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Saving the Glavin Center comes down to one man
In many of the photographs that Rosemary Dumont has of her son Stephen, a red vertical wound can be seen at the top of his forehead, almost seeming to divide his forehead in two.
That wound is the result of Stephen’s habit of banging his head on any hard object near him, such as the corner of a table. Before he was admitted to the Glavin Regional Center in Shrewsbury five years ago, he would open up the wound on practically a daily basis.
Community-based residences and hospitals tried to solve the problem with drugs, which didn’t work. It got to the point where no community-based group home would keep or accept him as a resident. At one point, the only place his parents, Rosemary and Will Dumont, were able to find for him was the controversial Judge Rotenberg Center. There, Stephen was given electric shocks when he banged his head. But that didn’t stop the behavior.
The story was finally different at the Glavin Center where the staff have been able to reduce Stephen’s head-banging episodes to once or twice a year through constant supervision and supportive behavioral treatments. Now, he’s able to go home to stay with his parents on weekends without the threat of a flare-up of his aggressive behavior. Those home visits weren’t possible while he was in the community system.
The Dumonts know this “miracle” of treatment for their son will disappear when Glavin is closed, as the Patrick administration is moving quickly to do. Not only is there no community-based setting that is likely to accept, much less successfully treat, Stephen, any change at all in his living arrangement is likely to trigger a descent into his old cycle of self injury.
For Stephen, who has an intellectual disability in addition to having cerebral palsy and deafness, the act of leaving a long-term home such as Glavin and its staff and fellow residents results in a conviction that those people have all died. “He loves all these people (at Glavin) to death,” Rosemary says. “He can’t handle the change.”
For that reason, the Dumonts are desperate to keep Glavin open. And they know that for now, the fate of the center rests with one man — State Senator Stephen Brewer of Barre.
Under the Legislature’s current budget process, it is totally up to Brewer whether to approve a state budget amendment that would require an independent cost analysis before the Department of Developmental Services can move more people out of Glavin and subsequently close the center. Brewer, who is chairman of the powerful Senate Ways and Means Committee, has the authority to decide whether to place all proposed budget amendments in either a reject pile or a pile of amendments headed for a single up-or-down vote on the Senate floor this week.
So far, Brewer hasn’t given the Dumonts much reason for hope that he will accept the study amendment for the floor vote. When the Dumonts and a small group of other Glavin family members met with Brewer earlier this month to urge him to allow the study amendment to reach the floor, Brewer told them that he “didn’t have the energy” to fight for the Glavin Center, Will Dumont said. Dumont said Brewer referred to it as a “losing battle.” The Dumonts, who live in North Brookfield, happen to be constituents of Brewer’s.
The administration is closing Glavin and three other developmental centers, contending they have become too costly to continue to operate. The Dumonts and other supporters of the centers disagree with the administration’s cost analysis. COFAR, a family-supported nonprofit organization that I work for, maintains that the administration’s cost analyses for all of the centers have been flawed and that an independent study is needed.
COFAR moreover believes it would be cost effective to the state to expand the missions of Glavin and the other developmental centers by enabling them to provide medical and other hard-to-get services to community-based DDS clients. Glavin, for intance, has long provided medical, dental, speech, psychology, guardianship and other services to intellectually disabled persons throughout central Massachusetts.
It’s the hope of the Glavin families that an independent cost study will establish once and for all that the savings in closing the facility are illusory. That, they hope, would convince the Legislature to block the administration’s plans to close Glavin.
But the administration strongly opposes an independent study, as does the Arc of Massachusetts and the Association of Developmental Disabilities Providers, which are vocal opponents of the developmental centers. And Brewer has shown little inclination to oppose those organizations or the administration, as evidenced by his statement to the Dumonts about lacking the energy to fight for the facility.
Yet, if the battle has been a losing one, that has at least partly been because of Brewer himself. Last year, Brewer scuttled a similar independent study amendment, which had been filed by Senator Michael Moore of Worcester. Moore has once again filed the study amendment. It would require that the cost study be done by a non-governmental entity selected by the state Inspector General.
Will and Rosemary Dumont are hoping this time they can scrounge up enough local support for Glavin that they can put some counter-pressure on Brewer. Will Dumont has enlisted all his friends in his hunting club near his hometown of North Brookfield to call and email Brewer’s office. Last week, Will, Rosemary and some other Glavin family members visited legislators’ offices in the State House. Meanwhile, Rosemary has been signing up friends on Facebook to support the cost study, and said last week that her effort had “gone viral.” Other Glavin families are making calls and sending emails as well and urging their friends to do so.
