Paraprosdokians

This made me chuckle:

A paraprosdokian is a figure of speech in which the latter part of a sentence or phrase is surprising or unexpected in a way that causes the reader or listener to re-frame or reinterpret the first part. It is frequently used for humorous or dramatic effect, sometimes producing an anticlimax. For this reason, it is extremely popular among comedians and satirists.

"Where there's a will, I want to be in it," is a type of paraprosdokian.

I asked God for a bike, but I know God doesn't work that way, so I stole a bike and asked for forgiveness.

Do not argue with an idiot. He will drag you down to his level and beat you with experience.

Going to church doesn't make you a Christian any more than standing in a garage makes you a car.

The last thing I want to do is hurt you, but it's still on the list.

Light travels faster than sound. This is why some people appear bright until you hear them speak.

If I agreed with you, we'd both be wrong. (I have to remember this one)

We never really grow up, we only learn how to act in public.

War does not determine who is right - only who is left.

Knowledge is knowing a tomato is a fruit; Wisdom is not putting it in a fruit salad.

The early bird might get the worm, but the second mouse gets the cheese.

Evening news is where they begin with 'Good evening', and then proceed to tell you why it isn't.

To steal ideas from one person is plagiarism; To steal from many is research.

A bus station is where a bus stops. A train station is where a train stops. On my desk, I have a work station.

How is it one careless match can start a forest fire, but it takes a whole box to start a campfire?

Some people are like Slinkies ... Not really good for anything, but you can't help smiling when you see one tumble down the stairs.

Dolphins are so smart that within a few weeks of captivity, they can train people to stand on the very edge of the pool and throw them fish.

I thought I wanted a career, turns out I just wanted pay checks.

A bank is a place that will lend you money, if you can prove that you don't need it.

Whenever I fill out an application, in the part that says "If an emergency, notify:" I put "DOCTOR".

I didn't say it was your fault, I said I was blaming you.

I saw a woman wearing a sweat shirt with "Guess" on it...so I said "Implants?"

Why does someone believe you when you say there are four billion stars, but check when you say the paint is wet?

Women will never be equal to men until they can walk down the street with a bald head and a beer gut, and still think they are sexy.

Why do Americans choose from just two people to run for president and 50 for Miss America?

Behind every successful man is his woman; behind the fall of a successful man is usually another woman.

A clear conscience is usually the sign of a bad memory.

You do not need a parachute to skydive. You only need a parachute to skydive twice.

The voices in my head may not be real, but they have some good ideas!

Always borrow money from a pessimist. He won't expect it back.

A diplomat is someone who can tell you to go to hell in such a way that you will look forward to the trip.

Hospitality: making your guests feel like they're at home, even if you wish they were.

Money can't buy happiness, but it sure makes misery easier to live with.

I discovered I scream the same way whether I'm about to be devoured by a great white shark or if a piece of seaweed touches my foot.

Some cause happiness wherever they go. Others whenever they go.

There's a fine line between cuddling and holding someone down so they can't get away.

I used to be indecisive. Now I'm not sure.

When tempted to fight fire with fire, remember that the Fire Department usually uses water.

You're never too old to learn something stupid.

To be sure of hitting the target, shoot first and call whatever you hit “the target”.

Nostalgia isn't what it used to be.

Some people hear voices. Some see invisible people. Others have no imagination whatsoever.

A bus is a vehicle that runs twice as fast when you are after it as when you are in it.

Change is inevitable, except from a vending machine.

Regional Centers and audits

From ResCoalition:

In March of this year, the legislature passed SB74. This bill was intended to find additional savings in an effort to reduce the budget deficit. Within this bill there five (5) trailer bills in addition to specific savings. One trailer bill was titled Regional Center Audits. Within this trailer bill were provisions that mandate vendors to also get audits in some cases. Since this trailer bill has created a great deal of confusion and frustration amongst the vendor community this is being written to clarify what the new requirements are. First, you are only required to get a financial audit IF you receive more than $500,000.00 in payments from one or more regional centers a year. This means total gross income from one or more regional centers, not just more than 500,000.00 per vendorized program. It is important to remember that it is regional center payments NOT room and board payments. This means that if the regional center is payee, you don’t include the SSA/SSI payments in calculating your threshold. You also exclude any money paid by the RC for P&I.

