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Questions surround the governor’s budget plan for DDS

January 28, 2013 Leave a comment

In a conference call with advocates last week, Department of Developmental Services Commissioner Elin Howe put what seems to be a highly optimistic spin on the governor’s FY 14 budget plan for her department.

Howe said that, “I think we’re entering into this (budget process) in better shape than in a considerable period of time.”   Last spring, she similarly described the plan for the current-year DDS budget, as it emerged from the House Ways & Means Committee, as “the best budget the Department has had in five years.”

Governor Patrick’s $1.5 billion, FY 14 budget plan for DDS appears to be typical of his overall budget proposals for human services, but we aren’t ready to make too many rosy projections about it.

First, there’s the  question whether the governor’s budget proposals are realistic, given that they depend on passage of his plan to raise taxes.  And as was the case last year, Howe seems to be focusing on the brightest spots in a budget for her department that appears to have many dark spots as well.

Howe did begin the Wednesday call by noting that the governor’s proposed budget (H1) depends on legislative passage of his proposal to increase the income tax rate to 6.25 percent.  The state’s current revenue estimate for the coming fiscal year “doesn’t support all of what we’re trying to do,”  she said. 

Howe said, though, that she had no figures on what might happen to the DDS line items for FY 14 if the Legislature were to balk at the governor’s tax plan, which seems a good possibility.

Secondly, while Howe noted that H1 calls for increasing a number of DDS line items, she acknowledged there are also a number of projected shortfalls and cuts in it.  Among the line items in H1 with projected shortfalls are DDS Administration (which funds service coordinators), State-operated group homes, and Community-based Transportation programs.

Also, the community-based Adult Family Supports and Turning 22 accounts would be only level-funded under H1, while the Autism Division account would be cut by a small amount. 

In addition, the state-run developmental center line item would be cut by $10.4 million, bringing the total amount cut from this account by the Patrick administration to nearly $80 million since FY 2009.  As we’ve said many times before, we have yet to see how that cut in developmental center funding has provided much in the way of benefits for the average DDS client in the community system.

Moreover, Howe said there is no money in the H1 budget for the developmental center account for the continued operation of the Fernald Center in the coming fiscal year, meaning the Department will once again have to ask for supplemental funding for Fernald.

The following is a line-item breakdown for DDS, under H1  for FY14:

DDS Administration and service coordinators  (5911-1003):

H1 would increase this line item by $1.7 million, to $64.7 million.  However, Howe said this increase is the result of salary increases due to collective bargaining with the SEIU state employee union.  Without an additional $500,000 in the account, 10 to 12 service coordinator jobs could be lost, she said.

Service coordinators have the critical task of making sure DDS clients are receiving the right services in the community system, and their caseloads are growing out of control.  SEIU is asking for an additional $2.5 million in the administrative line item in order to restore 50 service coordinator jobs out of the 82 jobs lost since 2007.

Community Transportation (5911-2000):

H1 would increase this account by $537,000, to $13 million.  However, Howe said this increase will still result in a shortfall in the transportation account of $500,000.

Community Residential (5920-2000):

H1 would increase this account by $71.7 million, to $860.3 million.  Howe said some of this increased funding is the result of  “Chapter 257,” a 2008 “global payment” initiative, which established pre-set rates for DDS residential service vendors.  The Arc of Massachusetts says the Chapter 257 increase amounts to $55 million and is a “down-payment” on a total $175 million increase in funding that is expected to be given to the vendors.

State-operated Residential (5920-2010):

H1 would increase this account by $10.6 million, to $191.4 million.  Howe noted that this increase is largely for the operation of new state-run group homes for residents from developmental centers marked for closure.  Overall, she said, the increase in this account is $3.5 million less than what DDS requested, meaning the Department is once again projecting a shortfall in needed funding.

Community Day and Work (5920-2025):

H1 would increase the amount by $28.4 million, to $161.9 million, which is good news.