We may know whether their efforts have paid off by tomorrow when the Senate begins debate on the budget. We hope Senator Brewer has enough compassion for the residents and families of the Glavin Center that he will at least put the amendment for the cost study into the pile for a Senate floor vote.
DPPC faults care plan in group home resident’s death
A state investigative agency has concluded that a Tyngsborough group home resident died last year as a result of having ingested an inedible object, and that there was sufficient evidence to conclude that his death was due to a lack of adequate supervision by caregivers.
The 50-year-old man, who had formerly lived at the Fernald Developmental Center, had reportedly ingested a plastic bag
The March 29, 2012 report by the Disabled Persons Protection Commission, which was obtained by COFAR, concluded, however, that there was insufficient evidence to identify when or how the man had obtained the material he ingested, or whether he was in his group home, day program, or being transported between the two when he ingested it. The report also appeared to place the blame for the lack of supervision on the fact that the man’s plan of care, also known as an Individual Support Plan or ISP, had no requirement that he be kept in sight by staff at all times.
The 50-year-old man had lived in the group home for about a year after having been transferred there from the Fernald Center. According to sources, the man had a history of ingesting foreign objects, a condition known as pica.
The July 6 death of the resident is one of two cases of sudden death involving former developmental center residents, both men in their 50s, which COFAR first reported about last August. COFAR also reported about the case of another man who died suddenly of a blood clot in his lung in a Tewksbury group home on July 24, four days after having been transferred there from the Templeton Developmental Center. An investigation of that death is apparently still ongoing.
Both Fernald and Templeton are among four developmental centers that have been targeted by the Patrick administration for closure.
The March 29 DPPC report leaves many questions unanswered about the Tyngsborough group home resident’s death, including whether the man’s ISP was changed in a significant way after he left the Fernald Center, and whether his level of supervision in the group home was less than the level he had received while at Fernald. There is an indication in the report that the man’s ISP was changed in September 2010, apparently after he moved to the group home, to remove “target (presumably inedible) items” from mention in the plan. Much of this discussion, however, is redacted in the report.
…the appropriate DDS designee review the above noted additional finding of risk pertaining to (blank) and ISP language and determine what, if any, action should be taken to identify within a person’s ISP those specific items known to be ingested by the person, as a means to minimize or eliminate the risk they pose.
In a third case about which COFAR recently reported, a 51-year-old resident of a Northeast Residential Services home died on February 7, 2012 after having been sent back to his residence twice by Lowell General Hospital. That man had formerly lived at the Fernald Center as well.
We need to take a larger view on monitoring human services vendors
Alleged state credit card misuse and other financial irregularities at the Life Focus Center of Charlestown are the latest in a series of mini-scandals involving human service contractors to the Department of Developmental Services and other state agencies.
A few months ago, we learned of financial improprieties at the Merrimack Special Education Collaborative. Also during the past year, we heard about the Northeast Center for Youth and Families. And then there was Adlife Healthcare and the Greater Lawrence Community Action Council.
The problem is that in uncovering all of these mini-scandals, the state’s auditing agencies and the media seem to be focusing on the trees and overlooking the larger problem of the forest. The approach has been decidedly piecemeal — the steady release of individual audits of individual vendors, with the details of the previous audit forgotten as soon as the next one is issued.
As we’ve maintained many times, the state has a serious problem in monitoring its $2.6 billion human services contracting system. A more systematic approach to dealing with it is needed than we’ve seen so far. While state legislators appear to be interested in cracking down on welfare recipients who use electronic benefit or EBT cards, there seems to be no such impetus to examine the widespread potential for corruption by human services contractors.
To be fair, two state lawmakers, Reps. Kevin Kuros and Sheila Harrington, last year called for legislative hearings following the Merrimack Collaborative and Greater Lawrence Community Action Council audits. This, however, led The Nonprofit Quarterly’s investigative writer Rick Cohen to suggest that there needs to be a wider investigation:
into why the Commonwealth of Massachusetts is so deficient in its oversight of state-subsidized nonprofits that years of dysfunction and misspending could go unnoticed.
Do you suppose these hearings have yet been scheduled, by the way? The answer would be no, according to an aide to Harrington.
State Auditor Suzanne Bump last September asked for legislation that would give her agency authority to subpoena records of nonprofits that contract with the state. But it isn’t clear whether Bump or Attorney General Martha Coakley, whose office is investigating the Adlife Healthcare case, are taking as broad a view of the nonprofit monitoring problem as we think they should.
The Life Focus of Charlestown audit by Bump’s office illustrates problems that crop up over and over again in the vendor system. In her March 7 report on the company, Bump stated that the audit identified $129,982 in unallowable expenses related to state-funded contracts and $1.1 million in undocumented employee compensation expenses.
