NO. 45.  AN ACT RELATING TO RESTRUCTURING THE AGENCY OF HUMAN SERVICES.

(H.450)

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1.  INTENT AND PURPOSE

(a)  It is the intent of the general assembly that the agency of human services be structured so that services are provided in a holistic, comprehensive, and coherent way, and public resources are allocated efficiently and produce the best possible outcomes.  Direct services provided by the agency and its community partners shall be centered on individuals and families, easy to access, and sufficiently flexible to respond to unique situations. 

(b)  It is further the intent of the general assembly that the process of restructuring of the agency of human services:

(1)  reflect the policy and budgetary priorities of the general assembly; and

(2)  should not compromise services, supports, and assistance levels.

(c)  As used in this act, “case management” means the function of:

(1)  organizing, coordinating, and ensuring appropriate and timely services for an individual or family;

(2)  ensuring that case plans are developed and implemented;

(3)  mediating differences among providers; and

(4)  providing a method for ongoing review of progress and outcomes. 

 

Sec. 2.  FINDINGS

The general assembly finds:

(1)  The agency of human services serves all Vermonters through public health services and 235,000 Vermonters through direct service programs, some of which have received national recognition for their innovation and effectiveness.

(2)  However, the current structure of the agency of human services:

(A)  poses barriers to systematically providing a full range of appropriate services to each individual or family and is not designed to address multiple interrelated needs;

(B)  hinders efforts to effect coordinated policy initiatives, resulting in inconsistent policies and eligibility requirements across programs and departments;

(C)  does not consistently respond proactively to the earliest signs of a family, child, or individual in need;

(D)  may result in duplication of functions for each different category of individuals with respect to:

(i)  financial and case management supports;

(ii)  contracting;

(iii)  service provider negotiations; and

(iv)  information technology;

(E)  does not promote the most effective and efficient allocation of financial and staff resources.

Sec. 3.  GOALS AND PRINCIPLES

(a)  The agency of human services shall be structured in a manner designed to achieve the following goals:

(1)  provide services to Vermonters that are comprehensive, integrated, client-centered, outcome-based, easy to access, and sensitive to the diverse needs of individuals and families;

(2)  improve services to Vermonters through collaboration with other agencies, including those responsible for housing, education, transportation, employment, and justice;

(3)  improve the well-being of Vermonters by supporting continual progress toward achieving universal outcomes of well-being;

(4)  measure progress toward achieving the outcomes of well-being through specific and objective indicators;

(5)  encourage individuals to seek access to appropriate services;

(6)  promote maximum personal independence in the most integrated setting and promote the individuality and productivity of Vermont citizens;

(7)  hold offenders accountable, repair harm done to victims and communities, and promote, as appropriate, the use of restorative justice principles and a nonadversarial community process to resolve conflicts and disputes;

(8)  promote maximum self-sufficiency;

(9)  ensure the efficient and effective allocation of financial and staff resources;

(10)  establish effective data collection systems to support ongoing assessment of service quality and enhance continual organizational improvement; and

(11)  develop and utilize strong partnerships with clients, communities, schools, and service providers.

(b)  The following principles shall guide the agency of human services:

(1)  Prevention and early intervention should be reflected in policy and service development and practice.

(2)  Individuals and families should be involved in the development of their case plans and goals with an emphasis on self-determination.

(3)  Case plans should promote self-sufficiency and, as appropriate, recovery.

(4)  The agency should be designed to support a holistic approach to serving individuals and families and to ensure the coordination of services when multiple interrelated needs exist.

(5)  Maximum communication and collaborative planning among different specific service providers should occur when more than one service is being provided.

(6)  To the extent possible, individuals and families should be able to access services through any component of the agency, including designated contractors.

(7)  To the extent possible and when appropriate, individuals and families should be able to have their needs identified in a single, uniform process, and have planning occur through one service representative or within a single team.

(8)  Assessments should ensure the identification of services needed to support successful attainment of case goals.

(9)  The agency should be designed to provide a continuum of services capable of adapting and responding to changing needs and unique situations, including transitional stages.

(10)  The role of work and productivity in people’s lives should be supported.