Adult Family Supports (5920-3000):

H1 would level-fund this account at $49.5 million, which is not good news.

Autism Division (5920-3010):

H1 would cut this account by $22,166, to $4.6 million. Bad news.

Turning 22 (5920-5000):

H1 would level-fund this account at $6 million.  However, it would increase the annualized amounts for Turning 22 clients in the community residential, community day programs, and community transportation accounts.  Mixed news.

Facilities (developmental centers) (5930-1000):

H1 would cut this account by $10.4 million, to $123 million.  The Facilities account has been cut by nearly $80 million since FY 09.

Templeton Retained Revenue (5982-1000):

H1 would level-fund this account at $150,000

Non-DDS line items:

EOHHS Salary Reserve (1599-6901):

It does not appear that H1 contains any funding for the salary reserve for wage increases for direct-care workers employed by DDS vendors.   In November, Patrick froze $20 million that had been placed in the fund for the current fiscal year.

Disabled Persons Protection Commission (1107-2501):

H1 would increase this account by $23,000, to $2.3 million.  The effect, however,  is level-funding of the agency, which has been level-funded since FY 2009.  The DPPC is an independent state agency charged with investigating complaints of abuse and neglect of people with intellectual and other disabilities.

We’ll stay tuned of course to see what the House and Senate do with the governor’s budget for DDS.  All in all, we don’t share the assessment that we’re entering into this budget process in great shape.

We are no doubt well into an era of reduced public services and of having to do more with less.  Unfortunately, the administration doesn’t appear to have put much thought into how to accomplish that.  It’s main initiative has been to close developmental centers, which hasn’t boosted funding to most community-based accounts.

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Are they really cutting that program?

March 14, 2012 1 comment

“I want to shake you all,” the woman said through an interpreter.

It was a plea to the impassive panel before her of members of the House and Senate Ways and Means Committees, none of whom could really have more than an inkling of what it must be like to live, as this person does, with both deafness and blindness.

I didn’t catch the name of the woman, who testified at a hearing on the state budget in Gardner auditorium at the State House on March 9.  But her message was clear.  She wanted to stop the yearly cycle of budget cuts that continually threaten her lifeline to the outside world.  

Specifically, she was referring to the proposed elimination in Governor Patrick’s Fiscal Year 2013 budget of $450,000 for a program to provide her and other deaf and blind people with community-based support services.  Yes, $450,000 for a program to provide interpreters and other assistance in daily living to people who are both deaf and blind.  It’s apparently something this administration can’t bring itself to support, despite its claim to be a pioneer in developing community-based services for the disabled.

“Can you imagine being deaf and blind and trying to go food shopping without any help?” the woman asked the committee. “If this program is eliminated, I will be suicidal.”

Apparently, some of the members of the Ways and Means panel were beginning to imagine that.  There were expressions of assurance that the funding for the program will be found.  Representative Martha Walz of Boston, a member of the House Ways and Means Committee, responded that “it is the governor who proposes to cut these programs every year and the Legislature that restores it year after year.”

March 9 state budget hearing before the House and Senate Ways and Means Committees

 

But even if the Legislature restores the $450,000, the promise of “Community First” will be far from realized, even for the estimated 500 people in the state who are both deaf and blind.  Chris Emory, a member of the deaf-blind community, maintained that the program in question is able to provide services for only about 70 of those people.

(By the way, the administration committed $45.8 million to the Community First Initiative for FY 09, and termed it the first year of funding under this initiative.  I haven’t been able to find any subsequent appropriations under that line item.)

Also testifying at the March 9 hearing was David Berkeley, who urged that the Legislature add $7 million in funding for “clubhouses” that provide a range of community services to people with mental illness.  Berkley said the program, which has been level-funded by the governor and Legislature for the past 12 years, has kept him from needing hospitalizations for his own disability.  Before he received help from the program, he had been hospitalized more than 50 times over an 11-year period, at a total cost of $750,000.

