DMR going down the same old (expensive) road

Getting the word out (6.00 / 4)

The fact that the state will be paying $2 million or more per group home under the DMR's leasing plan as outlined above is apparently not of any interest to the MSM.  Last week, the Fernald League and COFAR sent a joint press release to the AP, The Globe, The Herald, most of the state's other daily newspapers, and several TV and radio media outlets, disclosing DMR's latest leasing scheme.  No one ran a word about it.  Posting on Internet sites such as BMG is the only way to get the word out on this.

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by: Dave from Hvad @ Mon Dec 01, 2008 at 08:22:30 AM CST

Divide the burden (0.00 / 0)

I would like to offer an urban perspective on this.

If the state takes a "cost only" approach to group homes, the end-result will be that group homes will be concentrated in the poorest communities and neighborhoods in this state.

Why? Because if an agency has $400k to spend on a residence, they aren't going to spend it in a community where a 1,000 s.f. ranch sells for $400k. They will spend it in a lower-income community where they can buy 5,000 s.f. for their $400k. And they can crow about "centralized services" to boot.

Group homes are necessary, but are also a drag on neighborhoods. The activity of the group home is not the problem -- the presence of the group home is the problem. I have seen streets with multiple group homes on them. They are less desirable than streets with zero or one group homes on them.

I hope that the state realizes that group homes should not be concentrated, even if that means spending more money to site them in a more diverse set of neighborhoods. It is not about "wasted taxpayer money" -- it is about dividing the burden more equitably.  

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by: NoPolitician @ Mon Dec 01, 2008 at 13:16:37 PM CST

What makes them a drag on the neighborhoods? n/t (0.00 / 0)

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by: LynPB @ Mon Dec 01, 2008 at 13:21:59 PM CST

[ Parent ]

Why they are a drag (0.00 / 0)

Two things: direct impacts and indirect public opinion.

I know of one street in Springfield where there are 6-7 group homes for recovering drug users (all owned and operated by the same organization). People from these homes wander the streets aimlessly all day and night. The people are harmless, but it is a seriously creepy street to be on. Because of those concentrated group homes, owner-occupants do not want to buy on that street. They don't want to live near that nuisance. The surrounding houses have become run-down because they are owned by absentee landlords. That is a clear direct impact of concentrated group homes.

There is also a general fear of group homes. I will agree that the fear is usually not rational, however, when you have the chance to buy a house on a street that has a group home for recently released felons, and one without such a group home, which would you pick? People are not usually familiar with the type of group home either, so in their mind a group home for people with a benign mental disability is the same as one for troubled teens or ex-criminals.

The current policies basically guarantee that certain communities (poorer urban areas) will have a lot of group homes, and others (wealthier suburban areas) will not have very many, if any. That is just another negative selling point for the poorer urban areas, and another reason for people to self-segregate into wealthier communities.

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by: NoPolitician @ Mon Dec 01, 2008 at 15:24:45 PM CST

[ Parent ]

Thought we were talking about group homes for people with MR (0.00 / 0)

DMR will not let providers site homes in an area if there are already homes that are funded through DMR or DMH.

The real barrier to siting homes in wealthy communities is the cost of housing which I think is the point you are trying to make.

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by: LynPB @ Mon Dec 01, 2008 at 15:43:58 PM CST

[ Parent ]

Yes (0.00 / 0)

That is my exact point -- by focusing on "cost", the end result is concentration, and concentration of group homes is seen as another undesirable facet of an urban area.

I'm glad to hear that DMR does not site homes near other DMR homes, but there are a lot of different group homes out there, and they are all trying to maximize their dollars.

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by: NoPolitician @ Mon Dec 01, 2008 at 15:58:23 PM CST

[ Parent ]

There are a couple of separate issues here (0.00 / 0)

We're not saying that the state should build cheap homes.  On the contrary, they should be as well-built as possible.  The problem is the 20-year lease-back arrangement, which greatly adds to the expense of the home, no matter how it's built.  The fact that these homes will each cost the state $2 million or more is not a function of how well built they are, but of the inappropriate 20-year leasing arrangement.  DMR simply does not want to pay up front for these homes. The arrangement is good for the developers, though, who can seek financing from the state to build the homes from sources such as the Mass. Housing Finance Agency.  They can, in effect, make a profit in building the homes without risking any of their own capital.  It's a good deal for the developers and a bad deal for taxpayers.

