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MNA opposes state plan to close four developmental centers

The MNA, which represents registered nurses and health professionals who provide clinical care to the clients, residents and patients at state-operated health care facilities, joined with Coalition of Families and Advocates for the Retarded (COFAR), in registering strong opposition to the Patrick administration’s plan to close four of the six developmental centers serving the most vulnerable citizens in the commonwealth.

The Patrick administration announced last month it would close the Fernald Developmental Center in Waltham, the Glavin Regional Center in Shrewsbury, the Monson Developmental Center in Palmer and the Templeton Developmental Center in Baldwinville. The Wrentham Developmental Center and the Hogan Regional Center in Hathorne will remain open.

About 900 people live in the six institutions. The Department of Mental Retardation said about 316 people – including 180 who live at the Fernald facility in Waltham – will be transferred to community settings or one of two remaining state institutions during the next four years.

The facilities provide a wide range of medical, dental and psychiatric services to the residents, as well as physical, respiratory and occupational therapy services, speech and communications services, and adaptive technologies, such as wheelchairs retrofitted with switching devices.

"These residents are the most severely and profoundly disabled in the state. Many are on respirators and have a variety of severe medical problems in addition to their mental disabilities. If one doesn’t take into account the actual makeup of the population at these facilities, one might assume the residents could be cared for in the community. But that is not who these people are," said Michael D’Intinosanto, RN chair of the MNA Unit 7 and a nurse at the Templeton Developmental Center. "These individuals will be unable to find employment opportunities or enjoy the community living experience without high levels of support. To misrepresent who these people are and what they truly need is not only bad policy, it is life threatening. And the assumption that most, if not all, of these residents could be moved out into the community is a false and dangerous one."

D’Intinosanto added, "We are also concerned that the closing of these facilities will create a shortage of beds for severely disabled residents who made need this high level of care in the future."

"This is an unacceptable attack on the minority of people with MR/DD who are the most disabled, medically fragile, and behaviorally complicated—the most in need of state supports," said COFAR Executive Director Colleen M. Lutkevich. "It violates the spirit of the 1993 court settlement, the Supreme Court’s Olmstead decision, and HHS Secretary JudyAnn Bigby’s personal promise a year ago to Fernald families that their loved ones could move to another facility, and if they did so would not be forced to move again. By guaranteeing the future of only one facility, in the Southeast corner of the state, Governor Patrick has denied many families any meaningful choice. A safe placement too far to visit, versus a riskier one closer to home is not a full set of options."

COFAR President David J. Hart added, "Federal law regulates the six developmental centers as Intermediate Care Facilities/Mental Retardation. By DMR decision, no group homes are allowed to apply to meet this standard, which includes 24-hour nursing care and concentrated programs of active and secure treatment. ICF/MR placement is a legal option under Medicaid, and most of the residents of the four centers have rights to stay in an ICF or ‘equal or better’ under the 1993 disengagement agreement. Thousands of others now in the community resident system have a right to return, which some aging people will want to use. I have to come back to the issue of family choice. Moving a loved one into the community system might be a death sentence; but moving them far from family who can now often visit them at Fernald, Monson, Templeton, or Glavin (Shrewsbury) might be another kind of death sentence. And Hogan families have four years of sitting on pins and needles. It just isn’t fair," concluded Hart.

COFAR Vice President Thomas J. Frain pointed out, "The federal court monitor looked at case files two years ago, and found a 30 percent greater chance of abuse and neglect in the community residential system. This is even more of a risk with the highly disabled residents who remain in developmental centers now. Advocates for one-size-fits-all promise to do better, but haven’t facility residents endured enough in the bad old days without being forced into risky experiments in privatization now?" asked Frain.

According to D’Intinosanto, the MNA will work closely with COFAR and other unions at the facilities to ensure the population served by DMR is provided with fair treatment, and if and when closings occur that all residents and their families/guardians receive equal or better care that preserves their health and dignity. "We will be watching closely to make sure the family’s wishes are honored and that our disabled citizens receive the care they need and deserve," he concluded.