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House Ways & Means budget for DDS continues many of the governor’s cuts

April 19, 2012 Leave a comment

Last week, Department of Developmental Services Commissioner Elin Howe described the House Ways & Means Committee’s proposed Fiscal Year 2013 budget for DDS programs and services as “the best budget the department has had in five years.”

Speaking with advocates during a conference call, Howe cited some boosts in funding in the HW&M plan.  Those include a proposed $10 million increase over the governor’s plan for Adult Family Supports, which  help families care for intellectually disabled people at home.  They also include $1 million more than the governor proposed for Turning 22 services, which are geared toward people who are moving from the special education system to the adult service system.

But we wouldn’t agree this is a particularly good budget overall for people with intellectual disabilities.  In fact, this budget fails to restore most community-based line items to what they were four and five years ago, and it continues to decimate the state developmental centers and to underfund other state-operated residential services.

In the conference call, Howe acknowledged that “the state side has taken the burden of the reductions” under the HW&M plan, but termed it “good news for the private sector.”   We disagree that the HW&M budget is really all that good for the private sector; but Howe’s remark does unfortunately underscore this administration’s well-known bias against state-delivered care.

On the state side, the HW&M budget plan would lead to the loss of critically important service coordinators because it proposes to fund the DDS administrative line item, which pays for them, at about $1.1 million less than the governor’s plan.

SEIU Local 509, which represents service coordinators in the DDS system, had previously stated that the governor’s proposal would essentially level-fund service coordinator staffing for the coming year.   The HW&M budget proposal would lead to a loss of 24 service coordinator positions. 

Also, the HW&M budget plan fails to rectify a $4.1 million shortfall in the governor’s budget plan in the state-operated group home line item.  At a time when the administration is busy trying to close four state developmental centers, we think it makes little sense to fail to adequately fund the state-operated group home system and to cut service coordinator jobs. 

Under the HW&M budget for FY 13, funding for the developmental centers would be down $71 million from FY 09 in inflation-adjusted dollars, according to the Massachusetts Budget and Policy Center’s excellent budget line item calculator.  But while the $71 million cut in the developmental center’s line item reflects the administration’s efforts to phase down and close the four developmental centers, there hasn’t been a corresponding increase in most community-based line items.

The HW&M budget plan still fails to restore a number of line items that support community-based programs to what they were in FY 2009.  For instance, even the HW&M’s $10 million increase over the governor’s proposed funding for Adult Family Support services would leave funding for that program at $9 million below what was appropriated for it in FY 09 in inflation-adjusted figures.   Under both the governor’s and HW&M’s plans, funding for autism services would be cut from current-year spending and would remain more than $2 million below the FY 09 funding level.
 
Other non-DDS programs that benefit persons with intellectual disabilities in the community system would be cut as well in the HW&M budget plan.  For instance, the HW&M plan follows the governor’s proposal to cut the Massachusetts Rehabiliation Commission’s supported employment line item by 17 percent from current-year spending.   The governor’s and HW&M  proposed budgets would both fund this line item at a level 78 percent below what had been appropriated for it in FY 09.
 
And then there’s the chronically under-funded Disabled Persons Protection Commission, which is charged with investigating abuse and neglect in the DDS system.  Under the governor’s budget plan, the DPPC’s funding would be cut by $39,000 from current-year spending and $309,000 in inflation-adjusted dollars from what it was in FY 09.   The HW&M plan would add $46,000 back to the DPPC, but still leave the agency down $263,000 from FY 09.
 
It’s now up to the full House to adopt amendments to increase funding incrementally for the service coordinators, Turning 22, the DPPC, and the salary reserve.  The fact that Howe could call this the best budget she’s seen in five years says something about how far we’ve sunk. 
 
 
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We need to take a larger view on monitoring human services vendors

April 10, 2012 Leave a comment

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.