Department of Mental Retardation

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5911-1000	Admin.	$6,029,262	$6,384,457	$13,404,870	$12,102,349	$13,102,349	$12,780,909
5920-1000	Regional Admin.	48,683,630	50,611,983	50,724,936	51,549,675	52,316,518	53,853,237
5911-1210	Worker Certificatn.	1,544,650	1,437,451	437,451	0	--	--
5911-2000	Transport.	25,049,926	23,879,506*	14,708,746	13,239,367	13,782,367	13,882,296
5911-9999	Insurance Assess.**	9,535,105	8,873,369	--	--	--	--
5920-2000	Comm. Residences	353,695,256	376,277,607	422,648,101	452,720,888^^^	476,614,523	499,491,126
5920-2010	State Residences	99,998,330	110,025,001*	111,238,845***	110,905,005	113,269,640	119,978,807
5920-2020	Boulet Wait List	--	15,000,000	36,500,000	49,500,000	70,000,000	85,614,227
5920-2025	Day/Work Programs	90,185,163	94,126,063*	104,179,308^	106,451,278	109,171,278	113,106,979
5920-3000	Family Supports	50,248,489	51,416,056*	61,739,428^	46,800,000^^	48,800,000	50,789,967
5920-4050	Waiting List	35,838,105	34,838,105	--	--	--	--
5920-5000	Turning 22	6,950,000	6,467,670	6,467,670	6,467,670	6,467,670	6,467,670
5920-6000	Older Unserved	6,750,000	6,281,550	--	--	--	--
5920-8000	Child/ Adolescent	5,024,156	5,011,548	--	--	--	--
5930-1000	Facilities	164,767,603	171,839,637*	165,581,181***	164,461,641^^^	160,220,259	166,072,065
5982-1000	Templeton Ret. Rev.	100,000	100,000	100,000	100,000	100,000	100,000
DMR	Totals	$904,399,678	$962,570,003	$987,730,536	$1,014,297,873	$1,063,844,604	$1,122,137,256
5948-0012	DMR/DOE	7,500,000	7,500,000	7,500,000	7,500,000	7,500,000	7,500,000

*    These figures include funds passed in the $18.848 million supplemental reserve budget for DMR (an EOHHS reserve account).

** These funds were consolidated into other accounts.

*** These figures include supplemental appropriations ($3.4 million transferred to 5920-2010 and $3.6 million transferred to 5930-1000 from the $7 million supplemental budget).

^    These are consolidated accounts and cannot be compared directly with previous year's funding. 5920-2025 and 5920-3000 in FY03 includes emergency 9(c) reductions made by the governor.

^^  The funds from this account were consolidated into 5920-2000.

^^^  These figures include a supplemental budget appropriation-of $3.2 million in 5920-2000 and $800,000 in 5930-1000.

The Department of Mental Retardation (DMR) is part of the Office of Community and Disability Services under the umbrella of the Executive Office of Health and Human Services (EOHHS). DMR serves over 32,126 individuals statewide through 24 area and 5 regional offices, 6 residential facilities (development centers), 1,932 community residences, and through contracted services with 265 private provider agencies. The agency provides a variety of services, including: individualized service coordination, flexible family supports, employment services, day services, and residential supports. DMR works to tailor services to an individual's and/or family's needs and to maximize self-determination and choice for its clients.

Rolland v. Cellucci and Boulet v. Cellucci

Two legal settlements shape DMR's current funding needs. Between FY01-FY07 DMR's budget has grown and will continue to grow faster than the other agencies due to the settlement agreements of two class action lawsuits: Rolland v. Cellucci and Boulet v. Cellucci. The settlements mandate that DMR annually provide residential placements and flexible supports to increasing numbers on its long waiting list. In addition, the Commonwealth made a commitment when the Boulet case was settled to stem the continued growth of the waiting list by fully funding each year's Turning 22 class. These are the students who age out of special education services and into the adult service system each year. Without adequate funding in the adult services system, the waiting list would continue to grow.

For FY05 alone, Boulet, Rolland, and Turning 22 total $47.35 million in new expansion funding to the DMR budget. The new money is to bring new clients into the service system off the waiting lists, and to annualize the previous year's new clients by providing them with a full year of funding for services.

