Home > Uncategorized > Children and Families Committee needs to show it’s serious about investigating the DDS group home system

Children and Families Committee needs to show it’s serious about investigating the DDS group home system

At the start of a legislative hearing last week on the Department of Developmental Services, state Representative Kay Khan made what seemed to be a major announcement about a new federal report on problems in group home care in Massachusetts and two other New England states.

Khan, who is House chair of the Children, Families and Persons with Disabilities Committee, said the committee will be guided by the report in whatever review or investigation her panel  undertakes of the DDS system in Massachusetts.

But if that’s the case, it doesn’t look as though the Children and Families Committee will be doing much of an investigation because there wasn’t much in the report, which was issued by the Inspector General for the federal Department of Health and Human Services.

I first developed the pessimistic assessment that the committee wasn’t going to do much of an investigation after listening to an hour of listless questioning by Khan and other legislators of the heads of DDS and the Disabled Persons Protection Commission during last Wednesday’s hearing.  Reading through the HHS IG’s report only strengthened that assessment.

The committee scheduled last week’s hearing in the wake of a case last year in which Yianni Baglaneas, a young man with Down Syndrome, nearly died in a DDS-funded group home after aspirating on a piece of cake.

Although the committee hearing room last week was filled with family members of DDS clients, including Yianni’s mother, Anna Eves, those family members were not permitted to testify verbally.  The Children and Families Committee wanted to hear only from Acting DDS Commissioner Jane Ryder and from Nancy Alterio, executive director of the DPPC, an agency charged with investigating abuse and neglect of disabled persons.

We hope the committee gets more serious about this investigation. We have submitted written testimony (here and here) to the panel and have read the written testimony from Anna and from many other family members and guardians who detailed harrowing experiences in a dysfunctional system.

During last week’s hearing, Ryder, in particular, painted a rosy picture of DDS’s role in managing and overseeing the group-home system. None of the Children and Families Committee members challenged Ryder’s assertions or asked any particularly probing questions of her.

Anna Eves and Michael Horn at hearing 1.17.18

Senator Joan Lovely, Senate chair of the Children and Families Committee, talks following last week’s committee hearing with Michael Horn, the father of Alexa, who suffered unexplained injuries while living in a group home. At left is Anna Eves, the mother of Yianni Baglaneas, who nearly died in his group home after aspirating on a piece of cake. Neither Eves nor Horn were allowed to testify verbally before the committee about those cases.

We have been calling for years for a comprehensive legislative review of the system of care for persons with developmental disabilities in Massachusetts. The last such review was done in the late 1990s by the House Post Audit and Oversight Committee, which found problems of abuse, neglect, and financial irregularities throughout the system.

When I first glanced through the latest federal IG report, I thought that agency had finally produced a report on the level of that Post Audit Committee report in Massachusetts.  The IG report looked comprehensive. But I was admittedly seduced by the color and graphics. After actually reading the report, my assessment of it changed.

First, it turns out the findings in the IG’s report about failures to report abuse and neglect incidents in Massachusetts were simply repeated from an earlier report issued by the IG in July 2016.

That previous report found that abuse and neglect incidents in Massachusetts were not being reported regularly to investigators. But that report was limited to that single issue about incident reporting. The IG had also previously issued a similar report about Connecticut.

Moreover, the new material in the latest IG’s report consists of a series of vague recommendations that don’t seem to fully address a request in 2013 by U.S. Senator Chris Murphy of Connecticut for a major investigation into abuse and neglect in privatized group homes throughout the country.

Sen. Murphy’s letter in 2013 to the IG concluded by stating:

Privatization of care may mean lower costs but without the proper oversight and requirements for well-trained staff. While individuals with developmental disabilities may not be able to speak for themselves, we are not absolved of the responsibility to care for them in a humane and fair manner. … Again, I respectfully request that you conduct an investigation into this issue. I believe that it would be able to shed light on the trend towards privatization and the impact that has on the care of the individuals. (my emphasis)

The IG’s report, however, doesn’t appear to address issues related to privatization such as low wages paid to direct-care staff, high turnover, denial of family rights to visitation, violations of federal law requiring that DDS provide state-run services and other care options to persons desiring them; or violations of federal law stating that families are the key decision-makers in the care of the intellectually disabled.

There is no reference anywhere in the IG’s report to problems accompanying the increasing privatization of services or to the resulting elimination of state-run programs, or the resulting lack of meaningful activities for participants in day programs, or the excess funding of salaries of nonprofit executives.  Murphy specifically stated in his letter to the IG that he hoped the IG’s investigation “would be able to shed light on the trend towards privatization and the impact that has had on the care of the individuals.”

One has to wonder if anyone from the IG’s office has read any of a number of media reports in recent years of the deeply troubling problems plaguing group home systems around the country.

Those reports include exposes in 2013 by The New York Times and The Hartford Courant,  (here and here)  and more recent exposes by papers such as The Chicago Tribune. That latter newspaper reported last year that while officials in Illinois continued to issue rosy accounts of the process of transferring clients from developmental centers being closed in that state to group homes, many of those group homes were “underfunded, understaffed and dangerously unprepared for new arrivals with complex needs.”

We reported that the HHS IG first produced a virtual joke of a report in 2015 on the group home system in New York State. That report had no critical findings and was a total of six pages long.

As noted, at least part of last week’s IG report was a rehash of those previous findings on incident reporting in Massachusetts and Connecticut. The latest report does purport to go further than the previous reports by including “suggestions for ensuring group-home beneficiary health and safety.”

For instance, the latest IG report includes recommendations on “quality assurance mechanisms” for community-based services.

But while those recommendations seem intended to get to the larger issues inherent in care in the provider system, they are still vague. The recommendations are presented in an appendix to the report, but little explanation and few specifics are provided even there.

