1

OVERVIEW

Services, Supports and Needs

for Job Development

Kathryn duPree, Deputy Commissioner

January 12, 2006

Revised January 20, 2006

2

Our Mission

Presence and participation in Connecticut town life Opportunities to develop and exercise competence Opportunities to make choices in pursuit of a personal future Good relationships with family and friends Respect and dignity.

The mission of the Department of Mental Retardation is to join with others to create the conditions under which all people with mental retardation can experience:

3

Our Values

Personal choice Self-determination Importance of families Community inclusion Partnerships Teaching and skill development Protection of rights Promoting safety and health.

Our mission and values drive our services and supports. They place a strong emphasis on:

4

Salisbury

NorthCanaan

Canaan

Norfolk

Goshen

Cornwall

Sharon

Colebrook Hartland

WinchesterBarkhamsted

TorringtonNew

Hartford

HarwintonLitchfieldWarren

Kent

ThomastonMorrisWashington

NewMilford

BethlehemWatertown

Sherman

Bridgewater

RoxburyWoodbury

Middlebury

Waterbury

Wolcott

CheshireProspect

Naugatuck

BeaconFallsOxford

Southbury

Newtown

Brookfield

NewFairfield

Danbury

Bethel

ReddingRidgefield

Greenwich

StamfordDarien

NewCanaan

Wilton

NorwalkWestport

Weston

Easton

FairfieldBridgeport

Stratford

Trumbull

Monroe

Milford

Orange

DerbyAnsonia

Seymour

Shelton

Woodbridge

BethanyHamden

NorthHaven

NewHaven East

HavenWest

HavenBranford

NorthBranford

Wallingford Durham

Guilford

Meriden MiddletownMiddlefield

EastHampton

Haddam

Killingworth

MadisonClinton

Westbrook

DeepRiver Essex

Chester

EastHaddam

Lyme

OldLyme

GranbyEast

Granby

SuffieldEnfield

Windsor

Bloomfield

SimsburyCanton

SouthWindsor

EastWindsor

SomersStafford

Ellington

Tolland

Vernon

BoltonManchesterEast

Hartford

WestHartford

Avon

BurlingtonFarmington

Plymouth

BristolPlainville

NewBritain

BerlinSouthington

RockyHill

Newington Glastonbury

Marlborough

Hebron

Andover

UnionWoodstock

Thompson

WillingtonAshford

EastfordPomfret

Putnam

Killingly

BrooklynHamptonChaplin

MansfieldCoventry

Columbia

Lebanon

WindhamScotland

CanterburyPlainfield

Sterling

Voluntown

GriswoldLisbon

SpragueFranklin

Bozrah NorwichColchester

SalemMontville

Preston

Ledyard

NorthStonington

StoningtonGroton

NewLondon

Waterford

EastLymeOld

Saybrook

CromwellPortland

WindsorLocks

Hartford

Wethersfield

NORTH

SOUTH

WEST

DMR Regions

5

The People We Serve

Of these, DMR serves:

19,497 people

There are an

estimated

33,500 people living

in Connecticut

who have mental

retardation

Mental retardation is a developmental disability. It is present in about 1% of the Connecticut population. According to our statutes, in order for a person to be eligible for DMR services they must have IQ scores less than 70 points along with demonstrated deficits in adaptive behavior, both before the age of 18-yrs. In addition, DMR is the lead agency for the Birth to ThreeSystem in Connecticut. This system serves infants and toddlers with developmental delays. Altogether, DMR assists about 19,800 individuals and their families.

Residential services for

about 700 people arefunded by other sources.

About 39% of the people we serve

7,519either live in

residential settingsor receive funds forresidential support

DMR provides or fundsresidential supports for more

than 6,800 people.

61% of the peoplewe serve

11,978live in their ownhomes or withfamily without

residential support

More than 7,400 DMR Consumers living at homewithout residential support

Over 4,500children living at home and receiving only Birth to Three services

WHO RECEIVESRESIDENTIAL SUPPORT

Includes Birth to Three children.