Boulet v. Cellucci is the waiting list lawsuit. Five families on DMR's waiting list sued for services in federal court and won their case in July 2000. Judge Woodlock certified a class of 2,225 Medicaid eligible people who have faced years of delay in receiving services. Then, in January 2001, the case was settled with a 5-year plan to eradicate the waiting list. The plan called for providing services to the 2,437 people who overall made up the waiting list. Of these individuals: 1,961 were certified as needing out of home placements; 266 were certified as needing both residential and non-residential services; and another 210 were certified as needing non-residential services only. DMR agreed to provide residential services even to those on the waiting list who were not eligible for Medicaid (MassHealth). In addition, the agreement requires that DMR educate people on their housing and services options.

From FY02-FY06, a combination of new funds and DMR base resources are to be used to serve each of the 2,437 people who made up the list. For residential support, DMR began with the most urgent cases. Other funds have been allocated for interim services-providing for such things as respite to families and community access for individual program participants-to those who must still wait. (See the analysis for line item 5920-2020, below, for the specific funding requirements of the Boulet settlement agreement.)

Rolland v. Cellucci is the nursing home lawsuit. In January 2000, the Rolland suit was settled. The suit charged that the state illegally placed people with mental retardation in nursing homes rather than in community programs. A class was certified involving 1,600 adults with MR and other developmental disabilities who resided in nursing facilities or who were or should have been screened for admission to nursing facilities on or after October 29, 1998-900 of these are candidates for community living.

From FY01-FY07, DMR is and will be moving hundreds of people who wish to leave nursing homes for community-based residential care. Up to 150 persons per year are affected. In addition, DMR must divert a total of 275 potential nursing home admissions over 6 years, and the Department is to provide specialized services-including work supports, social supports, community outings, and other services-to those who remain in nursing homes. (See the analysis for line item 5920-2000, below, for the specific funding requirements of the Rolland settlement agreement).

FY05 OVERVIEW

Most Cuts Averted in FY05

The FY05 budget is largely positive for DMR, with total funding at $1.063 billion-$49.6 million above the FY04 allocation. Of that, $47.35 million is full funding to support Boulet, Rolland, and Turning 22 needs, while another $20.5 million supports Boulet and includes "catch up" funding-to patch the under-funding of previous years-which is necessary for the Commonwealth to abide by the settlement agreement.

The FY05 governor's initiative to end day and work programs for nearly 800 DMR clients who were not covered by state, federal, or court-ordered mandates was rejected by the legislature. In addition, both chambers of the legislature unanimously overrode the governor's veto of the $20 million salary reserve. Hence direct care workers are receiving their first cost-of-living adjustment in three years, an essential support for the DMR community system. [Editor's Note: See the Salary Reserve chapter to learn more about that issue.] In addition, there is a $640,000 restoration to the $2 million in cuts that flexible family supports sustained between FY02 and FY03.

On the downside, a $600,000 shortfall to Community Residential programs is impacting clinical team services for up to 2,400 residents (line item 5920-2000). A $900,000 cut to Regional Administration (line item 5920-1000) is terminating 18-20 service coordinators.

H1 FOR FY06 OVERVIEW

Lawsuits, Turning 22 Funded-No Restorations, No Cuts

H1 recommends $58,292,652 more than FY05 for DMR, a 5.5% increase. The funds provide for the requirements of the Boulet and Rolland class action settlement agreements. There is essentially level funding for Turning 22 (services for young people who are graduating or aging out of special education services), which is growing increasingly inadequate (see line item 5920-5000 below). Nearly $8.3 million of the increase is to annualize the FY05 POS Salary Reserve initiative for the lowest paid direct care workers, and nearly $8.8 million is for Unit 2 collective bargaining increases to the salaries of unionized workers.

This budget does not fund any new service coordinator positions, despite the expanding caseload of the agency. Neither does it restore the 18-20 service coordinator positions that were cut in FY05. The Flexible Family Supports account receives level funding, outside of Turning 22 annualization and salary reserve-related increases. There are no additional funds to pay for the new autism division at the department.

