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2009 Budget Tool Kit
Action Alert - Download WORD VERSION or PDF VERSION
Dwight Stratton
President, The Arc of California
Tuesday, June 16, 2009
As a parent, I must take strong exception to the decision our elected
Legislators made yesterday to ignore the will of the people of the State of California, by decimating the Lanterman Act. We must let them know how this has harmed our children and our children’s future.
The 10 members of the Legislature’s budget conference committee late yesterday accepted, without discussion, Governor Schwarzenegger’s devastatingly destructive cuts in the support system for people with developmental disabilities and their families.
The six Democrats and four Republican legislators voted 10-0 to accept all of the cuts recommended by Schwarzenegger’s Department of Developmental Services.
Virtually every Californian with a developmental disability will be hurt. For thousands of people, this very likely will mean the end of the Lanterman Act’s promise of the most appropriate supports for people with DD. Children who could have been saved from serious disabilities by early intervention will have those serious disabilities as long as they live.
We’re working on a summary of these cuts. Please check www.ArcCalifornia.org soon.
This catastrophe wasn’t necessary. The Arc and other community groups relentlessly presented responsible alternatives that would have saved the state just as much money without these terrible results. In the end, Governor Schwarzenegger and these 10 legislators ignored us.
Our community must respond promptly and strongly. Please call Governor Schwarzenegger and the 10 legislators immediately and express your strong disappointment, even outrage if that’s what you feel. Their numbers are at the bottom of this Action Alert.
We are especially disappointed in those we’ve always seen as our friends, beginning with Governor Schwarzenegger, a supporter of the Special Olympics and the son-in-law of disability champion Eunice Kennedy Shriver. His Department of Developmental Services proposed more cuts than necessary to meet the dollar goals Governor Schwarzenegger ordered them to meet, and they disregarded our alternative proposals. The department convinced the 10 legislators that the community “stakeholders” all supported these cuts. We did not.
Our groups’ professional advocates in Sacramento clearly and repeatedly, as recently as yesterday morning, let the legislators’ staff members know that these cuts were the Schwarzenegger administration’s proposals, not ours, and that we have concrete alternatives. Hundreds of people testified at three separate hearings with some of these 10 legislators present. Thousands called, emailed and faxed letters to all 10 of them.
For us, the cruelest betrayal was by legislators who have been our friends, who have visited our service programs, spoken at our conferences and meetings,
supported some of our bills in the past, listened respectfully to our testimony, and even spoken about how Governor Schwarzenegger’s proposed cuts were too much.
Assemblywoman Noreen Evans, the committee chair, had said all the harmful cuts that Governor Schwarzenegger proposed should at least be temporary, yet she ignored our repeated urgent appeals to make any cuts in the DD support system temporary. We had let Ms. Evans know that the department was flatly wrong when it said or implied that the “stakeholder” groups supported some of the cuts, yet today she said that they were “developed by the stakeholder groups.”
Senator Mark Leno had told an earlier public hearing that the amount Governor Schwarzenegger proposed to cut was too much, yet today he voted for it. He had seriously questioned the department’s proposals to shift much of the decision-making power over the IPPs from the IPP teams to the regional centers, yet today he didn’t say a word as the committee adopted them.
Assemblyman Robert Blumenfield, Assemblyman Kevin de Leon, Senator Denise Ducheny, and Senator Alan Lowenthal, all people we have considered our good friends, were silent -- and all voted for the cuts.
Senator Robert Dutton, Senator Mimi Walters, Assemblyman Jim Nielsen, and Assemblyman Roger Niello also all went along with all the cuts.
Please call them all and tell them what you think of their votes today.
- Don’t be shy. Our community’s future rests on politicians learning that attacking our vulnerable people has consequences. Speak your mind, even if your voice shakes.
- Don’t be deterred if they have represented you well in the past. They didn’t represent you today.
- Don’t be bothered if you know and like them. This isn’t personal, it’s about what’s right for people with DD and their families. Friends tell friends when they feel betrayed.