Among the specific problems alleged in the audit:
- For 114 days in which Life Focus billed DDS $239,969, there were no block schedules or other records to substantiate these billings.
- During fiscal years 2009 and 2010, the company’s executive director and deputy director charged 1,291 expenses totaling $123,173 against the company’s corporate credit cards. A total of $28,436 in credit card expenses were questionable in that they were either inadequately documented or did not appear to be directly related to program activities.
- Hundreds of thousands of dollars were spent on consulting services done by family members of company staff without competitive bidding or signed contracts.
Interestingly, a defense used by Life Focus to the audit findings was that none of these alleged problems was identified in a previous DDS licensure survey of the company. In fact, an October 21, 2010 DDS licensure report for the Life Focus Center called the Center “a viable and thriving community resource,” and cited the organization for only minor problems in its operations.
However, in our view, that clean bill of health that the DDS license staff gave Life Focus may say more about the inability of the state to monitor its vendors adequately than it does about this particular company. Moreover, it was apparently only after Bump’s audit was released that DDS started to crack down on the vendor.
The Boston Herald reported that DDS Commissioner Elin Howe sent a March 27 letter to the Life Focus Center’s Board of Directors, expressing “significant concerns” about Bump’s audit findings and the reportedly continuing unchecked use by John Millerick, the executive director, of the company credit card. This is apparently the second letter Howe has written to the Board in the wake of the audit.
Howe and DDS have yet to show much concern over the larger problem of oversight of all of the department’s vendors.
Meanwhile, while Life Focus’s Board chairman resigned in the wake of Bump’s audit, The Herald also reported that the company had hired Rasky Baerlein Strategic Communications, a PR firm, to protect the company’s image. Whether the state pays for that cost or not, it’s money that will not be going toward direct care services.
Trial in alleged assault of intellectually disabled man is put off again
Today (Tuesday) marked the fifth time Sheila Paquette has traveled from her home in western Massachusetts to Cape Cod to seek justice in the alleged assault of her brother, John Burns, an intellectually disabled resident of a group home in West Springfield.
But Paquette learned today she will have to make yet another trip to the Cape, along with David V., another resident of Burns’ group home, and Dan Aguda, a Department of Developmental Services instructor. The three were scheduled to testify today in Falmouth District Court in the trial of John Saunders, a former resident of Burns’ group home, who is charged with assaulting Burns during an outing on the Cape in June 2010.
As Paquette and the others sat in the courtroom all morning on Tuesday waiting for the proceedings to finally begin, the judge at the last moment postponed the trial until June 4 because a defense witness had failed to appear. Paquette, who is president of the Advocacy Network, a COFAR member organization, was visibly shaken by the sudden decision.
Sheila Paquette (left) in front of Falmouth District Court Tuesday after the trial of the man accused of assaulting her brother, John Burns, was postponed yet again. To Paquette's right are Dan Aguda, a DDS instructor in John Burns' day program; Deborah Reid, the house manager in Burns' group home; David V., a resident of the group home; and Ed Strout, a Board member of the Advocacy Network, a COFAR member organization.
“I can’t believe this is happening again,” Paquette said to Assistant District Attorney Kerry Whalen. “I’ve come down here five times, and every time there’s another delay.”
“It’s been almost two years (since the alleged assault),” Aguda added. “Memories will start to fade in terms of testifying.”
Whalen tried to reassure them and said she believes the trial will go forward on June 4. The judge, she said, will not grant another continuance to the defense witness.
Paquette isn’t convinced of that, but she and the other prosecution witnesses are prepared to travel to Falmouth again in June. “Anyone who assaults the intellectually disabled should know that these cases will be pursued,” she said.
The last time Paquette and the group from western Massachusetts were in court on the Cape was January 9, when Saunders’ trial was first scheduled. But Saunders himself was a no-show that day.
Saunders was reportedly arrested by police a couple of days after the January trial date and was released after posting bond that had been set by the judge at $1,000. The Falmouth District Attorney’s Office stated that it had requested a $5,000 bond for Saunders. He was present in the courtroom on Tuesday.
Paquette personally filed assault charges against Saunders in July 2010 after she became frustrated with the slow pace of state and law enforcement authorities in investigating the case. The Center for Human Development, a nonprofit firm that contracts with the state Department of Developmental Services to operate the group home in which Saunders worked, subsequently fired Saunders.
Saunders allegedly hit Burns in the face while toileting him during a vacation outing on the Cape for residents of the group home. Burns suffered two black eyes and other injuries. In recent months, Burns has been confined to a wheelchair. Paquette says she was told by her brother’s neurologist he has a neck injury typical of serious whiplash.
