Applicant defends referral, wait‑list and Medicaid plans as OHS seeks readmission data

At a public hearing of the Office of Health Strategy, an applicant for Paramount’s proposed Stamford/Stanford aftercare and outpatient facility described referral relationships, a wait‑list policy, plans to seek Medicaid enrollment and an 11/15 waiver, and confirmed a five‑year lease at 1290 Summer Street.

The most detailed public statement came from Joseph Pinnell, a veteran who said he completed Paramount’s July–September 2023 program and strongly supports the Stanford proposal. "I was given so much love and compassion," Pinnell said, adding staff "met me at my level" and gave him tools and continuity he credited with helping him change his life.

Cassandra Ruela, who spoke for the applicant team, told OHS examiners that Paramount has letters of support from several regional providers — including CCAR, Newtown Parent Connection, Tri State EAP, Blue Sky (a partial IOP in Danbury) and Liberations in Stamford — and that those letters state the providers would refer clinically appropriate clients to Paramount. Ruela said those referral relationships are working, but not formalized by contract: "We have a working list of referral partners," she said, and added that the letters of support were submitted with the application.

OHS examiners pressed the applicant on a stated policy that clients would not be kept on Paramount’s wait list if treatment could not start within 14 days. Ruela described the 14‑day window as tied to outpatient scheduling: "Two sessions" would typically occur within 14 days, she said, and if Paramount could not see an outpatient client within that time Paramount would refer the person to another provider rather than leave them on a wait list.

Panelists asked how Paramount verifies referral partners’ capacity and utilization. Ruela replied the team does not have access to other providers’ utilization data and instead relies on relationships and tours of partner facilities: "My team has toured, we've met their administration, we've met their clinical teams, and we trust them to provide the same level of care that we would provide," she said.

When asked to substantiate applicant claims that geographic barriers contribute to readmissions from the proposed PSA, Ruela cited general sources and prior studies and OHS requested a late file with PSA‑specific readmission figures. The hearing record shows staff asked for a late file labeled "late file 1" to include readmission data for outpatient care in the proposed PSA.

Ruela confirmed Paramount Haddam is an approved Medicaid provider and said Paramount expects to apply for Medicaid enrollment for the Stanford facility within its first year of operation, timing dependent on certificate of need and licensure approvals. She also said the Stanford site is being built to be "11/15‑waiver compliant" from inception and that Paramount intends to apply for Medicaid and the 11/15 waiver concurrently.

On expected effects to local providers, Ruela told the panel she anticipates a negligible shift in existing Medicaid/Medicare volume and that most new Medicaid patients would come from underserved people not currently receiving care: "We're looking to treat the people who are not being treated," she said. She estimated about 25 percent of Paramount Haddam patients would step down to the Stanford facility and said referrals from other residential treatment facilities would be a fraction of total volume.

The applicant said it is negotiating an emergency transfer agreement with Stamford Hospital and has an established transfer agreement with Middlesex Hospital; Ruela reiterated that letters of support are the primary documentation supplied for referral relationships. The applicant also confirmed the lease for the proposed Stanford location at 1290 Summer Street has been executed for five years.

The hearing recessed for a short break and OHS said questioning would resume with Mr. Lazarus followed by additional public comment. OHS staff also noted the applicant had submitted a case management needs assessment as attachment "completeness 2b" and that the document is available in the record.

The Office of Health Strategy did not take a final vote during the session; examiners requested the late file of readmission data and indicated further review would follow.