* Report On Controlling Regional Center Spending

* "Comprehensive" List of Possible Cuts & Savings

* Supported Living Proposed Regulations In December

* Self Directed Services Proposed Regulations In Dec

* Closure of Agnews Still on Schedule for June 2008

 

SACRAMENTO (CDCAN)  -  Under the shadow of California's budget crisis and a shortfall projected at $10 billion next year, top officials from the Department of Developmental Services said Tuesday (November 27th)  during a CDCAN Townhall Telemeeting that a "comprehensive"  report to the Legislature that identifies ways for controlling spending and growth, including a  list of possible new spending reductions is "being developed" though has not yet been released.  The Department of Developmental Services is required to submit the controversial report to the Legislature as part of the 2007-2008 State Budget passed last summer and is separate from the regular budget process where departments and agencies are moving forward their proposals to the Governor for next year's budget.

 

Report Will List All Options - No Date On When It Will Be Submitted

While he could not say when the report would actually be submitted to the Legislature, Hutchinson said the report would identify all possible options to control regional center funded spending and the impact of each option.

Hutchinson, who was appointed Chief Deputy Director last July, said that the report is "separate and apart" from the regular process of the State budget for next year. He did say however that some ideas in the report might also be reflected in the Governor's proposed budget on January 10th, in part because the report needs to identify existing cost containment measures already in place.  The Legislature approved various cost containment measures, including freezing levels of State reimbursements to community-based providers that impact worker wages, as part of the 2002-2003 and 2003-2004 State Budgets. Virtually all of those cost containment measures have been continued since then, though in the 2006-2007 Budget, the Governor did propose and the Legislature approved one time 3% rate increases for many regional center funded community-based providers and about $19 million to help provide one-time increases in worker wages for specific providers. 

 

The report will identify spending reduction proposals, referred to as "cost containment measures" previously proposed and not enacted or currently in place and also new and different ideas that could control spending.  The report would not actually contain recommendations Hutchinson said, but identify options or ideas for the Legislature to consider. [CDCAN note: CDCAN held a special conference call in September on this issue. See earlier CDCAN reports on the budget in July, and also August and September on this issue, at www.cdcan.us]

 

The report  was a surprise requirement that was included in a budget related bill - referred to as a budget "trailer bill"  (AB 203) that was agreed to by Assembly Republicans and Democrats in July. The bill, which included many other health budget issues, was later approved by Senate Democrats and Republicans in August and signed by the Governor.  [see CDCAN website for copy of the bill at www.cdcan.us]

The delay in submitting the report is in part due to the 52 day budget standoff that didn't end until August 21, 2007.  Hutchinson said that the Department of Developmental Services has staff who are working specifically on getting the report ready. 

 

The work on the report is a "fairly comprehensive effort" Hutchinson said during the CDCAN Townhall, and that the Department of Developmental Services is "trying to get this through as quickly possible" and  "have dedicated staff to work on the report". 

 

DDS Spending and Report Brought Up At Senate Budget Hearing

The issue of the report and the spending for developmental services also came up in an informational hearing on the State budget held earlier on Tuesday morning, November 27th by the Senate Budget and Fiscal Review Committee, chaired by Sen. Denise Ducheny (Democrat - San Diego). 

Republican and Democratic Senate Budget Committee members questioned the Governor's Department of Finance Deputy Director Vince Brown on the delay in receiving the report.  Brown promised to get the report as soon as possible to the Legislature.  

 

Brown also said during the hearing that while no final decisions have been made regarding proposals to cut spending, the Governor will be considering options to possibly propose mid-year cuts to the current State Budget now in place. 

As a comparison, previous major mid-year reductions were proposed by Governor Davis for the 2002-2003 State Budget, and by Governor Schwarzenegger for the 2003-2004 State Budget when projections of a budget shortfall were also enormous.  Most of those proposals were rejected, though some were enacted by the Legislature controlled by the Democrats. 

 

HIGHLIGHTS OF 11/27  TOWNHALL TELEMEETING

* The following were the main issues covered during the CDCAN Townhall Telemeeting, moderated by Marty Omoto and Nancy Chance, with a response panel made up of persons with disabilities, family members, and providers.

* The townhall telemeetings are open to anyone and accessed via toll free phone lines allowing people with disabilities, mental health needs, family members, seniors, workers, community organizations and advocates, local and state policymakers to connect together - many who may not have the resources or ability to travel to a specific physical meeting location in Sacramento or elsewhere. 

