Concerns over proposed Trailer Bill language affecting DC clients and services

As part of an apparent effort to reduce costs to the State General Fund while shifting those costs to federal waivers, California's Department of Developmental Services (DDS) has Proposed Trailer Bill Language Titled 652 Consumers With Challenging Needs, which has raised real concern in the developmental disability community.

While placement outside a developmental center may be a good option for some when the family and care team endorse it, requiring someone to endure a life-altering (and in many cases, life-endangering) relocation in order to obtain increased federal matching funds seems unreasonable and a strategy lacking in compassion.

In summary, as we read the trailer bill, it would make the following changes:

• DC's are not to be considered as the placement of last resort. Technically, this Bill closes the remaining DC's in 5 years without calling it a closure.
• The moratorium on placements into DC's is absolute, even for those in crisis or under court order. They even refuse to accept more placements into Porterville, with a max of 230 residents in the secured facility. 
• Fairview can only serve crisis individuals for 6 months, then they have to move out, unless the DDS Director herself signs a waiver. 
• 962 homes & delayed egress facilities will be developed across the state, but still only restricted to DC movers. 
• Crisis beds and homes must be made available to any regional center in the state, so if there is an open bed in San Diego for someone from Sonoma, they will be moved.
• Regional centers must do assessments on ALL DC residents who they have not assessed in the last year. Of course the goal is to start a plan for transfer.

Fortunately, there are opportunities to make simple and reasonable adjustments and we've listed some specific concerns and proposed solutions below. If you would like to contact legislators to urge them to consider making changes to the trailer bill, we have also included contact details at the end of this post.

Specific concerns (and proposed solutions) regarding the proposed language include: 

1. The DDS places “a moratorium on new admissions to the developmental centers” (from the 8-page “Proposal to Achieve Savings” summary).

Concerns:

• The summary begins with a reference to “preserving the Lanterman Act entitlements” yet, via this moratorium, goes on to deny, for individuals in a crisis situation, the option of a developmental center placement. DC’s have acted as a ‘safety net’ for crisis situations ever since the community-based service system was developed, fifty years ago. Where will these individuals fall if their safety net is removed?
• The trailer bill proposes development of new crisis and ARFPSHN homes across the state, to serve individuals with “challenging service needs”. In the Agnews and Lanterman closures, these homes required nearly two years to develop, from purchase to move in. Why would the DDS propose a moratorium effective July 2012 if development of new homes has yet to begin and will take 2+ years?
• A moratorium on admissions lacks compassion for those individuals who live in areas where alternative options are not accessible or appropriate (such as incarceration within the correctional system).

Solution: Delay the implementation of a moratorium until after alternative resources and homes have been constructed.

2. Notwithstanding any other provision of law or regulation, effective July 1, 2012, Fairview Developmental Center shall be the only developmental center authorized to admit a consumer…”

Concerns:

• This mandate places families in northern California, who may need a crisis placement, in extreme hardship. Such a placement would prevent most families and friends from regularly visiting a loved-one placed at Fairview, especially when, during crisis situations, family and team support is critically important to the individual.

Proposed Solution: Make Sonoma Developmental Center available as a crisis resource for consumers living in northern California.

3. 4684.74 The State Department of Developmental Services shall only approve the development of Adult Residential Facilities for Persons with Special Healthcare Needs (ARFPSHN) that are directly associated with the community placement of developmental center residents.

Concerns:

• We applaud the DDS for creating additional ARFPSHN homes, a model that was first created for the transition of medically fragile residents out of Agnews. We simply ask why these excellent care options should be restricted to individuals being moved out of developmental centers? Many community individuals with challenging service needs would benefit from placement in an ARFPSHN home. 
• This limiting of placements to only DC movers created vacant beds at homes developed for Agnews’ movers, after the consumers living there died. Beds were empty for months while service coordinators searched for DC transfers, while local consumers could have benefitted immediately from placement.
• The success of the Agnews ARFPSHN homes was largely a result of knowledgeable, experienced staff that transitioned with the clients from the developmental center (over 120 state staff made this transition). Without the closure of a developmental center, the newly developed ARFPSHN proposed in this trailer bill will not have accessed to a pool of experienced state staff, which is necessary to ensure the well being of the consumers.

Proposed Solutions:

• Remove the reference in the trailer bill to ‘DC residents only’
• Add to the trailer bill a plan for a training program (possibly conducted at the DC) for new staff to be employed in the crisis and ARFPSHN homes.