Reva Stein, executive director of the Massachusetts Clubhouse Coalition, said the flat funding for the program has, in effect, amounted to a budget cut because the clubhouses serve 1,200 more people than they did just seven years ago.  The Clubhouses offer a wide range of services to the mentally ill, including job training, employment placement, benefit counseling, housing support, homeless prevention, and social opportunities, according to a Coalition fact sheet.

According to testimony at the hearing, the governor’s budget would provide additional funding to the Department of Mental Health for residential services, but the money would be earmarked only for people being transferred from Taunton State Hospital, which has been targeted by the administration for closure.

Similarly, the governor’s budget provides additional funding for community residential services for intellectually disabled people being transferred from four developmental centers targeted for closure.  Other community-based programs would be level-funded or cut, however.

I delivered testimony to the Ways and Means panel on behalf of COFAR that time is running out on the Fernald, Templeton, Monson, and Glavin developmental centers.  The number of residents left in them has been reduced from roughly 475 in 2008 — when the administration first announced they would be closed — to about 165 today.  Yet, no independent cost analysis has ever been done of the closures of those facilities.

It so happens that a bill (H. 3964) requiring such an independent analysis of the costs of closing three of the developmental centers — Templeton, Monson, and Glavin — is currently before the House Ways and Means Committee.  The bill was sent to the committee last month after having sat in the Children, Families, and Persons with Disabilities Committee for more than a year. 

These developmental centers provide a safety net for a small segment of the state’s intellectually disabled population that cannot function successfully in community-based group homes Even the Association of Developmental Disabilities Providers, which represents state contractors that operate the group homes, acknowledges that the closures of the developmental centers have so far not produced promised fiscal benefits to the community-based system of care.

I said all of this to the members of the House and Senate Ways and Means panel.  They listened impassively, as they had to everyone else.   But when I was done there were no assurances provided and no questions.

I was left thinking that the Legislature in this state will indeed often find the money to undo some of the most egregious damage caused by the administration in care for our most vulnerable residents.  But it is essentially a Band-Aid solution.  The Legislature appears less interested in addressing or questioning the overall policy this state has been following of cutting and privatizing vital human services.

DDS stonewalling on cost, care information

January 24, 2012 1 comment

(Part 2 of 2-part series on transparency issues in the Patrick administration)

The Patrick adminstation contends it is striving to be “transparent” in the way it conducts the public’s business, and touts its Open Checkbook website among other initiatives.

But when it comes to getting public information from individual agencies within the administration, the record of transparency doesn’t always live up to the billing.  We think our own recent experience with the Department of Developmental Services is a case in point.

We’ve been fighting with DDS for several years over public information requests, but the agency’s disinclination in recent months to provide requested information seems to have gotten worse. 

It now takes months to get even the most minimal public records in response to our requests.   And DDS recently cited the letter of the Public Records Law in claiming they have no obligation to answer any questions about records that they have provided to us.  Also, in two cases in the past year, DDS cited confidentiality requirements in refusing to release what we think, in at least one of the cases, are clearly public documents.

Meanwhile, even a state lawmaker has been unable to get information out of DDS on deaths in the agency’s system.  State Rep. Anne Gobi, a Democrat from Spencer, wrote to DDS Commissioner Elin Howe in mid-October, asking for information on the number of residents who had been transfered from the developmental centers to community-based group homes and how many of those residents had died after the transfers.  As of this month, Gobi’s staff said she had not received any response to her inquiry.

Here are some more details about our efforts to get records and information from both DDS and the Executive Office of Health and Human Services:

  • In October, COFAR submitted a request similar to Gobi’s to DDS for information and public records concerning the number of developmental center residents who have been transferred to group homes since 2008 and the number of those residents who have died.

