State of Connecticut Department of Developmental Services

Transcription

1 State of Connecticut Department of Developmental Services M. Jodi Rell Governor December 14, 2009 Alyssa Goduti Connecticut Community Providers Assoc. 35 Cold Spring Road, Suite 522 Rocky Hill, CT Peter H. O Meara Commissioner Kathryn du Pree Deputy Commissioner Dear Alyssa: Thank you for your letter of November 25, 2009 in which you ask a number of questions regarding the impact of the Governor s rescissions and deficit mitigation plan on the Department of Developmental Services (DDS) consumers, families and providers. We have been analyzing the implication and can provide your association with some direction and explanation. Up to this point, DDS has absorbed the majority of the reductions through changes made in public services and a reorganization of our administrative functions. Between FY 09 and FY 10, $35 million has been removed from the personnel, operating expenses and clinical service accounts. This resulted in an 11.3% overall reduction to public sector costs. It is no longer possible to continue to fully absorb further cuts without reductions in the accounts which fund private sector services. My administration will approach making these reductions with the goal of maintaining stability to the greatest extent we can. Following are the answers to your questions: Birth to Three Parent Fee Increase Timing of Federal Review and Implementation The federal notice and comment period ended December The amended application has been submitted to the federal government. Implementation is planned for January 1, The regulatory notice and comment period has ended as well. Our submission to the Regulations Review Committee is planned for early DDS Conversion of 17 Group Homes Update To date, four homes have been awarded to providers and we anticipate making five more awards the week of December 14, 2009 in light of the committee s activities. The review committees are continuing to review proposals for five other CLAs. We anticipate the actual transition of homes to start in February. A second RFP will be issued this week for the three homes that were not bid on in the original RFP. Funding Reduction for Transportation We will achieve the level of cuts required. Providers will be asked to make transportation efficiencies and we will use money made available through vacancies or underutilization of individual budgets. We will continue to look for other ways to achieve the savings without reducing transportation for consumers. Phone: TDD Fax: Capitol Avenue Hartford, Connecticut ddsct.co@ct.gov An Equal Opportunity Employer

2 Page 2 Rate Study Committee and Pilot Program DDS has appointed its three members. The legislation requires the Speaker and Senate President to appoint the chairpersons, and the chairpersons are required to schedule the first meeting. DDS has identified administrative staff to help the committee once all members have been identified, chairpersons have been selected and a first meeting date is set. DDS Memo Regarding HIPAA Requirements Encryption Software This issue was recently clarified in the most recent edition of Executive Briefs that went to all providers. One Time funding Availability of funding for FY 10 and FY 11 The regions were given some funding in their FY 10 allocations to address unmet needs. They are analyzing how much of this will remain available considering the recent rescissions and will communicate with providers who have made requests. Update on H1N1 DDS Protocols and Available Resources There is information posted on the DDS website including updates, a guide for employees and a video on protocols. DDS uses the Connecticut Department of Public Health (DPH) and Center for Disease Control (CDC) websites for the most current and accurate information. Links to these are available on the DDS website. Providers have been asked to update their COOP plans and are responding to a survey regarding their need for vaccines if DPH is able to make them available through DDS. Questions Related to the Governor s Deficit Mitigation Plan and Rescissions 1. When do rescissions take effect? Some rescissions are currently in effect. The savings associated with the rescissions must be achieved by the end of the fiscal year. 2. If the rescissions are effective 1/1/10 and the cut is 2% across the line item, does this mean that the actual cut between 1/1/10 and 6/30/10 is actually 4%? At this time, the department does not plan to make any across the board percentage reductions. 3. Will human services cuts be managed by freezing access to services? Creating waiting lists for services? Limiting the hours of service? Limiting the scope of services? Transitioning individuals being served out of service? Reducing rates? Consolidating programs? Cuts in forensics (Cooperative Placements), VSP, autism and the $250,000 in day services will be achieved by delaying the start of new placements, maintaining a waiting list for VSP, recouping funding when a vacancy occurs, and from underutilization. DDS is still determining how best to achieve the $3.6M cut in day services but is seriously considering implementing an attendance based reimbursement system. We do not anticipate reducing existing services to waiver participants. There will continue to be waiting lists for new applicants to services.

