Scheff Summer Tour 2021- Questions and Answers

Respite Centers
 
-How does my loved one access Respite Center through DDS? 
To access DDS public respite centers please contact a regional respite coordinator:
-Have Respite Centers that closed during the pandemic reopened? 
Most respite centers have reopened to partial capacity.  The team continues to review circumstances to determine when all centers will return to full capacity. DDS continues to take numerous precautions, including health screenings, PPE requirements as well as thorough sanitation and cleaning requirements to maintain the health and safety of all individuals and staff. 
 
-Does DDS plan to add more respite centers and expand who may be eligible to utilize them? 
DDS understands that respite centers provide a vital service for an individual and their family. DDS is currently reviewing several plans to expand respite opportunities.  
 
Transportation
 
-Transportation continues to be a challenge for DDS providers in both logistics and funding. Does DDS have any plans to improve the service and the rates for transportation? 
The pandemic has made transportation difficult, as social distancing has been a concern. DDS continues to evaluate transportation plans and rates and is exploring some creative solutions to these challenges. 
 
COVID-19 Vaccines 
 
-Is DDS tracking COVID vaccination rates for staff and individuals? 
DDS is tracking vaccination status for DDS-supported individuals through reporting from providers.  DDS is not tracking vaccination status for staff. 
 
-Is the COVID vaccine mandated for DDS staff? 
The COVID-19 vaccine is strongly encouraged for all CT residents who can take it.  Governor Lamont issued Executive Order 13B on August 6, 2021, which mandates COVID-19 vaccine for staff of long-term care facilities, which includes ICF/IIDs.  In addition, Governor Lamont issued Executed Order 13D on August 19, 2021, which mandates the COVID-19 vaccine for all state employees.  Those not fully vaccinated must comply with a weekly testing requirement.  We are awaiting further implementation guidance on these Orders.
 
-Can DDS providers ask an individual if they have been vaccinated and turn down service to them if they are not?
Please see the attached DDS guidance regarding vaccination and masking requirements. https://portal.ct.gov//media/DDS/COVID19_2021/Employment_and_Day_Provider_guidance_FINAL_5_27_21.pdf
 
Day & Employment Programs 
 
-In the Commissioner’s presentation there was little time spent talking about the future of day programs. Is there a reason why this was not mentioned?
The future of Employment and Day programs has been the singular focus of a departmental initiative titled “DDS State Leadership Employment Network (SELN) Assessment” led by our Employment & Day Services Director, Amber Burke.  Amber has been leading stakeholder engagement over the past two years to discuss the future of employment and day programs. The discussion on this topic in the Commissioner’s presentation was limited in acknowledgment of this ongoing work. The department will be sharing the lessons learned and discussing key elements from the DDS State Leadership Employment Network (SELN) Assessment process and will continue to invite stakeholders to the table to expand that dialogue.
 
-Does DDS have any plans to expand workforce development opportunities to individuals?
DDS is working to expand competitive employment opportunities by creating relationships with local businesses throughout the state and improving our employment-based programs to provide skill-building work and training opportunities. The department has developed and continues to expand on opportunities such as internships like Project Search. Project Search focuses on connecting business and individuals by providing opportunities for young adults to learn marketable skills in an occupational setting with the goal of securing competitive employment post-internship.
 
The DDS Employment and Day Services Unit recently launched a series of subcommittees with the intent to focus on the agency’s macro and micro-level efforts to increase opportunities for those seeking competitive integrated employment and greater community inclusion. The subcommittees are soliciting participation from different stakeholders, including, providers, family, and staff. We look forward to the conversations that will occur in these subcommittees and their recommendations as we move through the process. 
 
-Are all Day & Employment Programs reopened after the pandemic caused most to close? 
Employment and day programs have reopened as providers have been able to safely operate them.  The state does not have any restrictions in place.  Providers continue to implement health and safety guidelines. Some providers also continue to provide virtual supports, on an as-needed basis. For the latest on reopening plans and COVID related updates to providers please visit https://portal.ct.gov/DDS/General/COVID19/COVID-19-Updates-for-DDS-Providers 
 
-Is DDS working to improve quality oversights and monitoring of day and employment programs? 
DDS strives to continuously improve all quality oversight mechanisms to expand and enhance supports and services to the individuals we serve. DDS also uses feedback from individuals, families, and our provider community to plan for improved service delivery in the future.
 
