HB 5293 — AN ACT CONCERNING THE DEPARTMENT OF DEVELOPMENTAL SERVICES' RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO DEVELOPMENTAL SERVICES STATUTES.

657 sHB5293 File No.

657 to any transfer of such person fromone facility to another for any reason other than a medical reason or an emergency, or may request such a transfer.

(e) Any person with intellectual disability, or the legal representative of such person, may request a hearing to contest the category assignmentPublic madeAct byNo. the department for persons seeking residential placement, residential services or residential support.

24-122 9 of 28 Substitute House Bill No.

5293 assignment made by the department for persons seeking residential placement, residential services or residential support.

(f) Any person with intellectual disability or the legal representative ofsuchperson,may object to (1)aproposedapprovalby thethedepartment department of a program for such person that includes the use of behavior- modifying medications or aversive procedures, or (2) a proposed determination of the department that community placement is inappropriate for such person placed under the direction of the commissioner.

The department shall provide written notice of any such proposed approval or determination to the person, or to the legal sHB5293representative /of Filesuch No.person, [at least] not less than ten days prior to making such approval or determination.

657 sHB5293 File No.

657 representative of such person, [at least] not less than ten days prior to making such approval or determination.

The notice required by this subsection shall provide such person and such person's legal representative with information regarding the person's right to object to such transfer, except in the case of an emergencyPublic transferAct orNo. a transfer for a medical reason as provided in this subsection, and shall include the name, address and telephone number of the nonprofit entity designated by the Governor in accordance with section 46a-10b of the general statutes to serve as the Connecticut protection and advocacy system.

24-122 10 of 28 Substitute House Bill No.

5293 emergency transfer or a transfer for a medical reason as provided in this subsection, and shall include the name, address and telephone number of the nonprofit entity designated by the Governor in accordance with section 46a-10b of the general statutes to serve as the Connecticut protection and advocacy system.

sHB5293(b) /Any Fileperson No.with intellectual disability who is eighteen years of age or older and who resides at any residential facility operated by the Department of Developmental Services, or the legal representative of any person with intellectual disability who resides at any such residential facility, may object to any proposed transfer, emergency transfer or transfer for a medical reason of such person from one residential facility to another for any reason or may request such a transfer.

657 sHB5293 File No.

657 (b) Any person with intellectual disability who is eighteen years of age or older and who resides at any residential facility operated by the Department of Developmental Services, or the legal representative of any person with intellectual disability who resides at any such residential facility, may object to any proposed transfer, emergency transfer or transfer for a medical reason of such person from one residential facility to another for any reason or may request such a transfer.

In any such transfer hearing, the proponent of a transfer shall have the burden of showing, by clear and convincing evidence, that the transfer is in the best interest of the resident who is being considered for transfer or has been transferred and that the residential facility and programs to which transfer is proposed or has been made (1) are safe and effectively supervised and monitored, and (2) provide a greater opportunity for personal development than the setting in which the resident presently resides.Public Act No.

24-122 11 of 28 Substitute House Bill No.

5293 resides.

A person's right to object to a temporary transfer and right to request a sHB5293hearing /pursuant Fileto No.subsection (b) of this section shall be stayed until thethirtiethdayofthetemporarytransfer.Ifahearingisrequested,such hearing shall be conducted in accordance with subsection (b) of this section.

657 sHB5293 File No.

657 hearing pursuant to subsection (b) of this section shall be stayed until thethirtiethdayofthetemporarytransfer.Ifahearingisrequested,such hearing shall be conducted in accordance with subsection (b) of this section.

The commissioner shall provide any person whoPublic isAct beingNo. temporarily transferred and that person's legal representative, if any, with written notice of the temporary transfer as soon as practicable, but not more than ten days after the date of the temporary transfer.

24-122 12 of 28 Substitute House Bill No.

5293 who is being temporarily transferred and that person's legal representative, if any, with written notice of the temporary transfer as soon as practicable, but not more than ten days after the date of the temporary transfer.