* The townhall telemeetings were first started by CDCAN in 2003 and since then have attracted thousands of people, with a single townhall having a live audience anywhere from 150 to over 500 people. 

* The November 27th townhall telemeeting attracted well over 240 persons across the State, with hundreds more listening to the recorded audio version on the CDCAN website (www.cdcan.us). 

* Townhall Telemeetings focusing on Medi-Cal and the federal Deficit Reduction Act impacting Medi-Cal is scheduled for December 4 at 1:00 PM, and a townhall on In-Home Supportive Services (IHSS), and SSI/SSP us scheduled for December 13th also at 1:00 PM.  See CDCAN website on how to access and for more information.

 

Report Required by AB 203

* Hutchinson said that  the projected growth in spending for the Department of Developmental Services, as cited in the recent Legislative Analyst report on the State Budget, is projected at 8.9% every year over the next five years, while State revenues are projected to grow at 7.7% over that same time period.  Hutchinson said that the 8.9% "is the largest percentage growth  for population based programs in health and social services" and as a result there is a "bright light" on how "we operate and administer the programs and services" under the Department of Developmental Services, which oversees the 21 regional centers and also 5 State owned and operated developmental centers and 2 smaller health facilities. 

* Hutchinson said that "the expectation [from the Legislature] is that we will be looking at the drivers of these costs".  * According to Hutchinson the budget related legislation - called a budget "trailer bill" because it follows or trails the main budget bill -  required that the Department of Developmental Services "...develop and submit a report to the Legislature that identifies cost containment or ideas that have been implemented or could be implemented, basically a laundry list of ideas that could be considered or evaluated for the purpose of controlling costs of the Department. That report is still in the development stage, and I can't really talk too much about that at this point."

* He said that the Department of Developmental Services is working "diligently" on the report adding that  "...what I mean by a 'bright light' on our system [is] that we are going to have to be accountable why our program is growing at the rate it is growing compared to other population based programs."

* Hutchinson said that the Schwarzenegger Administration has made it clear the State budget for next year will be "difficult"  and that "we will examine various options looking at various cost reduction options." 

* He made it clear however that  the Administration has not made any final decision on any proposal and that any decision won't become public until January 10th next year, which is the date the State Constitution requires the Governor to submit a proposed budget to the State Legislature. 

* Hutchinson, on explaining what the report required by AB 203 will contain said that it will be "fairly comprehensive" and will contain a "variety of ideas" that have been already implemented but also listing what has been tried or attempted unsuccessfully and that the report will also address the potential impact for each idea. 

* Hutchinson said he could not yet say when the report would be available and released to the Legislature.

* He said that the governor's commitment is "to deliver a balanced budget" adding that "when forecasts are projecting decreased revenues and creating a significant gap, the administration takes that very seriously"

* A parent with an adult son with autism asked if  the report "...would be a laundry list what has been tried...and no recommendations in it?"  Hutchinson replied that AB 203 required that the report contain a "list of ideas and concepts associated with cost containment and only asked for impacts".  

 

Note: The Department of Developmental Services operates and staffs five facilities called "Developmental Centers" of "DCs" located in San Jose (Agnews Developmental Center, slated for closure), Costa Mesa (Fairview DC), Pomona (Lanterman DC), Porterville (Porterville DC) and Eldridge (Sonoma DC) and two smaller facilities located in Yuba City and Cathedral City.  The five developmental centers are licensed and certified as Nursing Facility (NF), Intermediate Care Facility/Mentally Retarded (ICF/MR) and acute care hospitals. The two smaller community facilities are licensed as ICF/MR facilities.
About 200 persons with developmental disabilities now remain at Agnews, according to Department of Developmental Services data, compared to 800 persons who lived there in 1994.

STATUS OF OTHER FACILITIES

AGNEWS CLOSURE DATE

Agnews Developmental Center final closure of the facility in San Jose, is still slated for June 30, 2008 according to Julia Mullen.