If you have gross revenues from one or more regional centers you must get a financial audit from an independent CPA, and must be done in accordance with the American Institute of Certified Public Accountants. This means they’ll look at your accounting practices and methods, and your procedures for recoding, classifying, and summarizing transactions and accumulating information. If yours is a nonprofit you should already be doing annual independent financial audits. As a result, you wouldn’t be required to do another. You can turn in that one.

If you have gross revenues from one or more regional centers between 250,000 and 500,000 (remember excluding room and board payments and no P&I), you are not required to do a financial audit. Instead you are required to get a financial review. This is a less cumbersome (and cheaper) process.

Now there is an interesting issue surrounding this mandate. There is no legal requirement for when the audits must be completed. By this we mean there are no timelines for completion. This means that a Regional Center cannot cite you for failing to get an audit done on time – there is no time requirement. We appreciate this will be a contentious issue because RC’s will attempt to give us deadlines. However, these deadlines are not enforceable and they cannot penalize us for failing to comply.

If you have any thoughts or questions please don't hesitate to throw them back. If you have a question, I'd bet at least 30 other people are thinking the same thing so get back to us.

Since we're talking about XB/SB74 trailer bill language, there is a section that now requires negotiated rate programs (if you are funded under the ARM rate structure, you are not negotiated rate) to spend at least 85% of funding on direct service expenditures. If more information on this is of interest to you, please let us know.

Boyd Bradshaw

President ResCoalition

Total Care Exceptions and Hospice Care

Here's the policy:

Health and Safety Code Section 1569.73 requires facilities to obtain a Hospice Care
Waiver from the California Department of Social Services if they wish to retain clients
receiving hospice care services. Residents receiving hospice care services may
eventually require “total care,” which is a prohibited health condition as outlined in
California Code of Regulation (CCR), Title 22, Section 87615(a)(5).

Total care isdefined as a condition where residents depend on others to perform all of their activities of daily living, see (CCR) Title 22, Section 87459 Functional Capabilities.
A licensee must request a total care exception to allow a resident to be retained in the
Residential Care Facility for the Elderly (RCFE) if the resident’s condition requires total
care. The requirements for requesting this total care exception are found in California
Code of Regulation (CCR), Title 22, Section 87616.

To see the new and improved procedure, to to
http://ccld.ca.gov/res/pdf/10rcfe04.pdf

CA Budget passed

CDCAN Information:

LEGISLATURE PASSES BUDGET BY MAJORITY VOTE - HEADS TO GOVERNOR

SACRAMENTO, CALIF (CDCAN) [Last updated 06/28/2011 09:19 PM] - The California Legislature passed, on a majority vote, the main budget bill for 2011-2012, SB 87 that did not rely on any votes from Republicans.

The Assembly voted to pass the main budget bill after brief debate by a vote of 51 to 25 just after 6:30 PM.. The State Senate followed but had alittle more difficulty in rounding up the needed 21 votes among Democrats to pass it. The first roll call taken at around 7:25 PM, failed to win the necessary 21 votes to pass, but subsequently passed at 9:19 PM by a vote of 21 to 19.

SB 87 was sent immediately to the Governor for his approval, which he is expected to sign either this evening or tomorrow morning.

Both houses also approved 6 of the 7 budget trailer bills. As of 09:19 PM both houses are waiting for the one remaining budget trailer bill dealing with education finance that the State Senate has still not received from the Legislative Counsel for members to review and vote on. That trailer bill is expected to be delivered to the Senate at around 9:45 :PM and both houses are expected to take up the bill and pass shortly after that, wrapping up their work on all the budget bills. .

State Employees Getting Raises?

In response to information that Psych Techs will get a raise this year, while most other services take cuts, this information is adapted from a bulletin board. Raises some pretty interesting questions, doesn't it?

How can the state afford to increase pay to state employees while so many state funded health and human service programs in our communities are in danger of collapse?

I have talked about the DDS budget with many consumers and family members and there is one statistic that concerns them more than any other. How can it be that the average cost per individual served at the State Developmental Centers has been allowed to reach $346,000 per person per year? It’s true that as population declines, the cost per person rises, but at some point it becomes ridiculous, and we are long past that point.

And it never stops. Of all the destructive things included in the Governor’s 2011-2012 budget, there is one item that few people have noticed. In August, 2010, the Legislature approved a new contract for the California Association of Psychiatric Technicians (CAPT). That contract raises the TOP of the wage scale for Psych Techs at the Developmental Centers by 5% - effective January 1, 2012. This means that the direct service staff in the Developmental Centers, who are already at their highest level of earnings, will get an even bigger share of the funds available for the developmental disabilities system. Meanwhile, community-based services are starving.

