There’s No Plan for the Mentally Retarded

In the wake of the Oct. 1 federal Appeals Court ruling that U.S. District Court Judge Joseph Tauro lacked jurisdiction to order the Fernald Developmental Center to remain as an option for its current residents, the Patrick administration is pulling out all the stops to shutter the facility.

Layoffs are being implemented with announcements of more on the way. A clinical unit at Fernald will be closed. Morale among the remaining staff is dropping rapidly.

None of this might appear to be of pressing concern to anyone outside of the Fernald community. But it should be for one key reason. The administration is pushing ahead with Fernald’s closure in the apparent absence of a plan for the care of all people with mental retardation.

The Department of Mental Retardation provides services and supports to more than 30,000 people in Massachusetts. Roughly 9,000 people with mental retardation currently live in community-based residences in the state, according to departmental figures for 2002 (the year of the department’s most recent annual report on its Web site). Somewhat fewer than 1,000 people with mental retardation live in the state’s six remaining large facilities for care, including Fernald.

Major problems confront this large group of people, both in the community and in institutional settings. In the community system, services and supports are subject to little effective government oversight and are characterized by high turnover of direct-care staff and low salaries. Abuse and neglect by caregivers is an ongoing problem.

The large facilities are slowly dying by attrition as the administration cuts their budgets, lays off their staff, and continues a longstanding policy of prohibiting new admissions to them. Meanwhile, thousands of people with mental retardation are living at home and waiting for services and residential housing.

The system is broken, and potential solutions need to be carefully considered by the department and all its stakeholders. Yet, this administration seems to have focused on just one initiative with respect to this entire population — the closure of one state-run institution. It is pursuing it in a single-minded way, without any discussions with those stakeholders most directly affected, and without the benefit of valid cost analyses or analyses of the impact of this closure on the rest of the system. Moreover, the administration has yet to announce its long-term intentions regarding the five remaining state facilities for people with mental retardation in Massachusetts.

This isn’t to say that the administration isn’t engaging in any planning for people with disabilities. In mid-September, the administration posted its “Community First Olmstead Plan” on its Web site.

But according to Stan Eichner, director of disability program development for the Executive Office of Health and Human Services, this plan applies to elderly and disabled people in nursing homes or likely to be admitted to nursing homes, not to persons with mental retardation.

Nearly halfway through Patrick’s first term, there is no comparable plan for the care of people with mental retardation. How will the administration find the services necessary for the thousands of people with mental retardation who are currently waiting for them? Where will the housing come from for the remaining 160 Fernald Center residents if that facility is ultimately closed?

Eichner’s answer is that the administration “will continue to figure out the best and most appropriate array of services for all individuals with mental retardation in the Commonwealth, including residents of Fernald.” In other words, the administration will continue doing what it has always done and what the Romney administration did before it. It will attempt to muddle through. That is not a good-enough strategy, given the daunting problems facing this large and vulnerable group of people.

We are not saying that the administration has to plan for or solve these problems alone. We have long advocated the creation of a task force of state and elected officials and stakeholders throughout the system to work on a comprehensive plan for the future of care for people with mental retardation. It’s a shame that the administration has yet to respond and is letting this critically necessary opportunity slip by.-

Marilyn Meagher is president of the Fernald League for the Retarded Inc. This article first appeared in the Boston Globe.