TRANSITION INTO COMMUNITY:

* Julia Mullen reported that 61 homes in the Bay Area have been purchased for people who transition out of Agnews. By the end of December, according to Mullen, 27 of those homes would have been remodeled and ready for people to move into.  The numbers of people in each home would vary, depending on how the home is used (3 persons with "significant behavior challenges

* Homes - 61 homes have been purchased.  By the end of December, Mullen said that 27 of those 61 homes would have been remodeled and ready for people to move into those homes. Each house would have 3 to 5 persons depending on the type of home and the needs of the person.  [CDCAN Note: for more details on the housing and closure and transition plans, see May 2007 Department of the Developmental Services to the Legislature on the CDCAN website]

QUESTIONS ON RELATED AGNEWS ISSUES

* A woman from Redwood City had a question about her 56 year old brother who is a resident of Agnews and whether and that she has been encouraged to apply to be in the adoption or foster care program to help support him when he moves out.  Julia Mullen said both programs were for children and suggested she check with her brother's social worker at Agnews regarding conservatorship and how she can get help in supporting her brother in her own home.

* Several persons raised what they said are "major" concerns about the impact of workers in community-based organizations paid lower wages and benefits compared to the closure plan that allows State workers from Agnews to continue to provide supports to people moving out of that facility into the community. 

* As authorized by State legislation and part of the approved closure plan, certain State employees from Agnews "will retain classification and state pay...[and] retain all other aspects of state employment" according to Mark Hutchinson but said that the program "does not require [community-based] providers to select state staff"  and that those providers would have to decide how they participate in that program.  He said that there are 200 State staff positions associated with the State staff program.

 HOUSING EFFORT OF THE DEPARTMENT

* Mullen said that the Department of Developmental Services is working with other State departments and advocates on what opportunities there are for housing for persons with developmental disabilities. 

COMMUNITY PLACEMENT PLAN

* Mullen said that the Department of Developmental Services recently issued housing guidelines to the 21 regional center as it relates to Community Placement Plans.  The Community Placement Plans are meant, according to Mullen, to provide a plan to move people out of development centers or to develop community resources so people don't need to go into Developmental Centers, referred to as "deflection" within developmental services. 

[CDCAN Note: it is referred to as "diversion" by other advocates and policymakers when dealing with people with other disabilities and mental health needs and seniors  in other types of health or medical facilities. 

* Mullen said that the housing guidelines outline how regional centers can actually acquire permanent housing either through ownership by a separate non-profit organization or "deeply subsidized" rentals as part of the Community Placement Plan.

* The guidelines are not currently available to the general public or posted on the Department of Developmental Services website but in response to requests during the Townhall Telemeeting, Mullen said she didn't she why it could not be available saying "...we just need to bundle it up and sent it to our IT [Information Technology] people to put it on our website".

* Related to other postings on the Department of Developmental Services website, including requests made during the Townhall Telemeeting about the posting of other reports and guidelines including regional center performance contract information and data, Mark Hutchinson said "we will look at that".

* In response to a question of how people with developmental disabilities are "deflected" from going into a developmental center, Mullen said that  regional centers determine what their needs are through an analysis that includes reviewing the trends in admitting people into developmental centers and looking at "those for whom significant case management resources are needed because of the number of crisis that a person might have in maintaining their life in the community".

*  Related to the issue of unmet need of accessible and affordable housing and also employment, a question was asked by the Townhall Telemeeting moderator "As a follow-up to the housing issue, does the Department [of Developmental Services] have any numbers of what the department views as the unmet need for affordable and accessible housing for persons with developmental disabilities? We [previous CDCAN Townhall Telemeeting] actually asked this question of Terri Delgadillo [Department Director] a couple of months ago.  If we don't know need - we don't know what success is in meeting that need. Out of the 220,000 who receive or are eligible for regional center funded services, out of that number, what number are we looking at in terms of housing, and also related to that, what number are we looking at in terms of employment - people who can be employed, people who want to work and for whatever reasons there are not opportunities to work. I don't know if the department or the State of California have those numbers at all or if its available?"

Julia Mullen responded that "we don't have that - those numbers. I think it is safe to say for adults with developmental disabilities whose income is typically Supplemental Security Income [SSI] and given the  high price of housing in California there is an incredible unmet need...In terms of employment , we are looking at data. There is about 10% of adults in our service delivery system who are employed.  When you talk with consumers, next to transportation, getting a job is something that is of keen interest. So I think we can also be pretty safe to say that there is a great number of folks with developmental disabilities who want to be employed who are not employed".

