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Baker’s revised budget for the current year would cut funding for day programs, increase funding for implementing ‘Nicky’s Law’
Governor Charlie Baker last week proposed a revised state budget for the current fiscal year in light of the COVID crisis that would boost funding for some programs for persons with developmental disabilities, but would sharply cut day program funding.
The community-based day program cut reflects the impact of the COVID pandemic on in-person programs, according to a statement from the Department of Developmental Services (DDS). The resulting changeover to virtual programs on platforms such as Zoom has not been welcomed by some families and guardians who say the quality of in-person programs cannot be replicated on virtual platforms.
Baker’s $45.5 billion state budget does contain a proposed increase of $780,000 over his original plan in January in order to fund the implementation of “Nicky’s Law.” The new law would create a registry of names of caregivers in the DDS system who have had abuse cases substantiated against them.
It isn’t clear, however, that Baker’s budget plans will be approved by the Legislature. The governor’s revised budget proposes increases in overall state spending beyond what he proposed in January despite the projected loss of $3.6 billion in state tax revenues due to the pandemic.
Overall, the impact of the governor’s revised budget on programs and services funded by DDS appears mixed. Also, while Baker’s budget would boost Medicaid funding by $834 million, it isn’t clear how that would affect DDS programs.
Day program funding would be cut
As noted, the news isn’t good in Baker’s revised budget for the provider-based line item for community-based day programs (5920-2015). The budget proposes a cut of $22.4 million, or 9.2%, in that line item when adjusted for inflation.
Baker had originally proposed a 6% increase in the day program line item in January.
DDS Ombudsman Chris Klaskin issued a statement from the Department that appears to indicate that a significant number of DDS clients aren’t attending day programs in light of the pandemic:
The proposed funding level incorporates revisions to (day) program forecasts as a result of DDS provider agency closures, reduced demand for services, and capacity requirements to maintain physical distancing in transportation and congregate settings advised by the Centers for Disease Control and Prevention (CDC).
Over the course of COVID-19 pandemic, DDS and its agency providers have worked in partnership to accelerate and incentivize alternative day programming in virtual and remote settings (i.e. Zoom classes) to supplement in-person services in the interim.
Some families have indicated to us that Zoom-based activities don’t work well with their loved ones who are DDS clients. At the same time, those families do not want to expose their loved ones to possible COVID infection in in-person programs.
We have noted that while staff working in residential DDS programs are now required to be tested for COVID-19, there still is apparently no such requirement for staff in day programs.
I sent a follow-up request to Klaskin today for information on the number of day program agencies that have closed, and the amount of the drop-off in demand for the programs.
Transportation funding would be boosted
In addition to the increased funding for the implementation of Nicky’s Law, Baker’s revised budget proposes a $3.5 million, or 11.7%, increase in the DDS transportation line item (5911-2000). It’s not clear why that provider-based line item would be increased by such a large percentage at the same time that the day program line item is being cut.
Mixed news for provider-run group homes
It appears the largest DDS line item — provider-operated group homes (5920-2000) — would get a very modest increase from Fiscal 2020 under the governor’s proposal. It’s actually a small cut of 0.33% when adjusted for inflation.
However, despite that apparent slow-down in funding this year, the provider-run group home line item will have been boosted since Fiscal 2012 by almost $423 million, or 49%, to $1.28 billion, if Baker’s proposal is adopted.
We have frequently noted that overall, the Legislature and successive administrations have steadily increased funding for privatized DDS-funded functions while either cutting or providing minimal increases in funding for state-run services.
Also, the governor proposed what appears to be a big increase in the Chapter 257 Reserve Fund (1599-6903), which goes to the residential providers in the form of rate increases. Baker would increase that line item by $119 million to $160 million. It isn’t clear, though, that the entire increase would take effect in the current fiscal year, which would be half over by the time the governor’s budget were to go into effect.