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by: Dave from Hvad @ Tue Dec 02, 2008 at 08:05:07 AM CST

[ Parent ]

Group homes not a drag/ not an advantage for people with severe-profoundl MR (6.00 / 3)

Disclosure: I work for COFAR, a coalition which includes teh Fernald League.

In response to the problem of locating group homes, it is well to remember that we are talking about state-operated group homes, so these are serving people who are typically more disabled than other DMR residents. They often do not speak or walk -- neighbors will not see a lot of them unless they visit. The homes are employers, and these are good jobs in remote areas that need jobs.

In terms of Dave's main point, that the taxpayers are being tricked with a shell game that first blames the most vulnerable disabled people served by the Commonwealth for high spending at developmental centers like Fernald, then hides the price of relocating them by offshoring the construction costs, handing can't-lose contracts to favored non-profit providers -- well, this is part of an ideology that "decentralized" means "community integration."

For tens of thousands of people with mild-to-moderate MR/DD, that has been true and terrific; for the minority (perhaps 8-10 percent) of DMR clients who are much more disabled, the trade-off is really debateable. From the group homes, they have more trips to the mall and the movies, but transportation is a nexus of abuse and neglect -- because many of the drivers are much less screened and trained. On the other side, they lose the concentration of theraputic resources -- on-site medical, physical therapy, occupational therapy, library of adaptive technology, full swimming pool, etc. -- of the Developmental center, as well as the safety of secure treatment by familiar people. The more atomized and decentralized and privatized the system of care becomes, the less people with limited communication are well-known to their caregivers.

--Moe

--Moe

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by: Moe @ Mon Dec 01, 2008 at 13:42:56 PM CST

I couldn't disagree more (5.67 / 3)

I don't think we should discriminate based on a person's level of disability. I think all people benefit from living in the community.

I have been in the field for 20 years. I provide services to some very disabled individuals, some who used to live in institutions. If they could talk they would tell you that they much preferred living in the community. We recently had a 20 year anniversary at one of our homes. All of the parents who had been very reluctant to let their children leave institutions were talking about how glad they were that they made the choice they did. (Some of the same staff that welcomed them 20 years ago were still working and helping at the party.)

In addition to it being a plus for the person with disabilities, it is also a plus for the public. We opened a house in a neighborhood several years ago that serves five individuals with profound MR. Before we moved in, the neighbors were scared and angry. They didn't want "those" people in the neighborhood. They said "those" kind of people should be kept in places like Fernald. After a few months they couldn't be happier that we were there. They brought over cookies for Christmas.

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by: LynPB @ Mon Dec 01, 2008 at 15:37:17 PM CST

[ Parent ]

DMR going down the same old road (6.00 / 2)

I don't know if I agree or not with the "drag" argument.  I DO know that the perception of group homes is negative.  An individual I know heard a RUMOR that a house in their neighborhood might be purchased by a "group home organization" and the entire neighborhood was up in arms and contacting their town officials protesting.  And it was just a rumor.

I can see no logic in the states position.  Given the economy--all you hear every day from every avenue of the media is how the state is in financial trouble--so they decide the thing to do is close a facility that is more than adequately servicing the needs of its residence to build homes they will never own!  In the case of Fernald there is definitely room for compromise--ITS TIME FOR THE LETS WORK TOGETHER GOVERNOR TO RE-EVALUATE HIS PLAN AND WORK WITH THE RESIDENTS OF FERNALD ON A SOLUTION. Had the state been willing to discuss alternatives back when the battle started four years ago, they could have already sold the vast majority of this land--at $1 million an acre--and refilled the state coffers with approximately $150+ million.  How come no one is up in arms about this missed opportunity that makes sense for all?  I wonder how much taxpayer money has been spent on the legal battle to get this land-it is their only real interest here.  Logic?????

