Government Administration and Elections Committee

JOINT FAVORABLE REPORT

Bill No.:

HB-6155

Title:

AN ACT AUTHORIZING DEEMED STATUS LICENSE RENEWALS FOR CERTAIN NONPROFIT COMMUNITY SERVICE PROVIDERS.

Vote Date:

3/27/2017

Vote Action:

Joint Favorable

PH Date:

2/15/2017

File No.:

579

SPONSORS OF BILL:

Government Administration and Elections Committee

REASONS FOR BILL:

To reduce costs for nonprofit providers by providing a means for them to forgo duplicative state licensing requirements for certain license and certificate renewals if they are accredited by an accepted national accrediting body that has requirements no less stringent than the state's. Currently Private Providers could be tasked with providing multiple licenses through multiple state departments as various services fall under various departments purview. The bill would require the departments of children and families (DCF), developmental services (DDS), public health (DPH), and social services (DSS) to adopt regulations to allow a “deemed status” license or certification renewal for providers, which would license a Private Provider for two years.

The bill would allow providers to satisfy their license or renewal requirements by submitted proof of national accreditation for the same services they currently provide. The accreditations must be within the preceding 12-month period and come from an accrediting organization that is accepted by the department and listed in their regulations. It authorizes these agencies to set an administrative fee to cover associated processing costs.

In practice a deemed status keeps departmental authority over the Private Provider intact, but allows the department to exempt them (a Private Provider) from the normal inspection and investigation that occurs with standard yearly renewals. If passed as law it would enact on October 1st, 2017.

RESPONSE FROM ADMINISTRATION/AGENCY:

Connecticut Department of Public Health, Commissioner Raul Pino: Opposes the bill. DPH opposed the bill as presented at the time of the public hearing for a multitude of reasons that include;

● No indication to which providers would be allowed to waive their licensing requirements

● No indication of which statutes would be impacted/which departments would have to comply with the new requirements

● No mention of which bodies would be approved to offer accreditation

The Department also felt that not all non-profit would have the resources available to them to become accredited as a national accreditation costs are significant.

Finally through past surveys conducted at the request of the Centers for Medicare and Medicaid Services the department the Department has reason to question the reliability and quality of certain accreditation organizations.

NATURE AND SOURCES OF SUPPORT:

InterCommunity, William Young, Chief Strategy Officer: Supports the bill.

Provider Info: InterCommunity provides a range of mental health addictive, and primary medical care services in the greater Hartford and East Hartford area. This requires them to maintain a dozen separate licenses from various state agencies. They also maintain accreditation through The Joint Commission (TJC) or the Commission on the Accreditation of Rehabilitation Facilities (CARF).

Allowing deemed status would save time, reduce administrative costs, and allow providers more time and resources to those served. Mr. Young makes the argument that national accreditation process often exceeds that of the state licensing requirements. Also he points out that the state currently uses deemed status for Hospitals and related healthcare services.

Oak Hill, Stan Soby, VP for Public Policy & External Affairs: Supports the bill.

Provider Info: Oak Hill has over 20 distinct programs; 152 program sites, classrooms, and homes located in 77 towns; and employs over 1,700 professionals to service close to 40,000 people. This includes their affiliate Gilead Community Services who operates in Middlesex County. Gilead is accredited by CARF. All of this requires Oak Hill to maintain 100 separate licenses from state agencies.

Complying with multiple redundant licensing requirements is a costly time consuming administrative burden that can take up to three days per compliance check. Mr. Soby notes that national accreditation often exceeds state licensing requirements and that deemed status is already used in Connecticut for Hospitals and related healthcare services.

Mr. Soby also submitted extra written testimony with information from Peter Hathaway, Managing Director of CARF in response to a question posed by Sen McLachlan. That written statement added that:

● 49 states currently use some sort of deemed status or accreditation status

● Deemed status carries several different meanings. Sometimes it means a business is required to be accredited to operate. Other times it means accredited organizations get a better rate for services. Some states accept several accreditors and some only accept CARF or another specific accreditor.

● Mr. Hathaway continues with examples of states that have a deemed status and the number of organizations accredited in the Employment and Community Services portion of CARF

North Carolina requires accreditation for many ID/DD services, CARF accredits 286 organizations

California Department of Rehabilitation requires vendors to be accredited, CARF accredits 187 organizations

Ohio requires accreditation for some ID/DD and some Voc Rehab services, CARF accredits146 organizations

Georgia requires accreditation for its ID/DD programs and CARF accredits 145 organizations

● He adds that this list doesn't tell of all of the other organizations that have sought accreditation due to deemed status and those organizations may have become accredited regardless or been required.

The Kennedy Center, Inc., Martin Schwartz, President: Supports the bill.

Provider Info: The Kennedy Center employs approximately 700 staff, has 250 plus volunteers, and serves over 2,000 clients.

If passed the bill would reduce agency and state costs associated with duplicate licensing, free up employee time allowing more time to help clients, and save the state money while continuing to provide service at the highest standards.

Mr. Swartz notes that he has worked with CARF as a surveyor for over 30 years and that CARF is a world leading accrediting body for health and human services. He continues that CARF has as many as 1,000 performance standards tailored to a wide range of programs and services. Preparing for a CARF Accreditation Survey requires a minimum of 200 hours for a Team Leader, an additional 100 hours per committee member of eight and specialists or direct care staff members.

