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.