Measuring caps on the Mohs scale.

There are several notorious topics to pick up after my sabbatical from this blog. My favorite format on this blog has been the debate format, so let's start with a discussion of the hard cap on spending which I believe will be on the ballot in May. (Part of the compromise made with Republicans for a fifth of their votes.)  If voters approve the proposition (I'm guessing,) the spending side of the state budget will be limited to current spending plus a growth factor, likely to equal population growth plus inflation.

There's no question a hard cap causes realistic concerns for the future of this system and, more importantly, the people the system serves. But the notion not only attacks the principle of a community digging in to support the needs of their neighbors, it also defends the principle of good government. As with previous debate posts (here and here,) I'll post five arguments for and against a proposition and invite commenters to give their own opinions.

The proposition:  A hard cap on state spending may benefit people supported by California's developmental disability system.

Pro:

1. With the size of government set in the constitution, the focus may move from polarizing and tiresome demagoguery to governance.  The debate I listened to from the Senate Gallery on Wednesday and read in the press was a competition between a philosophy that taxes are the root of all evil and one that government spending is the sole source of earthly virtue.  If the voters set the proper size of government, legislators can turn to subtler and more constructive discussions of priorities and process.  Of course, we'll probably need a whole different set of legislators to grasp the concept.

2.  Under a spending cap regime, voters will have to better interrogate their own values.  As dismal as our legislators have been, their most meritorious action has been to claim to represent their constituents.  In proposition after proposition and election after election, spending whether for water, punishment or people with problems seems to get our rubber stamp.  If the hard cap requires that long imprisonments and prosperous prison guards must be weighed against help for people born challenged, it is entirely possible that we discover ourselves to be a little more Tamino with our neighbors and a little less Night Queen.  A society that chose help for a struggling neighbor over vengeance upon an erring one might be easier for the disabled to integrate into.

3.  A leaner system might produce better outcomes.  Another way our State has failed to choose is between the well-intentioned control-freak and the good-hearted failure.  Regulations build up in our system for good reasons but without any cost-benefit analysis.  Meanwhile, the system does not discriminate between (or identify) functionaries and agencies that are highly productive and those that kindly serve badly.  There are often many people who have to say yes before an individual can be served, or their services can change.  Heaven alone knows how many people are struggling needlessly due to ineffective support.  Hell has the accounting on needless regulatory costs. If this system has to struggle with choices, some of the energy and resources we lose might well be doing mild harm or weak good while stronger support is available

4.  A trade-off between growth and predictability has value.  The cycle has quickened from annual to pretty near monthly in which promises are made, budget crises confessed,promises revoked, outrage erupts and the promises get restated but only partially and decreasingly kept.  It's hard to imagine who benefits from such chaos.  A system in which per-person funding declined slowly and predictably might be better than such a volatile one, even setting aside that the funding outcome might not be worse.  A learning system could probably improve efficiency and keep pace with the declines in capacity if those declines were predictable.  Morever, it is unrealistic to think government can continue to grow sustainably  as a share of society.  

5.  We have more important battles to fight.  This is almost corollary to the point above, but I remember a conversation with the mother of a 40-year-old with autism when her son was about 32. My friend said, at a protest of budget cuts, that we haven't even started the right war yet.  The important struggle has always been making the system work better for those it serves.  At least since I got here in 2000, the urgent one has been funding.  Steven Covey says that what is important but not urgent makes the best use of time.

Con:

1.  Changes in the frequency and severity of developmental disabilities do not track the population and or correlate with inflation.  Duh.  The increasing frequency of autism, for example, had nothing to do with the factors which will ultimately determine the total size of the state budget.  Once a hard cap is enshrined in the constitution, the state will lose flexibility to address important changes.

2.  See #2 of the pro arguments.  We might also discover that as a people we really prefer to persecute our neighbors than to meet them.  In fact, I kinda do.