 

Adoption Assistance Program (AAP) Update

Note: Adoption Assistance Program is  funded with federal and state dollars and includes a part of the program that is overseen by two state departments [Department of Developmental Services and the Department of Social Services] to assist families to adopt or provide foster care of children with developmental disabilities.  The issue became highlighted last summer as part of the 2007-2008 State Budget when significant changes to how that part of the program would operate and be funded were proposed by the Schwarzenegger Administration in mid-May. Many advocates of the families who provide foster care or have adopted children with developmental disabilities under the Adoption Assistance Program raised major concerns on the changes and were critical of what they view as "last minute" changes that gave them little opportunity to comment on. 

UPDATE ON ADOPTION ASSISTANCE PROGRAM CHANGES

* Mullen said that Adoption Assistance Program provides a funding in a rate that is paid to families to help pay for the additional needs in care and supervision for that child.

* Mullen said that as part of the 2007-2008 State Budget (in a budget related bill or "trailer bill") provisions were included to increase the rate of payment to those families who provide foster care or have adopted children with developmental disabilities of $2,600 per month, which she said is a higher rate than given to families who adopt or provide foster care for children without disabilities. 

* Mullen told the Townhall Telemeeting audience that if a child with developmental disabilities requires "extra ordinary care and supervision needs" a county can provide a supplement to the rate paid to the families "of up to $1,000 based on objective criteria".  She said that this "objective criteria" is being currently being developed by the Departments of Developmental Services and the Department of Social Services along with stakeholders, including representatives of families. 

* Mullen said the changes to the Adoption Assistance Program are a "two-fold benefit" because in some areas of State there was "confusion" over what the rate  paid to the families was supposed to cover. Mullen said that "...in some areas [of the State]  it was seen as something that was supposed to cover respite and day care - other services typically covered by regional centers. But the law is now clear, that a regional center is not supposed to look at that rate as anything but covering typical family care and supervision of the child. So regional centers will purchase services not related for caring of the child."  

* She said that the changes provides "clarifying language" that she believes will be "good for families" that will mean an increased rate to families who adopt or foster a child with developmental disabilities, Mullen said that she hopes that it will mean an increase in numbers of children with developmental disabilities  who are adopted or placed into foster care. 

* CDCAN Note: the changes remain controversial for many of the families, who are concerned about a reduction in funding that their children need and are worried on how the counties and regional centers implement those changes.  Regional centers and counties are also concerned on how the details for implementing the changes - including "objective criteria" are decided on by the two State agencies overseeing the Adoption Assistance Program.   CDCAN will be scheduling soon a townhall telemeeting and conference calls on this issue. 

 

Special Education - Impact of Elimination of "Stay Put"

Note: The reauthorization in December 2004 of the federal "Individuals with Disabilities Education Act" (IDEA) included a provision that policymakers believed eliminated what is referred to as the "stay put" requirement for school districts.  The issue involves what happens to a child with special needs between the ages of 3 and 5 as they move from one program to another that are overseen by different agencies and state departments.

The "stay put" requirement generally means if there is a dispute between a school district in continuing services a family wants continued in a school setting that their child with special needs received under the Early Intervention program (called "Early Start"in California and locally implemented by regional centers and overseen by the Department of Developmental Services), the school district must continue those services until the issue is resolved in fair hearing. 

Most policymakers in the schools and at the State level believe that the new version of IDEA as passed in 2004 removes and eliminates the "stay put" requirement and point to recent federal regulations.  

The issue came up in California when the requirement was not included in AB 1663 by Assemblymember Noreen Evans (Democrat - Santa Rosa) which aligned state law with the changes to the federal special education laws as required by the 2004 IDEA reauthorization. 

Though passed overwhelmingly by both houses and signed by the Governor in October, Assemblymember Sally Lieber (Democrat - Mountain View) raised the concerns on the Assembly Floor before the final vote, about the elimination of the "stay put" provision in California law and received assurances from Evans and others that the issue would be addressed and resolved when the Legislature reconvenes in January.

ROLE OF DEPARTMENT OF DEVELOPMENTAL SERVICES ON THIS ISSUE

* Question was asked by a parent advocate asking what the regional centers (and the department) plan to do about the impact of elimination of the "stay put" provision for special needs children.

* Julia Mullen said that "I do know that a number of school districts after IDEA was reauthorized quit doing 'stay put'. If it has an effect, it will vary within school districts by regional centers. "  She indicated that the Department of Developmental Services is following the issue but that she is "...not sure if there will be an impact because most of the larger districts quit doing 'stay put' years ago.  We did not see an increase in services as a consequence to that."

* CDCAN will be scheduling a series of townhall telemeeting and events on this and other special education related issues. 

 

 

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