Assisted Living and Residential Care

"Building Partnerships, Supporting Choices"

2009-09-21T11:18:00.000-07:00

That's the tag line on DDS letterhead - has that filtered down to the regional centers?

Supporting choices?

Like for the woman recently moved from her home of 15 years with 2 hours notice?

Building partnerships?

Your partner is interesting.... you take all of the financial risk and your partner is in complete control.

What do you think?

Regional Center Update

2009-09-21T11:07:00.000-07:00

Here's the uniform closure schedule. I'd love to hear from those of you who will have to staff at times you haven't had to in the past. I'm trying to figure out the real impact of the budget - which is significantly more than the 3% "discount" for residential.

For me, the issue that keeps getting swept under the rug is that there is only one place in the developmental services system that didn't take a cut (4 budget areas - DDS headquarters, State Developmental Centers, Regional Center Operations, and Purchase services). I'll give you a hint - DDS HQ and State DCs are staffed by state employees who have to take furlough days. So what's wrong with this picture? The "stakeholder" meetings where information was gathered about how to best approach budget cuts didn't seem to take the information from all of the "stakeholders." The question I kept posing to legislators was to consider the importance of specific services to the people with developmental disabilities - Choice: roof over head or case manager? Choice: Early intervention services or 21 accounting departments? I may have oversimplified the choices here, but I think the message is clear.

Please let me know what your thoughts are. You can send messages on this blog and no one has to know who you are - for those who fear retaliation should you have an opinion that is counter to those who sign the payment authorization forms and make referrals.

Uniform closure schedule:

1. January 1

2. The third Monday in January

3. The third Monday in February

4. March 31

5. The last Monday in May

6. July 4

7. The first Monday in September

8. November 11

9. Thanksgiving Day

10. The day after Thanksgiving Day

11. December 24

12. December 25

13. December 26 (for 2009 this Holiday is observed on Monday, December 28, 2009)

14. For 2010 ONLY, April 5, 2010

15. Effective 2010 and on, the second Monday in October (due to the 60 day notice requirement this is NOT a FY 2009-10 Holiday)

Regional Center Update

2009-09-11T12:18:00.000-07:00

I've taken about 8 calls in the last month that give me a sense that regional centers have increased their expectations of providers. Long term clients are being moved with little or no notice, providers are being required to do renovations to their property, and there has been a lot of pressure to meet the training requirements (not that I'm complaining about that, of course).

I am a major supporter, as those who know me will attest, of great programs that are respectful of clients, but it seems that increasing expectations right now is just bad timing. All of you have given the regional center services at a 3% "discount" and it's still unclear what the impact of the day program universal closure days will be. It seems like the regional centers might be looking at how to better value the services provided in residential care.

And then there's training...... Our company is a training company, so you won't hear me telling people not to get training. We've tried to keep our catalog reasonably priced. We've increased our online offerings, to save you travel costs and time. And yet, I hear about regional centers that don't accept online training to meet the Title 17 requirements, and those that are requiring people to get training to meet plans of correction. My favorite was a request to train people on how to cook chicken. As my teenage daughter might say, "whatever...."

And to that training requirement..... Third Thursday at Sam's Cafe at New Horizons in North Hills. Reasonably priced at $20 for 3 CEUs; 4th staff person may attend at no cost. Call us or check website www.CommunityTrainingOnline.com for more information.

Fee Increase from Community Care Licensing

2009-09-11T12:09:00.000-07:00

Today I sent an email newsletter with the good news and the bad news from Community Care Licensing. Annual fees are increasing by almost 10%. Since most of our client facilities are experiencing, in some cases, unprecedented open beds, this is really bad news. For those funded by regional centers, this is a major slap in the face. First a 3% "discount" on your billing; new days for day program closure where you'll staff when you haven't in the past; now an increase in rates.

Here's the full fee schedule, effective 7/28/09:

http://ccld.ca.gov/res/pdf/Fees.pdf

It's a good thing that most of you love the work you do and that the residents/clients/consumers come first for you. It's hard to imagine that those making these decisions have considered the impact on the people you serve. Maybe I've been around this continuous state budget crisis too long.

