Connecticut Seal

General Assembly

File No. 422

    February Session, 2018

Substitute Senate Bill No. 400

Senate, April 11, 2018

The Committee on Public Health reported through SEN. GERRATANA of the 6th Dist. and SEN. SOMERS of the 18th Dist., Chairpersons of the Committee on the part of the Senate, that the substitute bill ought to pass.

AN ACT CONCERNING GRADUATE FUNDING AND THE PROVISION OF SUPPORT AND 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, 2018) (a) The Department of Developmental Services shall annually (1) evaluate the needs of persons with intellectual disability who are eligible for services from the department and have turned or are turning twenty-one years of age during the school year, and (2) determine the projected cost of providing day, employment and other support services to such persons following the end of the school year after such person turns twenty-one years of age. On or before January 1, 2019, and annually thereafter, the Commissioner of Developmental Services shall report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and appropriations, and to the Office of Policy and Management regarding the needs of such persons and the funding needed to cover such projected cost for all such persons who turn twenty-one years of age in each of the following three fiscal years.

(b) On and after January 1, 2019, the Department of Developmental Services shall provide services, including day, employment and other support services, to each person with intellectual disability who is eligible for services, immediately following the end of the school year in which each such person turns twenty-one years of age.

(c) Notwithstanding the provisions of chapter 50 of the general statutes, the appropriations recommended for the Department of Developmental Services for graduate funding under subsection (a) of this section shall be the estimates of expenditure requirements transmitted to the Secretary of the Office of Policy and Management by the Commissioner of Developmental Services pursuant to subsection (a) of this section and the recommended adjustments and revisions of such estimates shall be the recommended adjustments and revisions, if any, transmitted by said commissioner to the Office of Policy and Management.

(d) Notwithstanding the provisions of section 4-85 of the general statutes, the Governor shall not reduce allotment requisitions or allotments in force concerning the graduate funding described in subsection (c) of this section.

Sec. 2. (NEW) (Effective July 1, 2018) (a) The Commissioner of Developmental Services, in consultation with the Commissioner of Social Services, shall adjust, within available appropriations and in accordance with the application of standard accounting principles, as prescribed by said commissioners, the amount of payments for programs, services and supports made to nonprofit private provider organizations that contract with the state to provide residential, day, employment and other support services to persons with intellectual disability. Such adjustment shall provide an annual pro-rata increase based on direct care employee salaries for services provided in the state and included in the annual report of residential and day services for cost year 2016 of the Departments of Developmental Services and Social Services, which shall be adjusted to reflect salary increases occurring after the release of such report. Such pro-rata increase shall reflect reasonable costs mandated by collective bargaining agreements with certified collective bargaining agents or otherwise provided by an organization to its employees, including an increase in direct compensation and the provision of pension benefits to all employees. For purposes of this subsection, "employee" does not include a person employed as a manager, chief administrator or any individual who receives compensation for services pursuant to a contractual arrangement and who is not directly employed by a nonprofit private provider organization that provides residential, day or employment services.

(b) The Commissioner of Developmental Services may establish an upper limit for reasonable costs associated with salary adjustments beyond which the adjustment made pursuant to subsection (a) of this section shall not apply. Nothing in this section shall require the commissioner to distribute such adjustments in a way that jeopardizes anticipated federal reimbursement. Such adjustment may not provide disproportional increases to any nonprofit private provider organization. If a nonprofit private provider organization receives an adjustment under subsection (a) of this section, but does not provide any increase in employee salaries on or before October 1, 2018, such private provider may be subject to a rate decrease in the same amount as the adjustment made for such provider under subsection (a) of this section.

Sec. 3. (NEW) (Effective July 1, 2018) (a) The Department of Developmental Services shall establish a training and development advisory committee to develop training guidelines and improve the level of training received by direct care workers who provide services to persons with intellectual disability. The committee shall determine (1) the extent to which such direct care workers who serve persons with high levels of need may require additional training to adequately serve such persons, (2) the curricula that needs to be developed to provide such additional training, and (3) the manner in which to provide such training to ensure consistent care across the direct care workforce and the appropriate state agencies.

