COFAR blog

Governor Maura Healey last week proposed a budget for Fiscal Year 2025 that includes an increase in funding for the Wrentham and Hogan Intermediate Care Facilities (ICFs) and state-operated group homes in Massachusetts.

But the governor’s budget doesn’t appear to be an attempt to change a longstanding practice of underfunding those state-run services and steadily increasing funding to corporate group home and community-based day program providers.

Healey proposed an increase of only $1.2 million in the ICF line item, which would amount to a funding hike of less than 1%, for FY ’25. That is well under the current average inflation rate for New England of 2.9%. As such, the governor’s budget proposal represents a cut in the ICF line item when it is adjusted for inflation.

Healey’s proposed $15.3 million increase in the state-operated group-home line item would amount to a 4.8% funding boost. While that is above the inflation rate, it is still far less than the governor’s proposed percentage increases in many DDS corporate provider line items.

For instance, Healey is proposing an 18.5% increase in the community-based day program line item, a 19.3% increase for transportation providers, and a 22% increase for respite providers.

Corporate group home cut would be offset by reserve account increase

Healey cut the DDS corporate provider group home line item by $40.3 million earlier this month as part of an across-the-board series of “9C” cuts in the face of a decline in projected revenues in the current fiscal year.

But in her FY ’25 budget, the governor is proposing not only to restore $23.2 million of the $40.3 million cut to the line item, she is also proposing a record-breaking $217 million increase to a separate reserve fund for the corporate providers. The governor’s FY ’25 budget would bring total funding under the Human Services Provider Reserve fund to $390 million.

So it would appear that despite the declining revenues, corporate DDS and other human services providers would receive a net increase of nearly $200 million under the governor’s budget plan.

Questions about provider reserve fund 

Last week, The Boston Globe reported that Healey was planning in her FY ’25 budget to “tackle the staffing crisis plaguing social service care providers with a big investment…”  That investment appears to include the governor’s proposed $390 million appropriation to the human service provider reserve fund, plus $95 million from a number of other reserve funds.

The total of $485 million in proposed additional funding is projected by the administration to raise direct-care wages to $20 an hour, “at the lowest,” the Globe reported.

We have a number of questions about the oversight of the reserve fund, however. We have long been unable to get answers to those questions, including the amount that has been spent from the fund to actually raise direct-care wages.

Also, for the past two fiscal years, the Legislature has inserted language into the line item for the reserve fund stating that 75% of the funding under the account must be directed to boost direct-care wages. Yet, this language is not included in Governor Haley’s FY 25 proposal for this line item.

Also. the governor’s FY ’25 budget plan indicates that zero dollars were expended in FY ’23 from this same line item that year even though $285 million had been appropriated to it. (See screenshot below.) It’s not clear what has been expended from the line item in the current fiscal year. This raises further questions for us as to where the money in the line item gone.

Minimal increase for ICFs

Gov. Healey’s FY ’25 budget would increase the ICF line item (5930-1000) by $1,777,048, or less than 1% over the current year appropriation. The FY ’25 ICF line item proposed amount is $124,809,632. 

We are recommending a $5 million, or 4%, increase in the ICF line item in the FY ’25 budget. That would nominally raise the line item to $128,577,887. That increase would allow the line item to keep pace with inflation moving forward.

The news is better for the state-operated group home line item (5920-2010). The governor’s FY ’25 budget would raise that line item by $15,327,687 or 4.8%. That would raise the line item to $333,099,736.

ICF budget language

We are continuing to recommend changes in the ICF line item language. (The language doesn’t appear to be a part of the governor’s proposed budget. It gets added by the Legislature.)

The legislative language in the current year budget states that DDS must report yearly to the House and Senate Ways and Means Committees on “all efforts to comply with …(the) Olmstead (U.S. Supreme Court decision)…and… the steps taken to consolidate or close an ICF…” (my emphasis). However,  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 to justify continuing to underfund the line item, and possibly to seek the eventual closures of the Wrentham and Hogan centers.

We believe the budget language should be changed to state: “…the steps taken to consolidate or close an ICF and the steps taken to inform families of the choices available for residential care including ICF care.”

Secondly, the legislative line item lists three conditions for discharging clients from ICFs to the community, but leaves out one of the key conditions in Olmstead, which is that “the client or their guardian does not oppose the discharge.” We are requesting that that condition be added to the language in the line item.

In sum, we hope the governor and her staff will begin to understand the importance of state-run services as a part of the fabric of care for persons with intellectual and developmental disabilities. We are seeking a meeting with the governor and her staff to explain the disastrous result if current budget trends are allowed to continue.

Secondly, we think the administration and the Legislature need to understand that adequate oversight is needed of the hundreds of millions of dollars in budget appropriations that are intended to raise direct-care staff wages.