Depending on how much well-deserved criticism they receive in the next few days, there may be some chance to reverse some of the worst cuts, or at least make them temporary. Without a community response, there’s no chance.
The department’s next “stakeholder” meeting to advise the department on the bill language is today. We and the other groups will be there fighting for our community.
Please phone all 11 if you’re able. Calls have more impact. The email addresses are for people who can’t call. The fax numbers are for faxing letters on your group’s letterhead.
If you live in the district represented by any of the 10 legislators, start by giving them your name and address so they know you’re their constituent. If you’re a member of the same party as theirs, say so.
All of their phone numbers are in the 916 area code.
- Governor Arnold Schwarzenegger, 445-2841, 558-3160 (fax), email using the web form at www.ArcCalifornia.org, "Write Your Legislators."
- Assemblywoman Noreen Evans, 319-2007, 319-2107 (fax), [email protected]
- Senator Denise Ducheny, 651-4040, 327-3522 (fax), [email protected]
- Senator Robert Dutton, 651-4031, 327-2272 (fax), [email protected]
- Senator Mark Leno, 651-4003, 445-4722 (fax), [email protected]
- Senator Alan Lowenthal, 651-4027, 327-9113 (fax), [email protected]
- Senator Mimi Walters, 651-4033, 445-9754 (fax), [email protected]
- Assemblyman Roger Niello, 916-319-2005, 319-2105 (fax), [email protected]
- Assemblyman Kevin de Leon, 319-2045, 319-2145 (fax), [email protected]
- Assemblyman Bob Blumenfield, 319-2040, 319-2140 (fax), [email protected]
- Assemblyman Jim Nielsen, 319-2002, 319-2102 (fax), [email protected]
Please call all 11 of them now. And please forward this Action Alert far and wide.
Dwight Stratton
President
The Arc of California
Review of the Details in the $234 Million Reduction (today we are addressing the implementation language):
Total Proposed Cut by Governor |
Revenue or (Savings) |
Comments |
|
$234 |
|
Increased Federal Funds and DC Cuts ($90), Closure of Sierra Vista sometime next fiscal year, Regional Center Operations ($10 million). DDS to apply for 1915i Waiver for future offsets. |
-$100 Million |
During the first meeting we were not allowed to discuss federal funds though we pushed it in the legislature. DDS stepped up and offered several revenue generating options, efficiencies, and DC and OPS reductions. The Arc feels more can be done in this area but DDS disagrees. |
Residential Services |
$1.2 Million |
This is achieved by reducing some group homes and making them “homelike” |
Behavioral Supports (no ABA or IBIS as respite, day care, school, or primary crisis; access family insurance; ABA or IBIS evaluated every six months; require parent participation) |
$21 Million |
The original reduction was about $35 million. The proposals impacted several families with Autism who opposed all the reductions. The Arc of CA supported this opposition with the legislature. |
Respite (originally written as a POS standard and eventual negotiated to accept language in the IPP for increasing hours based on individual needs depends on TBL) |
$5.2 |
The language in this proposal is written as a POS standard with a cap on services. We want an ability to appeal arbitrary reductions not base on family need and situation. |
General Standards (no experimental treatments, individuals and family must accept eligible generic services; must first get denial from generic resource; must choose least costly vendor who can meet consumer needs, inform families of services provided). Compromise added to insert IPP language to account for choice. |
$50.6 |
This is the main reason for stating the Lanterman is Ending. These POS standards could end your chance to make decisions in your IPP. If you can no longer choose your service provider and you could lose your current provider and be made to use a new provider then we have lost a core element of the Act. |
Eliminate the state option to support “at risk” children in Early Start. Compromise developed to create a block grant approach |
$17.7 |
There is some question of whether or not the family has appeal rights or even an IPP if the child is identified as “at risk” it basically sets up a parallel program outside of the Lanterman Act. |
Eliminate a variety of “non-core” services. Compromise was to allow for the us of these services when family can define as critically important (non-medical therapy, music therapy, equestrian therapy, social rec programs, etc.). Compromise was to allow for an exception process in the IPP. |