Line Item Analysis

Account:      Administration

Line Item:   5911-1000

The Administration account funds $4.5 million for central administration, payroll, and travel. It also provides $8.5 million for workers compensation, Medicaid, unemployment, and universal health (from FY03 forward, when line item 5911-1000 was consolidated with former line item 5911-9999 for insurance assessments). Finally, there is $99,000 in FY05 for a consultant to work on asset management and development related to any reuse of Fernald Development Center's land or property.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5911-1000	Admin.	$6,029,262	$6,384,457	$13,404,870	$12,102,349	$13,102,349	$12,780,909
5911-9999	Insurance Assess.**	9,535,105	8,873,369	--	--	--	--
Totals:		$15,564,367	$15,257,826	$13,404,870	$12,102,349	$13,102,349	$12,780,909

**   These funds were consolidated into 5911-1000.

FY01-FY05 Impact

In FY02, the account was cut by $1.2 million. Staff reductions absorbed the cut. In FY04, this account was cut another $1.3 million, reflecting the reorganization of EOHHS and the centralization of agency administrative functions.

To accommodate its new reduced administration budget, DMR revised its regional structure. Five regional offices were consolidated into four by combining the Western and Central regions. This combined region acquired the Middlesex West area office. In addition: the Springfield and Westfield areas combined offices; the Southeast region acquired the South Coastal Area office; the Northeast region acquired the Central Middlesex Area office; and Metro Boston now includes the entire city of Boston as well as the Charles River and Newton South-Norfolk area offices. DMR also relocated administrative functions that were at the former Dever Development Center site to the Southeast Regional Office in Carver.

In FY05, $1 million is returned to the account. DMR reports that the allocation is still short $300,000 for FY05 expenses. Overall, DMR's staff has been cut 483 full-time equivalent staff (FTEs) since June 2001, a 6.5% staff reduction.

FY06 Needs

DMR has established the need for an additional $634,690 for this account in FY06. The funds are to cover the chargebacks that EOHHS requires DMR to pay for human resources and other services that have been centralized at the EOHHS central administration office.

H1 for FY06 Recommendations

H1 would reduce this account by $321,440 (2.44%), due to the governor's unemployment reduction.

Account:      Regional Administration

Line Item:   5920-1000

The Regional Administration account funds the operational expenses of regional and area offices, including service coordinators.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5920-1000	Regional Admin.	48,683,630	50,611,983	50,724,936	51,549,675	52,316,518	53,853,237

FY01-FY05 Impact

The FY05 budget underfunds this account by close to $900,000, eliminating 18-20 out of 477 service coordinator positions. Service coordinators play an essential role in connecting individuals to needed resources and in performing risk management functions to protect individuals from harm.

FY06 Needs

DMR has anticipated needs totaling $4.352 million for FY06. These include: $1.15 million for 23 new service coordinator positions due to caseload increases; $1 million to restore the 18-20 service coordinators cut in FY05; $1 million for 20 additional needed administrative positions; $300,000 for investigator positions (4 backfilled and 4 to annualize); and $200,000 for unfunded chargebacks (to pay for centralized services at EOHHS).

H1 for FY06 Recommendations

H1 would improve the funding to this account by $1,536,719 (2.9%). The money will not provide for any new service coordinator positions nor restorations, according to DMR.

Account:      Transportation

Line Item:   5911-2000

The Transportation account funds transportation of people with mental retardation to residential, day and employment programs. By statute, transportation is considered to be an entitlement for individuals placed in a program. In reality, vendors who operate day programs are sometimes asked to transport individuals themselves, or parents are expected to assist with transportation services. DMR transports roughly 6,000 adults to and from day, work, and residential programs daily.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5911-2000	Transport.	25,049,926	23,879,506*	14,708,746**	13,239,367	13,782,367	13,882,296

*    This figure cannot be compared to previous years since the FY03 account consolidation and restructuring transferred some transportation funding to the Day/Work account.

** This figure includes $550,000 that DMR transferred to this account from the $18.848 million discretionary reserve created by the supplemental budget.

FY01-FY05 Impact

Funding for the Transportation account has been eroding for more than 15 years. Unadjusted for inflation, the budget for these services is more than $8 million below funding in FY89.

Between FY01-FY04, account restructuring makes comparisons challenging. Cuts over these years totaled more than $4.7 million, but DMR reports that they managed the reductions through a new collaborative effort with the Office of Medicaid (MassHealth) in which DMR assumes responsibility for the management of transportation at a lower cost. According to the Department, no DMR service participants have been cut from transportation services. Advocates argue that transportation has been underfunded for years and these cuts are compounding already long routes, overcrowding, and serious safety concerns.

