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 – 3,795

(total filled count as of June 30, 2006)

Number of consumers served – 19,150

Recurring operating expenses - $823,678,874

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; Investigations 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 (DMR), 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 under contract or enrolled with the Department, in addition to the state operated services. These services include residential placement and in-home supports, day and vocational programs, early intervention, family support, respite, case management, and other periodic services such as transportation, interpreter services, and clinical services.

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 continue in areas related to risk management systems, including risk screening procedures through the development of an enhanced Health and Safety Assessment, a revised Individual Planning document, new critical incident management protocols for services delivered in personal homes, and staff training materials and fact sheets for individuals and families who self-direct their own services. DMR continues to be involved in initiatives designed to meet the increasing expectations of the Centers for Medicare and Medicaid Services (CMS) to meet health and welfare and quality improvement protocols for the operation of Home and Community Based waivers.

Emergency Management:

DMR and the Connecticut Department of Emergency Management and Homeland Security (DEMHS) established a collaborative relationship in 2002. Since then, DMR has participated in several DEMHS emergency drills associated with nuclear safety and homeland security. DMR has tested the department’s Special Operations Plan for Emergency Management within the confines of emergency management exercises. In the spring of 2005, DMR participated, along with other state agencies and municipalities, in the biological terrorism exercise TOPOFF 3, which included participation with the State of New Jersey, the United Kingdom and Canada. DMR staffed emergency operations centers around the state. This included participation with the statewide emergency operations team at the State Armory in Hartford. In September 2005, DMR joined DEMHS in preparing to receive Hurricane Katrina evacuees at Southbury Training School. This reception and housing did not come to fruition due to changes in the federal evacuation strategy. DMR has also participated in a variety of federal and state emergency management drills and a wide array of emergency management workshops sponsored by federal, state and local agencies.

DMR staff are represented on the following emergency management committees: DEMHS Area 1 Regional Emergency Planning Team and Emergency Preparedness Planning for Developmental Disabilities Services: NASDDDS Self-Assessment Instrument. In addition, DMR is collaborating with DEMHS, FEMA and the Nuclear Regulatory Commission (NRC) to establish a host community for special populations, operating at the Southbury Training School in Southbury, CT. The host community will be a reception, triage and decontamination site in the event of a radiological event. To establish the host community, DMR has received four grants from the Nuclear Safety Emergency Preparedness (NSEP) fund for physical plant renovations, equipment and training, the fourth of which was recently awarded in June 2006. DMR continues to work in conjunction with IBM to develop DMR statewide business continuity plans.

Case Management:

DMR hired 47 Case Managers during the fiscal year, including the 20 positions that were newly funded in the FY06 budget. These new positions allow for a more manageable caseload size for Case Managers supporting individuals who do not receive waiver services (reducing these caseloads from 100 to 85). Case Managers received training in the new Level of Need (LON) assessment process. New orientation training for Case Managers was developed and offered. Through a redistribution of existing resources, the department plans to hire an additional six Case Managers to address caseload increases from newly eligible clients and increasing the number of individuals receiving wavier services.

Self-Advocate Coordinators:

The DMR self advocates continue to help lead change efforts in Connecticut by 1) promoting self advocacy representing consumer viewpoints on agency committees and workgroups; 2) providing training and education to consumers, family members, providers, and community members on the rights of people with disabilities and on all aspects of self advocacy and self determination; 3) training and mentoring peers to become public speakers; 4) developing fact sheets, resource guides and other material written by and for people with intellectual disabilities; and 5) assisting DMR staff within the region to better understand and apply best practices in self advocacy and self determination for all people served by the department.

Improvements/Achievements 2005-06

Individuals Served:

During this past year the department continued to make significant strides serving individuals on the Waiting List for residential services. New development funds were used to support 166 people during the fiscal year from the Waiting List. Of this group 128 had been living in their family or own home. Funding was utilized by 68 of these individuals to receive supports and stay with their families or in their own homes, and the remaining 60 utilized funding to receive residential services outside the family home. The remaining 38 individuals who received funding were on the Waiting List because they needed additional funding to address changing needs over time. The department was also able to provide residential placement for 50 additional people through the use of funded vacancies in existing residential settings. The Waiting List initiative continued to add rent subsidy funding to help facilitate new residential support options for those adults who would like to move out of their family home, and again provided enhanced family support services for an additional 100 individuals and their families in this past fiscal year.

DMR also provided adult day services to 229 new high school graduates and transitioned 96 young adults from DCF who were in need of either residential support or day services. The Governor’s Budget included a proposal to transfer the responsibility of serving children with mental retardation who participate in the DCF Voluntary Services Program (VSP) to DMR. This was included in the legislative budget for FY06. During FY06, 124 youth were transitioned to DMR from DCF and 31 new applicants were enrolled in the Voluntary Services Program operated by DMR. A Children’s Services Committee was developed with representatives from families, DCF, DMR and the Office of the Child Advocate to help develop alternatives to congregate care settings for children and adolescents. Funding is included in the FY07 budget to transfer the remaining 75 youths with mental retardation who are still served by DCF. DMR will continue to accept new applications and enroll eligible children and adolescents.

In addition to the 591 individuals served in FY06 with new funds, an additional 92 individuals were served with FY05 dollars that were carried forward bringing the total number of new individuals served to 683. The additional 92 individuals served include 19 from the Waiting List, 12 enhanced family support, eight residential ageouts, 16-day ageouts and 37 high school graduates.