State-run developmental center funding cut as usual
Funding for the two remaining state-run developmental centers (5930-1000) would be cut as usual. Baker’s revised budget would cut the line item by $1.7 million, or 1.6%, when adjusted for inflation. That line item will have been cut by more than $70 million since Fiscal 2012. Since then, four of six remaining centers have been closed.
Under Baker’s revised budget, the relatively small state-operated group home line item (5920-2010) would get a modest increase of $3.86 million this year, or 1.7%, when adjusted for inflation.
Also, the DDS administration line item (5911-1003) would get a proportionally larger increase of $4.5 million, or 6%. At least some of that funding is for DDS service coordinators, who manage and oversee services to thousands of DDS clients.
Funding increased to implement Nicky’s Law
One piece of potential good news is that the governor’s revised budget would boost funding to the Disabled Persons Protection Commission (DPPC) by $909,600, or 18.6%. That is $781,000 more than the 2.6% increase that Baker proposed in January for the DPPC.
As noted, the additional funding is intended to implement Nicky’s Law. That funding would enable the administration to avoid a lengthy delay in implementing the long-sought legislative initiative to prevent abusive caretakers from continuing to work in the system.
A member of the staff of state Representative Kay Khan, House Chair of the Legislature’s Children, Families, and Persons with Disabilities Committee, said the additional $910,000 for the DPPC is a pro-rated amount. It is based on the DPPC’s original Fiscal 2021 request for $1.2 million to establish the registry.
Andrew Levrault, DPPC assistant general counsel, said the agency anticipates hiring additional investigatory and legal staff, in part, to defend the agency in legal appeals of the placement of individuals on the registry. He said more than 700 provider agencies are expected to access the registry each year to conduct checks on thousands of prospective employees. In addition to the investigative and legal staff, the DPPC “needs to substantially expand its information technology infrastructure” to meet the registry access needs of the providers.
As usual, the budget process raises many concerns about the near-term and long-term future of care for those in the DDS system; and answers are often hard to come by. The COVID crisis is vastly complicating an already complicated process.
A newspaper’s coverage of abuse and the enactment of Nicky’s Law are steps in the right direction
One newspaper in Massachusetts has been shining a spotlight lately on the problem of abuse and neglect of persons with developmental disabilities in the state.
Meanwhile, the state Legislature took a strong step last week in barring abusive caretakers from working for providers in the system.
Yet these two positive developments also highlight the fact that the media in Massachusetts in general and the Legislature as a whole have to do more than they have been in recognizing ongoing problems in the care of persons served by the Department of Developmental Services (DDS).
As we have long maintained, these problems have gotten steadily worse as functions and services for the developmentally disabled have been steadily privatized over the years without sufficient oversight of the corporate provider-based system.
One newspaper’s systematic coverage and one important legislative victory appear to be the exceptions to the rule, which has generally been one of benign neglect on the part of the media and Legislature.
The media exception has been The Springfield Republican, which published an in-depth report on January 10 about a DDS corporate provider, Guidewire, Inc. The newspaper revealed, among other disturbing facts, that at a Springfield group home operated by Guidewire, staff encouraged residents to fight each other and awarded prizes including money, cigarettes, marijuana and alcohol.
Perhaps not coincidentally, the article ran just a few days before the Massachusetts House unanimously approved a bill that would create a registry of caregivers found to have committed abuse or neglect. Such persons would be banned from future employment in DDS-funded facilities. The bill known as “Nicky’s Law,” which was passed by the Senate in October, is expected to be signed into law by Governor Baker within the next 10 days.
A few days before the Springfield Republican article ran, the same newspaper published a follow-up to COFAR’s blogsite report about the termination of a DDS contract with another DDS provider, the Center for Human Development, to operate two group homes in which care was found to be substandard. In that case, COFAR had first reported allegations of poor care raised by the foster mother of a resident of one of the group homes.
Last year, the Republican followed up on COFAR’s initial reporting on CHD, and ran a comprehensive article about the failure of DDS’s licensure inspection process to identify ongoing problems in the two CHD group homes.