-How is DDS streamlining monitoring efforts to not overburden providers, while maintaining the integrity of the oversight?
DDS has participated in several Lean projects and working groups with the intent to streamline and improve the efficiency of quality oversights and licensing requirements. Some of these groups are still meeting regularly and working to determine where duplications can be eliminated, and efficiencies can be made. During the pandemic, DDS also implemented technology solutions to streamline quality and licensing processes. Many of these have now been integrated into the standard process.
 
-Are there any plans to extend the hours that day program can be offered? 
Authorized day supports hours (including Individual Day, Non-vocational, and Senior Supports) may be utilized outside of the traditional Monday through Friday, 9 am-3 pm hours as long as the team has approved and the individual is actively working on day goals written in his/her IP.
 
Level of Need Assessment Tool
 
-Is DDS still using the Level of Need (LON) tool for assessments? Do you plan to move to another tool is this tool working in terms of capturing the needs of individuals supported by DDS appropriately? 
DDS continues to use the Level of Need tool for assessments of DDS individuals. DDS continues to work with state partners to determine a timeline and process for possibly moving to a universal assessment tool. It is important to note, however, that the process for transition will take much review to ensure the assessment tool is properly measuring the specific needs of individuals with intellectual disabilities. We will continue to share updates as we move through this process.
 
-Is there a process for families that believe the LON has not accurately measured the needs of their loved one and therefore would like an increased budget allotment and different services? 
DDS has a few different processes in place to review LON assessments and allow families to request increased services and/or budget allotments. A family should work with their case manager to explore these options including a request for a utilization resource review or a one-time request. In addition, if a family is not in agreement with a budget or service decision, they always have the right to request an informal appeal through the region called a Programmatic Administrative Review (PAR). In some cases, a family may also request a formal appeal through the Department of Social Services. For more information please visit the following links:
Cost Settlement
 
-Is it true that cost settlement is removed for DDS nonprofit providers? 
Public Act 21-65 removes cost settlement, effective July 1, 2021, for DDS providers. This means providers who meet contractual requirements can retain any savings realized from the contracted cost for services. 
 
Medicaid
 
-Why did the program that allows guardians to be paid for providing support end? 
The provision that allowed DDS to pay guardians for providing services and supports was a part of the federal public health emergency Appendix K application process and was specifically approved by the federal Centers for Medicare and Medicaid Services. The program, however, was only approved for a temporary amount of time and ended in CT on July 31, 2021. 
 
-Is DDS able to provide information about ABLE Accounts? 
The Achieving a Better Life Experience (ABLE) Act of 2014 enables individuals with disabilities to save money in tax-advantaged accounts which they can later use for meeting their disability-related needs with limited impact on their eligibility for certain means-tested benefits. They are similar to CHET or 529 accounts except that beneficiaries of ABLE accounts own the account. Eligibility for an ABLE account is open to an individual of any age who has blindness or a disability that occurred before the age of 26. An individual is allowed only one ABLE account and can open an account in any state’s ABLE program. The determination of eligibility for an ABLE account is the responsibility of the ABLE program in which an individual seeks to establish the account. 
For more information on CT ABLE accounts please visit: https://savewithable.com/ct/home.html 
 
Public/State Run Settings
 
-I hear a lot of discussion on the Step-Down unit but I am unable to find additional information. How can my loved one access this service? 
The Step-Down Unit was created to support adult individuals in crisis and in need of behavioral stabilization, who are coming from community-based settings or hospital emergency departments.  This temporary setting is focused on treatment and intervention with the goal of the individual transitioning back into a community-based setting. The Unit can house a maximum of five people at one time and the intake process is through regional referrals only. As the unit is specifically focused on crisis intervention, appropriate referrals through the region are necessary to ensure a proper fit.
 
-Is DDS exploring the option to expand or create additional step down units? 
DDS is exploring expanding and replicating the step-down unit, including for programs geared toward different populations (e.g. children). 
 
Can DDS share the future plans for state-run CLAs and Regional Centers?
DDS envisions that state-operated services will remain an important part of our service system for the foreseeable future.  State-operated services will likely continue to change over time (e.g. Southbury Training School, which continues to reduce capacity in accordance with the Messier Settlement Agreement).  DDS continues to explore how state-operated services can, over time, be focused to best fill certain gaps in our service system or act as a specialty provider in certain complex areas.
 