Safety Campaign:

The department initiated a Safety Campaign in FY06 to reinforce the importance of safety and risk management for all staff responsible for the care and welfare of individuals with mental retardation. The Commissioner developed a safety video that was reviewed by all public and private direct support staff and a review of safety protocols was undertaken by each team serving someone with identified safety concerns. Safety materials were developed for distribution throughout the system in early FY07. A Safety Summit with families, consumers, staff, providers, and labor representatives occurred in July 2006.

Federal Reimbursement:

During FY 2006, the Department generated $337,171,708.93 in federal Medicaid reimbursement. This is $28.8 million more than fiscal year 2005. 7,349 people participated in the Home and Community Based Services Program during fiscal year 2006, a net growth of 583 individuals over fiscal year 2005 enrollment. The waiver program allows for federal reimbursement for residential habilitation, day programs and support services provided in the community. On October 1, 2005 a new Comprehensive Support Waiver was initiated. This works in tandem with the Individual and Family Supports Waiver that was implemented in February 2005. The Department will continue to examine ways to maximize federal reimbursement through these waivers and other federal programs.

Respite Program:

DMR’s Respite Program continues to be a success. An additional respite center was opened during FY 06, bringing the total to ten. DMR now has a total of 62 respite beds in the ten centers and an additional two centers are currently in the planning stage. 1,431 individuals used the respite centers in FY 06.

Information Reported as Required by State Statute

Affirmative Action/Equal Opportunity

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.

Culture is a major determinant of the way in which different groups of people approach and use DMR supports and services. 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. Additionally, both DMR Public and Private providers are required to conduct cultural competence organizational self-assessments and improvement plans.

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 2005-2006, the Council budget was $863,041 for initiatives on public information and education, quality assurance, self-advocacy, self-determination and parent support, social role valorization training, community building and transportation.

Regulations/ Studies:

Autism Pilot:

Section 57(a) of PA 05-251 (the budget act) provided funding in FY06 to DMR to support the new position of “autism coordinator” within the department. The Autism Coordinator is responsible for coordinating various initiatives for adults with autism who do not have mental retardation. This position was filled in January 2006. An interim progress report was submitted to the legislature in January 2006. Another progress report was submitted in July 2006 and is available on DMR’s website.

The Department of Mental Retardation (DMR) is required under Section 37 of Public Act 06-188 to establish a small pilot program for individuals who have Autism Spectrum Disorder and do not also have mental retardation and are not receiving services from DMR. In February and March of 2006 two working groups were formed to begin planning the pilot project. A state agency workgroup comprised of representatives of 12 state agencies and a steering committee comprised of representatives of various stakeholder groups began the planning process. These two groups combined in May of 2006 and will continue to meet. Several subcommittees have been formed during the process to devote more time and effort to particular topics. The state agency workgroup, steering committee and subcommittees have made decisions on the vision and goals of the program, eligibility criteria and pilot location, services, training and revision of the Level of Need tool. Previous work by the Advisory Commission on Services and Supports for Persons with Developmental Disabilities was used as a direction for much of the planning. Service recipients have begun to apply for the pilot as of July of 2006. It is expected that person centered plans will begin to be developed through the summer with services to begin by October of 2006. The University of Connecticut Health Center, Center on Aging has be contracted to complete and evaluation of the pilot.

DMR Name Change:

Public Act 06-92 (HB 5478), An Act Concerning the Department of Mental Retardation, that passed the Connecticut State General Assembly this session and requires DMR to solicit input regarding a name change for the Department from clients and families receiving services provided by the department, advocates of persons with mental retardation and other interested parties. DMR is required to submit a report of findings and recommendations, including the cost of any recommended name change, to the Governor, the Office of Policy and Management and the Public Health Committee no later than January 1, 2007. There is a new link on the DMR website with the most up to date information about this issue. http://www.dmr.state.ct.us/NameChange.htm. As mentioned on the website, there are several opportunities for public input. The CT Council on Developmental Disabilities has graciously offered to host a Weblog regarding the potential name change for the Department of Mental Retardation. The Department has designed a questionnaire to gather input, available on the DMR website. There will also be a statewide public forum in September 2006 at the Legislative Office Building in Hartford. The department has commenced outreach efforts to gather as much input as possible on this important issue.

Birth to Three Program:

The Department of Mental Retardation (DMR) published a Request for Proposals to conduct a

Unit Cost Study and to subsequently make rate recommendations for the Connecticut Birth-to-

Three Program. Solutions Consulting Group, LLC of Maine was the successful bidder for this

service. The purpose and design of the cost study was to gather sufficient information to address a

variety of issues including the potential for differential rates for geographic location, differential

rates for programs delivering specialty services to children who are deaf or hard of hearing,

supplemental rates for programs serving children with intensive service needs, and rates for

initial evaluation. The legislature adopted most of the recommendations in the study resulting in a rate increase effective January 2007 as well as a one-time payment to providers to help offset the increase in gasoline costs since most services are delivered in the home. The Birth-to-Three System narrowed its eligibility in 2003 in order to achieve savings and maintain the entitlement status of the program. As a result, 3.5 percent fewer children were served in FY06 than the previous year and referrals were down by 4 percent. Expansion of eligibility continues to be a priority for those involved in the Birth-to-Three system as well as the Governor’s Early Childhood Cabinet.