In that request, COFAR also asked for the number of community-based group homes that have been built to house former developmental center residents.  In early November, a DDS attorney responded that the agency was in the process of searching for the requested records.  There has been no further word since then.  We wrote to DDS on January 17, seeking an update on the status of our request, but have received no response to it.

  • In October, the DDS general counsel denied a request COFAR had first made in July for records detailing the costs of medical, nursing, clinical, and therapeutic services for individuals in a group home program operated by the May Institute, Inc.

COFAR initially filed the request for the records concerning the May Institute with both DDS and EOHHS.  In August, an EOHHS official responded that that agency was in the process of searching for the records.  Then, in September, a DDS attorney stated that DDS was searching for the same documents.

There has been no further word from EOHHS since August regarding the records.  In October, however, the DDS general counsel appeared to reverse the Department’s September position by stating that documents detailing funding for medical or clinical services for individuals would be part of their individual client records and therefore exempt from disclosure under the Public Records Law.

COFAR appealed the denial to the Supervisor of Public Records in October,  suggesting that DDS redact any names or any other information that might identify individual clients.  In the October appeal, COFAR maintained  that it was seeking only to find out the total cost to taxpayers of care for community-based clients such as those in the May Institute program.  Should DDS refuse to provide that information, “the public will have no way of knowing basic details about the provision and funding of these kinds of public services,” COFAR’s appeal added.

To date, the Public Records supervisor has not ruled on COFAR’s appeal.

DDS similarly denied a request in July from COFAR for information about the death of a man in a group home earlier that month, four days after he had been transferred there from the Templeton Center.   In that case, the Public Records Supervisor upheld DDS’s denial, accepting the Department’s argument that the information was private.

  • In July, COFAR asked DDS for detailed budgetary information regarding the Monson, Templeton, and Glavin developmental centers, which have been targeted by the administration for closure.  In response, DDS in August provided only a single line item amount for each facility, representing the total spending for that facility.  There was no budgetary breakdown of the line item for any of the facilities. 

 After COFAR appealed to the Public Records Supervisor, DDS, in late October, provided an “aggregated” spreadsheet containing numerous line items for all three developmental centers.  However, this time there was no separate breakdown for each facility.   Moreover, the total aggregated spending amounts for each of three fiscal years in the October response did not correspond with the totals provided in the August response.

As a result, COFAR sent an email to DDS asking why there was such a big difference, in particular, between the $176.3 million in total spending listed in the October spreadsheet for the three facilites  in FY 2009, and the $57.8 million listed in the August response for the same three facilities.

In a letter sent to COFAR in response, a DDS assistant general counsel wrote that the agency “is not required to answer questions…” under the Public Records Law.  So much for letting us, and the public, in on the inner workings of the state’s finances.

Earlier this month, an attorney with the Public Records Division, sent us a nice email, apologizing for the delay in responding to our October appeal regarding the May Institute documents, and saying:

I know that you are working very hard to help those in the Commonwealth who are the most in need, and that receiving records from custodian’s, like DDS, is a crucial part of assisting those individuals. 

Now, if only DDS wouldn’t balk at simple requests for information, and showed a dedication to following through on the administration’s claims of transparency.

Open Checkbook could be more open

January 19, 2012 1 comment

(Part 1 of a 2-part series on transparency issues in state government)

Despite its promises of greatly increasing government transparency, the Patrick administration’s new  Open Checkbook website  seems to me to fall a little short of the hype.

Open Checkbook was launched in December with lots of claims made about how it was going to give the average Internet user a powerful new lens into the inner workings of public finances.  The state budget office in conjunction with the Comptroller and Treasurer jointly instituted the website in response to legislation that sought to upgrade the state’s  relatively low ranking  in a state-by-state transparency survey by MassPIRG.

Open Checkbook is divided into two major sections, State Vendor Spending and Payroll & Pension Spending.  I found the vendor spending section to be  disappointing in one major respect.  It displays a lot of about where the money to vendors comes from, which is very good, but no information on where the money goes, i.e., how the vendors spend it.  (I haven’t yet tried out the Payroll & Pension Spending section.)