(11)  Treatment and recovery programs should recognize the prevalence of co-occurring disorders.

(12)  Service delivery systems should recognize the prevalence of the many kinds of trauma, including psychological trauma, and agency staff and service providers should be trained to ensure that client interactions are respectful and sensitive to trauma.

(13)  The importance of safe and supportive communities should be recognized and promoted.

(14)  Accountability should be clearly defined.

(15)  Confidentiality requirements shall be defined and met.

(16)  Regular systematic reporting of outcomes experienced by individuals and families and measured by recognized quality indicators is essential to the proper evaluation of all programs.

(c)  The following principles shall guide the restructuring of the agency of human services:

(1)  Individuals served by the agency should be engaged in restructuring activities to ensure the interests of consumers are understood and addressed.

(2)  Expertise in serving individuals with specialized needs should be maintained.

(3)  Services, supports, and assistance levels should not be compromised.

(4)  Resource investment should be prioritized toward proven case management models, best practices, and evidence-based care and services.

(5)  Ongoing and broad public input should be solicited to result in a system design that is most effective and responsive.

(6)  The administrative costs of the agency and nonprofit service delivery systems should be as minimal as necessary to support the efficient delivery of services.

Sec. 4.  TIMELINE AND PROCESS

The secretary shall engage in the following process as part of the restructuring of the agency:

(1)  The secretary shall:

(A)  Collaborate with agency staff, community partners, clients, advocacy groups, providers, advisory groups, law enforcement agencies, courts, the department of education, and other stakeholders in order to receive input on organizational models and design of the agency.  This process may include focus groups, public meetings, newsletters, surveys, and the use of a website and shall continue through December 2003.

(B)  Collaborate with agency staff, clients, advocacy groups, providers, community partners, the department of education, law enforcement agencies, courts, and other stakeholders to determine specific accountability indicators needed to measure the success and performance of agency restructuring.

(C)  Begin development, after consultation with affected partners, of a data-based system using common identifiers.

(D)  Examine areas where consultation may be needed, such as information technology design consultation, federal cost allocation consultation, and organizational development consultation.

(E)  Establish teams consisting of agency staff, community partners,  staff of affected agencies, clients, and advocacy groups to investigate the following and, as appropriate:

(i)  Develop a common intake form.

(ii)  Develop a common screening tool.

(iii)  Develop lead case manager protocols, including designation and best practice guidelines.

(iv)  Develop case budgeting capacity.

(v)  Develop best practice protocols to guide early intervention efforts.

(vi)  Develop training programs designed to promote best practices to strengthen comprehensive case management.

(vii)  Work with communities to align services to support schools.

(F)  Convene 12 regional advisory groups consisting of representatives of advocacy groups, clients, and service providers interested in the restructuring of the agency. 

(G)  Develop and implement staff development programs necessary to assist the agency staff to carry out their responsibilities in the restructured agency.

(2)  A statewide advisory group is created to advise the secretary on the design of the agency and the creation of a client-centered system.  It shall consist of no more than 20 members, one designated by each of the regional advisory groups, two designated by the Vermont State Employees Association, and the remaining members to be designated by the secretary in order to achieve a broad representation of interests.  Appointments shall be made no later than September 15, 2003, and shall be for terms of one year.  Members of the advisory group not receiving compensation for service on the advisory group from another source are entitled to compensation under section 1010 of Title 32.  

(3)  Beginning October 1, 2003, the secretary shall examine functions such as administrative support, supervision, space requirements, and grants management necessary to establish a client-centered service delivery system.

(4)  On or before January 15, 2004, the secretary shall prepare and present to the legislative oversight committee on human services restructuring established in Sec. 5 of this act:

(A)  a report containing initial recommendations for restructuring the agency;

(B)  draft legislation necessary to conform existing statutes;

(C)  a report on the budgetary impacts and transitional costs of restructuring; and

(D)  a report on the structure and membership of the regional and statewide advisory groups and how they were formed.

