In response to decades of underfunding, the Lanterman Coalition – a coalition of statewide and regional organizations representing people with intellectual and developmental disabilities and their families – has proposed a multi-year strategic investment plan which ensures that the I/DD community and the promise of the Lanterman Act moves from a time of crisis and into a time of opportunity, innovation, and measurable outcomes. With that plan in place, the state of California will enter a new era of community inclusion, including employment opportunities, robust early intervention, legally-required case- load ratios for service coordination, access to housing, and individual health and wellbeing. In addition, the 150,000 direct support professionals in California will finally have job stability and a livable wage.
The plan would do the following:
Phase-in the recently published CA Department of Developmental Services (DDS) rate models over three years (the DDS rate models identified a $1.8 Billion shortage in funding for I/DD services and supports);
Make immediate actions to increase funding for early intervention services and other services committed from recent budget increases, and take immediate actions to reduce regional center caseload ratios;
Ensure all DDS funded services & supports receive adjustments for state minimum wage increases;
Secure a foundation for long-term planning by removing the recently enacted suspension date for all budget increases of January 1, 2022.
Thursday, January 10th, 2020, Governor Newsom released his 2020-21 budget blueprint. The budget projects continued surplus revenue for 2020-21, but less of surplus than last year. In this Budget, as with last year’s, the majority of the surplus is devoted to one-time spending. Overall the Governor proposed a 2.3% total increase in state spending. Below is a summary of the governor’s proposed budget and its impact on Californians with intellectual and developmental disabilities and their families:
*note: budget amounts are shown in Total Fund amounts, which equals state’s portion (GF or General Fund) plus the federal government’s portion. Some amounts also show just the GF (General Fund) amount for comparison.
Regional Center Services
The proposed budget estimates regional center caseload growth from 333,000 clients in 2019, to 350,00 clients in 2020, and 368,000 clients in 2021. The Governor’s Budget proposes $8.75 billion ($5.3 billion GF) for the Regional Center system, an increase of $952 million ($613 million GF) as compared to the updated current year budget. The increase is mainly a result of caseload adjustments and increases to minimum wage.
On Friday the Department of Developmental Services released their updated rate models to conclude the DDS Rate Study. Also released were the summary of public comments in regard to the draft rate models. More analysis of the rate models will be forthcoming; however, the finalized rate models continue to demonstrate that services for Californians with IDD are underfunded by nearly $2 billion.
The Budget proposal includes $18 million ($10.8 million General Fund) in 2020-21 and $35.9 million ($21.6 million General Fund) in 2021-22 to provide supplemental rate increases for Early Start Specialized Therapeutic Services, Infant Development and Independent Living services, consistent with the supplemental rate increases included in the 2019 Budget Act. These services did not receive the 8.2% rate increase that was passed in last year’s budget. The reasoning for their omission was that the draft rate studies indicated that those services should actually get a decrease. Those conclusions in the draft rate models were later admitted by the contractor of the study to be based on bad data inputs. This budget investment aims to correct that mistake. Unfortunately, however, the Governor’s proposes to wait until January 1, 2021 to correct the mistake, which would be a full year after those services should have received the increase.
The Budget proposes to delay the suspension date of provider rate increases from December 31, 2021 to July, 2023.
The Governor proposed an increase of $78.0 million ($60.0 million GF) to establish a Performance Incentive Program for Developmental Services administered through Regional Centers. The Performance Incentive Program would align with each Regional Center’s performance contract and require Regional Centers to meet an advanced tier of performance measures. (It is unclear at this time if these funds would be tied to the rate models as finalized in the DDS rate study, and/or if these funds are proposed to fund regional centers or service providers.)
Enhanced Caseload Ratios for Young Children—The Budget proposal includes $16.5 million ($11.2 million General Fund) to establish a reduced regional center service coordinator caseload ratio for consumers who are under the age of five years.
Systemic, Therapeutic, Assessment, Resources and Treatment Training—The Budget proposal includes $4.5 million ($2.6 million General Fund) to provide training on person-centered, trauma-informed, and evidence-based support services for individuals with co-occurring developmental disabilities and mental health needs.
Warm Shutdown of Fairview Developmental Center—The Budget proposal includes $11.9 million General Fund to extend the warm shutdown period at Fairview Developmental Center through 2020-21 until a site assessment is completed to inform the disposition of the property.