All data as of September 2005

4545

3066

1284

9643

959

0

2000

4000

6000

8000

10000

12000

Birth toThree

Children YoungAdults

Adults Seniors

Developmental Period

No

. P

eo

ple

Se

rve

d

(0-2) (3-17) (18-21) (22-64) (>64)

Age Distribution ofPersons Served by DMR

6

14207

10998

1276511,690

18,673

16,468

10000

11000

12000

13000

14000

15000

16000

17000

18000

19000

20000

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

No

. Pe

op

le

No. Clients Total Served (Incl B3)

No. people served includingBirth to Three (and Early Connections).Note large jump in 1997 w hen DMRassumed responsibility as lead agency

No. people w ith mental retardation served by DMR. Does NOT include Birth to Three.

The no. of people with M R served by DM R has grown by over 3,200 , or about 30% since 1992. For the past 5 years, about 375 new people joined DM R each year.

10 Year Growth TrendNo. People Served by DMR

FY92 - FY01

Each year, DMR serves about 375 MORE PEOPLE than the year before.Eligibility

Beginning this fiscal year, DMR has instituted a SINGLE POINT OF ENTRY for all individuals seeking eligibility for services. This new approach is designed to simplify the application process and assure statewide consistency in reviewing and determining eligibility across the five regions.

A FEW FACTS ABOUTNEW REFERRALS

• Every month more than 90 people apply for services

• 65% of new referrals are for children (<18 yrs old)

• About 25% of new referrals are for adults older than 20 yrs of age

• The remaining 10% are young adults age 18-20 yrs.

3 primary factors used to determine eligibility based on CGS 1-1g:

1. Significant deficits in intellectual functioning

- IQ profile <70 on standardized IQ test

2. Deficits in adaptive behavior

- evaluate using standardized measure

- consistent profile across social, economic & self- help domains

3. Manifest during developmental period

- clear evidence of both intellectual and adaptive deficits before age 18

- medical records, school records, standardized testing

Plus individuals with Prader Willi Syndrome

7

404

2111

4041

0

500

1000

1500

2000

2500

3000

3500

4000

4500

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

No

. Peo

ple

10 Year Residential TrendNo. People Served with Public, Private, and Individual Support

PRIVATE SECTOR

PUBLIC (DMR)

INDIVIDUAL SUPPORT

Individual Support is the FASTEST GROWING approach for providing residential support. In just the past 5-yrs it has increased by >450%.

Residential services provided by the public sector have been shrinking over the past 10 years, primarily due to downsizing at campus programs.

Residential services provided byprivate sector agencies have grown at a steady rate over the past 10-yrs, and now serve 37% more people than they did in FY92.

$164,747,700

$100,000,000

$125,000,000

$150,000,000

$175,000,000

$200,000,000

$225,000,000

$250,000,000

$275,000,000

$300,000,000

$325,000,000

$350,000,000

$375,000,000

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Fiscal Year

Do

llars

GROWTH IN CONTRACTED EXPENDITURESfor Services to People with Mental Retardation

DMR Budget: FY92 - FY01

40% of total

DMR expendituresin FY92

54% of total

DMR expendituresin FY01

Since FY92, expenditures for contracted services (private sector services) has increased by about $190 million, or 120%. Private sector expenditures now represent more than half of the entire DMR budget.

Who Provides Residential SupportThe past decade has witnessed a dramatic shift away from residential services provided by public programs operated directly by DMR and toward services and supports operated by the private sector community. In fact, in 2004, public programs serve only one quarter of all people who receive a residential support.

Over the past 12 years:• Public programs have shrunk by 25% • Private sector residential services

have increased by 65%• Self directed Individual Supports is

the fastest growing approach to residential service.

Providers of Residential Support

September 2005 MIR

Individual Supports9%

Private66%

Public25%

8

Kind of SupportIndiv.

