Seeking a chance to speak truth to power
State Rep. Anne Gobi (right) listens to Joan Douty (center) talk about her daughter's experience at Glavin
The administration, which also has no time to listen to people like Joan Douty, claims Glavin and the other centers must be closed because they’re too expensive to operate. But COFAR has maintained that the administration’s claimed cost savings in closing the centers appears to be based on an apples-to-oranges comparison of the average community-based resident and the average facility-based resident. Developmental center residents are older, more medically involved and more intellectually disabled on average than community-based residents.
Moreover, as COFAR and other advocates have noted, the centralized services model of the developmental centers is highly cost-efficient when compared to the dispersed clinical, medical, and day services that characterize the community system.
COFAR has called since last year for an independent study of the cost of closing or maintaining the developmental centers because previous budget amendments have resulted in flawed analyses done by the administration itself, concluding, of course, that the facilities should be closed.
But here’s the problem. In the Massachusetts Legislature, a handful of people make all the decisions, and Rep. Dempsey is one of them. There was no floor vote this week on Rep. Gobi’s amendment for the independent study. In a closed-door meeting in his office, Dempsey simply ordered that Gobi’s amendment be scuttled. It was not included in a catch-all budget amendment boosting human services line items that will be voted on this week.
Among those who Rep. Dempsey apparently has been listening to are the human service vendors in Massachusetts, who run most of the community-based group homes in the state and who are seeking more business when the developmental centers are closed. In a letter sent to Dempsey and other legislators a day before Gobi’s amendment was thrown out, the Association of Developmental Disabilities Providers continued to pump out misinformation about the developmental centers.
The ADDP letter called for rejection of Gobi’s amendment and repeated the dubious claim that the developmental centers are “expensive and inefficient to operate.” So why not agree to an independent study which would settle the question as to which system is most efficient? To that, the ADDP letter made the ridiculous assertion that “this issue has been the subject of study for 30 years.”
Among the other pieces of misinformation in the ADDP letter was the claim that the developmental centers aren’t needed because “families overwhelmingly choose community settings for their loved ones.” The ADDP letter didn’t mention that that’s because admissions to the developmental centers have been effectively blocked since the 1980s.
The fact is that families that are being transferred from the developmental centers targeted for closure have overwhelmingly chosen to be placed at other developmental centers or in state-operated group homes. They are avoiding the vendor-run system because they know it is beset with problems of poorly paid and under-trained staff.
The Senate now remains the only real hope for this sorely needed independent cost study. We believe the study should be done by a non-governmental entity selected by either the State Inspector General or State Auditor. Once again, though, the question remains whether Senate leaders will allow such an amendment to be debated in the light of day or whether they will do what the House did and quietly kill it in the proverbial smoke-filled room.
Where is our money going?
How accurately is the state tracking salaries earned by human services contractors in Massachusetts?
We looked at state fiscal reports, known as Uniform Financial Reports (UFR’s), which were filed by three of the largest contractors to the Department of Developmental Services, and we think these records raise that question.
In each case — the May Institute, Vinfen, and Seven Hills — the UFRs for the Fiscal Year 2009 listed lower salaries and other compensation for the same executives than did 2009 IRS tax filings for the same firms (Form 990s available on GuideStar). The UFR’s also listed a lower number of executives earning high levels of compensation than were listed on the Form 990s for the same firms.
Why might this be a problem? Because the state Operational Services Division (OSD) depends on the information in the UFRs to determine how much in state funds to apply to that compensation. By regulation, state funds going towards an indivdual contractor executive’s compensation are capped at $143,986 a year, according to OSD.
Take the May Institute, for instance. According to its UFR, the nonprofit contractor took in roughly $105 million in revenues in 2009, of which about 66 percent came from the Department of Developmental Services and a variety of other government agencies in Massachusetts. About 79 percent of the total revenues came from all government sources.
As of April 8, 2011, the online UFR states that Walter Christian, the May Institute CEO, made $509,798 in salary and other compensation in the year ending June 30, 2009. Based on that number and on information from OSD, we calculate that OSD would have been required to “disallow” about $366,000 of that total compensation, meaning that amount would have to come from other sources than the State of Massachusetts.
However, the IRS Form 990 for the May Institute for the same 2009 fiscal year lists Christian’s total compensation as $1.087 million. That’s a difference of more than half a million dollars between Christian’s compensation as listed on the state’s UFR and on the IRS 990 form. If Christian really earned $1.087 million in compensation, we calculate that the state should have disallowed more than $940,000 of it, not just $366,000 of it.
All of this suggests that based on the 2009 UFR, the commonwealth may mistakenly think that more than half a million dollars in potential state funds went into direct care or other operations at the May Institute, when it really went toward Christian’s compensation.
I would note that the UFR website stated as of April 8, 2011, that the latest online version of the May Institute 2009 UFR had been submitted by the contractor on March 22, 2010, more than a year ago, and still hadn’t been reviewed by OSD. A previous version of the UFR had been submitted in December 2009. The website stated that there were “no issues pending” regarding that version.
On March 21, I submitted a written question to OSD about the discrepancy in the listing of Christian’s compensation on the UFR and Form 990, and followed up with a phone call and an email on April 5, saying I was preparing a blog post about the issue. I still haven’t received a response.