As for the individual who has worked with the disabled for 20 years, you of all people, should know that each of these individuals are unique.  What is good for one is not necessarily good for another.  You used the phrase "should be kept in places like Fernald".  FERNALD IS A COMMUNITY.  My brother lives at Fernald.  The reality is, he lives in a "group home" on the Fernald grounds.  Its a cottage type building with 7 residence who have been together for more then 25 years--a family.  Their care givers have been with them for more than 20 years--more than just caregivers.  They have their bedrooms, livingroom, kitchen, backyard in a "neighborhood" of similar cottages.  The ONLY difference is the community is Fernald. My brother participates in day programs, work programs, has ready access medical facilities, therapeutic facilities, activity centers and church. It affords my brother the closest thing to a
"normal existence-whatever that is" in a secure-protected environment that is critical to his needs.

 

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by: ssurette @ Mon Dec 01, 2008 at 21:22:03 PM CST

[ Parent ]

Simplistic (0.00 / 0)

LynnPB,

The people who left Fernald twenty years ago were among the "cream of the crop": - they were relatively high functioning and can not only survive, but thrive in a group home.  The people who are currently living at Fernald are the multiply handicapped; the profoundly impaired, physically, mentally and often dually diagnosed.  These are people who need centralized service delivery for their medical needs - physical therapy, respiratory therapy, OT, Adapt, Psych - and on and on.  These intensive needs cannot be met in an isolated group home - away from their clinical service providers.

Published in the AJMR, a follow up investigation by Dr. David Straus revealed that his previous study on the deinstitutionalization movement in California had an even higher body count that previously understood.

Note: Shavelle, Robert & David Strauss. Mortality of persons with developmental disabilities after transfer into community care: a 1996 update. AJMR, 1999, 104(2), 143-147

What the study determined was that non-ambulatory, non-verbal and incontinent patients were 72% (and higher, in some settings) more likely to die once they were removed from their service delivery center and residence.  These are the people who live at Fernald now.  

You may tell all the kumbaya stories you'd like, the fact remains that the people who currently live at Fernald are at a significant risk if they are shoehorned into inappropriate placements - ie, a non-central service delivery setting.  

"The world was made for people who aren't cursed with self-awareness." ~Annie Savoy, Bull Durham

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by: Justice4All @ Wed Dec 03, 2008 at 13:00:47 PM CST

[ Parent ]

Justice4All, Don't insult me. (0.00 / 0)

I know who lives at Fernald. I know the clients I serve. They are not that different. I work with clients who came out of Fernald 20 years ago, 10 years ago, and 5 years ago. People should not be discriminated against because of their level of disability.

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by: LynPB @ Wed Dec 03, 2008 at 18:53:43 PM CST

[ Parent ]

Would not be able to tell the difference... (0.00 / 0)

If you met some of the people in the group homes I run and people who live in the cottages at Fernald you would not be able to pick out who lived where.

I don't think there is a good argument that some people have to live in segregrated institutions because of their level of disabilty.

The argument that makes more sense to me has to do with breaking up groups of people who have lived together forever. I know one group of seven individuals who have lived together for over 20 years. Their families are willing for them to leave Fernald if they can move together. However DMR regs state that you can't have more than 4 people in a group home with two exceptions; 1)you can get a waiver to increase the census to 5 per group home or 2) there are 8 person homes that folks who came out in 1985 and moved into ICF/MRs live in. DMR has to figure out a way to let those groups live together in the community.

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by: LynPB @ Wed Dec 03, 2008 at 19:08:03 PM CST

[ Parent ]

Forget it Lyn (0.00 / 0)

 Our feel good liberals don't want to talk about it. Maybe if they ignore us we'll go away. Gimps and 'tards are supposed to sit in a corner and be overjoyed with the fact that these social Darwinists are letting us breathe their "clean" air.
Got news for you backslapping liberals: I'm not going anywhere.
I have asked this question before and never received a reply. How many wheelchairs were on the floor of Your all-encompassing Democratic State Convention in Worcester? I will now accept no response as ZERO. If you're gonna talk the talk, at least accept the fact that you're all abunch of do-nothing chickens**ts.  

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by: billxi @ Wed Dec 03, 2008 at 19:47:20 PM CST

[ Parent ]

You wouldn't be happy just sitting with the other wheelchair users ;) (0.00 / 0)

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by: LynPB @ Wed Dec 03, 2008 at 20:09:26 PM CST

[ Parent ]

EXACTLY (0.00 / 0)

 I prefer the term "morthanable". The dis prefix is in itself prejudicial. I will never cease in my efforts for "equal" rights.