Both the reporting by the Republican and in COFAR’s blog posts helped to spur an internal investigation of CHD by DDS. Last fall, the DDS Bureau of Public Integrity cited potential “systemic issues” across CHD group homes.
Guidewire details underscore the need for Nicky’s Law
According to the Republican. eight employees of Guidewire were fired after the “fight club” details were brought to the attention of DDS in 2011. But the employees were given the right to return to work at other DDS-funded facilities in 2018. And while Guidewire was subject to a corrective action plan and staff were retrained, no criminal charges were filed in the case.
To that extent, the Guidewire case underscores the need for Nicky’s Law, which would potentially have prevented DDS from continuing to employ those caregivers.
Persons applying for caregiver positions in the DDS system currently must undergo criminal background checks, which disclose previous convictions for abuse and other crimes in Massachusetts and other states. However, even when abuse against persons with developmental disabilities is substantiated by agencies such as the Disabled Persons Protection Commission (DPPC), it does not usually result in criminal charges. As a result, those findings of substantiated abuse are not made known to providers or other agencies seeking to hire caregivers. That’s why an abuse registry is needed in Massachusetts.
The Springfield newspaper cited COFAR’s own findings last September in which we identified Guidewire as one of the service organizations in the state with the most abuse complaints filed, substantiated and referred for criminal prosecution.
More recently, we analyzed DPPC data on a per-client basis to control for size of each provider, and found that between Fiscal 2010 and 2019, Guidewire was third highest out of 75 providers surveyed in the number of substantiated abuse cases per client. Guidewire was third as well in complaints referred per client for criminal investigation.
But abuse and poor care are problems that go far beyond one provider. COFAR analyzed the outcomes of more than 14,000 abuse complaints in the Fiscal 2010-2019 period.
Rest of the media needs to examine these issues
The Springfield Republican’s reporting shows the good things that can happen when the media shines a light on issues and activities that are causing harm. But it usually takes a commitment and cooperation among several media outlets to place these matters on the agenda of politicians and policymakers in order to bring about real change.
Unfortunately, with the exception of the Republican, the mainstream media in this state has shown little interest in systematically reporting on the serious problems that afflict the care of persons with developmental disabilities in the DDS system.
Major investigations have been undertaken of abuse of the developmentally disabled in group homes by newspapers in other states in recent years. Those reports include multi-part exposes starting in 2011 by The New York Times, in 2013 by The Hartford Courant, and in 2016 by The Chicago Tribune.
The mainstream media in Massachusetts has yet to to pay more than passing attention to the DDS system. We have also not had any success in getting a response from The Boston Globe to our concerns about currently proposed legislation that would make the state’s process of investigating abuse of the developmentally disabled far less transparent.
Children and Families Committee has yet to demonstrate a serious concern about the issues
We are also trying to persuade the state attorney general and the Legislature’s Children, Families, and Persons with Disabilities Committee to begin seriously looking at these issues. While we applaud the role played by the Children and Families Committee in getting Nicky’s Law enacted, the committee has yet to demonstrate a sustained commitment to examining and addressing the problems within the DDS system.
In 2018, the Children and Families committee held two informational hearings on abuse and neglect in the DDS system. But members of the general public were not permitted to present verbal testimony at either hearing, and the committee never followed up on those hearings with a report. It’s not clear what, if any, the purpose of those hearings was.
In the final analysis, media attention and the attention of legislators and policymakers are linked. Legislators, in particular, are not likely to act to address society’s problems if the media isn’t focusing on those problems. It seems we’ve entered an age in which the media’s attention is more fractured than ever before.
The enactment of Nicky’s Law is one example of a piece of legislation that the media did get behind. Yet, the enactment of that law is just a first step in what needs to be a comprehensive reform of the system.
Every now and then, a media outlet like The Springfield Republican gives us hope that there still are journalists out there who will go further than reporting on one bill and will examine the issues underlying the legislation.
Once the media focus is there, we think legislators and policymakers will act more systematically on issues of concern to those people they are supposed to protect — the most vulnerable people in society.
COFAR blog 