Header, the Administration of the Honorable Lincoln C. Almond
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August 5, 1996


In accordance with the provisions of Section 43-1-4 of the General Laws, I am transmitting herewith, with my disapproval, 96-S 2594, Substitute B, "An Act Relating to Mental Health, Retardation and Hospitals Developmentally Disabled Adults."

This Act would create a new class of persons entitled to services from the Department of Mental Health, Retardation and Hospitals (MHRH) based solely on the fact that an individual has received "developmental, supportive, ancillary, or residential services for three (3) or more years immediately prior to referral to the department," excluding certain services provided to juvenile offenders. Under the Act, such individuals would be presumed to be both a "developmentally disabled adult" and an "adult with serious mental illness" for purposes of qualifying for entitlement to MHRH services. This presumption would be rebuttable under the Act only "by clear and convincing evidence to the contrary."

This legislation attempts to address significant difficulties which have arisen when children under'the care of the Department of Children, Youth and Families become 21 years of age and must qualify under different criteria applicable to the adult system. In some instances, an " individual who has received intensive treatment through DCYF as a child has been found ineligible for MHRH services by failing to satisfy eligibility requirements for such services. These circumstances could produce a very harsh result in which an individual heavily dependent on the state for treatment becomes ineligible for further services solely by reason of reaching adulthood.

Unfortunately, the solution prescribed by the Act goes too far. For those individuals targeted by the Act, the eligibility criteria governing MHRH services would be jettisoned and replaced with presumptive eligibility which could be disproved only upon clear and convincing evidence. Such presumptive eligibility is provided under the Act not only to those persons in intensive, residential DCYF care, but also to those receiving "developmental, supportive, [and] ancillary" services for three years immediately prior to referral to the adult system. This leads to an incongruous result: individuals who have received counseling or other non-intensive services for three years would be "presumed" to be both "developmentally disabled" and "seriously mentally ill" irrespective of the individual's actual clinical condition.

Additionally, individuals who may not meet the federal eligibility criteria would be found entitled to MHRH services, but services to these individuals would not qualify for Medicaid reimbursement. These expenditures would then be fully state-funded services and are not included in the FY 1997 Budget. These costs are currently indeterminable and would potentially "have a substantial negative impact on the Departments budget.

Moreover, MHRH currently provides programs and services only to those clinically determined to be developmentally disabled or seriously mentally ill. The Department does not currently offer services to individuals who may suffer from some other condition, and would need to develop new programs to serve this new population.

While I disapprove of this legislation, I do agree that the problem underlying this legislation needs to be addressed. In this regard, I intend to form a study group by executive order to recommend to me appropriate legislative or administrative action which responds to the issue in a compassionate and cost-effective manner.

For the foregoing reasons, I disapprove of this legislation and respectfully urge your support of this veto.


Lincoln Almond