Department of Mental Retardation

At a Glance

PETER H. O’MEARA, Commissioner

Kathryn duPree, Deputy Commissioner

Established – 1975

Statutory authority – CGS Chap. 319b – 319c

Central office – 460 Capitol Avenue,

Hartford, CT 06106

Number of full-time employees – 3,643

(total filled count as of June 30, 2003)

Number of consumers served – 20,656

Recurring operating expenses - $724,745,487

Organizational structure – Services and Supports to over 19,000 individuals and their families, including birth-to-three services, are provided through a network of public and private providers across Connecticut. The Office of the Commissioner Oversees and directs the following divisions: Administrative Services; Family and Community Services; Legal and Government Affairs; Strategic Leadership Center; Chief of Staff and Human Resources; Affirmative Action; and the Office of the Ombudsperson. The Department operates three regional offices, various campus programs, and an Operations Center in Central Office, which coordinates all contracted services. In addition, the Department is the lead agency for the Connecticut Birth-to-Three Program.

Mission

The mission of the Department of Mental Retardation is to join with others to create the conditions under which all people with mental retardation can experience presence and participation in Connecticut town life, opportunities to develop and exercise competence, opportunities to make choices in the pursuit of a personal future, good relationships with family members and friends, and respect and dignity.

Statutory Responsibility

The Department of Mental Retardation, with the advice of the Council on Mental Retardation, is responsible for the planning, development, and administration of complete, comprehensive, and integrated statewide services for persons with mental retardation and persons medically diagnosed as having Prader-Willi Syndrome. DMR provides services within available appropriations through a decentralized system that relies on private provider agencies with which the department contracts. These services include residential placement, day programs, early intervention, family support, respite and case management.

Public Service

During the last fiscal year the department engaged in a number of activities designed to improve services and the management of its public and private programs. Significant improvements were introduced to risk management systems, including enhancements to the mortality review and investigations procedures that contributed to full compliance with the Governor’s Executive Order No. 25. A new quality improvement system is being developed based on the results of a pilot. The system will expand the Department’s oversight to include a formal review of supported living, individual support and day services in addition to licensed settings. The concept of program integrity is being expanded to include consistent measure for both private and public settings. The new system will give the department the ability to produce benchmarks and provider profiles that consumers and their families can access. This system incorporates personal outcomes as a critical indicator of service quality and agency performance, and is designed to provide more focused evaluation of services in non-licensed settings and programs.

In addition, Public Act 03-146 was passed by the Connecticut General Assembly during the 2003 Legislative Session. This legislation was the result of an analysis conducted by the Legislative Program Review and Investigations Committee of the many systems Connecticut has put in place to protect and safeguard our citizens with mental retardation. The committee focused its findings and recommendations on a variety of strategies to enhance the effectiveness of our oversight practices. The department certainly recognizes that continual improvement should always be a goal within any governmental entity and commits to strengthen our risk prevention and service oversight systems. However, it is very important to formally note that the Connecticut DMR currently has one of the most comprehensive systems of risk prevention and group home oversight anywhere in the country. For example, our mortality review process was not only one of the very first in the U.S., but continues to serve as a model for many other states who are only now establishing such a system. Our unique relationship with the Connecticut State Police provides DMR with extremely competent and professional unbiased third party oversight of the abuse and neglect investigation process. We also have implemented a number of other oversight enhancements, including the use of root cause analysis, program integrity team review, clinical nurse investigation of deaths, more unannounced visits and reviews of group homes, web posting of licensing inspection results, and the publication of a very comprehensive and detailed annual mortality report. These system enhancements represent evidence of our commitment to assuring that review and oversight practices are thorough.

Improvements/Achievements 2002-03

During these economically challenging times, the department is streamlining administrative services in order to continue to serve as many consumers as possible. During fiscal year 2003, the Department experienced a significant reduction in its workforce due to layoffs and Early Retirement. Changes were made in day services and family support to adjust to the loss of 268 positions through layoff. Over 470 employees accepted the Early Retirement Incentive Program (ERIP) and left state employment between April 1, and June 1, 2003. We anticipate filling many, but not all, of these vacancies because of the cost savings needed to help balance the budget.

Numerous work groups met during the spring to revise business, human resource, contract management, and facilities management practices to be less reliant on personnel. Effective June 2, 2003 the agency consolidated from five regions to three and announced Regional and Assistant Regional Directors. The three new regions will be: West, a combination of the existing Northwest and Southwest Regions, including Southbury Training School, the North, which is the existing North Central Region and the northern half of the Eastern Region which includes Windham and Tolland Counties and finally, the South, which encompasses the existing South Central Region and the southern half of the Eastern Region including New London County. The regional offices will be located in Waterbury, (West Region), Wallingford, (South Region) and Farmington, (North Region). Satellite offices will be maintained during the coming year for case managers, Early Connections staff, family support and residential support staff. Overall, family access to the regional staffs will remain the same. The Department is also converting the operation of 30 public Community Living Arrangements to private management. The savings will allow the department to fully staff its remaining residential programs and provide some funding for the Waiting List.

During fiscal year 2003, the department generated $288.4 million in federal Medicaid reimbursement. This is $2.2 million more than in fiscal year 2002. Approximately 6,035 people were participating in the Home and Community Based Services Waiver at the end of fiscal year 2003, a net growth of approximately 135 individuals over fiscal year 2002 enrollment. The waiver allows for federal reimbursement for residential habilitation, day programs, and support services provided in the community. The department continues to examine ways to maximize federal reimbursement through the waiver and other federal programs and intends to enhance oversight activities to assure full compliance with a new CMS waiver protocol.

