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Day Habilitation Rates
 One other problematic area for the Administration is how they are currently handling the issue of Mass Health Day Habilitation rates. This program, serving the most behaviorally and medically fragile in the state, has gone for a decade with only a 20 cent per unit increase in its payment rate, while the state has asked providers to handle more and more people each year. Per state and federal regulations, these programs are required to have a rate hearing and adjustment every two years; the state is five years late on this matter. Providers have been told that their rate increase, funded in the FY 14 Budget, is ready for release, however many believe that the leadership of EOHHS and A&F are unilaterally blocking the owed rate from going into effect, apparently using those dollars to subsidize other expenditures. Providers are mounting a public campaign starting with phoning the Governor and Secretaries of A&F and EOHHS to request that they release the owed Day Habilitation Rate. Contact numbers for the Governor and Secretaries are: Governor Deval Patrick
617-725-4005
EOHHS Secretary Polanowicz
617-573-1600
A&F Secretary Glen Shor
617-727-2040
Providers are requesting a required public hearing in December and the rate go into effect on January 1, 2014.
Several emails and letters have been sent to Secretary Polanowicz on behalf of the Governor requesting the date of the Public Hearing and Implementation date. He has not responded. ADDP and The Arc expect to escalate our public campaign pending a response and clarification from the Secretaries and the Governor.
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Chapter 257 ALTR Residential Rates
Earlier this summer, Governor Patrick's Administration announced that DDS Residential Rates will go into full compliance on April 1, 2014, and fully funded in FY 15.
The disability community fully expects the Governor and Secretary Polanowicz to honor this legal obligation in FY 15; this being one glass ball that can't be passed over if the Governor and Secretary's word is their bond.
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Any Ball Could Drop and Lead to More State Challenges
It's not unusual to hear state leaders being compared to circus jugglers. In the case of the circus, the juggler generally uses balls that can bounce, however in the case of the Governor the balls he must balance are best compared to glass. Drop one and its breakage could cause more headaches than imaginable.
Here are a few of the Governor's challenges and possible ramifications if the ball is punted or not addressed in the upcoming FY 15 budget.
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Disability Employment
 Massachusetts has been advised by a variety of national legal and advocacy experts that the Commonwealth's current DDS Employment programs are at risk for potential Federal Court action. The Commonwealth, along with several other states are currently under the microscope by the Department of Justice for violation of the Americans with Disabilities Act (ADA) Olmstead integration mandate.
For years, DDS has been attempting to strengthen Community Based Day Supports and Supported Employment, as the state has struggled to close its sheltered workshops.  Trouble is the state has not put its money where its principles are, resulting in significant exposure to a DOJ inquiry. Similar DOJ and Court action in Rhode Island, New York and Oregon have resulted in states being forced to add hundreds of millions of dollars under Court Order and control, rather than fixing the issue under state control.
To address this concern for the last several months, ADDP, The Arc of Massachusetts and DDS have been collaborating on a Blueprint to revise DDS Employment programs and avoid costly litigation. To implement the Blueprint, the Governor will need to invest more dollars in CBDS and Supported Employment programs.
To not do so, or to shatter this glass ball, the  Commonwealth will likely find itself in Federal Court and likely ordered to fund tens to hundreds of millions of dollars more than the Blueprint calls requests.
 To date, the Governor and his Secretaries of Health & Human Service and Administration and Finance have not shown their hand on this matter. On a recent WGBH Radio phone in program, Governor Patrick acknowledged the challenge but only committed to saying: "I'll do my best".
In the past budgets, the Governor has been supportive in protecting disability programs from cuts. FY 15 will call for vision and investment to strike the right balance for program responsibility and fiscal wisdom. Stay tuned and let's hope this glass ball doesn't shatter.
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