Advocates criticize Municipal Empowerment Act’s approach to public meeting reforms

Advocates criticize Municipal Empowerment Act’s approach to public meeting reforms

Proposed legislation fails to guarantee equitable access and undermines the spirit of the Open Meeting Law

FOR IMMEDIATE RELEASE

February 27, 2024

CONTACTS:

Kate Lagreca, klagreca@aclum.org

Geoff Foster, gfoster@commoncause.org

BOSTON – The state’s Joint Committee on Municipalities and Regional Government is scheduled to hold a public hearing today on parts of Governor Healey’s Municipal Empowerment Act S.2571. A coalition of democracy, disability access, and open government advocates expressed strong concerns about the bill’s consequences for access to local government meetings included in sections 2-5. The proposal would make the format of local open meetings completely discretionary instead of maximizing access by guaranteeing hybrid public meetings with both in-person and remote access.

The ACLU of Massachusetts, Boston Center for Independent Living, Disability Law Center, Common Cause Massachusetts,  League of Women Voters of Massachusetts, Massachusetts Newspaper Publishers Association, MASSPIRG, New England First Amendment Coalition, and New England Newspaper & Press Association released the following joint statement in response to the bill:

 

“The Municipal Empowerment Act falls short on ensuring access to public meetings. It will shut people out of the democratic process by only allowing — and not requiring — municipalities to provide hybrid participation options. Giving every government body complete discretion about how to provide public access to their meetings means people with disabilities or other reasons they can’t attend meetings will be completely shut out when city councils, select boards, or school committees decide to hold meetings exclusively in person.

 

“Last session, the House passed forward-thinking legislation that would have guaranteed hybrid participation by entities under the Open Meeting Law, and together the House and Senate passed a $30 million bond authorization to support municipal IT infrastructure, which Governor Baker vetoed. Passing on the opportunity to build on the Legislature’s earlier efforts, the language in the Municipal Empowerment Act is a major step backwards. It’s time to guarantee the permanent removal of long-standing barriers to participation that particularly impact people with disabilities, caregiving responsibilities, or limited transportation. We look forward to working with the House and Senate to ensure a reasonable guarantee of public access by strengthening the Open Meeting Law for residents of all 351 cities and towns.

 

“We’re also concerned that a matter of such significant importance is being considered by the Joint Committee on Municipalities and Regional Government instead of the Joint Committee on State Administration and Regulatory Oversight, which has substantial expertise in this area and is able to properly consider the application of the Open Meeting Law to state agencies as well as municipalities. In addition, the language in the bill would undermine the spirit of the Open Meeting Law, because it could result in the level of access to local public meetings varying dramatically from one municipality to the next. The Open Meeting Law has always ensured a statewide standard for public access for all 7 million Bay Staters across all 351 cities and towns.”

 

Background:

In spring of 2023, the coalition conducted a survey of every city council, select board, and school committee in the state. According to that survey, more than half of those bodies are already conducting fully hybrid or live-streamed meetings. Indeed, hybrid meetings are already standard operating procedure for many government entities in municipalities of every size, from Boston to Gosnold.

  • City councils and select boards: 45% of city council and select board meetings are fully hybrid and 17% more are live streamed. In total, 62% are fully hybrid or live streamed.
  • School committees: 35% of school committee meetings are fully hybrid and 25% are live streamed. In total, 60% are fully hybrid or live streamed.

The coalition supports a legislative proposal (H.3040/S.2024) that will ensure greater access to open meetings for everyone—particularly for people with disabilities, caregiving responsibilities, or limited transportation—by requiring options for officials and members of the public to attend meetings in person or remotely.

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Investigation at Bear Mountain at Worcester

FOR IMMEDIATE RELEASE

Contact: intake@dlc-ma.org

DLC Report Finds Harmful Lack of Proper Care for Patients at Bear Mountain Nursing Facility in Worcester

Understaffing, overmedicating, and isolating practices plague facility’s long-term patients;

Weak state standards; lackluster enforcement contribute to woeful conditions

 

BOSTON, MA (January 31, 2024): The Disability Law Center, Inc. (DLC), the Commonwealth’s Protection and Advocacy system, today released an investigative report detailing harmful practices at the Bear Mountain Worcester nursing facility. The report finds the facility, part of a large for-profit healthcare group, demonstrates a detrimental lack of proper patient care. Understaffing, overmedication, and neglect are among the practices of concern highlighted in the report.