3.  Competition for state funds favors the many and the well-funded.  Even after clients, families, support staff and people of conscience are totaled up, those who fear crime, want wider roads and/or use marijuana outnumber us.  Teachers, prison guards and ne'er-do-wells are more organized and wealthier.  In an uncapped budget, there are two ways we can grow: by winning an argument with other beneficiaries or one with tax protestors.  Under a hard cap, we can only grow at the expense of another beneficiary.  What's more, other beneficiaries will see us the same way.

4.  There is no reason to think our system will get smarter as it gets leaner.  The record so far: We cut less costly and more integrated service modalities more aggressively than more expensive and segregated ones.  We cut low-cost providers proportionally with more expensive providers of the same service.  Most new regulations are written for the purpose of containing cost and avoiding risk, not to make services more efficient or integrative.  The best and smartest advocates our system has had in the legislature haven't succeeded in making positive reforms.  Nothing has been accomplished in my time here to make the market mechanisms in the system work to allow useful accountability, transparency or information to clients or family members.  A cheap dumb system is unlikely to function as well as a prosperous dumb system.

5.  Are self-directed services rolled out yet?  Right.  SDS in many ways represents a miniature of  the best we could hope for from a capped state government and three gubernatorial terms have not brought it to statewide reality.  Unpromising.

OK, y'all's turn.

A note about position papers

I read the ARCA position paper today, and will just call it a proxy for all the others out there in order to save time. When the state has an unsustainable budget and the legislature has shown itself unable to think or act and you release a paper announcing your opposition to most of the cuts, the intended audience is fellow stakeholders not government.  Kind of like the guy who raises his hand in class because he wants the attention of a classmate. Very thorough, although they seem to have left out their position on cuts to DDS headquarters. Can anyone tell me what else is missing?

Rushing Reform

According to my good friend, Marty Omoto, Republicans in the California Legislature, while auditioning for hell, have argued that the state budget crisis should be resolved through "cuts and reforms."  I have argued here consistently that reform would likely benefit both the system and the budget.  I have also complained about the fact that legislators seek to cut the budget without streamlining the system.  So I should be happy.

But this blog is filled with what I mean by reform.  What the legislators mean, in this case, is making cuts and crossing your fingers.  That's the opposite of reform.  It is, in fact, the status quo, everyone too rushed to think about what they're doing and why and whether they should. So, by all means, lets get to reform.  But fix the budget crisis first.

As to the aforementioned Brer Omoto, a fundraiser will be held December 15 to raise money for CDCAN.  Information on how to contribute can be found clicking here.  Marty and CDCAN have done more to democratize and link information and advocacy than any other person/organization and represent a crucial ingredient in any smart reform.

The Governor's New Proposal

Well, that was fast. The three-month late annual budget lasted six troubled weeks and now the legislature is back in session, ordered by the Governor to redo the math. In the governor's proposal is a 3% payment reduction to regional center vendors and a 3% cut to regional center operations. Vendors and regional centers would be hurt a little. Also on the table are cuts to SSI/SSP, IHSS and MediCal. People with disabilities could be hurt a lot.

What ought to also be considered is how to make some of the cuts less damaging. For vendors and regional centers, that means relaxing some compliance costs. While the transition to genuine and efficient outcomes-based accountability will remain beyond the scope of the special session (and the grasp of the legislators,) authority could be given to DDS to reconsider some of its regulations on a cost-benefit basis. As of right now, regional centers and vendors have the power to reduce some of our more paper-centered activities. While accountability of some form is absolutely critical, there is a conflict between cost and agility on the one hand and compliance on the other. I suspect if we looked more analytically and honestly, we'd find we err far on the latter side. Of course, if we were more analytical and honest, we'd all be bankers.

The Obama rate increase

Apologies for my absence, it's likely to continue, but I wanted to point up that the Obama economic recovery plan which will not occur regardless of who wins in the election includes a $3000 tax credit for small businesses who take on a new employee.  For my colleagues in the executive directing business with high turnover, this plan could really add up.  Be careful, though, spend it on wage increases and you risk killing the goose that laid the golden egg.