-Can DDS share the future plans for Southbury Training School (STS)?
State statute has prohibited DDS from accepting any new admissions into Southbury Trainings School since 1997. As the census for the setting goes down, DDS continues to work with the state and stakeholders on planning for the future of STS. 
 
DDS Supports and Services 
 
-Can DDS share its future vision for self-determination? 
DDS believes that Self-determination is an option open to all individuals funded by the Department. Self-determination allows an individual to determine their future, design their own support plans and choose the assistance they need to live full lives of their own choosing. DDS continues to enhance and expand the array of services within the self-direction program while using feedback from individuals that receive supports from the program to improve the quality of services. The overall goal of self-determination is to allow an individual to fully decide how to live their own life.
 
-Is DDS posed to see a large amount of DDS state employees retire over the next two years?
Generally, yes. DDS projects that a large number of DDS state staff are eligible to retire in the next year alone. Understanding the importance of transferring years of institutional knowledge to a new generation of DDS employees, DDS has already started planning and hiring staff in all regions to minimize the potential impact retirements may have on the operations of the department and delivery of services. 
 
-Can DDS share its future vision for Community Companion Homes? 
A Community Companion Home (CCH) is a waivered residential program model that facilitates an individual to live in a licensee’s home. The Licensee provides supports, services, and a family setting. The Licensee is paid a stipend for providing space in their home and other supports. The model has not only proven to be a successful, community-integrated model that focuses on independence and family integration, but it is also a cost-effective residential model when compared to more expensive congregate-type settings like a group home.  DDS is working to expand the CCH program, grow the number of licensees participating, and improve the model to better fit individuals interested in receiving residential supports. As part of this future vision, DDS is reviewing the requirements to become a licensee and the stipend process to determine where improvements can be made. DDS expects to share more information on the CCH program soon. 
 
-Can DDS share its future vision of Shared Living? 
Shared Living is a waivered residential program model that allows an individual to continue to live in their own home, and a person is known as the “shared liver” moves in to provide basic supports and services. Although this model has been available in the DDS waivers for a few years, the program has grown slowly. To that end, DDS is embarking on a full review of the program to determine what changes are necessary to educate others on the program and grow the program to its fullest potential. As a residential model that focuses on independent living, it is important that DDS defines the program to make it a valuable model in our residential service delivery system. DDS is currently reviewing the programmatic guidelines for the program and the payment methodology. DDS expects to share more information on the Shared Living program soon. 
 
-Can DDS provide more information on the CMS Final Settings Rule and the expectation DDS has for providers to meet the requirement? 
In 2014 the Centers for Medicare and Medicaid Services (CMS) issued a final rule for home and community-based services (HCBS) that requires states to review and evaluate home and community-based settings, including residential and non-residential settings to determine that such settings allow for, and facilitate the integration of residents into their community.  CMS has recently clarified the requirements of the settings rule and has communicated that states must comply with the rule by March 2023. In June of 2018, in partnership with the single state Medicaid agency, the Department of Social Services (DSS), DDS submitted a statewide transition plan to CMS for approval.  The plan was approved and confirmed (as of that time), that all current DDS settings meet or could meet the expectations of the final settings rule.  For new settings created after June 2018, DDS must ensure the setting meets the requirements outlined by CMS. DDS Point of Service qualified providers are contractually obligated to meet the final settings requirements. DDS plans to provide further training and informational sessions on the settings rule for providers this fall and winter. In the meantime, additional information on the settings rule can be found on the DDS website under the provider gateway section: https://portal.ct.gov/DDS/OperationsCenter/Providers/CMS-Final-Settings-Information 
 
-Can DDS explain the purpose of the Abuse and Neglect registry? Is this registry public? 
According to state statute, in 1997 DDS created and currently maintains a registry of former DDS or qualified provider employees who have been terminated or separated from employment as a result of substantiated abuse or neglect. As the statute describes, the registry is only available to certain agencies for purposes of protective service determinations, determining whether an applicant for employment appears on the registry, or conducting background checks for volunteers. State law also details that the registry is not disclosable under the Freedom of Information Act. This registry is separate and distinct from criminal prosecution, although depending on the substantiated offense criminal prosecution may be warranted. 
 
-Can DDS expand on therapy services that may be offered to eligible individuals? 
DDS continues to review the types of direct and consultative services available through the regions.