Unnecessary delays

The state must eliminate waiting lists for services from the Department of Mental Retardation

Us District Court judge Douglas Woodlock deserves high praise for forcing the Cellucci administration to respond seriously to his recent court ruling ordering the state to eliminate the lengthy waiting lists for families seeking services from the Department of Mental Retardation (see "The Waiting Game," News and Features, September 22). Woodlock was supposed to hold a hearing yesterday on the state's plan to deal with the list -- but he postponed it until October 25. After looking at the state's answer to his mandate, as well as a proposed plan from the plaintiffs in the lawsuit, Woodlock has rejected the state's proposals and has ordered it to come up with a "substantive response."

It's about time somebody forced the Cellucci administration to address the problem behind Boulet, et al. v. Cellucci. In March 1999, five families sued Governor Paul Cellucci and various state agencies for denying them assistance in caring for their mentally retarded adult relatives -- assistance to which they are legally entitled under the federal Medicaid Act. The five families named in the suit represent thousands like them who've languished on the Department of Mental Retardation (DMR) waiting list for years, and in some cases for decades.

Consider the plight of Fred Studley and his wife, Fay, who are named as plaintiffs in the suit. The Studleys have three children. One of them, 26-year-old Bridget, is mentally retarded and has cerebral palsy. Her disabilities give her the temperament of a two-year-old, but she has the strength of an adult. During one tantrum, Bridget shattered the windshield of the family car with her hand. Incidents like this convinced the Studleys that they should place Bridget in a community-based residential program, where she could receive 24-hour care and skill-building assistance. Five years ago, they applied for help from the state.

They're still waiting.

There are 2437 families on the DMR list with stories like the Studleys'. Eliminating the list in 90 days or fewer -- the maximum amount of time the law says a family must wait -- will cost the state millions of dollars. Almost 90 percent of the cases on the list require residential placement at an annual cost of $60,000 to $80,000. The ultimate price for eliminating the list has been pegged at $150 million, half of which would be reimbursed by the federal government. The mandate could cost the state 15 percent of the DMR's $905 million budget.

When he handed down his July 14 verdict, the first of its kind in the nation, Woodlock gave the Cellucci administration a break. If the state couldn't meet its obligation within three months -- and 90 days isn't much time to find residential beds for approximately 2400 people when only 14 beds are available today -- the judge said he'd consider an alternative plan, complete with its own time line.

The state took advantage of the reprieve. But what the Cellucci administration proposed was a joke: it recycled a plan the DMR already had in place to spend $8 million to serve about 200 families this year. It didn't include a time line or a price tag for dealing with the other 2200 families.

Contrast this with the plaintiffs' response to the state's plan. On September 19, Neil McKittrick, the Boston attorney for the families, filed a brief that not only quantified the waiting-list problem but presented a reasonable time line -- up to 18 months -- for getting rid of it. In the meantime, he presented four steps the state should take in the next 90 days to begin addressing the problem. First, the state must allocate funding for residential services. Second, it must hire the community-based providers that would offer housing and support services. Third, it must meet with all 2437 families to develop service plans. Finally, it must provide temporary support until desired programs are made available.

Woodlock was right to reject the state's meager response to his ruling and ask for a better one. Obviously, the postponement means that the families on the state's waiting list will have to wait a little longer, but they can find comfort in this latest delay. By ordering the state to file yet another response, Woodlock is in effect ordering the Cellucci administration to confront the issue. "The positive is that the judge is taking our efforts seriously," McKittrick says, "and is holding the state's feet to the fire."

This time, the Cellucci administration needs to get it right.

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