I used the vendor portion of Open Checkbook to look up one specific company, the May Institute, Inc., for Fiscal Year 2010.  This is the same nonprofit provider for which COFAR has unsuccessfully sought cost information lately from the Department of Developmental Services. 

I clicked on one particular category of funding for that vendor and got a long list of dates followed by  payment amounts.    By clicking on July 14, 2009, for instance, I was able to find out that DDS paid the May Institute $367,000 on that date for residential and day services.  It doesn’t appear to be possible to find out much more detail about that payment. 

What is good is that I was able to do a refined search, based on the residential and day services account, and find that a total of $26.9 million was paid to the May Institute under this account by DDS in FY 2010.

The bad news, as noted, is there is no way to track where the money goes after it gets to the vendor.   For instance, there there appeared to be no way to view administrative expenses for the May Institute or to find data on the compensation of executives of the agency.   It would seem that a checkbook should tell you about both incoming and outgoing funds.

Also, the site doesn’t display contracts, as some similar state sites do; and the data on Open Checkbook doesn’t go back before Fiscal Year 2010.  An official with the state budget office said displaying actual contracts is “on our list” for improving the site, but that hasn’t been decided yet. 

It’s also worth noting that much of the information available on Open Checkbook is available as well on the state’s longstanding Uniform Financial Report website for vendors.  In fact on the UFR website, you can find total payments to vendors broken down by government agency as well as spreadsheets that do show where the money is going, including amounts paid to executives of the vendor agencies.  (That salary information may be incomplete, in several cases, as we have reported.  But at least some of it is available.) 

The UFR site, for instance, shows that a total of $30.29 million was paid by DDS to the May Institute in FY 2010 as part of a total of $104.4 million in revenue to the vendor.  Admittedly, the information on the UFR site isn’t nearly as up to date as the Open Checkbook site.  But you can find a lot of information on the UFR site that isn’t available on Open Checkbook, such as the fact that the May Institute had $101.6 million in expenses in FY 2010, including $396,716 in compensation to its CEO and $56 million on direct care salaries.  Also the UFR information goes back to FY 2002.

What the UFR site doesn’t appear to show, which Open Checkbook does, is a breakdown of funding going to vendors per budgetary account, such as the Residential and Day Services account.

One other problem I had with Open Checkbook has to do with its presentation of a large amount of abbreviated or otherwise highly techical information.  For instance, the the funding listed for the May Institute was broken down into five categories on the site, including Grants to Nonpublic Entities, Legal Support Services, Medicaid, Purchased Human and Social Services for Clients/Non Medical, and a fifth and largest category dollarwise, titled “PurchH&Ss For Clit.Med/HC Rel (MM3).”    Spending under this category was listed as $23,047.235.83.  What exactly does “Clit.Med/HC Rel (MM3)” stand for?

I was able to hover my cursor over the acronym, and up came the following definition, which didn’t clear up the confusion very well.  The definition was:

Payments pursuant to contracts with organizations to purchase social services or programs with medical or healthcare related components on behalf of specifically identified clients or a specific target group.  Includes services rendered by an individual with payment to a corporate entity.  Federal funds are reported as sub-recipient payments.

The “MM3” part of the acroym is an object code classification for the payments.  The Open Checkbook site FAQ page states that individual object codes are defined in the “Expenditure Classification Handbook” maintained by the Comptroller’s Office.  But unfortunately, the link on Open Checkbook FAQ page  to the Comptroller’s Handbook didn’t work.

As administration officials have said, Open Checkbook is a work in progress.

One way to avoid cutting Medicaid

October 3, 2011 2 comments

The Patrick administration’s “Community First” approach to caring for people with intellectual  and other disabilities depends on a huge, $2.6 billion, state and federally funded network of nonprofit contractors.