Community Crisis Homes for Children – Decrease of $4.5 million GF in onetime start-up funding.
Development of STAR Homes – Decrease of $3.0 million GF in one-time startup funding to develop two STAR homes in Central CA.
Enhanced Behavioral Supports Homes (EBSH) with Delayed Egress and Secured Perimeter (DESP) – Increase of $7.5 million GF to develop five EBSHs with DESP to reduce reliance on restrictive settings and provide opportunities for individuals to move to the community, with appropriate and necessary supports
Systemic, Therapeutic, Assessment, Resources and Treatment (START) Training – Increase of $4.5 million ($2.6 million GF) to support individuals in their current residential arrangement and prevent disruptions and admissions into more restrictive settings, such as Institutions for Mental Diseases, out-of-state services, acute psychiatric settings, Community Crisis Homes and STAR services through the provision of 24-hour crisis services and planning, and by providing training to families, direct support staff, and local partners (e.g., police, hospital staff, teachers) on person-centered, trauma-informed, and evidence based support services for individuals with co-occurring developmental disabilities and mental health needs.
In 2015, the state announced the planned closure of the three remaining developmental centers: Sonoma, Fairview, and the general treatment area of Porterville. The last residents at Fairview and the Porterville general treatment area are transitioning to the community in January 2020. The Department will continue operating the secure treatment program at Porterville, the Canyon Springs community facility, and state-operated acute crisis facilities in Northern, Central, and Southern California, with an estimated population of 322 by June 30, 2021.
Persons with intellectual and developmental disabilities who are deemed incompetent to stand trial (IST) often languish in county jails while awaiting a more appropriate placement. We are pleased that Governor Newsom has invested $8.9 million general fund dollars for the temporary activation of a 20-bed unit in the Porterville secure treatment program to help reduce the number of individuals awaiting placement. The Governor proposed budget includes:
$8.9 million General Fund for State-Operated Facilities to temporarily activate a 20-bed unit in the Porterville secured treatment program for individuals with IDD who are deemed incompetent to stand trial (IST). The additional unit will sunset June 30, 2024, are more integrated community setting are developed.
$7.5 million General Fund for Community Services to develop 5 enhanced behavioral support homes with secure perimeters aimed at providing long-term placement for individuals who are deemed IST.
$24.6 million General Fund to implement a Community Care Collaborative Pilot Program, a 6-year pilot in 3 counties, to provide incentives to treat and serve individuals deemed IST.
$8.9 million General Fund ($11.2 million General Fund thereafter) to expand Jail-Based Competency Treatment programs in 8 additional counties.
Department of Youth and Community Restoration $289.7 million ($260.8 million GF) 2020-21 and $295.6 million ($266.8 million GF) annually thereafter to establish the Division of Juvenile Justice as a new Department of Youth and Community Restoration. $2 million for an Interagency Agreement between Department of Youth and Community Restoration and California Volunteers for navigators.
In his presentation the Governor stated that special education in California is in crisis and it’s a real shame.” The Governor cited his own benefits from special education as a child. As a result the Governor proposes significant investments and made mention of “leaning into” SELPAs. The proposed budget included $900 million for each workforce development, and the Budget proposes an additional $250 million ongoing Proposition 98 General Fund based on the number of children ages 3 to 5 years with exceptional needs served.
Effective January 2020, the maximum SSI/SSP grant levels are $943 per month for individuals and $1,583 per month for couples. The projected growth in the Consumer Price Index is 1.7 percent for 2021. As a result, the maximum SSI/SSP monthly grant levels will increase by approximately $13 and $20 for individuals and couples, respectively, effective January 2021. CAPI benefits are equivalent to SSI/SSP benefits. The 2019 Budget Act included $25 million General Fund ongoing to assist homeless, disabled individuals applying for SSI/SSP benefits.
The Budget includes $14.9 billion ($5.2 billion General Fund) for the IHSS program in 2020-21, a 16-percent increase in General Fund costs over the revised 2019-20 level. Average monthly caseload in this program is estimated to be 586,000 recipients in 2020-21, a 4.5-percent increase from the revised 2019-20 projection. Other Significant Adjustments: • Minimum Wage—The Budget reflects $1.1 billion ($523.8 million General Fund) to support planned minimum wage increases of $13 per hour on January 1, 2020 and $14 per hour on January 1, 2021.