$30 |
This is an “almost” categorical elimination of services. The compromise allows for some exceptions but only one sixth of the funding is available for this so it is not really expected to be accessible to most people. |
Eliminate all Non-federally required Early Start Services (Childcare, diapers, dentistry, interpreter, genetic counseling, housing, etc.) |
$6.3 |
A compromise was struck to put back durable and medical equipment. |
Issues Brought Up but quickly removed: Means Testing the Entire Lanterman Act System, Reduce Day Programs to 3 or 4 days a week, Total elimination of Early Start, Elimination of All Day Care, etc. |
Rejected |
There were also many other options in written form that were so terrible no one brought them up for discussion. |
Future Developments: Sierra Vista Closure, Porterville movement from lock area to unsecured area, Individual Budgets and Self Directed Services approaches. |
? |
The 3% reduction to providers is scheduled to sunset by the end of the year but the savings associated with it is already out of the base budget. Proposals in the first $100 is expected to account for this because in the second year they will have full year savings. |
DDS Response to the Alternatives
We discussed with DDS Director Terri Delgadillo during the June 12, 2009 stakeholder meeting the following concepts and logic and she felt each one as not viable. Sue North (R&K), former Budget Staff for many years and currently representing CalDSA, worked with us to develop the Community Alternative and this quick reference sheet so we were confident that the logic was sound. DDS told legislators they were not and the legislators did not come back to us for our rebuttal.
Specific Ideas for Increasing Federal Funds Under the Home and Community Based Services Waiver
SUMMARY
Total new waiver funds available for transportation |
|
$ 29,466,667 |
Total new waiver funds available for SLS |
|
$ 29,145,760 |
Total new waiver funds available for enrollment |
|
$ 75,600,000 |
TOTAL INCREASED FEDERAL FUNDS $134,212,427
Alternative One
- Beyond the increases DDS sees in expanding billing transportation services within the “ICF-DD Wraparound” package of billings, we believe that the current service population already under the Home and Community Based Services Waiver could have their transportation costs billed under the Waiver if the vendors were asked by the regional centers to gather client-specific billings and submit them monthly:
TRANSPORTATION |
|
|
Total Expense Contract Transportation |
|
$100,000,000 |
Waiver % |
|
56% |
Waiver Funds |
|
56,000,000 |
% of RC not billing for Contract Transportation |
|
81% |
Waiver Funds Available |
|
45,333,333 |
% of Consumer who are waiver eligible |
|
65% |
Total new waiver funds available |
|
$ 29,466,667 |
DDS Response
The Director said the transportation alternative was already done because they invested in additional staffing for each regional center to identify an increased amount of waiver billable transportation services. They feel they have maximized this revenue option. (The Arc) In talking with providers they believe more can be done working together with regional centers).
- Supported Living Services clients are among those with the most severe disabilities, so they are most likely to be HCBS waiver-eligible and enrolling them is likely to draw down large amounts waive r funds. One regional center successfully bills 93% of all SLS services under the Waiver. We believe that all regional centers should be placing highest priority on reviewing all clients receiving SLS services to enroll those eligible in the Waiver. Assuming half of those currently receiving SLS services are enrolled there is an additional increase in federal funds as follows:
SUPPORTED LIVING |
|
|
# of people receiving SLS services |
|
6,138 |
# of people receiving SLS services on the waiver |
|
4,174 |
# of people receiving SLS services not on waiver |
|
1,964 |
% waiver eligible |
|
50% |
# consumers eligible for waiver |
|
982 |
Expense per consumers receiving SLS services |
|
53,000 |
Total Expense for eligible consumers |
|
$52,046,000 |
|
|
56% |
Total new waiver funds available |
|
$29,145,760 |
DDS Response
Regional centers are totally different from center to center and it is not correct to think one regional center’s experience with SLS could be similar to the next.
