Like the Wrentham and Hogan Centers, Pappas remains open, but is its future truly secure?
In a striking parallel to the uncertainty surrounding the future of the Wrentham and Hogan Intermediate Care Facilities (ICFs), uncertainty lingers over the fate of the Pappas Rehabilitation Hospital for Children in Canton.
Governor Maura Healey has stated that she has paused her proposed closure of Pappas in the wake of strong opposition to the closure from unions and other advocates, including COFAR. The governor has made no formal statements regarding the future of Wrentham or Hogan, but we believe the fates of all three facilities are connected.
Back in June, we joined self-advocates, families, and staff members urging legislators to protect the hospital-school during a public hearing of a Special Legislative Commission tasked with investigating the long-term direction of the facility.
Many speakers offered testimony, but one message was apparent: concerns about restrictive admissions criteria, lack of new long-term admissions, and ongoing discharges have raised suspicions about a quiet closure of Pappas. The same dynamics are true involving Wrentham and Hogan.
Although comments during the legislative hearing appeared to indicate that the Healey administration has changed its course and is now embracing a collaborative approach to revitalizing the campus, it is unclear how this response has materialized in the months following the committee hearing.
With reportedly 12 long-term patients and no short-term respite patients today, 28 beds remain unfilled at Pappas in the face of statewide need. The question remains: is the closure of Pappas truly paused?
The situation at Pappas has staggering parallels to the trajectory of the Wrentham and Hogan Intermediate Care Facilities (ICFs), state-run developmental centers for adults with intellectual and developmental disabilities. The census at Wrentham has dropped from 323 residents in fiscal year 2012 to 132 today, while the census at Hogan has decreased from 155 to 82 during that same time frame.
As COFAR has previously reported, the administration is also allowing the Wrentham and Hogan Centers to die by attrition by denying admissions to all but a handful of applicants in recent years while their censuses steadily drop. Families report that they are not informed of ICF options or have their placement requests rejected. If these trends continue, closure of these facilities is inevitable.
During the legislative committee hearing, COFAR voiced concerns about the restrictive admissions process at Pappas and shared our experience working with families facing similar barriers at Wrentham and Hogan, encouraging commissioners to re-examine the policies that shape access to care.
The pattern opens broader concerns about the future of essential state-run services in Massachusetts.
Background on proposed closure of Pappas
Originally founded in 1904, Pappas Rehabilitation Hospital for Children, previously known as the Massachusetts Hospital School, provides medical care and educational, rehabilitative, and therapeutic services for children and young adults with multiple disabilities ages 7 to 22+.
The 166-acre campus boasts a variety of unique features specifically designed to accommodate the needs of individuals with disabilities, ranging from covered walkways for wheelchair maneuvering, a pool with ramps, and a rehabilitation engineering department creating customized equipment and assistive technology for residents. Moreover, the facility offers patients extensive recreational programming, including horseback riding, adaptive sports, and creative arts, as well as a bowling alley, electronic gaming room, and reservoir pond for waterfront activities.
In January 2025, Governor Healey announced in her FY ‘26 budget proposal that she planned to close the Canton facility due to “aging infrastructure” as detailed by a 2023 feasibility study administered by the state. A number of children would be moved to Western Massachusetts Hospital in Westfield, over 100 miles away, where a 25-bed, modernized pediatric wing would be established in the predominantly adult hospital. She said the decision was merely a “redirecting of services of care” and would save the state 31 million dollars.
These savings amount to 0.10% of the state’s 30.4+ billion dollar Executive Office of Health and Human Service’s (EOHHS) FY ‘25 budget.
An email from Pappas admin to families specified that other students could be transferred to alternate placements such as hospitals, nursing homes, group homes, or family homes. The Department of Public Health (DPH) reported that the facility at the time had 36 patients, over half of whom were over the age of 18 and already pending discharge to “more appropriate” settings.
DPH Commissioner Robbie Goldstein justified the decision by stating, “What we know is that many of those children actually could be better cared for, more safely cared for, more compassionately cared for at home.”