An OSD official told me in the April 5 phone conversation that he had been too busy to get an answer to my question (and a few related questions about the UFR) and was going on vacation the following week. He said he didn’t know when he would be able to get the answers.
It’s not just with Christian’s compensation that there are discrepancies between the UFRs and the Form 990s, however. The May Institute UFR lists only Christian and one other executive as making over the $143,986 compensation threshold, above which compensation must come from sources other than the state. The Form 990 lists a total of 13 employees of the May Institute as making over that threshold amount. The discrepancy in listed compensation between the two forms was $3.4 million.
For Vinfen, the 2009 Form 990 listed a total of 10 employees as making over the threshold compensation for a total of $2.2 million, whereas the UFR lists a total of only four employees making only $997,000 — a difference of $1.2 million.
The UFR website stated as of April 8, 2011, that the latest online version of the Vinfen 2009 UFR had been submitted by the contractor on December 10, 2010, and was found by OSD to be “deficient.” No further information was provided.
For Seven Hills, the 2009 Form 990 lists four employees making over the threshold, for a total of $1.2 million in compensation, compared with the UFR, which lists only two employees making a total of $816,000. That’s a difference of $385,000.
The latest online version of the Seven Hills 2009 UFR was submitted to OSD on April 21, 2010. The OSD website stated that there were “no issues pending.”
Last month, The Globe published a letter I wrote on behalf of COFAR, suggesting that Governor Patrick scrutinize the salaries of human services contractors as part of an overall crackdown he had announced on salaries in the state’s independent agencies.
In response, Michael Weekes, president of the Providers’ Council, accused me of attempting to “smear the leaders” of the human services sector and of “making scurrilous attacks that distort the facts and mislead taxpayers.” Weekes said my concern over executive compensation was “moot” because state law caps the amount of state funds that can be applied to executive compensation. He added that my “real concern” should be over the low pay of direct-care workers in the human services contract system, many of whom only make $12 an hour and have gone three years with no increase.
I agree with Weekes that we should be concerned over the low pay to those direct care workers. That’s exactly why we’re asking these questions about the salaries of executives making as much as $1 million or more a year, and whether those executives’ salaries may be soaking up state funds that should be going to the direct care workers.
The fight goes on to save the Glavin Center
At a breakfast on Tuesday at the Glavin Regional Center in Shrewsbury, state lawmakers heard from family members and guardians trying to save this critically important facility from closure.
And the families heard from the lawmakers, who said they will have a tough battle on their hands to get their message heard among the well-organized forces on Beacon Hill calling for the shutdown of all remaining developmental centers in the state for persons with intellectual disabilities.
Meanwhile, lawmakers will file an amendment to the state budget bill coming up for debate in the House, requiring an independent cost analysis before Glavin and two other centers can be closed.
State Senator Michael Moore of Milbury made the comment during the Glavin breakfast, saying the amendment will specify that the study be done by the state auditor, inspector general, or another independent entity selected by a competitive bidding process.
COFAR has criticized a cost analysis submitted to the Legislature last summer by the Patrick administration, which claims that closing the Glavin, Monson, and Templeton developmental centers will save the state $20 million a year. No analysis was submitted at all for the Fernald Developmental Center, which is the first on the administration’s closure list.
Because we believe there are numerous flaws in the administration’s cost analysis, we at COFAR have urged that an independent study be submitted to the Legislature.
Rep. Anne Gobi (left), Rep. Vincent Pedone (center), and Senator Michael Moore (right) at Glavin breakfast. Moore said lawmakers will file a budget amendment calling for an independent analysis of the costs of closing three developmental centers.
At Tuesday’s breakfast, Al Bacotti, a former director of the Glavin Center, made the case to the lawmakers that Glavin is both cost-effective to operate and functions as a “safety net” for a group of severely intellectually disabled people who have been unable to live successfully in community-based settings.
Bacotti maintained that he saw a number of instances in which costs tripled for Glavin residents needing intensive care, after they were transferred to community residences. Those residents no longer had the benefit of centralized clinical, therapeutic, and medical services, which had been available at Glavin, he said.
Bacotti also disputed the argument made by facility closure advocates that Glavin and the other developmental centers are segregated from the surrounding community and restrict residents’ freedom.
Former Glavin Director Al Bacotti (standing) speaks at breakfast. Seated to his left is Roland Charpentier, president of Friends of Glavin. Bacotti termed Glavin "cost effective" and a "safety net."
“There are actually more freedoms here (at Glavin) than for many people in community settings,” Bacotti said. “To the argument that everyone should be in the community, my answer is it didn’t work for the people here.”
Rep. Vincent Pedone of Worcester replied at that point that he needs more data on those cost issues because “people (on Beacon Hill) are telling us the opposite is true.” COFAR delivered a set of facts and figures on developmental center and community costs directly to Rep. Pedone today (Wednesday).
During the Tuesday breakfast meeting, Wilfred Dumont told the lawmakers about his son, Stephen, 26, who has been a Glavin resident for the past four years. Stephen is intellectually disabled and is deaf and has cerebral palsy and other medical conditions. Prior to coming to Glavin, he lived in a community-based facility where he began banging his head so severely that even a helmet didn’t help.
“He opened up his head at least 30 times,” Dumont said. That behavior has ceased since he’s been at Glavin. “Now he’s smiling for the first time and he comes home on weekends,” Dumont added. He said Stephen still has some behavioral episodes, but they no longer go on for a month at at a time. “To move him to another facility won’t work. You might as well put him in a cage,” he said.