Consider this: The average annual cost to serve an individual at a State Developmental Center in 2011-12 will be approximately $346,000. The best estimate I've heard of the average annual cost to serve individuals in the community who have moved out of a Developmental Center is $110,000. Just a few years ago the average cost at the DCs was about $249,000. If the DCs were required to limit their average annual cost per consumer to $249,000, a savings of $97,000 per individual would be realized. Since there are approximately 1800 individuals currently residing in California's DCs, the annual savings to the State would be $174 million. That is the exact amount the legislature is requiring to be saved from community services in the coming year.

When asked how direct service staff in DCs could possibly be getting raises at this particular moment, we are told that these raises make up for other concessions they’ve made. Concessions with an incredible benefit package, which so many community services are simply not able to provide.

Your thoughts?

Community Care Licensing - Key Indicators

Due to the ongoing fiscal crisis in California, CCLD has lost 30 percent of the staffing resources necessary to complete mandated inspections. To increase health-and-safety protections for those in care, CCLD is implementing a program to increase the current frequency of inspections and implement Key Indicators Compliance Reviews. The key indicators are a shortened version of the larger set of regulations. They are "key" in that they measure and predict compliance with the full set of regulations. This does not eliminate the licensee's responsibility to be compliant with all regulations. Nor does it mean that a facility will not be cited for noncompliance with regulations not listed as key indicators.

Check out the key indicators:

http://www.myccl.ca.gov/res/docs/ARF-kit.pdf
http://www.myccl.ca.gov/res/docs/RCFE-kit.pdf
http://www.myccl.ca.gov/res/docs/GH-kit.pdf

And how can you stay in compliance?
Community Training Connection's Regulatory Update Subscription AND
Compliance Connection - regulatory compliance and best practices - with people with over 100 total years of industry experience.

http://www.communitytrainingonline.com

Budget thoughts - Regional Centers

I have been writing to the Governor, legislators, and talking to anyone who will listen (and many who didn't want to listen at all) about this situation - which I hear about almost weekly from clients.

Just got off the phone with the administrator of a regional center-funded residential facility that has 4 clients, 4 service coordinators, 1 quality assurance staff, and a case management liaison. Each of those regional center staff visit this facility at least 4 times a year (and the service coordinator sees each client quarterly if they are on different visit cycles based on their birthday month), bringing the grand total of regional center visits to at least 12 times per year, plus at least 1 CCL visit. And most of the residents/consumers/clients in these facilities attend a day program, so there are additional people who might notice changes that would require follow up (if you accept the assumption that the monitors are assuring people's health and safety in facilities). In sharp contrast to RCFEs, who can go up to 5 years without seeing a monitoring person. I understand that the CCL part has to do with Medicaid Waiver and an agreement with Department of Health Services, but really??????? Is it just me?

My letters to legislators address the massive inefficiencies in our systems. Assigning one person to each facility still means quarterly visits which can be done at a fraction of the current cost to the operations budget. And might begin to address the disparity between expenditures for regional center operations and purchase of services. Residential providers are expected to provide routine transportation without additional compensation to their current rates. The rates were set when gasoline was somewhere around $1.25 (according to CA Energy Commission). RC staff have had been reimbursed at progressively higher rates since the residential rates were set. And whose rates of pay have been decreased by over 4%? And who will have to pay back funds from July 2010? Hmmm.......

I know people read these posts. I know why no one responds in writing. I wish you would, though.

Argh…..

Soles 4 Souls at Sports Chalet

In response to the devastating earthquake and tsunami that hit Japan, Soles4Souls has once again reached out to Sport Chalet to ask for help collecting gently worn shoes.

During our last Soles4Souls shoe drive, you collected and brought in over 1.3 million pairs of shoes to help those in need in Haiti.

Your help is needed again.

Sport Chalet Locations will be accepting gently worn men's, women's, and kids' shoes through Sunday, April 10th.

All shoes collected will be sent directly to Soles4Souls for distribution in Japan and other areas of need.

So take a look in your closet, under your bed, and out in the garage...

Go next door and ask your neighbor if they have shoes they'd like to donate too.

Then just stop by your local Sport Chalet and drop them in the box.

We thank you so much!

=========

If you are attending classes on April 9 in Torrance or April 10 in Granada Hills, bring shoes. We will drop them off at Sport Chalet by the April 10th deadline. It's all good.

Trailer Bill Language

This information is from ResCoalition, an organization representing residential service providers who serve people with developmental disabilities.

