As developmentally disabled face cuts, Southbury Training School under renewed scrutiny
Legislators are eyeing overtime costs at Southbury Training School as a way to save money in the tight budget for serving people with intellectual or developmental disabilities, but officials at the agency that runs the institution say those savings are unlikely to be achieved.
The savings idea comes from four parents of people with disabilities, who pored through public records and suggested it would be possible to save approximately $14 million in overtime costs and close to $5 million in operations at the training school, which now serves 305 people. People with intellectual or developmental disabilities who don’t live in institutions are facing cutbacks under Gov. Dannel P. Malloy’s proposed budget, but the parents wrote in a report on the savings that the Department of Developmental Services could find money to serve more people by addressing “pervasive inefficiencies in the system.”
The parents’ report was released in the wake of intensifying calls to set a date to close Southbury —which has not taken new residents since 1986 — and as advocates warn that the gulf is widening between what they call the “haves and have nots” in Connecticut’s service system for people with developmental disabilities.
While Southbury and the state’s other five institutions – known as regional centers – serve fewer than 500 people and cost more than $350,000 per person, nearly 2,000 people are waiting for state-funded residential services.
“It just made me crazy when I know what people are losing and what people are suffering through now, waiting for services, and to know that they’re willingly spending this much money on Southbury, which eventually is going to close,” said Collette Bement Langner, a Tolland resident who helped prepare the report.
Bement Langner’s son Scott, 28, has developmental disabilities, autism and a seizure disorder. She and her husband became involved in pushing for changes when they learned two years ago that, because of a lack of state funding, Scott was unlikely to receive residential services until his parents died.
Sen. Beth Bye, who co-chairs the Appropriations Committee, has asked legislative analysts to examine the parents’ report and said she has concerns about overtime at Southbury. She said she and her co-chair on the budget-writing panel are looking at overtime there, as well as in other state agencies, as a possible source of savings.
But officials at the Department of Developmental Services say the savings the parents suggested aren’t achievable. In a report issued Friday, department officials said the parents’ analysis appeared to be inaccurate or incomplete, including estimating more direct care workers at Southbury than department records show.
Employee costs have decreased as the population drops and the campus is downsized while on a path toward eventual closure, DDS officials say. Two of the 23 cottages where Southbury residents live are scheduled to close this spring, bringing an anticipated $1.7 million in overtime savings.
The DDS report identified significant overtime costs: $15.7 million in the 2014 fiscal year. But department officials say overtime has been used to meet staffing needs as an alternative to hiring new state employees, who would bring long-term liabilities.
According to the department’s report, many of Southbury’s lower-need residents have moved out, leaving a higher percentage of clients with higher needs. Three-quarters of Southbury residents have severe or profound intellectual disabilities and 43 percent also have a psychiatric diagnosis.
“It is critical, in negotiating the final budget, that all parties have the most accurate information at their disposal,” Developmental Services Commissioner Morna Murray said. “The danger of inaccuracies at this level can lead to reductions that are not only unintended but ill-advised for the people we serve.”
Bement Langner said she also has concerns that if legislators see Southbury as a source for savings in a tight budget year, there’s a chance the money will go to some other function, rather than serving others with intellectual or developmental disabilities. But she said years of underfunding have left families of people with disabilities in a desperate situation.
“I think if there was enough money to go around, there wouldn’t be this problem, but literally the state has pitted Southbury against the kids who have no services,” she said.
Staffing levels, overtime
Bement Langner and three other parents calculated the potential savings using public documents, including worker pay records on the state’s transparency.ct.gov website. They found four workers who earned more than $100,000 in overtime and 63 whose overtime pay topped $50,000.
Their analysis concluded that, between regular time and overtime, Southbury had the equivalent of 824 fulltime, direct-care staff in the 2014 fiscal year, when the number of residents averaged 348. That equated to a 2.7 to 1 staff-to-client ratio, higher than the 2.1 to 1 ratio identified in a 2010 state report. Overtime alone accounted for the equivalent of 203 fulltime workers, they found. They suggested the facility needed closer to 620 workers.
DDS’ report said the agency’s numbers show a different picture – 546.5 fulltime equivalent direct care workers as of January, an overall 1.75 to 1 staff-to-client ratio. And DDS officials said the needs of residents require a staffing ratio greater than 2 to 1 – a difference that has been achieved through overtime.
Among Southbury’s residents, the average age is 66. Twenty-five persons are non-ambulatory, and 36 percent have seizure disorders. Thirteen percent require 24-hour tube feeding, and 16 percent have a diagnosis of PICA, a condition in which people eat inedible objects. The nursing staff administer more than 9,000 medications and treatments each day, according to the DDS report.
Of the 410,020 hours of overtime Southbury staff worked in 2014, according to the report, about a third was considered straight-time overtime – that is, the 36th through 40th hour employees work in a given week. Their contracts are for 35 hours per week, but they work 40, and the five additional hours are considered overtime but are paid at their usual rate, according to DDS.
Murray said agency officials are looking at using seasonal workers as a way to help cover labor costs. Overtime, she said, is the most efficient way to increase staffing at a facility that will ultimately be closed, an alternative to hiring new state employees.
Bye acknowledged that argument, but said the state also incurs long-term costs of overtime. Because pensions are calculated based on workers’ pay in their final years of service, Bye noted, “If somebody’s making $100,000 in the last five years that they work, that has implications for 30 years, and we just can’t be so shortsighted.”