During Fiscal Year 2003, the DMR continued to utilize CTHealthjobs.org, a public/private workforce development initiative that was implemented the previous year. The initiative showed steady increases in all areas, including employer participation and applicant activity. During the year, CTHealthjobs.org received 4,708 new applications from individuals who are interested in working in the field of developmental disabilities. The applications were made available to the network of public/private agencies that subscribe to cthealthjobs.org, free of charge. CTHealthjobs.org continues to serve as a valuable recruitment tool for over 75 agencies that participate in the network.

DMR has completed deployment, training and migration to our Local Area Network (LAN) system at all regional offices. We anticipate the continuation of deployment to DMR group homes as soon as a statewide communications contract is in place. When we have computers in our group homes we will be better able to communicate with our community-based staff. This will also enable them to access CoreCT systems. As part of the LAN project we transitioned from a one printer per workstation model to a shared model where multiple workstations utilize a single printer. We also implement a wireless network at our Southbury campus, which resulted in cost savings in comparison to a traditional “hard” wired installation.

During the fiscal year the Department sponsored a special Aging Focus Team that included representation from state agencies, providers, family members and professionals. It was co-chaired by the Department and the University of Connecticut Health Center. The Focus Team has made recommendations addressing the needs of individuals with mental retardation who are aging. The final report will be issued in the fall of 2003.

During the year the Department was able to open two additional Respite Centers in the Southwest and Northwest areas of the state. These centers will serve approximately 300 people each year. In addition, DMR has plans to open another Respite Center in the fall of 2003 at the Lower Fairfield Center in Norwalk. These Respite Centers allow families to experience a rest or a break from the ongoing role of caring for a family member who has mental retardation by providing temporary care. Respite may be provided for an afternoon, an evening, a weekend, a planned vacation, or in response to an emergency situation or illness. During this time of restricted budgetary resources and an ever-growing waiting list for residential services, DMR Respite Centers are a welcome opportunity for caregivers so that they may have an opportunity to have some personal time for themselves.

The Department increased its focus on Forensic Services forming a statewide steering committee to review existing practices and service models. The goal is to improve both program and cost effectiveness.

Information Reported as Required by State Statute

Affirmative Action

Commitment to affirmative action is incorporated into all aspects of DMR’s employment process including recruitment, selection, hiring, training, promotions, benefits, compensation, layoffs, and terminations. It is the objective of the Department to achieve the full and fair participation of women, African-Americans, Hispanics, persons with disabilities, and other protected groups in our workforce.

The Department’s affirmative action posture is reflected in its practices for selecting outside contractors. In line with this commitment, the department will not knowingly do business with any contractor, sub-contractor, bidder or supplier of materials who discriminates against members of a protected class. Additionally, DMR has established goals for the use of small businesses and minority and women-owned businesses and actively solicits their participation.

The Department strives to provide services and programs in a fair and impartial manner. To achieve this the Department has developed strategies to nurture the development of a culturally diverse workforce, expand outreach efforts, and provide services and communications that are sensitive to the language and cultural preferences of individuals and families from diverse backgrounds.

Developmental Disabilities

The Council on Developmental Disabilities is an independent entity, operating under the federal Developmental Disabilities Act (PL 106-402), composed of Governor-appointed members, and attached administratively to the Department of Mental Retardation. The mission of the Council is to promote full inclusion of all people with disabilities in community life. In 2002-2003, the Council budget was $655,066 for initiatives on the Americans with Disabilities Act and Olmstead implementation, Partners In Policymaking, a family conference, personal assistance, inclusive education, culturally appropriate supports, respite care, and self-advocacy with kids.

Regulations/ Studies

Pursuant to Public Act 01-140, the Commissioner submitted a report containing findings and recommendations as a result of a study of the law regarding guardianship of persons with mental retardation that was conducted in collaboration with designees from the Office of the Probate Court Administrator, the Office of Protection and Advocacy for Persons with Developmental Disabilities, ARC-CT and FORConn. The report was dated January 2003 and was submitted to the Public Health Committee at that time. Public Act 03-51 which made technical changes to the guardianship statute was a direct result of the study and the report.

A certified copy of DMR’s amendments to the regulations implementing sections 17a-247, et seq. of the General Statutes to clarify administrative hearing processes and procedures applicable to the Department’s abuse and neglect registry were received and filed by the Office of Secretary of the State received on December 10, 2002, the effective date of these regulations.

Pursuant to Public Act 01-154, the Department is still in the process of promulgating regulations to establish and implement DMR’s policies with respect to the placement and care of clients who may pose threats to others in the absence of appropriate supervision and security. The most recent action on these regulations is that they were rejected without prejudice for a second time at the Legislative Regulations Review Committee’s July 2003 meeting. Staff from DMR’s Legal and Government Affairs Division are currently responding to the Legislative Regulation Review Committee’s comments and plan to resubmit them at an upcoming meeting.

Public Act 03-203 (SB 946) An Act Concerning Criminal History Records, codifies DMR’s current policy requiring that all agencies licensed and funded by the Department should conduct a State of Connecticut Background Check and carefully review any identified criminal histories. The Public Act also requires the department to prepare a report to the Public Health Committee outlining the various impacts of imposing a national criminal history check. This report is due to the Committee by January 1, 2004.