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DDS emails show concern that governor’s COVID vaccination mandate could worsen staffing shortage in state-op group homes
Department of Developmental Services (DDS) Commissioner Jane Ryder and at least one other top DDS official were concerned last September that Governor Baker’s COVID vaccination mandate for state employees could worsen an already existing staffing shortage in the Department’s state-operated group homes.
Those concerns were expressed in a handful of emails, which COFAR received from DDS late last month after a nine-month battle for internal records relating to closures and consolidations of the homes.
On July 8, the state’s Public Records Supervisor ruled that DDS must produce the records because the Department had not met its burden of proof that the emails were exempt from public disclosure. DDS provided the emails to us on July 29.
The internal emails confirm that there had been closures of some state-operated group homes in Massachusetts due to an executive order issued last August by Governor Baker requiring all state employees to be vaccinated by October 17 or face termnation.
That vaccination mandate applies only to staff of state-run residential facilities. It does not apply to the much larger network of DDS-funded group homes that are run by corporate providers.
As of October 21, we had received unconfirmed reports that up to seven state-run homes in the southeastern region of the state had been closed because staff in them had not been vaccinated for COVID.
In an email, dated September 24, Gall Gillespie, the DDS Metro Region director, stated that she wasn’t sure whether Baker was aware of the impact his vaccination mandate might have on the state-operated group home system. Her email, which was sent to a DDS consultant, stated:
I am not sure the governor knows about the impact (of his vaccination mandate). Jane (Ryder) is briefing the secretary (Health and Human Services Secretary Marylou Sudders).
We have had homes consolidate and close, staff taking individuals home with them, and administrative staff working shifts. Some agencies are asking about the National Guard… We may be asking area and regional staff to fill in shifts if staff get terminated around the vaccine mandate. We cannot ask staff if they are vaccinated; so only know a percentage based on a cross check with DPH.
In an email earlier that same day to the same consultant, Gillespie described “a major crisis looming with the staff shortage…I think it is a problem that is almost too scary to address and it seems not in our control. It also does not directly affect some of our senior staff. Some of us are meeting and trying to come up with plans if we lose 20-40% of our direct care staff on October 17.”
But while those emails show a concern within DDS over the staffing shortages in the group home system and the potential impact of the vaccine mandate, no concerns were expressed in the emails about other potential causes of the staffing shortages such as the problem of low direct-care wages. One email from Gillespie said only that DDS would pay overtime to staff willing to work shifts in state-operated group homes after their regular work week was completed.
We have reported that a key cause of the staffing shortages has been low direct-care wages that have plagued the entire DDS system.
No discussion about future of state-run group homes
Administration officials have declined to comment to us on the staffing shortages or closure reports regarding either state-operated or provider-operated homes. The emails provided to us on July 29 confirm the Department’s concerns about those issues, at least regarding the state-run homes.
But the emails don’t contain any discussions about any plans or concerns DDS might have had regarding the future of the state-run group home system, which was one of the reasons we sought the internal documents.
We view the state-operated group home system to be a crucial backstop for care in the DDS system as a whole. Yet DDS has been allowing the number of residents in the state-operated group home network to drop in the past several years.
Overtime offered to staff willing to work in state-ops
In an email on October 13 to DDS state-operated group home personnel, four days before the October 17 vaccination deadline, Gillespie again referred to the staffing shortage that DDS anticipated “will get worse after the deadline for the vaccine mandate passes.”
Gillespie said that while some staff had volunteered to work in Metro Region homes the previous week, DDS was now offering to pay overtime for staff willing to work shifts in those homes beyond their regular work week. She added that the Central West Region was also looking for volunteers to staff group homes.
In an October 12 email to all of the DDS regional directors, a DDS official listed clinics around the state at which state employees could get vaccinated.
As noted, none of the emails addressed the issue of long-term DDS policies concerning closing or consolidating state-operated group homes. As a result, it’s not clear why DDS fought so hard against releasing these emails to us.
No clear plan for addressing the staffing shortage or direct-care wages
It’s also not clear from the records that DDS has a systematic plan to address the staffing shortage or direct-care wage problems in either the state or provider-run group home networks.
The one thing that the internal DDS documents appears to show is that DDS offcials were, and potentially still are, concerned about staffing shortage in state-run group homes.
But it doesn’t appear DDS has done more to address that issue than to issue appeals for volunteers and offer to pay overtime to staff willing to work beyond their regular work week.