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by: billxi @ Wed Dec 03, 2008 at 22:37:43 PM CST

[ Parent ]

Not Discrimination (0.00 / 0)

and your words indicate your bias, Lyn.  This should not be an "all or nothing" equation.  People who need centralized service delivery should have it and those who don't - who can thrive in the community, can and should live in group homes.  This is only common sense; people who need centralized service delivery live in congregate living setting all the time - except we call them universities, assisted living facilities, and over-55 communities.  It's funny how it's only "discrimination" when a vendor op says it is.

So please, don't insult my intelligence, not when I've been in the trenches fighting to maintain services that have been watered down after people leave the facility.  Yeah - that's what vendors do to improve the bottom line.  

Another thing, Lyn, is the extremely high turnover rate in the vendor ops, which put multiply handicapped people at risk.  There is far more stability in state ops, group homes or facilities.    


"The world was made for people who aren't cursed with self-awareness." ~Annie Savoy, Bull Durham

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by: Justice4All @ Thu Dec 04, 2008 at 07:46:35 AM CST

[ Parent ]

There are very few people left at Fernald who may need a centralized delivery service n/t (0.00 / 0)

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by: LynPB @ Thu Dec 04, 2008 at 09:26:47 AM CST

[ Parent ]

That's a lie (0.00 / 0)

I was there just a week ago.  There was a huge Thanksgiving Dinner at the Activity Center, held just after Mass at the Chapel - all wonderful events, and very well attended...just like in the "community." Families and friends, all gathered around.  The food was prepared by family members and about 175 were fed.  

BTW, I am very familiar with both the residents and the staff.  I would estimate that of the current population that maybe 10-15% would NOT need centralized service delivery.  

From the Boston Globe:
http://www.boston.com/news/glo...

Faced with a human services dilemma, the Patrick administration is ducking the issue and whining instead that a federal judge has no business intervening in a state matter. If anyone has a right to intervene, however, it would be Tauro, who monitored Fernald for decades. The real issue is the wisdom of allowing mentally retarded residents, including many with complex medical problems, to remain in the only home they know and receive the consistent services they need from a staff that includes on-site doctors. This is a question of common decency, not states' rights. And the right answer is to leave Fernald residents in place and in peace.

And the editorial's advice to Mr. Patrick:

Elin Howe , the incoming mental retardation commissioner, should be crafting a solution that makes economic and therapeutic sense. Meanwhile, the Patrick administration should stop sparring with a judge whose rulings are consistently in the best interest of Fernald residents

and yet...he has fought on, full speed ahead, body count be damned!  Blessedly, it ain't over till the fat lady sings.  

and Lyn - you are right that group hopes are the right place for most people with MR/DD.  But you really do need to lose the cookie cutter, one-size fits all mentality if you ever want to be taken seriously on this issue.

Most advocates for the mentally retarded argue that home-based services or group homes for people with intellectual or developmental disabilities are more dignified and less expensive than institutions. They are absolutely correct when it comes to the great majority of the 32,000 people served by the Mental Retardation department. The fervor of the deinstitutionalization cause, however, should not outweigh the individual knowledge of Fernald families. And general cost comparisons aren't much help when looking at an overall population that includes mildly retarded people capable of holding jobs as well as elderly people who need feeding tubes and constant care to survive.

These issues are not merely an academic exercise for the families of profoundly disabled people.  So, while the academics, the vendors (who stand to gain substantially with the closure) and other assorted "stakeholders" push to close these facilities - they get to put their pencils in their desks and go home at the end of the day....while the families will have to do whatever it takes to protect their loved ones.

Disclosure: My sister, Lyn - weighed 65 lbs on a good day.  She was non-ambulatory and non-verbal; she was oxygen dependent and had a trach and a feeding tube.  She needed 24 hour nursing care.  She was placed for a short time in a group home, and she nearly died, because her medical needs were not being met.  

"The world was made for people who aren't cursed with self-awareness." ~Annie Savoy, Bull Durham

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by: Justice4All @ Thu Dec 04, 2008 at 13:04:20 PM CST

[ Parent ]

Limitations of Research (0.00 / 0)

What you write, LynPB, isn't wrong for the people and families you know. And research supports that most of the people who left the institutions, including people with profound or severe MR/DD to the extent that they can communicate -- like where they are now.

