COFAR blog

Fiscal Year 2023 in Massachusetts actually started this past Friday — on July 1 — but, as has become inceasingly the case in recent years, the state Legislature has gone past the fiscal year deadline wthout enacting a state budget.

For nearly a month, the Fiscal 2023 budget has been subject to closed-door deliberations in a conference committtee whose job is to iron out differences between the budget positions adopted this spring by the full House and Senate.

As a result, our budget priorities remain up in the air — dependent on the decisions being made by the six-member conference committee. Until the committee submits its report to the full Legislature, we won’t know the outcomes of the following priorities (not necessarily in order of importance to us):

1. More funding for direct-care wages

In early June, the Senate approved a budget provision requiring that any corporate human services provider receiving state funding under a special reserve account direct at least 75% of that funding to compensation for direct-care and front-line staff.

There was no such requirement in the House version of the budget. As a result, the House-Senate conference committee will decide whether the 75% provision stays in the final budget.

Earlier this year, both the House and Senate approved $230 million in funding for the reserve account for Fiscal 2023 — the same amount proposed by Governor Baker. The 75% funding provision would appear to require that $173 million in the reserve account be directed by human services providers to boost direct care wages.

We are supporting the 75% funding requirement although it is unclear how much the requirement would raise direct care wages. We have called for a mnimum direct care wage of $25 per hour.

2. Higher funding for state-operated group homes and Intermediate Care Facilities

State-operated group homes and the Wrentham Developmental Center and Hogan Regional Center would receive nominal dollar increases in the Fiscal 2023 budet.

But while the increase for the state-operated homes would have been roughly equal to the inflation rate when the governor proposed his budget in January, the proposed funding increase both for those residences and the Hogan and Wrentham centers would be lower than the inflation rate today.

Both the House and Sente have adopted the governor’s budget numbers for those line items. In inflation-adjusted terms, these budget numbers amount to cuts in funding for both the ICFs and state-operated group homes.

While we don’t expect the conference committee to increase funding for either line item, we hope it doesn’t cut either one.

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

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

That decrease in funding when adjusted for inflation stands in contrast to funding for the DDS corporate residential line item (5920-2000), which has skyrocketed over the past decade to over $1.4 billion. That is an amount that dwarfs the funding for state-operated group homes and the two remaining ICFs in Massachusetts.

3. Rectifying problems with state commission on the history of state facilities

We have urged members of the budget conference committee not to approve what appears to be a last-minute Senate budget amendment that would establish a state commission to study the history of institutional care of persons with developmental and other cognitive disabilities.

As is the case with proposed legislation still in committee to establish the commission, the Senate amendment does not make it clear that the proposed commission would acknowledge major improvements since the 1980s in care and conditions in the state’s developmental centers or ICFs.

Given that the House did not adopt a similar budget provision to establish the commission, the commission proposal is subject to the House-Senate conference committee.

We think it is unwise for the conference committee to adopt the commission idea as a budget provision. This is an idea that needs to work its way through the checks and balances of the committee process.

At the least, we think language should be added to the proposed legislation stating that the commission will examine the complete history of the state’s institutional facilities.

4. Correcting misleading language that the U.S. Supreme Court ordered the elimination of institutional care

We have asked legislative leaders to correct language in the budget that mistakenly implies that the U.S. Supreme Court ordered the closures of institutions for persons with developmental disabilities.

The budget language cites Olmstead v. L.C., the Supreme Court’s landmark 1999 decision, which considered a petition by two residents of an institution in Georgia to be moved to community-based care.

The Olmstead decision has been frequently mischaracterized as requiring the closure of all remaining state-run congregate care facilities in the country. The decision, however, explicitly states that federal law — specifically the Americans with Disabilities Act (ADA) — does not require deinstitutionalization for those who don’t desire it.

In one of three instances in which we are seeking changes or corrections, the budget language states that DDS must report as of December 15 to the House and Senate Ways and Means Committees on “all efforts to comply with …Olmstead…and… the steps taken to consolidate or close an ICF…” (my emphasis)

In letters sent in May to the chairs of the House and Senate Ways and Means Committtees, we noted that closing institutions was not the intent of the Olmstead decision, which was written by the late Justice Ruth Bader Ginsburg.

We are concerned that the misstatements in the ICF line item in the state budget each year could allow the administration and Legislature to justify continuing to underfund the line item, and possibly to seek the eventual closures of the Wrentham and Hogan centers.

Once again, given that this language is in both the House and Senate versions of the budget, it isn’t clear that the conference committee will make any changes in this particular budget. But whatever the short-term outcomes, we will continue to fight for these priorities.