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2013 Session

Budget Amendments - SB800 (Member Request)

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Chief Patron: Favola
Survey of Training Center Residents/Placement Decisions (language only)

Item 314 #2s

Item 314 #2s
Health And Human Resources
Behavioral Health and Developmental Services, Department of

Language
Page 285, after line 18, insert:
"M.  1. No later than 90 days after enactment of this Act, the Commissioner of the Department of Behavioral Health and Developmental Services (DBHDS) shall engage an independent professional survey organization to conduct a survey of the authorized representatives of the Commonwealth’s Training Center residents to determine if they would prefer for the resident they represent to stay in their existing training center or move into a community placement.
2. If 50 or more of the authorized representatives of any training center elect for their residents to remain in the training center, then the DBHDS (a) may not close the center but (b) must keep the center open and come up with a plan to lower the costs of the center.  Such plan may include, but is not limited to, joint uses of the facilities or land and selling or leasing unused portions to benefit people with intellectual disabilities.  
3. If fewer than 50 authorized representatives at a training center elect for the residents they represent to remain at the training center, the DBHDS shall engage an independent professional survey organization to conduct a second survey to determine whether the authorized representatives prefer a local community placement or a placement in another Training Center that will remain open. The DBHDS shall transition those who wish to move into the community into a local placement.  For those who wish to move to another training center, the DBHDS shall, to the extent feasible, provide a placement at the training center the authorized representative selects.
4. Where fewer than 50 authorized representatives chose to remain in the training center, the center shall not be closed until such time as the Commonwealth has met all the conditions in sections 5 and 6.
5. On a regional basis, the community services boards serving the residents who wish to move into the community shall certify that:
i. There is sufficient private vendor capacity in the region to provide the intensive services needed to serve those residents;
ii. There is in place adequate Medicaid reimbursement for day support, residential services, and other individually required services to cover the cost of services so as to assure adequate provider long-term economic viability; and
iii. Vendor staff have sufficient specializations, training, skill, and on-site presence to provide appropriate medical, behavioral, and therapeutic care for the residents leaving the Training Centers.
6. On an individual basis, the community services boards serving the residents shall certify that all residents have successfully transitioned to the community.  For purposes of this section, a successful transition means:
i. All supports called for in the transition plan, including those required by training center health professionals, are in place, and the community residence is staffed with fully trained and licensed personnel;
ii. The placement provides services and treatment equal to or better than those the resident was receiving in the training center, consistent with that person’s needs, as determined by the person’s health professionals in consultation with the person’s authorized representative;
iii. Sufficient funding is available to sustain those supports for the foreseeable future, including both transitional funding and long-term supports; and
iv. These supports are provided within the region of family and friends, if the resident has local contacts to sustain."

Explanation
(This language amendment requires the Commissioner of the Department of Behavioral Health and Developmental Services to conduct surveys at the Commonwealth's five training centers to determine how many people wish to remain where they are. If at least 50 wish to remain, the Center would not be closed and the Department must develop a plan to lower the costs of the center. If fewer than 50 elect to remain, a follow-up survey must be conducted to determine whether the authorized representatives prefer a local community placement or a placement in another training center. The Department shall transition those who wish to move into the community into a local placement and those who wish to move to another training center provide a placement at the training center to the extent feasible. Where fewer than 50 authorized representatives choose to remain in the training center, the center shall not be closed until the community services boards determine that a) there is sufficient private vendor capacity in each region to provide the intensive services needed to serve those residents, b) there are adequate, long-term Medicaid reimbursements for day support, residential services, and other individually-required services, and c) providers have sufficient capacity to provide timely and appropriate medical, behavioral, and therapeutic care. Further, budget language requires that community services boards certify that all residents have successfully transitioned to the community meaning that (i) all supports in the transition plan are in place and the community residence is staffed with fully trained and licensed personnel, (ii) the placement provides services and treatment equal to or better than those the resident was receiving in the training center, consistent with that person’s needs, as determined by the person’s health professionals in consultation with the person’s authorized representative, (iii) sufficient funding is available to sustain those supports for the foreseeable future, including both transitional funding and long-term supports, and (iv) these supports are provided within the region of family and friends, if the resident has local contacts to sustain.)

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