Gilead Community Services, Inc., Daniel Osborne, CEO: Supports the bill.

Provider Info: Gilead is currently provides service to over 600 individuals and is tasked with maintaining up to 8 separate licenses from state agencies and local municipalities in order to operate. Each license requires periodic renewals and compliance requirements that divert resources and staff away from their normal duties.

Mr. Osborne notes that currently when the rare incident occurs within their programs it triggers redundant reporting due to the multilayer oversight that currently exists. He provides the example of a power outage that would need separate paperwork for DMHAS, DCF, DPH, the city of Middletown and CARF.

If passed the bill would save time, money, and help increase productivity.

Midwestern Connecticut Council of Alcoholism, Richard Radocchia, Chief Clinical Officer: Supports the bill. Provider Info: MCCA has locations in Danbury, Sharon, Kent, Torrington, New Milford, Waterbury, Derby, and New Haven. Currently they have to keep over 20 separate licenses to operate. Additional monitoring comes from Beacon Health Options, Private Insurers, DMHAS, DPH and JBCSSD. Compliance visits are numerous, costly, and time consuming.

If passed the bill would allow nonprofits to forgo duplicate state licensing if accredited by an accepted national accreditor and would help save the state and nonprofits money in the process. Additionally the state already uses deemed status for hospitals and related health services, which arguably offers higher level/higher risk services.

MARC Community Resources, Linda Iovanna: Supports the bill. Provider Info: currently they are tasked to maintain 6 separate licenses from DSS to operate their group homes. This requires 2 staff to work for 16 hours over three to complete all the required administrative work.

If passed Ms. Iovanna states that if passed MARC Community Resources would go out of their way to get national accreditation form an accepted accreditor. She continues that multiple surprise compliance visits has caused undue stress to staff and the cancelation of otherwise planned events, outings, and trips for their programs.

LifeBridge Community Services, William Hass, President & CEO: Supports the bill. Provider Info: has served the Bridgeport community since 1849. They serve over 17,000 people each year with their four Core Services, one being Behavioral Health. This requires as many as 4 separate licenses from various state agencies. Compliance checks take staff time and resources over for one to three days to complete. LifeBridge has been accredited by the Council of Accreditation since 1980.

If passed the bill would allow then to forgo duplicative licensing. Additionally deemed status is already used in CT for hospitals and related health services.

The Alliance, Brunilda Ferraj, Senior Public Policy Specialist: Supports the bill. Provider Info: The Alliance is CT's statewide association of community nonprofits, which serve over 500,000 people each year and employ around 14% of CT's workforce. The nonprofits The Alliance represents have to keep sometimes as many as 20 to 30 separate licenses to operate. As well as periodic renewal for each licenses and compliance visits.

If passed staffing costs would be lowered for the state and nonprofits by eliminating redundant administrative work. Additionally the state formed a workgroup several years ago with nonprofits and other stakeholders to explore deemed status and that workgroup found that national licensing standards were just as stringent, if not more, than state standards.

Wheeler Clinic, Wendy DeAngelo, Chief business Development Officer: Supports the bill. Provider Info: provides comprehensive health and human services to more than 23,000 individuals and families across 35 locations in Bristol, Hartford, and New Britain. They maintain at least 19 separate licenses of seven distinct types connected to 21 different facilities. Each facility maintains one to six licenses. Also the Uniform Licensing Application process that was implemented through the state's BizNet system that was intended to streamline the process has not achieved the desired effects. Wheeler is already nationally accredited by The Joint Commission.

If passed the bill would allow them to forgo duplicative state licensing requirements, save nonprofits and the state money, and allow staff to focus more time on the services provided. Additionally Deemed status is already used in CT with hospitals and related health services.

BHcare, Inc. and PCRC, Roberta Cook, President/CEO: Supports the bill. Provider Info: BHcare is one of six private nonprofits in CT that offer mental health services. They are the DMHAS designated Local mental Health Authority for towns in greater New Haven, the Lower Naugatuck Valley and the Shoreline. Additionally they provide services for nearly 3,000 residents, including some additional 1,000 children and families each year. They are required to maintain six separate licenses from various state agencies. Compliance checks consume time and resources that could otherwise be used elsewhere.

If passed the bill would allow them to forgo duplicative state licensing requirements by being accredited by a nationally recognized accreditor who often requires more stringent standards than the state. Additionally Deemed status is already used in CT with hospitals and related health services. BHcare estimates deemed status could help them save upwards of $20,000 per license series in lost productivity and staff time.

Ability Beyond, Heidi Chelednik, Director of Services: Supports the bill. Provider Info: Ability Beyond is required to keep as many as 32 separate licenses from various state agencies. Compliance visits take one to three days and demand valuable staff time and resources. Additionally they have been CARF accredited since the 1970's.

If passed the bill would allow them to forgo duplicative state licensing requirements, save nonprofits and the state money, and allow staff to focus more time on the services provided. Additionally Deemed status is already used in CT with hospitals and related health services.

NATURE AND SOURCES OF OPPOSITION:

See response from Commissioner Raul Pino of DPH above.

Reported by: Ethan Ives

Date: Date: 4/17/17