In FY05, the governor's proposal to cut the Transportation account by $4.3 million was rejected by the legislature. Services were maintained for the nearly 800 individuals who would have lost them.

FY06 Needs

DMR has identified the need for an additional $99,201 for this account in FY06. The funds would cover the unfunded chargeback increase for human resources and other services that have been provided by EOHHS since the restructuring and centralizing of state agency administrative services.

H1 for FY06 Recommendations

H1 proposes an increase of $99,902 (.7%).

Account:      Residential Community Programs

Line Item:   5920-2000

The Residential Community Programs account funds vendor-operated (i.e., privately run, not state-run) residential programs in the community. On average, a vendor-operated bed in one of these programs costs the state $54,797 per year.

Staff turnover in community residences is high, which adversely affects the quality of care. However, DMR reports that in the latest "State of the States in Developmental Disabilities," a study of the financing and programming trends in the U.S. between 1996-2000 by the University of Colorado, DMR rated high for the number of people living in community settings with 6 or less people and for reducing the number of people with mental retardation and developmental disabilities stuck in nursing homes faster than the national average.

Progress with reducing nursing home placements is due, partly, to the Rolland class-action lawsuit settlement (see the introduction to this chapter for more information on Rolland). In FY02, DMR reports that 175 people were moved to community residential placements and specialized services (e.g., day programming) were provided for more than 900 who remained in nursing homes. Due to this settlement and the need to annualize Turning 22 program participants, this account will grow each year through FY06. In FY02, there were a total of 9,015 people living in community-residential programs (including the state-operated ones funded by line item 5920-2010, see below).

In general, conditions in group homes are eroding. Level funding to providers has resulted in reduced staff and supports. Some providers are closing residences. Boulet funding (see the introduction to this chapter for information on Boulet) continues to develop new residential placements, but this money was never meant to compensate for an eroding base of residential services.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5920-2000	Comm. Residences	353,695,256	376,277,607	422,648,101	452,720,888^^^	476,614,523	499,491,126

^^^  This figure cannot be compared with previous years due to account restructuring.

FY01-FY05 Impact

In FY03 and FY04, this account was restructured, making comparisons with previous years difficult. In FY03, DMR reported that the consolidated account was under-funded by $3 million, but no service reductions would take place. Also in FY03, an $800,000 cut to the Rolland settlement compliance began, causing delayed placements. Meanwhile, the Commonwealth has been found not in compliance with the Rolland settlement due to inadequate funding for social and day/work supports and for supports to cover a person's full medical needs. The case has been in federal appeals court.

In FY04, the account was under-funded by $2.1 million, even after the passage of a supplemental budget. DMR reported that 15 different residential settings closed, terminating 36 beds. The funding amounts give the appearance of a dramatic increase in FY04-this is due to the transfer of funding for individual flexible supports from the Flexible Family Supports account (also called Respite, line item 5920-3000), the needed annualization funds for Turning 22 program participants ($9.52 million) and the Rolland settlement ($8.25 million), as well as funds needed for new Rolland clients ($4.8 million). (See the introduction to this chapter for more information on Rolland.)

In FY05, the FY04 cut of $2.1 million was restored and the governor's proposal to cut $1.2 million for clinical team services was not fully accepted. The good news is tempered, however, by $325,000 in new earmarking. The net effect is that clinical team services may be cut by $600,000 and as a result, some portion of the 2,400 individuals who receive counseling, occupational therapy, and nursing services will see cuts.

FY06 Needs

The Rolland settlement requires an additional $13.25 million ($5 million for new placements and $8.25 million for annualization) in FY06. Turning 22 program participants will require $9.52 million in annualization funds.

H1 for FY06 Recommendations

H1 recommends $22,876,603 above the FY05 funding level. This amount fully funds the Rolland settlement and Turning 22 annualization for FY06, as well as the FY05 salary reserve initiative for vendored direct care workers ($5.7 million).