Many of these contractors or providers are excellent; but, all too often, we hear about cases of abuse, neglect, mismanagement, and fraud, such as the allegations this past weekend by Attorney General Martha Coakley that Adlife Healthcare and three other companies had bilked the state’s Medicaid program out of $10 million.

Adlife Healthcare would seem on the surface to be a shining example of the Community First approach.  The company’s website states that it tailors its health care programs for disabled persons in a manner that “maximizes the client’s independence and dignity.”  The program, the website states, allows clients to remain in the “familiar comfort” of their own homes, and begins with a visit from a registered nurse who then arranges for services from additional nurses, physical therapists, case managers, and home health aides.

All well and good, except that, as Coakley alleges, Adlife charged Medicaid for services without having provided them, including billing for people who had died.  Ultimately, the company over-billed the state by $5.5 million, according to Coakley.

Medicaid, which is one of the state’s largest sources of budgetary spending, funds a wide range of services, from health care for both low income families to care and services for persons with intellectual disabilities in both the state developmental centers and community-based system.   Because of its sheer size, Medicaid nationally is likely to be a source of at least $1.2 trillion in revenue cuts that the “super committee” in Congress is required to recommend by November.

But there are experts around who argue that a significant portion of those cuts would not be necessary if the state and federal governments did a better job in preventing and detecting the kind of fraud that providers such as Adlife are accused of perpetrating in the Medicaid system. 

In his 1996 book, “License to Steal: Why Fraud Plagues America’s Healthcare System,” Malcolm Sparrow maintains that if the health care industry:

learns the art of fraud control, then the industry will have learned  a discriminating way to save money — by investing in the capacity to distinguish between legitimate and illegitimate claims.  The alternative is to use less discriminating methods, such as across-the-board reductions in benefits, further restrictions on eligibility, or lower reimbursement rates for providers.

State Auditor Suzanne Bump has reportedly decided to follow Sparrow’s advice.  According to The Globe, she plans to intensify her office’s focus on Medicaid fraud and has appointed a former federal prosecutor  to head those investigations.  One Medicaid fraud expert told The Globe that most Medicaid fraud is perpetuated by “providers who take advantage of loopholes in regulations to process claims that would be detected by more rigorous analysis.”    

Last week, COFAR President Tom Frain and I met with three members of Bump’s staff, to urge them to investigate the state’s human services provider system, particularly the contracting network funded by the Department of Developmental Services.   We hope Bump’s intensified focus on Medicaid fraud will include the DDS contracting system.

We fully support the community-based system of care in Massachusetts; but as the Adlife and too many other examples show, it is a system that is all too vulnerable to waste, fraud, and abuse and needs much better governmental oversight than is currently the case.

Update on our requests for cost records

September 16, 2011 3 comments

After a month and a half, it’s troubling that the Patrick administration is apparently still unable to locate cost records we requested pertaining to a single community-based group home contract.

I just received a letter from the Department of Developmental Services, dated September 14, that they are in the process of searching for the documents, which I had requested on July 29.   Meanwhile, the MassHealth Privacy Office in the Executive Office of Health and Human Services has been searching for these same records since August 9.

To recap, we’ve been trying to find out the sources of state funding for medical, nursing, clinical, and therapeutic services in a single DDS group home program run by the May Institute, a private provider.  We have a copy of a $1.2 million contract with the May Institute, which provides for 24-hour residential services under the program for 14 individuals in four residences in the DDS Central Middlesex Area.

The FY 2009 contract, however, only provides for direct care and limited nursing services for the 14 residents.  It does not mention medical, extended nursing, clinical or therapeutic services.

From what we’ve been able to determine, the administration has been basing its $20 million annual cost savings estimate in closing the Templeton, Monson, and Glavin Developmental Centers on a comparison of their budgets with the cost of community-based group contracts such as the May Institute contract.  But here’s the rub.  Our understanding is that the Templeton, Monson, and Glavin budgets do provide for medical, extended nursing, clinical, and therapeutic services. 