Emp. And Day Supp. N/A Public Private Supp. Total % Total

Ind. Supp. Emp. 37 934 47 1,018 6.8%

Group Supp. Emp. 91 2,775 26 2,892 19.3%

Sheltered Emp. 143 756 10 909 6.1%

Day Supp. Opt. 503 2,886 42 3,431 22.9%

Comp. Employment 517 20 537 3.6%

Other 14 63 362 439 2.9%

Sub-Total 517 788 7,414 507 9,226 61.5%

% Total 5.6% 8.5% 80.4% 5.5% 100.0%

LEA 4,034 4,034 26.9%

Res School 42 42 0.3%

Birth to Three 15 16 31 0.2%

Other 58 58 0.4%

Sub-Total 15 4,150 4,165 27.8%

Day Program Needed 418 418 2.8%

No Prog - Other Reason* 873 873 5.8%

Blanks 315 315 2.1%

Grand Total 2,123 803 11,564 507 14,997 100.0%

DAY/WORK STATUS

Educational and Developmental Services

How They Receive Support

Other

Day Service and Work Status (9/30/05)

“No Prog-Other Reason” includes medical, retired, refused day program.

Issued: December 22, 2005

Who Provides Day / WorkSupport for Adults

Competitive 5.5%Public 8.5%Private 80.4%Individual Support 5.5%

9

Employment and Day Supports in Connecticut DMR

Group SupportedEmployment

Community NonWork

ShelteredEmployment

CompetitiveEmployment

Individual SupportedEmployment

37%

31%10%

11%6%

10

Service Needs – Day / Work Statewide(September 2005)

No Day Supports Emerg. Prior. 1 Total

Family or Own Home 5 198 203

Out of Home 2 80 82

Total no supports 7 278 285YTD 1 70 71

Transition

June 2005 Grads (Home) 0 115 115June 2005 Ageouts (DCF, LEA, ISA funded) 0 23 23

Total 0 138 138

DMR Day Programs 1 22 23

Private Day Programs 0 126 126

Total 1 148 149

WAITING LIST

DMR Funded/Operated Supports

School Graduates Ageouts

June 2006 218 60

June 2007 64 41

June 2008 27 43

FUTURE PLANNING

No Day Supports Priority 2 Priority 3 Total

Family or Own Home 11 4 15

Out of Home 3 2 5

Total no supports 14 6 20YTD 2 -1 1

DMR Day Programs 5 2 7

Private Day Programs 18 7 25

Total 23 9 32

DMR Funded/Operated Supports

PLANNING LIST

11

What we have learnedfrom our consumers about

vocational training and work….

12

INDICATORS:

Proportion of people who receive…

• Supported Employment

• Group Employment

• Facility-based (sheltered) Employment

• Non-vocational Day program

Services

CONCERN: Services and supports currently received.

HIGH Supported Employment, Group Employment, MIDDLE Sheltered Employment, Non-Vocational Day Activity

LOW

Connecticut Ranks

NCI Phase V (2003)

Employment Supports

0.0%

20.0%

40.0%

60.0%

80.0%

High 41.3% 25.7% 57.2% 79.1%

Low 2.1% 1.8% 3.1% 17.1%

CT 22.1% 25.7% 22.1% 32.1%

State Average 17.3% 8.8% 39.9% 43.2%

Supp Emp Group Emp Facility Based Non-Voc Activity

7/92/9 1/9 6/9

Note: higher rankings re: supported and group employment v. lower rankings for sheltered employment and non-vocational activity can be considered a “positive” finding.

13

A relatively steady trend over time can be seen for people reporting less employment support, with the exception of non-vocational activity.

ServicesComparison across 3 years

NCI 3 Year Trend

Employment Supports

29%

36%

27%

33%35%30%

25% 26%22%

26%22%

32%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

Supp Emp Group Emp Facility Based Non-VocActivity

1999 2000/01 20002/03

TREND:

14

Consumer EmploymentNational Benchmarks on Wages & Benefits

NCI Phase V Average and Median Monthly Consumer Wage for

Work/Day Activity

$356

$257

$140

$63

$356

$257

$-

$50

$100

$150

$200

$250

$300

$350

$400

Mean Wage Median Wage

High Low CT

NCI Phase V Mean Monthly Consumer Wage by Type of Work

$-

$100

$200

$300

$400

$500

$600

$700

High $667.02 $508.04 $266.92 $166.91

Low $258.29 $59.55 $44.74 $97.63

CT $667.02 $375.68 $266.92 $166.91

Sample Average $417.37 $238.17 $167.89 $101.37

CompetitiveIndiv

SupportedGroup

SupportedFacility based

Work

1/5 2/5 1/5 1/5

Average and Median employment wages for consumers in Connecticut are the highest for the 5 states that participated in this aspect of the survey. They are also the highest in 3 out of the 4 categories of employment that were included in the survey.