Stephen Dumont (center) with his mother, Rose, and father, Wilfred. The staff at Glavin got Stephen to stop banging his head and injuring himself.
We will tell more about Stephen’s case and about other Glavin family members’ stories in our upcoming, May issue of The COFAR Voice.
Other lawmakers attending Tuesday’s legislative breakfast included Reps. Anne Gobi of Spencer, Kimberly Ferguson of Holden, Paul Frost of Auburn, and Matthew Beaton of Shrewsbury.
Update: some progress to report in abuse case
There have been some new developments in a case we reported on here, involving the alleged assault of an intellectually disabled man by a group home staff worker.
A state investigator has recommended that John Saunders, who has been charged with assaulting John Burns during an outing from his West Springfield-based group home last June, no longer be allowed to work with Department of Developmental Services clients. Saunders was fired after the alleged assault from the group home, which is run by the Center for Human Development.
Saunders allegedly hit Burns in the face while toileting him, causing Burns to suffer two black eyes. Saunders is scheduled to appear in Falmouth District Court on Monday, March 28, at 9 a.m. for a pre-trial hearing that has already been continued several times.
Charges against Saunders were personally brought by Sheila Paquette, Burns’ sister and co-guardian, after Paquette became frustrated with the slow pace of the state’s investigation into the case. Paquette has also been frustrated that she has gotten little information about the case so far from state and law enforcement authorities, which have not released an investigative report done by DDS on the matter.
However, in an email late last week to Paquette, Gail Quinn, the deputy general counsel of the Disabled Persons Protection Commission, did provide Paquette with the investigator’s recommendations. In addition to the recommendation against allowing Saunders to work with DDS clients, the investigator’s report cites the group home for failing to “identify” Burns’ injuries before sending him to his day program the morning after the alleged assault, and recommends retraining of staff in that regard.
Quinn also said the DPPC is changing its policy as a result of this case of withholding investigative reports from guardians of victims of alleged abuse pending the outcome of criminal investigations. She stated that the agency will notify district attorneys’ offices of its intention to send out investigative reports to guardians within a specified time frame unless the district attorney objects. Quinn wrote that the DPPC has issued such a notification to the district attorney in Burns’ case.
Quinn added in her email that, “The delay in getting (investigative) Reports out has been very concerning to us. Your case has brought the issue to the fore, and we have been able to deal with it in a manner that we think represents everyone’s interests in the content of the Report.”
Paquette, who is president of the Advocacy Network and a COFAR member, termed the DPPC’s new policy “encouraging,” but said she still isn’t convinced the system is fully on the victim’s side in these types of cases. Nevertheless, she said she is appreciative of Quinn’s comments.
Instances of assault and abuse of persons with intellectual disabilities often don’t get prosecuted by law enforcement authorities, and other state agencies tend to function slowly and inefficiently in these cases. Paquette said she was told by an investigator that had she not personally pressed charges in this case, it could have taken as long as two years for the matter to reach criminal court.
I talked about that today with Emil DeRiggi, deputy executive director of the DPPC, who said the agency supports decisions of individual family members or guardians to personally press charges in abuse cases. “We generally support anyone who learns something happened and believes filing charges is the right thing to do,” DeRiggi said. “I would encourage people to do whatever they think is best in these instances.”
DeRiggi said that in the case of Paquette’s brother, the State Police Unit assigned to the DPPC referred the matter to the district attorney’s office on Cape Cod, where the alleged assault took place. While that implies the case would have gone to criminal court without Paquette’s intervention, it does appear that her decision to press charges on her own may have, at the very least, speeded up the wheels of justice in this instance.
One other note: We have recieved the police report in the case from the Falmouth Police Department, where Paquette initally filed the assault charges. The report states that the alleged assault was witnessed by Burns’ roommate, who “reported seeing Mr. Saunders hand covering the mouth of Mr. Burns…and then witnessed Mr. Saunders strike Mr. Burns in the face with an open hand.” Saunders has denied the charge, according to the police report.
More on the ‘miracle’ of Templeton
[NOTE: Last month, we first posted an article here about the importance of the Templeton Developmental Center to three men living there and to their families. Below, I’ve posted some more information about those men and their experience, which didn’t make it into that first blog and which we weren’t able to include in the just-released March issue of The COFAR Voice.]
Jimmy Holdsworth kept getting thrown out of community-based group homes and sheltered workshops because his behavior was too volatile and his size and strength were too much for the staff to handle.
For Tony Welcome, community-based programs were ineffective in getting him to stop stealing cars.
Bobby Shepherd’s habit of wandering and trying to make friends with strangers frequently got him into trouble, and community-based programs didn’t provide the structure and supervision he needed.
In each of those cases, the Templeton Developmental Center turned out to be the solution to years of pain and struggle, not only for the men, but for their families. But it’s a solution that will no longer be available to those families or the families of the 103 other remaining residents of Templeton as of the end of Fiscal Year 2013.
The Templeton Center is one of four state-run Intermediate Care Facilities in Massachusetts that the Patrick administration has targeted for closure. The others slated to be closed are the Fernald, Glavin, and Monson developmental centers.
Families and guardians of the residents of the facilities have protested the planned closures and, in the case of Fernald, have filed administrative appeals of the transfers of the residents.
