January 25, 2005 |
2005-R-0093 | |
DEVELOPMENTAL DISABILITIES ADVISORY COMMISSION RECOMMENDATIONS | ||
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By: Saul Spigel, Chief Analyst | ||
You asked for (1) a brief summary of the findings and recommendations of the Advisory Commission on Supports and Services for Persons with Developmental Disabilities Who Do Not Have Mental Retardation and (2) the status of those recommendations.
The commission was created in 2000 (PA 00-35); it reported in July 2002. A summary of the report is available at executive summary).
FINDINGS
• Most states have a single agency to coordinate and provide services for all people with developmental disabilities; Connecticut is one of six states with an agency serving only people with mental retardation.
• The absence of a single responsible agency has resulted in a complex, confusing, and fragmented system of support for people with developmental disabilities. Seven state agencies have service eligibility criteria based on diagnostic levels, income, or discrete functional needs. This leads to uneven access to services, significant frustration and hardship for individuals and families, and use of inappropriate (and more expensive) systems of care such as hospitals and nursing homes.
RECOMMENDATIONS
• Develop and implement a statewide, coordinated system of supports and services
• Adopt the federal definition of developmental disabilities (which uses functional criteria) as the basis for service eligibility
• Designate the Department of Mental Retardation (DMR) as the lead agency for service coordination
• Establish an independent council to advise DMR in system design, implementation, and quality enhancement
• Develop a comprehensive, coordinated process for accessing information, resources, supports, and services
• Provide for individualized services and supports
• Establish procedural safeguards
• Establish an interagency data and information management system
• Develop a competent and adequate workforce
• Design and implement a quality enhancement and improvement system
• Secure sufficient resources to fund new services and supports.
COSTS
The commission estimated that between 5,000 and 10,000 people would seek state services and supports. It estimated the annual cost of serving this population at between $ 88. 5 and $ 147 million ($ 79 to $ 128 million for adults and $ 9. 5 to $ 19 million for children).
The commission recognized that DMR was already struggling to serve its existing population (1,500 people were on its waiting list for services at the time) and stated that unless additional resources were provided, it would “not serve these individuals or those persons with other types of developmental disabilities if the same resource base is expected to serve even more people. ”
IMPLEMENTATION
DMR and the Department of Social Services (DSS) responded jointly to the commission’s recommendations. They acknowledged its findings but stressed that budget constraints posed significant barriers to funding the recommendations.
The agencies focused on the lack of service coordination. They proposed a demonstration project in one location where existing, state-funded and state-provided services were coordinated within and across agencies and state and local levels. The pilot would concentrate on people who met the federal definition of developmental disability and who were or may be eligible for existing state-funded services and supports.
The agencies created an interagency developmental disabilities workgroup (IDDW) to develop a management plan for the pilot project, including tasks, timelines, responsibilities, outcomes, and evaluation. The plan would also detail where and how the IDDW would link with other statewide grants and initiatives.
The IDDW met between late 2002 and May 2003. (It disbanded when several members retired from state service. ) Although it did not complete its work, DMR Deputy Commissioner Katherine Dupree reports that the concept of coordinating services has been embedded in the implementation of a “Real Choice” grant DSS received from the federal Centers for Medicare and Medicaid Services. The grant’s purpose is to build capacity in the state to support informed decision-making, independent living, and a meaningful quality of life for people with disabilities.
Among other grant activities, Bridgeport, Groton, and New Haven received $ 75,000 each to help build their capacity to serve this population. The towns have each created a task force that includes consumers, families, the public, business, and the private, nonprofit sector. Other activities have included (1) assessing areas of need and developing action plans; (2) helping expand the paraprofessional workforce; (3) increasing the availability of affordable, accessible, and safe housing; (4) building collaborative partnerships; (5) developing peer support networks; and (6) training on how to provide information and resources to community leaders and others. More information is available at Real Choices.
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