Saunders has denied assaulting Burns. The Disabled Persons Protection Commission concluded there was reasonable cause to believe Saunders had used excessive force and had physically assaulted Burns.
The DPPC also recommended that Saunders no longer be permitted to work with DDS clients and cited the CHD group home for failing to identify Burns’ injuries before sending him to his day program the morning after the alleged assault.
Dying, intellectually disabled man sent home twice from hospital
The disabled are often treated as second-class citizens, even in hospitals, says Dorothy O’Rourke.
O’Rourke is concerned that may have been the case with a resident of a state-operated group home in Chelmsford. The 51-year-old man, whose name is being withheld, died earlier this month after having been taken twice in two days to Lowell General Hospital and sent away each time, apparently without any significant treatment.
The man had been having difficulty breathing and was sweating profusely when he was taken to the hospital on both February 6 and 7. He died, apparently en route to the hospital, after the group home staff called an ambulance for the third time on the afternoon of February 7.
The cause of death is listed on the death certificate on file in the City of Lowell as acute respiratory failure and aspiration pneumonia, which can indicate choking. A death report form filed with the Disabled Persons Protection Commission, however, states that the man died after experiencing cardiac arrest.
Despite the possible discrepancy in the stated causes of death, the Chief Medical Examiner’s Office declined to do an autopsy, and the man’s remains were cremated. He had lived in the same group home as O’Rourke’s son.
O’Rourke strongly defends the staff of the group home, which is managed by Northeast Residential Services, a division of the Department of Developmental Services. “The staff there are wonderful,” she maintains. “They did all they could for him, including performing CPR. It’s the hospital that kept sending him home. I thought they would have at least kept and monitored him. I don’t understand it.”
O’Rourke has no information about what actually happened in the hospital after the man was taken there on each occasion. But she maintains that many hospitals are ill equipped to deal with intellectually disabled people, particularly those who are non-verbal, as this man was. “I think hospitals tend to ignore the mentally disabled,” she said. “I think they may need a special unit to handle mentally disabled people.”
A spokeswoman for Lowell General said the hospital would have no comment on the case due to privacy issues.
According to sources, the man had been sent to his day program in Lowell on the morning of February 6, and the staff at the day program made the first call to 911 to take him to the hospital. A Lowell Police Department official said a squad car was sent to the day program site at 8:30 a.m. in response to a call about a male having trouble breathing. (A police car was dispatched in addition to an ambulance each time, and the man was accompanied by a staff member to the hospital each time.)
The hospital released the man shortly after his arrival, however, and sent him back home. The following morning, the man reportedly looked exhausted and “out of sorts,” and the group home staff made a decision not to send him to his day program that day. By about 8 a.m., the man was slumped over in his wheelchair and sweating heavily, a source said. A group home staff member called 911 shortly afterward. A Chelmsford Police official said a squad car was dispatched to the residence at 8:30 a.m.
However, once again, the hospital made a decision to send the man back to his home. The DPPC report form on the death states that the man had been observed at the hospital on the morning of February 7 to be sweating profusely, but his vital signs were good when he arrived. According to the report form, the man was sent home with a prescription (the name of which was redacted).
By the time he was back at the group home, he was leaning over the side of his wheelchair and was “sweating terribly,” a source said. After the staff noticed the man’s lips turning blue, they immediately called 911 again. A staff worker couldn’t find a pulse.
The DPPC death report states that shortly after arriving back at the group home, the man began to vomit and then lost consciousness, and that the staff began mouth-to-mouth CPR until the paramedics arrived. According to the Chelmsford Police Department, a squad car arrived at the house at 1:45 p.m. The group home received a call from the hospital later that afternoon that the man had died.
The man was formerly a resident of the Fernald Developmental Center. His case is the third we have heard about in which a former developmental center resident in his 50s died suddenly at a state-operated group home managed by Northeast Residential Services. In this case, however, there doesn’t seem to be any indication that the group home was in any way at fault.
“The staff did a tremendous job,” one source said, echoing O’Rourke’s assessment. “They did exactly what they were trained to do. “They jumped right in and did their best to save his life.”
“We hope the DPPC does a thorough investigation of this case,” said Colleen Lutkevich, Executive Director of COFAR, a statewide, family-supported nonprofit organization that advocates for persons with intellectual disabilities and their families and guardians. “If indeed this hospital was at fault in failing to treat this man adequately, we need to find out why. In particular, we need to know whether his disability played a role in the apparent lack of care he received.”
It’s budget time — time to blame the Fernald families
The Massachusetts human service vendors are at it again — blaming the families of Fernald Developmental Center residents for the state’s budget problems.
