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HOUSE DOCKET, NO. 1379         FILED ON: 1/16/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 151

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Tom Sannicandro and Katherine M. Clark

_______________

To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
              Court assembled:

              The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to real lives.

_______________

PETITION OF:

 

Name:

District/Address:

Tom Sannicandro

7th Middlesex

Katherine M. Clark

Fifth Middlesex

Kimberly N. Ferguson

1st Worcester

Paul Brodeur

32nd Middlesex

Denise Andrews

2nd Franklin

James Arciero

2nd Middlesex

Cory Atkins

14th Middlesex

Bruce J. Ayers

1st Norfolk

Ruth B. Balser

12th Middlesex

F. Jay Barrows

1st Bristol

Matthew A. Beaton

11th Worcester

Jennifer E. Benson

37th Middlesex

John J. Binienda

17th Worcester

Michael D. Brady

9th Plymouth

William N. Brownsberger

Second Suffolk and Middlesex

Antonio F. D. Cabral

13th Bristol

Thomas J. Calter

12th Plymouth

Christine E. Canavan

10th Plymouth

James M. Cantwell

4th Plymouth

Gailanne M. Cariddi

1st Berkshire

Tackey Chan

2nd Norfolk

Sonia Chang-Diaz

Second Suffolk

Thomas P. Conroy

13th Middlesex

Michael A. Costello

1st Essex

Sean Curran

9th Hampden

Mark J. Cusack

5th Norfolk

Josh S. Cutler

6th Plymouth

Marjorie C. Decker

25th Middlesex

Viriato Manuel deMacedo

1st Plymouth

Sal N. DiDomenico

Middlesex and Suffolk

Geoff Diehl

7th Plymouth

Stephen L. DiNatale

3rd Worcester

Diana DiZoglio

14th Essex

Paul J. Donato

35th Middlesex

James J. Dwyer

30th Middlesex

Carolyn C. Dykema

8th Middlesex

Lori A. Ehrlich

8th Essex

James B. Eldridge

Middlesex and Worcester

Tricia Farley-Bouvier

3rd Berkshire

Robert F. Fennell

10th Essex

John V. Fernandes

10th Worcester

Ann-Margaret Ferrante

5th Essex

Michael J. Finn

6th Hampden

Jennifer L. Flanagan

Worcester and Middlesex

William C. Galvin

6th Norfolk

Paul K. Frost

7th Worcester

Sean Garballey

23rd Middlesex

Denise C. Garlick

13th Norfolk

Kenneth I. Gordon

21st Middlesex

Danielle W. Gregoire

4th Middlesex

Patricia A. Haddad

5th Bristol

Sheila C. Harrington

1st Middlesex

Jonathan Hecht

29th Middlesex

Paul R. Heroux

2nd Bristol

Bradford Hill

4th Essex

Kate Hogan

3rd Middlesex

Kevin G. Honan

17th Suffolk

Donald Humason

 

Bradley H. Jones, Jr.

20th Middlesex

Brian A. Joyce

Norfolk, Bristol and Plymouth

Louis L. Kafka

8th Norfolk

Jay R. Kaufman

15th Middlesex

Mary S. Keefe

15th Worcester

John D. Keenan

7th Essex

Kay Khan

11th Middlesex

Robert M. Koczera

11th Bristol

John J. Lawn, Jr.

10th Middlesex

Jason M. Lewis

31st Middlesex

David Paul Linsky

5th Middlesex

James J. Lyons, Jr.

18th Essex

Timothy R. Madden

Barnstable, Dukes and Nantucket

John J. Mahoney

13th Worcester

Elizabeth A. Malia

11th Suffolk

Brian R. Mannal

2nd Barnstable

Paul W. Mark

2nd Berkshire

Christopher M. Markey

9th Bristol

Paul McMurtry

11th Norfolk

James R. Miceli

19th Middlesex

Leonard Mirra

2nd Essex

Michael O. Moore

Second Worcester

James M. Murphy

4th Norfolk

Kevin J. Murphy

18th Middlesex

Harold P. Naughton, Jr.

12th Worcester

Rhonda Nyman

5th Plymouth

Shaunna O'Connell

3rd Bristol

Kathleen O'Connor Ives

First Essex

James J. O'Day

14th Worcester

Eugene L. O'Flaherty

2nd Suffolk

Jerald A. Parisella

6th Essex

Sarah K. Peake

4th Barnstable

Alice Hanlon Peisch

14th Norfolk

William Smitty Pignatelli

4th Berkshire

Elizabeth A. Poirier

14th Bristol

Denise Provost

27th Middlesex

Angelo J. Puppolo, Jr.

12th Hampden

David M. Rogers

24th Middlesex

Dennis A. Rosa

4th Worcester

Jeffrey N. Roy

10th Norfolk

Jeffrey Sánchez

15th Suffolk

Paul A. Schmid, III

8th Bristol

John W. Scibak

2nd Hampshire

Carl M. Sciortino, Jr.