3 Page 3 4. What is the impact of consumers not able to access service, denied service or receiving reduced services? Individuals on the waiver will continue to have access to the services they receive and the department will make every effort to address their identified unmet health and safety needs. Individuals not yet receiving services will be placed on waiting lists. They can access limited family support services through their case manager or the regional help lines. 5. What is the impact on families if their family members cannot access services? Family members will continue the significant responsibility they have for their relative who lives with them. We don t foresee anyone losing current supports and services. 6. What is the impact on residential services if individuals lose access to employment opportunities / day services? We do not anticipate this occurring. 7. What is the impact on communities if individuals no longer have access to mental health, substance abuse or services that support individuals with developmental disabilities? Increased use of emergency rooms hospitals or prisons? DDS is continuing to work with DMHAS and mental health providers offering inpatient services to assure continued access. 8. Which services are considered entitlements: Medicaid fee for service and Medicaid waiver services? Individuals on Medicaid are entitled to receive case management services. Individuals enrolled in a HCBS waiver are required to receive services to meet their health and safety needs. 9. DDS budget What services are provided through Clinical Services Account? The clinical services account primarily supports individuals in public services. This account does not provide the basis for funding individual budgets. We do not anticipate significant impact on our consumers from the reduction in this account. How does the Department plan to implement the Employment Opportunities and Day Services cut? As noted above, we are currently developing a plan to implement attendance based reimbursement and will provide the details as soon as the plan is finalized. How would Home and Community Based waiver funding be impacted by the employment opportunities and day program cut? What happens if the funding cut means that an agency can no longer meet the needs of the consumer? If the agency can no longer meet the needs of the consumers, DDS will need to assist the consumer locate another qualified provider. What happens to the consumers who would have enrolled in the Voluntary Service Program? Will they be able to receive any services from the Department? Children who live at home can apply to use respite and other family support services.

4 Page 4 How many individuals will not get service as a result of the Autism Pilot reduction? How many clients was the program initially planned to serve and how many will get services by the end of this fiscal year? The autism pilot was funded to serve up to 75 individuals. Currently, 57 individuals are enrolled and 4 others are being reviewed for eligibility. The reduction to this account will be achieved as a result of participants using less service than originally requested and by delaying the starting dates for new applicants. What is the impact of the cuts to cooperative placements program? DDS will delay the starting dates for new people. Current individuals served under this account who live alone or whose costs exceed $175,000 will be reviewed this year by the regional utilization committees to determine if reductions are warranted. I fully understand the difficulties these rescissions pose for all of us who are concerned with the welfare of the individuals we serve and the staff and organizations committed to improving the quality of their lives. However, Connecticut must provide services within the resources it has available and we must all work cooperatively to design solutions that maintain supports and services. We appreciate the many efficiencies that providers have implemented to live within their allocations. This has been mitigated, in some part, by the continued growth in the number of people served in the private sector and the increase in funding to support new school graduates, age-outs, VSP participants and people who were on the Waiting List. All of the department s new development has been through contracted and self directed services for several years. Over the past six years, the private sector has increased the number of people it serves by almost 2,500 individuals. This results in private sector funding accounting for the majority of the Department s budget. I am hopeful that this strong funding base will help providers weather the changes that will need to occur over the next few years until the economy rebounds. Sincerely, Peter H. O Meara Commissioner

5 Copy: Terry Edelstein Ron Cretaro Lynn Warner Julia Wilcox Kathryn du Pree Vince O Connell Marty Zito Christine Pollio Joe Drexler Peter Mason Fritz Gorst John Houchin Mary McKay