5 Participating States:• CA (Orange Co.)• CT• IN• PA• SD

15

Consumer EmploymentNational Benchmarks on Wages & Benefits

In addition to the five states that completed the wage and benefit portion of the 2003 NCI Survey, additional benchmarks are available from four other states based on NCI State Data Systems information submitted in 2002. In reviewing these benchmarks it is important to note that the data reflects two very different methods of collecting information and may therefore not be directly comparable.

National Benchmarks for Average Consumer Monthly Wage

$100

$150

$200

$250

$300

$350

$400

$450

Dol

lars

per

Mon

th

Ave Monthly Wage $196 $383 $425 $225 $310 $356 $140 $163 $143

MA VT WA WY OC CT IN PA SD

Based on 2002 System Data Based on 2003 Consumer Survey

CT consumer wages are still relatively high when compared to these additional benchmarks.

16

Consumer EmploymentNational Benchmarks on Wages & Benefits

CT consumers who are competitively employed would appear to work the greatest number of hours. They have the second highest no. hours for group supported employment and when participating in community activities associated with a day program. However, the level of participation/work for CT consumers who are involved in individual supported employment and facility-based work or activity programs is lower than those of consumers in most of the other benchmark states.

NCI Phase V Mean Monthly Hours by Type of Work/Activity

10

20

30

40

50

60

70

80

90

No.

Hou

rs

High 80.1 75.5 81.1 83.0 84.6 83.9

Low 58.8 48.2 59.8 72.3 73.6 17.8

CT 80.1 48.2 78.3 72.3 74.7 78.1

Sample Average 66.1 56.9 70.2 79.3 78.1 43.9

CompetitiveIndiv

SupportedGroup

SupportedFacility Work

Facility Activity

Community Activity

1/5 5/5 2/5 5/5 4/5 2/5

Data reflects the average no. ofhours worked per month for the 5 survey states across 6 different categories of work/day program.

17

Consumer EmploymentNational Benchmarks on Wages & Benefits

Connecticut ranks at the highest levels for stability of consumer employment and presence of benefits for persons with MR/DD who are employed. In fact, Connecticut was rated at the top of all reporting states for these three indicators.

NCI Phase V Average No. Years in Current Job

2.5

66

0

1

2

3

4

5

6

7

Ave. Years in Current Job

No

. Y

ears

High Low CT

NCI Phase V Percent with Continuous Employment

10%

45%45%

0%

10%

20%

30%

40%

50%

Continuous Employment

No

. Y

ears

High Low CT

NCI Phase V Percent with Benefits

2%

22%22%

0%

10%

20%

30%

Benefits

No

. Y

ears

High Low CT

18

Examples of Interagency Coordination

Youth Vision Team

Vision Statement

Create a collaborative, sustainable and performance-focused system that prepares Connecticut’s most at-risk youth for success in education, in the global demand-driven economy, in their families and in their communities.

Activities: Data collection, leveraging resources, youth involvement, infrastructure linkages, youth oriented outcomes.

19

Youth

National Governor’s Association Policy Academy Improving outcomes for young adults with disabilities One of six state chosen Agency partners: BRS, DMR, DCF, DMHAS, DOL, DSS, DOC,

Judicial Dept., OPM, DOE, UCE, Young Adult Consumer Challenges: Lack of funding

- No designated agency for adults with developmental disabilities

- Limited resources

- Fragmentation

- No common data system.

Examples of Interagency Coordination

20

BEST Practice for Job Development

Start with a comprehensive needs assessment Listen to your consumers Use this information to create an individual plan Provide hands-on experience Market the strengths of your consumer with future employers Locate real work with:

Good payBenefitsOpportunity for change

Be educated about and use creativetechnology to help people with intellectualdisabilities become more independent.

21

Final Words of Advice….

People will learn the jobs they are in with the right supports.

Job developers need to tackle the difficult or social aspects of the world of work.

Coach on social interaction and personal hygiene skills.

AIM HIGH!