The Human Services and Appropriations committees approved a federal selective provider contracting waiver renewal that allows Connecticut to continue the current Birth to 3 contracting model for early intervention services.

The waiver, requested by the Department of Social Services and the Office of Early Childhood, enables the Office of Early Childhood to manage how Birth to 3 providers are selected and monitored in each community; it does not change Medicaid coverage or payment rates, which are handled through the Medicaid state plan and would require a separate state plan amendment.

Commissioner Andrea Barton Reeves of the Department of Social Services and Commissioner Beth Bye of the Office of Early Childhood testified in support of the renewal, describing the waiver as a mechanism for the lead agency to supervise provider implementation of federal Individuals with Disabilities Education Act (IDEA) Part C requirements and to preserve the regional contracting approach used in Connecticut. "This waiver will allow the OEC to continue to manage the number of early intervention services in each community," Reeves said. Bye added that the state’s approach supports relationships between providers and public schools and helps ensure timely access.

Both commissioners told the committees the waiver must be renewed every two years and that the waiver renewal itself does not alter what Medicaid covers; any changes to reimbursement rates would come through a Medicaid state plan amendment. Committee members were told that DSS and OEC published a 30‑day public comment period on the waiver renewal and received no comments, and that materials were distributed to representatives of two federally recognized tribes; the agencies said the waiver does not have a unique tribal impact.

Legislators pressed staff on provider rates and workforce issues. Senator Derek Lesser asked about a rate study and the status of proposed rate increases; committee witnesses said the governor’s proposed increases were not fully funded in the final budget and that the approved appropriations did not adopt the tiered reimbursement recommended in the rate study. Commissioner Bye and DSS staff said the state plan amendment process would be required to change rates and is separate from the waiver filing.

Provider representatives testified in favor of the renewal and described certification, contract and training requirements. Cindy Jackson, chairperson of the Birth to 3 Interagency Coordinating Council and a Birth to 3 provider, told the committees that programs must sign a roughly 40‑page state purchase‑of‑service contract, meet personnel and training standards, obtain initial certification to provide Birth to 3 services regardless of hours worked, and complete required service‑coordination training. Jackson also said Connecticut providers are not allowed to maintain waiting lists and must evaluate and, if eligible, start services for referred children within 45 days. Nicole Cossette, Connecticut’s Part C coordinator, described the professional development and technical assistance OEC provides to support providers and to meet monitoring requirements.

The Human Services Committee approved the waiver by roll call on a motion by Representative Norma Santiago, seconded by Representative Gregg Hughes; the clerk recorded 16 yeas, 0 nays, 0 abstentions. The Appropriations Committee subsequently approved the same waiver by roll call (motion and second noted in committee proceedings); the clerk recorded 42 yeas, 0 nays, 0 abstentions. Committee clerks will include in the Human Services record a note that one member who experienced technical difficulties may submit how they would have voted for the minutes.

Next steps, as described during the hearing, are for DSS and OEC to submit the selective provider contracting waiver renewal to the Centers for Medicare & Medicaid Services (CMS) for federal approval. Committee testimony made clear that the waiver renewal is intended to preserve Connecticut’s regional contracting and oversight approach for Birth to 3 services; changes to reimbursement rates or other payment policy would need to follow the Medicaid state plan amendment process.

The committees’ approvals leave in place the state’s current contracting, certification, and monitoring structure for Birth to 3 providers while the state continues separate discussions about provider rates and workforce recruitment and retention.