Bill Text: CT HB05036 | 2012 | General Assembly | Introduced


Bill Title: An Act Implementing The Recommendations Of The Legislative Program Review And Investigations Committee Concerning The Provision Of Selected Services For Persons With Intellectual Disability.

Spectrum: Partisan Bill (? 1-0)

Status: (Introduced - Dead) 2012-02-16 - Public Hearing 02/22 [HB05036 Detail]

Download: Connecticut-2012-HB05036-Introduced.html

General Assembly

 

Raised Bill No. 5036

February Session, 2012

 

LCO No. 405

 

*00405_______PRI*

 

Referred to Committee on Program Review and Investigations

 

Introduced by:

 

(PRI)

 

AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE LEGISLATIVE PROGRAM REVIEW AND INVESTIGATIONS COMMITTEE CONCERNING THE PROVISION OF SELECTED SERVICES FOR PERSONS WITH INTELLECTUAL DISABILITY.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (NEW) (Effective October 1, 2012) (a) Notwithstanding the provisions of section 17a-277 of the general statutes, the Commissioner of Developmental Services shall not accept any person with intellectual disability for admission to a regional facility or community-based residential facility operated by the Department of Developmental Services, unless such person is a department client: (1) Transferred from the Southbury Training School; (2) transferred from a regional facility operated by the department; (3) who is in need of placement at a particular facility operated by the department because such facility is the only facility designed to serve a specific need of the client; or (4) who is placed at such a facility operated by the department pursuant to a court order.

(b) Not later than January 1, 2013, and not later than January first annually thereafter the Commissioner of Developmental Services shall evaluate the direct care staffing levels for the Southbury Training School, each regional center and each community-based residential facility that is operated by the department. Such evaluation shall include consideration of: (1) The service and programming needs of each of the facility's clients, as determined by the department's level-of-need assessments; and (2) a determination of the appropriate level of security and supervision needed by the facility's clients. The commissioner shall compare staffing levels at facilities operated by the department with the staffing levels at facilities in the private sector that serve clients with similar needs. Where the commissioner finds that staffing levels in a facility operated by the department are higher than a comparable private-sector facility, the commissioner shall reassign staff from the department-operated facility to assist clients living in their homes who are awaiting residential services. Such assistance may include respite care and other direct care client services. All staff reassignments made by the commissioner pursuant to this subsection shall be made in accordance with applicable collective bargaining agreements.

(c) The Commissioner of Developmental Services shall not hire any person to fill a direct care staff position for a residential, day services or an employment program of the department without prior authorization from the Secretary of the Office of Policy and Management. The commissioner shall, prior to making a request to the Secretary of the Office of Policy and Management to hire a person to fill such a position, ensure that: (1) The hiring is related to public health or safety; (2) the hiring is necessary to ensure compliance with a collective bargaining agreement, court order, or state or federal law; and (3) there is no alternative way to carry out the function of the position.

Sec. 2. (NEW) (Effective October 1, 2012) (a) As used in this section: (1) "Interdisciplinary team" means a group of persons arranged by the Department of Developmental Services for each client of the department, that may include a social worker, psychologist, nurse, residential programmer, educational or vocational programmer and such other persons who work closely with the client and whose participation may be necessary to determine the needs of the client; and (2) "most integrated residential setting" means a residence that enables the client to interact with persons without a disability to the fullest extent reasonably possible.

(b) The Department of Developmental Services shall arrange for an evaluation of each client of the Southbury Training School and each client of a regional facility operated by the department to be conducted by the client's interdisciplinary team. The interdisciplinary team shall, based upon the members' professional judgment, determine the client's priority programming needs and determine the least restrictive and most integrated residential setting in which those needs are likely to be met.

(c) Not later than March 1, 2013, the interdisciplinary team shall notify the client, if appropriate, and the client's parent, conservator, guardian or other legal representative, in writing, of its determination of the most integrated residential setting appropriate for placement of the client. The interdisciplinary team shall provide the client, if appropriate, and the client's parent, conservator, guardian or other legal representative with sufficient information to assist the client and the client's parent, conservator, guardian or other legal representative in deciding whether to accept the recommended placement. Such information shall include, but not be limited to, reports of inspections conducted by the Department of Public Health or the Department of Developmental Services for each facility in which the client currently resides and for each facility in which placement of the client is recommended.

