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Archive for May, 2013

Thousands falling through the cracks in the DDS system

Lauren Baletsa has Prader-Willi Syndrome, a genetic defect that causes such a strong compulsion to overeat that she forged her father’s signature on checks to buy food.

Baletsa was one of dozens of people who testified on Tuesday before the Legislature’s Children, Families, and Persons with Disabilities Committee in support of proposed legislation that would require the state to provide services to people with Prader-Willi and other developmental disabilities.

Many people with these disabilities have cognitive impairments and autism, leaving them unable to function normally or adequately in society.  However, many of them have IQs that are just above the cutoff  level to qualify for services from the Department of Developmental Services. 

In testimony before the Committee, Rick Glassman of the Disability Law Center maintained that Massachusetts appears to be the only state in the nation that does not grant eligibility for services unless the individual has an intellectual disability as measured by an IQ score.

Glassman said research done by the DLC indicates that every other state provides services based on at least some additional measures of disability such as substantial functional limitations or designated impairments such as autism.  “I hope I’m wrong about that and am missing something,” Glassman said.  “But if so, I can’t figure out what it is.”

Glassman and other advocates, including COFAR, noted that DDS’s restrictive eligibility standard for services has left thousands of people in the state without services of any kind.  COFAR has joined the DLC, the Arc of Massachusetts, the Aspergers Association of New England and other organizations in urging support for legislation (H.B. 78 and similar measures) that would require DDS to provide services to people with developmental disabilities and not just “intellectual disabilities.”

As Glassman and others pointed out, just because someone has an IQ higher than 70 (the DDS’s approximate cutoff level for providing services) does not mean that person is high functioning or able to complete even basic tasks such as dressing or bathing without assistance.

Awilda Torres is a case in point.  She testified Tuesday that her son Carlos, 22, who has autism, was recently riding in a van when he jumped out while the van was moving, ran to a policeman and insisted he had been kidnapped by the driver.  Carlos’s IQ, Torres said, is just above the DDS cutoff point for services.

Other parents of autistic adults testified that while services and even state-supported day and work programs were available to their children before they turned 22, those programs ceased once the children reached that age.  At the age of 22, people with intellectual disabilities in Massachusetts, who had been receiving special education services through local school districts, must enter the DDS system with its more restrictive eligibility standard.

Karen Kadzen-Pandolfi testified that her son, who is now 23, lost his services a year before because his IQ was measured at 71.  He has a problem with aggression and violent behavior.  As a result, she must now stay home from her job to care for him.   “My life is on hold,” Kadzen-Pandolfi said.  “I keep searching for an answer, but there are no answers.”

Delivering COFAR’s testimony, I noted that the public is largely unaware of the severity of these developmental disabilities and of the fact that so many people are not receiving any services to cope with them.  Tuesday’s hearing at the State House was not covered by any mainstream media outlets nor was a similar hearing last November in Worcester that had been held by DDS to consider proposed regulations regarding its IQ eligibility standard.

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State audit confirms salary overpayments to DDS provider

The state improperly reimbursed the May Institute, a corporate provider to the Department of Developmental Services, for hundreds of thousands of dollars paid to company executives in excess of a regulatory cap on their salaries, according to the state auditor

The auditor’s findings confirm concerns we raised in April and May 2011 that the state may have paid Walter Christian, the CEO, and other executives of the May Institute more than the state’s approximately $143,000 regulatory limit on individual executive salaries. 

The auditor also found that Christian was improperly paid roughly $140,000 for a home health aide for his wife, day care fees for a grandson, the use of a minivan in Georgia, and a separate vehicle that he used when visiting Massachusetts.  Christian, who retired in January, had been living in Georgia for a decade while running the Massachusetts-based company, according to the audit report. 

Our blog posts in 2011 specifically noted that the May Institute appeared to be under-reporting Christian’s and other executive salaries as well as the number of people receiving those salaries, on Uniform Financial Reports (UFRs) submitted to the state Operational Services Division.  

The two posts also noted that the same under-reporting of salaries appeared to be the case with Vinfen and Seven Hills, two other DDS providers.  The state auditor focused solely on the May Institute, however. 

The state auditor’s report noted that a state regulation capped state reimbursements to providers for salaries and other compensation paid to their executives at $143,986 in FY 2010 and $149,025 in FY 2011.  Providers can pay their executives more than those amounts in salaries and other compensation, but the state is permitted to reimburse the providers only up to the threshold amount in a given year.  The state attempts to keep track of those payments via the UFR’s, which the providers are required to submit to the Operational Services Division on a yearly basis. 

