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Committee’s recommendation on STS is no Christmas present

December 29, 2011

On December 20, the Connecticut Legislature’s Program Review and Investigations Committee issued a report recommending against closing the Southbury Training School.

That would seem at first blush to be a great Christmas present to STS residents and their families and guardians.  But the Committee report also recommended that last year’s Messier v. STS settlement, which established a process to move STS residents to community-based group homes, be “vigorously implemented.” 

The report stated that vigorously implementing the Messier settlement “seems a more humane, less litigious, and less costly option” than outright closure of STS.  The problem is that vigorous implementation of the Messier settlement may well lead to the same outcome — the closure of STS. 

We believe keeping STS open to its current residents and, moreover, allowing it to accept additional residents waiting for care, would be a real Christmas present, not only to the current residents but to clients throughout the Department of Developmental Services system.

We’ll have more to say about that idea in coming posts.  Right now, we’d like to explain why the recommendation to empty out STS via the Messier settlement is the wrong way to go. 

First, STS families and guardians were named as plaintiffs in the Messier case against their wishes and were not involved in the settlement.  Under the guise of benefiting the families and residents, the  settlement was actually written to transfer out the people remaining at STS as quickly as possible.

The primary plaintiff in the Messier case was the Arc of Connecticut, many of whose members are DDS-funded providers.  Those providers stand to gain financially from the closure of STS.  The Arc that took a lead role in negotiating the settlement.

Moreover, there was no need for the Program Review Committee to suggest that DDS Commissioner Terrence  Macy be vigorous in implementing the settlement.  Macy, a former group home provider executive, told legislators last spring that he wanted to move STS residents to private group homes in order to help improve the financial outlook for the provider industry. 

DDS has given every indication, starting well before the Program Review Committee report was issued, that they were moving vigorously to transfer people out of STS.  As the Program Review Committee noted, DDS has been bringing in providers in the past several months to meet with STS residents.  The department also signed contracts for two private group homes to house eight STS residents and found vacancies in existing group homes for 10 other residents, the report stated.  DDS also plans to open a state-operated group home in next spring for another five residents.

One of the more troublesome features of the Messier settlement is its apparently contradictory language regarding the rights of guardians to make their own choices in how and where their loved ones are cared for.  The settlement states:

It is recognized that the ultimate decision about residence rests with the guardian unless the department believes that this legal representative is not making decisions in the best interest of the class member.  (my emphasis)

In other words, the ultimate decision about residence rests with the guardian unless DDS decides that the ultimate decision doesn’t rest with the guardian.  Not only is this language self-contradictory on its face, it may violate the federal Developmental Disabilities Assistance and Bill of Rights Act (a.k.a. the “DD Act”), which states that:

Individuals with developmental disabilities and their families are the primary decisionmakers regarding the services and supports such individuals and their families receive, including regarding choosing where the individuals live from available options,… [42 U.S.C. § 15001 (c)(3)] (my emphasis)

That’s the way it should be, as family members overwhelmingly have no motives other than acting in the best interest of their loved ones in DDS care.   Note that the DD Act doesn’t say that individuals and their families are the primary decision makers unless someone in the federal government decides they are not acting in their own best interest.

We think legislation may be needed at the state level affirming that any family member or guardian who selects STS as a preferred placement option for their loved one shall be presumed to be acting in that resident’s best interest.

In its final report, the Program Review Committee also reiterated its  preliminary finding from September that STS is more than twice as expensive to operate per client as the private community-based group home system.  While this finding is being used by the Committee to support its recommendation to implement the Messier decision vigorously,  we wrote to the Committee earlier this month to state that it was failing to take into account the cost to community-based clients of a range of medical, dental, and therapeutic services that are provided at STS.  When these services are provided in the community, the funding often comes from sources other than the DDS budget. 

In our letter to the Committee, we maintained that a comparative analysis of services at STS and in the community must be done in order to determine whether there will really be equal or better care in  transferring STS residents to privatized group homes and whether any money will really be saved.   In its final report, the Committee stated that it had “hoped to compare health services provided to DDS clients in the various residential settings.”   However, the Committee “was unable to do so,” the report stated, “because it could not access comprehensive health care information for the DDS clients.”

The Committee did acknowledge in its report that dental care is less available to residents of private group homes than to residents at STS because of the difficulty of finding dentists in the community who will treat Medicaid DDS clients.  Nearly 40 percent of DDS clients in community-based group homes had no record of Medicaid dental payments, according to the report.

The Committee also acknowledged that some of the cost of health care for direct-care workers in private group homes is apparently shifted from DDS to the state’s Medicaid budget.

In addition, the Committee  discussed the problem in the community system of a waiting list of nearly 1,000 persons for care and residential services.  The number of individuals on that list increased by 13 percent between Fiscal Years 2009 and 2011.  What the Committee didn’t mention is that transferring STS residents to group homes will mean that disabled individuals on the waiting list will have to wait that much longer for placements.

Admissions to STS have been closed since the 1980s.  In the final analysis, keeping STS open and admitting new residents would both alleviate the waiting list problem and lower the per-resident cost of care there.

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3 Comments
  1. Thank you for continuing to express in such an eloquent way the concerns that face guardians of STS residents. I appreciate your sharing what you learn about happenings in Connecticut with regard to STS.

  2. Rose Petruzzi permalink

    I am always amazed how DDS and the legislators do not have a vision for the life-cycle of developmentally disabled individuals. How many individuals are now in the process of being “dumped” or conveniently ignored by the system and left to twist in the wind? Unfortunately I also hear this scenario for the now, young adults in the community who have pioneered “mainstreaming” and now have no where to go, with no or few peers, and are hungry to continue their individual explorations of “life”.

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