The governor signed into law SB74 which finalized the DDS budget. What this means to residential service providers is the following:

In addition to the trailer bill language listed below, there was a provision of SB74 that mandates that DDS create and present best practices to the legislature by May 15th. These best practices replace the Purchase of Services Standards that was previously required. It is expected however that they will generally be the same.

4620.3. (a) To provide more uniformity and consistency in
the administrative practices and services of regional centers
throughout the state, promote appropriateness of services,
maximize efficiency of funding, address the state budget deficit,
ensure consistency with Lanterman Act values, maintain the
entitlement to services, and improve cost-effectiveness, the
department, in collaboration with stakeholders, shall develop best
practices for the administrative management of regional centers
and for regional centers to use when purchasing services for
consumers and families. Developing regional center administrative management
best practices, the department shall consider the establishment of
policies and procedures to ensure prudent fiscal and program
management by regional centers; effective and efficient use of
public resources; consistent practices to maximize the use of federal
funds; detection and prevention of fraud, waste, and abuse; and
proper contracting protocols.

There are NO PROVISIONS FOR FUNDING TO BE CUT FURTHER. The outstanding $174 million dollars is attached to DDS's best practices/purchase of service (POS) standards. There is NO provision to cut funding further if adequate savings is not achieved through the best practices/POS standards process.

Trailer bills were passed as part of this bill to "save 191 million dollars". These trailer bills impact us in the following ways . . .

4629.7. (a) Notwithstanding any other provision of law, all
regional center contracts or agreements with service providers in
which rates are determined through negotiations between the
regional center and the service provider shall expressly require
that not more than 15 percent of regional center funds be spent on
administrative costs. For purposes of this subdivision, direct service
expenditures are those costs immediately associated with the
services to consumers being offered by the provider. Funds spent
on direct services shall not include any administrative costs.
Administrative costs include, but are not limited to, any of the
following:
(1) Salaries, wages, and employee benefits for managerial
personnel whose primary purpose is the administrative management
of the entity, including, but not limited to, directors and chief
executive officers.
(2) Salaries, wages, and benefits of employees who perform
administrative functions, including, but not limited to, payroll
management, personnel functions, accounting, budgeting, and
facility management.
(3) Facility and occupancy costs, directly associated with
administrative functions.
(4) Maintenance and repair.
(5) Data processing and computer support services.
(6) Contract and procurement activities, except those provided
by a direct service employee.
(7) Training directly associated with administrative functions.
(8) Travel directly associated with administrative functions.
(9) Licenses directly associated with administrative functions.
(10) Taxes.
(11) Interest.
(12) Property insurance.
(13) Personal liability insurance directly associated with
administrative functions.
(14) Depreciation.
(15) General expenses, including, but not limited to,
communication costs and supplies directly associated with

This bill would make certain persons or entities that have been
convicted of prescribed crimes or have been found liable for fraud
or abuse in any civil proceeding, or that have entered into a
settlement in lieu of conviction for fraud or abuse in any
government program, within the previous 10 years, ineligible to
be regional center vendors, and would require the department to
adopt related emergency and nonemergency regulations. The bill
would require the State Department of Social Services and the
State Department of Public Health to notify the department of any
administrative action, as defined, initiated against a licensee serving
consumers with developmental disabilities

4640.6. (a) In approving regional center contracts, the
department shall ensure that regional center staffing patterns
demonstrate that direct service coordination are the highest priority.
(b) Contracts between the department and regional centers shall
require that regional centers implement an emergency response
system that ensures that a regional center staff person will respond
to a consumer, or individual acting on behalf of a consumer, within
two hours of the time an emergency call is placed. This emergency
response system shall be operational 24 hours per day, 365 days
per year.

4648.12. (a) The Legislature finds and declares that under
federal and state law, certain individuals and entities are ineligible
to provide Medicaid services.
(b) An individual, partnership, group association, corporation,
institution, or entity, and the officers, directors, owners, managing
employees, or agents thereof, that has been convicted of any felony
or misdemeanor involving fraud or abuse in any government
program, or related to neglect or abuse of an elder or dependent
adult or child, or in connection with the interference with, or
obstruction of, any investigation into health care related fraud or
abuse, or that has been found liable for fraud or abuse in any civil
proceeding, or that has entered into a settlement in lieu of
conviction for fraud or abuse in any government program, within
the previous 10 years, shall be ineligible to be a regional center
vendor. The regional center shall not deny vendorization to an
otherwise qualified applicant whose felony or misdemeanor charges
did not result in a conviction solely on the basis of the prior
charges

