TESTIMONY OF THE DEPARTMENT OF DEVELOPMENTAL SERVICES ON
HOUSE BILL 5021, AN ACT MAKING ADJUSTMENTS TO THE BUDGET FOR
THE BIENNIUM ENDING JUNE 30, 2009
February 13, 2008
Senator Harp, Representative Merrill, Members of the Appropriations Committee.  I am Peter O’Meara, Commissioner of the Departmental of Developmental Services, and I am here to testify on House Bill 5021, An Act Making Adjustments to the Budget for the Biennium Ending June 30, 2009.  I thank you for the opportunity to appear before you today to discuss Governor Rell’s Budget for 2009.  I would first like to discuss the Results Based Accountability initiative and then bring to your attention the overall highlights of the DDS Budget.
Results Based Accountability Initiative:
The department was pleased to continue its participation in the Results Based Accountability initiative of the Early Childhood Cabinet.  We had selected the Birth to Three program as one that provides information and supports to families, identifies children with developmental delays, and ultimately (in collaboration with preschool special education programs) attempts to ensure that all children will be "Ready for Kindergarten" by age five.

As you can see on our attached RBA template, we selected three very important program measures that respond to the question:  "Is anyone better off ?"

For children, we look at two measures.  First, we use functional assessments done at the time of entry and at the time of exit to determine whether their development in three important outcome areas has either maintained at age level (kept up with their peers), improved to age level, or improved but not to age level.  We are pleased to report that our data on 883 children indicates that although 90% of the children entering showed delays in the areas of social/emotional, knowledge, and behavior, upon exit 94% - 96% had made significant gains after a minimum of six months enrollment.  In addition, we look at whether children that had been enrolled in Birth to Three required special education when they reached Kindergarten.  We are pleased to say that when we looked at this year's Kindergarten students, 63.6% of those that had exited Birth to Three were not in need of special education.  This is higher than the 50% figure we had previously obtained.
For families, we measure our impact on their ability to help their children develop and learn.  Our first year of data shows that we met a standard in that area in which 88% of families surveyed agreed that as a result of receiving Birth to Three services they 1) felt that their efforts helped their children, 2) do things with and for their children that are good for their children's development, and 3) understand their children's special needs.  This was up from 84.4% in the previous year.

Given that both the child and family outcomes in this area appear to be positive, we turned to a fourth performance measure, which is the number and percentage of eligible children, served.  We can demonstrate that if we have a positive impact on more children, then more children will be able to meet developmental milestones as a result of Birth to Three enrollment.

Therefore, our fourth measure shows that although enrollment had been rather flat over the past five years, hovering at about 3% of all children in this age cohort, the data taken most recently has risen to 3.4%.  Our neighbors in Massachusetts, Rhode Island, and New York serve a larger percentage of children in their program and we rank 12th nationally.  We have also had some success in the area of children under the age of 12 months.  We now rank 18th compared to all other states (up from 30th last year) serving 1.23% of children in this age cohort.  We are looking forward to continued progress in this area since eligibility was broadened effective 7/1/07 to include babies born at less than 1000g or 28 weeks gestation or less; children with significant delays in speech combined with biological risk factors; and children with mild or unilateral hearing loss.  We have been concentrating on targeted outreach to health care providers about these changes as well as insuring that there is sufficient program capacity to receive increased referrals.  In addition to adding five new provider agencies in 2007, we have recently added six autism-specific programs.  We're still not at the capacity we need and we will be seeking additional general and autism-specific programs during 2008.
DDS Budget Overview:
The Governor’s proposed mid-term budget adjustment provides for $996,984,136 in direct appropriations and other funds to the Department of Developmental Services. This is an increase over the budget that passed last session by $22,926,608.  At this time, I would like to review some highlights of the Governor’s recommended Mid-Term Budget:
Personal Services:
The department’s fiscal year 2009 appropriation provides sufficient funding within the Personal Services SID to adequately fund the Department’s Program and Administrative infrastructures in order to serve the Department’s consumer population.  We are also pleased that the Governor’s budget includes funding for an additional 6 case managers, which will assist us to continue to adjust caseloads.
New Residential and Day Services:
The department’s FY09 appropriation supports the continuation of the waiting list initiative and funding for age outs, voluntary services and school graduates. The Governor’s Fiscal Year 2009 Mid Term Budget supports the adjustments necessary to serve children and youth who were identified to the department subsequent to the appropriation made at the beginning of the biennium.  This includes 9 age outs needing day services, 19 additional school graduates and 18 age outs needing residential services. The mid-term budget also supports the growth we have experienced in the Voluntary Services Program by adding funding for 60 additional referrals.  The Governor’s Budget recommends a one-time reduction of $1,016,000 to reflect typical delays in placement development.

Waiting List: 
Since the beginning of the Waiting List Initiative in July 2004, through December 31, 2007, the department has served 997 individuals who were on the waiting list using both new resources and residential vacancies. Each year we have been able to surpass our targets of 150 people served with new funding and an additional 75 served by using vacancies in existing residential programs.  At the beginning of this initiative the waiting list had 1014 people on it. The current waiting list is 634, a reduction of 380 individuals when taking into account all the new people who request residential services each year.
Autism Division:  
The Governor’s Fiscal Year 2009 Mid-Term Budget maintains the appropriations for a new Autism Division within the Department of Developmental Services.  The Division is funded at $2 million for FY09. This includes $1 million to continue the current Pilot Program, an additional $500,000 to expand services under the Pilot and $500,000 to hire staff for the division effective July 1, 2008.
Revenue Update:
DDS has increased its federal revenue reimbursements 134% since 1995.  Over $331 million dollars in federal revenue was received as reimbursement during fiscal year 2007.  The revenues received this past fiscal year pushes total federal dollars generated by DDS operated programs and collected by the state since 1995 to over $3.3 billion dollars.  The DDS increased retrieval of federal dollars has been made possible through DDS’s increased participation in the Federal Medicaid program that includes the operation of two Home and Community Based Service Waivers.  Involvement in this program allows the state to receive federal reimbursements for a significant portion of the services provided to people with mental retardation who are served by the department.  Today, there are over 7,700 eligible individuals served by the Department enrolled in a waiver program.  Pursuant to Connecticut General Statutes 17a-218(g), remaining eligible individuals must be enrolled.  The Department is taking every possible step to assure that eligible persons who are receiving services are enrolled.
Overall, DDS is pleased and grateful for the maintenance of a budget that allows the important needs of those we serve to be met.  We thank Governor Rell and you as legislators for making a commitment to some of Connecticut’s most vulnerable citizens, individuals with mental retardation and their families, and meeting many of their needs through the budget process.  Again, I thank you for the opportunity to testify before you today.  The Department looks forward to continuing to work with the legislature throughout the session and we would be happy to answer any questions that you might have for us at this time.