Sec. 5.  THE LEGISLATIVE OVERSIGHT COMMITTEE ON HUMAN

              SERVICES RESTRUCTURING

     (a)  There is created the legislative oversight committee on human services restructuring to oversee the restructuring of the agency of human services.  The committee shall be composed of two members from each of the house committees on health and welfare, government operations, and appropriations to be appointed by the speaker of the house, not all from the same party, and two members from each of the senate committees on health and welfare, government operations, and appropriations to be appointed by the committee on committees, not all from the same party.  Initial appointments shall be made by July 1, 2003.

(b)  The committee shall review whether agency restructuring is achieving the goals of this act effectively, efficiently, and with satisfaction.  The committee shall specifically:

(1)  solicit input from individuals served by the agency;

(2)  monitor the restructuring process and timeline; and

(3)  measure the efforts of the agency against the goals and principles described in this act.

(c)  The committee is authorized to meet up to six times per year while the general assembly is not in session to perform its functions under this section.

(d)  The secretary of the agency of human services shall report to the committee as required by the committee.

(e)  Members of the committee shall be entitled to compensation and reimbursement for expenses under section 406 of Title 2.

(f)  The committee may prepare and propose draft legislation which amends the Vermont Statutes Annotated to conform to the restructuring of the agency.

Sec. 6.  RESTRUCTURING; AUTHORIZATION

After filing the report required in Sec. 4(4)(A) of this act, the secretary of human services shall have the authority to restructure the agency of human services according to the goals, principles, and processes set forth in this act.  For the purposes of this act:

(1)  The secretary may transfer appropriations within the agency in order to carry out the purposes of this act, provided that the total amount appropriated to the agency shall remain the same.  The secretary shall not transfer an appropriation without the approval of the joint fiscal committee.  Prior to transferring an appropriation, the secretary shall submit a written proposal for the transfer to the legislative oversight committee on human services restructuring and the joint fiscal committee.  The oversight committee shall have up to 30 days to review the proposal and advise and provide its recommendation thereon to the joint fiscal committee.  The joint fiscal committee shall meet within 45 days of the date of its receipt of the proposal to review and act upon the proposal.  However, the joint fiscal committee shall not act upon the proposal until it receives a recommendation from the legislative oversight committee on human services restructuring or after the passage of 30 days from the date of its receipt of the proposal.  If the joint fiscal committee fails to meet within its 45-day period for review, or meets but fails to act upon the proposal, the transfer shall be deemed approved by the joint fiscal committee and the secretary may implement the transfer. 

(2)  The secretary may transfer or reallocate personnel, functions, and programs consistent with this act, subject to personnel laws, rules, and contracts.  The secretary shall identify personnel laws, rules, and contracts which unreasonably restrict the agency’s ability to meet the goals and principles set forth in this act.

(3)  The secretary may use pilot programs or action research initiatives to facilitate the development of agency protocols and tools, including case management.

Sec. 7.  STRATEGIC PLAN

On or before January 15, 2005, the secretary shall prepare a strategic plan which shall be updated biannually and presented to the general assembly and to members of the house and senate health and welfare committees.  The strategic plan shall include desired outcomes for Vermonters, shall report on the outcomes experienced by individuals and measured by quality indicators, shall set and clarify goals, shall describe the process for engagement of agency staff, community partners, clients, advocacy groups, providers, advisory groups and other affected agencies, shall provide an ongoing assessment of the effectiveness of the plan and shall establish and describe milestones for development of the plan. 

Sec. 8.  APPLICATION

(a)  Nothing in this act, nor any action taken pursuant to this act, shall affect the validity of agency of human services rules in effect, assets owned, or contracts or other agreements entered into by the agency.  Rules in effect on the effective date of this act shall remain in effect until amended or repealed by the secretary.

(b)  If there is a conflict between this act and another provision of law, this act shall prevail.

Sec. 9.  SUNSET

Subdivision (1)(F) and subsection (2) of Sec. 4 (advisory groups), Sec. 5 (legislative oversight committee on human services restructuring), and Sec. 6 (restructuring authorization) of this act shall expire on July 1, 2006.

Sec. 10.  EFFECTIVE DATE

This act shall take effect upon passage.

Approved:  May 29, 2003