Healey’s plan faced public backlash before she visited Pappas for the first time in February and ultimately paused the closure later that month, first seeking to elicit feedback from stakeholders. Families and staff members emphasized the vital nature of the specialized services provided by Pappas and expressed concern that patients would be separated from their loved ones and Pappas’ 225 employees who might not be able to relocate two hours away. Many also vocalized frustration that they were never consulted about the decision.
State House leadership echoed this surprise, with Speaker of the House Ronald Mariano asserting that the closure plans came “out of the blue” and he “didn’t know anything about it.”
Now, Pappas can neither be closed nor have patient services reduced until the Special Legislative Commission, established by an amendment filed by Canton Representative William Galvin to the FY ’26 budget and subsequently extended, submits a report with its findings and recommendations by the end of the calendar year 2027. The Commission is led by Senator William Driscoll and Representative Marjorie Decker, co-chairs of the Joint Committee on Public Health. Other members include state officials, executive leaders, Pappas staff, and the parent of a current Pappas patient.
This Commission effectively builds on the work of the Pappas Working Group (PWG) previously convened by the governor. The PWG developed an October 2025 report assessing options for the campus in the wake of the closure pause, such as “re-imagining” the campus by expanding services, pursuing phased investments on campus, maintaining the status quo, lowering the level of care, and closing the facility.
Special Legislative Commission hearing
The Pappas Special Legislative Commission hosted its June 17 public hearing to gather personal accounts and other information that would guide its study into the facility’s future. The hearing lasted over four hours and united a diverse group of families, self-advocates, staff members, and public officials, nearly all, reiterating their observations of what appeared to be a de facto closure of Pappas. COFAR also testified during this hearing in support of maintaining the facility.
Commissioners seeking concrete steps to protect Pappas
In opening statements, several Commissioners urged for substantive actions to secure Pappas’ future.
Representative Galvin stated he was “very frustrated and angry with this administration and the way they have handled this situation.” He explained that he filed an amendment establishing the Special Legislative Commission in response to the Governor’s Pappas Working Group, which he believed was created to support the administration’s closure decision. Given the new commission’s formation, he expected the administration to begin examining possibilities for facility repairs following years of underfunding and offer ideas for possible partnerships with providers but received “nothing” from them. He said he hopes that the Commissioners will develop a concrete plan for directing money into Pappas as a result of these meetings.
Similarly, Senator Paul Feeney, whose district includes Pappas, commented that he was “a little bit talked out on this.” He acknowledged the value of the Commission but stressed that it is time to “start putting our money where our mouth is and making it happen” through funding decisions to reimagine Pappas.
Closure by attrition
The urgency for these substantive changes was illuminated by the declining census referenced across hearing testimonies.
Kim Daley, a special education teacher at Pappas and member of the Commission, described how a “clear shift” has taken place since the January 2025 closure announcement in her opening statement. She stated there has been “a noticeable and sustained focus on discharging patients while admissions appear to be effectively blocked and have not been approached with any comparable urgency.”
Jim Durkin, the Legislative Director of AFSCME Council 93, similarly identified a disconnect between the administration’s official position and the messaging staff conveyed to staff. “You hear one message from the top, and then when you get down on the ground, it’s an entirely different message down there and we keep hearing the same excuse: ‘It just hasn’t trickled down yet; we’re open for business.’ Again, I call B.S.,” he said.
Senator Paul Feeney cited a monthly report from the Department of Public Health showcasing a census decline from 35 to 21, with only 2 long-term admissions and 18 discharges between January 2025 and March 2026. All other admissions are occurring on a respite basis, with stays typically lasting no more than a couple of weeks. SEIU Local 509 President David Foley later clarified that the 2 intakes were actually students who were discharged within 2 months.
Speakers attributed this lack of new admissions to the Commonwealth’s narrow definition and application of “hospital level of care” criteria. Commissioner Nicole Friel, whose daughter currently attends Pappas, noted that she was told her daughter “would no longer meet the criteria for admission had she applied currently,” despite having the same medical condition. Friel questioned whether “we are somehow defining things differently now than we did in the past.”
