Friday, April 11, 2008

Controlling Regional Center Costs.

The California Department of Developmental Services (DDS) has produced a document entitled "Controlling Regional Center Costs."  (You can click on the title of this post to download it or read it in your browser.)  To my eye, the document is very carefully written not to give license for foolish cuts.  Once you have read most of the proposals contained you would have to be as dumb as box of rocks to consider smart.  Also, for those in the panicky state of fretting that this report represents an assault on the entitlement or a murderous conspiracy, it ought to be noted that some of the most favorably described cost control measures are preventive, such as investments in better dental care, expanding employment and affordable housing.  I would give some laud and honor to the writers for careful wording. 

This may be the first of a series of posts on this report, the next likely to deal with selected proposals but start with two questions:

Given the past experience of DDS reports and their influence on policy-making, is it likelier that advocates will pay too little or too much attention to this?  The Service Delivery Reform report opened few doors in Sacramento but it has held a lot of doors open.

Why is socialism the only answer to reduce government spending?  An ongoing frustration of mine is that all the virtues of the Lanterman Act as a mechanism for efficient, responsive care depends on innovation, creativity, liberty and choice.  It continues to depress me that centrally defining, regulating and limiting what can be done is always the response of government, and frankly, of most of our advocates.   We love to talk about innovation and creativity, never more than when we find some new way to instruct our neighbor.

And, friend Paul, I promise that none of the posts regarding this document, if there are more, will discuss or promote funding as a purpose or point.  That's not what I do here, and really isn't what I do in Sacramento either.


stanley said...

will not discuss funding after this post...but it should be said...

[doug say] I promise that none of the posts regarding this document will discuss or promote funding as a purpose or point

you did note doc title is “Controlling RC Cost” while we are not discussing funding...the state (DDS) is controlling cost (cutting programs)...tho;

certainly funding is neither the only and nor the most critical...the state sets the agenda and it is about controlling cost, reduced rates, cutting programs.

Before funding canNOT be discussed...there should be/must be parity between quality of service provided and compensation for disparity: per capita funding $17,000 for community support v $288,000 for DC support is ludicrous...and still ludicrous if it JUST $100,000 to $25,000.

proof funding is not the most critical the $288,000 did not prevent DC abuse, murder and life times of benign neglect...OTOH;

quality of labor pool does contribute to Broken Homes in the community.

BTW it will be interesting to observe the quality in the 160 Agnes residents homes who transitioned to the community at an initial investment of $530,000 with an eventual annual $248,000 cost...

really interesting would be a comparison of the Broken Homes and the Agnes 160’s homes.

stanley seigler

Doug said...

Right, Stanley. The report was named in statute and serves that purpose. This blog serves the purpose of its own title, to talk about how we can change the system so it works better. For that reason I don't include funding advocacy in the mission statement of this blog.

On the funding parity point, though, I will say this: I firmly believe that per capita funding for this system is unlikely to improve significantly in the next decade. Furthermore, as you point out, an almost 20-fold preference in funding for the DCs hasn't bought the quality we want. So, while I agree that funding is relevant, winning funding parity would be an extraordinary, unlikely and probably empty victory.

paul said...

“And, friend Paul, I promise that none of the posts regarding this document, if there are more, will discuss or promote funding as a purpose or point.”

After attaining an upright position and opposable thumbs one of the first lessons I was suppose to learn was to not piss where I eat. This blog is definitely where I eat, so the latter is without question, and now I hope that I do not commit the former – too much.

Funding is just the “tip” of the spear. The shaft consists of the legislature, the governator, and DDS in any shape or form, including a DDS report to the legislature. While the spear should be discussed, it is – at length. This blog is my oasis without spears.

The Lanterman Act was created in hopes that local communities, via regional centers, would carpe diem (In a manner of speaking). They have not. While there are many arguments as to WHY this has not happened; Prop 13, over-regulation, dismantling of the ‘essence’ of Lanterman by the legislature – it can be argued that ALL of these things happened upon a common stepping stone – the mantra, the misdirection “Ask not what Regional Centers are empowered to do (and perhaps have not), but what Sacramento can do, has done, will do, is thinking about doing to the system”.

If a Regional Center was an employee of mine, I would give it high scores for redirection, but then have a serious problem with it also being MISdirecton.

paul said...


There is a CDCAN Townhall Telemeeting on Wednesday April 30th @ 1 PM featuring the Department of Developmental Services (DDS)Director.

How many times has the director of DDS appeared on a CDCAN Townhall Telemeeting?

How many times has any REGIONAL CENTER director (any of the 21 incuding ARCA) been featured on a CDCAN telemeeting?

Doug said...

Paul: Regarding your first comment, not at all. I appreciate that you don't want to have the funding conversation. I don't either and you're welcome at the table, although I think you'll find our wine list disappointing. Regarding the trivia quiz, Mike Clark of Kern RC has been a panelist. I believe Phil Bonnet has as well. Also, non-chief executive regional center employees have been on as have Bob Baldo and Anh Nguyen of ARCA. Directors of DDS have been on more often that, obviously. Here's another trivia question: How many government officials from departments other than DDS have been on?

paul said...

Good Answer - I actually was not aware that so many XDirectors from RC have been panelists.

As for your question I cannot wager an educated guess. I have had the pleasure of listening to only ONE CDCAN meeting (after the fact), but from my reading I am aware that there has been some individuals from HHS, but this could be argued to be within the same org. chart, just one notch up.

So – my uneducated answer is "What is 0" Alex.

If I am correct I will take “eligibility” for 400 please Doug.

Doug said...

I don't know either, actually.

OK, for 400 words: This person is not eligible for regional center services under the fifth category.

paul said...

OK, for 400 words: This person is not eligible for regional center services under the fifth category. -Doug-

Well - If this one has an answer it will serve as a PERFECT segue to add another soapbox and step up.

Since the 5th category is based on a level of function there can be no categorization or label put to the type person that NOT eligible under 5th category.

As long I do not have a disability that is solely physical in nature AND presuming I have a "substantial disability" I can be eligible under the 5th category with NO label as long as I have a condition "... closely related to mental retardation" OR a condition that requires "treatment similar to that required for individuals with mental retardation."

So - I hope there is some humor in your answer. Otherwise - this would be one data point that shows that the players [those at the RC that are eligibility “experts”] in our system live in a netherworld that does not obey the laws of physics/Lanterman.

Scotty “you cannot change the law of Physics” [Scottish Accent]

RC Director: “Oh Contrar ” [French Accent]

Doug said...

Paul, the whole system as a whole qualifies under the fifth category with significant disabilities in honest communication and adaptive skills. I'm a grinding cog myself.