34th Middlesex

Theodore C. Speliotis

13th Essex

Karen E. Spilka

Second Middlesex and Norfolk

Thomas M. Stanley

9th Middlesex

Ellen Story

3rd Hampshire

William M. Straus

10th Bristol

Benjamin Swan

11th Hampden

James E. Timilty

Bristol and Norfolk

Timothy J. Toomey, Jr.

26th Middlesex

Cleon H. Turner

1st Barnstable

Chris Walsh

6th Middlesex

Martin J. Walsh

13th Suffolk

Daniel A. Wolf

Cape and Islands

Jonathan D. Zlotnik

2nd Worcester


HOUSE DOCKET, NO. 1379        FILED ON: 1/16/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 151

By Mr. Sannicandro of Ashland and Senator Clark, a joint petition (accompanied by bill, House, No. 151) of Tom Sannicandro and others for legislation to assist people with disabilities in realizing their rights and exercising their responsibilities.  Children, Families and Persons with Disabilities. 


The Commonwealth of Massachusetts
 

_______________

In the Year Two Thousand Thirteen

_______________

 

An Act relative to real lives.
 

              Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

              Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

              Chapter 19B of the General Laws, as appearing in the 2010 Official Edition, is hereby amended by inserting the following three sections:

              Section 19. As used in this section, the following words shall have the following meanings:-

              (a)“Department”, the Department of Developmental Services.

              “Fiscal intermediary”, a financial management service or fiscal intermediary to assist an individual who self-directs in disbursing funds allocated to an individual in their individual budget and in accordance with their person-centered plan. The intermediary shall work at the direction of the individual or an appointed designee identified in the person-centered plan.

              “Individual”, an individual eligible to receive services through the Department of Developmental Services.

              “Individual budget”, a dollar amount for goods, services and supports specified in the person- centered plan that is under the control and direction of the individual.

              “Person-centered plan”, a plan of service for individuals who chose to participate in self-direction.

              “Self-determination,” an approach to providing services that underpins a self-direction model of service delivery. Self-determination is based on five principles:

              (1) Freedom, the ability for an individual with disabilities, with chosen family and friends, to plan a life with necessary supports rather than purchase a program;

              (2) Authority, the ability for an individual to control a certain sum of dollars in order to purchase these supports, with the backing of a social network or circle of friends, if needed;

              (3) Support, the arranging of resources and personnel, both formal and informal, to assist an individual to live a life in the community, rich in community associations and contributions, and;

              (4) Responsibility, the acceptance of a valued role in an individual’s community through employment, affiliations, spiritual development, and general caring for others, as well as accountability for spending public dollars in ways that are life-enhancing;

              (5)Confirmation, affirming the central role individuals have in leadership and change.

              “Self-determination domains”, for individuals who choose self-direction these are the domains to be prioritized in their service planning:

              (1) A place to call home with control over anyone who comes through the front door or otherwise provides any services or supports with freely chosen assistance when necessary;

              (2) Economic self-sufficiency through supports or funds as needed provided through jobs, self-employment and active or passive pursuit of private dollars

              (3) Family, friends and other significant relationships of the individual’s choosing and receive assistance to develop or maintain these relationships;

              (4)Community membership with real connections to citizens and memberships in vital community organizations.

              “Self-direction”, a model of service delivery in which services and supports are person-centered, person-defined and person-controlled.  Self-direction in a service delivery system includes features ensuring that:

              (1) the individual is central to and directs the decision making process that will determine which supports are utilized;

              (2) the individual has easy access to information, options, services and supports to enable the individual to self-direct;

              (3) the service system is flexible so that the individual can tailor their support to meet their unique needs.

              “Support broker”, a person chosen by an individual participating in self-direction to assist as dictated by the individual in the development and execution of the person-center plan. This role can include but is not limited to adviser, advocate, facilitator and support staff.

              (b) The general court finds that people with disabilities have the same rights and responsibilities as other citizens and the Commonwealth must assist them to realize those rights and exercise those responsibilities as contributing members of our communities. Further, the general court finds that services should help people achieve quality outcomes regarding personal choices, satisfaction, social integration and increased learning that may lead to rewarding occupations.  In order to increase flexibility and choice of services, the Department shall promote the growth of self-determination through a self-direction model of service delivery for persons receiving services and supports funded through the Department.

              (c) The Department shall establish a Self-Determination Advisory Board to evaluate and to advise the Department on efforts to implement self-direction and to participate in educational outreach efforts on self-direction. The  Self-Determination Advisory Board shall include individuals participating in self-direction, family members of individuals participating in self- direction, providers, service brokers, and representatives of advocacy organizations, including but not limited to: The Arc of Massachusetts, Massachusetts Developmental Disabilities Council, Massachusetts Families Organizing for Change, Massachusetts Advocates Standing Strong, Advocates for Autism of Massachusetts, Massachusetts Down Syndrome Congress, Disability Law Center and the Association of Developmental Disabilities Providers.