(d) The Commissioner of Developmental Services shall ensure placement of a client occurs as soon as reasonably possible after the client and the client's guardian or family member accepts a recommended placement. If a client and a client's parent, conservator, guardian or other legal representative do not accept a placement recommendation, the interdisciplinary team shall reevaluate the client's needs and make a recommendation for placement at least once annually.

Sec. 3. Section 17a-227 of the 2012 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2012):

(a) No person, firm or corporation shall operate within this state a community living arrangement or community companion home which it owns, leases or rents for the lodging, care or treatment of persons with intellectual disability, Prader-Willi syndrome or autism spectrum disorder unless such person, firm or corporation, upon written application, verified by oath, has obtained a license issued by the Department of Developmental Services.

(b) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to [insure] ensure the comfort, safety, adequate medical care and treatment of such persons at the residential facilities described in subsection (a) of this section. Such regulations shall include requirements that: (1) All residential facility staff be certified in cardiopulmonary resuscitation in a manner and time frame prescribed by the commissioner; (2) records of staffing schedules and actual staff hours worked, by residential facility, be available for inspection by the department upon advance notice; (3) each residential facility develop and implement emergency plans and staff training to address emergencies that may pose a threat to the health and safety of the residents of the facility; (4) department staff verify during quality service reviews and licensing inspections, that (A) staff is adequately trained to respond in an emergency, and (B) a summary of information on each resident is available to emergency medical personnel for use in an emergency; and (5) not less than one-half of the quality service reviews, licensing inspections or facility visits conducted by the department after initial licensure are unannounced.

(c) After receiving an application and making such investigation as is deemed necessary and after finding the specified requirements to have been fulfilled, the department shall grant a license to such applicant to operate a facility of the character described in such application, which license shall specify the name of the person to have charge and the location of each facility operated under the license. Any person, firm or corporation aggrieved by any requirement of the regulations or by the refusal to grant any license may request an administrative hearing in accordance with the provisions of chapter 54. If the licensee of any such facility desires to place in charge thereof a person other than the one specified in the license, application shall be made to the Department of Developmental Services, in the same manner as provided for the original application, for permission to make such change. Such application shall be acted upon not later than ten calendar days from the date of the filing of the application. Each such license shall be renewed annually upon such terms as may be established by regulations and may be revoked by the department upon proof that the facility for which such license was issued is being improperly operated, or for the violation of any of the provisions of this section or of the regulations adopted pursuant to this section, provided the licensee shall first be given a reasonable opportunity to be heard in reference to such proposed revocation. Any person, firm or corporation aggrieved by such revocation may request an administrative hearing in accordance with the provisions of chapter 54. Each person, firm or corporation, upon filing an application under the provisions of this section for a license for a community living arrangement, shall pay to the State Treasurer the sum of fifty dollars.

(d) The Department of Developmental Services may contract, within available appropriations, with any qualified provider for the operation of a community-based residential facility, provided the qualified provider is licensed by the department to operate such [facilities] facility. The department shall include in all contracts with such licensed qualified providers, provisions requiring the department to (1) conduct periodic reviews of contract performance, and (2) take progressive enforcement actions if the department finds poor performance or noncompliance with the contract, as follows: (A) The licensed qualified provider may be placed on a strict schedule of monitoring and oversight by the department; (B) the licensed qualified provider may be placed on a partial-year contract; and (C) payments due under the contract may be reduced by specific amounts on a monthly basis until the licensed qualified provider complies with the contract. If compliance cannot be achieved, the department shall terminate the contract.

(e) In each residential facility operated by the Department of Developmental Services or a person, firm or corporation licensed to conduct or maintain a residential facility pursuant to this section, said department, or such person, firm or corporation shall permit clients in the residential facility, relatives and legal representatives of clients in the facility and any other person designated by such clients and persons to review all inspection reports pertaining to the residential facility made by the Department of Developmental Services, the Department of Public Health, the State Fire Marshal, local fire and health departments and other state and local agencies having jurisdiction over the facility, and all summary copies of current inspection reports of the United States Department of Health and Human Services, as provided in the Social Security Act. Said department or such person, firm or corporation shall provide a room adequate for such review during normal business hours, provided no such inspection report or copy thereof shall disclose the name of any client of the residential facility. Said department or such person, firm or corporation shall post or cause to be posted in a conspicuous place in the residential facility a notice stating that such inspection reports are available for review and the location where such reports may be reviewed.