(b) The training and development advisory committee shall be comprised of the following members:

(1) Two impartial representatives of the disability rights community, who shall be appointed by the Governor;

(2) The Commissioner of Developmental Services, or the commissioner's designee;

(3) The Commissioner of Social Services, or the commissioner's designee;

(4) The Secretary of the Office of Policy and Management, or the secretary's designee;

(5) Two representatives of private care providers, who shall be designated by the Connecticut Community Nonprofit Alliance; and

(6) Two representatives of organizations that represent direct care workers, who provide services to persons with intellectual disability.

(c) The chairperson of the training and development advisory committee shall be selected by the Governor from among its members.

(d) On or before October 1, 2018, the training and development advisory committee shall report to the Commissioner of Developmental Services regarding an estimate of the funds required to pay for the appropriate level of additional training it determines to be necessary under subsection (a) of this section. Such training funds shall be available to pay any private provider that wishes to participate in the additional training program.

(e) On or before December 1, 2018, the training and development advisory committee shall report to the Commissioner of Developmental Services regarding the guidelines it developed pursuant to subsection (a) of this section and its recommendations regarding additional training required for direct care workers.

(f) The Commissioner of Developmental Services shall adopt regulations, in accordance with the provisions of chapter 54 of the general statutes, to implement the provisions of this section.

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

Section 1

October 1, 2018

New section

Sec. 2

July 1, 2018

New section

Sec. 3

July 1, 2018

New section

PH

Joint Favorable Subst.

 

The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.


OFA Fiscal Note

State Impact:

Agency Affected

Fund-Effect

FY 19 $

FY 20 $

Department of Developmental Services

GF - Cost

None

5,830,000

Resources of the General Fund

GF - Revenue Gain

None

2,915,000

Department of Developmental Services

GF - Potential Cost

up to 5,100,000

up to 5,100,000

Social Services, Dept.

GF - Potential Cost

up to 12,100,000

up to 12,100,000

Resources of the General Fund

GF - Potential Revenue Gain

up to 8,600,000

up to 8,600,000

Note: GF=General Fund

Municipal Impact: None

Explanation

The bill requires the Department of Developmental Services (DDS) to: (Section 1) provide Employment and Day Services to DDS consumers turning 21 years of age during the school year, on or after 1/1/19, (Section 2) grant increases to certain DDS contracted nonprofit providers, and (Section 3) establish a training and development advisory committee to determine necessary training and funding, and provide such funding. The fiscal impact of each provision is summarized below.

Section 1

High School Graduate Funding

The bill requires DDS to provide Employment and Day Services and other services to DDS consumers turning age 21 during the school year. Each year there are between 300 and 360 such DDS eligible individuals graduating from special education programs. The projected number of DDS High School Graduates in FY 20 is 315 with an estimated cost for Employment and Day Services of $5.8 million. This is based on initial year utilization of an average of 10 months, resulting in a fully annualized cost of $6.9 million. The per person annual cost of providing Employment and Day Services ranges from $11,300 to $28,200, depending on the consumer's level of need. While the bill does not define “other services”, for the purpose of this cost estimate transportation costs of $2,800 per person have been included.

Federal Revenue

The state receives 50% reimbursement for the cost of eligible services provided under the Medicaid Home and Community-Based waiver programs. The Employment and Day Services required by the bill are covered under the waiver and the anticipated revenue to the General Fund is shown below.

Waiver Component

FY 20 $

Employment and Day Services for High School Graduates

5,830,000

Medicaid Waiver Revenue

2,915,000

The bill also specifies that the Office of Policy and Management may not adjust the funding estimates recommended by DDS, or reduce allotment requirements for graduate funding, which is in agency's Employment and Day Services account. This may impact individuals receiving services not considered as graduate funding.

Section 2

Private Provider Increases

The bill requires DDS, within available appropriations, to implement a private provider grant increase for Employment and Day Services (funded in DDS) and Community Residential Services (funded in Department of Social Services) based upon direct care employees' salaries as reported in the providers' 2016 annual reports. Since the bill specifies that the increase is to be provided with available appropriations, the estimated cost is reflected as a potential one.

The estimated maximum cost of a 4.28% increase1 in the direct care salaries of employees of private providers is shown below. The bill references a pro-rata increase that could lower what DDS distributes to providers.