But as many guardians see it, it’s not the closures of the buildings that make up the developmental centers that are at issue; the problem lies in the planned elimination of the federally prescribed level of care provided in them.
At Templeton, for instance, the administration plans to continue to operate three existing residences for persons with intellectual disabilities as community-based programs and to build two additional duplex homes on the grounds. Those residences, however, will no longer be subject to federal ICF regulations governing staffing and care.
The dairy barn at Templeton
Bonnie Valade, Tony Welcome’s mother and guardian, was only able to get her son admitted to Templeton after a long struggle with the then Department of Mental Retardation (now Developmental Services), which had continually contended that Tony was not intellectually disabled.
By the time Tony was 19, he had already been placed in a number of mental health facilities, which had failed to control his impulse to steal cars. His IQ had continually been measured in the 50s, which is well below the DMR requirement that a person have a maximum IQ of 70 in order to receive services.
But when Tony was tested by DMR at at the age of 19, his IQ was found to be 75, making him ineligible for DMR care. Two years later, DMR rejected him again after measuring his IQ at 71, just one point over the cut-off for eligibility. As a result, Tony was placed in a Department of Mental Health facility with eight emotionally disturbed females, which turned out to be inappropriate for him, and later in a homeless shelter.
At one point, with eight different car theft charges pending against him, Tony spent six months in the Worcester County Jail, where he was beaten so badly by another inmate that he had to be placed in solitary confinement for his own protection. Since Tony was accepted at Templeton in 1989 at the age of 24, he has not had any further behavioral incidents, Valade says.
When Tony was in the community system, he had alcohol problem. Today, he suffers a low red blood cell count because anti-psychotic drugs had been improperly administered to him in the community-based system while he was drinking alcoholic beverages. The licensed nursing staff at Templeton understand this, Valade says; but Valade is concerned that once he is back in the community system, drugs will be administered to Tony by direct-care workers with minimal training.
As far as Tony Shepherd is concerned, it will no longer be beneficial for his brother, Bobby, to continue living in his residence at the Templeton Center following a change from ICF-level care there to community-based care. Shepherd, who is Bobby’s guardian, is concerned that under the community-based care model, the intensive clinical and medical supports that have sustained Bobby for more than 50 years will be greatly reduced.
Shepherd said, for instance, that he is grateful for quick action by Templeton’s nursing staff when he was visiting Bobby last fall and noticed while they were having lunch in the cafeteria that he seemed to be feeling unwell. Shepherd asked if a nurse was available, and one arrived within two minutes, checked Bobby’s color and vital signs and then returned with a wheelchair and took him to the nurse’s station.
There, according to Tony Shepherd, further examination showed that Bobby was experiencing a drop in his oxygen level. He was administered oxygen and kept overnight at the nurse’s station for observation. Had he been living in a community-based group home, it is unlikely that a nurse would have been available to respond to the emergency, Shepherd believes.
Shepherd notes that at Templeton, nurses, doctors, and other trained medical personnel are available on a full-time basis to monitor Bobby’s health and administer his medications. A clinical board meets quarterly to evaluate the effectiveness of his prescriptions.
Bobby Shepherd’s intellectual disability stems from low oxygen levels that he experienced at birth. He is verbal, Tony says, but can’t read or write. He has always been nonviolent, but was never easy for his parents to control because of his habit of wandering away from his house. He has a trusting and friendly nature, and has always tried to make friends with total strangers. That would sometimes get him into trouble.
At Templeton, Bobby lives with four other men in a two-story, white farmhouse called Waite Lodge. He’s free to come and go on the Templeton campus, but lately his breathing problems have kept him from venturing out.
Tony Shepherd is worried about Bobby’s future after Templeton closes. At 73, Tony is seven years older than Bobby. “What’s going to happen to him and who is going to look after him if he’s still around after I’m gone?” Shepherd asked. Bobby, he adds, is a “genuine ‘babe in the woods’” who would become “a target of ridicule and abuse [in a less supervised environment] because of his natural but naive belief that everyone is his friend.”
Had the administration not planned to eliminate the ICF model of care at Templeton, Shepherd said he would be a lot less worried about his brother. “The staff is simply not going to be here once this place is switched over to state-operated group homes,” he said. “We’ll be lucky if there are any clinical people left here at all.”
For Jimmy Holdworth’s parents, a social life proved impossible because no community-based residence or program could handle their son, and because he couldn’t be left at home with caretakers other than themselves.
It was only when his parents were in their 60s that Jimmy was finally admitted to Templeton, according to his sister, Judy Holdsworth, who is now his guardian. “At Templeton, he learned for the first time to control himself. It was amazing to me,” she said.
Holdsworth said that in addition to intensive behavioral therapies, the clinical staff at Templeton placed Jimmy on medications to control his impulsiveness and aggression. At first, she said, her parents resisted the idea of placing their son on any medications, but they were persuaded it was the right thing to do when they saw how carefully it was monitored.
“His psychiatrist and nurse always talked with us about it,” Holdsworth said. “We’ve been very satisfied with the way it has worked.” She said her brother is active, alert, and healthy, and “everyone at Templeton can tell when something is bothering him. That’s part of the miracle that occurred with my brother.”
Justice elusive in assaults of the intellectually disabled
When Sheila Paquette found out her intellectually disabled brother had apparently been viciously assaulted while on an outing from his group home last June, she had no idea of the long road she would be traveling to seek justice in the case.
