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…..

Regional Center Update

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 Funding June 2009

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

Regional Center Budget Cut Proposals

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.