- The cap on the number of clients enrolled in the federal Waiver grows to 90,000 during the next federal fiscal year. With high priority assigned by the state to the regional centers to maximize this enrollment cap, increased federal funds could be estimated:
Open CAP |
|
|
FY 2009-10 CAP |
|
90,000 |
FY Budget Waiver Participants |
|
81,000 |
FY 2009-10 CAP unused |
|
9,000 |
Average Expense per consumer. |
|
15,000 |
Total Expense for Eligible consumers |
|
$ 135,000,000 |
Waiver % |
|
56% |
Total new waiver funds available |
|
$ 75,600,000 |
|
|
|
DDS Response
The department is very confident that they have identified all they possibly can for the waiver and they don’t believe anything more can be done to find more. When asked about the low national ranking in spending on people with ID/DD Terri said those rankings aren’t accurate because CA only records money spent from DDS and other states include all departments (i.e. Medi-cal, IHSS, SSI, etc.). (The Arc) We subsequently researched this issue and found the comparison was an accurate “apples to apples” comparison.
CLICK HERE to review the complete Community Alternative Plan.
June 8, 2009 - Alert Download
The State Is Deciding Your Future Now!
Immediate Action Needed
People with developmental disabilities and families! Governor Schwarzenegger wants to cut community services by more than half a billion dollars in state and federal funds!
The Legislature is making decisions now. If you do not act today, this can happen:
- Programs will close and not be replaced.
- You will lose control of what goes into your IPP.
- You will lose your right to an appeal.
Tell the Legislators and Governor in your own words:
- No more cuts in community services for people with developmental disabilities.
See the back of this flier for the key decision-makers you need to contact now.
Action Needed in the Coming Weeks
Stay in touch! We could win this week and still face big cuts soon as the state budget fight continues. Check www.ArcCalifornia.org for the latest information. And join The Arc’s Action E-List!
Action Needed Today
- Call, email, or fax (don’t mail) short letters on your group’s letterhead to all of the following key decision-makers. All their numbers are in the 916 area code:
- Your own local state senator and Assembly representative. Be sure to give them your address so they know you live in their districts. If emailing them, please use The Arc’s web form at www.ArcCalifornia.org, “Write Your Legislators.”
- Governor Arnold Schwarzenegger, 445-2841, 558-3160 (fax), email using the web form at www.ArcCalifornia.org, “Write Your Legislators.”
- Senate President pro Tempore Darrell Steinberg, 651-4006, 323-2263 (fax), [email protected]
- Distribute this Action Alert widely.
June 3, 2009 (PDF)
Budget Crisis Update - Consumers and Families:
The State is making decisions right now that will seriously impact your services and your future. Drastic proposals to cut services and change public policy are on the table for action in Sacramento. You must act now if you want to protect your services and your rights.
Most of you already know what has happened so far:
- Supported Employment Services received a 10% rate cut effective 7-1-08.
- All other community services and Regional Centers received a 3% cut effective 2-1-09.
- In February, the Legislature directed the Department of Developmental Services (DDS) to cut an additional $100 million from the DDS budget.
- If this is not accomplished, the Legislature will institute a devastating additional 7.1% rate cut to all community service providers on September 1, 2009.
Although a 3% cut may sound manageable, it is on top of decades of grossly inadequate funding for community services, and threatens the survival of an already broken developmental disabilities system in California. This is in addition to major reductions also being proposed for Medi-Cal, IHSS, SSI and other services that are essential to the health, safety and well-being of all people with disabilities. And once a cut has been imposed, it is extremely difficult to reverse even when the state has increased its revenue.
Then, just days ago, the Governor instructed DDS to recommend another $234 million in cuts to the developmental disabilities system! Advocates were stunned. No one can expect the system to survive cuts of this magnitude.
The Legislature will be taking action on these budget cuts very soon. Actions could begin as soon as Saturday, June 6. We must reach our legislators immediately and tell them to reject these terrible cuts and accept the reasonable and responsible alternatives being proposed by advocacy groups. The following information will give you more detail about what has happened and what is at stake.
What’s happening with the cuts that started in July, 2008 and February, 2009?
Service providers and regional centers are working to find ways to survive. Some community programs have already closed and others are on the brink of closure. But given the seriousness of the State’s budget problem, the community is trying to do its fair share by accepting these cuts.
