Archive

Posts Tagged ‘Patrick administration’

This is where our money is going

June 24, 2011 4 comments

Inspector General Gregory Sullivan has alleged numerous financial abuses in the state-funded Merrimack Special Education Collaborative, which coordinates special education programs among several school districts in Massachusetts.

Meanwhile, State Auditor Suzanne Bump is investigating whether the case is part of a larger pattern of abuse in the special education system in the state.   And Sullivan’s findings are being reviewed by Attorney General Martha Coakley’s office. 

While as many as three state agencies are now investigating this matter and potentially other special education contracts, it’s clear that state oversight of the special education system in Massachusetts has been lacking.  The system has allowed one man, John Barranco, to allegedly fleece taxpayers of more than $10 million.  The allegations include using a credit card for tens of thousands of dollars in personal items, gifts to a family member, and a no-show job to a lobbyst caught up in the Cognos software scandal involving former House Speaker Sal DiMasi.

We’ve just looked at the federal and state financial filings of the Merrimack Special Education Collaborative and related, nonprofit Merrimack Education Center, both of which Barranco allegedly controlled.   These two organizations are clearly interrelated in a troubling way; and, as in the cases of some other contractors we’ve looked at, state and federal records don’t appear to match up with each other regarding the salaries of Barranco and other executives of the Special Education Collaborative and Education Center. 

For instance, the federal IRS Form 990 for the Merrimack Education Center listed Barranco’s total compensation as $464,411 in FY 2009 and $525,198 in FY 2010. 

However, the state Operational Services Division listed Barranco’s total compensation as $427,909 in FY 2009 and didn’t list any compensation for him in FY 2010 on its Uniform Financial Reports on the Merrimack Special Education Collaborative.   (The OSD does not appear to have a UFR on file for the Education Center.)  Is OSD unaware that Barranco apparently received more than a half million dollars in state-funded compensation  in FY 2010?

According to the Globe, Barranco retired as executive director of the Special Education Collaborative in 2005 and appointed John Fletcher and Donna Goodell in 2007 as co-executive directors.  Both Fletcher and Goodell were listed on OSD’s UFR for the Special Education Collaborative in FY 2009 as making over $200,000 each, and in FY 2010 as making about $150,000 each.  In FY 2009, Barranco, despite his alleged retirement, was still listed on the UFR for the Collaborative as a third executive director.

The UFR and Form 990 reports raise numerous other questions about the financial accounting practices of both the Center and the Collaborative.  For instance, although the OSD uses the UFR to disallow state funds for salaries of vendor executives in excess of $143,900, the 2009 UFR for the Collaborative indicates that no funds were disallowed for the Collaborative in 2009, even though five executives of the Collaborative — including Barranco, Goodell, and Fletcher — were listed as making over the threshold amount that year.

The FY 2009 and 2010 UFRs state that the Collaborative received $24.5 million from “Massachusetts local and quasi-governmental entities” (apparently the 10 member school districts in the Merrimack Valley) in FY 2009 and $15.9 million in FY 2010.  In addition, the Collaborative received over $800,000 each year from the Department of Developmental Services. 

Senate President Therese Murray has promised to introduce legislation to increase oversight of the special education collaboratives.  But these collaboratives are only a part of the vast human services contracting industry in Massachusetts, and their alleged abuses are not unique to special education.  The entire $2.6 billion vendor system needs better oversight.

Judge rules against Fernald transfer

June 17, 2011 5 comments

A state administrative judge has thrown a new hurdle in the path of the closure of the Fernald Developmental Center, ruling that moving one of the remaining 14 residents out would not be in that resident’s best interest.

In a June 9 decision, Administrative Law Magistrate Kenneth Forton ruled that the resident, identified as Daniel O., would not receive improved services and quality of life if he were moved, as planned, to the Wrentham Developmental Center.

This is the first appeals case to be decided in favor the remaining Fernald residents, whose guardians have appealed the transfers to the state Division of Administrative Law Appeals.  The appeals have already kept Fernald open a year beyond the administration’s planned closure date;  and the administration appears to be projecting that the Center will stay open at least another year as a result of the ongoing litigation.

But before the Association of Developmental Disabilities Providers once again rushes in to blame the guardians of these intellectually disabled residents for the cost of delaying Fernald’s closure, let me pre-emptively make a few points:

1.  As the guardians’ attorney, Stephen Sheehy, has pointed out, the appeals are not intended to keep Fernald open.  They are based on a state law, which says that the state must show that a resident’s services and quality of life will be improved if he or she is to be transferred to another location.

In the case involving Daniel O., the administrative magistrate has concluded that he will not receive improved services or quality of life as a result of the move to Wrentham, at least under the circumstances established by the Department of Developmental Services.  If DDS can demonstrate that the move will be in Daniel O.’s best interest, his guardian will not object to it, Sheehy says.

2.  It is DDS, not the guardians, that is responsible for the cost of keeping Fernald running for the 14 remaining residents while the appeals are pending.  DDS has continually refused to discuss longstanding proposals by the guardians and other advocates for a settlement of the dispute.