Need for high-acuity care for children statewide
Massachusetts Nurses Association (MNA) President Katie Murphy asserted that these developments have transpired even with a “larger need” in the Commonwealth as reflected in the report issued by the Governor’s own Pappas Working Group. This report found that there are over 12,000 children in the state with medical complexity and under 2,000 beds available in the Commonwealth, leaving considerable children “stuck” in acute care hospitals over time.
“Needs of Special Needs Population” per Governor’s Pappas Working Group Final Report
Student regression in alternate settings
Speakers detailed how many students discharged from Pappas have been moved to settings unable to meet their needs despite objections from their families, teachers, and clinical team.
Caitlin Horrigan, a Pappas teacher for over a decade, highlighted student regression post-discharge. She recounted one student who shifted from independently navigating Pappas’ campus to using a wheelchair with a 1-1 support staffer in public school and suffering a medical event requiring extended hospitalization and surgery within one month of discharge from Pappas. Other students, she said, transferred to residential programs without comparable vocational opportunities, lost key IEP services, or were denied admissions from other residential schools because of their medical complexity. “Is this ‘the community’ DPH is talking about?… They deserve a least restrictive environment for them. I have yet to see a student ‘more compassionately’ or ‘better cared for’ when they left Pappas,” she exclaimed.
Jennifer Ford, a former Pappas educator, stressed the day-to-day realities many families with medically complex loved ones face. She said, “After hearing the DPH Commissioner claim that this population is cared for more compassionately at home and better served in the community, I’ve learned firsthand it’s just not that simple. These families are the toughest, most self-sacrificing people out there; the majority of the families I serve are single mothers, often with multiple children living in cramped apartments without wheelchair lifts or elevators. It is common for a parent to physically lift a grown child out of their wheelchair and carry them up multiple flights of stairs… but what about her quality of life?”
Numerous speakers underscored that Pappas is a vibrant community in its own right. Pappas graduate John Mariani recalled in his testimony that he “didn’t feel like [he] fit in with public school” but at Pappas, finally “belonged [and] fit in.”
Response from DPH Commissioner Robbie Goldstein
DPH Commissioner Robbie Goldstein, however, maintained that the facility is operating regularly. He said, “Let me be clear in this statement: we fully support keeping Pappas Rehabilitation Hospital open and stable while this Commission conducts its vital work. The Governor’s budget fully funded continued operations of Pappas. That means we are continuing admissions and appropriate discharges, backfilling staff positions as needed, avoiding layoffs, avoiding service reductions as the process to design the best future and the right future for caring for medically complex children in the state proceeds.”
He explained that the facility is facing “challenges,” most notably, physical infrastructural issues that limit the facility’s ability to serve children with higher medical and behavioral support needs, such as individuals who require mechanical ventilation or 24/7 monitoring.
Nevertheless, he noted that leadership has “not waited” to address some of these difficulties. He stated they hired a psychiatric nurse practitioner for the first time, staff developed marketing materials to broaden outreach, and they strengthened referral networks through site visits with various hospitals.
When questioned by Chair Driscoll about how the facility appears to be “depopulated” over time, Commissioner Goldstein replied that he “can’t speak to what prior admissions have done.” He stated that during his oversight, the DPH has adhered to hospital regulations that require patients to meet “a hospital level of care.” Failure to adhere to this standard, he said, would put the state in violation of its Medicaid contracts, risking fines and other penalties from the federal government. He acknowledged that monthly admissions have historically decreased but attributed this to the “reality of the legal structure we exist in as a hospital and the physical limitations of the plant.”
In response to staff reports that they have been informed of a future closure, Commissioner Goldstein insisted, “From the top of the Department of Public Health, we have been very clear that the hospital remains open,” and individuals who say otherwise “may not be listening to leadership” and current admissions procedures.