What she — and we at COFAR as well — have learned is that there often isn’t a lot of interest among law enforcement authorities in prosecuting cases of abuse of the disabled, or in the mainstream media in reporting on it. Paquette is a COFAR member and president of the Advocacy Network, a COFAR affiliate, which advocates on behalf of persons with intellectual disabilities in Massachusetts.
Paquette’s brother, John Burns, was allegedly assaulted by John Saunders, a group home staff worker, who allegedly poked his fingers in both of Burns’ eyes while he was toileting Burns. The alleged incident occurred in the late morning at a vacation house on Cape Cod that was rented by the Center for Human Development, a state contractor operating Burns’ West Springfield-based group home.
Burns was not examined by a doctor until the following day, when he was taken, at Paquette’s insistence, to Noble Hospital in Westfield. Paquette said she was told by the medical staff there that Burns’ black eyes “were consistent with somebody taking their fingers and shoving them right into his eyes with sufficient force to cause blood to pool.”
In an article in the Advocacy Network’s Fall 2010 newsletter, Paquette wrote that she took the unusual step some three weeks after the alleged assault of personally filing a felony charge against Saunders of Assault and Battery on a Disabled Person. “Until I filed the charge myself, the situation wasn’t taken seriously by the law enforcement authorities,” Paquette contends.
Photo taken of injuries to John Burns' eyes
Paquette isn’t alone in questioning our society’s commitment to ensuring justice or safety for persons with intellectual disabilities. The New York Times reported yesterday that an inquiry by the paper found that New York State’s group home system of care “operates with scant oversight and few consequences for employees who abuse the vulnerable population.”
An investigation by The Cincinnati Enquirer described “a statewide law enforcement system (in Ohio) that routinely fails to investigate and punish those who abuse and neglect mentally retarded citizens.” There’s not much reason to assume the situation is any different in Massachusetts.
Paquette said the alleged assault of her brother was witnessed by his roommate, who said the incident was entirely unprovoked. Later in the day, Burns and his roommate were driven back to West Springfield by another staff member of the group home. Paquette said her brother had to sit in the back seat with Saunders, the alleged perpetrator, the whole way.
Paquette wrote that she was later told informally by an investigator that her brother spent the night in his group home moaning and crying. But it wasn’t until he was sent the following day to his regular day program that someone from the program called Paquette’s other brother, Jim, who shares guardianship with her. The caller said John Burns had two black eyes and was being sent back to his residence.
That was the first Paquette had heard about the injury to her brother. She said she gathered her camera and a notebook and went to the group home to find her brother indeed with two big black eyes. It was then that she began to experience the first of many frustrations with the state’s system for responding to reports of abuse of the intellectually disabled.
After examining her brother, she asked the house manager to report the injury to the police and the Disabled Persons Protection Commission. But when a police officer arrived at the house, he said he couldn’t investigate the incident because it had occurred in another town, outside his jurisdiction.
The DPPC was called immediately to investigate. But the chronically under-funded agency handed the investigation over to the Department of Developmental Services (which funds the contractor running the group home).
Fortunately, Paquette said, the management of the group home did take the situation seriously. Both the house manager and his supervisor questioned Burns’ roommate on separate occasions about what he saw, and were convinced his description of the event was consistent and credible. Burns’ roommate is intellectually disabled, but is able to communicate. CHD fired Saunders immediately, based on the assault allegation.
Nevertheless, the system has been slow and inefficient in tracking Saunders down. Saunders failed to show up in Falmouth District Court for a pre-trial hearing that had been scheduled in October. He is currently free on bail and is currently scheduled to appear in court on March 28.
In the meantime, Paquette has gotten little information about the case, she says, from the investigating authorities. The DPPC, for instance, will not release the report done on the incident by DDS even to her because the matter is under criminal investigation.
“I’ve gotten nothing in writing from DPPC and nothing from CHD,” Paquette says. “The DPPC says they can’t release anything to me because it’s in criminal court, but it’s in court only because I happened to file the charges.
“What did the DDS find out about this case?” Paquette adds. “What did CHD write up? If everyone in those agencies has seen those reports, why not the victim, or at least why not me, who is the victim’s voice? It’s almost surreal. It’s just like fog. I’m trying to stay calm, but I find myself getting more and more irritated.”
At COFAR, we’ve also been frustrated in trying to get media coverage of this case. Although we notified the media around the state prior to a pre-trial hearing for Saunders that was scheduled for March 3, no one showed up to cover the hearing, and nothing appeared in any media publication about it.
Paquette said her goal isn’t “to put someone in jail for 30 days, it’s to have a jury hear this case, to let people know about this problem (of abuse of the intellectually disabled), and to make sure agencies check on their employees and make sure they can fire them if they are causing these types of problems.”
We all know that the media is facing its own financial issues and is cutting back on its coverage of issues in all facets of society. Yet, in New York and Ohio, newspapers have recognized the importance of the problem of abuse of the disabled.
After we sent follow-up emails to some local newspapers in the Cape Cod (location of the pre-trial hearing) and Springfield areas (location of Burns’ group home), we heard back from the editors of The Cape Cod Times and The Daily Hampshire Gazette. We were told by the Cape Cod paper’s editor that their news editor is “considering” a story about the incident that would run around the time of the next court date. The editor of The Gazette said somewhat apologetically that West Springfield is outside of that paper’s circulation area, but otherwise, “we would have covered this type of story.”