For years, we have proposed a “postage stamp” arrangement for Fernald under which new, cost-effective housing would be provided in a reduced section of the campus for the current residents, while the remainder of the campus was developed for other uses.  A compromise based on the postage-stamp idea would end the entire litigation process and allow the state and the Fernald guardians and families to move forward with a cost-effective plan for the future.

Sheehy has stated that DDS remains uninterested in negotiating any type of compromise settlement.  The adminisration has even refused to discuss proposals for saving money during the appeals process by consolidating the remaining residents into one building or location.  Right now the residents are dispersed among several buildings on the campus.

3.  The ADDP has repeatedly inflated the current cost of operating Fernald, stating erroneously that the state is spending as much as $1.3 million per month for the remaining residents there.  In fact, the $1.3 million is an average figure for care throughout the entire current fiscal year, during which there have been as many as 70 residents at Fernald.  The reason for the per-person cost at Fernald has risen is solely due to the mathematical fact that the number of residents left there has steadily declined.  It is a reason to look for more cost-effective ways to operate the Center,  but DDS inexplicably refuses to do.

4.  The ADDP has wrongly stated that  the continued operation of Fernald and the other developmental centers for a small number of people is taking away funding for thousands of people in the community.  This is comparing apples to oranges.  Most of the people in the community system don’t have the high level of needs that the developmental center residents do.  Even if the centers were all closed tomorrow, the state would still have to spend a much larger-than-average amount of money per person to care for those former residents elsewhere.

Think of it this way:  A university with 30,000 students buys 80 helmets for the football team.  The ADDP is effectively arguing that this is unfair — the school should be buying helmets for everyone.  It’s a false argument.  Not everyone in the school needs a helmet; in fact, only a small minority need them.  If the school, out of a misguided sense of fairness, decided not to buy the helmets for the team, it wouldn’t save money in the long run.

A pattern of denigrating Fernald

June 10, 2011 1 comment

Opponents of Intermediate-Facility-Level care in Massachusetts have repeatedly denigrated the Fernald Developmental Center during the past two years as part of a campaign to encourage the shutdowns of that facility and three other state-run developmental centers in Massachusetts for people with severe intellectual disabilities.

Our review shows a pattern in the tactics used by the opponents, which have included repeatedly publicizing inflated figures on Fernald’s per-person cost and falsely characterizing the care at Fernald and other developmental centers as outmoded or obsolete.  The ironic purpose of the campaign has been to close the centers as fast as possible without conducting any meaningful cost studies.

The organizations most directly involved in the campaign against Fernald include the Association of Developmental Disabilities Providers and the Arc of Massachusetts.  Joining them last year was the Governor’s Commission on Mental Retardation, which the Fernald League noted had previously been reconstituted  by the Patrick administration to lobby on behalf of the developmental center closures.

The record appears to show that the efforts to spread misinformation about Fernald have been effective in bottling up cost studies, which would have actually pertained to the three other developmental centers marked for closure.  The misinformation has also been damaging to the reputations of guardians and families of the Fernald residents.

Fernald and five other developmental centers are the only sources in Massachusetts of ICF-level care, which must meet federal standards for staffing and supervision.  The Patrick administration has targeted the Fernald, Monson, Templeton, and Glavin centers for closure, starting with Fernald, by Fiscal Year 2013.  Fernald, which was scheduled to be shut last July, has remained open pending the outcomes of administrative and court appeals filed by the guardians of 14 remaining residents.

For at least the past two years, the ADDP and the Arc have focused during state budget debates in the Legislature on the alleged cost of maintaining Fernald.   Our review shows that during this year’s budget debate in April and May, leaders of those organizations repeatedly made inaccurate claims about Fernald’s per-person cost of operation that were as much as 70 percent higher than the most recent projection by the Department of Developmental Services.

In public statements, the ADDP and the Arc also inaccurately blamed those alleged per-person costs on appeals filed by guardians of their wards’ transfers from Fernald.  The erroneous cost figures were provided to state legislators as the House and Senate were considering budget amendments in April and May that would have required an independent cost study prior to closing the separate Templeton, Monson, and Glavin centers. 
 
 On April 25, ADDP President Gary Blumenthal claimed to the State House News Service that the annual cost per person at Fernald had “nearly quadrupled” to $917,000.  The News Service said the cost was based on documents from DDS.  The News Service account was picked up by The Boston Globe.   However, DDS General Counsel Marianne Meacham told COFAR that to her knowledge DDS has never cited a cost as high as $917,000 per person at Fernald, and that she had no knowledge of any documents listing that amount. 
 
(We called the author of the State House News article to ask for a copy of the alleged DDS documents.  The reporter said he was unable to locate them.)  
 