We noted in our April 2011 post that the May Institute’s UFR listed only Christian and one other executive as making over the state salary threshold in 2009.  Yet, a federal tax form, which was filed by the May Institute with the IRS for the same fiscal year, listed 13 individuals in the company as making over $150,000 each. 

An OSD official maintained at the time that the state agency allows the state to pay costs in excess of the salary limit for clinicians working for providers.  However, COFAR’s May 2011 post noted that all 13 May Institute employees who made over $150,000 were not listed on the IRS form as clinicians, but as executive-level employees, starting at senior vice presidents on up to the president and CEO.  

In its report, the state auditor also found that several May Institute employees who were paid over the threshold amounts were managers and not clinicians. 

We think this report by the state auditor lends strong support to our call for a comprehensive, independent study of outsourcing of care by DDS.  The auditor’s findings also support the need for more funding for state-operated group homes for the developmentally disabled as an alternative to provider-operated residences.

But as I noted in a previous post, House leaders last month rejected budget amendments that would have both authorized a study of the DDS system and restored cuts made by the House Ways & Means Committee in the governor’s budget for state-operated residences.  There is one more chance for these amendments coming up in the Senate, of course. 

We applaud the state auditor for examining the May Institute’s payments to its executives.  We hope, though, that Auditor Suzanne Bump expands her review to include additional providers in the wake of our concern that this is a potentially wider problem than just one company.

The House lets down the most vulnerable

May 1, 2013 5 comments

Have our legislators forgotten about the most vulnerable people in our society?

Unfortunately, that’s the message we’ve taken away from last week’s actions by the House on the state budget.

First, we urged legislators to approve an amendment calling for a comprehensive, independent study of the Department of Developmental Services system, along the lines of a similar study that was approved last year of the Department of Mental Health system.

Among the questions we think need to be examined are whether the ongoing privatization of services to people with developmental disabilities is really resulting in improved care.  Or is  this trend simply padding the ample salaries of the executives of the hundreds of corporate providers that contract with DDS?

We also urged legislators to approve additional funding to prevent the layoffs of state service coordinators, who make sure that people in the DDS system are getting the services they need.  And we asked for additional funding to prevent the possible closures of state-operated group homes, to which many former residents of state developmental centers are being sent as those centers are closed down.

The House rejected all of those amendments.  But they did pass an amendment that provides all kinds of goodies to the corporate providers, including a state subsidy if residents of their group homes opt to leave those homes.  That amendment will implement the so-called ‘Real Lives’ bill, without bothering with the need for a public hearing.

Could all this have anything to do with the fact that legislators nowdays seem to act solely in the interest of those who contribute the most to their political campaigns?  Is there anyone out there who still doesn’t believe that’s the way our modern “representative” system of government works?

Apparently, lawmakers don’t feel under much of an obligation anymore even to fulfill promises made to those who don’t have political clout on Beacon Hill, or Capitol Hill for that matter.

What else are we to make of the virtual promise that state Representative Patricia Haddad, a leader in the House, who spearheaded last year’s legislation to study DMH, made to support the DDS study?

In a meeting with families of residents of the state-run Glavin Regional Center in September, Haddad had this to say about the proposed DDS study, which would have included a study of the closure of Glavin itself:

“Someone has to be the first to say we’re not afraid to have an outside study done to tell us what’s wrong and what’s right,” she said.  That day, she also said a number of other things that the Glavin families desperately wanted to hear from her, including the statement that “there are more horror stories than good stories” in the privatized system of DDS care.

It initially came as a shock to us, therefore, when we found out just before the budget debate last week that Haddad had declined even to co-sponsor the amendment to undertake that outside study of DDS.   Maybe she truly feels that someone has to be the first to say we’re not afraid to have the study, but it wasn’t going to be her.

Why won’t legislators like Haddad support these critically important initiatives for our most vulnerable residents when push comes to shove?  Is there anyone who doubts that we need to re-examine the DDS system?  It is a system in which, as Haddad herself said, there are often more horror stories than good stories.

As the state has increasingly come to rely on corporate-controlled care for people with developmental disabilities, the waiting list for services only appears to be growing longer.  It’s a system in which the state does a mediocre job at best in monitoring the care provided in thousands of dispersed residences whose staff are largely poorly paid and do not receive adequate training.

It’s a system that is beginning to resemble the “warehouses” of yesteryear, when thousands of people with developmental disabilities were packed into institutions that did not have the staff or resources to care for them.  Now, they’re simply packed into corporate-run group homes, which don’t have the staff or resources to care for them.

When will our elected leaders wake up to this and care enough to do something about it?