The Springfield Republican initially assigned a reporter to the story, but nothing has appeared in the paper, and neither the reporter nor the executive editor have responded to our follow-up emails about the matter.
Paquette noted, by the way, that 15 years ago, her brother was badly injured by a house manager in a different residence in Westfield. At that time, The Boston Globe sent a reporter all the way out to Westfield to interview her, and Geraldo Rivera sent a television reporter as well. Times have apparently changed.
Among the issues Paquette would like to find out is why the firm running the day program, in particular, didn’t bring her brother to the hospital immediately, but rather just sent him home after observing his black eyes.
She also wants to know whether a State Police unit attached to the DPPC is conducting its own investigation of the case, separate from the Falmouth District Attorney’s Office. It was only after she filed the charge that the DPPC sent a Massachusetts State Trooper to her home to interview her, Paquette says.
Paquette believes her decision to personally file the charge took many people by surprise. “I don’t think it occurred to anyone I would go and file charges myself,” she says. “I believe everyone was waiting around for DPPC and DDS to go do whatever they do.” She said she was told by a DDS investigator that had she left the matter entirely in that agency’s hands, “this more than likely would have taken two years for this to get to the criminal court. I short circuited the process, she says.”
Update: We just received some cost records from DDS…but
On Friday, I received a letter and some short spreadsheets from the Department of Developmental Services in response to our Public Records request for documents supporting the administration’s cost analysis in closing three developmental centers in Massachusetts
The administration’s cost analysis, which was submitted to the Legislature last summer, concluded that closing the Templeton, Monson, and Glavin developmental centers would save tens of millions of dollars in state funds. As readers of our posts know, we’ve long questioned that claim.
It took two and a half months to get a total of six pages from DDS on Friday, and it only happened after we filed an appeal for the documents with the State Supervisor of Records. The problem now is that these six pages do not appear to be responsive even to our pared-down documents request in January. We will probably have to file another Public Records request with DDS and we may continue our appeal with the state Public Records Division.
Still, the documents we’ve received so far do shed a little light on how the administration came up with its projected savings in closing the Templeton, Monson and Glavin Centers and transferring a projected 274 of their residents to community-based residences and to the Wrentham Developmental Center. As we suspected would be the case, the documents indicate that many important costs of community-based care were left out of the administration’s analysis. And, as we’ll explain below, at least part of the analysis is based on an inappropriate apples-to-oranges comparison of developmental center and community-based residents.
First, I’d note that the administration appears to have submitted two entirely separate analyses in the same report to the Legislature on the cost of closing the centers. The first analysis primarily used DDS budget costs and came up with a $14.7 million annual savings in closing the centers; and the second analysis used what were described as “fully loaded costs,” meaning they included some additional fringe benefit and other costs that DDS factored in. That analysis came up with a $20.3 million annual savings in closing the centers.
The records I received on Friday indicate that the administration’s first analysis was based largely on what the records stated is a $150,000-per-person, yearly cost of operating a group home for eight former residents of the Fernald Developmental Center. (This appears to be a group home in Bedford, although the DDS letter I received on Friday doesn’t identify it as such.) The analysis multiplied the $150,000 cost of the group home by 97 Monson, Templeton, and Glavin residents projected to be transferred to new community-based residences, and came up with a total cost of care in new community-based residences of $14.5 million.
(We had specifically asked DDS for documents supporting that $150,000 cost. The only thing DDS provided us was a one-page budget sheet, which the DDS letter stated was a budget for the group home for Fiscal Years 2008 through 2011. It’s unclear from this budget sheet, though, how the $150,000 cost was calculated.)
As part of the same analysis, the administration also determined that it would cost $95,000 per resident to place a projected 76 former Monson and Templeton residents in existing community-based homes (total $7.2 million), and $135,000 per person to place 42 Glavin residents in existing community-based homes ($5.7 million). The administration also determined that it would cost $70,000 per resident to place a projected 59 residents at the Wrentham Center ($4.1 million). The total cost of closing the three developmental centers was therefore determined to be $31.6 million.
(Despite our request, the DDS provided no backup documents showing how those figures for placing Monson, Templeton, and Glavin residents in existing homes or in the Wrentham center were derived. Why was the Wrentham center cost only $70,000 per resident, for instance, if developmental centers are supposed to be so expensive?)
The analysis then used the Fiscal Year 2009 bugets of the Templeton, Monson, and Glavin centers to determine costs per person in each, and multiplied those figures by the number of residents projected to be transferred from each facility to determine a cost of keeping the three centers open ($46.3 million).
The analysis concluded that closing the developmental centers will therefore result in an annual savings of $14.7 million.
Unlike the first analysis, the second analysis appeared to be based on the average cost of care in the community-based system as a whole. The administratation appears to have first calculated a fully loaded community residential cost in Massachusetts in FY 2009, which was listed as $603.2 million for vendor-operated homes and $163.8 million for state-operated homes. It’s not clear where those numbers came from, but they appear to track line items in the FY 2009 state budget for community residential and state-operated group homes. The numbers are a little higher than the budgetary line items possibly because they are fully loaded figures.