Bye said she expects DDS should be able to reduce costs at Southbury as the number of residents shrinks. But she acknowledged that there will be challenges.
“I think the expectation has to be that there are some very complex cases, and there are people who’ve lived there their whole lives, so how do you accommodate those complex cases and people who’ve lived there their whole lives?” she said.
Bye also questioned whether Southbury needs its own fire department, and suggested that if the town of Southbury couldn’t handle the additional responsibilities, perhaps the state could give the local fire department funding to help. The Southbury fire department was another expense the parents’ report questioned, along with the training schools’ maintenance shop, power house and 18 main kitchens and 34 mini-kitchens.
DDS’ report said Southbury town officials have said the town is not in a position to assume responsibility for the fire calls at the training school. Southbury Training School’s emergency services provided 1,207 ambulance transports in 2014, and the facility’s fire department responded to 281 alarms and smoke conditions.
In response to the questions about food service expenses, DDS’ report pointed to residents’ needs. Eighty-two percent require therapeutic diets, 56 percent have swallowing and choking-related issues, and 56 percent require food at special consistencies. Residents live in 23 cottages on the nearly 600-acre campus.
“The department is committed to finding savings in the system,” Murray said. “And we are equally committed to spending any additional resources on people who currently are waiting for services.”
Cuts to community services
The four parents who dug through the Southbury payroll are part of a larger movement to bring attention to the need for more services for people with intellectual or developmental disabilities.
Connecticut officials have known since Mansfield Training School closed in 1993 that there was a growing argument to close Southbury.
But when state finances plunged into the Great Recession in 2009, and emerged two years later in a seemingly unending state of crisis, things really changed: Advocates for more resources for community-based care reached a state of desperation, said Leslie Simoes, executive director of The Arc of Connecticut, which has called for Southbury to close by 2020 and which distributed the parents’ report.
“The politicians have shown us over and over and over again [since 2009] they have no interest in doing anything to fix this,” Simoes said.
And aging parents waiting years, or decades, for a community placement for their children, “not only have nothing” in terms of results, “they have no hope,” she said.
After DDS released its response to the parents’ report, Simoes said, “I stand by the report.”
“I stand by our families and I am proud of their work looking for solutions,” she added.
DDS did not provide updated figures Friday on the per-person costs of Southbury and the five regional centers. In December, advocates cited department figures showing that the state spends $442,265 per person each year at the regional centers and $356,350 per year at Southbury.
According to DDS, 647 people are on the waiting list for residential services and considered either emergency cases or expected to need residential services within a year. Another 1,280 people are on what DDS calls the “planning list” for residential services, while 250 receive DDS residential services but need more support, or live in institutional settings but want to move to the community.
Malloy’s budget proposal for the next two fiscal years did not include funding to serve more people currently on the residential services waiting list. And it includes several cuts to services for people with intellectual or developmental disabilities living in the community. More than 300 new high school graduates would not receive any funding for day services, which advocates say means parents could be forced to stay home with their children or hire someone to do so.
The governor’s plan also cuts 60 percent of the funds from the DDS voluntary services program, which serves nearly 550 young people with an intellectual disability or autism as well as a mental health diagnosis and challenging behaviors. Some families in the program have described it as a lifeline, rescuing their families from crisis.
With those cuts looming, Bement Langner said the costs of Southbury seem particularly unfair. Her son has become eligible for residential funding, but she worries about the many others who are not.
“To say to somebody, ‘Ok, we’re going to have our direct care workers there work and get paid two times their base salary in overtime, but your kid who’s graduating in June, is going to have to be sitting at home with you now because we just don’t have the money,’ and the point is they do have the money,” she said. “They need to be more efficient about it. They need to be willing to make the changes that should’ve been made a long time ago.”
Southbury is closing, but when?
There is one thing those on all sides of the Southbury debate agree on: it will eventually close. The dispute is about when.
Bye, who co-chairs the legislature’s Intellectual/Developmental Disabilities Caucus, is one of several legislators pushing for a proposal that would require state officials to develop and implement a plan to close all state-operated institutional facilities for people with intellectual disabilities and produce a timeline for it by December.
Relatives of Southbury residents have opposed calls to close Southbury, expressing concerns about their loved ones being forced to leave their longtime home and the state’s track record of flat-funding private operators of group homes, leaving them to pay low wages and cope with high worker turnover.
Murray has opposed setting a timeline. She noted that Southbury is governed by a court settlement that does not allow any residents to be forced to leave. And she said there are many variables that can affect how quickly those who want to move out can do so, including the availability of housing. It typically takes 18 to 24 months for people to relocate from Southbury.
“We have been and are in the process of closing Southbury and other public institutions, in accordance with the settlement agreement and frankly, in accordance with trends across the country of people moving into more integrated community settings,” Murray said.
And she pointed to the complexities of winding down Southbury.
“This is not easy stuff,” Murray said. “If it was we would likely have figured it out by now. We are committed to a process that is thoughtful and above all, respectful, to everyone involved – residents, families and individuals on the waiting list. We have to serve everyone’s best interests. That is our commitment.”
In an interview this week, Malloy suggested that Southbury’s future could be coming to a head.
“At some point it becomes unjustifiable. We may be there now. I think we’re getting or approaching that,” Malloy said.
Bye said that any savings that occur as people leave institutions must go toward community-based services for people with intellectual disabilities, rather than to the state’s general fund. She said she’s particularly concerned about the low wages paid to workers at privately run group homes that contract with the state.
Mark Pazniokas contributed to this story.
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