Monday, September 2, 2013

Coming To A Regional Center Near You!

If S.B. 468 clears its final hurdles, California regional center clients could soon have the option to manage their own service budgets, and to make their own purchase of service decisions. (Update 9/12/13, in comments, below.)

Under current law, an individual program plan (IPP) team determines the amount and type of services a regional center client may need, but the regional center manages the purchase of services, including the hiring,
firing and compensation of service providers. Moreover, all decisions are subject to various regional center policies and procedures, including the type of services that may be offered, the agencies that are allowed to provide those services, and the rates that are paid for the services.

SB 468 proposes a voluntary program to allow the individual more control over these decisions ("self-determination") -- not just over the type and amount of services needed, but also over who will provide those services and how much the providers will be paid. These decisions would be bound by an overall budget and budget categories,[1] but they would be free of such other restrictions as rate-setting procedures, purchase-of-service guidelines, and vendorization requirements. As a rule of thumb, most participants' budgets would be set at their individual, most recent 12 months' purchase of service amounts, but adjustments could be made for changed circumstances or previously unaddressed needs.

Participants also would be required to use the services of a"financial manager" approved by the regional center. The financial manager would be responsible for paying the bills; managing all required governmental reporting, accounting, and withholdings; securing background checks; and assuring compliance with state and federal employment laws. The cost of the financial manager would be paid out of the individual's budget.[2]

Self-determination is not a new idea. Other states have similar, successful programs, and California has had a successful pilot project since 1999. In 2002, the Department of Developmental Disabilities (DDS) submitted a report to the Legislature, showing "pilot project participants were happy and experienced more freedom and responsibility in controlling the direction of their services and life choices, and the project was cost-neutral in the aggregate."[3]

S.B. 468 is sponsored by Sen. Bill Emmerson (R-Riverside) and Sen. Jim Beall (D-San Jose), and is supported by a broad coalition, including the Autism Society of Los Angeles, Disability Rights California, Easter Seals California, Network, Self-Advocacy Board of Los Angeles County, North Los Angeles County Regional Center, Bet Tzedek, Cal TASH, Area Board 10, and more. [8]

S,B. 468 should be scheduled for an Assembly vote sometime this week, then to the Senate for concurrence, and then to the Governor for signature (assuming it passes all votes). If you would like to help make self-determination happen for California, call your State legislators (Assembly and Senate) and Governor Brown to let them know your support. Also, if you click on the comment button, and scroll to the bottom, you can "subscribe by email" and receive notice of updates and comments to this post.

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[1] The services also should fit within categories approved by the federal Centers for Medicare and Medicaid Services, and the providers should have all applicable licenses and qualifications. This is to allow California to seek federal funding for the program.
[2] And the initial budget would not be increased to include the cost of the financial manager. For example, if a program participant's most recent 12 months' purchase of service amounts were $6,000, and the annual cost of a financial manager were $300, the client's budget would still be just $6,000 -- he would need to identify ways to pay for equivalent services, plus pay for a financial manager, within the same budget as before.
[3] S.B. 468, Section 1(b) (as amended Aug. 21, 2013).
[4] Report, Hearing, Assembly Committee on Human Services, M. Stone, Chair (August 13, 2013).

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