What’s happening about the $100 million cut?
Many of you participated in the state-wide stakeholder input process that took place in February and March. At these meetings, DDS staff heard from people all over the state about how to save the required $100 million and avoid the threatened 7.1% rate cut for service providers.
At those meetings the voices of consumers, parents and family members were loud and clear. DDS was asked to protect community services and secure all available additional federal funds to help solve the problem. The community said if there must be cuts that they be shared among all 4 parts of the system: Developmental Centers, DDS Headquarters, Regional Centers and community services.
DDS took this community input and worked with a small stakeholder group to develop recommendations to the Legislature about how to save the $100 million. Unfortunately, the final DDS recommendations do not reflect the vast majority of community input. DDS made 15 proposals to the Legislature and 94% of the cuts in these proposals primarily impact community service providers or families directly. The DDS proposals can be viewed on the DDS website. Go to www.dds.ca.gov and click on “What’s New” in “Popular Links.” Then scroll down to “DDS Budget Proposals” (4-7-09). There you can read a general description of each of the 15 proposals.
But there is something you won’t see on the website and it is much more important than these general descriptions of the 15 proposals. You cannot see the actual language that DDS is proposing to put into law to implement these proposals. The actual language that becomes law is the only thing that matters. It is referred to as “trailer bill language” because it goes into law in bills that are passed along with the budget (bills that “trail” the budget) to implement the budget actions. Those who have seen the actual trailer bill language to implement the 15 proposals are very concerned. While some of it is reasonable and consistent with the general descriptions of the proposals, some of it does something very different and will have very severe negative impacts on consumers, families and the community service system.
Here are a few of the things DDS’s proposed trailer bill language will put into law:
- Many children between 24 and 36 months of age with certain developmental delays who are now eligible for early intervention (Early Start) services will no longer be eligible.
- Day programs will be required to change their services for adults over age 50 and serve them in groups of 8 at a reduced rate, making community participation impossible.
- All day programs and transportation services will be forced to close for the week between Christmas and New Year’s.
- Regional Centers will be given explicit control over what services are written into some IPPs and IFSPs. This violates the most fundamental element of the Lanterman Act – the right of the individual planning team to determine what is in your IPP or IFSP. This means that you no longer have a choice about the services you receive.
- A few of the specific things Regional Centers will be required to do include:
- Purchase group training for parents instead of in-home behavioral intervention services
- Purchase day care in neighborhood preschools instead of professional early intervention services in infant development programs
- Purchase transportation for adults only to the lowest cost day program available.
This language proposed by DDS goes too far. The needed cost savings can be achieved without changing the law in ways that undermine your services and your fundamental rights under the Lanterman Act.
What’s happening with the proposal for another $234 million cut?
All advocates agree that this additional reduction cannot come from community services. If further reductions beyond the $100 million cannot be avoided, the alternative proposal described below provides the Legislature with ways to find the needed savings.
There is another way!
Advocates at The Arc of California (The Arc), the California Disabilities Services Association (Cal-DSA), the Infant Development Association (IDA) and the California Supported Living Network (CSLN) have developed an alternative proposal. This proposal is reasonable and responsible. It accepts some of the 15 DDS proposals but rejects those that do outright harm to consumers, families and community services. It provides the Legislature with alternative trailer bill language and alternative methods of realizing the needed savings. This proposal has been made available to all Legislators, including decision-makers on the Budget Conference Committee. Other advocacy groups are also suggesting alternatives to the 15 DDS proposals and to the Governor’s additional $234 million cut. There is a better way!
The alternative proposal can be described in simple terms. Those who care about people with developmental disabilities in California must contact their own elected Senators and Assembly Members, the members of the Budget Conference Committee, and the Governor to tell them:
- There can be no more cuts in community services for people with developmental disabilities.
- Please support the alternative plan being promoted by The Arc and other advocates:
- Bring in all available federal dollars to offset state costs.
- Reduce spending at state-run Developmental Centers
- Reduce administration and bureaucracy, not direct services.