In a May 25 letter to COFAR, DDS Commissioner Elin Howe stated that DDS had actually projected an annual cost of care of $635,414 per person at Fernald, based on the 14 remaining residents.  Moreover, Howe stated that overall costs at Fernald had dropped during the past year and a half as the residential population has dropped, but that the per-person cost had risen  to the $635,000 amount due to the declining population.  She termed the cost spike “a typical pattern in previous closures.” 

 
That per-person cost spikes occur when facilities are closed was not recognized by the ADDP or the Arc in their accounts of Fernald’s costs.  On April 25, the same day Blumenthal was citing the $917,000 figure to the State House News Service, a letter to legislators, signed by Blumenthal, Leo Sarkissian, president of the Arc of Massachusetts, and about a dozen human service providers, claimed that Fernald was costing “$1.3 million per month for 16 individuals due to administrative appeals.”   That would equate to an annual cost of $975,000 per resident.  Later that same day, as the ADDP/Arc letter had requested, the House leadership rejected an amendment to the House budget bill for the cost study for Templeton, Monson, and Glavin.
 
Whether it was the result of a cost spike due to a declining population or not, the $975,000 figure was wrong.  In her May 25 letter, Howe indicated that the $1.3 million cost at Fernald was an average monthly cost, based on a $15.6 million projection for the full current fiscal year.  At the start of the year, between 50 and 70 residents were still living at Fernald, not 16.  Thus, it would be inaccurate to claim that Fernald was costing $1.3 million per month for only 16 individuals, or that the $1.3 million figure could be annualized, “to understand the high cost of delay and obstruction,” as the ADDP/Arc letter claimed.
 
Nevertheless, a month later, on May 24, the Boston Herald ran a story  that similarly claimed erroneously that $16 million was being spent to care for a remaining 14 residents at Fernald.  That story inaccurately implied that the cost per resident was as high as $1.1 million.  Blumenthal was quoted in the Herald story as terming the cost cited by the Herald  “excessive” and “the cost of delay” in closing Fernald. 
 
A budget amendment requiring the independent cost analysis prior to closing the Monson, Glavin, and Templeton centers was rejected by the Senate leadership two days after the Herald story ran.
 
A similar pattern of unsupported or inaccurate information about Fernald was evident during the legislative budget debate a year previously.  In May 2010,  the ADDP claimed that delaying Fernald’s closure by undertaking a cost study of Fernald and the three other centers marked for closure would cost an additional $13 million a year.   There was no backup or explanation for that number.

That same month, the Governor’s Commission on Intellectual Disability cited a  $1.3 million cost per month at Fernald in calling for rejection of that same cost study.   This number was unsupported as well in the Commission’s letter.

(By the way, the only publication  listed on the Governor’s Commission publications page on its website is the administration’s 2009 developmental center closure plan, which the Commission didn’t even write — the document was written by DDS.)

Meanwhile, as the ADDP and the Governor’s Commission were citing those unsupported cost claims for Fernald in 2010, Sarkissian of the Arc of Massachusetts was claiming erroneously that Fernald and the other developmental centers were providing inferior care to community-based facilities.  In an op-ed article in The Waltham Tribune,  Sarkissian variously termed Fernald and the other developmental centers “decrepit,” “archaic,” “outdated,” “Dickensian,” and “inferior.”

In the op-ed piece, Sarkissian raised issues from the 1960s and earlier about sexual abuse, military experiments, and other issues at Fernald that have not been current for a half century or more.

Last week, I wrote to Blumenthal, asking him to publicly disavow the inflated cost figures for Fernald that he and his organization cited this year.  He declined to do so, saying the cost figures had been provided by DDS.  The question we still can’t answer  is whether DDS itself knowingly publicized inaccurate figures on Fernald’s cost.

It’s about the care model

A disturbing incident involving an attempted rape of a woman by an intellectually disabled resident of a community-based group home last month can teach us all a valuable lesson.

We’ve been in the midst of the wrong debate here about care for people with intellectual disabilities.  We really shouldn’t be having a debate between “community-based” care versus institutional care.  What’s really at issue here is the care model for these people in Massachusetts.

Bear with me for a moment. 

On June 3, The Lowell Sun reported that a resident of a state-run group home in Chelmsford walked out of his residence, went next door and attacked a pregnant woman as she was sitting in her living room with her husband and three-year-old daughter.  The man managed to tear off Amy Hillman’s shirt and jump on top of her before he  was pulled away by Hillman’s husband, James.

The group home resident, Tholda Chhom, and James Hillman ended up in the front yard, where Chhom continued to charge at Hillman before running back to his residence just before police arrived, according to witnesses.  Chhom was later charged with assault and attempted rape, and has been placed in a “more secure state facility,”  according to The Sun.

Meanwhile, the Hillmans and their neighbors have been left asking questions.  Will Chhom be allowed to return to the group home?  Why were the Hillmans previously told that Chhom did not have violent tendencies, even though he frequently used to yell out of his window at passersby?

The Hillmans, in fact, were so concerned about Chhom, prior to the May 8 incident, that they built a stockade fence around their yard.  According to James Hillman, Chhom appeared to be left all day long in his room.  But on the day of the attack on Amy Hillman, the staff at the group home reportedly didn’t even know he had left the group residence.

