Senators Urge State to Let Adults With Disabilities Stay at Out-Of-State Facilities

Andrew Kitchenman | May 6, 2015 | Health Care
But Human Services officials say population is better served in community placements

Acting Human Services Commissioner Elizabeth Elizabeth Connolly (right).
Legislators’ appeals to administration officials to allow adults with disabilities who have lived outside of New Jersey for most of their lives to stay where they are made no progress yesterday.

State officials continue to argue that these adults can be better monitored at New Jersey facilities; that they deserve to live in homes that are integrated into communities; and that the state can receive more federal funds that can serve more residents if they’re returned.

The families of some of these adults have been fighting efforts to return them from out-of-state facilities. While school districts still place children with developmental disabilities in out-of-state residential facilities to meet their educational needs, New Jersey has had a policy for several years of bringing them back when they’ve grown up.

There are still 382 adults who are living in these out-of-state placements, while 170 have been brought back to small group homes as part of the Return Home New Jersey program.

Sen. Linda R. Greenstein (D-Mercer and Middlesex) said during a budget hearing yesterday that the state should be flexible in addressing the needs of individuals. As a lawyer, Greenstein worked on disability issues for 10 years with the Community Health Law Project.

Greenstein noted that some institutions — like Woods Services in Langhorne, PA — provide a level of services that would be difficult to recreate in small group homes.

“There is some need for this institutional-type setting,” Greenstein said, noting: “Apparently, some people are amazingly happy there.”

Acting Human Services Commissioner Elizabeth Connolly said that there are New Jersey providers who deliver the same level of care, with facilities that receive a higher level of monitoring than can be ensured outside New Jersey. She added that concerns have been raised about residents’ safety in some out-of-state institutions.

New Jersey is spending $48.3 million on the 382 residents living out of state, and would likely spend a similar amount if they were returned. But the state would also become eligible for an additional $22.8 million in federal Medicaid matching funds, since the federal government furnishes additional funding for community-based placements. This money can be used to benefit a larger number of residents than just those subject to Return Home New Jersey, officials have said.

Greenstein said the state should “grandfather” those residents who’ve lived in their current homes for decades.

“I beseech you to take another look at this,” she said. “I think it’s the humane and right thing to do. I think that they are happy where they are; I think the families are happy; and when they’re happy they’re also a little healthier; and I think that anything we can do not to cause them mental anguish is an important thing for us to do.”

[related]While Greenstein said that many senators “feel very strongly there’s something wrong — that there is an injustice being done,” Connolly said state officials feel very strongly that people should be “integrated into the community, not isolated and not part of an institution. We believe that community living is good for everyone.”

Sen. Jeff Van Drew (D-Atlantic, Cape May and Cumberland) also said it’s hard to see the benefits to residents of transferring them when they or their families don’t want them to return. He noted that some residents are elderly, while others have been considered by a dozen or more New Jersey agencies that ultimately decided that they couldn’t meet the residents’ needs.

“Moving those people just to prove that point it seems to me just a little counterproductive,” Van Drew said.

He said the policy was “harsh.”

“You have people that are just good sincere people that are just crying and heartbroken and terrified of what’s going happen,” he said.

Connolly said that the state Department of Human Services would continue to consider each person’s needs and look for a provider that will meet them. Officials also said that the transfer process generally moved very slowly, since the state carefully considers the health, safety, social, and emotional needs of each person over what can be several years.

Gov. Chris Christie vetoed a bill that would have applied a moratorium on any transfers under Return Home New Jersey. While legislators have worked on a compromise bill, including one that would have applied to about half of the out-of-state adults, Sen. Paul Sarlo said he doesn’t think that a compromise will be reached.

“This is a very, very difficult time for many of these people, and not just their loved ones but the people who are here in New Jersey and thinking about that unknown of moving somebody … out of a facility they called their home,” for up to 40 years, Sarlo said.

The arguments over Return Home New Jersey have paralleled a similar debate about the closure of two developmental centers, which are large state-run facilities that serve residents with developmental disabilities. The closures of the facilities in Woodbridge and Totowa led to many residents being moved to centers in distant parts of the state, raising concerns that family members wouldn’t be able to visit.

State officials have cited the need to place community residents in the least-restrictive environment under a 1999 U.S. Supreme Court decision. Closure opponents said that decision doesn’t apply to cases in which a person or his or her guardian opposes a transfer.