Channeling Paul

In the comments to the post below, Paul wrote: 

Doug,

Have you noticed that over the last several years we have “hammered out..” a budget that actually shrinks our opportunitu to hammer out one in the future? What I mean is this…

As we shift more and more to federal funding as an answer to our budget we become more and more enslaved to the whims of federal budget makers. Is this the Sacramento’s fault? Ultimately I would say yes, after all they are the ones that say yeah or nay.

But lets be fair – we do not need to search far to find fantasies and fallacies about unmatched state dollars, waiver, backfill, and outrageous numbers like 1.4 Billion in untapped federal monies. In fact, we do not need to search at all. The advodivas, the advocrates – the politicians are within our own ranks.

How can we not love a person that implies through poignant protestation that we are being short changed 1.4 Billion dollars? We love him or her just as we love the politician that tells us that he or she will cut our taxes and double our entitlements at the same time.

Until we can address our realities Andy words are axiomatic, “It does not, will not, cannot exist in our government.” Until we acknowledge that some of our efforts at home are, “little more than the brightly-colored bunting and balloons of a democracy”

I have noticed, just as I noticed that you said articulately something I've been trying to squawk out for the lifetime of this blog. Missing from his list is the amount of time, energy and audience we waste debating the prevalence of "classic" autism.  There are a few problems that I would identify in our approach:

1.  We argue with the idea of waste in the system before looking for it.  If there is waste in the system, and we all know there is, it is interfering with effective support for people with disabilities and counteracting the well-spent funds.  If there is waste in the system, identifying and eliminating it would be that much funding we would not have to defend.  That we find so many ways to fight against the unexamined implication also allows those who would cut our finding to decry wasteful spending without expectation of quantifying it.

2.  That we even care what resources might be available takes the conversation away from the mission and into the money.  We will never win an argument about money.  We have people who need and deserve our support.  They are compelling people, sympathetic people and above all, people.  It is easy to not care about acronymmed arcana like FFP.  It is hard to dismiss a human striving to overcome a profound challenge.

3.  Nothing depresses me more than the number of my dear friends in the DDS advocacy community who have been saying for 8 years that we can't start the important fight until funding is secure.  Funding will never be secure.  As long as you think funding comes first, you have surrendered the battle for everything you say matters.

How to have self esteem when you're a DD service provider

I may be, as a social services chief executive, a member of a despised class rightly suspected of promoting unaccountable, dishonorable and inefficient expenditures.

I may be, as an advocate, a typical charlatan using blubbery words to ask my neighbors to place my interests above their own.

I may be, as a blogger, the tea-totaling equivalent of that obnoxious souse at the bar holding forth on matters beyond his ken as if an alcoholic haze were a worthy substitute for any actual knowledge.

I may be scandalous, stupid and self-important, lazy, long-winded and loveless but I am not a California legislator, Alhamdulillah!

The opportunity for Democrats and Republicans to demonstrate their commitment to principles has passed and it passed with no creditable gestures toward principle.

The opportunity to hammer out a smarter, leaner or more compassionate and just budget passed with no apparent fervor for smartness, leanness, compassion or social justice.  

It is time for the legislators to stop pointing at one another. It is time to vote for a flawed, inefficient, stupid budget because this year's budget has gestated too long not to resemble its parents.

Selah

P.S.  The above was provoked by an email sent by State Senator Dutton to supporters sharing Pete Wilson's criticism of Schwarzenegger's budget plan.  In all likelihood, all of his colleagues in both houses are sending similarly sanctimonious and second-hand commentary to supporters (more and more loosely defined.)  As a supporter, I wanted to explain the following:

Drug dealers may be predators, but they perform.

Government contractors may be parasites, but they are humble.

Undocumented workers may be illegal, but they do what they are paid to do.

People with severe enough disabilities may not be as economically productive as their non-disabled peers, but many accept wages in consideration of output.

In short, there is nobody in this state that any member of our legislature might wish to punish, prosecute or patronize who is not a better public servant until a budget is presented the governor.  Until then, criticize no one.