It would be tempting for us to say that Chhom should never have been in a community-based group home; he should have been in a develpmental center, where, at the very least, it would have been more difficult for him to have gotten out out and to attack a resident in the community.  But that argument may miss the real point here.

What people like Chhom are missing in the community system — even in state-run community residences — is an intensive care model that meets the federal standards set for Intermediate Care Facilities.  ICF-level care, which happens to exist only in the developmental centers in Massachusetts, stipulates that residents receive onsite clinical, medical, and nursing care and full-time supervision.  Not everyone with intellectual disabilities needs this level of care.  Only a small fraction of them do.  But Chhom would appear to be one of them.

That’s why we’re so upset that the Patrick administration is shutting down four of the six remaining developmental centers without replacing the ICF care model available in them.  We don’t want the big old buildings there either.  It’s the ICF care model we want to preserve for those who need it.

We think the current residents of the developmental centers should be able to stay in their current locations in the most cost-effective residential settings, while receiving the same level of care from their familiar staff.  That might well mean they would live in small group homes on the campuses — the “postage-stamp” idea.  Meanwhile, other people in the community, such as Tholda Chhom, who need that level of care, should be able to receive it as well.

But the administration is seeking to eliminate the ICF model and replace it with care under which the ICF standards have been waived.  It’s referred to as community-based care, but it should really be labeled “waiver based” care, because the standards are lower.  Direct-care staffing levels do not have to be as high, clinical and medical personnel can “float” among different homes in geographic regions, and medications can be administered by people with less training.

What does this mean for the safety of neighborhoods around the state where thousands of community-based group homes exist?  What does it mean for people like Tholda Chhom, if there will no longer be an ICF-level facility one day to accept him?  Will he simply be thrown into prison?

Once again, let me be clear.  I’m not trying to make an argument here to preserve the six developmental centers as they exist today, although no doubt we’ll continue to be accused of that. 

Go ahead, call it all community-based care.  Just keep the care model and let the current residents of the developmental centers stay in their current locations with their familiar staff.   And finally, provide the opportunity for ICF-level care for all who need it, such as Tholda Chhom.

What are they afraid of?

June 1, 2011 4 comments

It’s now clear that there will be no independent study of the cost of closing versus maintaining the Templeton, Monson, and Glavin developmental centers for people with profound intellectual disabilities in Massachusetts.

Instead, the Patrick administration will continue on its path of closing these critically important institutions on the basis of its largely unscrutinzed claim that doing so will save money.

We figured the administration and the Association of Developmental Disabilities Providers wouldn’t want an independent assessment of that savings claim.  Now we know the leadership in the House and Senate didn’t want it either.  As a result, it will not happen.

Last week, the Senate leadership scuttled a budget amendment, which would have specified that a study of the cost of closing Monson, Templeton, and Glavin be undertaken by a non-governmental entity selected by the Inspector General. 

This occurred after the House had scuttled a similar amendment, and after the ADDP and The Boston Herald had cited inflated numbers on the cost of operating the Fernald Developmental Center.  (Fernald, by the way, wouldn’t even have been included in the proposed cost study.)

What were the administration and the ADDP, in particular, so afraid of?

I think I can guess.  There is a possibility that the entity selected to undertake the study would have come up with a conclusion that the administration, the ADDP, and the legislative leadership didn’t want to hear, i.e., that there would be little or no savings in closing the three facilities. 

Even if you believe we will save money in closing these institutions, why not verify that with an impartial study?  Because it might delay the closures of these facilities by a few months?

In fact, the administration is on schedule, as far as we know, to close all of these facilities as of Fiscal Year 2013.  Fernald, which was first on the closure list, remains open, not because of any cost studies that have been conducted, but because of administrative appeals filed by the guardians of its remaining residents.

The administration has steadily moved residents out of all four of these developmental centers.  This has caused tremendous displacement and anxiety among hundreds of families and guardians, and is leading us toward a system that no longer meets the same high federal standards of care as do the developmental centers. 

Elderly residents of these centers are being forced to leave homes many have known for practically their whole lives.  The key justification the administration has given for doing all this is saving money.   Yet, we are told we cannot afford to have an impartial review of that savings claim because it might slow down this march of “progress” by a few months.

The fact is that studies in other states have come to conclusions that don’t support the Patrick administration’s claim that closing developmental centers saves money.  (See, for instance: Journal of Mental Retardation cost studies review and Connecticut DDS studies of the cost of closing the Southbury Training School.)  Were an independent study in this state to reach a conclusion similar to those out-of-state studies, it would present a public relations problem, at the very least, for the Patrick administration.

That, it seems to us, is the real reason the administration and the ADDP fought so hard to make sure the independent cost study amendment didn’t see the light of day here in Massachusetts.   Last month, Rep. Brian Dempsey, House Ways and Means chairman, wouldn’t allow the study amendment, which had been sponsored by Rep. Anne Gobi, even to come to a floor vote in the House. 