Under a heading in the appendix on the “quality assurance mechanisms,” the report recommends “person-centered planning.” But there is no explanation provided of person-centered planning, which is an approach being promoted in Massachusetts by DDS. We’ve expressed concerns that person-centered planning has the potential to marginalize families and guardians in helping develop individual support plans or ISPs.

The same appendix in the HHS IG report also calls for audits done by providers that:

  • Include assessments of staff training (There are no specifics provided about this.)
  • Include assessments of performance evaluation (Again, no specifics.)

An additional category in the appendix is labeled “Assessment of the fiscal integrity of (provider) service billing and reimbursement.” This would appear to be a key recommendation regarding financial integrity, but it consists only of the following two statements, with no specifics or explanation:

  • Includes ongoing State desk audits
  • Includes periodic on site audits of select service providers and support coordination agencies

Finally, the report states that the federal Centers for Medicare and Medicaid Services should form a “SWAT team” in order to address “serious health and safety findings involving group homes.” But while that sounds impressive and urgent, the report provides no details about what such a SWAT team would consist of or do.

We hope the Children and Families Committee develops an investigative scope that goes well beyond that of the HHS IG. We also think the committee can demonstrate its seriousness by scheduling another hearing in which families would be invited to provide verbal testimony.

Last week, Senator Joan Lovely, the Senate chair of the committee, told some family members that she would speak to Rep. Khan about scheduling that additional hearing. We hope that happens soon.

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  1. Anonymous
    January 23, 2018 at 1:43 am
  2. Dick Faucher
    January 23, 2018 at 2:52 pm

    Thank you David for being the eyes and ears for those of us who could not make it to the state house for testimony or giving physical support..

    I wonder if anyone remembers “Ricci” and what it did for our dd population. Maybe it is time to review that track for results. DF

  3. Richard Faucher
    January 23, 2018 at 2:55 pm

    Thank you David for being the eyes and ears for us who could not make it to the state house. I wonder how many folks remember “Ricci” and what that did for the IDD population. Maybe it is time to start up that track again.?? Dick Faucher  

    ‘ Pretty much all the honest truth-telling there is in the world is done by children’                                 Oliver Wendell Holmes

    ‘We can’t all be heroes, because somebody has to sit on the curb and clap as they go by.’                           Will Rogers

            

    From: COFAR blog To: victorylap02@yahoo.com Sent: Monday, January 22, 2018 5:47 PM Subject: [New post] Children and Families Committee needs to show it’s serious about investigating the DDS group home system #yiv1268213435 a:hover {color:red;}#yiv1268213435 a {text-decoration:none;color:#0088cc;}#yiv1268213435 a.yiv1268213435primaryactionlink:link, #yiv1268213435 a.yiv1268213435primaryactionlink:visited {background-color:#2585B2;color:#fff;}#yiv1268213435 a.yiv1268213435primaryactionlink:hover, #yiv1268213435 a.yiv1268213435primaryactionlink:active {background-color:#11729E;color:#fff;}#yiv1268213435 WordPress.com | David Kassel posted: “At the start of a legislative hearing last week on the Department of Developmental Services, state Representative Kay Khan made what seemed to be a major announcement about a new federal report on problems in group home care in Massachusetts and two other” | |

  4. Anonymous
    February 2, 2018 at 7:34 pm

    Of course Jane Ryder touted how great DDS group homes are…She was the Director of NRS for years.

  5. Stan Eads
    February 24, 2018 at 10:36 pm

    My adult daughter has Down’s Syndrome, and I brought her to Massachusetts from New Mexico after I relocated here. I expected that services for her would be better than in the rather poor state from which we moved, but I was in for an unexpected shock. Massachusetts DDS has done exactly nothing for her, other than suggesting places I might want to look for help. Adina (my daughter) has had residential services continuously since 1993, and part time since 1984. She had a life of her own, and was thriving. In wealthy, progressive Massachusetts, things would be even better, right?

    Utterly wrong! Not only does she get nothing from the state here, I see from the “priority system” in place here, that she will get absolutely nothing until I die or become incapacitated (I am approaching 70). She now sits at home all day with her headphones on, listening to her favorite singers and watching her favorite movies over and over on her iPad. Or she goes to a Medicaid-funded day-hab program which serves low-functioning (mostly non-verbal) clients. She has declined in many ways since arriving here, going on two years ago, and DDS washes their hands of responsibility (and they tell me that her case manager is NOT her advocate).

    My research tells me that this “priority system” was put in place in order to circumvent a court order issued in a lawsuit filed in 1999: Boulet et al. v. Celluci (107 F. Supp. 2d 61). This was a class-action lawsuit filed by parents of adults children with disabilities, challenging the state’s use of a wait-list for those in need of services. The wait was often many years long. The court order forced the abolishing of wait-lists, and all eligible individuals were ordered to receive immediate services. So what did DDS do? They abolished the wait-lists, and created a prioritization list. Those formerly wait-listed were now simply categorized as “no immediate need” and had their cases closed. The wait-list, became a rejection bucket – utterly circumventing the intention of the court order. (Of course the named plaintiffs in the case were given the demanded services, even though their need profiles put them in the “no immediate need” category.)

    The state of Massachusetts allocates about twice the amount of money per-client as does New Mexico, yet they provide almost no services, while New Mexico provides whatever the disabled citizen needs, in most respects. What in God’s name is wrong with us here?

    I believe that a new class-action lawsuit is called for. I do not have the resources to retain the legal team, but I can provide an excellent plaintiff with an activist-minded father/guardian. Surely there are enough persons suffering under this corrupt department who would be willing to join me, right?

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