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I’ll be defending the Pacheco Law at a Boston Bar Assn. forum next month
Based on our blog posts earlier this year defending the scrutiny of the privatization of state services that is provided under the Pacheco Law, I’ve been asked to present a defense of the law at an upcoming forum sponsored by the Boston Bar Association.
Arguing in opposition to the Pacheco Law at the January 7 forum will be Charles Chieppo, a senior fellow at the Pioneer Institute, one of the state’s leading proponents of privatization and leading critics of the Pacheco Law.
Also participating in the forum will be two presenters from the State Auditor’s Office, which administers the law, and Michael LaGrassa, assistant vice chancellor for administrative services at at UMass Dartmouth.
The Pacheco Law has borne the brunt of much bad press and political criticism over the years; but we have argued that most of that criticism has been based on misinformation about the intent of the law and what it actually does.
The law requires a state agency seeking to privatize services to compare bids from outside contractors with a bid from existing employees based on the cost of providing the services in-house “in the most cost-efficient manner.”
If the state auditor concurs that the proposed contract is less expensive and equal or better in quality than what existing employees have proposed, the privatization plan will be likely to be approved. If not, the auditor is likely to rule that the service must stay in-house.
Earlier this year, in the wake of a critical report about the Pacheco Law by the Pioneer Institute, the state Legislature suspended the law’s provisions for three years with regard to the MBTA.
While the Pacheco Law does not appear to have had a role in preventing the past privatization of human services, which we are primarily concerned with, we are concerned that the Baker administration’s next step might well be to exempt future privatization of human services from the law.
At Blue Mass Group, where we often cross-post our blog posts, I and other commenters have already engaged in quite a bit of online debate (here and here) over the Pacheco Law with Greg Sullivan of the Pioneer Institute. I’m looking forward to continuing to set the record straight about this important law at next month’s forum.
We shouldn’t criminalize intellectual disability
When people with intellectual disabilities commit assaults or other violent crimes, our response should not be to race to lock them up.
That, however, appears to be the intent of the Bristol County District Attorney’s Office.
An Attleboro District Court judge has ruled that Brett Reich, who has a severe intellectual disability, is not competent to stand trial for assaulting two female staff workers outside his group home last March. The Bristol County D.A.’s office, however, has appealed that ruling, contending that Brett had “engaged in very serious assaultive behavior, and it is our obligation to ensure the protection of the public.”
Brett’s father, Daniel, is concerned that the D.A.’s actions could lead to imprisonment for Brett, or his possible placement in Bridgewater State Hospital, a facility for persons with mental illness who have been convicted of or charged with committing violent crimes. “It’s inhumane,” Daniel Reich said. “He’s never going to get out if he goes to Bridgewater State. They are trying to destroy him and us. We want him home safe with us.”
We agree with Daniel Reich that neither Bridgewater State Hospital nor jail would be appropriate places for Brett. Brett, who is 24, is intellectually disabled, not mentally ill. He needs residential care from the Department of Developmental Services.
Bridgewater State has, in fact, been a focus of continuing controversy over the use of restraints and isolation. Last year, The Boston Globe published a series of articles about the use of isolation and forced restraints at at the facility, including restraints that resulted in the death of a patient there in 2009. The federally funded Disability Law Center has called for major reforms at Bridgewater State Hospital, including removing it from the control of the Department of Corrections.
Assault and then eviction from provider residence
After the alleged assault occurred outside his Attleboro group home, Brett Reich was evicted from the residence, according to his father, Daniel. The group home is run by Lifeworks, Inc., a DDS provider.
Brett is large man — he stands 6 foot, 3 inches and weighs about 240 pounds. He allegedly assaulted the two staff workers, one of whom was his personal caretaker, as he was being taken for a trip outside the residence.
As he was being placed in a van, Brett suddenly turned on the staff worker. According to The Attleboro Sun Chronicle, Brett began choking the woman and grabbed a fistful of hair from her head before she fled to the group home where she locked the door.
While still outside the home, Reich allegedly attacked another female staff member moments later when she arrived at the home to assist the first worker. The newspaper said he punched her head and body and bit her right hand. Both women, who were treated for cuts and bruises at Sturdy Memorial Hospital in Attleboro, told police they feared for their lives.
In retrospect, it doesn’t appear that the Lifeworks group home was suitable for Brett. Daniel Reich does not believe the staff in the residence were properly equipped or trained to deal with Brett’s behavioral issues. Daniel said that when Brett was first placed by DDS in the Attleboro group home, he and his wife, Carrie, had requested that Brett have male direct-care staff “who were bigger and stronger.” That request was not heeded, however.
Before being placed in the Attleboro group home, Brett had lived in a residential facility in New Hampshire in which his aides were men. That program, however, came to an end when Brett turned 22 and was required to move from the special education system to the DDS system of care in Massachusetts.
Reich said that Brett’s behavioral issues are controllable if he receives his prescribed medications.
We think an appropriate residential setting for Brett would be either a secure DDS state-operated group home (which would tend to have better trained staff than a provider-run residence) or the Templeton Developmental Center, a DDS-run Intermediate Care Facility, which has staff that is experienced in caring for residents with behavioral issues. Other possible ICF choices that should be made available to Brett are the Wrentham Developmental Center and the Hogan Regional Center.
As we have previously noted, however, DDS does not appear to inform most individuals and families in the system that state-run residential care is available to them. Daniel Reich said DDS offered only the Lifeworks group home as a residential option for Brett. We think most families of developmentally disabled persons are not even aware that state-run alternatives to provider-operated residences exist.
Under federal law, DDS is required to provide developmentally disabled individuals with a choice of available residential alternatives, which we believe would include the facilities I’ve noted above. The Home and Community Based waiver of the Medicaid Law (42 U.S.C., Section 1396) specifically requires that intellectually disabled individuals and their guardians be informed of the available “feasible alternatives” for care.
In addition, the federal Rehabilitation Act (29 U.S.C., Section 794) states that no disabled person may be excluded or denied benefits from any program receiving federal funding.
If, in fact, DDS is unwilling to provide Brett with a state-run residential placement, as required by law, then it would seem the only options left for him would be prison or Bridgewater State Hospital.
The case of Anthony Remillard
Prison, in fact, has been the outcome for the past two years for Anthony Remillard, another developmentally disabled man, who was charged in the fatal assault of Dennis Perry, a 64-year-old developmentally disabled man, at the Templeton Center.
After the alleged assault against Perry, Remillard, who is also now 24, was placed in the Worcester House of Correction. In August of this year, he was found be a Superior Court judge to be incompetent to stand trial. But as of November 30, Remillard remained an inmate in the prison.
While DDS cleared itself of responsibility in the Remillard case, we believe the incident raises many questions about the Department’s policies and procedures involving care and supervision of clients with behavioral issues. Despite that, we are convinced that a facility like Templeton remains a far better option for people like Brett Reich and Anthony Remillard than does either Bridgewater State Hospital or the Worcester House of Correction.
The lack of adequate options for care for potentially violent people with developmental disabilities is something that policy makers should be concerned with. It is unfortunate that the state Legislature, in particular, has shown little interest in this problem, even though the Children and Families Committee at one point considered holding a hearing on the Remillard case. That hearing has never occurred.
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