The Executive Office of Health and Human Services, which accounts for more than half of the state’s proposed $61.9 billion budget in fiscal year 2026, is responsible for overseeing services including public health, child welfare, MassHealth, and public assistance programs. The administration proposed increasing the office’s overall budget by 9 percent in the coming year, to $33.3 billion.
Departments that would benefit from the overall increase include those responsible for senior services and support for people with intellectual and developmental disabilities, which are slated for budget increases.
Pappas, operated by the Department of Public Health, is one of two residential facilities the governor’s budget would close. The other, the Department of Mental Health’s Pocasset Mental Health Center on Cape Cod, provides inpatient and outpatient care, including special services for young adults. State officials expected to save about $31 million through hospital consolidations.
In comments Wednesday, Healey said the hospitals were underused and aging, and the services they offered would be redirected.
Chrissy Lynch, president of the Massachusetts AFL-CIO labor union, opposed the cuts, which she said, “come at a time when our communities, children, parents, social workers, nurses, and educators are already struggling to navigate an overburdened mental health care system and a lack of affordable options for children with disabilities.”
Pappas, in Canton, once known as The Massachusetts Hospital School, has offered disabled children services for more than a century. The existing campus, which includes a main hospital building and several cottages, is too old to meet the state’s standards for more modern care, state officials said. The nearly 40 young people living there now, ranging in age from 7 to their early 20s, have complex conditions such as cerebral palsy and Duchenne muscular dystrophy. They would move to Western Massachusetts Hospital in Westfield.
“Ultimately, this is about improving services and providing every child with the care they need,” said Robbie Goldstein, the state’s public health commissioner, in a statement.
Leahy said she and her colleagues are heartbroken about parting from the hospital’s residents, many of whom don’t receive visits from families. She also doubted Western Massachusetts Hospital, which she likened to a nursing home, could provide the experiences Pappas offers. Those include trips to Red Sox and Bruins games, on-site wheelchair repair, and a unique pain management program.
“We have so many services at Pappas that will never, ever, ever get to Western Mass.,” she said.
Hospital management informed workers Monday they would be able to transfer to another DPH facility, but most workers, if not all, can’t uproot their lives and move to Western Massachusetts, said Leahy, who lives in Braintree.
Closing Pappas is part of a proposed 5 percent budget cut to the Department of Public Health, leaving the department with a proposed $949.9 million budget.
The Pocasset program’s closure would be part of an $82.7 million cut to DMH’s budget that also includes cutting half of the department’s case workers, 170 people, according to the AFL-CIO.
Case managers provide outpatient mental health support, helping clients maintain stability and obtain needed services, union officials said. They can play an important role in helping people before mental health troubles lead to a crisis, including hospitalization or suicide.
Daniel Shark, HHS’s assistant secretary for administration and finance, said during a presentation on the budget Wednesday that the staff cuts wouldn’t result in reduced services and reflect new ways DMH is delivering services.
“This reflects a shift to a more streamlined short-term practice management program,“ he said. ”It will better serve people’s needs.”
Case workers would receive help transferring to other HHS jobs, state officials said. DMH’s overall budget is pitched at almost $1.3 billion.
The job cuts came as a shock, though, amid a troubling lack of mental health care access in Massachusetts. Hospital officials have said a lack of mental health care contributes to overcrowding at emergency rooms statewide. The Department of Mental Health’s own residential facilities consistently have more patients than available beds, state records show.
Earl Miller, of Agawam, worked for the agency for four years and is now director of community supports for the Wildflower Alliance, a Western Massachusetts-based national peer support and training organization created by people with a history of psychiatric conditions. The loss of case workers could have a profound impact on the people they work with, he said.
“They’re going to have a huge uprooting of their system of care,” Miller said. “Often these case workers have been the most consistent person in their lives for decades.”
He was also concerned about how layoffs could reverse the agency’s progress adding Black and Latino case workers to its ranks. Diversity is critically important, he said, to give people access to case workers who can relate to their experiences.
The DPH-run Bureau of Substance Addiction Services is also facing a roughly 9 percent cut of $18.9 million. The proposed reduction comes amid the persistent spread of the ultra-potent synthetic opioid fentanyl. State and local officials have also struggled to combat the dangerous trend of combining multiple substances, including stimulants such as methamphetamine and cocaine, with opioids.
“DPH is committed to addressing substance use and preventing deaths, and we can continue to provide our core functions and support harm reduction services, recovery initiatives, and prevention efforts with the more than $200 million we are investing in substance use disorder funding,” Goldstein said in a statement. “The reductions in this year’s budget proposal were targeted to minimize impact (for example, to initiatives that were ending or could be moved to another funding source).”
The number of people who died in Massachusetts from opioid-related overdoses fell by 10 percent in 2023, the largest decrease in the state in more than a decade. Yet the total number of deaths for the year, 2,125, was still the third-highest since 2001, and recent progress has not been uniform across racial and ethnic groups.
“By cutting this funding we are leaving thousands within our community — mothers, fathers, children — without care that we know saves lives. Recovery is possible for everyone, but not without funding,” said Jennifer Knight-Levine, cofounder and chief executive of the SAFE Coalition, a social services agency that provides mental health and substance use counseling in west-central Massachusetts.
Jason Laughlin can be reached at [email protected]. Follow him @jasmlaughlin. Chris Serres can be reached at [email protected]. Follow him @ChrisSerres.
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