System of care for clients with intellectual disabilities or autism

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§5003-A. System of care for clients with intellectual disabilities or autism

1.  System of services and support.  The Legislature declares that the system of services and support through which the State provides services to and programs for persons with intellectual disabilities or autism must be designed to protect the integrity of the legal and human rights of these persons and to meet their needs consistent with the principles guiding delivery of services as set forth in section 5610.  

[PL 2021, c. 321, §1 (AMD).]

2.  Responsibilities of the department.  To facilitate the development of a system that meets the needs of persons with intellectual disabilities or autism, the commissioner shall:  

A. Provide a mechanism for the identification, evaluation, treatment and reassessment of and the provision of services to persons with intellectual disabilities or autism that is consistent with the principles guiding delivery of services, as set forth in section 5610, through appropriate personal planning offered to persons served by the department in accordance with section 5470‑B;   [PL 2011, c. 542, Pt. A, §83 (AMD).]

B. Identify the needs and desires of persons with intellectual disabilities or autism through appropriate personal planning and record any unmet needs of persons served or eligible for service by the department for development of budget requests to the Governor that are adequate to meet such needs;   [PL 2011, c. 542, Pt. A, §83 (AMD).]

C. Provide programs, insofar as resources permit, for appropriate services and supports to persons with intellectual disabilities or autism regardless of age, severity of need or ability to pay;   [PL 2011, c. 542, Pt. A, §83 (AMD).]

D. Support the establishment of community services for persons eligible to receive services from the department by promoting access to professional services in the person’s community. Such support may be provided directly or through contracts with qualified providers. For persons who have professional service needs identified through personal planning, the department shall monitor the provision of those services;   [PL 2007, c. 356, §16 (NEW); PL 2007, c. 356, §31 (AFF).]

E. Eliminate the department's own duplicative and unnecessary administrative procedures and practices in the system of services and support for persons with intellectual disabilities or autism, encourage other departments to do the same and clearly define areas of responsibility in order to use present resources economically;   [PL 2021, c. 321, §2 (AMD).]

F. Strive toward having a sufficient number of personnel who are qualified and experienced to provide treatment that is beneficial to persons with intellectual disabilities or autism;   [PL 2021, c. 321, §3 (AMD).]

G. Encourage other departments to provide to persons with intellectual disabilities or autism those services that are required by law, and in particular:  

(1) The commissioner shall work actively with the Commissioner of Education to ensure that persons with intellectual disabilities or autism receive appropriate services upon being diagnosed with either disability regardless of the degree of functional limitation or accompanying disabilities;  

(2) The commissioner shall advise other departments about standards and policies pertaining to administration, staff, quality of care, quality of treatment, health and safety of clients, rights of clients, community relations and licensing procedures and other areas that affect persons with intellectual disabilities or autism residing in facilities licensed by the department; and  

(3) The commissioner shall inform the joint standing committee of the Legislature having jurisdiction over human resources matters about areas where increased cooperation by other departments is necessary in order to improve the delivery of services to persons with intellectual disabilities or autism; and   [PL 2021, c. 321, §4 (AMD).]

H. Post quarterly reports on the department’s publicly accessible website, for each home and community-based services waiver from the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services in which the State participates, data on how many persons were served and how many were on the waiting list for services. The department shall post this information by prioritization category when applicable and shall include one or more indicators of the length of time that persons are on the waiting list.   [PL 2021, c. 321, §5 (NEW).]

[PL 2021, c. 321, §§2-5 (AMD).]

3.  Plan.  The commissioner shall prepare a plan pursuant to this subsection.  

A. The plan must indicate the most effective and efficient manner in which to implement services and programs for persons with intellectual disabilities or autism while safeguarding and respecting the legal and human rights of these persons.   [PL 2011, c. 542, Pt. A, §83 (AMD).]

B. The plan must be prepared once every 2 years and must be submitted to the joint standing committee of the Legislature having jurisdiction over health and human services matters by no later than January 15th of every odd-numbered year.   [PL 2007, c. 356, §16 (NEW); PL 2007, c. 356, §31 (AFF).]

C. The joint standing committee of the Legislature having jurisdiction over health and human services matters shall study the plan and make recommendations to the Legislature with respect to funding improvements in programs and services to persons with intellectual disabilities or autism.   [PL 2011, c. 542, Pt. A, §83 (AMD).]

D. The plan must describe the system of intellectual disability and autism services in each of the adult developmental service regions and statewide.   [PL 2011, c. 542, Pt. A, §83 (AMD).]