              (d)All persons eligible for services through the Department shall be eligible for self-direction, including persons with complex medical or behavioral conditions, persons with profound intellectual impairments and persons eligible for services through special eligibility.

              (d) The Department shall provide information about self-direction to all persons eligible for services through the Department. (1) The Department shall provide information about self-direction to a person eligible for services upon: (i) the notification to a person of their priority for services; (ii) the beginning of the development of an individual support plan; (iii) the beginning of the renewal of an individual support plan; (iv) the annual notification of persons who have declined an individual support plan of their option to participate in the individual support plan process. (2) The Department shall encourage individuals entering their Turning 22 program that are prioritized for services to pursue self-direction.

              (e)(1)The Department shall publish information on the self-determination concept and self-direction options annually and shall make this information available to the public on the Department’s website. (2) The Department shall email information on the self-determination concept and self-direction options annually to any organization or interested party that agrees to forward or post the information on their website and who provides their email address. Organizations include: The Arc of Massachusetts, Massachusetts Developmental Disabilities Council, Massachusetts Families Organizing for Change, Massachusetts Advocates Standing Strong, Advocates for Autism of Massachusetts, Massachusetts Down Syndrome Congress, Disability Law Center and the Association of Developmental Disabilities Providers.  (3) The Department, in collaboration with the advocacy organizations represented on the Self-Determination Advisory Council, shall hold educational forums with families and individuals to provide information about self-direction no less than four times annually in each service region.

              (f) The Department, in collaboration with the advocacy organizations represented on the Self-Determination Advisory Council, shall hold meetings annually with providers to discuss self-direction, how providers can participate, what it means to the present purchase of service system, and how the Department can work with providers to establish self-directed choices within the service system. The Department shall work with providers to help those interested in changing their business model to offer services supporting persons who choose to self-direct. The Department may offer introductory and on-going training to providers and provider staff on the subjects of self-determination, self-direction and the related elements of person-centered planning and individual budgeting.

              (g)The Department shall educate all staff, except for staff classified as janitorial, maintenance, or secretarial, on self-direction not less than two times annually.

              (g) For individuals who choose self-direction, the Department shall implement a person-centered planning process. The individual shall direct the development of the person-centered plan and shall direct who is involved in the planning process. The person-centered plan shall be designed around the self-determination domains.

              (h) Individuals who choose to self-direct shall receive an allocation of resources based on their assessed needs. The amount of allocation and development of an individual budget shall be determined through a person-centered plan. The Department shall determine an individual’s prioritization for services and the amount allocated for an individual’s services in a transparent manner. The individual or a legal representative designated by the individual shall be able to utilize resources allocated to them through the individual budget to choose which services and supports best serve the individual’s needs and are consistent with meeting goals developed in line with the self-determination domains.

              (i)(1)Individuals who choose to self-direct shall have access to a support broker to assist in the development of a plan of service and an individual budget in the person-centered planning process, to assist in the purchase of services and to assist in monitoring expenditures through the year. The support broker shall be made available through the Department or through a qualified private sector broker of the individual’s choice. (ii) The Department shall establish basic competencies that must be met in order to qualify private sector or public sector support brokers in consultation with the Self-Determination Advisory Board. (2) Individuals who choose to self-direct shall have access to a state-designated or other qualified fiscal intermediary of the individual’s choice to assist in the execution of the purchase of services. (3) If an individual chooses to utilize a private sector support broker, an allocation for the purchase of this service shall be included in the individual’s budget. If an individual chooses to utilize a private sector fiscal intermediary, an allocation for the purchase of this service shall be included in the individual’s budget.

              (j) Providers and employees providing services to individuals through self-direction shall be eligible for a proportional amount of any additional appropriation designated for the increase of salary for workers employed by the Department or its providers.

              (k) Individuals who choose to self-direct shall be surveyed at least once annually about their experiences with self-direction and potential improvements to the self-direction model and its overall operation.

              (l) The Department shall provide an annual report, after consultation with the Self-Determination Advisory Board, to the Joint Committee on Children, Families, and Persons with Disabilities documenting progress in terms of numbers served through self-direction, ongoing improvements to the Department’s self-direction program and challenges related to the Department’s self-direction programs. The annual report shall include an analysis of the annual survey of individuals participating in self-direction mandated in section K and strategies to address the issues identified in these surveys.

              (m) The Department shall utilize the Home and Community Based Waivers to maximize federal reimbursement for services rendered through self-direction and related models. As necessary, the Department and Executive Office of Health and Human Services shall amend the waiver and take any other steps to ensure that activities or services can be implemented to achieve goals under self-determination domains for individuals.