In an online email to members this week, Gary Blumenthal, president of the Association of Developmental Disabilities Providers, once again resorts to misleading statements about Fernald’s operating cost in order to stick it to family members and guardians of the 14 remaining residents there.
Here’s what Blumenthal says about the Fernald families in his message, which discusses a $10.2 million supplemental bill filed by the Patrick administration to keep Fernald operating:
While the state is still intent on closing Fernald and three other state institutions, the final closure date is uncertain as the last 14 families attempt to hold out, hoping against reality that they can force the state to reverse it’s closure decision.
Despite the families being offered “equal to or better services” per federal Court Orders, the last Fernald families are using every available delay option available, urged on by anti-closure ideologues who still think they can force the state to leave Fernald open for the lifespan of the remaining 14 individuals.
First of all, through their own volition, these families are exercising their legal right to prevent what they see as the unjust eviction of their loved ones from their long-time home.
Moreover, in at least three of the 14 cases, administrative judges in the Patrick administration itself have ruled that the guardians demonstrated that care would not be better in the new locations proposed by the Department of Developmental Services for those residents.
That’s why these cases have dragged on. The administrative judicial decisions have been taken to state Superior court by both the administration and the 11 guardians who didn’t win their administrative appeals. That is their legal right. But Blumenthal and the ADDP have choosen to castigate the families and unidentified “anti-closure ideologues” for somehow bringing the state to its knees fiscally.
We suppose Blumenthal is referring to COFAR as an anti-closure ideologue. It’s true that we oppose the administration’s planned closures of Fernald and three other state developmental centers, which we believe provide critically needed care to some of the state’s most severely and profoundly intellectually disabled residents. But who are the real ideologues here?
We recognize the importance and need for community-based care for the majority of people with intellectual disabilities in Massachusetts. What we have long argued is that the developmental centers are a necessary part of the continuum of care. It is the ADDP and their state-funded vendor members who are the pro-closure ideologues. They argue that the state should abdicate its responsibility of caring for its most vulnerable citizens and hand the entire business over to them.
In furtherance of this aim, Blumenthal has to bend himself into a pretzel logic-wise, and, as we said, make misleading statements about Fernald’s operating cost. He implies in his message that if Fernald were closed immediately, the $10 million in supplemental funding would somehow be re-invested in the community system of care.
Yet, in the same message, Blumenthal admits what we’ve been saying for years — that the state has “reneged” (his word) on its longtime promise to re-invest funding from the developmental centers into the community system. Thus, Blumenthal knows full well that were Fernald to be closed tomorrow, that $10 million would not be invested in the community. The money, or a good portion of it, would follow the residents themselves to their new locations, wherever they might be. The community system as a whole would not benefit in any way.
Further, as they do every year at budget time, Blumenthal and the ADDP single out Fernald and discuss how the per-resident cost there has “skyrocketed.” It’s true that cost has skyrocketed. But what Blumenthal doesn’t say is that’s what happens when you drastically reduce the population of a care facility. The fixed costs get spread out over a smaller and smaller base of residents.
Despite the photo of an abandoned building at Fernald rising out of the weeds that runs atop his message, Blumenthal erroneously makes it sound as though the remaining residents are living the high life because the cost per resident there has risen. As one of the 14 guardians wrote in an email in response to Blumenthal’s message:
Based on what he (Blumenthal) has to say about the “evil 14”, you’d think we were having a blast, loads of fun and just a grand old time!
Also, just once I’d like to see a picture of one of Fernald “homes” like Malone Park or a cottage, or our beautiful chapel, not a building that hasn’t been occupied for 35 years!
You’d think I be use to this by now, but I guess not.
DDS vendor executives not sharing the pain of their workers
Direct-care workers in the state’s contracted human services system have seen their wages stagnate in recent years, but the executives who run the largely nonprofit contractor agencies that employ those workers do not appear to have been feeling that same pain.
We examined compensation to both CEOs and direct-care workers in a sample of 30 service vendors to the Department of Developmental Services, both large and small, from around the state in Fiscal Years 2008 and 2011. This information is available in Uniform Financial Reports, which are submitted to the state Operational Services Division by the vendors and are posted online by the OSD at www.mass.gov/ufr.
The CEO compensation of our sample increased by an average of 16.6 percent during the four year period while the direct-care salaries decreased by an average of 2.17 percent during that time. (See Vendor Compensation Table.)
Among the 30 vendors, the average CEO compensation in FY 08 was $197,068. It increased to an average of $229,872 in FY 11. In FY 08, the average direct care salary for the sample was $33,508. It decreased to $32,780 in FY 11. In FY 11, direct-care workers were earning an average of 14 percent of what the CEOs of those vendors were earning, down from 17 percent in FY 08.