Account:      Community-Based Residential Services

Line Item:   5920-2010

The Community-Based Residential Services account funds state-operated (i.e., run by DMR staff) residential programs in the community. DMR residential services cost the state about $113,327 per bed, as compared to $54,797 per bed in the vendor-run programs (see line item 5920-2000, above). Note, however, that these figures should not be considered a straight comparison because the vendor rate excludes some costs that are covered in the DMR program. According to DMR, the cost is higher because DMR employees are paid higher salaries, and the DMR-run programs serve individuals with disabilities who are leaving institutions. DMR staff frequently follow individuals who move to these programs from the state institutions. In FY03 there were 987 state-operated community-based beds.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5920-2010	State Residences	99,998,330	110,025,001*	111,238,845**	110,905,005	113,269,640	119,978,807

*     This figure includes $4,267,811 transferred to this account from the $18.848 million discretionary reserve created by the supplemental budget.

** This figure includes $3.4 million transferred to this account from the $7 million supplemental budget. A veto cut $100,000 from this account in FY03.

FY01-FY05 Impact

Funding for Community-Based Residential Services has not kept up with inflation.

In FY04, the account was funded at $333,840 below the FY03 level. Under-funding impacts direct care staffing. The FY03 figure includes $3.4 million transferred to this account from the $7 million supplemental budget.

In FY05, there was modest good news. According to DMR, there is a $427,460 increase to this account which will allow the Department to increase direct care staffing. (The remaining nearly $2 million increase is mostly a transfer from line item 5920-2000.)

FY06 Needs

DMR has identified the need for a $1.787 million increase to this account for FY06. Close to $1 million is for anticipated fuel increases and nearly $800,000 is for additional clinical staffing needs.                                                                                                                                

H1 for FY06 Recommendations

H1 for FY06 recommends $6,709,167 above FY05. Of that, $4.2 million is for collective bargaining increases to the salaries of unionized state employees, and $25,478 is to annualize the FY05 POS salary reserve initiative for the lowest paid direct care workers.

Account:      Boulet Waiting List

Line Item:   5920-2020

The Boulet Waiting List account funds the Boulet lawsuit settlement agreement (see the introduction to this chapter for a fuller explanation of the Boulet class-action lawsuit). Boulet requires new funds, in combination with some base resources, to eradicate the DMR waiting list problem for 2,225 members of this class action suit over 5 years.

The Boulet agreement calls for particular actions in each of the following years:

·       In FY02-$22 million was to be appropriated for residential services to approximately 250 individuals and for interim services to individuals who require residential services but must continue to wait; and an additional $5.97 million in base resources to provide residential supports to another 125 waiting individuals.

·       In FY03-$18 million in new funds was to be appropriated, plus the use of base resources.

·       In FY04, FY05, and FY06-$15 million in additional funds was to be appropriated each year; additionally, $5.37 million of base funds was to be used in FY04 and $6.44 million each was to be used in FY05 and FY06.

·       In FY06-all individuals on the Boulet waiting list are to be served by the close of FY06.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5920-2020	Boulet Wait List	--	15,000,000*	36,500,000	49,500,000	70,000,000	85,614,227

*     These funds were passed in a supplemental budget.

FY01-FY05 Impact

In FY02, the final budget did not fund Boulet, but a supplemental budget passed on the heels of the FY02 budget did allocate $15 million-$7 million short of the settlement agreement's requirement. DMR reports, however, that 375 individuals received residential placements as required by the agreement in FY02 and that interim services were provided to 1,556 individuals.

In FY03, the final budget again under-funded Boulet, this time by $3.5 million. To fully fund the settlement agreement, $25 million in new funds ($7 million to make up for what was missing in FY02 and $18 million to fully fund year 2 of the 5-year plan) was necessary. DMR reports that a total of 400 people did receive residential placements with this funding (and with the agency's base resources) and 1,250 received interim supports. In effect, DMR had to absorb the $3.5 million of under-funding out of its base resources, impacting other programming.

In FY04, the final budget provided $13,000,000 in new funds, $2 million short of the settlement agreement, while doing nothing to correct the under-funding of last year. The under-funding will likely put additional pressure on DMR's base, which ultimately impacts programming. The governor's $1,300,000 veto to this account was overridden.

FY05 brought good news. Full funding is provided for Boulet, a $20.5 million increase over FY04, which is catch up funding to meet the back obligations of prior years, in addition to what is called for in FY05 by the settlement agreement.

FY06 Needs

For FY06, the settlement agreement calls for $15 million in new funds, for a total account allocation of $85 million.