Late last month, Governor Baker signed the Fiscal Year 2023 budget, which includes a provision requiring DDS and other human services agencies to direct up to $173 million in state funding to boost wages of their direct-care workers, But to date, there has been little or no information available as to when that money will start flowing, or even what the impact will be on worker wages.
We think a plan is urgently needed from the administration that includes details on how the administration intends to deal with these issues.
Judi Lydon-Ruby receives the Manuel Carballo Award for public service
By Joe Corrigan
COFAR would like to congratulate Judi Lydon-Ruby, recipient of the Manuel Carballo Governor’s Award for Excellence in Public Service.
Judi is director of the Wrentham Developmental Center (WDC). She has had a long history with WDC, starting at the age of 16 in their kitchen until becoming director in 2018.
Roughly two years ago, we all woke up to learn of a growing pandemic the likes of which haven’t been seen in 100+ years. Most of us began to take precautions in our own immediate families by masking, distancing, etc.
Judi Lydon-Ruby
Now imagine also having responsibility for an additional approximately 1,000 staff and nearly 200 very vulnerable residents with intellectual and other developmental disabilities (I/DD) and medical frailties in a campus setting. This describes the daunting task Judi was facing.
Beyond creating difficulties for staff in continuing to provide great everyday care for the residents, the pandemic created challenges that nobody was prepared for.
Throughout the pandemic, Judi has adapted to the challenges requiring masking, distancing, quarantining, isolation, testing, innoculations, vaccination mandates, resource balancing, hiring and training for infectious disease and more. She created a plan where there was none and no doubt helped people survive.
Given all that and more, the WDC Board of Trustees, along with support from the Wrentham Families Association, nominated Judi for the Manuel Carballo Governor’s Award in September 2021. The nomination was well received by the administration, and on January 10, 2022, Judi received the award.
Congratulations to Judi and her staff for a continuing job well done.
(Joe Corrigan is a COFAR Board member. His sister Patricia is a resident at WDC.)
Large increase in COVID among residents in DDS provider-run group homes, but not in state-operated homes
The latest state report on COVID testing in facilities funded by the Department of Developmental Services (DDS) shows what appears to be a major increase in residents testing positive for the virus in corporate provider-run group homes.
However, there appears to have been little or no increase in COVID among residents of the smaller network of DDS state-run group homes.
According to the state data, the number of residents testing positive in DDS provider-run group homes jumped from 34 to 146 in the period from November 30 to December 28.
In the DDS state-operated group home system, the number of residents testing positive rose only from 9 to 10 in that time frame. We think this difference may reflect the fact that staff in state-run facilities are required to be vaccinated, whereas there is no similar vaccination requirement for staff in provider-run residences.
Staff testing positive in state-run group homes did rise from 20 to 66, according to the latest report. But there is no information available on the number of staff that have tested positive in provider-run group homes. For some reason, that number is not reported.
At the DDS-run Wrentham Developmental Center, the number of residents testing positive rose from zero to five or less. (Numbers under 5 are not specified.)
Staff testing positive at the Wrentham Center rose from three to 24. But that hike in positive staff does not appear to have been mirrored by a large increase in residents testing positive there. Also, as one family member of a Wrentham Center resident said, most of the staff testing positive there are either asymptomatic or have mild symptoms, apparently due to the required vaccinations.
At the Hogan Regional Center, zero residents have tested positive since January of last year. Five staff tested positive at Hogan as of December 28. Prior to that date, no staff had tested positive there since last April.
Despite the increases in residents testing positive in DDS provider homes, deaths among residents have not risen in either the provider-run or state-run networks. In the month prior to December 28, less than five residents died in the state-run and provider-run group homes. (Numbers of deaths are not reported separately for each network.)
There were zero deaths of residents at Hogan or Wrentham in the month prior to December 28. Data on deaths among staff in DDS facilities, whether state-run or provider-run, are not reported. Also, testing results are only now reported monthly, which makes analyses of trends difficult.
Vaccinations of all staff urged
Rick Glassman, director of advocacy for the Disability Law Center, was quoted by WBUR last week as saying that regardless of staffing shortages facing some DDS group homes, vaccines should be mandated for all group home workers, and there should be more frequent testing of both residents and workers.
“It is to the state’s credit that they require vaccines in nursing homes,” Glassman said, according to WBUR. “But people with intellectual and developmental disabilities are equally, and sometimes more, vulnerable.”
Inconsistencies in vaccination policies
We have similarly called for a requirement that staff in provider-run residences be vaccinated. The difference in vaccination requirements for state and provider staff has resulted in major inconsistencies in the state’s response to the virus.