A staff member for Senator Michael Moore, the sponsor of the independent cost study amendment in the Senate, would only say this week that “(Senate) Ways and Means was not supportive” of the amendment.  As we understand it, Moore was first told he would not be allowed to include language in the measure requiring legislative approval of the study. 

Then Moore was told he would have to knock Templeton and Monson out of the amendment, and restrict the study just to Glavin, which is in Moore’s district.  Moore complied with all of those directives.  But it didn’t help. 

Moore’s watered-down cost study amendment was nevertheless then reportedly bundled with other budget amendments in the Senate’s consolidated “no” pile, meaning it was doomed to be rejected, along with all the other amendments unwanted by the leadership, in a single voice vote on the Senate floor.  You couldn’t have done in this cost study amendment more thoroughly if you tried.

You have to hand it to the administration and the ADDP.  If they don’t want something getting through the legislative process in Massachusetts, it apparently doesn’t get through.  The problem is that doesn’t say much for the democratic process in Massachusetts.

The Herald headline and story are wrong

May 26, 2011 4 comments

On Tuesday of this week, The Boston Herald’s readership was treated to a bombshell headline and story, purportedly about government waste due to delays in the closure of the Fernald Developmental Center.

The headline was “$16M to care for 14 people”; and the story went on to imply that the 14 remaining residents of Fernald, whose guardians have filed administrative and court appeals of their transfers from the Center, are each costing taxpayers more than $1 million per year.

The only problem is that the headline and story are wrong.  I just received a letter from Department of Developmental Services Commissioner Elin Howe, confirming our information that the annual cost of caring for the remaining 14 people at Fernald is projected at $8.9 million.  It seems the $16 million is the projected cost of keeping Fernald open throughout the current fiscal year, during which time there have been far more than just 14 people living there.

As of the end of last June (at the start of the current fiscal year), there were some 70 residents left at Fernald, according to our records, and by the end of July, that number was down to about 40.  The adminstration has steadily moved people out, and 14 is the number of residents who remain as of this month.  So, the $16 million cost clearly reflects a higher number of residents than 14.

Moreover, Commissioner Howe stated in her May 25 letter that:

While the costs associated with operating Fernald have dropped following the census (residential population) reduction, the per-person costs have actually increased as the census declines in the final stage of closure.  This has been a typical pattern in previous closures.

In other words, a per-person cost spike is something that occurs in virtually all developmental center closures — it’s not something unique to Fernald because of the appeals filed by the guardians.  There are certainly added costs associated with the delay in closing Fernald, but those costs are something the administration should have anticipated as part of the overall cost of closure.

Nevertheless, the inaccurate claim that $16 million is being  spent on 14 residents was immediately seized upon this week by the Association of Developmental Disabilities Providers, whose members stand to benefit from new state contracts as Fernald and three other developmental centers are closed.  ADDP President Gary Blumenthal decried the alleged $16 million cost as “tremendous” and “excessive,” and implied that the Fernald guardians are responsible for it.

On Wednesday, the Herald’s editorial page picked up on the theme, stating that the alleged $16 million being spent on 14 Fernald residents is taking away from community-based services “and it’s impossible to argue that point.”   It’s especially difficult to argue it when the editorial’s point is based on deliberately misleading and inaccurate information.

The Herald editorial, by the way,  is very carefully worded not to equate the $16 million directly with the 14 residents, although it puts the two numbers as close together in the same paragraph as possible.  And of course the editorial never even bothers to mention our longstanding contention that the costs of operating Fernald and the other developmental centers have been overstated by the administration in comparisons made with the community system.

(I talked at length, by the way, with the Herald reporter about that whole developmental center-versus-community cost issue when she called me the day before her story ran on Tuesday.  None of that made it into print, of course.)

I would also note that Howe stated in her letter that the 95 staff left at Fernald is a projected number after a current round of layoffs is completed.  Howe provided a number of reasons for that apparently high number of remaining staff, and concluded that “all appropriate staff reductions have been or are being  taken and the remaining staff are necessary to meet the remaining residents’ needs.” 

We’re not sure, however, that  it’s the case that DDS has done everything they could to reduce costs lately at Fernald, particularly if — as Stephen Sheehy, the attorney for the remaining residents has pointed out — DDS has failed to take steps to move the remaining residents into one location on the campus.  That is something, according to Sheehy, that the residents would welcome, and which would no doubt save some money.
 
 

Setting the record straight about Fernald and COFAR

May 24, 2011 2 comments

If any more evidence was needed that the human services providers and the Patrick administration are attempting to tarnish the Fernald Developmental Center’s families in order to discredit the highly successful model of state-run care for the intellectually disabled in Massachusetts, today’s Boston Herald story provides it.

“16M to care for 14 people,” is the headline; and in the story, Gary Blumenthal, president of the Association of Developmental Disabilities Providers, calls the cost “excessive” and blames it on the guardians of the remaining Fernald residents because they are delaying the Center’s closure.  Those guardians have simply exercised their statutory right to file administrative and Superior Court appeals of the transfers of their wards out of Fernald.