Among the sample, nine CEOs received compensation increases in the four year period reviewed while the direct care workers employed by those same vendors actually saw their wages cut. In two of those cases, the CEOs received increases exceeding 100 percent.
That many CEOs have taken hefty pay increases and the direct-care workers have gotten little or nothing, or in many cases decreases, raises questions about repeated calls from the vendors to add $28 million to a state budget reserve fund to increase those direct care salaries.
If the Association of Developmental Disabilities Providers and its member vendors are really concerned about their direct-care workers’ pay, why have these companies given raises only to their CEOs? Should the state be called upon to bear the entire burden of raising direct-care wages?
“The vendors appear to have it in their own power to give their direct-care workers increases, but they’ve chosen not to,” said Colleen Lutkevich, COFAR executive director. “Instead, they’re looking to the Legislature.”
If the Legislature does step in to fund the direct-care salary reserve account, it will not be at the urging of Governor Patrick. Despite the ADDP’s appeals, the governor’s budget for the coming fiscal year proposes zero for the reserve fund.
Note: We were not able to use data from one of the vendors, Massachusetts Mentor, Inc. Massachusetts Mentor is a subsidiary of NMH Holdings, Inc., a for-profit corporation that provides residential and other services for intellectually disabled persons in 36 states. NMH Holdings was incorported in Delaware, according to its audited financial statements, though it actually appears to be headquartered in Massachusetts. (NMH Holdings appears to be referred to as The Mentor Network on its national website.)
Massachusetts Mentor’s UFR and other reports filed with the state OSD employ what appears to be an unusual method of listing only partial salaries of top executives. The compensation listed is apparently the amounts of the executives’ salaries that are attributed to Massachusetts. For instance, total compensation for Edward Murphy, CEO of both Mass. Mentor and The (national) Mentor Network, was listed as only $14,830 in FY 10, in a filing with OSD). (The company does not appear to have filed a UFR report in Massachusetts for FY 11.) Murphy is a former commissioner of both Mental Health and Youth Services in Massachusetts.
Greg Torres, chairman of the Board of Directors for both Mass. Mentor and The Mentor Network, earned a total of $2,484 in compensation in FY 10, according to the OSD filing. Torres, a former chief of staff of the Massachusetts Senate Ways and Means Committee, is also currently president of MassINC, the nonprofit civic think tank in Massachusetts that publishes CommonWealth magazine. (CommonWealth frequently advocates for more transparency in governmental finances and operations.)
Also working for Mass. Mentor is Gerald Morrissey, a former commissioner of DDS in Massachusetts. Morrissey’s total compensation as a vice president at Mass. Mentor was listed in the FY 10 OSD filing as $5,113. None of these clearly partial compensation listings could be reliably compared with other CEO and direct-care compensation in Massachusetts.
NMH Holdings earned more than $1 billion in revenues in FY 10, according to filings with OSD, while Massachusetts Mentor took in $3.7 million from DDS and $19.4 million from the Department of Social Services in FY 10, according to its UFR report.
Calls and emails to OSD with questions about Mass. Mentor’s and NMH Holdings’ partial compensation listings for their executives were not returned.
Gov’s budget continues the cuts
With a few exceptions, Governor Patrick’s proposed budget for the coming fiscal year, which he unveiled last week, appears to continue the trend in recent years of cutting funding for care for the intellectually disabled.
We see little to change our longstanding contention that the Department of Developmental Services community-based system, in particular, is not benefiting from the closures of four developmental centers. A few years ago, Health and Human Services Secretary JudyAnn Bigby promised that as a result of the phasedowns and closures of the Fernald, Monson, Glavin, and Templeton developmental centers, some $45 million a year was going to be plowed back into the community-based system of care.
There’s no question but that the developmental centers line item (5930-1000) has been cut deeply as the state facilities have been phased down in recent years. Under the governor’s FY 13 budget, this line item would be cut by an additional $20 million next year, a 13.1 percent reduction. This brings the total cuts in funding for the developmental centers to $55 million since FY 09.
But that found money does not appear to have benefited key community-based accounts such as Adult family supports, Turning 22, and the Salary Reserve to increase the static wages of direct-care human services workers in the community system.
First, let’s look at what would be increased in the governor’s FY 13 budget proposal for DDS and related accounts:
- The Community Day and Work line item (5920-2025) and the previous Transportation line item (5911-2000) would jointly be increased by $9.6 million under the governor’s proposal over current year spending. It’s hard to compare these line items with last year, however, because they have been merged together for some reason in the governor’s budget for next year. The Massachusetts Arc and the Association of Developmental Disabilities Providers are saying that the transportation component of the new line item is “short” by $3.1 million. We’re not exactly sure what they mean by that.