For instance, Nicole Coughlin, a DDS service coordinator, was suspended without pay on December 27, according to a Mass Live report, and threatened with termination because she had not received a second Moderna shot by the October 17 vaccination deadline set by Governor Baker for state employeees. Coughlin’s first vaccine shot last February prompted a severe allergic reaction that accelerated her heart rate and made it difficult to breathe.
According to the report by Mass Live, the Baker administration denied Coughlin a medical exemption even though three medical specialists, including her doctor, recommended that she not receive a second Moderna shot. One specialist said a second shot could be fatal to her.
It makes no sense that some DDS employees are facing a vaccination requirement that apparently allows for virtually no exceptions, while a much larger group of employees in the same field face no requirement at all.
It has been fortunate that the uptick in residents testing positive in the DDS system has so far not resulted in more deaths among those residents. But there is much to be concerned about regarding the increase in COVID cases, and little information on which to evaluate those concerns.
Even though the death rate hasn’t gone up, has the rise in residents testing positive in the provider-run group homes resulted in a higher hospitalization rate or in potentially long-term health complications among those residents? Since no data are reported on hospitalizations or health impacts, we don’t know the answer to those questions.
DDS denial of our request for records could indicate plans exist to close state-operated group homes
In a move that may indicate plans are in the works to consolidate or close state-operated group homes in Massachusetts, the Department of Developmental Services (DDS) has denied our request for internal records concerning such plans.
In a December 13 response to our request for the records, DDS said the documents are exempt from disclosure under the state’s Public Records Law because the records relate to an “ongoing or evolving policy matter.”
At issue are eight internal emails that DDS said are responsive to our records request.
We think the fact that DDS cited that Public Records Law exemption for evolving policy matters could be an indication that the Department is developing a new policy regarding the future of its state-operated group home network. We are concerned such a policy might not be good news for those facilities; however, any documentation that might shed light on that is now being withheld.
We first asked DDS on October 15 for any and all internal records, generated since September, that concern closures or consolidations of DDS state-operated group homes due to unvaccinated staff for COVID or for other reasons.
In mid-October, we received a report from a COFAR member that up to seven state-run homes in the southeastern region of the state had been closed because staff in them had not been vaccinated. Later that month, we heard that a state-run group home in western Massachusetts was being closed and that at least one of the residents there was moved without written notice to a location in another town.
In August, Governor Baker issued an executive order requiring all state employees to be vaccinated by October 17 or ultimately be terminated.
In October, we reported that we were growing increasingly concerned that the critically important state-run DDS group home network could be facing a crisis that could threaten its long-term existence.
We often advise families whose loved ones are experiencing poor care in provider-run residences to ask for placements in available state-run group homes. Staff in the state-run network generally receive higher pay and benefits and more training than their counterparts in the provider system.
DDS initially was going to charge $1,000 fee for the records
In an initial response to our public records request on October 29, DDS stated that there were potentially 1,600 responsive emails, and that producing the documents would require us to pay a $1,000 fee.
In a Nov. 9 phone call, I talked with Brian Fleming, the DDS associate general counsel and records access officer, about narrowing our request.
In his December 13 written response to us, Fleming said the narrowed search had turned up a total of 190 emails, and that eight of those were determined to be responsive to our request. However, he said that all eight of those emails were being withheld because they relate to the Public Records exemption for “interagency or intra-agency memoranda or letters relating to policy positions being developed by the agency.”
Fleming said the Governor’s Executive Order requiring all executive branch employees to be vaccinated “is an ongoing and evolving policy matter which is subject to the deliberative exemption.”
Fleming said that in addition, an unspecified number of emails were being withheld on the basis of attorney-client privilege. He provided a log of 10 emails that he said were subject to that latter exemption.
Appeal unlikely to be successful
Unfortunately, it has been our experience that if DDS cites the evolving policy exemption or the attorney-client exemption, we would probably lose any appeal for the records that we might file with the state Supervisor of Public Records. We believe the Supervisor would claim an inability to determine whether an internal departmental policy is settled or evolving. Similarly, it is unlikely that the Supervisor would dispute a departmental claim of attorney-client privilege.
A pattern of withholding information
With this latest denial of our Public Records Request, we once agan find ourselves in the position of having to speculate as to what DDS’s plans are regarding the immediate and long-term future of care in the system.
In this case, we had initially emailed DDS Commissioner Jane Ryder and the press office at the Executive Office of Health and Human Services (EOHHS) on October 14 with questions about the reports of closures and consolidations in the state-operated group home network.