Moreover, we’ve just learned that DDS stated in Superior Court earlier this month that the cost of operating Fernald may actually be $9.8 million, not $16 million (more about that below).  Secondly, if, in fact, 95 staff do remain at Fernald for the remaining residents, as the Herald story and DDS say, that is an indication of mismanagement on the part of DDS; it’s not the fault of the guardians.

Meanwhile, in a comment on our previous post on Blue Mass Group about the use of Fernald as a political football, Blumenthal (under the user name, Garyof Sudbury), chides COFAR for encouraging “endless appeals and endless studies” in an effort to keep the developmental centers open.  This is a mischaracterization of COFAR’s role in advocating for adequate care for DDS clients.

Here, to the best of our knowledge, is what is really happening regarding Fernald and the other developmental center closures:

1.  Earlier this month, the administration provided numbers on the cost of operating Fernald that are nearly 40 percent lower than what it is publicly citing to the Herald.  In a comment posted on the COFAR blogsite, Stephen Sheehy, the attorney representing the remaining Fernald residents, states that on May 6,  DDS submitted an affidavit in Middlesex Superior Court that the cost of keeping Fernald open is approximately $9.8 million per year.

DDS Commissioner Elin Howe stated in a conference call last week that the cost of operating Fernald this year was $15.6 million.  The Herald is saying $16 million (and stating, by the way, that was the cost last year when there were far more than 14 people left at Fernald).  So, who knows what the real figure is.

2.  The administration and the ADDP are ignoring COFAR’s longstanding proposals to rightsize the remaining developmental centers in Massachusetts or otherwise operate them more efficiently. 

COFAR and other affiliated organizations have long called for “postage-stamp” arrangements at the developmental campuses that would enable current residents to remain there and receive the same level of care while the rest of the campuses were developed for other uses.  No one is advocating the preservation of  large, outdated buildings on these campuses.  What we do want to preserve is the model of care that currently exists there in the most cost-effective way possible.

The administration has never even wanted to discuss the postage-stamp approach.  They have always viewed the issue in purely binary terms: either we continue to operate all the facilities as they are today, or we close them all and evict all their remaining residents.  There have been no other options even worth considering for them.

3.  The ADDP is deliberately mischaracterizing the history of litigation over Fernald in order to paint COFAR as somehow responsible for the cost of delay in closing Fernald.

Here’s a brief history of that litigation (reprised from my response to GaryofSudbury):

From 1974 to 1993, U.S. District Court Judge Joseph Tauro presided over the landmark Ricci v. Okin consent decree case, which brought about significant improvements in care and services at Fernald and other developmental centers in Massachusetts.

In 2004, the Fernald plaintiffs in the Ricci case (some of whom are COFAR members) urged  Tauro to reopen the case, not to delay Fernald’s closure, which Tauro said he would not do, but to investigate apparent violations of Tauro’s order that transfers out of Fernald must result in equal or better care.  It was the Patrick administration — not COFAR or the Fernald plaintiffs — who then went to court to appeal Tauro’s 2007 ruling in which he found that DDS had engaged in a systemic violation of his order.

In 2008, the U.S. Court of Appeals overturned Tauro’s 2007 ruling.  The Fernald plaintiffs appealed to the U.S. Supreme Court, arguing that the Appeals Court had not given Tauro due deference in their decision. The Supreme Court declined to hear the case.

Since that time, some of the Fernald guardians have exercised their statutory and regulatory rights to file administrative appeals of the transfers of their wards from Fernald, on the grounds that these transfers would not result in improved services.  COFAR has not publicly or privately encouraged or discouraged those appeals.  We fully support the personal decisions that any guardian chooses to make in these cases.

It’s perhaps ironic that if the administration had agreed years ago to consider our proposal to develop cost-effective group homes delivering the current level of care on the current campuses, we could have avoided all the delays and litigation that the providers and the administration are now decrying.

In summary, as we pointed out in our previous post, what we’re now seeing is a campaign by the administration and the providers to use Fernald to discredit a proposed budget amendment that would require an independent cost study before the Templeton, Monson, and Glavin developmental centers could be closed.  The argument being made by the administration and the provders is that this budget amendment would cause delays in the closures of those three facilities, and that soon we will be paying the same high costs to keep those centers open that we’re allegedly paying for Fernald.

This is nonsense.  An independent cost study will simply help us determine whether we’re on the right track fiscally in closing these facilities.  As I hope we’ve shown, we can’t leave it solely up to this administration to provide credible numbers or other information about this matter.

Fernald being used as political football

May 22, 2011 10 comments

The Fernald Developmental Center may be almost closed, but it’s now apparently being used as a political football by the administration and the human service providers who are seeking to close at least three additional state facilities for persons in Massachusetts with intellectual disabilities.

