The Arc opposes the Administration's 13-point plan for Fernald
The Administration released a 13-point plan which would continue to operate buildings on the Fernald property. Three components of the 13-point plan are discussed below.
Malone Park
Greene Building
Moving consumers to the remaining five facilities
Fernald should close
Why is Keeping Malone Park Open as a State-Operated Program Short-Sighted and Non-Olmstead Compliant?
July 2, 2004
There are four residential buildings at Malone Park, all nearly identical, each a one-story structure nearly 20 years old (built in the mid-1980s), 4,100 square-feet, and at the end of its economic life, given the hard institutional usage of six to eight residents each (total of 24 to 32 residents). The buildings are painted battleship gray, with no historical or architectural value.
The location of Malone Park is unfortunate, as it is in the Western Greenway, a swath of green space that stretches for six miles, beginning in Belmont and Lexington and looping through Waltham. A greenway is open spaces, riverways, forests, farms, and historic structures. It can be as simple as a foot trail connecting neighborhood parks, or as complex as an intricate network of trails and roads. The location of Malone Park as a group home is the exact opposite of what is desirable: It interrupts a valued natural resource in an urban area, while segregating residents from vibrant community life that is about contacts with people much more than communing with nature.
For the state to implement the June 8 proposal for Malone Park, it has to invest capital dollars; there is no way that the structures will survive another twenty years without that investment. What we expect, however, is for the state to level the existing buildings and rebuild, as that is far less costly than renovation. So the June 8 proposal puts the state in direct conflict with one of the numerous organizations advocating smart growth (Waltham Land Trust), because it would be rebuilding or renovating in the Western Greenway, an open area.
The state’s June 8 proposal is a disaster:
Buildings are at the end of their economic life (short-term thinking).
Buildings are isolated, far from community life (overly restrictive, non-Olmstead compliant).
People live in settings of six to eight (overly restrictive and non-Olmstead compliant compared with settings of fewer people).
Buildings are located in the Western Greenway and in direct conflict with smart growth planning (short-term thinking).
Renovating or rebuilding requires capital dollars that the state does not have (short-term thinking; there is an eight-year queue for capital dollars based on a dollar cap negotiated between the state administration and representatives of Wall Street).
Programs would be state operated. (Compared with private community operators, state-operated tend to be less integrated into the community and bureaucracy-driven.)
The Arc strongly recommends that DMR close Malone Park and transfer residents to community programs. If DMR insists on operating Malone Park, then The Arc wants no capital investment in the buildings to minimize the disaster of the June 8 proposal. Further, The Arc wants no admissions to Malone Park, with its antiquated service model of six to eight residents.
Why Is Keeping Greene Building Open as a Skilled Nursing Facility (SNF) Short-Sighted and Non-Olmstead Compliant?
July 2, 2004
The Greene Building is a multi-story masonry structure of 113,000 square feet that has twenty years or more of future economic life. DMR’s proposed usage as a SNF for 65 residents will occupy less than 25 percent of the building, based on the footprint of the existing SNF at Fernald (Marquardt Center) with a capacity of 29 people in approximately 10,000 square feet. That leaves at least 70,000 square feet for non-SNF uses, including some dedicated space for the existing pool and gym. The building has no historical or architectural value, and could be converted to many uses as offices, condominiums or commercial space.
The state’s June 8 proposal is a disaster:
Closing the existing Marquardt SNF and converting Greene will add 36 new nursing home beds. At the same time, DMR is cutting its census in nursing homes by 700 beds statewide by moving people to community settings, in response to the Rolland suit and in compliance with the Olmstead decision. Why is DMR increasing SNF capacity at Greene while moving people to community residences from other SNFs? It makes no sense from the perspective of individuals and their families.
A dedicated SNF for people with mental retardation is not necessary, as the specialized services each individual needs are now available statewide. Some history is helpful. Starting in the early 1970s, state workers warehoused people in SNFs without specialized services as a way to cut costs, leading to lives without stimulation or supports of needed therapies. At its peak in the late 1990s, between 1,500 and 1,700 people were warehoused, until the Rolland suit (The Arc was a plaintiff in the suit and continues in a monitoring role). The settlement required specialized services immediately for all DMR SNF residents, and a planned wind-down of at least 700 SNF residents to community residential settings in least-restrictive settings (Olmstead compliant). Converting Green to a SNF is short-term thinking; the Rolland suit makes dedicated SNF capacity unnecessary, and expanding that capacity at Greene is a policy disaster.