(NEW) (Effective from passage) (a) As used in this section and sections 17a-210 of the general statutes, as amended by this act, and 17a- 238 of the general statutes, as amended by this act, (1) "human rights committee" means a committee established pursuant to subsection (b) of this section, (2) "department" means the Department of Developmental Services, (3) "commissioner" means the Commissioner of Developmental Services, (4) "regional director" means the person appointed by the commissioner to be directly responsible for the management of a service region of the department, and (5) "training school director" means the person appointed by the commissioner to be directly responsible for the management of the Southbury Training School.

sHB5293(b) /There Fileshall No.be, within each service region of the department and at the Southbury Training School, a human rights committee, with members appointed by the regional or training school director.

657 sHB5293 File No.

657 (b) There shall be, within each service region of the department and at the Southbury Training School, a human rights committee, with members appointed by the regional or training school director.

(A) Aversive procedures, (B) restrictive interventions, (C) intrusive programs or devices,Public (D)Act restitution,No. and (E) presedation medication.

24-122 13 of 28 Substitute House Bill No.

5293 devices, (D) restitution, and (E) presedation medication.

(NEW) (Effective from passage) (a) As used in this section and sections 17a-210 of the general statutes, as amended by this act, and 17a- 238 of the general statutes, as amended by this act, (1) "program review committee" means a committee established pursuant to subsection (b) of this section, (2) "department" means the Department of Developmental Services, (3) "commissioner" means the Commissioner of Developmental Services, (4) "regional director" means the person appointed by the commissioner to be directly responsible for the management of a service region of the department, and (5) "training school director" means the person appointed by the commissioner to be directly responsible for the management of the Southbury Training School.

Each program review committee shall advise the regional and training school directors and sHB5293the /Commissioner Fileof No.Developmental Services on best practices for reviewing plans that include, but need not be limited to, behavior support strategies, use of psychotropic and behavior modifying medications and the use of restraints for each person who receives services from the department.

657 sHB5293 File No.

657 the Commissioner of Developmental Services on best practices for reviewing plans that include, but need not be limited to, behavior support strategies, use of psychotropic and behavior modifying medications and the use of restraints for each person who receives services from the department.

Sec.Public Act No.

24-122 14 of 28 Substitute House Bill No.

5293 Sec.

For purposes of this subsection, "aversive procedure" means the contingent use of an event which may be unpleasant, noxious or otherwise cause discomfort to alter the occurrence of a specific behavior or to protect an individual from injuring himself or herself or others and may include the use of sHB5293physicalisolationandmechanicaland /physicalrestraint.Nothinginthis Filesubsection No.shall prohibit persons who are not placed or treated under the direction of the Commissioner of Developmental Services from independently pursuing and obtaining any treatment plan or course of treatment as may otherwise be authorized by law.

657 sHB5293 File No.

657 physicalisolationandmechanicalandphysicalrestraint.Nothinginthis subsection shall prohibit persons who are not placed or treated under the direction of the Commissioner of Developmental Services from independently pursuing and obtaining any treatment plan or course of treatment as may otherwise be authorized by law.

Sec.Public Act No.

24-122 15 of 28 Substitute House Bill No.

5293 Sec.

(a) There is established an independent [ombudsperson office] Office of the Developmental Services Ombudsperson within the Department of Developmental Services that is responsible for receiving and making recommendations to the commissioner for resolving complaints sHB5293affecting /individuals Fileunder No.the care or supervision of the department or of any public or private agency with which the department has contracted for the provision of services.

657(b) sHB5293The Filedirector of the [ombudsperson office] Office of the Developmental Services Ombudsperson shall be appointed by the Public Act No.

65724-122 affecting16 individuals under the care or supervision of the28 departmentSubstitute orHouse ofBill anyNo. public or private agency with which the department has contracted for the provision of services.

(b)5293 The director of the [ombudsperson office] Office of the Developmental Services Ombudsperson shall be appointed by the Governor, with the approval of the General Assembly.

If the General Assembly is not in session at the time of the Governor's or council's designation of a candidate, the candidate shall serve as the acting ombudsperson until the General sHB5293Assembly /meets Fileand No.confirms the candidate as ombudsperson.

657A sHB5293candidate Fileserving as acting ombudsperson shall be entitled to compensation and have all the powers, duties and privileges of the Public Act No.

65724-122 Assembly17 meetsof and28 confirmsSubstitute theHouse candidateBill asNo. ombudsperson.

A5293 candidate serving as acting ombudsperson shall be entitled to compensation and have all the powers, duties and privileges of the ombudsperson.

(3) terminate a service or decrease substantiallyitstotallicensedbedcapacity;or(4)relocatealloraportion sHB5293of /such Filefacility's licensed beds, to a new facility or replacement facility, Public Act No.

65724-122 sHB529318 Fileof 28 Substitute House Bill No.

6575293 of such facility's licensed beds, to a new facility or replacement facility, shall submit a complete request for permission to implement such transfer, addition, expansion, increase, termination, decrease or relocation of facility beds to the Department of Social Services with such information as the department requires, provided no permission or request for permission to close a facility is required when a facility in receivership is closed by order of the Superior Court pursuant to section 19a-545.

The department shall review a petition for closure to the extent it deems necessary and the facility shallPublic submitAct information the department requests or deems necessary sHB5293 / File No.

65724-122 sHB529319 Fileof 28 Substitute House Bill No.

6575293 shall submit information the department requests or deems necessary to substantiate that the facility closure is consistent with the provisions of this subsection.

(A) The date the facility submittedPublic theAct petitionfor closure, (B) that only the Department ofSocial Serviceshastheauthority to eithergrantor deny thepetitionfor closure, (C) that the Department of Social Services has up to thirty days to grant sHB5293 / File No.

65724-122 sHB529320 Fileof 28 Substitute House Bill No.

6575293 submitted the petitionfor closure, (B) that only the Department ofSocial Serviceshastheauthority to eithergrantor deny thepetitionfor closure, (C) that the Department of Social Services has up to thirty days to grant or deny the petition for closure, (D) a brief description of the reason or reasons for submitting the petition for closure, (E) that no patient shall be involuntarily transferred or discharged within or from a facility pursuant to state and federal law because of the filing of a petition for closure, (F) that all patients have a right to appeal any proposed transfer or discharge, and (G) the name, mailing address and telephone number of the Office of the Long-Term Care Ombudsman and local legal aid office, or, in the case of a residential facility for persons with intellectual disability licensed pursuant to section 17a-277, as described in subsection (a) of this section, the Office of the Developmental Services Ombudsperson and local legal aid office.

A certificatePublic ofAct needNo. application shall be deemed withdrawn by the department, if a department completeness letter is not responded to within one hundred eighty days.

The24-122 Office21 of the28 Long-TermSubstitute CareHouse Ombudsman,Bill or, in the case of a residential facility for persons with intellectual disability licensed pursuant to section 17a-277, as described sHB5293 / File No.

6575293 sHB5293certificate Fileof No.need application shall be deemed withdrawn by the department, if a department completeness letter is not responded to within one hundred eighty days.

657The Office of the Long-Term Care Ombudsman, or, in the case of a residential facility for persons with intellectual disability licensed pursuant to section 17a-277, as described insubsection(a)ofthis section,theOffice ofthe DevelopmentalServices Ombudsperson shall be notified by the facility at the same time as the letter of intent is submitted to the department.

(1) The projected date the facility will be submitting its certificate of need application, (2) that only the Department of Social Services has the authority to either grant, modify or deny the application, (3) that the Department of Social Services has up to ninety days to grant, modify or deny the certificate of need application, (4) a brief description of the reason or reasons for submitting a request for permission, (5) that no patient shall be involuntarily transferred or discharged within or from a facility pursuant to state and federal law because of the filing of the certificate of need application, (6) that all patients have a right to appeal any proposed transfer or discharge, and (7) the name, mailing address and telephone number of the Office of the Long-TermPublic CareAct OmbudsmanNo. and local legal aid office, or, in the case of a residential facility for persons with intellectual disability licensed pursuant to section17a-277,asdescribedinsubsection(a)ofthissection, the Office of the Developmental Services Ombudsperson and local legal aid office.

(f)24-122 The22 Department of Social28 ServicesSubstitute shallHouse reviewBill a request made pursuant to subsection (b) of this section to the extent it deems sHB5293 / File No.

6575293 sHB5293Long-Term FileCare No.Ombudsman and local legal aid office, or, in the case of a residential facility for persons with intellectual disability licensed pursuant to section17a-277,asdescribedinsubsection(a)ofthissection, the Office of the Developmental Services Ombudsperson and local legal aid office.

657(f) The Department of Social Services shall review a request made pursuant to subsection (b) of this section to the extent it deems necessary, including, but not limited to, in the case of a proposed transfer of ownership or control prior to initial licensure, the financial responsibility and business interests of the transferee and the ability of the facility to continue to provide needed services, or in the case of the addition or expansion of a function or service, ascertaining the availability of the function or service at other facilities within the area to be served, the need for the service or function within the area and any other factors the department deems relevant to a determination of whether the facility is justified in adding or expanding the function or service.

Upon the request oftheof the applicant, the review period may be extended for an additional fifteen days if the department has requested additional information subsequent to the commencement of thecommissioner'sreviewperiod.ThePublic directorAct oftheofficeNo. of certificate of need and rate setting may extend the review period for a maximum of thirty days if the applicant has not filed in a timely manner information deemed necessary by the department.

24-122 23 of 28 Substitute House Bill No.

5293 thecommissioner'sreviewperiod.The director oftheoffice of certificate of need and rate setting may extend the review period for a maximum of thirty days if the applicant has not filed in a timely manner information deemed necessary by the department.

(g) The Commissioner of Social Services shall not approve any requests for beds in residential facilities for persons with intellectual disability which are licensed pursuant to section 17a-227, as amended sHB5293by /this Fileact, No.and are certified to participate in the Title XIX Medicaid Program as intermediate care facilities for individuals with intellectual disabilities, except those beds necessary to implement the residential placement goals of the Department of Developmental Services which are within available appropriations.

657 sHB5293 File No.

657 by this act, and are certified to participate in the Title XIX Medicaid Program as intermediate care facilities for individuals with intellectual disabilities, except those beds necessary to implement the residential placement goals of the Department of Developmental Services which are within available appropriations.

(a) No person, firm or corporation shall operate within this state a community living arrangement or community companion home [which] that it owns, leases or rents for the lodging, care or treatment of personsPublic withAct intellectualNo. disability, Prader-Willi syndrome or autism spectrum disorder unless such person, firm or corporation, upon written application, has obtained a license issued by the Department of Developmental Services.

24-122 24 of 28 Substitute House Bill No.

5293 persons with intellectual disability, Prader-Willi syndrome or autism spectrum disorder unless such person, firm or corporation, upon written application, has obtained a license issued by the Department of Developmental Services.

(1) All residential facility staff be certified in cardiopulmonary resuscitation in sHB5293a /manner Fileand No.time frame prescribed by the commissioner;

657 sHB5293 File No.

657 a manner and time frame prescribed by the commissioner;

(c) After receiving an application and making such investigation as is deemed necessary and after finding the specified requirements to have been fulfilled, the department shall grant a license to such applicant to operate a facility of the character described in such application, which license shall specify the name of the person to have charge and the locationPublic ofAct eachNo. facility operated under the license.

24-122 25 of 28 Substitute House Bill No.

5293 location of each facility operated under the license.

Each such license shall be renewedannuallyuponsuchtermsasmaybeestablishedbyregulations and may be revoked by the department upon proof that the facility for which such license was issued is being improperly operated, or for the violation of any of the provisions of this section or of the regulations sHB5293adopted /pursuant Fileto No.this section, provided the licensee shall first be given a reasonable opportunity to be heard in reference to such proposed revocation.

657 sHB5293 File No.

657 adopted pursuant to this section, provided the licensee shall first be given a reasonable opportunity to be heard in reference to such proposed revocation.

(A) The licensed qualified provider may be placedPublic onAct aNo. strict schedule of monitoring and oversight by the department;

24-122 26 of 28 Substitute House Bill No.

5293 placed on a strict schedule of monitoring and oversight by the department;

(f)Any person,firmorcorporationwhooperatesany facility contrary sHB5293to /the Fileprovisions No.of this section shall be fined not more than one thousand dollars or imprisoned not more than six months or both.

657 sHB5293 File No.

657 to the provisions of this section shall be fined not more than one thousand dollars or imprisoned not more than six months or both.

(g) If the commissioner determines, after investigation of a report received pursuant to the provisions of section 46a-11b, that a person, firmor corporationlicensedto operate acommunity living arrangement or community companion home committed abuse or neglect against a person receiving support or services from the department during a licensure period, and such determination resulted in the revocation or surrender of such person, firm or corporation's license, the commissioner may disclose (1) the name of such person, firm or corporation, (2) the date of such revocation or surrender, and (3) the type of abuse or neglect committed to (A) authorized agencies, as defined in section 17a-247a, for the purpose of protective service determinations,Public (B)Act employersNo. whose employees provide services to persons who receive support or services from the department, and (C) the Departments of Children and Families, Mental Health and Addiction Services, Social Services and Administrative Services for the purpose of making a determination on an application for (i) employment with, or (ii) licensure or certification as a provider for the Departments of Children and Families, Mental Health and Addiction Services, Social Services and Developmental Services.

This24-122 act27 shallof take28 effectSubstitute asHouse followsBill andNo. shall amend the following sections:

Section5293 1determinations, (B) employers whose employees provide services to persons who receive support or services from passagethe Newdepartment, sectionand Sec.(C) the Departments of Children and Families, Mental Health and Addiction Services, Social Services and Administrative Services for the purpose of making a determination on an application for (i) employment with, or (ii) licensure or certification as a provider for the Departments of Children and Families, Mental Health and Addiction Services, Social Services and Developmental Services.

2Approved fromJune passage5, 20-1202024 Sec.Public Act No.

324-122 October28 1,of 202428 17a-249 Sec.

4 from passage 5-247(a) from passage Sec.

5 5-250(e) Sec.

6 from passage 5-254(a) Sec.

7 July 1, 2024 17a-210 Sec.

8 July 1, 2024 New section sHB5293 / File No.

657 sHB5293 File No.

657 Sec.

9 from passage New section Sec.

10 from passage New section Sec.

11 from passage 17a-238(b) Sec.

12 from passage 17a-247b(c) Sec.

13 from passage 17a-210a Sec.

14 from passage 17b-352 Sec.

15 from passage 17a-274(l) Sec.

16 from passage 17a-227 sHB5293 / File No.

657 27 sHB5293 File No.

657 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

See Below Municipal Impact:

See Below Explanation The bill expands the eligibility of grants and deferred loans that support the development of housing for people with certain disabilities to include municipaldevelopers.Thisresults inapotentialrevenue gain to municipalities beginning in FY 25 to the extent that municipalities are awarded this grant.

The bill also makes several changes to the supportive housing assistance program that could result in increased or more rapid use of fundsauthorizedfortheprogram,includingtransferringadministrative authority for the program from the Department of Developmental Services to the Department of Housing.

The program is funded through General Obligation (GO) bond funds.

Future General Fund debt service costs may be incurred sooner under the bill to the degree that it causes authorized GO bond funds to be expended or to be expended more rapidly than they otherwise would have been.

As of March 1, 2024, the unallocated bond balance available under the relevant authorization is $15 million.

The bill does not change GO bond authorizations relevant to the program.

House "A" allows the Department of Developmental Services (DDS) to share information regarding the license revocation of certain operators of community living arrangements and companion homes, has no fiscal impact.

sHB5293 / File No.

657 28 sHB5293 File No.

657 The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to the terms of any bonds issued.

sHB5293 / File No.

657 29 sHB5293 File No.

657 OLR Bill Analysis sHB 5293 (as amended by House "A")* AN ACT CONCERNING THE DEPARTMENT OF DEVELOPMENTAL SERVICES' RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO DEVELOPMENTAL SERVICES STATUTES.

SUMMARY This bill makes various changes to Department of Developmental Services (DDS)-related statutes.

Principally, it:

1.

codifies existing practice by establishing an Oral Health and Dental Services Unit within DDS’s Health and Clinical Services Division, and allows DDS to contract with dentists or provisionally licensed dentists for this purpose;

2.

revises a recently enacted grant program for providers of supportive housing for people with developmental disabilities, such as by (a) shifting primary responsibility for the program from DDS to the Department of Housing (DOH) and (b) expanding the types of entities eligible for program grants;

3.

removes the statutory cap of 11 DDS self-advocate coordinators;

4.

updates and revises the law on transfers from DDS-operated or - funded residential facilities, such as by authorizing DDS to temporarily transfer residents for up to 90 days during certain emergency situations;

5.

codifies existing practice by establishing in law a human rights committee and program review committee within each DDS service region and the Southbury Training School;

6.

makes information in DDS’s abuse and neglect registry available sHB5293 / File No.

657 30 sHB5293 File No.

657 to the Office of Labor Relations to determine whether an applicant for employment with DDS or certain other state agencies appears on the registry;

7.

specifically names the DDS ombudsperson office in law as the “Office of the Developmental Services Ombudsperson”;

8.

updates notice requirements related to intermediate care facilities for individuals with intellectual disability (ICF/IIDs) related to the certificate of need (CON) process, such as by requiring facility closure notices to go to the Office of the Developmental Services Ombudsperson rather than the Office of the Long-Term Care Ombudsman, and requiring the ombudsperson’s office to hold informational sessions related to these closures (the bill does not change the underlying CON requirements);

and 9.

allows DDS to share information with certain entities if a DDS- licensed community living arrangement (i.e., group home) or community companion home’s license was revoked or surrendered because of substantiated abuse or neglect during the licensure period.

The bill also makes minor, technical, and conforming changes.

*House Amendment “A” adds the provisions on DDS sharing information on group home or community companion home licensing actions due to substantiated abuse or neglect.

EFFECTIVE DATE:

Upon passage, except the provisions on residential transfers take effect July 1, 2024, and those on the supportive housing grant program take effect October 1, 2024.

§§ 1 & 2 — ORAL HEALTH AND DENTAL SERVICES UNIT The bill codifies existing practice by establishing an Oral Health and Dental Services Unit within DDS’s Health and Clinical Services Division.

Under the bill, the unit must:

sHB5293 / File No.

657 31 sHB5293 File No.

657 1.

support people with intellectual disability by helping them reach and maintain their optimal oral health;

2.

provide them access to oral and dental health care;

3.

educate them, their families, and support staff on oral disease prevention and early detection, and give them oral health and dental information;

and 4.

participate in oral health-related research and education.

The bill allows the Oral Health and Dental Services Unit to provide dental care services to people with intellectual disability at designated dental offices in any DDS service region.

These services must be (1) specialized and individualized to meet their needs and (2) provided under the scope of practice of a dentist or dental hygienist.

Under the bill, the DDS commissioner may contract with (1) licensed dentists or (2) dentists with provisional licenses (see below) to carry out the unit’s duties.

Provisional Licenses (§ 2) Existing law allows for provisional licensure for an in-state dental school’s full time faculty member who is not licensed in Connecticut but who is licensed in another state or has exceptional qualifications, upon approval by the state Dental Commission.

Under current law, the provisional license allows dental practice only at the dentistry school where the person is a faculty member or affiliated hospitals.

The bill additionally allows dental practice under this provisional license in DDS’s Oral Health and Dental Services Unit.

§ 3 — SUPPORTIVE HOUSING ASSISTANCE PROGRAM PA 23-137, § 53, requires the DDS commissioner to give grants to privatenonprofitsforsupportivehousingforpeoplewithanintellectual disability or other developmental disabilities, including autism spectrum disorder (ASD).

This bill makes several changes to this program.

It transfers to the DOH commissioner the responsibility to provide assistance under the sHB5293 / File No.

657 32 sHB5293 File No.

657 program in consultation with the DDS commissioner and makes related conforming changes.

For example, it requires (1) the DOH commissioner, rather than the DDS commissioner, to develop program guidelines and an application form, and extends from July 1, 2024, to October 1, 2024, the deadline for these materials to be posted online;

(2) recipients of program assistance to annually report to DOH rather than DDS;

and (3) DOH, rather than DDS, to annually report to specified legislative committees on the program.

The bill expands the allowable assistance under the program to include deferred loans.

It targets the assistance to eligible developers (e.g., nonprofit corporations, housing construction businesses meeting certain requirements, or municipal developers), rather than just nonprofit organizations, for this supportive housing.

It adds the condition that the developer have partnered with a DDS-qualified provider or a provider approved to provide services supporting people receiving services under the Department of Social Services’s (DSS) ASD Medicaid waiver program.

Current law requires DDS, when providing assistance under the program, to prioritize nonprofits that reserve at least 50% of a housing site’s initial residential capacity for people with these disabilities who are on a supportive housing waiting list DDS or DSS maintains.

The bill instead requires DOH to prioritize developers that reserve up to 25% of the initial residential capacity for people with these disabilities on a waiting list or who wish to move from a more structured setting to supportive housing.

§§ 4-6 — DDS SELF-ADVOCATE COORDINATORS The bill removes the statutory cap of 11 DDS self-advocates in a generalworker positionwho areeligiblefor specifiedsick,vacation, and personal leave and holiday pay benefits.

In practice, these positions are self-advocate coordinators.

The bill also specifies that the Department of Administrative Services commissioner’s authority to issue regulations on granting holiday time to certain non-permanent state employees is subject to the standard regulation approval process.

sHB5293 / File No.

657 33 sHB5293 File No.

657 §§ 7-8 & 15 — RESIDENT TRANSFERS By law, the DDS commissioner may assign someone with intellectual disability to a public or state-supported private residential facility.

The bill removes the specific requirement that the commissioner consider therecommendationsofaproperlydesignateddiagnosticagency before making these assignments.

It also updates and revises the law on transfers between these residential facilities.

Current law generally requires DDS to give at least days’ prior notice before transferring a facility resident, except for emergency transfers, for which notice must be provided within 10 days after the transfer.

The bill also allows this post-transfer notice, rather than prior notice, for medical transfers.

The bill specifies that for all transfers, including those for emergencies or medical reasons, adult residents of these facilities or residents’legalrepresentativeshavetherighttorequestahearingifthey object to a transfer.

Current law (1) has conflicting provisions on the right to request a hearing to contest an emergency transfer and (2) does not allow objections to a medical transfer.

The bill also creates a process for temporary emergency transfers, as explained below.

Temporary Emergency Transfers The bill sets standards and procedures for temporary transfers, without prior notice, due to emergencies or during a declared public health emergency.

Specifically, it allows the DDS commissioner to temporarily transfer anyone from a DDS-operated or state-supported residential facility if he determines that an emergency in the facility must be addressed immediately, including when the facility is left uninhabitable due to a natural disaster, utility malfunction, or temporary concerns with the facility staff’s ability to meet resident needs.

These transfers remain in place for up to 90 days or until the commissioner rescinds them, whichever is earlier.

sHB5293 / File No.

657 34 sHB5293 File No.

657 The bill also allows the commissioner, during a declared public health emergency, to request that the governor issue an executive order authorizing the commissioner to temporarily transfer a facility resident for reasons of health or safety.

If the governor issues the order, the commissioner may make temporary transfers as he deems necessary, and the transfers stay in place until the commissioner rescinds them or the order expires, whichever is earlier.

In either case, the commissioner must notify the person and the person’s legal representative (if any) in writing about the temporary transfer as soon as practicable, but no later than 10 days after the transfer.

The person cannot object and request a hearing until the 30th day of the transfer, and the hearing follows existing procedures and standards.

§§ 9-11 — HUMAN RIGHTS AND PROGRAM REVIEW COMMITTEES The bill codifies existing practice by establishing in law a human rights committee and program review committee within each DDS service region and the Southbury Training School.

The respective regional or training school director appoints the committees’ members.

Under the bill, the human rights committees must:

1.

advise and make recommendations to these directors and the DDS commissioner on best practices and 2.

address concerns and complaints on human rights issues involving people receiving DDS services, including those involving aversive procedures (see below), restrictive interventions, intrusive programs or devices, restitution, and pre-sedation medication.

The program review committees must advise the directors and commissioner on best practices for reviewing plans that include things like behavior support strategies, use of psychotropic and behavior modifying medications, and the use of restraints for people receiving DDS services.

sHB5293 / File No.

657 35 sHB5293 File No.

657 For each type of committee, the bill (1) requires the commissioner to establish uniform responsibilities and procedures and (2) allows him to adopt implementing regulations.

Human Rights Committee Recommendations on Aversive Procedures (§ 11) Current law prohibits using aversive procedures on anyone placed or treated under the direction of the DDS commissioner, except under procedures established by the commissioner.

The bill additionally provides that these procedures may occur only in line with recommendations from a regional human rights committee.

By law, an “aversive procedure” is the contingent use of an event that may be unpleasant, noxious, or otherwise cause discomfort and is designed to change a specific behavior or to protect someone from injuring himself, herself, or others.

It can include the use of physical isolation and mechanical and physical restraints.

§ 12 — ABUSE AND NEGLECT REGISTRY By law, DDS maintains a registry of certain former employees who left or were fired from their jobs because of a substantiated abuse or neglect complaint against them.

These are people who were employed by DDS, or an agency, organization, or person DDS licenses or funds.

The information is available only to certain agencies and employers for specified purposes.

The bill makes information in the registry available to the state’s Office of Labor Relations for determining whether an applicant for employment with certain state agencies appears on the registry.

Specifically, this applies to applicants at DDS or the departments of Children and Families (DCF), Mental Health and Addiction Services (DMHAS), and Social Services (DSS).

Existing law already grants these other agencies and the Department of Administrative Services (DAS) access to the registry to determine whether applicants appear on it.

§ 13 — OMBUDSPERSON OFFICE By law, an independent ombudsperson office within DDS receives complaints affecting people under DDS care or agencies with whom the sHB5293 / File No.

657 36 sHB5293 File No.

657 department contracts for services and recommends to the commissioner ways to resolve these complaints.

The bill specifically names this office as the “Office of the Developmental Services Ombudsperson.” § 14 — ICF/IID CON-RELATED NOTICES By law, long-term care facilities, including Medicaid-certified ICF/IIDs, generally must seek certificate of need (CON) approval from DSS before certain activities (such as introducing new services or eliminatingservices).Inseveralcases,thelawrequiresthefacilitytoalso give related notices to certain other state entities.

The bill updates these notice requirements for ICF/IIDs, generally requiring them to give notices to the Office of the Developmental Services Ombudsperson (and in some cases, other agencies) rather than the Office of the Long-Term Care Ombudsman.

Correspondingly, it requires the former, rather than the latter, office to take certain actions in response.

Generally, these notices and related actions are follows:

1.

facility notice of intended (a) pre-licensure ownership transfers, (b) new or expanded functions or services, (c) service terminations or substantial decreases in licensed bed capacity, or (d) bed relocations to a different facility;

2.

facility notice of closure petition;

3.

informational letter on patient rights (for patients and certain other parties) by the ombudsperson’s office and the Department of Aging and Disability Services (ADS) that must accompany the closure notice;

4.

informational session on the potential closure held by the ombudsperson’s office and the Department of Public Health;

5.

facility notice when submitting a letter of intent before filing a CON application;

and 6.

informational letter by the ombudsperson’s office and ADS that must accompany a letter of intent on potential service sHB5293 / File No.

657 37 sHB5293 File No.

657 terminations or substantial decreases in bed capacity.

§ 15 — INFORMATION SHARING ON ABUSE OR NEGLECT AT GROUP HOMES OR COMMUNITY COMPANION HOMES The bill allows DDS to share information with certain entities if a DDS-licensed community living arrangement (i.e., group home) or community companion home’s license was revoked or surrendered because of substantiated abuse or neglect during the licensure period.

(Community companion homes offer a family-like setting for people with intellectual disability when circumstances make it difficult for the person to live with his or her family.) Specifically, the bill allows the DDS commissioner to release the former licensee’s name, license revocation or surrender date, and type of abuse or neglect to the following entities:

1.

authorized agencies (i.e., agencies authorized to conduct abuse andneglect investigationsandresponsiblefor issuing or carrying out protective services for people with intellectual disability), for the purpose of determining protective services;

2.

employers of people providing services to those receiving DDS services or support;

and 3.

DCF, DMHAS, DSS, and DAS, to make a determination on an employment application or provider licensure or certification with DCF, DMHAS, DSS, or DDS.

(In practice, DAS generally oversees human resources functions for executive branch agencies.) BACKGROUND Related Bill sHB 5292 (File 106), reported favorably by the Public Health Committee, contains identical provisions on DDS sharing information on group home or community companion home licensing actions due to substantiated abuse or neglect.

sHB5293 / File No.

657 38 sHB5293 File No.

657 COMMITTEE ACTION Public Health Committee Joint Favorable Substitute Yea 37 Nay 0 (03/11/2024) Housing Committee Joint Favorable Yea 14 Nay 0 (04/08/2024) sHB5293 / File No.

657 39