In the past month, both the providers and the administration have cited an allegedly high current operating cost for Fernald as a reason to oppose a cost study prior to closing the Monson, Templeton, and Glavin centers.  Nevermind that Fernald is not even included in a proposed state budget amendment calling for the cost study.  

Moreover, while we haven’t yet seen the Fernald budget numbers the providers and the administration are citing, we understand the reportedly high cost is due to a decision by the administration to maintain an unusually high number of staff at the facility for its 19 remaining residents.   The reason for the high staffing level isn’t clear.  The guardians of those remaining residents have filed administrative appeals of Fernald’s closure.

During the ongoing budget debate in the Legislature, the Department of Developmental Services  and the Association of Developmental Disabilities Providers have been telling legislators that it is costing as much as $917,000 per resident per year to operate Fernald.   As the linked State House News story shows, ADDP President Gary Blumenthal last month cited that Fernald cost figure, which was disclosed by DDS,  in order to discredit a House budget amendment requiring an independent cost study prior to closing Monson, Templeton, and Glavin.

The logic of the administration and the provders appears to go something like this:  “Because we’re spending an unusually high amount this year to keep the Fernald Center open for the remaining residents,  we shouldn’t even waste time studying the cost of closing or maintaining  three other facilities where the costs actually happen to be considerably lower.   The Fernald cost shows we must close all four of these facilities as fast as possible.”

That this tactic has had an impact in the Legislature became clear when a small group of COFAR members met on Wednesday of last week with a staff member of Senator Stephen Brewer, chairman of the Senate Ways and Means Committee, to push for the cost study amendment.   The staffer, without any prompting, mentioned she had heard Fernald was costing $18 million this year to operate.

That afternoon, in a conference call, I asked DDS Commissioner Elin Howe about the reported $18 million cost.  Howe said the cost was closer to $15.6 million, which would translate to a still sky-high figure of $821,000 per person to keep Fernald running this year.  When I asked what the money was being spent on, Howe said the high cost was due to the fact that 95 staff remain at Fernald — a staff-to-resident ratio of 5 to 1.

I was so taken aback by what Howe had just said that I didn’t think to ask her why the administration is maintaining such a high staffing ratio at Fernald.  That ratio appears to be the reverse of the 1 to 3.2 staff-to-resident ratio required under federal regulations for Intermediate Care Facilities.   The next day, at DDS’s request, I submitted a written question to Howe about the situation.  I haven’t yet gotten a response.

Howe, by the way, said that if I wanted to get the same Fernald budget numbers that Blumenthal was citing to the State House News Service and which DDS has apparently provided to legislators, I would have to file a freedom of information request.  I did so the next day.

I then heard that day from Senator Brewer’s office that the high staffing level at Fernald is reportedly due to a court order that has prevented DDS from moving the remaining 19 residents there into one building on the campus.  But we’ve heard from other sources that there may not actually have been any such court order.

Whatever the reason for Fernald’s current operating cost, to introduce Fernald into a debate over whether to even study the cost of operating the Monson, Glavin, and Templeton centers is disingenuous and misleading.  Luckily, Senator Brewer now appears to understand that.  “We know it’s not accurate (to link the alleged Fernald cost to the other three facilities),” the staff member said.

Administration admits to discrepancies in vendor salary info

May 16, 2011 3 comments

Patrick administration officials appear to be admitting we may be on to something when we pointed out the state may be getting different information than the federal government gets about salaries earned by human services contractors in Massachusetts.

In an email sent to us on May 11, Terry McCarthy, director of audit in the state Operational Services Division (OSD), acknowledged there were discrepancies between executive salary information provided to the OSD and to the federal Internal Revenue Service for the same contractors.

McCarthy stated that the OSD will “reexamine the cited (federal and state salary reports) for proper compensation disclosures,”  and will seek explanations from two of the contractors we identfied for apparent discrepancies in their numbers.

At the same time, McCarthy put forward at least three explanations for the discrepancies, none of which fully satisfy our concerns about them.

First, a bit of background.  Concern has mounted around the country about salaries of executives of nonprofits.   In Massachusetts, that concern has largely centered around the pay of executives of hospitals and health insurers, but it has also extended to the hundreds of nonprofit vendors that contract with the state to provide human services to people with disabilities.

The OSD, which oversees the contracts with these vendors, requires them to provide detailed financial reports that disclose, among other things, the salaries made by their executives.  In addition, a state regulation caps the amount of state funding that goes to pay these salaries at $143,986 a year, meaning that sources other than the state would have to fund salaries higher than that amount.

One of the purposes of this regulation capping executive salaries is to ensure that an adequate amount of state funding is put towards wages of direct-care workers.

COFAR examined state Uniform Financial Reports (UFRs), which are filed with the OSD, and Form 990s, which are filed with the IRS,  for the May Institute, Vinfen, and Seven Hills, three of the largest contractors to the Department of Developmental Services.  In each case, 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. 

The UFRs also listed a lower number of executives earning high levels of compensation than were listed on the Form 990s for the same firms.   These discrepancies imply that OSD may be unaware of the total amount of state funding potentially being used to pay salaries of these executives.

