COFAR blog

While thousands of persons with developmental disabilities reportedly have to wait months or years for residential and other services from the Department of Developmental Services (DDS), internal departmental emails indicate that hundreds of individuals are also first being forced to wait for up to a year or more just to be ruled eligible for those services.

The emails, which were obtained by COFAR under a Public Records Law request, confirm that DDS is dealing with a backlog of eligibility applications due to a shortage of psychologists who are needed to make eligibility determinations on an individual basis.

One of the more severe backlogs apparently afflicted the DDS Metro Region, which had a backlog as high as 380 in unprocessed applications in recent months, although that backlog was projected to be reduced to 80. One unnamed region had a backlog as of this past September of nearly 600 applications.

Under DDS regulations, the Department must determine eligibility for supports and services within 60 days; but the process has taken more than a year in some cases, according to the internal emails.

The emails, which were provided on November 21, and documents previously provided on October 18, show that DDS had been dealing with the backlog problem at least as far back as January 2021. Also, as we reported, based on the first set of documents, DDS was the focus of a federal investigation of an inordinate delay in processing at least one application.

Lack of coordination in dealing with the backlog

The internal emails also indicate there has been a lack of coordination among DDS regions in responding to the backlog problem, and that some regions have experienced more severe backlogs than others.

The emails further suggest that there had been no statewide meeting among DDS regions to discuss the backlog problem until this past September. Discussions about the backlog issue appear to have largely been held within or between individual regions.

In one case, the director of the Northeast Region emailed the Central West and Southeast regional directors in September to ask if either or both of them could help with the Northeast Region’s backlog.

OCR investigation of complaint based on eligibility delay

The federal Office for Civil Rights (OCR) with the U.S. Department of Health and Human Services investigated at least one complaint that an inordinately long delay by DDS during the past two years in processing an application for services amounted to discrimination against the applicant.

It took more than a year for DDS to determine that the applicant was, in fact, not eligible for DDS services. Under the Department’s regulations, eligibility determinations should take no longer than 60 days.

The OCR ultimately determined that DDS had not discriminated against the applicant. However, the federal agency noted that DDS had acknowledged that the delay in processing the application was due to “limited clinical resources.”

According to the OCR report, DDS also stated that, “the departure of a full-time RET (Regional Eligibility Team) psychologist in June 2021 affected the turnaround for reviewing applications.” Under DDS regulations, the Regional Eligibility Teams consist at least one licensed doctoral level psychologist, an individual with a master’s degree in social work, and a Department eligibility specialist.

Backlog issue dates back at least to January 2021

According to the OCR report, the complainant alleged that the DDS Regional Eligibility Team had received their application for adult Community Developmental Disability (CDD) supports in January 2021. But it wasn’t until February 2022, or more than a year later, that the applicant was evaluated for his or her eligibility.

The emails COFAR received from DDS were dated from July 2022 through this past October. One of the email threads indicated that an applicant for services had been waiting without a determination from September 2021 through July 2022. A July 20, 2022 email in that thread, apparently between employees of the DDS Southeast regional office, stated that the individual had applied for services 10 months previously and had “not heard anything since then.”

In an email in the thread, Tracey Daigneau, who is listed as eligibility coordinator for the Southeast Region, stated that the individual’s application “was forwarded for a determination in late December (2021). Due to the high volume of applications and the fact that our full-time psychologist position was vacant for six months, we have a backlog that we are just now catching up from,” Daigneau stated.

One region had a backlog of almost 600 as of this past September

As recently as this past September, one DDS regional office was reporting a backlog of 590 applications awaiting determinations by an eligibility psychologist, according to a September 20 email.

The email was sent to Michelle Harris, a deputy assistant DDS commissioner. The name of the sender of the email was redacted in the document provided to COFAR, so we were unable to determine the region which the backlog concerned.

Harris responded the same day to the sender, saying, “Whoa! – We have a part-time psych starting next week and as soon as we have her up and running we will be able to float her over to help you out.” Harris also stated that DDS had “started the process to hire a second part-time psych and we will again float her over to help you out while you search to fill your position. Thanks for the numbers!”

Metro Region projected backlog reduction

In emails on September 25 and 26, an eligibility coordinator for the Metro Region stated that an increased pace in completing eligibility determinations by three psychologists working in that region was projected to reduce the region’s backlog from 382 to 80. Another regional official referred to the projection as “fabulous news.”

But that good news hasn’t been uniform throughout the various regions.

Northeast Region case

In the Northeast Region, an applicant emailed a DDS eligibility coordinator on April 6 of this year, stating that “we have been waiting for a response regarding DDS application for almost a year now. I’m just trying to get any update regarding application and to see if there is anything more I need to do.” The applicant’s name was redacted.

On April 10, the applicant received a reply, stating that, “our psychologists remain significantly backlogged at this time and I don’t anticipate an eligibility determination until sometime later this month. We apologize for the delay and appreciate your patience.”

Help sought from two other regions

In September, Kelly Lawless, the Northeast regional director, emailed the directors of two other regions, stating that the Northeast Region had a “10-12 month backlog and a vacancy for our psychologist yet again.”

In her email, Lawless asked the two other directors, “Do you have a backlog in your determinations? Any chance you have any capacity to help out the NE region?”

The following day, one of those directors, Anthony Keane, the Central West regional director, emailed a member of his staff to ask, “is there any bandwidth to assist (the Northeast Regional Office)?

Keane’s staff member emailed back on September 29 to ask what the scope was of the Northeast Region’s backlog problem, and said he did know it had been “a long-term issue.” The staff member wrote that while there was no backlog in making eligibility determinations in the Central West Office, there was still a delay “at the front end regarding receiving applications.”

As of October 6, Keane’s staff member stated that a psychologist who was working for the Central West region had stated that she would provide assistance to the Northeast region. 

Perceived lack of coordinated response among regions 

Despite the communications among regions, departmental emails in September implied that there was a perceived lack of coordination from the DDS Central Office in addressing the backlogs.

In one email, dated September 18, an official in the Metro Region stated to Lawless that following a meeting the previous week with Harris, the DDS deputy assistant commissioner, “the regions were asked to provide numbers about the backlog of applications. There was very little context about what was prompting this.” The official suggested a need for “common definitions across the regions.”

Lawless, who was then also the Metro Region interim director, responded to the regional official, stating that, “There is a plan to have a statewide meeting with key people around eligibility and ways to address some of the challenges.”

There was also confusion over a plan to enlist the UMass Medical School’s Center for Developmental Disabilities Evaluation & Research (CDDER) in addressing the backlog problem. On September 20, an official, whose name was redacted, emailed Harris to ask whether there was going to be a “‘restructuring’ or ‘reorganization’ of eligibility,” and adding, “We will need to jump on rumors and reassure staff to prevent any further loss of staff or loss of morale, or in the case of rumors being true, assist in transition to new roles.”

Harris responded, saying, “Not sure what the rumors are but no one needs to jump ship. Our new psychs are not from DDS and we can kill two birds with one stone – you can help get them experience for me and they can knock down your waitlist as they gain experience.”

DDS meanwhile stated in its November 21 response to our Public Records request that the Department was not under any legal obligation under the Public Records Law to respond to our questions about the documents.

As we stated in early November, the documents we had received in October implied a growing dysfunction within DDS in carrying out its mission of caring for the most vulnerable members of our society.

The second set of emails shows that DDS has taken measures to respond to the backlog problem, but the records do not provide much assurance that the Department has gotten a grip on the problem.

Regions appear to have largely been dealing independently with the situation. Employee morale has reportedly suffered, and, most importantly, clients and their families have been left, as usual, to wait for answers and for services.