Electronic Visit Verification—Federal law requires states to implement an electronic visit verification system for personal care services by January 1, 2020, and for home health care services by January 1, 2023. Failure to comply with the electronic visit verification requirement would result in an escalating fiscal penalty in the form of a percentage point reduction in federal matching funds. To comply with federal law, the Budget includes $34.9 million ($5.3 million General Fund) to implement an electronic visit verification solution and enhancements to the Case Management, Information and Payrolling System for personal care services.
California Access to Housing and Services Fund—The Budget provides $750 million one-time General Fund to establish a new fund, with the goal of reducing street-based homelessness and increasing the number of stable housing units.
NEW Department of Early Childhood Development
The Budget proposes to establish the Department of Early Childhood Development under the Agency to promote a high-quality, affordable, and unified early childhood system that improves program integration and coordination.
The budget proposes to launch a Medi-Cal Healthier California for All initiative (formerly known as CalAIM, or the California Advancing and Innovating Medi-Cal initiative), which builds upon waiver demonstration programs such as Whole Person Care, the Coordinated Care Initiative, Health Homes, and public hospital system delivery transformation. Medi-Cal Healthier California for All proposes to provide a wider array of services and supports for patients with complex and high needs. Medi-Cal Healthier California for All has three primary goals:
Identify and manage member risk and need through whole person care approaches and addressing social determinants of health;
Move Medi-Cal to a more consistent and seamless system by reducing complexity and increasing flexibility; and
Improve quality outcomes and drive delivery system transformation through value-based initiatives, modernization of systems, and payment reform.
The end of this month two hearings will take place in the state Capitol building which will impact California’s I/DD community. Please share this information within your network and attend if you can.
9:00AM, January 22, 2020
State Capitol, Room 4203
Senate Budget Sub 3 Informational Hearing: DDS Rate Study and Reform in the Developmental Services System
The Senate Budget Subcommittee on Health and Human Services will be holding an informational hearing on January 22 at 9:00am. There will be a discussion on the next steps concerning the DDS rate study, as well as the rate study-related provisions of Senate Bill 81.
1:30PM – 4:30PM, January 28, 2020
California State Capitol, Room 127
CA State Assembly Select Committee on Intellectual and Developmental Disabilities Statewide Summary: Hearing on Living with Intellectual and Developmental Disabilities
This statewide summary is the culmination of 8 Select Committee hearings conducted across the state over the past year. Families, providers and legislators are invited to attend and hear results from the Select Committee on how different regions of the state service the needs of those with intellectual and developmental disabilities.
Each year The Arc of California discusses and decides on budget and legislative priorities for the coming year. We want to hear from you, the intellectual and developmental disability community, about improvements, challenges, and changes that you would like The Arc of California to consider while developing our policy package. Your input could be specific ideas for a legislative bill, or could simply be an issue that is impacting you, your family, or organization. If you’d like to provide input then please click here. Your input will be sent directly to staff at The Arc of California.
Assemblyman Chris Holden (D) of Pasadena said recent budget victories for the developmentally disabled represent a big step, “but that there is more to do.”
With passage and signing of the first state budget under Gov. Gavin Newsom (D), Holden can point to his leadership in securing what grew to be $400 million for developmentally disabled service providers, as well as to having helped in the fields of speech pathology and music therapy.
Last week saw Keep the Promise rallies to save Lanterman Act services and fund the direct support workforce for Californians with intellectual and developmental disabilities (I/DD) throughout the state. The Sacramento rally on Wednesday, April 3 was a rousing success with crowds estimated between 1,500 – 2,000. Several rallies took place on Friday, April 5th which we will cover in next week’s Monday Morning Memo. These rallies play a key role in convincing lawmakers and the public to support the I/DD community.
Members of the press covered the Capitol rally, helping spread our message to the broader community. You can watch local NBC affiliate KCRA coverage on YouTube.
The following legislators came out to the Capitol steps to sign their names to the budget request letter, pledging their support for an 8% increase in funding to Lanterman Act services and supports for people with I/DD.
