The fight for Glavin is winnable, Senator Brewer

Despite the Patrick administration’s determination to close the Glavin Regional Center by next June, families of residents in the facility are prepared to wage a legal battle to save it, The Worcester Telegram & Gazette reported on Sunday.

The families are planning to use the same administrative and court appeal process to stay at Glavin that guardians of 14 residents of the Fernald Developmental Center have used to keep that facility operating more than two years past its scheduled closure date.

The appeal process is based on a state law, which says that the state must prove that a resident’s services and quality of life will be improved if he or she is to be transferred to another location.

“We’re not going to leave here without a fight,” Wilfred Dumont, the father of 28-year-old Stephen Dumont, a Glavin resident, told The Telegram & Gazette.  Dumont and his wife, Rosemary, are among several Glavin guardians who are actively opposing the transfers of their loved ones from the facility.

Not only has Glavin provided a high level of care that these families have not been able to find in the Department of Developmental Services community-based system, but Glavin has also provided a range of medical, dental and other services to community-based DDS clients.

As COFAR Executive Director Colleen Lutkevich stated in a letter submitted yesterday to the editor of the Telegram & Gazette:

…the reality is that Glavin is a wonderful community of residents, families, and staff.  Instead of closing this innovative state-of-the-art residence, built with such hope and promise not that long ago, we call on Governor Patrick and DDS Commissioner Howe to admit their mistake and cancel Glavin’s closure.  It is not only the morally right thing to do, it is good economics.

Ironically, the Glavin families, like their Fernald counterparts, have been forced to adopt the administrative appeal strategy because key state legislators have never supported proposals for either an independent cost study prior to closing those facilities or for legislative approval of the closures. 

Senator Stephen Brewer, chairman of the Senate Ways & Means Committee, is quoted in the Sunday Telegram & Gazette story as saying he wouldn’t support an independent cost study for Glavin this year because the fight to preserve the center “is unwinnable.”  He also raised a perennial red herring about the $10 million cost of operating Fernald for 14 residents (more about that below).

All along the way, however, Brewer has tried to play both sides of the fence, telling The Springfield Republican in May 2010 that he did support a cost study prior to closing Glavin and three other facilities, and saying:  “We’re in this to try to help the people stay in the places they call home.  Some of those people have been there 60 years.”   

It’s now clear that Brewer himself has personally played a major role in bringing about the closures of Fernald, Glavin, and the Monson and Templeton centers.  Meanwhile, he’s still trying to have it both ways.  In the debate over the current-year budget, Brewer supported an independent cost study prior to the closure of Taunton State Hospital, a Department of Mental Health facility.

As to the contention that Fernald and the other DDS centers have become too expensive to continue to operate, here’s what we’ve said many times: confirm that with an independent study.  No one in Massachusetts has done a comprehensive and independent study of the relative cost of care in the developmental centers versus community-based group homes.  That’s why COFAR began calling in late 2011 for such a study to be done by an accounting firm or other entity selected by the Inspector General.

If Senator Brewer and other opponents of the DDS developmental centers are  convinced it is more expensive to continue to operate them than to move everyone in them to community-based group homes, why do they oppose an independent study of that issue?

It is true that the cost per resident at Fernald, in particular, is currently very high.  But as DDS Commissioner Elin Howe herself has noted, the cost per resident of any institution that is being closed spikes as fixed costs are spread over a shrinking base of residents.  Let’s not forget, it was the administration’s choice, not the families’ and guardians’ choice, to move residents out of Fernald, Glavin, Monson, and Templeton.

The fact is that state funding for the four developmental centers has dropped by close to $70 million in the past four years.  Yet, funding for community-based programs such as transportation services, family supports, and day programs remains well below what it was in Fiscal Year 2009.  That the $70 million in so-called savings hasn’t helped those community line items should be of more concern to Senator Brewer than the temporary cost of continuing to operate Fernald or Glavin while guardians there exercise their lawful appeal rights.

Meanwhile, Brewer and other legislators should also be concerned about the loss of the intensive Intermediate Care Facility (ICF) model that is occurring as Fernald, Glavin, Templeton, and Monson are shut down.  ICF care conforms to federal standards that are much more stringent than the standards that govern community-based care.  This has real implications for care.

In their study of a major deinstitutionalization in California in the mid-1990s, Robert Shavelle, David Strauss, and Steven Day found that as of 1999, there had been 81 deaths among residents transferred from institutions to community-based group homes — a 47 percent increase in mortality over that expected in the institutions.  (The results were significant at the 95% confidence level.)

The California study concluded that the reasons for the higher mortality rate in the community system were the less intensive medical care and supervision available in the community than in the institutions in that state.

We should also respond to statements made by DDS Commissioner Howe in the Telegram & Gazette story on Sunday.  Howe said, among other things, that closing the developmental centers in Massachusetts follows a New England and national trend; that Connecticut has only one institution for people with developmental disabilities, and that none of the other New England states have any such facilities.

First of all, Connecticut currently has a total of six state-run ICFs that provide care under the same federal standards as Glavin, Fernald, Monson, Templeton and two other facilities in Massachusetts.  The Connecticut public ICFs include the Southbury Training School and five regional centers.

In addition, Connecticut has 69 privately operated ICF facilities, and private ICFs also exist in Maine, New Hampshire, Rhode Island, and Vermont.  Massachusetts, however, has no ICFs outside of six state-run facilities, four of which are targeted for closure.  

While the national trend has been to move people from large, state-run institutions to smaller, privately run facilities, the ICF model is not being phased out nationally as it is in Massachusetts.   More than 7,000 public and private ICFs operate nationwide, according to the American Health Care Assocation.  For the record, we have long supported the downsizing or “rightsizing” of the remaining developmental centers in Massachusetts.  What we oppose, as noted, is the phase-out of the ICF model. 

We also prefer that the ICFs continue to be state-operated because state workers tend to receive better pay and benefits, and consequently have less turnover, than those in privately run facilities.

Howe also maintained that the community system and two remaining developmental centers in Massachusetts “are strong enough to meet all of the individuals’ needs.”

Tell that to Wilfred and Rosemary Dumont, who were unable to find a community-based facility that could successfully treat Stephen, who had a habit of opening up a permanent wound on his head by repeatedly banging his head on hard objects.  Tell that to Brad and Joan Douty, whose daughter Anna hit herself in the head so often while living in a group home that she eventually detached the retinas in both eyes and is now blind.

Both Stephen Dumont and Anna Douty have been living successfully at Glavin for several years.

Or tell that to Roland Charpentier, who moved his brother Richard out of Glavin and into a non-ICF group home on the Glavin grounds a few years ago.  After his brother contracted pneumonia four times, Roland had him moved back into Glavin.

“My intention is to keep Richard here (at Glavin) no matter what the state wants to do,” Roland Charpentier told The Telegram & Gazette.  “I’m going to stand and fight for Richard’s rights.”