This cost analysis then added $19.2 million for day services and $16 million for transportation services to the other two amounts for vendor and state-operated residential care to derive a total community-based cost of care that could be compared with the cost of operating the Templeton, Glavin, and Monson centers. (Again, it’s unclear where the day services figure came from, in particular, because the Day Program line item in the budget in FY 2009 was around $128 million.)
The DDS documents show that the administration then calculated yearly, per-person costs for residential care, day services, and transportation in the community system, which were then added together. That sum was multiplied by the 215 residents projected by DDS to be transferred from Templeton, Monson, and Glavin to both new and existing homes in the community system. The total annual cost of community-based care for those residents was projected to be $30.3 million.
Next, the administration calculated a fully loaded cost of transferring a projected 59 residents from Templeton, Glavin, and Monson to the Wrentham Center, and came up with a figure for that of $13.9 million. So the grand total of placing 274 Templeton, Glavin, and Monson residents in both the community system and Wrentham came to $44.3 million per year.
Finally, the administration used the Glavin, Templeton, and Monson budgets for FY 2009 to calculate a total, fully loaded cost of serving the same 274 residents, and came up with a figure of $64.6 million. The administration concluded that there would therefore be a savings of $20.3 million in closing the developmental centers.
Here are some of the questions we have about both analyses:
First analysis: The budget sheet for the group home for former Fernald residents lists certain staffing and other costs for the group home in Fiscal Years 2008 through 2011, but it doesn’t break those staffing costs down in any way. As a result, it’s impossible to judge whether the costs listed for the group home are comparable to the developmental center costs cited by the administration.
For instance, does the $818,224 listed as employee compensation in the group home budget in FY 2009 include staffing for day programs outside the home? Does it include the cost of transportation and medical care for the residents? Does it include day habilitation costs, and service coordination costs? We don’t think it does; yet, all of those costs are included in one way or another the budgets of the developmental centers.
It was also unclear how the numbers on the budget sheet relate to the claimed $150,000 cost of operating the group home. And does that $150,000 include housing subsidies and food stamp costs, which help pay for housing and meals in the community system? Again, we don’t think those costs are included.
Also, we would question the validity of basing an analysis of the cost of care in new community-based homes on the cost of care of just one group home. Among other questions, are the particular Fernald residents in the Bedford home representative of all residents in the facilities slated for closure?
Second analysis: How were the figures for community residential, state-operated residential, day, and transportation costs derived in the fully loaded cost methodology?
Do the Bedford group home costs factor in any way into this fully loaded cost analysis?
Also, is the methodology of this analysis based– as it appears to be– on a comparison of the average cost of care in the community with the average cost in the three developmental centers? If so, this is the apples-to-oranges comparison we’ve been talking about all along. The developmental centers serve older, more medically involved, and more intellectually disabled persons than does the community system on average. As a result, transferring those people from the developmental centers to the community will not necessarily result in a savings.
As is the case with the first analysis, do the community-based costs in the fully loaded cost analysis include medical care, day habilitation, service coordination, housing subsidy, and food stamp costs? We don’t think those costs are accounted for here either.
In both analyses, is the relatively small number of people projected to be transferred to Wrentham realistic? Using the administration’s figures, if more people were transferred to Wrentham, the projected savings in closing the Templeton, Monson, and Glavin centers would drop.
Finally, do either of these analyses include the cost of further renovations at Wrentham that would have to be done to accomodate the additional residents projected to be sent there? We don’t think they do.
The bottom line is that in our view, numerous questions surround the administration’s claimed savings in closing the Templeton, Monson, Glavin AND Fernald developmental centers (Fernald wasn’t even included in the cost analyses submitted to the Legislature). We therefore have a couple of questions for the members and staff of the House and Senate Ways and Means Committees and the Children, Families, and Disabled Persons Committee, which received the administration’s cost analyses last summer:
Has anyone on these committees actually reviewed these analyses, and, if so, do they have any of the same questions we do? Last fall, we wrote to the three committees, raising some preliminary concerns about the cost analyses. We’ve still not heard back from them.
We’re still waiting for the administration’s cost documents
Almost two and a half months ago, we asked for public documents from the administration to support its claim that the state will save money in closing four developmental centers in Massachusetts for persons with intellectual disabilities.
We’re still waiting.
Our December 3 request was for specific documents backing up a cost analysis submitted by the administration to the state Legislature last summer. The cost analysis claims that the closures of the four developmental centers — Fernald, Templeton, Glavin, and Monson — will save the state $40 million a year.
Lest you think our request was overly broad, we offered last month to narrow it to a request for documents primarily supporting a specific projection in the administration’s analysis that it would cost $150,000 per person to place residents in new community-based homes. That figure compares with $172,900 per resident that the analysis contends is the average cost of operating three of the developmental centers targeted for closure. The difference of $22,900 is part of the savings claimed by the administration in closing the centers.
So far, we’ve received no documents. In fact, the last I heard from the administration on this matter was a December 21 letter from the general counsel of the Department of Developmental Services, stating that the agency would have to search for the records we were requesting and that the cost of the search was likely to exceed $100. The letter stated that the general counsel would contact me as soon as she determined the precise cost of searching for and copying the documents.
It’s interesting that DDS would have to search at all for documents used to back up a major cost analysis that was submitted to the Legislature only last summer. One would think DDS officials would know where these records are.
