November 8, 2013

The Honorable Stephen M. Brewer, Chair
Senate Committee on Ways and Means
State House, Room 212
Boston, MA 02133

The Honorable Brian S. Dempsey, Chair
House Committee on Ways and Means
State House, Room 243
Boston, MA 02133

Dear Chairman Brewer and Chairman Dempsey:

Line item 5920-5000 of Chapter 139 of the Acts of 2013 requires the Department of Developmental Services (DDS) to submit an annual report to the House and Senate Committees on Ways and Means on the projected use of funds encumbered or expended for the “Turning 22” program. 

Chapter 688 (better known as the “Turning 22” law) was enacted in 1984 to provide a planning process for young adults with severe disabilities as they leave special education and transition into the adult service system. Each year, DDS transitions hundreds of young people into the Department’s adult service system. One of the Department’s most significant challenges is to continually meet the needs of these young people coming to DDS from Special Education when their school entitlement services end. 

Figure 1 displays the number of individuals leaving Special Education and entering DDS services since Fiscal Year (FY) 1998. As noted in the chart, there have been steady increases in the number of “graduates” each year.  Historically, there has been a cumulative increase of students seeking DDS supports from the previous year. In FY14, this figure increased to 73 students, partly due to the continued trend and also to the slight revision to the Department’s eligibility criteria. In addition, the Department is experiencing a higher number of individuals with complex clinical profiles who have intensive support needs due to medical or behavioral challenges.

Figure 1
DDS Turning 22 Census by Fiscal Year

Figure 2 displays the annualized legislative appropriation for the 731 cohort of students who entered the DDS system in FY13. It is important to note that the line item 5920-5000 Turning 22 account no longer funds the annualization of services provided to the Turning 22 population as it did in prior years.

Figure 2
Legislative Annual Appropriation for the FY13 Class
 
Figure 3 represents spending from FY10 and onward as this appropriation only accounts for the first year of funding for services for some of the members of the Turning 22 class and it does not account for the funding necessary to annualize these services. The FY14 appropriation for line-item 5920-5000 was $6.5 million, an increase of $500,000 from the previous year.

Figure 3
5920-5000 Legislative 1st Year Appropriation

For FY14, DDS has identified 804 young people eligible for Turning 22 services. Line-item 5920-5000, the Turning 22 account, supplemented the cost to serve 240 young people who were identified as needing some Community Based Residential Services as they leave special education gradually over the course of this fiscal year. DDS allocated almost $6 million for their first year residential supports in a wide range of living arrangements in their community including small individual settings and group living situations. State and private vendors contracted with the Commonwealth to manage these services. Appropriate vocational and transportation services are also arranged for this group.

Figure 4 presents the number of those individuals receiving Community Based Residential Services by region.

Figure 4
DDS 5920-5000 Residential Census
REGION	Central/West	Metro Boston	Northeast	Southeast	TOTAL	
#	64	63	60	53	240	

As for the remaining 564 students, FY14 continues to be a challenging year to serve those living at home as they enter the DDS system. Figure 5 represents the remaining number of FY14 Turning 22 students by DDS region. Approximately $148,800 from line-item 5920-5000 was allocated by DDS to supplement the day supports for 23 “medically complex” individuals who are living at home and require special services.  The balance of the account (approximately $450,000) was appropriated to serve 541 individuals who are also living at home to supplement their day supports. This is in alignment with the Department’s Employment First Policy to expand work opportunities for the individuals we support. Other individuals availed themselves of their entitlement to MassHealth state plan services, such as day habilitation.

Figure 5
REGION	Central/West	Metro Boston	Northeast	Southeast	TOTAL	
#	216	120	125	103	564	
In addition to the data presented in this report, please note that the Department will be changing the array of services that will be available for the upcoming T22 class in recognition of the importance and positive impact work has on the lives of the people we support.  As a result, a major focus has been put on sustaining career paths for individuals turning 22. 

Previously, some individuals received services in our sheltered workshop model where they work in a secluded worksite, and individuals are not integrated into the working community with non-disabled people.  In alignment with the Patrick Administration’s Employment First initiative to expand work opportunities for individuals with disabilities, the Department believes the continued use of the sheltered workshop model does not serve the best interests of the individuals we support.  In that regard, this year, the Department has engaged with stakeholders in a planning process to gradually phase out this option for those turning 22 and as of January 2014, we will no longer be making referrals to sheltered workshop programs.