BALTIMORE - For Maryland’s Developmental Disabilities Administration, it’s been one issue after another.
There were the 23 unauthorized vehicles purchased for $610,000.
There was nearly $5.5 million in provider claims that might not have been submitted for processing for federal reimbursements.
And then there was the $820,000 that was recoverable, had the administration investigated and corrected claims.
All this was revealed during an audit of the organization in October 2013. The findings prompted state officials to take action.
Nearly a year after state auditors rated the DDA unsatisfactory, a new director, coupled with a long term restructuring plan, hopes to revitalize an agency that helps thousands of disabled residents every year.
Dr. Bernard Simons, former director of Missouri's Division of Developmental Disabilities, took over as head of the agency on April 15.
In four months, he’s been busy getting to work. State leaders gave approval for the organization’s restructuring in July.
“Now that we have have approval, I am working closely with everyone to make sure services are the best they can be,” Simons said.
Simons plans to focus improvement efforts in a few key areas, including a move towards “self directed” approach to services and providing more oversight into agency spending.
“The key is to let the person decide what works best for them,” he said.
DDA is the social service agency for the state’s residents with developmental disabilities, including those with cerebral palsy, Down syndrome and intellectual disabilities. The Department of Health and Mental Hygiene is its parent organization.
To make those decisions, Simons said he met with stakeholders all over the state. He’s also requested feedback from advocacy groups, families and service providers.
During his first month, Simons hired a new chief financial officer. He’s also helped implement new procedures to prevent the mishandling of departments funds.
In the next year, Simons also wants to restructure regional DDA offices, which helps allocate services to those enrolled with the agency.
He hopes to include a self-advocate in each district office in the state. This person in this part-time position would be charged with working with local outreach groups. In addition they would also train people to advocate for themselves.
“To have an advocacy specialist on a day to day basis is a powerful thing,” Simons said. “It helps things move forward.”
The DDA has also established a quality advisory council to get insight into how services from the agency are implemented around the state.
Members include a variety of people, who provide an outside perspective to DDA operations, Simons said.
“The chair is someone with developmental disabilities and the vice chair is a parent,” said. “It’s not anybody from the DDA, it was done intentionally that way.”
The blueprint for the plan was set by his predecessor, Tim Dooley, who acted as interim director of the DDA from June until April.
Steve Morgan, executive director of the ARC Baltimore, a nonprofit organization that works with individuals with developmental disabilities, said the meetings with Simons and the DDA have helped put a positive perspective on long term plans.
“Simons is someone who has the experience to help move the system,” he said.
Morgan said a more self-directing approach will help families choose what is best when it comes to support for the person receiving services.
In an effort to do this, the ARC recently launched its Career Catalyst project, which combines real-life work with classroom instruction for adults.
“Those enrolled are preparing for a future and get to choose their area of interest,” Morgan said. “We expect things to grow under this new initiative.”
In October, a report from the Office of Legislative Affairs found the DDA had many accountability and compliance levels that failed to govern the population its served.
The audit revealed the agency overpaid contractors, inadequately monitored services from providers and showed weakness in securing IT data.
Auditors also found the agency wasted millions due to computing errors, delayed billing and overpaying services.
Some of the findings had been repeated in previous reports, going back at least a decade.
To mitigate the issue, the Department of Health and Mental Hygiene took action by hiring a turnaround specialist from Alvarez & Marsal.
This led to the appointment of an interim DDA director and the drafting of a restructuring plan.
The General Assembly also held back nearly $1 million in funding until the restructuring plan was finalized.
Before the audit came out, advocacy leaders said statewide, there continues to be challenges in providing services to those using the services with the DDA, said Heather East, acting executive director of The Arc Maryland.
In terms of policy, East said one challenge continues to be residents waiting to get services.
Between 2013 and
2014, the wait list increased from 7,690 to 8,352.
“The waiting list continues to be an issue despite funding from the alcohol tax as many individuals are waiting for residential supports or day supports,” she said.
Advocacy groups were also concerned after the DDA returned $25 million in unspent funds to the state’s General Fund in 2011.
From his nearly 40 years experience, Simons also wants to create a network program connecting families that can talk with each other on navigating disability services.
“It was something we helped pilot in Missouri,” he said. “When a new family came in, they were automatically linked up.”
In a year, Simons said he hopes to see an organization that continues to provide quality care with a grassroots touch.
“Quality of life is important,” he said. “To do this, we have to continue to have supports in place that will help this organization successful.”