To date, Ryder has not responded to our query. A spokesperson for EOHHS said in a response to our email that we would have to file a Public Records Request for that information.
On October 15, we filed that Public Records Request with both DDS and EOHHS. EOHHS responded that same day that that agency did not have any records relevant to our query. And on December 13, DDS responded, as noted, that the records it has are exempt from disclosure.
As we’ve said many times, we think the secrecy practiced by the administration over DDS matters, in particular, is unnecessary and does not foster trust in government by the public. The administration has the discretion to be transparent about its plans and policies. It should consider doing so.
Governor signs bill to distribute federal money for direct-care worker pay, but there is still no distribution timeline set
Gov. Charlie Baker on Monday signed legislation that would target hundreds of millions of dollars for human services workforce retention and recruitment as part of a $4 billion federal and state spending package.
According to the State House News Service, the governor signed the bill (H. 4269), which earmarks both federal American Rescue Plan Act (ARPA) money and surplus state revenues for immediate needs. The bill also preserves some $2.3 billion in federal ARPA funds for future use.
There is still, however, apparently no clear timeline for distributing the funding to boost wages of direct-care and other staff in the Department of Developmental Services (DDS) system.
As of November 29, Shannon Guenette, executive director of Almadan, Inc., a DDS provider, told COFAR she still hadn’t seen any of the federal stimulus money even though Congress and the Biden administration had released $8.7 billion in federal stimulus funds to Massachusetts last March.
Guenette first told us in August that her agency and other DDS providers throughout the state desperately needed the additional federal funding to retain workers in light of a worsening shortage of direct-care and clinical staff.
The state Legislature finally voted on December 3 to enact the $4 billion bill and send it to Baker’s desk. The vote came after the House and Senate had failed to reach agreement on the legislation before starting their legislative winter break.
Baker echoes our concern about advisory panel
In signing the legislation, Baker vetoed a section of the bill that would require that an advisory panel be formed and consulted before premium pay could be awarded to frontline employees.
Accordng to the State House News Service, Baker said he was concerned the advisory panel would create “red tape” that could delay distribution of the funding. “We would rather just put a premium pay program together and get the dollars out the door to people,” Baker reportedly said.
We previously raised this same point, noting that the advisory panel sounded like a potential recipe for further delay without necessarily providing a structure for ensuring that the funding goes to the workers.
Timeline still uncertain
But Baker’s veto also apparently has had the effect of eliminating a deadline of March 31, 2022, for the advisory panel to make its recommendations on the funding distribution.
According to the News Service, House Speaker Ron Mariano said Monday he had “requested a timeline from the administration on when they would be able to get the money out to essential workers so we can make an informed decision.” That decision apparently concerns whether and when to attempt to override the governor’s veto.
The News Service stated that in his veto, Baker wrote to lawmakers that he supports the premium pay program, but said the advisory panel was “virtually guaranteed to significantly hinder disbursement of the funds.”
The governor said his veto would allow his administration to “immediately begin the process of distributing these funds.”
“We could send out $500 checks to almost 1 million Massachusetts residents as soon as possible,” Baker wrote, according to the News Service. “Reinstituting the panel-driven process envisioned by the Legislature will simply disrupt the rollout midstream. We urge you to let our administration proceed with this important program today.”
We have raised other concerns about the state’s planned distribution of the federal funding as well.
Even when the ARPA money is finally distributed, we are concerned about a potentially low $2,000 ceiling set on the amount of funding per worker under the legislation. Also of concern is a lack of clear oversight of the distribution of the funding.
And it appears at least some of the funding is intended to be used to move residents out of the state’s two remaining developmental centers and into the already overburdened privatized group home system.
In sum, we’re happy that the bill to distribute the funding has finally been signed. But a half year after the federal money was sent to Massachusetts, it seems far from certain if and when those funds will get to the people the money is supposed to help.
DDS provider head trying to raise the alarm about direct-care staffing shortage
Shannon Guenette, who heads a corporate agency that runs group homes funded by the Department of Developmental Services (DDS), is trying to get state lawmakers and policy makers to understand the impact the COVID crisis has had on direct care staffing in her agency’s residences.
She is facing a staffing shortage that appears to be afflicting the entire DDS system, yet legislative leaders don’t appear to be aware of it. And DDS Commissioner Jane Ryder confirmed in an email to two COFAR members only late last week that the staffing shortage is a “severe” problem affecting “all of our agencies.”
Guenette, who is the executive director of Almadan, Inc., which operates three DDS-funded and two Department of Mental Health-funded group homes in western Massachusetts, maintained that, “This isn’t a situation where we can turn grills off at night. My fear is we’re going to hit a breaking point if something doesn’t change soon.