Executive commitment to “turning a new page” for Pappas
Commissioner Goldstein later acknowledged that the administration is supportive of a collaborative approach to facilitating investments in the Pappas campus. He stated, “Now we are in a place where we have accepted that there are solvable problems there and we need to come together to figure out how to get the right investment into that campus so that it can be safe for children to be there” while also identifying solutions for the other vulnerable children statewide.
Chair Decker expressed surprise at the apparent shift from considering whether the facility should be saved to discussing how to revitalize the campus with executive collaboration but applauded it as a “welcoming conversation” that would alter how the Commission moves forward, aiming to invite members of the administration to future meetings.
She added she hopes to see “layers” of action from the administration, including identifying necessary baseline renovations, providing the Commission data regarding admissions and denials, and communicating to staff that the facility is open so information will “trickle down to the bureaucracy.”
Federal support for Pappas
The legislative hearing even drew federal participation, with Congressman Stephen Lynch, whose district is home to Pappas, testifying before the Commission.
Congressman Lynch praised Pappas as “irreplaceable” and a “national model for pediatric rehabilitation care.” He voiced frustration that federal assistance was not previously sought to maintain the facility, stating, “The leadership at Pappas has never asked me for money, never asked me for an earmark… that bothers me that we are not robustly and vigorously fighting for every single dollar we can get for that facility… We could do this building by building.” He vowed to “pursue every available federal resource to help the Commonwealth find a path forward that does not require the closing of this facility,” embracing a phased investment approach to redeveloping Pappas.
“Dear God, if we can’t help these people, what the hell are we doing… we need to step up and do the right thing,” he remarked.
Reality today
In the months following the legislative committee hearing, it is unclear how the Healey administration has changed its course to ensure Pappas’ longevity, as discussed during the hearing, although there have been some successes in the legislature.
Legislative developments
Through the legislative process, the final FY ‘27 budget, enacted July 9, fully funded the facility and extended the appointment of the Pappas Special Legislative Commission for another calendar year. However, additional efforts to obtain long-term capital investment in the facility have had mixed results. In the House version of the July economic development bill (H.5562), Representative Galvin filed an amendment proposing the establishment of a capital grant program to upgrade the Pappas infrastructure and the creation of a five-year capital plan. This amendment was not incorporated in the final version of the House bill.
In the Senate, meanwhile, an amendment filed by Senator Feeney seeking 2 million dollars for Pappas facility repairs and upgrades to increase admissions was adopted as part of the Senate’s economic development bill (S.3178) later that month. The bill is currently in conference committee. If advanced, the funding could help address longstanding infrastructure issues at Pappas, including the pool, which remains in disrepair, restoring student access to critical water therapies. Current alterations include repairing the clocktower and refacing and painting the pergolas.
Limited long-term admissions and ongoing discharges
There is limited evidence of meaningful progress in increasing long-term admissions.
In light of Commissioner Goldstein’s comments that Pappas is open and accepting admissions, members of the Pappas community took to social media to share information about the application process. On July 1, they celebrated that Pappas had received its first long-term admission in almost a year. That month, the exterior Pappas signage featured new postage “Accepting Admissions,” seemingly opening the doors to new students.
In an interview with Michael Poirier, a former Pappas student and staff member for decades, he revealed that the reality on the ground is much different. When Pappas students began the new school year, they were joined by only 11 long-term patients and 4 short-term respite patients, with multiple students slated for discharge in the first few weeks. 29 empty beds remained. He said at the time the July admission reflected the only new admission after the Special Legislative Commission hearing, with 6 discharges occurring since that time.
Today, there are reportedly 12 long-term patients and no short-term respite patients, with 28 empty beds.
This lack of new admissions has continued even in the face of demand for placement. Poirier said that the administration has “absolutely not” changed course to work collaboratively with the Special Legislative Commission as discussed during the hearing or achieve meaningful increases in admissions as aligned with Commissioner Goldstein’s claim that Pappas is open and accepting new admissions. He said it took until the beginning of October for the DPH to provide the Special Legislative Commission the information it requested during the June hearing regarding patient referrals and denials. He added approximately 20 long-term admission referrals have been denied over the past year, even when the admissions committee voted to accept the patients, since the decisions were overruled by Commissioner Goldstein and his team at the DPH and Pappas. This includes an individual who has reportedly been in an acute care hospital in Boston for over 100 days and is recognized by Boston physicians as meeting the criteria for “hospital level of care.”