E. The plan must include both existing service resources and deficiencies in the system of services.   [PL 2007, c. 356, §16 (NEW); PL 2007, c. 356, §31 (AFF).]

F. The plan must include an assessment of the roles and responsibilities of intellectual disability and autism agencies, human service agencies, health agencies and involved state departments and suggest ways in which these departments and agencies can better cooperate to improve the service systems.   [PL 2011, c. 542, Pt. A, §83 (AMD).]

G. The plan must be made public within the State in such a manner as to facilitate public involvement.   [PL 2007, c. 356, §16 (NEW); PL 2007, c. 356, §31 (AFF).]

H. The commissioner shall ensure that the development of the plan includes the participation of persons with intellectual disabilities, autism, brain injury and other related conditions; community intellectual disability and autism service providers; consumer and family groups; and other interested persons or groups in annual statewide hearings, as well as informal meetings and work sessions. The commissioner shall ensure the participation of persons reflecting a diversity of ethnicity, race and gender.   [PL 2021, c. 321, §6 (AMD).]

I. The commissioner must consider community service needs, relate these identified needs to biennial budget requests and incorporate necessary service initiatives into a comprehensive planning document.   [PL 2007, c. 356, §16 (NEW); PL 2007, c. 356, §31 (AFF).]

[PL 2021, c. 321, §6 (AMD).]

4.  General Fund account; Medicaid match; intellectual disability; autism.  The commissioner shall establish a General Fund account to provide the General Fund match for intellectual disability or autism Medicaid eligible services. Any unencumbered balances of General Fund appropriations remaining at the end of each fiscal year must be carried forward to be used for the same purposes.  

[PL 2011, c. 542, Pt. A, §83 (AMD).]

5.  Medicaid savings.  Intermediate care facilities for persons with intellectual disabilities or autism and providers of freestanding day habilitation programs shall submit payment to the department equal to 50% of any Medicaid savings due the State pursuant to the principles of reimbursement, as established under Title 22, sections 3186 and 3187, that are reported in any unaudited cost report for fiscal years ending June 30, 1995 and thereafter. Payment is due with the cost report. After audit, any amount submitted in excess of savings allocated to the facility or provider pursuant to the principles of reimbursement must be returned to the facility or provider. Notwithstanding requirements or conditions contained in the principles of reimbursement, any amount due the State after final audit in excess of savings paid on submission of a cost report must be paid to the State within 90 days following receipt of the department's final audit report.  

[PL 2011, c. 542, Pt. A, §83 (AMD).]

6.  Required reporting by the department.  The department shall make available, on at least an annual basis, a report or reports regarding the services and support provided by the department to persons with intellectual disabilities or autism.  

A. The goal of the reporting under this subsection is to provide the public with information on outcome measures established by the department. These measures may include, but are not limited to, whether:  

(1) Persons served by the department are healthy and safe;  

(2) Needs of persons are being met;  

(3) People are included in their communities; and  

(4) The system of services and support under this section is efficient and effective.   [PL 2021, c. 321, §7 (AMD).]

B. At a minimum, the department's report or reports under this subsection must offer information on the following:  

(1) Unmet needs;  

(2) Reportable events;  

(3) Adult protective services;  

(4) Crisis services;  

(5) Persons' and families' satisfaction with services;  

(6) Case management ratios;  

(7) Evaluations of costs of services;  

(8) Grievances;  

(9) Quality assurance and quality improvement efforts; and  

(10) New initiatives.   [PL 2007, c. 356, §16 (NEW); PL 2007, c. 356, §31 (AFF).]

C. A report under this subsection must be provided to the joint standing committee of the Legislature having jurisdiction over health and human services matters. The commissioner or the commissioner's designee shall appear in person before the committee and shall present the report. The report must be posted on the department’s publicly accessible website and must be made easily available to persons served by the department, families, guardians, advocates, Legislators and the provider community.   [PL 2007, c. 356, §16 (NEW); PL 2007, c. 356, §31 (AFF).]

[PL 2021, c. 321, §7 (AMD).]

7.  Committee authorized to introduce legislation.  The joint standing committee of the Legislature having jurisdiction over health and human services matters is authorized to introduce a bill in each first regular session of the Legislature and a bill in each second regular session of the Legislature to address the system of services and support for persons with intellectual disabilities or autism.  

[PL 2021, c. 321, §8 (NEW).]

SECTION HISTORY

PL 2007, c. 356, §16 (NEW). PL 2007, c. 356, §31 (AFF). PL 2011, c. 542, Pt. A, §83 (AMD). PL 2021, c. 321, §§1-8 (AMD).


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