[(e)] (f) The department may contract with any person, firm or corporation to provide residential support services for persons with intellectual disability, Prader-Willi syndrome or autism spectrum disorder who reside in settings which are not licensed by the department. The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to ensure the safety, adequate supervision and support of persons receiving such residential support services.

[(f)] (g) Any person, firm or corporation who operates any facility contrary to the provisions of this section shall be fined not more than one thousand dollars or imprisoned not more than six months or both. Any person, firm or corporation who operates any facility contrary to the regulations adopted pursuant to subsection (b) of this section shall be fined not more than one thousand dollars.

Sec. 4. Section 17a-212 of the general statutes is amended by adding subsection (c) as follows (Effective October 1, 2012):

(NEW) (c) The Commissioner of Developmental Services shall establish a centralized utilization review process for clients in twenty-four-hour residential care facilities whose residential or day program funding and services exceed the Department of Developmental Services' funding guidelines that are based on the department's assessment of the client. Individuals conducting the department's centralized utilization review process shall include: (1) The director for each regional facility, or the regional director's designee; (2) the department's central office director of operations, or the director of operation's designee; and (3) the department's central office budget director, or the budget director's designee. The commissioner shall maintain an electronic database that includes the results of the utilization review process and shall: (A) Compare the number of the department's clients in each region whose residential or day program funding and services exceed such funding guidelines; (B) determine the reason such funding and services exceed such funding guidelines; and (C) determine the total number of department clients whose residential or day program funding and services exceed such funding guidelines. The commissioner shall include a summary of the results of the utilization review process in the department's management information report that is posted on the department's web site at the end of each fiscal year.

Sec. 5. (NEW) (Effective October 1, 2012) (a) In determining the amount of payments to be paid by the state under section 17a-246 of the general statutes to any organization or facility which provides employment opportunities or day services for persons referred by the Departments of Developmental Services, Mental Health and Addiction Services and Social Services, or any other state agency, the total cost allowance for the salary of the director of such organization or facility shall not exceed one hundred thousand dollars, except that on July 1, 2007, and each July first annually thereafter, the cost allowance for the salary of the director may be increased by an amount not to exceed the percentage increase of any cost of living increase provided under the terms of the contract with the organization or facility.

(b) The Commissioner of Developmental Services shall, prior to entering into or renewing a contract with a person, firm or corporation to provide residential support services, as described in subsection (f) of section 17a-227 of the general statutes, as amended by this act, review the salaries to be paid to the person, firm or corporation's direct care employees in relation to: (1) The salary of the executive director for the person, firm or corporation; (2) the self-sufficiency measurement calculated pursuant to section 4-66e of the general statutes; and (3) income eligibility levels for an individual or family to receive state Medicaid benefits and benefits under other state-administered assistance programs. The commissioner shall consider such factors in determining the amount of payments to be paid by the state under section 17a-246 of the general statutes.

(c) The Commissioner of Developmental Services shall, prior to renewing a contract with a person, firm or corporation to provide residential support services, as described in subsection (f) of section 17a-227 of the general statutes, as amended by this act, ensure the person, firm or corporation has substantially complied with the department's cost-reporting requirements.

Sec. 6. Section 20 of public act 91-11 of the June special session, as amended by section 7 of public act 07-238, is repealed. (Effective October 1, 2012)

This act shall take effect as follows and shall amend the following sections:

Section 1

October 1, 2012

New section

Sec. 2

October 1, 2012

New section

Sec. 3

October 1, 2012

17a-227

Sec. 4

October 1, 2012

17a-212

Sec. 5

October 1, 2012

New section

Sec. 6

October 1, 2012

Repealer section

Statement of Purpose:

To implement the recommendations of the Legislative Program Review and Investigations Committee regarding the provision of selected services for persons with intellectual disabilities.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]

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