TO: The DMR Community
FROM: Gerry Morrissey
DATE: March 13, 2007
RE: Update 152

DMR State House Event Set for March 29th at 10:00 a.m.

On Thursday, March 29, 2007, the Department of Mental Retardation and the DMR Statewide Advisory Council will celebrate "March is MR/DD Month" with an event that will be held at the Grand Staircase in the State House in Boston . Our guest emcee will be David Brown, one of the meteorologists of News Center 5's newscasters.

This year, we will recognize the successes achieved in getting the supports that have enabled individuals with mental retardation to leave nursing facilities and return to the community as well as the efforts that have allowed individuals at risk of nursing home admission to remain living in the community. Stories highlighting the importance of the collaboration of individuals, families, providers, and DMR in supporting these individuals will be shared that day. For more information, contact Ralph Edwards at 617-624-7755 or email him at: Ralph.Edwards@state.ma.us.

Human Rights Conference Set for June 12th, 2007

The 23rd Annual DMR Human Rights Conference will take place on June 12th at the DCU Center in Worcester . This year the keynote and luncheon events will be held on the first floor which will allow for more people to attend. Brochures and registration forms will be available in early April. Also, check the DMR web-page for updates. Currently on the website is a call for nominations for the annual human rights awards by the human rights conference committee.

Assistive Technology Exchange in New England

Last month, the Assistive Technology Exchange went live. The AT Exchange is a website and database that permit descriptive listings of assistive technology items to be entered, edited, searched and removed. The Assistive Technology Exchange in Massachusetts is designed to facilitate simple, easy transactions between Massachusetts residents who can benefit from assistive technology devices and those who have assistive technology devices that are no longer needed. It is not for vendors or distributors to buy equipment, although vendor participation through donations of equipment or posting equipment for loans is welcomed. To post an item or to look at items available, go to www.getATstuff.org.

What's New on the DMR Web Page

Check out www.mass.gov/dmr. Under "Key Initiatives," you will find the DMR COOP (Continuity of Operations Plan) and under "DMR Reports," you will the 2005 Annual Mortality Report. The COOP describes how DMR would perform its essential functions in the event of a disaster. The 2005 Mortality Report is the fifth annual report published by DMR that analyzes information on all deaths for individuals over the age of 18 who have been determined to be eligible for DMR supports. It is independently compiled by the Center for Developmental Disabilities Evaluation and Research of the University of Massachusetts Medical School. This report is an important component of the Department's quality management system and informs the Department's on-going organizational learning and service improvement efforts. Massachusetts is one of but a handful of states that compiles, analyzes and publishes mortality information.

Budget Hearings

On Monday, March 12 th, the Joint (House and Senate) Committees on Ways and Means held its FY 2008 budget hearing for the Department of Mental Retardation and other agencies within the Executive Office of Health and Human Services (EOHHS) at the Franklin Municipal Center in Franklin. On Thursday, March 15 th, the Joint Committees on Ways and Means held the public hearing on the FY 2008 budget at the Gardiner Auditorium in the State House, in Boston . This hearing was open to all people who wished to testify on any aspect of the state budget, including DMR and EOHHS.

DMR Testimony at the March 12th Budget Hearing

On March 12, 2007 , DMR Commissioner Gerry Morrissey appeared before the Joint Committees on Ways and Means and provided the following testimony.

"Mr. Chairmen and members of the Committee, thank you for the opportunity to appear before you today to talk about the Department of Mental Retardation and the Fiscal Year 2008 state budget. The Budget filed on our behalf by Governor Patrick provides the Department with an appropriation for Fiscal Year 2008 that puts the Department in position to continue to provide necessary supports to individuals in the coming year.

The Department of Mental Retardation, established under Chapter 19B of the General Laws, is charged with "all matters" affecting the welfare of people with mental retardation in the Commonwealth. Every day, the Department provides supports and services to more than 32,000 people with mental retardation and their families in Massachusetts. These supports and services can include:

  • A safe place to live;
  • Rides to work, training programs or other essential needs;
  • Assistance in daily living;
  • Help in getting a job or preparing for work;
  • Family support or respite services; and
  • Intense levels of treatment, monitoring or care; support in developing social and recreational skills.

The majority of families who have a loved one with mental retardation need little or no assistance from the state. But for those who do, the Department has approximately 7,000 dedicated state employees, as well as nearly 18,000 private employees of the 228 provider agencies who contract with DMR. In fact, more than $800-million of DMR's budget goes toward contracted services - for day and work programs, for transportation, for community residential services, and for family support. In addition, state employees provide the overall administration of the agency, case management, clinical care and residential supports at state facilities and state-operated homes.

The provisions of the current FY'07 DMR operating budget are good thanks to an exceptional collaborative effort that has developed over the past several years among the Executive Branch, the House and the Senate.

