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…..