COFAR blog

State-operated group homes would receive an increase in funding in the coming fiscal year roughly equal to the inflation rate, according to Governor Charlie Baker’s proposed Fiscal Year 2023 budget, which was released Wednesday (January 26).

Overall, the budget contains mixed news for Department of Developmental Services (DDS) line items. The new fiscal year starts July 1.

While the state-operated group homes would get a much needed 6.17% increase in funding, the numbers don’t look as good under the governor’s budget for the developmental centers, community-based day programs, autism services, and transportation programs.

According to the governor’s proposal, state-operated group homes would receive $256 million in Fiscal 2023. That would amount to an increase of $14.8 million from the current-year appropriation. That is an increase roughly equal to the current inflation rate for New England. We are urging a minimum increase in state-run programs at least equal to the inflation rate.

Still, even with that increase, the state-operated residences would have a long way to go to catch up to the percentage increases in funding for provider-run group homes over the past decade.

Developmental centers, day programs, and transportation continue to see cuts

The Wrentham and Hogan Developmental Centers line item would receive $109.1 million under the governor’s Fiscal 2023 budget. That would amount to an increase of $5.4 million, or 5.2%. That is less than the minimum $6.3 million increase needed to keep pace with inflation.

The developmental center or Intermediate Care Facility (ICF) line item has, moreover, been cut by $68.4 million, or 39%, over the past decade, when adjusted for inflation.

Community-based Day and Work Programs would receive $227.4 million in Fiscal 2023. That would amount to a cut of $7.6 million, or 3.6%. We are urging a minimum increase of at least $13.4 million in that account to keep it even with inflation. The account provides funding for job skills training and other activities to help clients make the transition to the mainstream workforce. 

A DDS “Progress Report” last year showed a drop in total “integrated employment” of DDS clients in Massachusetts from a high in October 2019. The Progress Report indicated that the numbers of clients being placed in DDS day programs, where few meaningful work activities are available, has exceeded the numbers entering integrated employment in recent years.

Transportation funding would be cut for the second year in a row under the governor’s proposal for Fiscal 2023. The line item would receive $24.8 million in funding, which amounts to a $7 million, or 22%, cut from the current fiscal year.

The Autism Omnibus line item, which provides services and supports for people with autism and related disabilities, would also be cut. That line item would receive $36.6 million in Fiscal 2023, down $4 million, or 10%, from the current fiscal year appropriation.

Some line items would get increases

The DDS corporate residential providers would receive $1.44 billion under the governor’s budget plan. That would amount to an increase of $34 million or 2.4% from current year. While the increase would be less than the rate of inflation, the provider group homes will have gotten an increase of $563 million, or 64%, since FY 2012, when adjusted for inflation.

In contrast, funding for the state-operated group homes has been increased by about half that percentage over the past decade.

In addition, Baker has proposed a major increase in a reserve fund (1599-6903) intended to boost contractual payments by the state to the residential providers. His Fiscal 2023 budget would increase the size of the residential provider fund from $79 million to $230 million in the coming fiscal year.

The Turning 22 line item would also get a major increase under the governor’s budget plan. The line item would receive $84 million in Fiscal 2023. That would require a $59.5 million, or 242%, increase in funding from the current-year appropriation.

Respite and Family Supports would be increased by $5.2 million, or 6%, to $90.6 million.

The DDS administration line item would receive $87.8 million in Fiscal 2023, a 6.4% increase. The administrative line item includes funding for DDS service coordinators, a key departmental function.

Reasons for our funding increase requests

Flat or declining funding levels for state-run residential programs appears to be connected with an apparent policy by the administration not to offer those settings as options for people seeking residential placements.

Documents provided by DDS last September confirm that the census in the state-operated group homes has been declining since Fiscal Year 2015. We previously received information from DDS showing a decline in the census and virtually zero admissions in 2019 and 2020 to the Wrentham and Hogan Centers.

In turn, funding for these facilities has dropped or has remained flat for years. 

Unless families have the money for a lawyer or are politically connected, most people waiting for residential placements are never informed that state-operated group homes or developmental centers exist. Yet, as COFAR has reported, the federal Medicaid law requires that individuals and their families and guardians be informed of all the “feasible alternatives” for placement.

State-operated group homes and the Hogan and Wrentham centers are the backbone of the DDS system because they care humanely and efficiently for even the most profoundly intellectually disabled and medically involved people. They also provide jobs.

These decreases in funding and the census in state-run residential facilities have been ongoing while funding under the DDS corporate residential line item (5920-2000) has skyrocketed over the past decade to over $1.4 billion, an amount that dwarfs the funding for state-operated group homes and the two remaining developmental centers in Massachusetts.

In a survey we conducted in 2015, we found that more than 600 executives employed by corporate human service providers in Massachusetts received some $100 million per year in salaries and other compensation. As just one example, the FY 2020 IRS filing by the Edinburgh Center, a DDS corporate provider, listed eight executives as each making over $100,000 that year, while the CEO received more than $230,000 in compensation.

Baker’s proposal to increase funding next year to the state-operated group homes, at least at the rate of inflation, is a positive step, albeit a minimal one. We hope over the next six months to see a turnaround in the declining funding trend for the developmental centers and day programs as well.