H1 for FY06 Recommendations

H1 would provide $15,614,227 above the FY05 level. It includes full funding for Boulet, $573,120 to annualize the FY05 POS Salary Reserve initiative, and $27,238 for collective bargaining increases for unionized state employees.

Account:      Community Day/Work Programs

Line Item:   5920-2025

The Community Day/Work Programs account funds supported employment programs, sheltered workshops, and other day programs. DMR has encouraged supported employment in the community for individuals with disabilities and is working towards limiting sheltered workshop programs. Supported employment programs provide job search and job skills training as well as life skills training. Persons who receive community-based work programs have found employment in fields such as food service, janitorial services and assembly work. Some program participants have started their own businesses. DMR served 5,346 people with community day and work supports in FY03.

The Community Day/Work Programs account grows each year due to Turning 22 annualization needs (see the introduction to this chapter for an explanation). Account language earmarks $2,720,000 for these young adults.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5920-2025	Day/Work Programs	90,185,163	94,126,063*	104,179,308^	106,451,278	109,171,278	113,106,979

*    This figure includes $3,999,763 transferred to this account from the $18.848 million discretionary reserve created by the supplemental budget.

^    This level of funding cannot be compared to previous years due to the consolidation of funding from the Transportation account.

FY01-FY05 Impact

Between FY03-FY04, this account was cut by roughly $3.5 million (mostly in FY03), impacting more than 250 persons with disabilities. As the ongoing consequence of cuts, individuals receiving day support services are increasingly provided with MassHealth-funded day habilitation services only. According to the Arc of Massachusetts, day services are becoming increasingly difficult to come by. In general, if a person gets services, they're headed for any open slot whether or not it has the supports they need. Providers have been seeking to absorb the cuts to these services by shifting their emphasis to MassHealth-reimbursed day habilitation services only, which have also been hit with MassHealth rate reductions. There have also been disruptions due to problems with transportation contracts.

For FY05, DMR reports that the account is fully funded for the same number of persons as were served in FY04. The legislature rejected the governor's proposal to cut services to nearly 800 individuals.

H1 for FY06 Recommendations

H1 for FY06 recommends $3,935,701 above FY05. Of that, $2,720,000 is for Turning 22 annualization and $1,215,701 is for annualization of the FY05 POS salary reserve initiative for vendored direct care workers.

Account:      Flexible Family Supports

Line Item:   5920-3000

The Flexible Family Supports account funds respite and flexible family support services for individuals receiving DMR services and their families. Services may include providing an in-home caregiver while the primary caregiver is away, out-of-home care for periods as long as a weekend, funds for a family to learn sign language, or an alternative communication device for someone who cannot speak. This account is a key Olmstead initiative and a program that other disabilities agencies are now seeking to replicate.

Advocates say that the Flexible Family Supports program is the single most important source of state-funded services that allow people with severe disabilities to remain in their own homes. Each year, DMR receives referrals of children for these services and there is increased demand as children grow into adolescents.

DMR serves about 14,900 families through this program. Individual supports used to be covered by this line item, but those funds were transferred to the Community Residential account (line item 5920-2000) in FY04. The account grows by $1.36 million each year to meet Turning 22 annualization needs.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5920-3000	Family Supports	50,248,489	51,416,056*	61,739,428^	46,800,000^^	48,800,000	50,789,967

*    This figure includes $1.2 million transferred to this account from the $18.848 million discretionary reserve created by the supplemental budget.

^    This is a consolidated account and cannot be compared directly with previous year's funding.

^^ Funds from this account were consolidated into 5920-2000.

FY01-FY05 Impact

The Flexible Family Supports program has received no increases in 8 years.

Between FY03-FY04, the program suffered approximately $2 million in budget cuts ($1.8 million in FY03 alone). The FY03 cut reduced support to each family by 5%.

In FY05, the final budget restored $620,000 of the $2 million cut to this program.

FY06 Needs

Advocates are seeking an additional $4.5 million in FY06 to provide services for as many as 1,000 more families, including many with autism spectrum disorders. Their proposal includes approximately $300,000 for the administration of a new autism division at DMR. The Arc notes that many families have young children who have aged out of Early Intervention services and that there continue to be adults living with families who require family assistance.