Naturally, the community system will appear to be less expensive than the developmental centers if certain community-based costs are not taken into account.  That’s why we want to find out exactly how much is being paid to fund those additional services to which the May Institute residents are reportedly entitled, and where that money is coming from.

By the way, we originally asked DDS on July 7 for the budgets of the Monson, Templeton, and Glavin Centers.   A month later, we received a one-page document from the department with single, line-item amounts representing the total annual spending for each facility.  There was no budgetary breakdown whatsoever for the facilities.

We appealed to the state’s Public Records Division for help, explaining that a budget of a state facility involves more than just a single line item.  As a result, I received a second letter from DDS, also dated September 14, stating that the department was in the process of searching for the “additional (budgetary breakdown) information” I had requested. 

I guess DDS considers a budget and a “budgetary breakdown” to be entirely separate concepts.  Stay tuned.

Once again, we’re waiting for the administration’s cost records

August 30, 2011 1 comment

It has been more than a month since we asked Secretary of Health and Human Services JudyAnn Bigby for public records detailing the costs of specified services in a particular group home program for intellectually disabled persons in Massachusetts.

It has been almost two months since we asked Commissioner of Developmental Services Elin Howe for the budgets of the Templeton, Monson, and Glavin developmental centers.

To date, we’ve received neither set of records.

As we’ve previously noted here, we’ve been attempting to compare the cost of an apparently typical vendor-run group home program with the three developmental centers.  We wanted to see whether the Patrick administration was comparing apples to apples in claiming to the Legislature in the last two fiscal years that closing the Templeton, Monson, and Glavin centers will save tens of millions in state funds.

As we reported,  a group home contract, which we did receive last May from DDS, specified a yearly cost per resident of $104,400.  In its cost savings analysis, the administration compared a very similar residential cost based on group home contracts with an average calculated cost of care at Templeton, Monson, and Glavin.

The potential problem with the administration’s analysis that we found in examining the single group home contract was that it specified budgeted costs for only direct-care, supervisory, and minimal nursing staff.  What about the extensive nursing, medical, clinical, and therapeutic staffing that exists at the developmental centers and to which the residents of DDS group homes are entitled? 

The fact that those additional medical, clinical, and therapeutic costs were not in the group home contract we examined appeared to raise the question whether the administration’s savings analysis was accurate.   One immediate question was: if those additional costs are not paid through DDS contracts, how are they paid?  Secondly, what is the total amount of those community-based costs that the administration may have missed in its analysis?

Once we get the answers to those questions, we can determine for ourselves whether there would be a savings or not in closing the developmental centers.

On July 29, we sent Public Records requests to both Secretary Bigby and Commissioner Howe, asking for copies of any documents detailing funding for medical, nursing, clinical, and therapeutic services for individuals residing in the community-based group home program we had selected for review.  About three weeks prior to that, we had asked DDS for the Templeton, Monson, and Glavin budgets for the same time periods as the group home contract. 

On August 9, I received a letter from the records custodian at EOHHS, stating that the agency was in the process of identifying the records we had requested regarding the group home contract.  Last week, I called the records custodian, and was told EOHHS was still working on our request.  He wasn’t able to tell me when the records would be found.

We’ve appealed to the Public Records Division for the Templeton, Monson, and Glavin budget documents.  We’re close to filing an appeal for the group home contract records.

But one piece of useful information may have emerged here.  The fact that the August 9 response to our request came from EOHHS and not from DDS does appear to confirm that it is not DDS, but some other source at EOHHS, that funds medical, clinical, and therapeutic services in the DDS vendor-run group home system.  We believe that other source of funding is MassHealth. 

In any event, it’s getting clearer and clearer that the administration wasn’t counting all the community-based costs of care it incurs when it told the Legislature there would be major savings in closing the developmental centers.