- Reject the DDS trailer bill language and accept the changes proposed by The Arc, Cal-DSA, IDA and the CSLN.
You can use the information below to reach the decision-makers who are now deciding your future!
- Call, email, or fax (don’t mail) short letters on your group’s letterhead to all of the following key decision-makers. All their numbers are in the 916 area code:
- Your own local state senator and Assembly representative. Be sure to give them your address so they know you live in their districts. If emailing them, please use The Arc’s web form at www.ArcCalifornia.org, “Write Your Legislators.”
- Governor Arnold Schwarzenegger, 445-2841, 558-3160 (fax), email using the web form at www.ArcCalifornia.org, “Write Your Legislators.”
- Senate President pro Tempore Darrell Steinberg, 651-4006, 323-2263 (fax), [email protected]
- Distribute this Action Alert widely.
May 29, 2009
The State Is Deciding Your Future Now!
Immediate Action Needed
The Arc of California Testimony May 29, 2009
People with developmental disabilities and families! Governor Schwarzenegger wants to cut community services by more than half a billion dollars in state and federal funds!
The Legislature will start making decisions as early as Saturday, June 6. If you do not act today, this can happen:
- Programs will close and not be replaced.
- You will lose control of what goes into your IPP.
- You will lose your right to an appeal.
Tell the Legislators and Governor in your own words:
- No more cuts in community services for people with developmental disabilities.
- Instead, support The Arc’s plan to bring in more federal funds, cut bureaucracy, and cut state-run developmental centers.
See the back of this flier for the key decision-makers you need to contact now.
Action Needed in the Coming Weeks
Stay in touch! We could win this week and still face big cuts soon as the state budget fight continues. Check www.ArcCalifornia.org for the latest information. And join The Arc’s Action E-List!
February 24, 2009
The California State Legislature has just passed a budget requiring devastating cuts to services for people with developmental disabilities.
YOUR SERVICES ARE IN JEOPARDY!
Very simply, the major cuts are:
- A 3% funding cut to all Regional Centers and all Regional Center-funded programs, scheduled to start on 3-1-09. This funding cut will impact every community program.
- An additional state-wide cut of $100 million. The State Department of Developmental Services, working with stakeholders, must find ways to save this $100 million. How this is to be done is not yet determined. But if a way is not found, the rates paid to community programs will be reduced by an additional 7.1% on September 1, 2009.
The 3% cut will be very, very difficult for local agencies to absorb. An additional 7.1% cut simply could not be managed. We must prevent this additional cut from happening.
Stakeholder Meetings are being held to ask for your input on how the cuts should be made. There will be one in Oakland on Friday, February 27 from 3:30 until 6:30 at the State Building, 1515 Clay Street. There will be one in Los Angeles on Monday March 2 from 1:00 until 4:00 at the Ronald Reagan State Building, 300 South Spring Street. Visit www.dds.ca.gov for more information or call a local agency, Regional Center or Area Board. If you care about your services attend these meetings, whether you speak or not.
This document has been prepared to help you understand the magnitude of the crisis and the options we face.
Let Your Voice Be Heard!
We recommend that you read this entire document, but we understand that some of you may want to just see our suggestions for testimony at the stakeholder meetings. If you need more information about the suggestions, you will find it later in this document.
In your testimony as a stakeholder you may want to consider supporting these 3 suggestions:
- Fully utilize every currently available method for bringing more federal money into the system.
- Assure that whatever reductions are made are done in a way that involves all 4 parts of the system:
- State Developmental Centers,
- State Department of Developmental Services,
- Regional Center Operations, and
- Regional Center Purchase of Services – these are the funds that flow to Community Service Providers.
- Given the many cuts already absorbed by the community service system and the much greater financial strength of the State Developmental Centers, achieve the $100 million savings by reducing the budgets of the Developmental Centers. Given their long history of stable funding, the Centers are in a better position to absorb the reduction without jeopardizing the health and safety of consumers.
Many family members have asked for more information to better understand the issues involved in this crisis and the options that have been suggested.