H1 for FY06 Recommendations

H1 would provide $1,989,967 more than the FY05 funding level. Of that, $1,360,000 is for Turning 22 annualization and $629,967 funds the FY05 salary reserve initiative to the lowest paid vendored direct care workers.

Account:      Turning 22 (T22) Community Services

Line Item:   5920-5000

The Turning 22 (T22) Community Services account funds services to persons with mental retardation and related disabilities who turn 22 and therefore age out of special education services. When an individual begins to receive services funded through this account, that person will be served for the remainder of the fiscal year in which she or he turned 22. The following year, annualization funds are necessary to provide for the full year of services-these are earmarked and spread out among the service accounts.

Massachusetts's Turning Twenty-Two Law mandates that an Individual Transition Plan (ITP) be developed for each person turning 22, to ease their transition into the adult services system for people with disabilities. However, the services dictated by such plans remained subject to appropriation for many years. Until 1999, DMR had been able to serve only about 150 of the most severely disabled out of the approximately 400 young people who turn 22 each year, leaving the remaining 250 individuals to join the long DMR waiting list. FY99 was the first year of full funding to the program, effectively stemming the growth of the waiting list.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5920-5000	Turning 22	6,950,000	6,467,670	6,467,670	6,467,670	6,467,670	6,467,670

FY01-FY05 Impact

Since FY02, this account has been under-funded by $482,330. A total of $6.95 million is needed to provide $4.4 million for services to the 160 most needy individuals, and $2.55 million to provide at least a day program to the remaining 290 people who would otherwise join the waiting list. The number of Turning 22 students has increased to approximately 450 annually. DMR reports that it has absorbed this cut by delaying placements. Line item language permits the funds to annualize to $13.6 million.

In FY05, the account was level-funded once again. Delayed placements continue to be the norm.

FY06 Needs

DMR has established the need for $7.467 million to this account for FY06, including $1.2 million for day and employment services.

H1 for FY06 Recommendations

H1 for FY06 recommends level funding only.

Account:      Facilities

Line Item:   5930-1000

The Facilities account funds the operation and management of the remaining 6 developmental centers, known archaically as state schools: Glavin; Monson; Templeton; Hogan; Wrentham; and Fernald. So far the state has closed 3 institutions: Belchertown (in 1992); Berry Rehabilitation Center (in 1995); and Dever (in 2002). In FY05, 1,077 individuals remain in the 6 institutions, down from 2,643 in FY92. DMR allows a handful of admissions each year, usually residents from other institutions or patients requiring short-term care.

In FY04, the governor called for the closure of Fernald, sparking families to protest (see the introduction to this chapter for more details). The state plan now is to maintain a 65-bed skilled nursing facility (Greene Building), and allow 24 residents to live at Malone Park (a Fernald cul-de-sac). The Shriver Center and the Adaptive Design Center would remain as well. Meanwhile, 65 residents would be transferred to other institutions; 80 would go to new state-operated community programs; and 25 would move to existing state-operated programs.

Line Item	Description	FY01	FY02	FY03	FY04	FY05	H1 for FY06
5930-1000	Facilities	164,767,603	171,839,637*	165,581,181***	164,461,641^^^	160,220,259	166,072,065

*     Includes $6,988,247 transferred to this account from the $18.848 million discretionary reserve created by the supplemental appropriation.

*** Includes $3.6 million from the $7 million FY03 supplemental appropriation.

^^^  Includes an $800,000 supplemental appropriation.

FY01-FY05 Impact

Funding for the Facilities account has declined annually, as has the population within the centers. Fernald families contend that funding cuts have eroded services and led to deteriorating conditions. DMR has reported that cuts have been managed through the consolidation of buildings and units and through transfers and community placements.

In FY05, the account is again below maintenance. DMR reports that the shortfall is $5 million and that the reduction again will be managed by a declining census.

FY06 Needs

Most advocates for people with developmental disabilities support the closure of the state facilities. They are seeking the closure of the state facilities and call for the money supporting each resident to follow that person into the community.

H1 for FY06 Recommendations

H1 for FY06 provides $5,851,806 above FY05. Of that, $4,526,455 is collective bargaining for state employee unions and $71,387 is to annualize the FY05 POS Salary Reserve initiative for the lowest paid vendored direct care workers.