A Program Review and Investigations Committee report found it costs less to care for an individual with developmental disabilities in the community than it does at the Southbury Training School, but the state said it has no plans to immediately close the facility, which hasn’t accepted any new admissions in more than 20 years.
Hugh Dwyer, whose brother has lived at the facility for 38 years, urged the Program Review and Investigations Committee Tuesday not to close Southbury Training School, a place his brother calls home.
After sitting through a more than an hour of testimony about how great the privately run residential facilities are in Connecticut, Dwyer said he has to believe there are “horror stories” going on somewhere in the state.
Dwyer’s sister Martha, who also testified, said her brother’s roommate for 20 years was one of the ones who decided to leave Southbury for a private residential facility. “Twenty seven days later he was dead,“ Dwyer said.
She said it was an accident, but the poorly trained staff person turned his back for a few seconds and that was long enough for him to reach into the fridge, grab a hot dog, choke on it, and die.
“Some people are so severely disabled they need the benefits of a place like Southbury,” Dwyer said.
According to a draft report by the Program Review and Investigations staff it costs an average of $321,983 to care for an individual at Southbury Training School, whereas the average cost per individual with the same level of need in a private facility is about $168,786. The study took a look at all private and public care for more than 15,000 individuals with disabilities receiving care in the state. The department is also facing more stringent requirements from the Centers for Medicare and Medicaid Services agency which is emphasizing that only systems that offer consumer choice will be reimbursed.
Department of Developmental Services Commissioner Terrence Macy said currently the department is operating under a legacy system, which is an “unsustainable paradigm.” He said the department needs to embrace a new paradigm, which includes supporting clients and families in their home and in the community.
“The private sector is a less expensive option,” Macy said. The study confirmed that not only residential care, but day care and other public offerings are more expensive than private care.
Macy said he doesn’t believe the federal government would rush to penalize the state for slowly transitioning to private care.
But he said he was cognizant private providers have been asked to do more with less over the past few years.
He said he wants the transition at Southbury to occur in a thoughtful way and he wants families to be able to have a choice to stay or leave.
Beginning Nov. 1, the 425 Southbury residents will be evaluated to see if they can live successfully in the community. The information will be given to the residents and their guardians so they can make an educated decision about whether they should leave. The evaluations are largely a result of the class action lawsuit over the state’s failure to adequately evaluation residents for community placement.
David Kassel, spokesman for the Southbury Training School Home and School Association said he hasn’t finished reading the Program Review and Investigations draft report on the cost comparison between public and private care, but he believes there’s other places to find savings in the Southbury budget.
He said he doesn’t believe the report takes into consideration the cost of the infrastructure that would need to be built in order to support the 425 residents in the community. He disagreed the private sector currently has the capacity to support the additional residents.
Jamie Lazaroff, a self-advocate coordinator and ARC board member, said he understands the hesitation of parents and guardians at Southbury.
“If I was there for 40 years and felt secure for so long, I may not realize what options there are,” Lazaroff said. “They need to have an open mind.”
Lazaroff said making a connection with staff is important, but he said he’s been through several staff and some you like and some you don’t.
“You find the good ones overtime,” he said.
Thomas Fanning, president and CEO of Ability Beyond Disability, said the argument over whether institutional versus community care is polarizing because all it does is take resources and energy away from the people who need services.
“All we’ve done is take millions away from those with disabilities,” Fanning told the committee. “More studies just delay the decision.”
He said it’s time to stop talking about this and do something about it.
Stephen Becker, president and CEO of HARC, said there seems to be overall agreement that the private sector can handle the clients currently being served by the public sector for less money. He said he agrees with the recommendations made in the study.
“Acknowledging the dual system is a costly one, (as this report’s analysis finds as well) the department has been implementing a policy of not accepting new admissions to any of its homes or facilities as a way to gradually reduce public residential services,” the report’s narrative says. “In fact, as a result of the retirement incentive program the state offered in 2009 and the number of DDS employees who retired, the state was able to convert 17 DDS-supported homes to private providers.”
Lawmakers didn’t make any decisions at the meeting Tuesday, but Macy made it clear his department is headed toward getting out of delivering direct services to individuals and handing over more of that responsibility to private providers.
The next phase of the study will explore factors that influence cost of client care and explore whether there are reasons for client well-being to maintain some public capacity. The study is expected to be done before the end of 2011.