This document is an effort to provide some information about these complex issues in a clear and relatively simple way. 4 topics are covered:
1. Basics about the system.
2. Dangers to Avoid
3. How the Money Flows
3. Ideas about how cuts could be made.
Basics about the developmental disabilities system.
California's system of services for people with developmental disabilities is the only system in the United States where every person is legally entitled to the services they need. This entitlement is established by law in the “Lanterman Act” which is part of the California Welfare and Institutions Code. The Individual Program Plan (IPP) is the document that identifies the services each person is entitled to. The consumer and family are supposed to have the primary voice in what goes into the IPP.
In other states, the government can decide what services people receive and not everyone gets services. Other states have long waiting lists and people wait for years just to get any services at all.
But California's unique entitlement has created a financial dilemma: since every person with a developmental disability is entitled to services, and about 10,000 new people are eligible for services each year, the cost to the state continues to go up, even in years when state revenues are down.
The state tries to honor the entitlement, but it is difficult to do so when the budget is tight. So the state tries to cut costs by reducing funding for various parts of the system. The system has 4 main parts:
1. State Developmental Centers - these are 4 large and 2 small institutions operated directly by the State, formerly referred to as “state hospitals.”
2. Regional Centers - California has 21 regional centers around the state. Regional Centers have two cost centers:
a. Operations - including case management services and administrative functions. Regional Centers are responsible for determining eligibility for services, for providing case management (your case managers) and for many administrative responsibilities.
b. Purchase of Services (POS)- Regional Centers purchase the services included in the individual's IPP. Most of the services are purchased from local community provider agencies.
3. Department of Developmental Services (DDS) - this is the state department in Sacramento that oversees the State Developmental Centers and the Regional Centers.
4. Community Service Providers - These are the local agencies providing direct services in the community. Regional Centers purchase these services with purchase-of-service (POS) dollars.
The funds are used to pay for the direct service staff and the administration of the local agencies.
When the State has to cut back on spending, they have to decide which part of the system will be cut. They can reduce funds to operate the Regional Centers or the State Developmental Centers or the State Department of Developmental Services. Or, they can reduce funds that Regional Centers use to purchase direct services for consumers and families. There are three main ways to reduce the funds used to purchase services:
- The number of people who are allowed into the system. Costs can be controlled by re-defining eligibility criteria. If the eligibility criteria are tightened, fewer people (mostly children) are eligible for services.
- The amount of service each person receives. Costs can be controlled by giving each person fewer services.
- The amount paid to service providers for the services they provide. Costs can be controlled by paying providers less for the services they provide.
Dangers to Avoid.
As the stakeholder process unfolds and as various options to reduce funding are considered, there are several dangers in the process itself that could hurt the system deeply:
#1: Some of the options violate the IPP process more than others. These options could weaken California's precious legal entitlement to services for people with developmental disabilities.
#2: There are some influential people who may try to utilize this fiscal crisis to force the elimination of certain types of services that they do not like. Some may want to eliminate adult day programs or work activity programs because they see them as "segregated." Some may want to eliminate more expensive services such as Supported Living in order to reduce costs. These options are very offensive to the individuals who are currently receiving the services and to those who want them. Such options would cause great disharmony in the community and would be extremely disruptive and damaging to the individuals currently receiving them.
#3: There is a potential for individual Regional Centers to implement cost control measures independently, outside the IPP process, with no appeal rights for consumers and families. This appears to be happening already in some areas, for example replacing existing programs with other services that are cheaper and less intensive. This will result in a further reduction in service quality and an even greater inconsistency of services from one Regional Center to another than is already the case.
#4: The local agencies providing community services have been underfunded for many years. Many organizations are barely surviving. The impact of each individual option on the overall financial stability of these agencies must be considered carefully in order to avoid the collapse of the community system.
How the money flows.
