What is The Arc and ADDP Position on the Duals Proposal?

The Arc of Massachusetts and ADDP believe that Long Term Supports and Service and the HCBS Waiver Services should be carved out and not included in the programs that will be assigned to ICOs.

The primary goal of the Dual Eligible Program is to improve care and coordination to programs serving individuals eligible for both Medicare and Medicaid services, as well as provide fiscal savings for both the federal and state governments.

These goals are currently strong features of the current manner in Massachusetts LTSS & HCBS Waiver/DDS programs.

Additionally cost controls and rate stability is the primary goal of Chapter 257 rate reform enacted four years ago.

The Arc and ADDP do not believe there is current research available that validates significant cost savings attained by turning over large parts of State Medicaid programs to managed care companies.

As well, The Arc and ADDP worry that funds needed to support Long Term Supports and Services may be diverted to cover shortfalls in health expenditures in a blended capitated rate system.

Under programs that feature managed care entities, such as the ICOs, managed care companies make their profit goals by denying or reducing service in order to create cost savings from which they are paid.

The Arc and ADDP fear that service reductions may cause significant harm to people with disabilities.

How can you learn more about the State's Dual Eligible Program?

Stay tuned for upcoming action alerts to help us get our position across to EOHHS.
You can read an earlier response to a MassHealth dual eligibles information request by The Arc at this site.
You can read Massachusetts demonstration proposal here.
MassHealth has a duals eligible site where information is posted.

Public Comment Hearings on the Draft Demonstration Proposal on Duals

December 16, 2011, 1 PM - 4 PM, Worcester Public Library, Saxe Room, 3 Salem Square, Worcester, MA
January 4, 2012, 9 AM - 12 noon, State Transportation Building, Conference Rooms 2 & 3, 10 Park Place, Boston, MA

These hearings will provide members of the public an opportunity to give oral comments on the draft Demonstration Proposal (see "Related Information" section on MassHealth's duals website). Commenters may also submit written testimony at the public hearings. Reasonable accommodations will be made for participants who need assistance. Please send any request for accommodations to Donna Kymalainen at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Does it make sense to close state developmental disabilities institutions?

Op/Ed Column by Gary Blumenthal, President & CEO of ADDP (2011)

Yes, it does. Closing state institutions and expanding community programs is best practice recommended by 30 years of practice and endorsement by disabilities professionals and embraced by the rest of the nation; and as the result of litigation by disabilities advocates motivated by a lack of options and services for people living in the community and civil rights advocates disturbed by patterns of past abuse & neglect in institutions across the country.

Massachusetts stands out as one of only a handful of states that has resisted closing excess state institutions. In fact there are only seven state institutions in all of New England, six of which are in Massachusetts.

As Massachusetts legislators are struggling to put together the FY 11 budget, they are once again facing the perennial discussion regarding the State's plan to close four of the state's six state institutions for people with developmental disabilities.

In December 2008, Governor Deval Patrick accepted a recommendation from EOHHS Secretary JudyAnn Bigby and DDS Commissioner Elin Howe to reduce the state's operation from six to two institutions, noting that the system, which once housed over 10,000 people with developmental disabilities had dwindled to serving less than 900 people, while the community system had grown to serving more than 30,000 people in both the private provider system and state operated programs.

The recommendation to close state institutions has been one supported by the developmental disabilities professional community, national family advocacy organizations, such as the Arc of the U.S. and UCPA-US, and notably the National Conference of State Legislatures (NCSL). In fact, for several years NCSL has recommended de-institutionalization and closure to its members.