COFAR blog

The Patrick administration has repeatedly assured the public that it intends to plow tens of millions of dollars in projected savings in closing four state developmental centers back into the community system of care.
 
But now, even the staunchest advocates of the developmental-center closures appear to be starting to question whether the community system is deriving any fiscal benefits from the planned shutdowns of the Fernald, Monson, Glavin, and Templeton centers.
 
In the current and coming fiscal years, Day Habilitation services, a key community-based budgetary line item is getting hammered by the administration.  And the Association of Developmental Disabilities Providers and the Arc of Massachusetts, which have pushed hard for closures of the developmental centers, are up in arms about the cuts.  Day habilitation involves a coordinated system of speech language therapy, occupational therapy, physical therapy, behavioral management, developmental skills training, and other programs for persons with intellectual disabilities.
 
In a series of press releases and emails to their members over the past week, the ADDP and Mass Arc have decried cuts of $1.6 million in the current fiscal year and $5 million in the coming year in Day Habilitation services.  
 
That may not sound like a lot of money being cut, but in an email to members, dated Feb. 4, the ADDP describes Day Habilitation services as a key component of the administration’s “Community First” initiative, which is centered around the closures of the developmental centers.  Day Habilitation should be one of the prime beneficiaries of the money supposedly being saved in closing the centers.  But it’s not deriving any benefit at all.
 
As the ADDP email states:

Over the last several years, the Commonwealth has turned to Day Habilitation programs to provide the day activity for state owned and operated group homes, as well as hundreds upon hundreds of people with disabilities who have moved from state institutions into community settings.

In fact, the Administration’s Community First, Institutional Closure and Olmstead Plans make heavy use of Day Habilitation services by moving former residents of Fernald and other closing state institutions into state owned and operated group homes and private provider day habilitation programs for non-residential supports and services (the state doesn’t operate similar day activity programs).

The proposed Mass Health Day Hab cuts means that there will be less staff on hand to serve many frail individuals who have a variety of challenging health concerns, as well as cognitive impairments.  
 

In 2008, Health and Human Services Secretary JudyAnn Bigby claimed to The Boston Globe that the administration would be plowing $45 million a year back into the community system as a result of the shutdowns of the developmental centers.  As of today, it doesn’t appear, however, that the administration is even able to prevent further cuts in one of the key components of its community-based approach.
 
It’s worth noting here is that Day Habilitation services are funded out of the state’s massive Mass Health budget, and not from the budget of the Department of Developmental Services.  Yet, similar habilitation programs in the developmental centers are funded under the developmental center line item in the DDS budget.  So, once again, while the administration may be claiming that closing the developmental centers will save money, what it is really doing is shifting DDS costs to other budgets and not adequately  funding those budgets. 

Bottom line: Rather than saving money, the administration has compounded its problems by both closing developmental centers and cutting the Day Habilitation line item.  The line item cut is a huge and scary loss and a problem for those who currently use Day Hab programs and those for whom it is proposed as they leave the developmental centers.  It is not solved by closing the centers, and in fact adds even more people into this overburdened system.