Among the supports and programs that the Department feels particularly strongly about for the coming year are the Turning-22 program and efforts by the Department's Autism Division.

Turning 22

The current budget continues our effort to provide services to persons with mental retardation who turn 22 years old and age out of Special Education programs. This program was begun with legislative support several years ago to address the problems faced by young people whose entitlement to state and local educational programs ended on their 22 nd birthdays. Until that time, what we had seen was that young adults who'd had meaningful experiences as students were left to stay at home because no adult services were available for them. When we began the program, we were serving an average of 450 persons each year with residential and day program supports. Now, with increases in demographics, with better medical care allowing disabled people to live longer lives, and with increasing diagnostic tools, we are serving more people than ever. In fiscal year 2007, for example, we will serve 571 persons through the Turning-22 program in residential services, day/employment services, transportation and family support services. The increase in FY'07 funding enabled us to substantially meet that need. We project that the number of people in need of services will continue to grow as the population increases. That number will be between 580 and 600 in FY'08, according to our projections.

Autism Spectrum Division

A few years ago, the Department was charged with creating a plan for an Autism Spectrum Division (DMR/ ASD) that could become the home agency for children with autism - helping to ensure effective coordination of services for families. Today, many state agencies and schools across the state provide support services for children with an autism spectrum disorder

The number one need for families, as identified through a planning process established by the Department when beginning the new Autism Division, is an increase in family support. Families are struggling to get by and need additional help for respite, additional therapies, equipment and social recreation activities for their children. A program such as the DOE/DMR project is considered to be most helpful in addressing this need. The planning process also noted a lack of coordinated information and referral resources services; difficulty with school transitions; education issues related to the IEP process; lack of appropriate social support programs, including camps and after school programs; and a desire for First Responder Trainings.

DMR received $3.0-million in funding for autism services in FY'07. Two million of that amount is to be utilized for services in conjunction with an Autism Waiver through the Federal Centers for Medicare and Medicaid Services ( CMS) 1915(c) Home and Community-Based Services Waiver. The waiver application has been forwarded and we are in contact with CMS to address their concerns and issues.

DMR/DOE Project

The Department of Mental Retardation, in conjunction with the Department of Education, is committed to exploring less restrictive, community-based options for public school students who are receiving special education services who are DMR-eligible consumers. This interagency initiative allows special education students who might otherwise need out-of-district residential programs to remain in their own homes with their own families at less cost to the state by allowing the Department of Mental Retardation to supply needed in-home supports to the students' families. In many cases, the Project has allowed students to return to their homes from residential placements.

Begun as a pilot project in 1993, the Project became fully implemented in 1996. The funding provided to the Department of Education and transferred to DMR in an interagency agreement provides this service to an average of 330 students across the Commonwealth annually. In FY2007, we project that we will be able to serve 328 students. The success of the program means that for every dollar spent in this program, a dollar is saved at the Department of Education.

Quality Management

The Department continues to undertake steps to ensure that the supports we provide to people are of the highest quality. Towards that end, we have a Quality Management and Improvement System that focuses on assuring that individuals are healthy, safe and enjoy a good quality of life. The Department's quality management system has consistently been held up as a national model and has enabled DMR to provide assurances regarding the health and safety of individuals we support to the Federal Centers for Medicare and Medicaid Services.

The Department's quality management and improvement system involves everyone in the Department and is approached on three levels: the individual, the provider and the overall system. Our system is designed to create a continuous loop of quality that provides for the early identification of issues, notification to concerned parties, correction, follow-up, data aggregation, analysis of patterns and trends and service improvement activities.

DMR's Quality Management and Improvement System is comprised of approximately 22 unique components including but not limited to a web-based incident management system, an investigations system, a rigorous licensure and certification process, a human rights and peer review system, a person centered planning process, a risk management process, a clinical mortality review process and regular on-site monitoring of services and supports.

DMR prides itself on a quality management system that focuses on a set of important outcomes in peoples' lives, and an open and transparent review by both internal and external stakeholders of our accomplishments as well as areas for service improvement. We publish and widely distribute an Annual DMR Quality Assurance Report. The publication reports on 12 outcomes detailed in 57 different measures determined to be important indicators of quality in the lives of individuals with mental retardation. The report shows where the patterns and trends in services are and is an important focus for quality improvement efforts. As further evidence of our commitment to a transparent and open process, the Department has 4 regional and 1 statewide Quality Council, composed of internal DMR staff as well as individuals, families and providers. These councils review and analyze the Quality Assurance Report and other quality assurance databases, recommend service improvement goals and measure progress towards achievement of goals.

