 441.302(d)]
Medicaid is federal and their laws supersedes state laws. Perhaps contacting the higher ups at Medicaid or who ever else that have powers beyond the state about this situation would be the way to go.
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Sadly, that wouldn’t be CMS Boston. Totally in cahoots with the state.
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We need to go to Washington, DC and speak to the folks at CMS there. When I was there for the VOR Legislative Initiative, Hugo asked if I could make a meeting at the CMS, but it was the time of my flight- so I didn’t go.
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I think I recall that there is something in the Medicaid regs that if the state doesn’t comply that they could lose their Medicaid funding. Might be worth looking into.
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How about setting up a meeting via zoom with the the folks at CMS in Washington first, then set up a meeting in person. I’d be definitely interested in the zoom meeting and the meeting in DC with CMS.
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