The report, the result of a two-year investigation into complaints originating from patients and their families, outlines the worries of those skeptical of the facility’s safekeeping of their loved ones. The federal Nursing Home Reform Act (NHRA) sets standards for ensuring proper care for nursing home residents for a facility to be deemed operable. DLC found many NHRA violations that also constituted abuse or neglect under the statutes that protection and advocacy systems utilize when conducting investigations.

“Our investigation uncovered deeply troubling practices at Bear Mountain’s Worcester facility. The treatment of patients in this facility violates their rights and reflects a wider issue within the industry,” said Nina Loewenstein, lead author of the report and Senior Attorney at DLC. “It’s imperative that immediate action be taken to ensure the safety and well-being of these vulnerable residents.”

In their research, DLC uncovered evidence of a reliance on antipsychotic drugs, questionable schizophrenia diagnoses, isolation, a lack of effective interdisciplinary behavior plans, and minimal engagement with patients in the neuro-behavioral unit. These typically derive from a severe lack of staffing and clinical expertise at facilities, a common issue within the industry, particularly among for-profit providers. The facility lacks any nursing staff who are trained and credentialed in psychiatric nursing, lacks a psychologist, and most importantly, lacks on-site psychiatric and neurological consultations.

Additionally, DLC found that patients have been routinely medicated with multiple antipsychotics and other psychotropic medications, raising compelling questions as to whether this is a consequence of the facility’s understaffing and lack of adequate training and oversight. This practice is prevalent within the neurobehavioral unit, where patients with varying diagnoses, including brain injuries, anxiety, depression, dementia, trauma, and similar behavioral health conditions, reside. The unit comprises two locked floors within Bear Mountain Worcester and is not frequented by other residents.

The report also notes that guardians and families of residents have reported widespread, serious infections spreading on site, as well as known rodent infestation and unclean communal spaces. Many residents are unable to report these hazardous conditions themselves.

In response to DLC’s audit, Bear Mountain has agreed to make changes within the facility, including working to certify identified staff on the neurobehavioral unit as certified brain injury specialists through the Brain Injury Association of Massachusetts, as well as conducting a 3-hour Fundamentals of Behavior Management course and an Applied Behavioral Analysis course. Additionally, Bear Mountain is refurbishing its van to facilitate offsite social and community activities, including offering special trips, such as personalized shopping trips, and increasing the number of therapeutic programs offered to residents, related to money management, activities of daily living, hygiene, social skills, and education about healthy eating and exercise.

“The conditions at Bear Mountain have been appalling. It has been a dire situation, and we must hold the Commonwealth accountable for its duty to inspect and ensure proper care in these facilities,” said Barbara L’Italien, Executive Director of DLC, the Commonwealth’s Protection and Advocacy (P&A) system and a nonprofit organization advocating for human rights, empowerment, and justice for people with disabilities.

DLC’s research shows negligence and misconduct are common issues in for-profit healthcare facilities. Their report informs that staffing nursing homes is often a costly endeavor with little return for the investor. Therefore, operating with as few staff as possible is often preferred within the for-profit nursing home sector. Nearly two-thirds of all Massachusetts nursing homes are for-profit.

“Patients and families trusted Bear Mountain to provide proper care, and the facility has failed them time and again,” said Rick Glassman, Director of Advocacy for DLC. “Our research unequivocally shows that the Commonwealth must promptly and carefully examine the negligent or abusive practices at Bear Mountain in Worcester. We are grateful to Bear Mountain for their cooperation in our review and the measures they are taking to improve their facility and we appreciate new state policies to oversee the use of antipsychotics. Our position remains that the Commonwealth is duty-bound to inspect these facilities with an eye towards identifying root causes of deficiencies. Also, the state must impose more rigorous sanctions and corrective action plans when necessary. In this instance, they have not done so.”