We are also one of only a handful of states that have a strong mortality reporting and review process. This process culminates in the publication of an independently produced Annual Mortality Report that is distributed widely and posted on our Departmental web-site.

In the area of health care for the people we support, we implemented and continue to support efforts to strengthen access to and quality of health care through the DMR Health Care Promotion and Coordination Initiative. This initiative developed standards for preventive screening for individuals with mental retardation, developed an electronic health care record, a health review checklist so that MR providers would go to a physician appointment with more specific information, developed information and training for direct support professionals to help them better observe and report signs and symptoms of illness and developed a protocol for a clinical consultation from a DMR area nurse. DMR also publishes a quarterly "Living Well" newsletter which gets mailed directly to every DMR provider home. The newsletter highlights key issues around health care and prevention. It is aimed at direct support staff to assist them in their daily care of the residents.

Finally, in an effort to assure that individuals and families are informed purchasers of services, the Department is in the process of posting the summary results of the licensure and certification reviews of all our state and private providers on the DMR web-site.

Workforce

Our most important question is how to attract and retain the best possible workers for the people we support. I look forward to working with my colleagues in the administration to come up with creative solutions to attracting and maintaining staff. We know that we have people working extra jobs in order to keep their own families solvent while providing support for people with mental retardation. Often, people leave the field because they simply can't afford to work for us. This budget preserves the POS salary reserve funding annualization of $13.0 million, which helps retain people who have developed good relationships with the people we support and their families. It also includes a salary reserve line item of $12-million to provide additional funding for those making less than $25,000 per year.

The Department has developed a working relationship with the state's Community Colleges to further the education of people who work with people with disabilities. We have looked at tuition exemptions to state colleges for people who work with us. One key issue that we are working on is where will we get people to do this work in the future. We have a strong cadre of dedicated people who have worked for and with the Department for decades. We have been tremendously fortunate over the years that there have been literally generations of people who have worked in this field. It is not unusual for parents and children to work together for the Department providing supports for people with mental retardation.

FY2008 House 1 Budget

For FY 2008 the Department's operating budget will be $1.22-billion. The House 1 budget allows the Department to continue to do many things. We will maintain and preserve our efforts in autism services at $3.0-million. The budget preserves the Department's Turning-22 program with a smaller phase-in period for first year funding while annualizing all the current recipients. The budget preserves the POS salary reserve funding annualization of $13.0 million. We are able to maintain our residential rate initiative funding at $2.0-million as we take further steps to reform our system of contracting services. The budget includes expected funding of $8.0-million for the DMR/DOE initiative. We will also be able to maintain all of our legal obligations with the federal court, including $87.8-million in funding for the Boulet settlement, with this budget.

At the end of the day, with all we are attempting to do, we can never lose track of our core mission. It is why we exist as an entity. It is why we do what we do. Every day, we provide supports to more than 32,000 people with mental retardation and their families in Massachusetts.

Thank you for the opportunity to appear before you today and thank you for your past efforts on behalf of people with disabilities. I would be glad to answer any questions you might have."

Carol Zurek Honored by Horace Mann School

Carol Zurek , the DMR Statewide Coordinator for Deaf and Hard of Hearing Supports, was recently chosen by the Horace Mann School for the Deaf and Hard of Hearing to be honored this year as a Successful Deaf Leader. At the March 7 th event, Carol and three other honorees were asked to address the students and speak about their successes and challenges. Congratulations to Carol for this honor and for her hard work in raising awareness of deaf culture in her daily endeavors.

DMR Northeast Region's Eighth Provider Recognition Celebration

On Thursday October 26, 2006, the Northeast Region held its Eighth Provider Recognition Ceremony. The Northeast Region recognized and honored 53 provider staff who, in their daily work, embrace the ideals, and bring the principles and practices of the DMR mission statement, inclusive of meaningful community involvement and contributions, to life with the individuals they support. The recognition ceremony was co-hosted by Regional Director Mandy Chalmers and Assistant Commissioner for Field Operations Larry Tummino. The provider staff that were recognized, exemplify support to individuals that enable their full participation in and contribution to the communities in which they live and/or work. The Northeast Region again extends a heartfelt thank-you for the important work that these providers do.

DMR Northeast Leadership Institute Graduation

On October 18, 2006, the Northeast Region graduated its 8 th class from their Northeast Leadership Institute . Fifteen participants completed the seven-month leadership development program. Pat Cronin, NE Regional Director of Staff Development and Training and Deborah Reidy of Reidy Associates gave the opening remarks. Pat McCarthy, Employment Services Manager for the Danvers Office of the Developmental Community Services Cluster, EOHHS, congratulated the graduates and awarded certificates to each graduate. To date, 126 people have graduated from the Northeast Leadership Institute.



This information is provided by the Department of Developmental Services.