The problems with applying this to everyone are the problems with both the research and using your experience. One size does not in fact fit all, and the remaining people at Fernald and the other developmental centers like where they are now. They have had more than 35 years to leave for the community-based system, and have preferred not to, as is their legal right. It is pure speculation that they would have been happier had they moved like the others. They may well be the minority of people who prefer the safety, familiarity, and concentrated resources of the much-reformed facilities -- often as involved in the surrounding communities as the state-operated group homes that are the likliest alternative.

One thing we do know is that people with brain illnesses of all kinds do not like change. So it is intrinsically bad to move them, more so when they are old, fragile, and set in their ways. If it has to happen, there are protocols to make it work, but they are painstaking and expensive.

Last year I had an impromptu tour of one of the state-operated group homes built on the campus of the Glavin Center, which makes it not unlike the idea of the Postage-stamp Fernald reform. The woman (early middle age) who took us around had been a Glavin resident. She was articulate and liked her new home, and since it was on the Glavin campus, she could still see her old friends. She was apparently less disabled than one of her housemates -- who was mutely in a wheelchair parked in front of a TV -- but this might well have been the case a few hundred yards away in the facility.

My guess is that she would have expressed satisfaction had she not moved. She was a positive kind of person. I'm sure her family prefers the new house, it's new, nicely equipped, with lively young staff, and its own van port and walk-in bathtubs should this woman become more disabled as she ages.

But how does moving a few hundred yards from a large motel-like designed ward to a group home in a row of group homes -- really constitute a move to the community?

This is where research, by averaging the opininions of a lot of people, loses track of the differences of individuals. And the real essence of settings.

This is also where your experience of a good group home can be misleading, because there are now some very good developmental centers, and we all know there are some very poorly run group homes. And the high-risk area of the whole system, in terms of complaints of abuse, is transportation, which is a daily experience for group home residents. Less so for facility residents

The current budget and additional cuts of October have really slammed the facilities budget Massachusetts, as if to make fully true what has been claimed in the past. So people who are forced to move now may prefer their new homes, where they wouldn't have a year ago.

--Moe

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by: Moe @ Fri Dec 12, 2008 at 01:01:10 AM CST

[ Parent ]

Concentration (0.00 / 0)

Why does "community integration" only apply to poorer communities?

Here is an example of a group home that I wouldn't want to live near, on Parkwood St. in Springfield:

Behavioral Treatment Residences - are campus or community-based models that can provide staff secure treatment for children with serious emotional, developmental, cognitive and behavioral disorders who do not require an educational placement in an on-site school. These programs are designed to support the education of these children in a community school. Many, but not all, of these children will be eligible for special education services.

Parkwood street also has the Gandara Parkwood Group Home. Gandara offers "Mental health and substance abuse services".

That street was also eyed for a group home from the Hampden County Sheriff, a home that would be to transition inmates back to living in society. I don't know if that one went through.

There are just 13 houses on that street, all very densely spaced. Do you think that the average person would buy a house on a street with three such group homes on it? What about buying on a street adjacent to one that has three such group homes on it?

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by: NoPolitician @ Mon Dec 01, 2008 at 15:54:14 PM CST

[ Parent ]

YO MASSACHUSETTS! (0.00 / 0)

 To much the dismay of you social Darwinists out there, and I don't care who I offend. Disabled people, physical and mental, are not vegetables. We won't just wither and die like you'd want us to. You can't just stick us in a corner until we expire.
About group homes: they tend to be the nicest looking property in the neighborhood. I volunteered at one. Very nice guys, regardless of mental capacity.
As for the buffoons who worry about the group home residents: I think it is time to do some self-examination. Are you really concerned about them? Or you're just prejudiced and don't want "those kind" living near you.
As to purchasing a $400,000 residence: No problem. The neighbors won't let you. They don't want "those kind"
(again, my apology for the redundancy) living in their neighborhood. Remind you of anybody? Yourself?
A better idea here: Lets stop talking and start building!I really don't need one more hack telling me about an eight year waiting list for affordable/accessible housing.

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by: billxi @ Wed Dec 03, 2008 at 11:43:51 AM CST