Senate Request Author: Senator Henry Stern, District 27
Senator Andreas Borgeas, District 8
Senator Shannon Grove, District 16
Senator Mike Morrell, District 23
Senator Jeff Stone, District 28
Senator John Moorlach, District 37
Assembly Request Co-Author: Assemblymember Jim Frazier, District 11
Assembly Request Co-Author: Assemblymember Chris Holden, District 41
Assemblymember Brian Dahle, District 1
Assemblymember Heath Flora, District 12
Assemblymember Devon Mathis, District 26
Assemblymember Tom Lackey, District 36
Assemblymember Christy Smith, District 38
Assemblymember Marie Waldron, District 75
The rallies, media attention, and legislators who support the 8% budget request represent a good start. However, we would like to see the signatures of every Senator and Assemblymember added to the budget request letter. There is still time for you to take action. Visit thelantermancoalition.org and click the “Take Action” button to write to your state representatives telling them why they must sign on to the letter and #KeepThePromise to Californians with I/DD.
Hopefully, you have already seen last week’s San Francisco Chronicle story that brought much-needed attention to the shrinking and closing of programs that people with I/DD rely on in the Bay Area. The article did a fantastic job of bringing the economic realities that we, as advocates, take for granted to the general readership who may have little to no prior knowledge of the system that people with I/DD depend on for their day to day existence.
The article highlights:
Funding is not keeping up with the rising costs of doing business
Service providers cannot pay competitive wages which has led to high turnover and job vacancies
The population of people who need services is growing while programs that provide services are closing due to lack of funding
The advocacy work that is being done this year to ensure an 8% rate increase.
Mainstream media has long overlooked the stories and realities faced by people with disabilities and the people who care for us. Therefore, many people are understandably uninformed, and in turn, do not show up to support the efforts of the disability community. The writing and sharing of articles like this play a crucial role in our efforts to ensure that California’s lawmakers live up to the promise made to Californians with I/DD by the Lanterman Act.
Last Wednesday, March 6, 2019, the California State Assembly Budget Subcommittee on Health & Human Services held a hearing to discuss several issues impacting people with intellectual and developmental disabilities (I/DD) throughout the state. Members of the committee listened to more than six hours of testimony by the Governor’s administration, the Legislature, and from the public on proposals that will have both immediate and long-lasting impacts to the I/DD community. You can view the hearing in its entirety here. Topics discussed include:
The provide rate study and emergency 8% funding increase for Lanterman Act services and supports (starting at 1:05:00 on the video)
Local minimum wage increases and the impact on service providers (starting at 3:07:15)
Safety net services for people in crisis (starting at 3:18:00)
14 day uniform holiday schedule, social recreation and camp services, an 1/2 day billing (starting at 4:42:00)
Racial disparities in I/DD services (starting at 5:21:00)
Join us in Sacramento on April 3, 2019, for the #KeepThePromise Capitol rally to save Lanterman Act services & fund the direct support workforce for Californian’s with intellectual and developmental disabilities (I/DD).
More than 330,000 Californians with I/DD live in our state – they are our neighbors, classmates, coworkers, family, and friends – however, their support structure has been grossly underfunded and is failing. Direct support staff are quitting the field or working multiple jobs due to low wages, essential programs are closing throughout the state, and individuals are forced to live with inadequate supports or with no support at all.
California’s lawmakers must fund the services and supports people with I/DD rely on to access their civil rights. An 8% increase will provide emergency stabilization which our community desperately needs.
This Wednesday the Assembly budget hearing on developmental disabilities will take place. Several key issues will be discussed including:
Provider Rate Study and Associated Investment Proposals; Proposals to Restore Reductions Made in Prior Budgets: Uniform Holiday Schedule, Half-Day Billing, and Social Recreation and Camp; and many others
This Wednesday the Assembly budget hearing on developmental disabilities will take place. Several key issues will be discussed including:
Provider Rate Study and Associated Investment Proposals;
Proposals to Restore Reductions Made in Prior Budgets: Uniform Holiday Schedule, Half-Day Billing, and Social Recreation and Camp;
and many others
The hearing will take place between 2:30 PM – 6:30 PM in room 437. The hearing is open to the public so please come and show your support for the I/DD community.
The full agenda can be viewed here.
To learn more about ongoing budget advocacy efforts in California’s I/DD community – including a schedule of upcoming events – visit: www.thelantermancoalition.org