Right now there are about 230,000 children and adults being served by the Department of Developmental Services throughout California. The total budget for the system is around $4 billion per year. Here is a rough idea of how the money is spent:
|
ANNUAL BUDGET |
# of People Served |
Ave. AnnuaL Cost Per Person Served |
Department of Developmental Services |
$30 Million |
No Direct Services |
N/A |
State Development Centers |
$700 Million |
Direct services for 2,700 |
$270,000 |
Regional Center Operations |
$500 Million |
Provide Case management for 227,000 |
N/A |
Community Service Providers |
$3.2 Billion |
Direct services for 227,000 |
$14,000
(varies depending on how average is calculated) |
When looking at the chart above it is helpful to remember these things:
California's spending per person on individuals with developmental disabilities in the community (that is, those not in the developmental centers) is much lower than in other states.
- Using the measure of "spending per $1000 of state personal income", out of the 50 states, California ranks 34th in spending per person.
- Using the measure of "amount of federal funds spent per person for people with developmental disabilities", California ranks 48th out of the 50 states.
These figures show that California's spending per person in the community is very low, even though California has a much higher cost of living than most other states. The reason why our spending is so low is because we serve everyone who is eligible for services. In other states they only serve some of the people who are eligible while others wait for years on waiting lists.
Remember that in California the amount spent per person in the community varies greatly. The average figure of $14,000 per person assumes that all eligible consumers are receiving services. But many need only case management and have no services purchased for them. The average can be as high as $45,000 depending on how it is calculated.
There is a wide range of types of services purchased for individuals in the community. Some people with very great needs are served at a high cost, but many are served at very low costs. Many people have different opinions about whether some services are as important, or as good, as other services. But because of the way California's law is written the IPP has been the place where each individual and family answers these questions for themselves.
For the last 30 years, California has controlled its overall spending by keeping the rates paid to community service providers very low. This has been very difficult for community service providers and has negatively impacted the quality of services. The biggest challenge for community service providers has been attracting and retaining qualified staff because the low rates result in very low wages.
In recent years, the state has also implemented a wide variety of additional cost control measures for Regional Centers and community service providers that have cut hundreds of millions of dollars and resulted in a badly underfunded, inadequate and unstable community service system. The $100 million cut now being required will be a devastating additional blow to the community service system.
Ideas about how cuts could be made.
The DDS report called "Controlling Regional Center Costs" lists 23 options for new ways to save money. (You can read the report at www.dds.ca.gov). And there are many other options currently being discussed around the state. Most people agree that the ideas in the report are harmful to people with developmental disabilities and are not desirable.
Most of these options are complex, but there are common themes that run through many of them. Below is a summary of the options grouped into general categories by these common themes. You may want to testify about which of these options are the most or least offensive to you:
- Tighten the definition of who is eligible for services (limiting the number of people who are allowed into the system).
- Require families to contribute towards the cost of services using a "sliding scale" to determine how much.
- Give Regional Center administrators more control over what kind of services will be available in their area or how much service an individual receives.
- Give Regional Center administrators more control over what services are written into individual IPPs.
- Put a "cap" on the number of people who can be served in the system. This means establishing waiting lists for services.
- Require Regional Centers to purchase the lowest cost services available, regardless of the consumer or family’s choice of service provider.
- Reduce the amount paid to families when they arrange for or provide services themselves.
- Further reduce the amount paid to community service providers for their services.
- Further reduce the amount of money Regional Centers receive for their operations (e.g., case management).
- Require more administrative "efficiencies" at Regional Centers and/or consolidate some Regional Center operations functions.
- Reduce the amount of money the State Department of Developmental Services receives for their operations.
- Reduce the amount of money the State Developmental Centers receive.
- Reduce the amount of money that Regional Centers and DDS use for contracted services (e.g., client rights advocacy).
- Eliminate services that are seen by some policy makers as being outdated.
- Eliminate services that are seen by some policy makers as being too expensive.
After reading the information in this document you may have other suggestions to offer.
We want to refer you again to suggestions we made on page 2. We believe these are much less harmful than the 15 listed above.
Again, please remember that this situation is unprecedented and critical and it is vitally important for everyone who cares about people with developmental disabilities to participate in this process!
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