Potential Cost of Provider Increase

Account

FY 19 $

FY 20 $

DDS Employment and Day Services

5,100,000

5,100,000

DSS Community Residential Services

12,100,000

12,100,000

TOTAL

17,200,000

17,200,000

Federal Revenue

The state receives 50% reimbursement for the cost of eligible services provided under the Medicaid Home and Community-Based waiver programs. Assuming the private provider increases required by the bill are reimbursable under the waiver, potential revenue to the General Fund is shown below.

Waiver Components

FY 18 $

FY 19 $

Cost of Private Provider Increases

17,200,000

17,200,000

Medicaid Waiver Revenue

8,600,000

8,600,000

Section 3

Training and Development

The bill requires DDS to establish a training and development advisory committee which is to report to DDS regarding the funds required to pay for the appropriate level of training determined by the committee. The bill also requires that such training funds be available to pay any private providers wanting to participate in the additional training program established by the committee. Since the committee has yet to determine the level of training required and the cost of providing the training, the cost associated with this provision cannot be determined at this time. Depending on the advisory committee determination, there is a potential cost to DDS if an additional position to undertake curriculum development and coordination of private provider training is required.

The Out Years

The annualized ongoing fiscal impact identified above would continue into the future.

Sources:

Core-CT Financial Accounting System

 

DDS Management Information Report

 

Department of Developmental Services

OLR Bill Analysis

sSB 400

AN ACT CONCERNING GRADUATE FUNDING AND THE PROVISION OF SUPPORT AND SERVICES FOR PERSONS WITH INTELLECTUAL DISABILITY.

SUMMARY

This bill makes various changes affecting the Department of Developmental Services (DDS), individuals with intellectual disability, and providers of services for such individuals. Principally, the bill:

EFFECTIVE DATE: July 1, 2018, except the provisions on graduate funding and the DDS budget are effective October 1, 2018.

1 — GRADUATE FUNDING AND DDS BUDGET

The bill requires DDS to annually:

The bill requires the proposed DDS budget for graduate funding that OPM submits to the legislature to be the estimates of expenditure requirements, together with any recommended adjustments and revisions, that OPM receives from the DDS commissioner. It bars the governor from reducing an allotment of such appropriated funds currently in force for, or an allotment of funds requisitioned by, DDS.

2 — PAYMENTS TO NONPROFIT PRIVATE PROVIDERS

The bill requires the DDS commissioner, in consultation with the DSS commissioner and within available appropriations, to adjust payments made to certain nonprofit private providers that contract with the state. The adjustment must provide an annual pro rata increase in salaries for direct care employees (not including managers and certain other individuals; see below).

Under the bill, this adjustment applies to state payments for programs, services, and supports to such providers that contract with the state to provide residential, day, employment, and other support services to individuals with intellectual disability. The commissioner must make the adjustment in compliance with standard accounting principles, as prescribed by himself and the DSS commissioner.

The bill requires the adjustment to provide an annual proportional increase based on direct care employee salaries for such services, as included in the departments' 2016 annual report of residential and day services. The increase must:

The bill allows the DDS commissioner to establish a cap on the reasonable costs associated with salary adjustments beyond which the adjustment described above does not apply.

The bill also:

Under the bill, “employee” does not include someone employed as a manager or chief administrator or someone who receives compensation under a contractual arrangement and who is not directly employed by such a nonprofit provider.

3 — TRAINING AND DEVELOPMENT ADVISORY COMMITTEE

The bill requires DDS to establish a training and development advisory committee to develop training guidelines and improve the training received by direct care workers who provide services to individuals with intellectual disability. The committee must determine:

Under the bill, the advisory committee consists of the following members:

The governor must appoint the advisory committee's chairperson from among its members.

The bill requires the advisory committee to report twice to the DDS commissioner, as follows:

The bill requires the training funds to be available to pay any private provider that wishes to participate in the additional training program.

Under the bill, the DDS commissioner must adopt regulations to implements these provisions.

COMMITTEE ACTION

Public Health Committee

Joint Favorable Substitute

Yea

25

Nay

0

(03/23/2018)

TOP

1 An increase of 4.28% was used in the calculation to reflect Bureau of Labor Statistics Employment Cost Index for wages and salaries, by occupational group and industry, for the period 2016 to 2018.