What do you think?

Date Changes

2009-06-12T16:58:00.000-07:00

We have moved our 3 hour training in the San Fernando Valley to the Third Thursdays, starting in August. Mostly we like the way it sounds......Third Thursday. Much easier to remember than any other schedule, isn't it? Information on these classes will be posted on our website within the week.

Regional Center Funding June 2009

2009-06-12T16:51:00.000-07:00

What follows is an invitation from Boyd Bradshaw, the president of ResCoalition to give your thoughts on changes that could be made to Title 17 that wouldn't affect consumer health or safety. There is a growing sense in Sacramento that not ALL stakeholders have been represented in the discussions about how to find millions of dollars in the budget. Most of you know that the current proposals for cuts ALL come from the provider budget. Here is your chance to say what's on your mind. In every class, one of you has wondered aloud about why the bureaucracy doesn't take the same level of cuts as the providers.

ResCoalition is the reason that Level 2 and 3 providers had an increase to accomodate changes in the minimum wage; ResCoalition is the reason that you had money returned to you shortly after the 3% "discount" was applied (SSI funds were not supposed to be discounted); ResCoalition is fighting for regional center oversight and transparency. In short, this group is a major voice for residential providers. I hope you'll send your thoughts.

- - - - - - - - - - - - - -
06/12/09

I met with DDS yesterday and they've asked us to try and identify anything that can be modified or changed within title 17 constraints to save money. Even though we're primarily residential service providers, they're interested in any and ALL ideas relating to Title 17 - lets give them some.

Please gather ideas and get them back ASAP to hcdd@pacbell.net. Don't worry about collecting everything and sending them once, feel free to blast as you come up with them.

If you have any questions or concerns please drop me an email or call me at 714 637-0200

Training for Regional Center Vendors

2009-06-09T11:35:00.000-07:00

This has been a tough year, hasn’t it? Real estate values are down. Cuts from the Regional Center with more on the way, it seems. Retirement accounts – who knows? Because we truly feel your pain, Community Training Connection, Inc. has added a cost efficient training program that gets you administrator CEUs (to meet Community Care Licensing and Regional Center requirements), as well as getting those CEUs required for the caregivers by Regional Centers.

The training will be offered on the Second Wednesday of every month from 10 AM to 1 PM at New Horizons at 15725 Parthenia in North Hills. There is plenty of parking in the back of the building. The fee for the classes is $20, which includes refreshments, handouts and a certificate for 3 CEUs. The classes are scheduled to be most convenient for staff who work around consumers’ day program schedules. If you send more than 3 staff members, one staff can attend at no fee.

Please mark your calendar with the following dates:

July 8, 2009

August 12, 2009

September 9, 2009

October 14, 2009

November 11, 2009

December 9, 2009

Taking these classes, and 20 hours online gets you the 40 required for Licensing. For Level 2 staff, three classes meets the regional center requirement. For Level 3 and 4, only four classes and the requirement is met. We’re doing our best to make life easier for you.

We do need to take reservations so that we can be sure to bring enough handouts. Please call Janet Tran in our office to reserve space. For your convenience, we accept all major charges, as well as checks. Walk ins are welcome, if space permits. You can also register online at http://www.communitytrainingonline.com.

As always, informative, lively and fun!

Regional Center Budget Cut Proposals

2009-05-01T16:00:00.000-07:00

I have been very vocal - and pro-active - about my concern that budget cuts should be made furthest from the people who need services. That, for me, means cutting at the bureaucracy - cutting out the parts of the system that are irrelevant to people with developmental disabilities and their families. There's so little talk about cutting at other levels, it seems like the elephant in the living room. By requiring the cuts to be at the purchase of service part of California's Developmental Services budget, I have seen vendors turn against vendor - not the most productive way to operate.

Here is a summary of the proposals - thanks Marty Omoto:

Transportation:

This reduction would be achieved by maximizing “cost effective” transportation services that reduces costs to specialized or contract transportation services.