In his response, McCarthy acknowledged that the total compensation of four of five identified Vinfen executives appeared to be underreported on the UFRs by $101,539, while the compensation of two executives of Seven Hills appeared to be underreported by $18,509.  McCarthy said OSD will seek explanations from those contractors about those differences.

COFAR also reported that the 2009 IRS form for Seven Hills listed four employees making over the $143,986 threshold, while the state UFR listed only two employees making over that amount.  The difference in reported compensation between the two forms was $385,000. 

For Vinfen, the 2009 IRS form listed a total of 10 employees earning more than the threshold compensation amount, while the UFR listed only four employees earning more than that amount.  The difference was $1.2 million. 

McCarthy, as noted, stated that the OSD will reexamine the compensation disclosures made by these vendors.  However, he also offered two explanations for the differences in the numbers of executives listed on the state and federal forms.  One is that there are different filing deadlines for the two forms: the IRS forms lag behind the UFRs.

That may be, but it doesn’t seem a sufficient reason to list different salary numbers on each report or to report salaries for more people on the 990 forms than on the UFRs.   Moreover,  the 2009 Form 990 for Vinfen was signed by its president on May 14, 2010.  The UFR was first submitted to OSD in November 2009 and refiled in April 2010 and then in December 2010.  Again, there’s no apparent reason why the final UFR, which was submitted after the Form 990, would have less executives listed and lower salaries than the Form 990.

The second explanation offered by McCarthy was that the Form 990 has “more expansive” compensation disclosure requirements than the UFR.  McCarthy said the UFR is limited to including individuals in policy making positions, and would therefore not include a highly paid clinician, for instance. 

That doesn’t seem to jibe, however, with the OSD’s reimbursable cost regulation, which doesn’t say anything about exempting non-policy making individuals from the salary cap.

Also, all of the 13 individuals listed in the May Institute Form 990 as making over $150,000 are executive-level employees, starting at senior vice presidents on up to the president and CEO.  Those people are all clearly policy-making individuals, yet only two of them are listed on the UFR. 

Finally, McCarthy addressed our finding that there was more than a half million dollar difference in the reporting of the compensation of the CEO of the May Institute on the state and federal forms in 2009.  This, he said, appeared to be largely due to a one-time $682,343 distribution to the CEO on a vested deferred compensation plan that had been previously reported annually as deferred compensation. 

It wasn’t clear, however, whether McCarthy was saying that because this was a one-time distribution on a previously reported deferred compensaton plan that it didn’t need to be reported on the 2009 UFR.   But even if the CEO’s compensation isn’t counted, the difference between the total compensation for the 12 other May Institute executives listed on the IRS form and the compensation for the one other executive listed on the state UFR is $2.8 million.

We’re glad the OSD will go back to these three vendors and check to see that their UFRs were filled out accurately.  But we’re concerned that there is a potentially larger problem here.  It seems OSD does not have the capacity to adequately oversee the contracting system in this state.  One indication of that is 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, yet it still hadn’t been reviewed by OSD as of today’s date. 

This administration needs to get a better handle on the human services contracting system in Massachusetts.

Seeking a chance to speak truth to power

April 28, 2011 3 comments
No doubt, State Rep. Brian Dempsey, chairman of the House Ways and Means Committee, has never talked with Joan Douty, the mother of a resident of the Glavin Regional Center in Shrewsbury.
 
Joan could tell Rep. Dempsey how the staff at the center saved her daughter’s life by getting her to stop repeatedly banging her head as she previously did in a community-based group home.  Anna Douty banged her head so violently and continuously — a behavior that the group home staff did nothing to stop —  that she eventually detached the retinas in both of her eyes and is now blind. 
 
Glavin provides high-level Intermediate-level Care, based on federal standards that do not apply to the community-based, group-home system in Massachusetts. 
 
Joan could also tell the Ways and Means chairman that she herself will probably no longer be able to visit her daughter if she is transferred to another Intermediate Care facility (ICF) once Glavin in closed.  Joan Douty, who is in the end stage of renal disease, undergoes dialysis treatments three days a week, and cannot drive for long periods in a car.
 
Glavin is close to where Joan and her husband Brad live.  It would be prohibitively long for her to drive to either the Wrentham Developmental Center or the Hogan Regional Center in Danvers, the only ICFs that will remain in the state after the Patrick administration completes its planned shutdowns of the Glavin, Fernald, Monson, and Templeton Centers.
 
Earlier this week, Rep. Dempsey refused to allow consideration by the full House of a budget amendment that would have required an independent cost analysis before Glavin, Monson, and Templeton could be closed.  (Fernald, the first ICF on the closure list, was not included in the amendment.)
 
The House budget amendment had been filed by Rep. Anne Gobi, D-Spencer, who did listen to Joan Douty’s story last month at a legislative breakfast at the Glavin Center (see photo).
 

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.

%d bloggers like this: