Summary of NJ De-institutionalization Bill A3625

This bill changes the way in which the Division of Developmental Disabilities (DDD) in the Department of Human Services (DHS) will use resources to provide services to persons with developmental disabilities by reducing the division's reliance on developmental centers and strengthening and expanding community based services and supports. Instead of investing a disproportionate share of the division's budget to support an inappropriate level of care through the State's seven developmental centers, the bill provides for the development and expansion of access to community services and supports to meet the unmet needs of persons on the community services waiting list, those persons in developmental centers whose interdisciplinary teams have made recommendations for community placement and who choose such placement, youth with developmental disabilities to transition to the adult system in a seamless and timely manner, and persons with developmental disabilities who are residing with their families.

The bill shifts financial and human resources from the State developmental centers and, instead, uses these resources to strengthen and expand community-based services, supports, and residential options to address unmet need by consolidating and closing developmental centers retaining one each in the northern and southern regions of the State within five years of the bill's effective date.

To make these changes, the bill establishes: the "Community Services and Support for Persons with Developmental Disabilities Bridge Fund"; the Community Services Planning Council for Persons with Developmental Disabilities in DHS which would create an implementation plan; and a steering committee to oversee the implementation of the plan.

The fund would be established in the Department of the Treasury as a nonlapsing, revolving fund which would be the repository for moneys generated by:

* the amount of Capital Construction funds appropriated for Other State Projects and Energy Efficiencies - Statewide Projects, which are intended to fund capital projects at the State developmental centers, excluding capital project costs that: will result in a reduction in overall operational expenditures at developmental centers; are required for life safety or environmental enhancements at developmental centers; are required as a condition of licensure, accreditation, or receipt of federal Medicaid reimbursement; or are required as part of an agreement between the State and the federal Department of Justice;
* fiscal year 2009 and each successive fiscal year through the end of fiscal year 2013 savings by DDD in "salaries and wages expenditures" due to reductions in overtime expenditures;
* fiscal year 2009 community care waiver federal financial participation funds received in excess of the amount identified in the appropriations act, as modified by the Governor's recommended budget for fiscal year 2010 and each successive fiscal year through the end of fiscal year 2013;
* reductions in developmental center operational costs achieved through consolidation in the first year and each subsequent year;
* proceeds achieved through the sale of developmental centers, to be utilized in accordance with the provisions of section 5 of P.L.1997, c.258 (C.30:4-177.57) (for capital and equipment costs associated with the development of community placement); and
* unspent funds from DDD's fiscal year 2009 budget and each successive fiscal year through the end of fiscal year 2013.

The bill specifies that the moneys in the fund would be distributed in a planned and expedient manner, through a request for proposal or other purchasing model that utilizes contract systems which promote timely access to services and supports. The moneys would be used to:

* build service capacity and expand access to certain services and supports in the community, as listed in the bill;
* establish a moratorium on future placements in developmental centers, except for court-ordered placements or in instances of imminent danger to life/safety; and concurrently develop, strengthen and expand community-based services, supports, and residential options to meet emergency needs;
* consolidate, downsize, and reduce reliance on developmental centers;
* afford the workforce of current developmental centers the opportunity for early retirement or alternate workplace opportunities within the State, including, but not limited to, employment at the consolidated developmental centers or at other State institutions;
* redeploy staff positions from developmental centers in a staff without walls approach that retains state status to regional or county assignments that support community-based services systems, fill gaps in regional and county operations, including but not limited to community casemanagent, specialty care such as occupational therapy, physical therapy, and medical, dental and other health related services, and address gaps in professional and direct care positions in the community;
* meet the unmet needs of persons on the community services waiting list in order to: reduce continued growth of the waiting list; avert the need for emergency out-of-home placement in a developmental center; and support persons with developmental disabilities who live with their families and afford them quality, engaged lives in the community, while also providing stability to families caring for loved ones at home;
* provide a seamless transition for young adults with developmental disabilities who are leaving the education system but are in need of continuing services and supports; and
* maximize available federal funds and direct those funds toward community-based services.

The Community Services Planning Council for Persons with Developmental Disabilities established under the bill would consist of 17 members as follows:

-- the Commissioner of Human Services and the State Treasurer, or their designees; the Assistant Commissioner of the Division of Developmental Disabilities in the Department of Human Services; and the chairs of the Assembly Budget and Human Services Committees and of the Senate Budget and Appropriations and Health, Human Services and Senior Citizens Committees, or their designees, who shall serve ex officio; and

-- 10 public members, to be appointed by the Commissioner of Human Services, as follows: two advocates for persons with developmental disabilities who are persons living with developmental disabilities, two family members of persons receiving services from DDD who have transitioned to community living from a developmental center, a representative from the Family Education Project in the School of Public Health in the University of Medicine and Dentistry of New Jersey, a representative from the New Jersey Association of Community Providers, a representative from the Autistic Self Advocacy Network, a representative from Advocates for Alternatives, Inc., a representative from a labor union, and a recognized national expert on developmental disabilities, public policy, and systems design and development.

The council is required to create a preliminary and comprehensive implementation plan that would:

* provide an overall strategy for the reduction of the population in the developmental centers by 80% within five years of the bill's effective date, and for the reduction in the number of developmental centers to one each in the northern and southern regions of the State;
* provide for the transfer into the community of persons with developmental disabilities residing in the developmental centers whose interdisciplinary teams have made recommendations for community placement and who choose such placement;
* provide details about the reduction, transition, and redeployment of the workforce, and of the downsizing and sale of developmental centers, which shall include the ongoing costs for preparing for the sale of developmental centers and a fiscal analysis of the redirection of funds to support community living;
* provide details about: the development and expansion of community services, supports, and residential options to meet the unmet needs of persons on the community services waiting list; the moratorium on future placements in developmental centers and the needs of persons in the developmental centers who will remain in a developmental center; the needs of youth with developmental disabilities to transition to the adult system in a seamless and timely manner; and support services to persons with developmental disabilities who are residing with their families;
* specify clear procedures for accomplishing the tasks necessary to carry out the provisions of the bill, and define positions of responsibility to accomplish these tasks in a timely, effective, and efficient manner;
* specify measureable objectives, and benchmarks and timeframes for meeting those objectives within five years of the bill's effective date;
* stipulate the use of moneys in the fund to strengthen and expand access to community services and supports; and
* specify a timetable and funding necessary to shift resources from institutional to community support.

The bill requires the council to submit the plan, which shall include a minority report, if applicable, to the Governor and Legislature within 180 days of the date of organization of the council.

In addition, the steering committee, established under the bill to monitor the plan's implementation, would consist of not more than 30 members and would include:

-- the members of the council; and

-- other members appointed by the Commissioner of Human Services as follows: the deputy and assistant directors or regional administrators of DDD, or both, who shall serve ex officio; representatives from developmental disabilities community provider organizations; and persons with developmental disabilities who are residing in the developmental centers or are on the community services waiting list, or their family members, or both.
Lastly, the bill requires the Commissioner of Human Services to provide quarterly progress reports on the development and implementation of the plan to the Governor and the Legislature.


--
Ari Ne'eman
President
The Autistic Self Advocacy Network