COFAR blog

Governor Charlie Baker last week proposed a revised state budget for the current fiscal year in light of the COVID crisis that would boost funding for some programs for persons with developmental disabilities, but would sharply cut day program funding.

The community-based day program cut reflects the impact of the COVID pandemic on in-person programs, according to a statement from the Department of Developmental Services (DDS). The resulting changeover to virtual programs on platforms such as Zoom has not been welcomed by some families and guardians who say the quality of in-person programs cannot be replicated on virtual platforms.

Baker’s $45.5 billion state budget does contain a proposed increase of $780,000 over his original plan in January in order to fund the implementation of “Nicky’s Law.” The new law would create a registry of names of caregivers in the DDS system who have had abuse cases substantiated against them.

It isn’t clear, however, that Baker’s budget plans will be approved by the Legislature. The governor’s revised budget proposes increases in overall state spending beyond what he proposed in January despite the projected loss of $3.6 billion in state tax revenues due to the pandemic.

Overall, the impact of the governor’s revised budget on programs and services funded by DDS appears mixed. Also, while Baker’s budget would boost Medicaid funding by  $834 million, it isn’t clear how that would affect DDS programs.

Day program funding would be cut

As noted, the news isn’t good in Baker’s revised budget for the provider-based line item for community-based day programs (5920-2015). The budget proposes a cut of $22.4 million, or 9.2%, in that line item when adjusted for inflation.

Baker had originally proposed a 6% increase in the day program line item in January.

DDS Ombudsman Chris Klaskin issued a statement from the Department that appears to indicate that a significant number of DDS clients aren’t attending day programs in light of the pandemic:

The proposed funding level incorporates revisions to (day) program forecasts as a result of DDS provider agency closures, reduced demand for services, and capacity requirements to maintain physical distancing in transportation and congregate settings advised by the Centers for Disease Control and Prevention (CDC).

Over the course of COVID-19 pandemic, DDS and its agency providers have worked in partnership to accelerate and incentivize alternative day programming in virtual and remote settings (i.e. Zoom classes) to supplement in-person services in the interim.

Some families have indicated to us that Zoom-based activities don’t work well with their loved ones who are DDS clients. At the same time, those families do not want to expose their loved ones to possible COVID infection in in-person programs.

We have noted that while staff working in residential DDS programs are now required to be tested for COVID-19, there still is apparently no such requirement for staff in day programs.

I sent a follow-up request to Klaskin today for information on the number of day program agencies that have closed, and the amount of the drop-off in demand for the programs.

Transportation funding would be boosted

In addition to the increased funding for the implementation of Nicky’s Law, Baker’s revised budget proposes a $3.5 million, or 11.7%, increase in the DDS transportation line item (5911-2000). It’s not clear why that provider-based line item would be increased by such a large percentage at the same time that the day program line item is being cut.

Mixed news for provider-run group homes

It appears the largest DDS line item — provider-operated group homes (5920-2000) — would get a very modest increase from Fiscal 2020 under the governor’s proposal. It’s actually a small cut of 0.33% when adjusted for inflation.

However, despite that apparent slow-down in funding this year, the provider-run group home line item will have been boosted since Fiscal 2012 by almost $423 million, or 49%, to $1.28 billion, if Baker’s proposal is adopted.

We have frequently noted that overall, the Legislature and successive administrations have steadily increased funding for privatized DDS-funded functions while either cutting or providing minimal increases in funding for state-run services.

Also, the governor proposed what appears to be a big increase in the Chapter 257 Reserve Fund (1599-6903), which goes to the residential providers in the form of rate increases. Baker would increase that line item by $119 million to $160 million. It isn’t clear, though, that the entire increase would take effect in the current fiscal year, which would be half over by the time the governor’s budget were to go into effect.

State-run developmental center funding cut as usual

Funding for the two remaining state-run developmental centers (5930-1000) would be cut as usual. Baker’s revised budget would cut the line item by $1.7 million, or 1.6%, when adjusted for inflation. That line item will have been cut  by more than $70 million since Fiscal 2012. Since then, four of six remaining centers have been closed.

Under Baker’s revised budget, the relatively small state-operated group home line item (5920-2010) would get a modest increase of $3.86 million this year, or 1.7%, when adjusted for inflation.

Also, the DDS administration line item (5911-1003) would get a proportionally larger increase of $4.5 million, or 6%. At least some of that funding is for DDS service coordinators, who manage and oversee services to thousands of DDS clients.

Funding increased to implement Nicky’s Law

One piece of potential good news is that the governor’s revised budget would boost funding to the Disabled Persons Protection Commission (DPPC) by $909,600, or 18.6%. That is $781,000 more than the 2.6% increase that Baker proposed in January for the DPPC.

As noted, the additional funding is intended to implement Nicky’s Law. That funding would enable the administration to avoid a lengthy delay in implementing the long-sought legislative initiative to prevent abusive caretakers from continuing to work in the system.

A member of the staff of state Representative Kay Khan, House Chair of the Legislature’s Children, Families, and Persons with Disabilities Committee, said the additional $910,000 for the DPPC is a pro-rated amount. It is based on the DPPC’s original Fiscal 2021 request for $1.2 million to establish the registry.

Andrew Levrault, DPPC assistant general counsel, said the agency anticipates hiring additional investigatory and legal staff, in part, to defend the agency in legal appeals of the placement of individuals on the registry. He said more than 700 provider agencies are expected to access the registry each year to conduct checks on thousands of prospective employees.  In addition to the investigative and legal staff, the DPPC “needs to substantially expand its information technology infrastructure” to meet the registry access needs of the providers.

As usual, the budget process raises many concerns about the near-term and long-term future of care for those in the DDS system; and answers are often hard to come by. The COVID crisis is vastly complicating an already complicated process.