4648.14. Notwithstanding any other provision of law, the State
Department of Social Services and the State Department of Public
Health shall notify the State Department of Developmental Services
of any administrative action initiated against a licensee serving
consumers with developmental disabilities. For the purposes of
this section “administrative action” includes, but is not limited to,
all of the following:
(a) The issuance of a citation requiring corrective action for a
health and safety violation.
(b) The temporary or other suspension or revocation of a license.
(c) The issuance of a temporary restraining order.
(d) The appointment of a temporary receiver pursuant to Section

4652.5. (a) (1) An entity receiving payments from one or
more regional centers shall contract with an independent accounting
firm for an audit or review of its financial statements subject to all
of the following:
(A) When the amount received from the regional center or
regional centers during the entity’s fiscal year is more than or equal
to two hundred fifty thousand dollars ($250,000) but less than five
hundred thousand dollars ($500,000), the entity shall obtain an
independent audit or independent review report of its financial
statements for the period. Consistent with Subchapter 21
(commencing with Section 58800) of Title 17 of the California
Code of Regulations, this subdivision shall also apply to work
activity program providers receiving less than two hundred fifty
thousand dollars ($250,000).
(B) When the amount received from the regional center or
regional centers during the entity’s fiscal year is equal to or more
than five hundred thousand dollars ($500,000), the entity shall
obtain an independent audit of its financial statements for the
period.

Existing law requires regional centers, in order to implement
changes in the level of funding for regional center purchase of
services, to reduce certain payments for services delivered by
4.25% from July 1, 2010, to June 30, 2011, except as specified,
and authorizes the temporary modification of personnel
requirements, functions, or qualifications, or staff training
requirements, and suspends prescribed annual review and reporting
requirements for affected providers, until June 30, 2011.
This bill would continue those provisions until June 30, 2012.

Support AB 862

ASSEMBLYMAN SILVA INTRODUCES

REGIONAL CENTER RECORDS ACT

February 17, 2011

SACRAMENTO – Today, Assemblyman Jim Silva (R - Huntington Beach) introduced

AB 862, the Regional Center Records Act. This measure will bring transparency to a major taxpayer-funded program in California. “Taxpayers have a right to know how their money is being spent. Parents, vendors and the centers themselves will benefit from increased transparency,” Silva said.

Since the passage of the Lanterman Act in 1969, the 21 Regional Centers have been the conduit to provide services to the developmentally disabled. While they have done great things in accomplishing this mission, recent investigative reports have given cause for concern. A report by the California State Auditor has raised serious questions about how the regional centers choose and pay vendors for the services they provide as well as capital projects and administrative services. The state auditor has suggested that a more uniform, transparent process would improve the cost effectiveness of this program.

“We are proud to be the sponsor of this Act. Regional centers are vital to the community but they need to be more forthcoming with their information,” said Boyd Bradshaw, president of the ResCoalition, a coalition of residential care providers.

California appropriated over $4 billion in last year’s budget to provide for the developmentally disabled. AB 862 will require the 21 Regional Centers to make several important points of data available to the public to include fiscal and administrative information. It can be heard in its first committee as soon as 30 days from introduction.

Assemblyman Jim Silva represents the 67^th Assembly District, which includes the communities of Anaheim, Cypress, Garden Grove, Huntington Beach, La Palma, Los Alamitos, Rossmoor, Seal Beach, Stanton, Sunset Beach and Westminster.

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Valentine's Day

The month of February and Valentines Day brings a celebration of love and stirs couples to rekindle feelings of romance and devotion. Not so different from young couples are aging seniors, celebrating memories of sweethearts and romance in days gone by. Sit a while with a senior couple and they will soon be telling you their romance story or listen to a widow or widower as they sing their favorite love song from their youth.

Dementia and Alzheimer’s can rob senior minds of many of these treasured memories, changing their personality and life style. Because of these and other illnesses, many seniors end up in nursing homes or care facilities where only their basic physical needs are cared for by the facility staff. To these seniors, Valentines Day becomes no different from every other day. They often find it difficult to relive memories of the past. In one care facility a sign placed lovingly over a patient’s bed reads, “I Am Somebody’s Sweetheart,” as if to say I once dreamed, lived and loved, please treat me kindly.

To see the rest of the article, go to http://www.longtermcarelink.net/article-2011-02-7.htm