Day Program and Work Activity Uniform Closure Dates:

Reduction is achieved by implementing a 14 day Uniform Holiday Schedule for day programs, look-alike day programs, and work activity programs.

Day Program and Work Activity for Older Adults:

Reduction would be achieved by creating a new service for seniors at a reduced rate and with a corresponding increase in the staffing ratio.

Increased Volunteerism and Employment:

Reduction would be achieved by creating the “Custom Endeavors Option” (CEO) which would will offer the opportunity to develop a customized employment or volunteer option with support from existing providers for 5% of current population.

Supported Living and IHSS

This reduction would be achieved by prohibiting regional centers from purchasing personal care services for consumers who are Medi-Cal beneficiaries. All Supported Living Service (SLS) Agencies will be required to assist a consumer to apply for IHSS within five days of moving into a Supported Living arrangement. All Supported Living Service (SLS) Agencies will be required to assist a consumer to apply for IHSS within five days of moving into a Supported Living arrangement.

Quality Assurance Review

This reduction would be achieved by eliminating Regional Center funding and requirement for conducting a Triennial Quality Assurance Review of vendored Community Care Facilities.

Just a few - so.....what do you think?

How many of you have contacted your state assembly or senate representative? Invite them to your facility? Ask them what suggestions they have for cutting anything further from your budget.

Disaster Planning for RCFEs in California

2009-05-01T15:46:00.000-07:00

Have you looked at your disaster plan lately? Will it be complete enough to meet the requirements of the new legislation? Do you have a back up plan for electricity? For some, it will mean having a back up generator. Have you thought about - really thought through - how you could stay in your facility for three days without electricity, gas or water? Are you absolutely certain that your staff would stick around until relief staff arrives?

Inquiring minds want to know.......

Swine Flu Information for Residential Care

2009-05-01T15:42:00.000-07:00

May 1, 2009

From Time Magazine (excerpt)

Top 5 Swine Flu Don'ts

By Bryan Walsh

The global rise in swine flu has showed few signs of slowing. Now in 11 countries, the H1N1 flu virus was confirmed on Thursday in the Netherlands and Switzerland; in Canada, cases rose to 27 and in the U.S., the caseload increased to 109 in 11 states, with hundreds of school closures that sent some 160,000 students home. Meanwhile, the World Health Organization (WHO) has said that a new flu pandemic is imminent, yet some pharmacies (in New York City at least) are temporarily running short of the antiviral Tamiflu. So, no one would blame you for feeling scared about getting sick.

Here are five things not to do in dealing with the swine flu frenzy.

1. Don't Rush to the ER

With the cable news networks reporting nonstop on swine flu, it feels like the disease is lurking everywhere, and that your slightest sniffle is a sign that you've contracted the virus. That would explain why people with no outward symptoms of illness are flooding emergency rooms in swine flu–affected states, afraid that they might be sick. That's a really bad idea.

First of all, having to examine people who aren't really sick only stresses the already strained resources of hospitals that are trying to prepare for a pandemic. Plus, going to an emergency room unnecessarily may even pose a slight risk to you. In past outbreaks, including SARS in 2003, hospitals were actually loci of infections — all those sick people in close proximity — and the same could be true of swine flu.

If you actually have flu-like symptoms — a fever above 100° F, headache, sore throat, body aches, chills or fatigue — and you live in an area where there have been confirmed swine flu cases, by all means report to your doctor. Otherwise, leave the hospital to the sick people.

2. Don't Be Afraid to Eat Pork

On April 29, the CDC announced that swine flu would no longer be referred to as swine flu, but as the "2009 H1N1 flu." It's less catchy, but more accurate. For one thing, there is no evidence that this virus makes pigs really sick. And the H1N1 virus actually contains genes from swine, avian and human flus. The virus also cannot be spread through pork products — you can't contract swine flu by eating bacon, hot dogs or anything else that was once a pig. Nor will culling pigs, as authorities did in Egypt, do anything to stem the spread of the disease. H1N1 has jumped to humans and is passing easily from person to person, so it's now a human flu that needs to be controlled in us, not the pigs.