DLC’s report includes recommendations that the Commonwealth should take to ensure the well-being of the residents at the facility. These include requiring clinical expertise in psychiatry and neurology; requiring robust multi-disciplinary behavior plans; and limiting enhanced compensation of specialized facilities to those settings which adhere to enhanced standards of care.  The Commonwealth must also ensure the facility is providing training for direct care staff in neurological care and psychotropic medications, as well as human-centered approaches to care and behavioral management; hiring sufficient staff to provide consistent quality care and maintaining basic hygiene; ensuring that residents and legal representatives understand the risks and benefits of medications; and investing in homelike environments and therapeutic spaces with resident involvement and choice. It is also recommended that Bear Mountain restore transportation services to community settings, including shopping and parks, and provide programming to develop activities and skills of daily living and vocational and education counseling.

DLC conducted six site visits from October 2021 until October 2023. During this time, DLC observed the facility’s conditions, reviewed patient records, and interviewed residents and staff, including facility administrators and behavioral health staff from the outside agency providing behavioral health services at Bear Mountain. A psychiatric nurse, a neuropsychiatrist and former nursing home administrator familiar with audits and reviews assisted DLC as experts in assessing the nursing home and final recommendations.

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Action Alert on Outpatient Commitment

Action Alert on Outpatient Commitment: This fall, the legislature’s Judiciary Committee will finish its hearing on the outpatient commitment (IOC) bill, H.164/S.980. If you would like to oppose this, instructions for submitting written testimony are at https://malegislature.gov/Events/Hearings/Detail/4637.  See also https://malegislature.gov/Search/FindMyLegislator

More information is available at https://www.mamh.org/advocacy/take-action/involuntary-outpatient-commitment

Read DLC’s written testimony submitted to the Judiciary Committee:

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Wheelchair Repair Bill – Press Release

FOR IMMEDIATE RELEASE:

Thursday November 3, 2022

Contacts: 

Harry Weissman (Disability Policy Consortium ) at hweissman@dpcma.org; 617 977 4084

Kay Schoucair (Boston Center for Independent Living) at kays@bostoncil.org; 617 821 4394

Rick Glassman (Disability Law Center) at rglassman@dlc-ma.org; 617 315 4606

BOSTON – November 3, 2022:  Massachusetts wheelchair users and advocates gathered at the State House this afternoon to applaud today’s action of the Senate Ways and Means Committee and the full Senate in supporting legislation to help fix the deeply broken wheelchair repair system in Massachusetts.  The measure was reported out favorably by the Senate Ways and Means Committee as S.3136  and was voted upon favorably by the full Senate.

Wheelchair users explained that the wheelchair repair bill is a critical piece of disability rights legislation that would improve warranty protections for people who use wheelchairs in Massachusetts.  Consumers and advocates described how wheelchairs and other durable medical equipment devices are often prone to defects and sudden failure. It is commonplace for consumers to be left stranded or isolated in their homes for weeks, or even months, awaiting repairs, unable to get to work, school, medical appointments, the grocery store, and in some cases to move around their own home. At worst, it can lead to serious health complications due to missed medical appointments, temporary solutions that are physically unsafe, and not being able to move one’s body.

The Wheelchair Warranty Bill, S. 3136, would expand warranty coverage to all wheelchairs in Massachusetts for two years; hold providers to firm timelines for responding when a chair is inoperable; provide loaner chairs and reimbursements to consumers while they wait for warranty repairs; and require providers to have access to an inventory of spare parts.

Senator John Cronin, the bill’s lead sponsor in the Massachusetts State Senate, explained why there is a dire need for this legislation. “When an industry becomes consolidated into only two or three providers, we may need guardrails to ensure basic fairness for consumers who have lost their bargaining power. This is especially true for people who use wheelchairs who are often already marginalized and who rely daily on their wheelchairs, to get to work, school, medical appointments or elsewhere in the community.

“Wheelchair repair is a health care crisis in Massachusetts, and we need legislation to address it,” said Harry Weissman, Director of Advocacy at the Disability Policy Consortium. “We’re grateful to the Senate for taking significant action on this issue today, bringing us a major step closer to fixing the broken repair system.”