4. 4418.25 b(2) Regional centers shall be required to provide DDS with information about all specialty resources developed with the use of Community Placement plan money and to make such resources available to other regional centers.

Concerns:

• During the closure of Agnews and Lanterman, one of the Department’s goals was to move individuals closer to their families. We applaud this goal and the resulting outcomes. The trailer bill language suggests individuals being moved out of DC’s (or those in crisis) would be placed at any regional center that had an available bed. There is no consideration for keeping the individuals, already confronted by a traumatic move, close to family and friends.

Proposed Solution:

• Add reference within the trailer bill to a seventy-five mile circumference for crisis placements.

5. 6000 (c ) Effective July 1, 2012 the DDS shall not admit any person to a developmental center pursuant to this section.
Concerns:

• Preventing admission to developmental centers for individuals under court order does not create alternative placements for these individuals. Where will they receive services, as promised by the Lanterman Act, after July 1, 2012?

Proposed Solution:

• Remove this reference from the trailer bill language, or at least define what alternative resource would be available to serve them.

6. 4418.25 c(2)Regional centers shall complete a comprehensive assessment of any consumer residing in a developmental center on July 1, 2012, who is not committed pursuant to 1370.1, has resided in a developmental center more than a year…

Concerns:

• Developmental centers conduct Individual Program Plans (IPP’s) for each consumer living there, on a yearly basis. The regional centers participate in these meetings, where comprehensive assessments are reviewed. Community placement is always considered as an option during these meetings, and regional center reps may suggest a potential placement, if they are aware of an appropriate and available option. Thus, this requirement seems to create a duplication of effort, as well as an undue burden on already overworked service coordinators.

Proposed Solution:

• Revise the language to read “regional centers shall review IPP’s and associated assessment of current DC residents…”

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LEGISLATIVE CONTACTS:
Senate Budget Subcommittee #3 on Health and Human Services

Mark Desaulnier(chair) Dist 7, Walnet Creek, Antioch, SF East Bay)
(Room 5035)
 Senator.Desaulnier@sen.ca.gov
916-651-4007 (ph); 916-327-2187 (f)

Chief of Staff: Krista Pfefferkorn, Krista.pfefferkorn@sen.ca.gov
Leg. Director: Rosanna Carvacho, rosanna.carvacho@sen.ca.gov
Exec. Assistant: Cruz Cole, cruz.cole@sen.ca.gov

Elaine Alquist District 13 (San Jose, Silicon Valley)
(Room 5080)
916-651-4013(ph); 916-324-0283 (f)
Senator.alquist@sen.ca.gov

Bill Emmerson District 37 (Riverside County, East LA, Palm Desert)
(Room 4082)
916-651-4037(ph); 916-327-2187(f)
Senator.emmerson@sen.ca.gov

Sub-committee #3 staffers    
Room 5019  
916-651-4103
Michelle Baass: michelle.baass@sen.ca.gov (health)
Jennifer Troia: Jennifer.troia@sen.ca.gov (social services)

Assembly Subcommittee #1 on Health and Human Services   (Room 6026)   916-319-2099
Committee Members
District
Office & Contact Information

Holly J. Mitchell - Chair
Dem-47
Contact Assembly Member Holly J. Mitchell
State Capitol, P.O. Box 942849, Sacramento, CA 94249-0047; (916) 319-2047

Wesley Chesbro
Dem-1
Contact Assembly Member Wesley Chesbro
State Capitol, P.O. Box 942849, Sacramento, CA 94249-0001; (916) 319-2001

Shannon L. Grove
Rep - 32
Contact Assembly Member Shannon L. GroveP.O. Box 942849, Room 3098, Sacramento, CA 94249-0032; (916) 319-2032

Allan R. Mansoor
Rep-68
Contact Assembly Member Allan R. MansoorState Capitol, Room 4177, Sacramento, CA 94249-0068; (916) 319-2068

William W. Monning
Dem-27
Contact Assembly Member William W. MonningState Capitol, P.O. Box 942849, Sacramento, CA 94249-002; (916) 319-2027

Bob Blumenfield - Dem. Alternate
Dem-40
Contact Assembly Member Bob BlumenfieldState Capitol, P.O. Box 942849, Sacramento, CA 94249-0040; (916) 319-2040

Jim Nielsen - Rep. Alternate
Rep-2
Contact Assembly Member Jim NielsonState Capitol Room #6031, Sacramento, CA 95814; (916) 319-2002

Health: Andrea Margolis, Andrea.Margolis@asm.ca.gov
Human Services: Nicole Vazquez, Nicole.Vazquez@asm.ca.gov