3. Don't Hoard Antivirals

The H1N1 virus has so far proven vulnerable to the antiviral drugs Tamiflu and Relenza, which is good news. A cornerstone of the government's pandemic preparations was the stockpiling of 50 million doses of those drugs over the past few years, enough to ensure that doctors would be able to respond sufficiently to new outbreaks. But that capacity could be compromised if people begin stockpiling antivirals for their own use. Already there are reports of pharmacies running short of Tamiflu, and many hospitals in the U.S. have begun restricting the power to prescribe antivirals to just a few doctors. Also, the misuse or overuse of Tamiflu or Relenza by patients can promote resistance in the flu virus — effectively removing the only bullets from our gun.

4. Don't Leave Home If You Feel Sick

In the absence of a vaccine, the only defenses we have against the spread of H1N1 are simple ones. Cover your mouth when you sneeze or cough (with your arm, not your hands, to avoid spreading the virus through handshakes) and wash your hands frequently. Buy a pocket-sized bottle of hand sanitizer and use it — it's the easiest way to avoid getting sick.

But when it comes to slowing the overall spread of a pandemic flu, the best thing we can do is keep sick people away from everyone else. It's called "social distancing," and studies of the deadly 1918 Spanish flu showed that cities that instituted distancing measures quickly suffered lower death tolls than cities that did nothing or reacted slowly. So if you're feeling sick, don't go to work until you feel better — even though that may not be the most welcome advice for the nearly 50% of private-sector workers in the U.S. who don't get paid sick days.

5. Don't Panic

TV anchors can't stop asking the question: "When is it time to start panicking?" How about never? Panic can only lead to stupid actions — on a personal and national level — that would likely make a pandemic worse.

As worrying as the epidemic has been, keep in mind that only one person so far has died of swine flu outside Mexico. Many scientists are beginning to think that even if we do have a full-fledged pandemic on our hands, it may likely be a mild one. A computer model by researchers at Northwestern University estimated that even if nothing were done to slow the spread of the disease from now on, by the end of May the U.S. would have only about 1,700 cases. The good news is that H1N1 is hitting North America at the tail end of its flu season. It's possible that the virus may peter out and re-appear next autumn, but that gives us months to prepare.

As WHO and CDC officials keep reiterating, influenza is an enigma, and H1N1 will keep evolving, keep changing — so we can't predict how the epidemic will progress. But one thing is certain: Panicking will only make the situation worse. "This is a cause for deep concern, but not panic," said President Barack Obama in his April 29 news conference. In the midst of all this anxiety, that's the best advice there is.

Marketing for Small Homes

2009-03-27T12:22:00.001-07:00

It may just be a flook, but the small homes that have all of their beds filled also happen to be the highest price homes. How many of you have lowered your price just to get the bed filled? That may not necessarily be the best thing for you in the long run. We have a few providers who are charging a daily rate for residential care, which is an interesting option. How many of you have thought about that?

Adult Residential Facilities

2008-07-30T20:14:00.000-07:00

How are the Regional Center funded programs doing in the face of this year's budget crisis? We hear that one regional center will not vendor new homes unless they commit to providing transportation to day programs. That service was generally funded under another vendor code when gasoline was $2.00 a gallon. Now that we're over $4.25 in most places, it seems to be pushing vendors over the edge. It's not like there was much of a profit to begin with. Who is meeting with legislators? Who has a better way to spend that gets more money closer to the client/consumer/individual/person?

Medication Training for RCFEs

2008-07-30T20:09:00.000-07:00

It seems as if most communities and board and care homes have figured out the training requirement, but we keep getting calls from homes where licensing is citing for reasons not clear in the legislation. What does a new facility do to assist with medication with a new residents, if the administrator does not have a person to shadow on the day of admission?

How are you destroying medication? We've had some interesting stories in our classes about how medication is getting destroyed.