- The Community Residential Supports line item (5920-2000) would be increased by $31.6 million or 4.2 percent, while the State-Operated Group Home line item (5920-2010) would be increased by $12.9 million or 7.8 percent. As we understand it, however, the increases in these line items are intended primarily to accomodate residents being transferred from developmental centers targeted for closure. It’s unclear that anyone else in the community system will benefit from the increases. The Arc/ADDP are saying the state-operated group home account is still “short” by $4.1 million. Again, not sure what they mean.
- The DDS Administrative line item (5911-1003) would be increased by $2 million or 3.4 percent. This line item funds service coordinators, who arrange for services for clients in the community system. But it’s not clear whether there would be any benefit in that increase to the service coordinators, who have faced layoffs in recent years as their caseloads have skyrocketed. According to SEIU Local 509, a state employee union, the $2 million increase will cover negotiated salary increases within the DDS administration as well as office rental increases, while essentially level-funding staffing.
The rest of the DDS and DDS-related line items appear to be either cut or level-funded, which amounts to a cut relative to inflation. They include the following:
- The Adult Family Supports line item (5920-3000) would be cut by $5.5 million or 11.8 percent. This comes on top of cuts totaling 26.9 percent since FY 09. Those cuts were only partially restored last year through supplemental funding. The governor’s FY 13 proposal would wipe out that restoration. We’re not sure why this account always gets cut so badly because it would provide funding for families to keep people at home, which was a critical component of the governor’s Community First initiative, as we understand it. The Arc/ADDP are saying this reduction will hurt 2,000 families.
- The Turning 22 line item (5920-5000) would be level-funded at $5 million. This program has been cut by $2.7 million since FY 09. The ARC/ADDP are saying the program needs $10.5 million (more than double its current appropriation) to fully serve 710 additional intellectually disabled students expected to graduate from school next year.
- The Autism line item (5920-3010) would be essentially level funded at $4.6 million next year.
- The Salary Reserve line item (4000-0017) to boost the pay of direct-care workers would once again receive zero in funding under the governor’s FY 13 budget. The Arc/ADDP are calling this situation “devastating.”
- The Department of Education/DDS line item (5948-0012) would be cut by $50,000 from current-year spending. This is a joint program for youths with disabilities.
- The Massachusetts Rehabilitation Commission Supported Employment line item (4120-3000) would be cut by $369,400 or 15.1 percent.
- The Massachusetts Day Habilitation and Adult Foster and Family Care accounts (4000-0700), which are funded by MassHealth, would be “funded at maintenance,” according to the Arc/ADDP. This appears to mean that these programs would be maintained at their current levels next year. They have both been sharply cut in recent years.
The bottom line line is that while the administation has seen the need to continue its policy next year of cutting a wide range of community-based programs for the intellectually disabled, it hasn’t helped matters with its single-minded policy of closing the developmental centers. Not only hasn’t the closure policy provided more community-based funding, but it has clearly delayed community-based placements for thousands of people waiting for that care.
DDS stonewalling on cost, care information
(Part 2 of 2-part series on transparency issues in the Patrick administration)
The Patrick adminstation contends it is striving to be “transparent” in the way it conducts the public’s business, and touts its Open Checkbook website among other initiatives.
But when it comes to getting public information from individual agencies within the administration, the record of transparency doesn’t always live up to the billing. We think our own recent experience with the Department of Developmental Services is a case in point.
We’ve been fighting with DDS for several years over public information requests, but the agency’s disinclination in recent months to provide requested information seems to have gotten worse.
It now takes months to get even the most minimal public records in response to our requests. And DDS recently cited the letter of the Public Records Law in claiming they have no obligation to answer any questions about records that they have provided to us. Also, in two cases in the past year, DDS cited confidentiality requirements in refusing to release what we think, in at least one of the cases, are clearly public documents.
Meanwhile, even a state lawmaker has been unable to get information out of DDS on deaths in the agency’s system. State Rep. Anne Gobi, a Democrat from Spencer, wrote to DDS Commissioner Elin Howe in mid-October, asking for information on the number of residents who had been transfered from the developmental centers to community-based group homes and how many of those residents had died after the transfers. As of this month, Gobi’s staff said she had not received any response to her inquiry.
Here are some more details about our efforts to get records and information from both DDS and the Executive Office of Health and Human Services:
- In October, COFAR submitted a request similar to Gobi’s to DDS for information and public records concerning the number of developmental center residents who have been transferred to group homes since 2008 and the number of those residents who have died.