              Section 20. (a)The Department shall establish a contingency fund to assist: (1) Individuals in need of services; (2) Individuals who participate or wish to participate in self-direction or self-determination; (3)Iindividuals with unanticipated, emergency or changing needs; (4) In the case of an individual who chooses to leave a group living arrangement, in order to mitigate impact to providers. (b) The fund shall be comprised of 40% of the savings from the closure of Monson, Glavin and Templeton and other funds as they may be available within the Department’s budget and at its discretion. The Department shall make every effort to ensure that the pool will retain sufficient funds for individuals utilizing self-determination and provider mitigation throughout the fiscal year. (c) The Department shall develop a policy related to the fund for individuals utilizing self-direction with the assistance of the Self-Determination Advisory Board.

              Section 21. (a) Individuals and their guardians shall have choice of Department services or qualified providers and shall be free to change the individual’s services or service provider.  When an individual or their guardian requests a change, the Department shall initiate the process for requested changes without delay.

              (b) Upon an individual or their guardian requesting a change of service or service provider for their group residence of or group living situation, the individual or their guardian and the provider shall take steps to see if a resolution to the situation can be reached. If, at any time, the individual feels that a resolution to the situation cannot be reached, the individual or their guardian can request that the following provision be initiated within 7 days of the individual or their guardian notifying the Department: (1) The Department shall assist the individual in developing an alternative living situation, both the Department and the individual will make a good faith effort to determine a suitable alternative; (2) The Department shall work in conjunction with the individual to transfer to an available alternative as expeditiously as possible and taking no longer than 90 days; (3) As necessary, the Department will work with the provider of the residence or group living situation to ensure stability including the use of the contingency fund for mitigation established in Chapter 19B, Section 20.

              to utilize a private sector support broker, an allocation for the purchase of this service shall be included in the individual’s budget. If an individual chooses to utilize a private sector fiscal intermediary, an allocation for the purchase of this service shall be included in the individual’s budget.

              (j) Providers and employees providing services to individuals through self-direction shall be eligible for a proportional amount of any additional appropriation designated for the increase of salary for workers employed by the Department or its providers.

              (k) Individuals who choose to self-direct shall be surveyed at least once annually about their experiences with self-direction and potential improvements to the self-direction model and its overall operation.

              (l) The Department shall provide an annual report, after consultation with the Self-Determination Advisory Board, to the Joint Committee on Children, Families, and Persons with Disabilities documenting progress in terms of numbers served through self-direction, ongoing improvements to the Department’s self-direction program and challenges related to the Department’s self-direction programs. The annual report shall include an analysis of the annual survey of individuals participating in self-direction mandated in section K and strategies to address the issues identified in these surveys.

              (m) The Department shall utilize the Home and Community Based Waivers to maximize federal reimbursement for services rendered through self-direction and related models. As necessary, the Department and Executive Office of Health and Human Services shall amend the waiver and take any other steps to ensure that activities or services can be implemented to achieve goals under self-determination domains for individuals.

              Section 20. (a)The Department shall establish a contingency fund to assist: (1) Individuals in need of services; (2) Individuals who participate or wish to participate in self-direction or self-determination; (3)Iindividuals with unanticipated, emergency or changing needs; (4) In the case of an individual who chooses to leave a group living arrangement, in order to mitigate impact to providers. (b) The fund shall be comprised of 40% of the savings from the closure of Monson, Glavin and Templeton and other funds as they may be available within the Department’s budget and at its discretion. The Department shall make every effort to ensure that the pool will retain sufficient funds for individuals utilizing self-determination and provider mitigation throughout the fiscal year. (c) The Department shall develop a policy related to the fund for individuals utilizing self-direction with the assistance of the Self-Determination Advisory Board.

              Section 21. (a) Individuals and their guardians shall have choice of Department services or qualified providers and shall be free to change the individual’s services or service provider.  When an individual or their guardian requests a change, the Department shall initiate the process for requested changes without delay.

              (b) Upon an individual or their guardian requesting a change of service or service provider for their group residence of or group living situation, the individual or their guardian and the provider shall take steps to see if a resolution to the situation can be reached. If, at any time, the individual feels that a resolution to the situation cannot be reached, the individual or their guardian can request that the following provision be initiated within 7 days of the individual or their guardian notifying the Department: (1) The Department shall assist the individual in developing an alternative living situation, both the Department and the individual will make a good faith effort to determine a suitable alternative; (2) The Department shall work in conjunction with the individual to transfer to an available alternative as expeditiously as possible and taking no longer than 90 days; (3) As necessary, the Department will work with the provider of the residence or group living situation to ensure stability including the use of the contingency fund for mitigation established in Chapter 19B, Section 20.

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