Dear Senators and Representatives:

We are writing regarding our recommendations for certain FY’2022 budget line items serving persons with intellectual and developmental disabilities (I/DD), including autism, and their families in the Commonwealth. We thank you for your past support and ask for your continued support of individuals with I/DD, their families, and the direct support workforce.

Summary

Governor Charlie Baker included a 6% increase in the budget of the Department of Developmental (DDS) Services. The rise in the DDS budget is primarily driven by rate increases for residential services (known as Adult Long-Term Residential-ALTR) and investments in Turning 22 for students with I/DD who require assistance as adults. The ALTR funds, though new for the DDS budget had been part of the FY’21 budget in line item 1599-6903 (Chapter 257 and Human Service Reserve). We do expect that MassHealth long term supports and services will remain stable in the coming fiscal year.

The increase in ALTR begins to address our direct support residential workforce shortage. This year Turning 22 (T22) allocations for 2021 graduates were combined with those graduating from schools in 2022. Typically, the funds for previous year graduates are increased in residential or day/employment accounts. The funding in T22 now totals $79.9 million to cover both fiscal year graduating classes. This change and two other line-item language changes will allow DDS to have more flexibility with the goal of handling shortfalls in employment/day and transportation in part or full. The governor recommended transfer authority for two other program accounts.

Also included in the Governor’s budget proposal is a $79 million rate increase for a range of DDS programs which includes Employment, Community Based Day Supports (CBDS), Shared Living and Family Support.  We are still reviewing the impact of this allocation, and we hope it reflects a 10% increase for these critical programs.  A significant portion of the rate increase will need to address direct support and other staff salaries. Even with this rate increase, we still face a substantial workforce shortage crisis. In addition, there are important line items that must be increased to support individuals with disabilities as integrated members of their communities using day and employment programs and provide much needed relief for family caregivers.

FY’22 Budget Asks to Increase Direct Support of Individuals and Families

People with disabilities have been disproportionately impacted by the COVID-19 pandemic. Not only are they at a potentially higher risk of contracting the virus due to underlying conditions, but they have also experienced significant disruptions to day and employment programs and other services they normally rely on. Please increase the Governor’s proposal for the following DDS budget line items.

1. Day/employment (Line item 5920-2025) – The current projection reflects under-utilization of individuals in day and employment programs due to the pandemic; however, it also means limited capacity to assist those who are home-bound; this is true for the Transportation account too (Line item 5911-2000). Distance regulations have limited the number of people in day settings and vehicles at any one time. We are unable to fully estimate the shortfall in day and employment programs. It will partly be determined by the planning on employment/day services presently in process. We will work with the Association of Developmental Disabilities Provides (ADDP) to have a request for the Ways and Means Committees and the General Court.

The Arc’s Budget Request:
  • Increase Line Item 5920-2025 by $15 million above the Governor’s House One recommendation to $219,962,246.
  • Increase Line Item 5911-2000 by $7 million above the Governor’s House One recommendation to $27,095,451.

  • Acknowledges an initial investment needed to re-design the service system to add new day service components or modalities, such as remote/virtual supports and in-home or in-community services.
  • Provides a “bridge” for community-based provider agencies to re-design their current service model, which will require recruiting, hiring, and training staff for new roles and responsibilities, and providing technology supports.
  • Allows an opportunity to develop a service model that is fluid based on real-time, individualized needs of constituents who may be unable to engage in traditional day services at any point in time.
  • Anticipates the increased service need once constituents are vaccinated and ready to return to their day programs.
  • Acknowledges the need for transportation to meet some constituent demand for the new day service components, in particular in-home and in-community supports. 

2. Family Support – Additional funding of $7 million is needed for family support, including $3 million in state-only support for the short term, to assist those individuals with disabilities who are home-bound. Caregivers have been providing 24/7 support to individuals with disabilities now for nearly 11 months. 
 
The Arc’s Budget Request:
  • Increase Line Item 5920-3000 by $7 million to total $84,853,898. $3 million of the request is to assist families through stipends (not federally reimbursable).

Our Budget Request accomplishes the following:
  • Relief for families and individuals who have spent the past year without their life-line supports in the community and in their homes. Family caregivers have stepped up to provide 24/7 care to their loved ones, including managing challenging behaviors, personal care, feeding, and even nursing tasks. They have also shifted to support virtual learning from their homes – most juggling work and/or other family responsibilities.
  • Helps protect thousands of family caregivers over 60, like those with I/DD, they have higher risk of susceptibility to the covid-19 virus and worse outcomes. Without these caregivers many individuals with I/DD would be in residential setting with lifelong state supports.

You have always been responsive to the needs of individuals with I/DD and autism and their families face as well as able to recognize the important programs and services that support them. In closing, we owe you a debt of gratitude for the consistent leadership and support you have shown to our community. Thank you for your public service and dedication. Included below is a chart laying out our priority line items and specific budget requests.

Fond regards,
Leo V. Sarkissian
Executive Director
Maura Sullivan
Director, Government Affairs
The Arc’s FY’22 Budget Chart with Requests
* Need more information regarding Line Item 5948-0012.
** DDS programs receive rate reviews during alternate years among other HHS agencies. Last year, ALTR (community residential) received a rate increase (in FY 2021 budget) and the transfer of monies is reflected in the 2022 budget in 5920-2000. This year the monies in the 1599-6903 account are directed again at several agencies; within DDS the programs are Day/Employment and Respite/Family Support.