“It’s a heavy weight on our team,” she added. “We have concerns for staff burnout, and worry what will happen if the staff shortage continues.”
The irony is that the state received $5.3 billion earlier this year under the federal American Rescue Plan Act (ARPA). Of that amount, some $500 million can be spent on DDS and other Home and Community Based Services (HCBS). The ARPA is one of the federal stimulus bills passed last spring.
The ARPA funding is earmarked, among other things, for higher pay to at least temporarily recruit new direct care workers.
Yet, Guenette said, even though she understands the federal Centers for Medicare and Medicaid Services has approved the state’s plan for spending the ARPA funding, the money still hasn’t been distributed to DDS group home providers. She said she was told at one point that the ARPA funds might be distributed by late fall. The delay won’t help the current critical need, she said.
In addition to the ARPA funds, the state began the current fiscal year in July with a projected $4.2 billion budget surplus. Yet the money is not reaching direct-care workers.
Guenette said Almadan’s total staff, which is normally around 100 full-time and part-time workers, is now down to 65 employees. Almadan provides residential, shared living, and individual support services, and some of its programs are more than 40 percent vacant in terms of staff.
Low wages have forced many direct care staff to work for multiple providers to earn a living, Guenette said. She said raising wages could help in hiring staff with more experience or passion in the field. Some staff have in fact left to accept higher paying positions in other fields.
DDS commissioner only now commenting on staffing problem
Ed and Gail Orzechowski, who are COFAR members, wrote last week to DDS Commissioner Ryder about the Almadan staffing problem. Gail’s sister, Carol, is a longtime resident of one of Almadan’s group homes in Pelham.
In an emailed response to the Orzechowskis on Friday, Ryder she she is “well aware of the severe staffing shortage all of our agencies are experiencing. It is a great concern to all of us. “
Ryder added that the administration is “in the process of getting the ARPA funds out to our agencies, but unfortunately it will take some time.” She said the funds will be retroactive to July 1.
Guenette noted that even though the funds will be retroactive, they are intended to be provided only through December of this year, and thus will only be “a temporary fix for a much larger problem.”
Ryder’s email is the first acknowledement she has made, that we are aware of, of the staffing shortage. Neither Ryder nor state Health and Human Services Secretary Marylou Sudders ever responded to our request in mid-July for comment when we first heard reports of a DDS staffing shortage.
In response to a follow-up email on Wednesday of this week from the Orzechowskis, state Senator Joanne Comerford said she planned to contact Ryder about the staffing and ARPA funding situations. “ARPA funding is moving through MA — albeit more slowly than I’d like,” Comerford stated.
Legislative leaders don’t see a need for hurry
Despite the concerns about the staffing shortage from Ryder, Guenette, and from parents and guardians of DDS clients, legislative leaders don’t appear to perceive a need for hurry in distributing the federal funding.
According to CommonWealth magazine, Senate President Karen Spilka said in early August she believes there is “wisdom in waiting” to spend federal ARPA recovery money. “We are no longer in the state of emergency, the major state of emergency at the height of COVID,” Spilka said, according to the magazine.
Spilka added that, “We are no longer in the rescue situation where money is needed to be spent urgently and quickly. We are now in recovery mode and back to the more normal budget type of appropriation process.”
But without the additional federal funding, Guenette said, Almadan can’t afford to pay its direct care staff enough to recruit new workers and compete with jobs that pay a living wage as little as $18 an hour. Almadan is currently able to pay its staff $15.25 an hour. She said she sees the low pay, in part, as a social justice issue because much of the staff of DDS-funded facilities are from marginalized, minority populations.
Guenette said Almadan has been fortunate in that there are currently no COVID positive residents or staff in its group homes. Almadan has a 90% vaccination rate among staff, and 100% among residents. DDS is requiring that staff be tested every week.
She said that when the crisis began, Almadan was proactive in their measures to keep everyone safe “with a dearth of (DDS) guidance.” The agency immediately began purchasing PPE and cleaning supplies, she said, and found food delivery sources that didn’t require any contact with the community.
Many DDS providers, however, are not in Almadan’s advantageous situation with regard to staff vaccinations. The Baker administration last publicly reported in April that less than 50% of DDS provider staff had been vaccinated.
We urge people to call or email their legislators, and call the Children and Families Committee at (617) 722-1660 to ask them to push for quick distribution of the ARPA funding in order to boost direct-care wages in the DDS system.
COFAR blog 