Any dedicated facility like a SNF effectively cuts itself off from the mainstream capability and all the evolutionary improvements that the mainstream enjoys. Meanwhile, the dedicated facility languishes, as has been shown through the failed segregated school systems in the first half of the twentieth century. It took the famous Brown vs. Board of Education case in 1954 to end separate-but-equal educational policy. Separate-but-equal (otherwise known as dedicated) is absolutely what DMR should avoid. Yet the state’s June 8 proposal adds dedicated SNF capacity at Greene (short-term thinking and a policy disaster).
As a residential choice, nursing homes are highly restrictive, limiting physical and social contacts for medical reasons. Within this world of few choices, DMR now proposes to narrow the world further by restricting admissions to people with mental retardation. No longer do residents have even a narrow opportunity for mainstream community. By adding dedicated SNF capacity, DMR creates a more-restrictive environment (contrary to the Olmstead decision and a policy disaster).
If the expanded SNF at Greene is staffed by state employees, it will perpetuate the two separate systems of higher-paid unionized state employees and lower-paid private providers (short-term thinking and a policy disaster).
The Arc strongly recommends that DMR close the existing Marqardt SNF with a capacity of 29 people and transfer residents to community SNFs with specialized services or community programs, as appropriate. Greene should not become a SNF. There should be no capital investment by DMR at Greene for this or any other purpose.
Why is Moving Consumers to the Remaining Five Facilities Short-Sighted and Non-Olmstead Compliant?
July 2, 2004
DMR is offering Fernald residents the opportunity to move to one of the remaining five facilities. For both the consumer and DMR, this choice is short-sighted, as the planned closure of the remaining facilities will require a second move. For consumers and families, added moves are disruptive; for DMR, every move is expensive, at least $50,000 each in out-of-pocket costs for added staff time and duplicate resources.
Moving from one segregated facility to another denies any opportunity to achieve personal independence in an integrated community setting, which is the whole objective of the Olmstead decision. Yes, the buildings are different, but daily living is still institutional.
Young adults with developmental disabilities and their families clearly see the advantages of integrated community residences, and are voting with their feet for community placements. The only individuals now placed in facilities are those in emergency situations, where placement choice is irrelevant. Transferring facility residents to maintain census at one or more could prolong their existence, but to no advantage of young adults, who already say “No thank you.”
Fernald Should Close
The Arc of Massachusetts along with most disability rights organizations strongly supports the State's proposal to close Fernald and other institutions as licensed ICF-MR facilities. This is not a new concept; it is a civil rights issue, and it has been since the 1970s.
The Arc agrees that residents of Fernald should have a choice of where to live in the community: now and in the future. Whether privately-run or state-operated, we prefer homes that are better-integrated into the community, offer more living choices (independent living, home supports, shared living and staffed apartments, as well as group homes), and are less bureaucracy-driven.
The Fernald Closure plan should also result in enhancing the availability of clinical specialists and supports for consultation in the community. Some of these services are now available to people with developmental disabilities in the community system. The Fernald Closure plan should provide funds for clinical services for people leaving Fernald and other people with developmental disabilities in the community.
All transfers to the community should comply with the principle that the money follows the person.
There are several important points to reinforce for our constituents and the general public.
Individuals living at Fernald and several other state institutions have the right for substantial services during their lifetime but not to determine public policy for the Commonwealth. More importantly, most class members from the historic consent decrees live in the community where demand for services continues to grow. The focus of our efforts should be there, expanding and enhancing community support services.
The population of people with disabilities which requires support and accommodations from the Commonwealth including the Dept. of Mental Retardation is growing, not static. Two or more generations of individuals with developmental and other disabilities have benefited from special education. They and their families are not looking to segregated campuses for services.
Individuals with profound and complex disabilities are served in the community. Admissions to institutions have been closed. Advocacy efforts on the part of almost all groups is focused on expanding community supports through disability agencies, MassHealth, and housing programs such as the bond bill presently in legislature.
Adult disability services have evolved to include a range of housing and support alternatives. Stereotypes and services limitations in other areas, such as community supports for elders, help to fuel efforts to keep institutions open.
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André Blanchet, M.D., President
Leo V. Sarkissian, Executive Director