While the Governor’s team has stated that there is a commitment to keeping Pappas open as the Special Legislative Commission continues its work, he said, “Indecision and failure to make important meaningful decisions that will meet the needs of those Pappas serves, could serve, or will keep the doors open undermines the Governor’s public commitment and is nonsense.” He urged infrastructural investments to improve existing buildings, opening the outpatient program, and a “true plan” to diversify the campus and meet the needs of people of all abilities across state agencies as the path forward. He noted a plan to reopen outpatient services was previously submitted to DPH leadership in May; however, no action appears to have been taken by the Department.
Healey administration assuring commitment to reimagining Pappas
During her remarks at AFSCME Council 93 Legislative Conference in September, Governor Healey reiterated the administration’s collaborative approach to reimagining the facility. She said, “I know people haven’t been happy about Pappas. Pappas was underinvested in for decades, okay. Now I think we’re in a good place; we’re having the conversations, we’re thinking about, with your input and involvement, how do we reimagine Pappas… We are going to do something good there, I can promise you that.”
In early October, a member of DPH leadership reportedly recognized the need for new admissions to Pappas and apologized to staff for some of the challenges occurring throughout the year. Soon after, the Chief Medical Officer (CMO) for DPH hospitals visited Pappas alongside other EOHHS officials.
In an October 10 weekly update from Representative Decker, she highlighted that she met with the legislative delegation and Healey administration officials to discuss the future of Pappas as part of the Special Legislative Commission’s ongoing work.
The Press Offices of Governor Healey, the Executive Office of Health and Human Services, and the Department of Public Health did not respond to my request for comment on the status of Pappas.
Similar circumstances at Wrentham and Hogan Intermediate Care Facilities (ICFs)
Ambiguity surrounding the status of Pappas also clouds the prospects of other state-run facilities. Although formal closure plans have yet to be announced, the future of Wrentham and Hogan Intermediate Care Facilities (ICFs) for adults with intellectual and developmental disabilities remains fraught.
Families indicate that they are not informed of the existence of these facilities and are denied placement. It is only through media coverage or attorney involvement that we have seen the few accepted individuals gain entry.
Meanwhile, the census continues to decrease. Wrentham’s census dropped from 323 residents in fiscal year 2012 to 132 today, while Hogan’s declined from 155 residents to 82 during the same period.
Even if Pappas is ultimately preserved, the loss of Wrentham, Hogan, and the similarly dwindling state-operated group home network will eliminate other high-acuity adult care options for Pappas patients aging out of the system.
COFAR raised concerns about admission policy restraints at Pappas and detailed similar impediments at Wrentham and Hogan during the Special Legislative Commission hearing, asking commissioners to review the policies impacting care access. The overlap presents wider concerns about the fate of important state-run services in the Commonwealth.
While we are working in the legislature to preserve Wrentham and Hogan and are interested in exploring the establishment of a legislative commission dedicated to their future, it appears that the efficacy of such a commission will depend on the administration’s willingness to collaborate.
Continued advocacy to protect Pappas, Wrentham, and Hogan
We are urging our members to contact their state legislators and encourage them to call for the Legislative Commission to begin working on a long-term plan for the future of Pappas Rehabilitation Hospital for Children.
Also, please ask the Commission to consider investigating restrictive admissions to other key state-run placements for people with disabilities, including the Hogan Regional Center and Wrentham Developmental Center. The patterns across these placements point to larger issues within the EOHHS involving patient access to care.
Let the Commission know that even if Pappas survives, the question remains where its residents will go when they turn 22 and age out of that care. If Wrentham and Hogan are closed, a critical option for residential care will have been lost permanently not only to those Pappas residents but to all persons with intellectual and developmental disabilities in Massachusetts.