In that request, COFAR also asked for the number of community-based group homes that have been built to house former developmental center residents. In early November, a DDS attorney responded that the agency was in the process of searching for the requested records. There has been no further word since then. We wrote to DDS on January 17, seeking an update on the status of our request, but have received no response to it.
- In October, the DDS general counsel denied a request COFAR had first made in July for records detailing the costs of medical, nursing, clinical, and therapeutic services for individuals in a group home program operated by the May Institute, Inc.
COFAR initially filed the request for the records concerning the May Institute with both DDS and EOHHS. In August, an EOHHS official responded that that agency was in the process of searching for the records. Then, in September, a DDS attorney stated that DDS was searching for the same documents.
There has been no further word from EOHHS since August regarding the records. In October, however, the DDS general counsel appeared to reverse the Department’s September position by stating that documents detailing funding for medical or clinical services for individuals would be part of their individual client records and therefore exempt from disclosure under the Public Records Law.
COFAR appealed the denial to the Supervisor of Public Records in October, suggesting that DDS redact any names or any other information that might identify individual clients. In the October appeal, COFAR maintained that it was seeking only to find out the total cost to taxpayers of care for community-based clients such as those in the May Institute program. Should DDS refuse to provide that information, “the public will have no way of knowing basic details about the provision and funding of these kinds of public services,” COFAR’s appeal added.
To date, the Public Records supervisor has not ruled on COFAR’s appeal.
DDS similarly denied a request in July from COFAR for information about the death of a man in a group home earlier that month, four days after he had been transferred there from the Templeton Center. In that case, the Public Records Supervisor upheld DDS’s denial, accepting the Department’s argument that the information was private.
- In July, COFAR asked DDS for detailed budgetary information regarding the Monson, Templeton, and Glavin developmental centers, which have been targeted by the administration for closure. In response, DDS in August provided only a single line item amount for each facility, representing the total spending for that facility. There was no budgetary breakdown of the line item for any of the facilities.
After COFAR appealed to the Public Records Supervisor, DDS, in late October, provided an “aggregated” spreadsheet containing numerous line items for all three developmental centers. However, this time there was no separate breakdown for each facility. Moreover, the total aggregated spending amounts for each of three fiscal years in the October response did not correspond with the totals provided in the August response.
As a result, COFAR sent an email to DDS asking why there was such a big difference, in particular, between the $176.3 million in total spending listed in the October spreadsheet for the three facilites in FY 2009, and the $57.8 million listed in the August response for the same three facilities.
In a letter sent to COFAR in response, a DDS assistant general counsel wrote that the agency “is not required to answer questions…” under the Public Records Law. So much for letting us, and the public, in on the inner workings of the state’s finances.
Earlier this month, an attorney with the Public Records Division, sent us a nice email, apologizing for the delay in responding to our October appeal regarding the May Institute documents, and saying:
I know that you are working very hard to help those in the Commonwealth who are the most in need, and that receiving records from custodian’s, like DDS, is a crucial part of assisting those individuals.
Now, if only DDS wouldn’t balk at simple requests for information, and showed a dedication to following through on the administration’s claims of transparency.
Alleged assaulter of disabled man is a no-show on trial date
Sheila Paquette’s long-running quest to bring the man who allegedly assaulted her intellectually disabled brother to justice took yet another turn this week.
After months of delay, Monday, January 9, marked the date for the trial of John Saunders, a former care worker in the group home in which Paquette’s brother, John Burns, lives.
The bad news is Saunders was a no-show at Falmouth District Court, to which Paquette and five witnesses in the case had traveled from their homes in western Massachusetts. But Paquette was not deterred or defeated. The good news is that the judge in the case ruled that Saunders had defaulted on his bail and should not be released prior to trial if he is picked up on a violation of any kind.
But Paquette said the judge’s ruling was “a really positive thing for us. If he (Saunders) gets picked up, he’ll be in jail and there is no way he can avoid showing up for trial again.” The question is when, if ever, Saunders will be picked up. Police are unlikely to go looking for someone wanted for allegedly assaulting a disabled man.
Nevertheless, Paquette believes she is proving by sticking with the case that the system can be made to work for crime victims, even when those victims are intellectually disabled. “The state and the public should know that we will take these cases to court,” she said. She said she has started a legal fund to raise money not only to pursue her brother’s case, but to help others pursue similar prosecutions of assaults against people with disabilities. “It’s a difficult process, and I think a lot of people are intimidated by it,” she said.
Paquette said her main concern now is that her brother may have become depressed in recent months and that his condition may be connected to the assault. “It’s one more assault he couldn’t manage,” she said, noting that her brother had been assaulted on two occasions in group homes prior to the alleged assault by Saunders.
COFAR blog 