One would also think that by now, the general counsel would have at least determined the actual cost of such a search. After all, the state’s Public Records Law [M.G.L. Chap. 66, Section 10 (b)] states that custodians of public records must comply with public records requests within 10 days. The regulations accompanying the law [950 CMR 32.05(2)] further state that requested public records should be provided “without unreasonable delay.” Nearly two and a half months since we first submitted our Public Records request, we haven’t even been told what the cost of searching for those records might be.
On Feb. 4, not believing that DDS was in compliance with either the letter or spirit of the Public Records law or regulations, I contacted the state Supervisor of Records, who can ultimately refer these matters to the atorney general or a district attorney. As of Feb. 11, a staff person in the Supervisor’s office told me that DDS had not responded to a fax she had sent to them, asking about our records request, and that she was going to send them a letter.
We asked for these documents for a number of reasons.
First of all, we believe the administration’s methodology in comparing developmental and community-based costs is flawed. The cost analysis appears to be based on a comparison of the average cost per resident of community-based care and the average cost of care in the Tempton, Monson, and Glavin centers. The problem is that the residents of the developmental centers are older and have higher levels of intellectual disability and greater medical needs than the average community-based resident. The average age of residents in those three facilities is 57.5, according to the cost analysis itself. In other words, the administration appears to be making an apples-to-oranges comparison.
Secondly, we believe that the $150,000 community-based cost figure projected in the administration’s analysis may not include at least some charges that have been shifted to the state’s Medicaid budget. Day Habilitation services, for instance, which are a key element of the care of persons who have been transferred from the developmental centers to the community system, are paid from Medicaid. Similar services, which are provided in the developmental centers, come from the DDS budget. The administration appears to be comparing costs only within the DDS budget of developmental centers and community-based care.
We don’t feel as though we’re grasping at straws here in trying to demonstrate that the cost of community-based care is not necessarily less expensive than developmental-center care for comparable residents. As we’ve previously reported, the State of Connecticut has projected that closing that state’s remaining developmental center would result in higher costs, not savings.
After we sent out a press release late last year expressing our concern about the apples-to-oranges comparison of costs, a spokesperson for the administration claimed to The Springfield Republican that the administration’s projections “have been accurate so far.” If that’s the case, then the administration should be eager to provide the documents we’ve requested, which would show what those projections are based on. The administration, however, seems to have shown a notable lack of eagerness to provide those documents.
Where, again, are those savings in closing the developmental centers?
The Patrick administration has repeatedly assured the public that it intends to plow tens of millions of dollars in projected savings in closing four state developmental centers back into the community system of care.
But now, even the staunchest advocates of the developmental-center closures appear to be starting to question whether the community system is deriving any fiscal benefits from the planned shutdowns of the Fernald, Monson, Glavin, and Templeton centers.
In the current and coming fiscal years, Day Habilitation services, a key community-based budgetary line item is getting hammered by the administration. And the Association of Developmental Disabilities Providers and the Arc of Massachusetts, which have pushed hard for closures of the developmental centers, are up in arms about the cuts. Day habilitation involves a coordinated system of speech language therapy, occupational therapy, physical therapy, behavioral management, developmental skills training, and other programs for persons with intellectual disabilities.
In a series of press releases and emails to their members over the past week, the ADDP and Mass Arc have decried cuts of $1.6 million in the current fiscal year and $5 million in the coming year in Day Habilitation services.
That may not sound like a lot of money being cut, but in an email to members, dated Feb. 4, the ADDP describes Day Habilitation services as a key component of the administration’s “Community First” initiative, which is centered around the closures of the developmental centers. Day Habilitation should be one of the prime beneficiaries of the money supposedly being saved in closing the centers. But it’s not deriving any benefit at all.
As the ADDP email states:
Over the last several years, the Commonwealth has turned to Day Habilitation programs to provide the day activity for state owned and operated group homes, as well as hundreds upon hundreds of people with disabilities who have moved from state institutions into community settings.
In fact, the Administration’s Community First, Institutional Closure and Olmstead Plans make heavy use of Day Habilitation services by moving former residents of Fernald and other closing state institutions into state owned and operated group homes and private provider day habilitation programs for non-residential supports and services (the state doesn’t operate similar day activity programs).
The proposed Mass Health Day Hab cuts means that there will be less staff on hand to serve many frail individuals who have a variety of challenging health concerns, as well as cognitive impairments.
In 2008, Health and Human Services Secretary JudyAnn Bigby claimed to The Boston Globe that the administration would be plowing $45 million a year back into the community system as a result of the shutdowns of the developmental centers. As of today, it doesn’t appear, however, that the administration is even able to prevent further cuts in one of the key components of its community-based approach.
It’s worth noting here is that Day Habilitation services are funded out of the state’s massive Mass Health budget, and not from the budget of the Department of Developmental Services. Yet, similar habilitation programs in the developmental centers are funded under the developmental center line item in the DDS budget. So, once again, while the administration may be claiming that closing the developmental centers will save money, what it is really doing is shifting DDS costs to other budgets and not adequately funding those budgets.
Bottom line: Rather than saving money, the administration has compounded its problems by both closing developmental centers and cutting the Day Habilitation line item. The line item cut is a huge and scary loss and a problem for those who currently use Day Hab programs and those for whom it is proposed as they leave the developmental centers. It is not solved by closing the centers, and in fact adds even more people into this overburdened system.
COFAR blog 