 

Joe Bellil, as Vice President of Public Affairs at EasterSeals Massachusetts, spoke to how he’s seen this issue play out in his professional role.  “Throughout my career I’ve seen people with disabilities stuck in their beds and jeopardizing their health by not being able to access the care they need, just because their wheelchairs weren’t working. I have seen employees who use wheelchairs be forced to miss work due to needed repairs taking too much time.” A wheelchair user himself, Bellil added, “We don’t need any more barriers to prevent us from being able to be part of the community, and this bill helps us move forward.”

“As I looked back on the difficulties I’ve had with wheelchair repairs over more than ten years – so this is not a recent supply chain issue – what stood out most was that there were problems every single time,” said Ellen Leigh, a resident of Arlington, MA, who uses a power wheelchair. “No exceptions. When I needed help, from replacing tires to motors, repairs have always taken months.”

Ellie Vargas, a power wheelchair user supporting this legislation explained, “I think the bill is very important because myself and many others are experiencing delayed repairs and severe depression from it. While I was heading over to the State House today, a part of my power wheelchair which covers the wiring fell off. Repairs are very necessary to improve our life in general and gives us the opportunity to be part of the community and to work in the workforce. I am always looking for work and if my wheelchair is not up to date and maintained then the opportunity to work like everyone else is taken away from me.”

Bill Henning, director of the Boston Center for Independent Living (BCIL), noted, “BCIL applauds the action of the Senate—those using wheelchairs, fundamental to basic movement and mobility, too long have been subjected to challenges from manufacturers of wheelchairs. These protections are long overdue.”

Barbara L’Italien, Executive Director at the Disability Law Center, stated, “The Disability Law Center views access to a fully functioning wheelchair to be a civil rights issue since the chair allows for access in the home, at work, and for every other daily activity. Too many people have had that basic right of mobility taken away through a repair system which took too long and was not prioritized. I applaud the Senate for addressing this critical issue by setting a standard for warranties and timely repairs and hope the House will follow suit this session.”

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Supporters:
Advocates supporting this legislation include the Disability Law Center, Disability Policy Consortium, Boston Center for Independent Living, Center for Living and Working, Northeast Independent Living Program, Ad Lib Center for Independent Living, Cape Organization for Rights of the Disabled, Disability Resource Center, Southeast Center for Independent Living, Independence Associates, Metrowest Center for Independent Living, Stavros Center for Independent Living, Health Care for All, Easterseals Massachusetts and Greater Boston Legal Services.

Resources:

Disability Law Center Investigation of Tewksbury Hospital – Findings and Recommendations

DLC initiated a monitoring of Tewksbury State Hospital on April 23, 2020 due to reported concerns regarding the spread of COVID-19 at the facility, which houses units run by the Department of Public Health (“DPH”) and the Department of Mental Health (“DMH”). In addition, DLC received a complaint to the system regarding the hospital’s COVID-19 practices and procedures. DLC found probable cause on June 9, 2020 to open an investigation. At that time, the COVID-19 Weekly State Facility Report stated that 180 staff tested positive, 154 patients tested positive, and 18 patients had died from COVID-19. As part of its monitoring and investigation, DLC interviewed hospital leadership, and reviewed records related to COVID-19 infection controls and the records of the 18 patients who died from causes related to COVID-19. In addition, DLC conducted remote interviews with 32 DMH and DPH patients.

 

Per a letter dated July 6, 2021, DLC found that failures and delays in implementing appropriate COVID-19 protocols at Tewksbury did not adequately protect patients at the onset of the pandemic. DLC also found that once the infection control assessments were completed and the recommendations were implemented, the hospital successfully reduced facility COVID-19 transmission. DLC recommended the immediate development of a pandemic preparedness plan, including the following:

 

  1. Detailed safety procedures concerning prevention of the spread of COVID-19 and other infectious diseases at Tewksbury and detailed criteria regarding when and how such procedures shall be implemented; 
  2. Detailed plans on how each unit will safely continue to provide services, recreation, exercise, fresh air and treatment when the pandemic preparedness plan is in place, rather than halt access to program and services; 
  3. Continued conversion of all quadruple and triple patient rooms to single and double rooms; and 
  4. Assessment of Wi-Fi dead spots and plans to immediately improve Wi-Fi access across the hospital. 

 

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