You can find your state legislators here: https://malegislature.gov/Search/FindMyLegislator
Additionally, we ask that you consider contacting Governor Healey’s office and encourage her administration to work collaboratively with the Legislative Commission by taking tangible steps to protect all of these valuable assets.
You can contact Governor Healey’s office at (617) 725-4005.
Former Pappas employee here. One of the big challenges at facilities like PRHC is that a fair number of would-be admissions struggle with behaviors that pose dangers to themselves and staff. Staff were constantly raising these concerns but lacked adequate or clinically appropriate staffing resources that would help to ensure the well-being of the children and the dedicated staff, all of whom deserve to be in a safe and supportive environment. Staff also raised these issues with MNA 7, but nothing was done apart from rally-round-the-flag “ra ra!” complaint sessions, and many staff were upset with the perceived inaction of the local union rep. Lots of talking, lots of mouths in motion, lots of online articles expressing outrage, lots of public posturing, lots of keyboard warriors, but pitifully little real world action.
So, it’s easy to express outrage and demand more admissions. But reality is more complicated than that. Before going on an admissions frenzy, wouldn’t you first want to slow down and make sure that the hospital is properly equipped to manage dangerous behaviors with the necessary clinical staff with the appropriate training and expertise? Not to mention the necessary infrastructure and equipment for complex medical needs? Last I heard, the mental health department had mostly vanished, and the medical staff turnover was an ongoing issue.
I think that your comment is extremely important. One of the issues with the new workforce safety bill is that there really is no plan for individuals who do not have the capacity for intent but have behaviors that could harm healthcare professionals. Many families are worried that their loved ones may end up incarcerated from that bill. I believe that this issue needs careful discussion, and individual plans need to be created. In terms of the Pappas closure—that will not help the problem you mentioned. It would merely move it to a new location. The other locations that the students will end up in will probably be even less equipped to handle these situations than Pappas is.
Agreed, individual plans with concrete behavior management strategies that are actually followed by appropriately trained and educated staff are extremely important but unfortunately scarce. And yes, I also agree that closing PRHC does nothing to solve anything, it just kicks the proverbial can into western MA…unless of course the new facilities will offer the necessary space, resources, equipment, and properly trained staff to address the many needs (I have no idea if that is the case or in the works).
Regarding the bill you reference, which I believe is H.4767, not only does it fail to address the key issues you raised, but it appears to accomplish little more than add to the already unmanageable avalanche of healthcare paperwork and bureaucratic talking-head orientation activities that are already draining the limited time and patience of the employees who do the legitimate hard work on the front lines, not to mention continuing to vampirize taxpayers.
State departments (and let’s not forget DMH and DDS) are already bloated with expensive job-justification rackets like “risk assessments” (read: let’s draft another 30-page ChatGPT-generated report that no one will read and rehash the same problem behavior that we already know exists from getting repeatedly assaulted on the front lines), elaborate internal reporting mechanisms (these already exist), and “orientation” programs often spearheaded by womb-to-tomb state employees who frequently lack the appropriate credentials, training, and/or real-world experience outside of cubicle culture. More paper, more reporting, more documentation, more talking head “educators” at lengthy orientations, and a “don’t worry, we’ll toss you some paid leave after you get badly injured” … is that really the best they can come up with?
the Healy administration seems to have a way with their words, dragging feet and ignoring. She’s up for election and trying really hard for her lies to be heard so people stop disliking her. “Reimagining Pappas” could mean anything. It doesn’t appear she has made a commitment to serving those who need it. Dragging their feet and not staffing it correctly and not letting people in is a move to appear cooperative, yet with no follow through. They fail individuals by choice not mistake. So sick and tired of broken promises, silence, lies and threats. I’m well past fed up. I will of course do my part by trying to be heard by the wall of stone they project.
A facility cannot meaningfully be described as available to the people it is intended to serve if the government controls admission under criteria that affected families cannot see or meaningfully evaluate. “Hospital level care” means nothing. What exactly are the criteria? Nobody knows. Just like nobody knows what the criteria is to get admitted to Wrentham.